2.1 Assessment of Needs

Audio & Quick Read Summary

1. Introduction

This policy sets out how Lancashire County Council meets its duties in relation to assessing any adult with an appearance of need for care and support under the Care Act 2014.

2. Policy Statement Aim

This policy aims to support people to identify their care and support needs and how these impact on their wellbeing, and the outcomes that they wish to achieve in their day-to-day life.

3. The Legal Framework

The Care Act 2014 assessment process starts when Lancashire County Council begins collecting information about the adult, who may require social care support. Assessments are not just a gateway to care and support, but a critical intervention in their own right. They can help people to understand their situation, their strengths and capabilities and what social care needs they have. The assessment process will identify opportunities to help to reduce, or delay the onset of greater needs, promote access to a range of support including that which is available to them in the community, from other networks and from commissioned services.

The assessment will determine whether the adult has Care Act eligible needs and create an understanding of how a range of commissioned and non-commissioned care and support may assist the adult in achieving their desired outcomes.  Eligibility determinations will be made on the basis of a proportionate assessment and cannot be made without that assessment being completed.

An assessment will be undertaken for any adult with an appearance of need for care and support, regardless of whether or not Lancashire County Council thinks the individual has eligible needs and irrespective of their financial situation.

4. The Assessment Process

The assessment process is one of the most important elements of the care and support system. The assessment is one of the key interactions between you and Lancashire County Council, whether you are an adult needing care or you are caring for someone (a carer). The assessment will be strengths-based, person-centred and outcomes focused throughout, involving you and supporting you to have choice and control.

The ‘assessment’ which you receive must follow the core statutory obligations, but the process is flexible and can be adapted to best fit with your strengths, needs, risks, wishes and goals. The assessment will be appropriate, flexible and proportionate. The nature of the assessment will not always be the same for all people, depending on your circumstances, and could range from an initial contact which helps you to access support in the local community, to a more intensive, ongoing process which requires the input of a number of professionals over a longer period of time.

An assessment can be carried out in several ways:

• a face-to-face assessment between you and a member of staff from Lancashire County Council. The staff members professional role and qualifications may vary depending on the circumstances, but they must always be appropriately trained and have the right skills and knowledge. The assessment may be carried out at your place of residence or an alternative agreed location.
• a supported self-assessment is an assessment carried out jointly by the adult with care and support needs or carer and Lancashire County Council. It places the individual in control of the assessment process to a point where they themselves complete their assessment form. But the duty to assess the person’s needs, and ensure that they are accurately and completely recorded, remains with Lancashire County Council. Once the person has completed the assessment, Lancashire County Council must ensure that it is an accurate and complete reflection of the person’s needs, outcomes, and the impact of needs on their wellbeing. Before offering a supported self-assessment Lancashire County Council must ensure that the individual has capacity to fully assess and reflect their own needs. Lancashire County Council must establish the individual’s mental capacity in accordance with the Mental Capacity Act.
• an online or phone assessment which can be a proportionate way of carrying out assessments (for example where your needs are less complex or where you are already known to Lancashire County Council the assessment is being carried out following a change in your needs or circumstances).
• a joint assessment where relevant agencies work together to avoid you undergoing multiple assessments (including assessments in a prison, where Lancashire County Council may need to put particular emphasis on cross-agency cooperation and sharing of expertise).
• a combined assessment where your assessment is combined with your carer’s assessment and/or an assessment relating to a child so that interrelated needs are properly captured, and the process is as efficient as possible.

Assessments will differ in breadth and depth depending on your circumstances. This means:

• additional exploration of your underlying needs may be required.
• you or your carer may have needs which require more consideration only within some aspects of their lives.
• adults with a clear understanding of those needs and/or the care and support system may require less intensive assessment than someone who has recently developed needs and has less clarity about their needs and the care and support system.

5. Aims of Assessment

See also Living Better Lives in Lancashire.

The aim of the assessment is to identify your strengths and needs and how your needs may impact on your wellbeing, and the outcomes that you wish to achieve in your day-to-day life.

The assessment will be strength-based and person-centred throughout and will not be delayed by any ordinary residence dispute. Lancashire County Council will consider your strengths and capabilities, and what support might be available from your wider support network or within the community.  This must include looking at the impact of your needs on your wellbeing and whether meeting these needs will help you achieve your desired outcomes. The assessment process also provides the opportunity to take a holistic view of your needs in the context of your wider support network.

The outcome of the assessment is to provide a full picture of your needs so that Lancashire County Council can provide an appropriate response at the right time to meet the level of your needs.  This response may range from offering guidance and information to arranging for services to meet those needs.

6. During the Assessment

Lancashire County Council will aim to fully involve you throughout the process because you are best placed to judge your own wellbeing.  Where you have care and support needs, Lancashire County Council will also make every effort (with your permission) to involve any informal carers and / or other representative.

Lancashire County Council will consider the impact of your needs for care and support on family members or other people as appropriate.  Lancashire County Council will, where applicable, offer a carers assessment to those who provide unpaid care to another person. Lancashire County Council will include anyone who may be part of your wider network of care and support with your permission.

You may be unable to request an assessment or may struggle to express your needs due to your circumstances or due to an impairment. In such situations, Lancashire County Council must consider accepting requests from other people such as carers, family or health professionals. Lancashire County Council will consider the Care Act 2014 and Mental Capacity Act 2005 to decide whether to accept the request and carry out an assessment.

Where you appear to have substantial difficulty understanding, retaining and weighing up information and communicating your wishes, Lancashire County Council will carry out supported decision making, helping your to be as involved as possible in the assessment, and will undertake a Mental Capacity Assessment where appropriate and refer to local independent advocacy services if required (See Independent Care Act Advocacy policy).  This should be done as early as possible in the assessment process so that your involvement can be supported throughout all stages of the process.

To support your involvement in the assessment, Lancashire County Council will establish your preferred communication needs and seek to adapt the assessment process accordingly.  To help you or your carer, prepare for the assessment, Lancashire County Council will provide in advance, and in an accessible format, the list of questions to be covered in the assessment. This will help you or your carer prepare for the assessment and think through what your strengths and needs are, along with the outcomes you want to achieve. You may require the support of a specialist interpreter to help you to communicate and engage in the assessment.  The assessment process should be individual to you.

You will be provided with a copy of your assessment.

7. Refusal of Assessment

If you refuse an assessment, Lancashire County Council is not required to carry out an assessment. If there is a question over your mental capacity to make this decision Lancashire County Council will, if required, use the Mental Capacity Act 2005 to determine whether carrying out an assessment would be in your best interests (See Mental Capacity guidance).

If you are experiencing or at risk of abuse or neglect, Lancashire County Council will conduct an assessment as far as is possible and document the risk of abuse or neglect or evidence of such.

Lancashire County Council will carry out an assessment if you change your mind after having previously refused an assessment.

8. Further Reading

8.1 Relevant chapters

Wellbeing Principle

Preventing, Reducing or Delaying Needs

Providing Culturally Appropriate Care

Carer’s Assessments

8.2 Relevant information

Chapter 6, Assessment and Eligibility, Care and Support Statutory Guidance (Department of Health and Social Care)

Quality Statement 1: Care and Support Needs assessment (NICE)

Evidence for Strengths and Asset-Based Outcomes: A Quick Guide for Social Workers (NICE) 

Strengths Based Approaches (SCIE)