‘Assessment’ – it can seem such a loaded term. When it comes to issues of health and wellbeing, often the process feels like something that is done to us, not with us. As social workers, we actively avoid such polarised relationships, preferring collaboration and discussion with those we are there to support and on whose behalf we advocate. This is no less true for individuals and families living with disability, for whom assessment of health and care needs must be conducted within a framework of honesty and trust.
It’s a point not lost on our colleagues from the NIHR School for Social Care Research. They have now channelled their incredible breadth of knowledge and expertise into a series of short films focusing on the complexities, sensitivities and challenges inherent in conducting social care assessments involving disability.
The films also showcase the value of reflective, person centred practice and, for this aspect alone, I cannot recommend them highly enough. Over to the NIHR’s Jon Symonds to tell us more…
Disabled people can often experience a social care assessment as stress-provoking. They have to disclose very personal information about themselves, emphasising the negatives, and moreover, they often feel ‘judged’ by assessors.
Although these facts are well known to social care assessors, our recent study in the wake of the 2014 Care Act implementation showed how service users can work together with social care practitioners to produce better, more collaborative practice.
Assessments have always been of central importance in social work with adults, but we still know very little about how effective person-centred practice can be achieved. The recent blogs on Lyn’s site by Ruth Allen and Colin Slasberg have shown that there is still some debate about how notions of strengths-based and person-centred practice can be achieved in a system that is designed around needs and eligibility criteria.
This tension continued to come out in the findings of the Values of Assessment where we collected both social workers’ and service-users’ views and made direct recordings of practice all of which are reflected in a series of short films that will be of interest to disabled people, those who train practitioners and managers alike.
Social workers interviewed in this study were very conscious that their professional judgements were framed by the need to allocate limited public funding. This meant being discerning of disabled people’s circumstances because, as one practitioner put it, ‘sometimes help is needed but not wanted, and sometimes help is wanted but not needed.’
This led disabled people to feel that their accounts of their own needs were scrutinised, a view compounded by the knowledge that the assessment was happening ‘all the time’, whether from the first telephone conversation, the home environment being observed, or worry about what was likely to be funded in ‘the dreaded RAS’.
In the recordings, we heard great practice too - characterised by social workers making time to talk to disabled people about their life and how they wanted to live it.
Some practitioners were clearly using their knowledge of the system to advocate for people and help them receive the resources they needed. Disabled people appreciated it when a meeting was more like a conversation and less about form filling, with a meaningful plan at the end of it.
One of the strengths of the study was the project team’s inclusion of disabled people, social workers and academic researchers from both the University of Bristol and the West of England Centre for Inclusive Living. Several people in the team had experience of conducting assessments, of being assessed themselves, and sometimes both.
The films offer a reflection of the project team’s richness of experience when considering the issues raised by the findings - from the feeling of being assessed, to filling in the form, to the experience of carers. There is also a series of re-enactments from the recordings as prompts for reflection and training, each of which poses the question: “What would you have done?"
About Jon Symonds
Jon is a Senior Research Associate at the University of Bristol and a qualified social worker. This blog was produced in collaboration with his colleagues Val Williams, Caroline Miles and Mike Steel.