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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views


Question 13: What further circumstances are there in which a person undergoing assessment would require a specialist assessor? Please describe why a specialist assessor is needed, and what additional training is required above the requirement for the assessor to be appropriately trained to carry out the assessment in question.

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56 comments

  1. Anonymous says:

    There are a number of circumstances when a specialist assessor would be beneficial, for example when the service user has dementia, specific medical conditions such as Parkinsons and if they require end of life care. It would not, however, be viable for all assessors to recieve training in all of the specific areas. It is therefore felt that assessors would require core skills in communication and assessment and either specialist training or the ability to recognise when other speicalist practioners should be involved in the assessment process.

  2. Anonymous says:

    People with PMLD should be a group that receive a specialist assessment.

    It has long been established that people with PMLD have very complex needs, including complex communication and health needs. We know from events over recent years, there are serious and tragic consequences when care or support goes wrong.

    If we are to provide a truly person centred service for people with PMLD, where they are ensured access to the care and support they require and receive the same opportunities to have a fulfilling life informed by accurate assessment, then the assessment must be undertaken by skilled individuals who have the necessary expertise to undertake the assessment and make recommendations for the persons support and care.
    It is essential that these needs are properly understood throughout the assessment and afterwards during reviews. The process of assessment is very complex and is often of considerable duration. A comprehensive and holistic assessment requires a skilled assessor who understands PMLD, and the complexity of people’s needs.
    The skilled assessor is someone who can bring in the right professionals at the right time to inform the assessment, is someone who understands the importance of interventions like postural care, multi-sensory, communication and medical technology, telehealth and telecare to achieve optimal health for people with PMLD.

  3. Anonymous says:

    In order that personalised assessments and self-supported assessments can be carried out assessors need to have information on and understand the issues relating to the individual. Systems need to be in place that enable – reliance on web-based self-assessment may disadvantage some groups. Groups where consideration and process and specific worker skills and knowledge would be required are:
    • Autism
    • Learning disabilities and difficulties (including dyslexia)
    • Dementia
    • Mental health issues
    • Neurological disorders

    Part of enabling assessment is ensuring that the environment the assessment takes place in is suitable and supports the individual to engage in the assessment.

  4. Anonymous says:

    Carers felt assessments needed to be personal and private and should be consistent. This means adequate training and support for assessors, who should have an understanding of both the condition of the person being cared for and the impact of caring. Local knowledge is also important, so assessors shouldn’t be from teams based a long way off. Quality of assessors is key: they need to be able to listen/hear/absorb and act.

    The carers assessment should be conducted completely separately from the cared-for assessment, possibly even by a different assessor, able to present the carer’s needs effectively and without pre-conceptions of the needs of the cared-for, but able to understand the cared-for situation.

    Carers would welcome more information about the condition of the person they care for and how to prepare for it, particularly in relation to mental health.

    There was concern that although carers have an entitlement to an assessment, the ability of the local authority to respond to a carer seeking help could be limited by resources.

  5. Anonymous says:

    People with communication difficulties like Asperger’s Syndrome may also need specialist assessments as the Autism Act identified the need for more training on this condition, which is still lakcking, and that this particular group has increased risk of comorbid conditions, increasing the need for specialist expertise (i.e. specialist assessments by specialist in the fields). Things like the effects of noise, smell, crime (e.g. mate crime), social isolation may need to be given particular detailed notice which general (especially self assessments) will tend to miss out on.

  6. Anonymous says:

    Concerned that the guidance gives presumption towards supported self-assessments. Concerned that carers, particularly those new to caring, may not have a sufficient opportunity to reflect on their own needs and the opportunities that may be open to them, and may not request a full assessment even though this may be beneficial. They need to understand why / what the assessment could lead to. This requires skill and carer knowledge.
    Where carers are new to caring, or their circumstances have significantly changed, a full assessment should be proactively offered and the pros and cons of self-assessments and full assessments outlined in order for the carer to make an informed choice.
    The requirement of the authority to take account of a self-assessment and to “discuss” what needs are eligible and how these might be met is weak and needs to be strengthened.
    It should be made clear that there should not be a presumption towards combined assessments, especially for reasons of cost and time. The decision to undertake a combined assessment should be made freely by the carer and the person with care needs, and presented as one option alongside the options to have a separate assessment. Where in undertaking a combined assessment, it becomes clear that one party may not feel able to fully express their needs, they should be offered an opportunity to discuss their needs individually.
    Anyone carrying out a carer’s assessment should have received specific training in the particular needs of carers, which can be significantly different from the needs of those receiving care.
    Very pleased to see the provisions relating to young carers included in guidance. Local authorities should consider how they will support the adult social care workforce to develop the skills involved in meeting these provisions, as most currently do not focus on children’s issues and it is unlikely that the majority of cases will be referred to Children’s Services staff in the first instance. All staff undertaking assessments for adult carers and adults with care needs should also be trained in the needs of children and who may be caring. A workforce development programme is required.

  7. Anonymous says:

    Most welcome is the guidance 6.72 – 6.75 on skills and expertise. I hope there will be a training fund to support this high level of skill. Also that case loads will be controlled, and administrative help made available so that the people with the expertise are not spending time in front of computers putting data rather than with the client agreeing outcomes.

  8. Anonymous says:

    There doesn’t appear to be any reference to communication needs. Communication is highly important for people with sensory loss and problems with communication can seriously affect their independence and interaction with family and the wider community. It needs to be in the guidance.

    Areas where people have multiple needs such as mental health and physical disabilities, or learning disabilities and a mental health need may require specialist assessments. In addition, some of the longer term conditions such as Motor Neurone Disease; Parkinsons Disease benefit from the inclusion in the assessment process of skilled knowledgeable practitioners and therapists.

  9. Anonymous says:

    There are currently apparent differences in the guidance between timing of assessments around the family’s wishes and the use of education, health and care plan assessment reviews to avoid duplication. This should be clarified in the guidance. There are also differences between adult carer assessments and parent carer assessments which the guidance should make clear.

  10. Anonymous says:

    Epilepsy Action notes the proposed requirement for Local authorities to ensure assessors have received suitable and up to date training to carry out assessments and that they must also have ‘the skills and knowledge to carry out the assessment of the specific condition(s) that they are being asked to assess, for example when assessing an individual who has autism, learning disabilities, mental health problems or dementia.’ Epilepsy awareness training enabling assessors to understand the fluctuating nature of epilepsy and the ways that people with epilepsy need to adapt their lives and manage risks is also important.

    As there are many types of epilepsy we are also pleased to see that ‘Where the assessor does not have the knowledge in carrying out an assessment for a specific condition, they must consult someone who has experience of the condition. This is to ensure that the assessor can identify any underlying conditions and ask the right questions relating to the condition and interpret these appropriately’ Epilepsy Action feels that local authorities should maintain a list of health professionals who can advise assessors.

  11. Anonymous says:

    Circumstances
    Circumstances in which a specialist assessor may be required (relating to both the adult potentially receiving care, and their carer):
    • Where an adult has substantial difficulties in communicating
    • Where an adult lacks/ may lack mental capacity
    • Where an adult is experiencing abuse or neglect
    • Where an adult is at risk of experiencing abuse or neglect
    • Where an adult has a primary health need i.e. there is a need for a CHC assessment
    • Where an adult has a complex mental or physical disability
    • Where the adult requires equipment/ aids and adaptions and/ or training in their use (e.g. via an OT assessment)
    • Where the adult requires reablement/ preventative services
    • Where there are needs relating to children (e.g. child carer).

    Why is a specialist needed in the above circumstances?
    • Where an adult has substantial difficulties in communicating
    • Where an adult lacks/ may lack mental capacity
    • Where an adult has a complex mental or physical disability
    (in respect of the above 3 bullet points, specialist support may be needed to ensure individuals can engage in the assessment, so that this remains person centred and allows their support needs to be properly established. Assessments should be collaborative; specialists may be required to ensure individual involvement in an understandable and transparent process)
    • Where an adult is experiencing abuse or neglect
    • Where an adult is at risk of experiencing abuse or neglect
    (in respect of the above 2 bullet points, safeguarding issues may necessitate a specialist response, via the assessment or otherwise)
    • Where an adult has a primary health need i.e. there is a need for a CHC assessment
    • Where an adult has a complex mental or physical disability
    • Where the adult requires equipment/ aids and adaptions and/ or training in their use (e.g. via an OT assessment)
    • Where the adult requires reablement/ preventative services
    (in respect of the above 4 bullet points, individuals may have additional needs which can only be met by consultation with wider professionals e.g. OTs).
    General points
    Specialist assessments may better facilitate –
    a) accurate identification of needs, so avoiding the costs associated with inappropriate interventions
    b) early identification of underlying conditions/ complex needs allows for prompt signposting and service provision
    c) early interventions can prevent needs progressing, and sustain independence and wellbeing.

    What additional training/ specialisms might be required?
    • Training in alternative communications methods e.g. signing
    • Training in the assessment of mental capacity
    • Training in safeguarding (i.e. beyond basic awareness) e.g. FGM
    • Medical/ nursing specialism to establish primary health needs
    • Medical/ nursing specialism in specific mental/ physical conditions e.g. Alzheimer’s, brain injuries, cerebral palsy
    • Basic training and/ or specialism in the ‘prescription’ of equipment/ aids and adaptions and/ or their use
    • Specialism in re-ablement/ preventative therapies e.g. physiotherapy.

    The potential for a dramatic increase in the volume of assessments and the cost required to meet them, is a significant concern.

  12. Anonymous says:

    Once again, I think this is a big ask of local authorities who will have to carry out a needs assessment and carers assessment. The requirement that an assessor who does not have experience in the condition that they are assessing must consult a person with experience in that condition appears to me to be open to error through inadequate description and tight time constraints.

  13. Anonymous says:

    Guidance and regulations should avoid creating new specific requirements about the qualifications or experience of staff involved in assessments, the only exception to this is AMHP and this is already in place.

    We recognise and accept the definition quoted from Think Dual Sensory in paragraph 6.77 of the guidance, but we do not think this is the same as the definition given in the following paragraph – “During an assessment the appearance of both sensory impairments, even if when taken separately each sensory impairment appears relatively mild, must trigger a specialist assessment.” The combination of a mild visual impairment and a mild hearing impairment is common among older people, and we do not think a specialist assessor is required unless there are specific issues arising from the combination of these two impairments. We think that the definition in Think Dual Sensory gets this right, and should be the only definition given in the guidance.

    • Anonymous says:

      If a combined sight and hearing loss, even where each individual loss is mild, creates problems with communication, access to information and mobility then it should trigger a specialist assessment, regardless of age or reason for sensory loss. This is important because the multiplying impact of dual sensory loss may be overlooked by a non-specialist assessor.

  14. Anonymous says:

    No comment. The regulations and guidance as they stand are supported

  15. Anonymous says:

    No matter how well assessments are conducted, they will fail to address the huge problem facing social care if those with only ‘moderate’ needs are effectively excluded for getting help. The latest figures available show that now only 13% of local authorities now consider the needs of those with moderate needs whereas ten years ago almost half our councils provided such help. This reduction in the provision older people need is particularly striking in the use of day care centres. Between 2005/6 and 2012/13 the attendances at such centres fell by 49%. In the same period the drop in the number of older people receiving home care fell by 21%. As the number of older people rises services available to them decrease. Without a significant increase in funding the present crisis will intensify. A new sense of urgency in this field is urgently needed.

  16. Anonymous says:

    If in future it is decided to ‘outsource’ the assessment process so that it is put out to tender, it is vital that any training and knowledge currently held by local authority assessors be given to the new assessors, and any specifications need to be highly detailed in this regard. No outsourcing should happen at all if the assessors are not deemed by the local authority at the time tenders are received to have the necessary knowledge to enable them to carry out the role, no matter how cost effective the service may appear.

  17. Anonymous says:

    specific training in the area of learning disability, PMLD and autism is essential if assessments are to be meaningful. The assessors need to be skilled communicators, able to listen effectively and comfortable with communication difficulties experienced by the people they assess. This requires a high standard of ability in the first language and communication method of the person being assessed. There should also be a degree of independence from the funder, to avoid the common practice of assessing to the services and level of funding available rather than the true needs of the person/people assessed. The assessor needs to know the difference and be able to identify between health care need and social care need and make these clear to avoid inappropriate means testing. The assessors also need to be aware of, and skilled in dealing with people functioning under very high levels of stress, sleeplessness and depression in a positive manner. Also those traumatised by previous abusive treatment in care situations. All of these conditions are extremely common to people with learning disabilities and autism. A good working knowledge of challenging behaviour in some people with LD and autism would be essential. Training should be specific in it’s outcomes, and competency based to ensure the assessors are able to put theory into practice effectively. Agreed competencies would enable the standard of training to be uniformly applied. This approach should enable similar standards to be applied to other specific groups requiring specialist assessment.

  18. Anonymous says:

    The understanding and skills for an indviduals needs with regards to un-common issues such as Lymphoedema need to be recognised. There are a number of conditions that will require special knowledge as to impact on an individual and what the indvidual needs as part of the assessment.

  19. Anonymous says:

    Need understanding/skills around individual needs – particularly learning disability and autism from the person carrying out the assessment

  20. Anonymous says:

    I would want and expect any assessor for my son who is severely autistic to not only have the skills of being an assessors but also to have received specialist training in autism for them to able to understand, listen, help, advise us and this is a statutory obligation from the AUTISM ACT anyway.

    perhaps when there are specifics like autism to be addressed and statutory obligations placed on councils then the specific illness/condition should be named in the CARE ACT itself otherwise you end up looking at several ACTS to find answers.

  21. Anonymous says:

    Specialist Assessors have real strengths in understanding the challenges and requirements of clients, thereby ‘teasing out’ the full picture.

    However above all, assessors need to listen. Assessments will then be an accurate reflection of real need rather than being ‘pigeon holed’.

    There is though an inherent danger with this approach that being so specialist, something else relating to another specialism outside of their own will be missed. This makes awareness training of a broad spectrum of conditions a critical requirement.

  22. Anonymous says:

    Autism – complexity of condition – do we need specialist assessor?
    Guidance from Skills for Care on what is “adequately trained” in development – what compulsion is there to complete it? Will it be compulsory?

    Mental should be special assessor.

    Dementia/long term neurological conditions – perhaps these are covered by guidance on “consulting appropriate person”? May need health specialist e.g. Parkinson’s nurse

    Guidance helpfully worded but some case examples may be helpful (consensus) including some non-social care expert involvement – e.g. who might you contact? Especially for young carers.

    How do you define a specialist vs expert? Open to misinterpretation
    Is this professional vs unprofessional? Medical consultant equivalent?

    Communication needs

    Reference workforce strategy Group and their work re: skills development across all agencies.

    Training by specialist vol orgs e.g. autistic society?

    Hard of hearing group often missed, because they can speak they are overlooked, but they don’t use sign language either so caught in the middle

    Carers need specialist assessors because of their complex family situations

    Carers of and people with learning disabilities

    People with dementia

    Mental health teams – how does it work for MH care coordinators (carers of people with substance use)

    MH training

    If staff “appropriately trained” for specific client – do you even need a list of “specialist” conditions?

    Appropriate training – generic skills (e.g. asset focus) but subsets of specialist skills?

    Something in guidance would create national benchmark of to what extent staff should be trained – this would be a good thing.
    Regular interval training is good – keeps practice up to date in changing social care world.

    Is there a competency framework to support understanding of what people need training in?

    Benefit of joint health and social care training – could this include shadowing?

    Should have skills to respond to all conditions as we respond to different language requirements etc – communication is accessible to the client.

    Focus needs to be on appropriateness of communication.
    Include autism?

    How does specialist training fir with self-assessing? – it is the professional that needs training and is the specialist, not the “self” assessor – worth clarifying.

    Trusted assessors – would they need training?

    Need to emphasise that anyone the LA delegates work to must adhere to the same standards of training “specialist assessor” as the LA.
    Add detail to what “adequately trained” means – this reflects the need to have the right person doing the assessment.

    Need to emphasis involving other specialists to support assessment process.

  23. Anonymous says:

    I wish to reinforce the views expressed elsewhere by others that such individuals require those who assess them to be adequately and specifically trained to do so. People with PMLD have very complex communication, health and social needs. In order to assess their needs effectively, the assessor must understand the impact of these complex needs in order to effectively carry out the task. Without specialist assessors this group of people will not get equal access to the support and opportunities that they require to have a fulfilling life.

    My particular concerns centre round the specialist communication skills required to interact with people who do not use formal communication such as words, symbols or signs. It is crucial that assessors understand and are skilled in this area so that they can involve people with PMLD meaningfully in assessments. The work of the late Jim Mansell and others highlights the dire consequences of not getting it right for this group of people. Without effective and well informed specialist assessment the risk of poor quality of life, inadequate service provision and even avoidable deaths is heightened. Specialist assessment by assessors equipped with specialist skills of involvement and communication for people with PMLD is vital.

  24. Anonymous says:

    Given the emphasis on personalisation as well as on well-being, early intervention and prevention, we believe that any staff assessing an individual’s needs should be a ‘specialist’ and appropriate trained and qualified. To be able to recognise the variety of different care and support needs an individual may have and to adopt a personalised, outcome focused, holistic approach, assessors need a broad knowledge base with a least an awareness of what might be considered more specialist areas. Housing related support workers already have a broad knowledge base and, with the advantage of interacting with their service users regularly and over relatively long periods of time, play a key role in promoting health and well-being, prevention and early diagnosis and intervention as well as signposting individuals to appropriate specialist services.

  25. Anonymous says:

    with apologies for limited awareness of what is in the rest of the Act, I want to raise the issue of maintaining ‘other significant personal relationships’ and assessing if one is ‘unable to achieve these outcomes’ (6.87). Please can there be consideration and inclusion of human-companion animal relationships (HCARs) as the proven vital health and social benefits that appropriate and well supported HCARs provide mean that they are of great significance to a proportion of the vulnerable population; and have wide ranging economic savings with enhanced social capital and, subjective and objective, wellbeing.

  26. Anonymous says:

    A wide ranging practice based knowledge and experiences with specialist skills would help to understand the user’s physical and medical conditions. This an assurance for holistic assessment and identification of actual and potential health and social care needs. The assessment goes beyond physical examinations but considers psychosocial Wellbeing in addition and source services from different multidisciplinary agencies as well as universal service.

  27. Anonymous says:

    Carers assessments require staff who have received training in carers needs which are often quite separate from those of the person they care for.
    Many carers may not immediately recognise themselves as such and
    would not request an assessment in the first place, those new to caring possibly won’t have had time to fully understand what their needs are and what support they will require moving forward.
    Self assessments may be viewed as a cost effective method of meeting the requirements of the Care Act and I am concerned that financial considerations may result in too great a reliance being placed on online self assessments.Caring affects people of all ages and abilities and specialist support must be offered to carers wishing to undergo an assessment.

  28. Anonymous says:

    The requirement to consider whether an expert is required to carry out an assessment and the requirement to consult people with experience of a specific condition during an assessment, where necessary, provides the framework to ensure that relevant expertise is used without creating a long list of conditions that it would be hard to gain agreement on.

    The clarity that the needs assessment must consider all the care & support needs before considering support from a carer is very helpful. The reinforcement that the financial assessment must come after eligibility is confirmed is also helpful with the reinforcement of the ongoing relationship with self-funders.

    What is less clear is the concept of proportionate assessment when the assessment still needs to be able to determine which needs are eligible and which aren’t. Examples would help.

    The case studies under “Interpreting the eligibility criteria” are helpful and more examples for other situations would be helpful.

  29. Anonymous says:

    I work as a Professional Team Lead for Occupational Therapy, in a Community Health & Social Care setting. To work in a truly person centred way, depending on the persons presenting needs, we may need to involve different professionals, with different expertise, to provide a full and evidenced assessment. We need to develop how our Reablement services are supported by Occupational Therapy, Physiotherapy, Nursing and Social Work, and how all these professionals can contribute to ongoing assessments.

  30. Anonymous says:

    I think that people with profound and multiple learning disabilities (PMLD)require specialist assessments because of their very complex and multiple needs. This group of people are likley to experience sensory, physical and communication impairments and may use a variety of ways to make their needs known. In order to make sure they are properly understood assessors must have an understanding of the range of impairments experienced by this group, be aware of the range of communication aids and processes available to communicate with the person, realise the process will take longer, have a working understanding of the mental capacity act and be comfortable in communicating with those who know the person well.

  31. Anonymous says:

    Safeguards need to be in place to ensure family carers of those that are covered by NHS funded continuing care are not assumed to need no help because their caree should be getting care-workers provided by the NHS. We have found the care coverage has continually broken down leaving me as a 24/7 carer. 24/7 solo caring for those with complex medical needs should be banned. Also the assessment of the carers situation should take into account the safety of the accommodation for carrying out caring. Assessments need to be living documents that are regularly reviewed and acted upon.

  32. Anonymous says:

    a person with a sensory impairment [ deaf and Sign language user]and/ or limited communication with additional complex needs, Autism and learning disabilities compounded by mental health issues will require a specialist assessor and not just an assessor with just an awareness of these conditions. All these conditions impact daily , on the person and have to be carefully weighed up to provide the proper care and ensure that the assessment reflects the fluctuating needs of the assessed person. Otherwise the whole person is not being properly assessed and provided with the care required to manage these needs which could result in a crisis and the carers having to pick up the pieces.

  33. Anonymous says:

    having an understanding of didability and the impact of this on the whole family should be considered.

  34. Anonymous says:

    The skills needed to carry out an assessment that can accurately identify a persons needs and balance history, needs, wants, choices, health, family and elgibility should not be underestimated. As well as specialist areas such as people with comunication or sensory difficulties and those who are more complex some account should be taken of situations where people are just trying to get services inappropriately – especially in light of direct payments. Being able to truly identify a persons functional ability in these cases takes appropriate training – specifically occupational therapy.

  35. Anonymous says:

    The need for a specialist assessor for Blind and Vision Impaired people should be mandatory. The person being assessed, particularly where advanced age and/or other health factors are involved, should be consulted prior to an assessment to ensure they are aware of the detail required when making a claim. Their needs should not be made to fit a predefined financial target, the final outcome should be a package which fully accommodates their every need both at the time of assessment and hopefully into the future. Reassessment on a regular (minimum annual) basis should also be mandatory to allow for deterioration in condition(s) and change of circumstances. there should be no grounds acceptable for Local Authorities to reinterpret the application of the assessment.

  36. Anonymous says:

    The implications of living with often misunderstood and variable conditions such as Multiple Sclerosis makes the assessment process difficult. Social workers often just do not understand how it impacts on everyday life because the symptoms are often hidden or not understood. We have difficulty in conveying that although my husband can bear weight with his legs he cannot walk or even lift his foot, so when he can stand up from his wheelchair, it doesn’t mean he doesn’t need his chair, or that he can transfer from one seat to another. A Social Worker who says they have experience of other clients with MS cannot know the full range of differing problems this disease causes and may have never come across another person with the same set of impairments.

    It is difficult to see how the local authority can access the many specialists that may be required to assist in an assessment and how much delay and costs this would involve.

  37. Anonymous says:

    I would hope that sufficient resources would be put in place (i.e. More trained social workers/needs assessors) so that the initial “needs assessment” is seen less as a one-off, and more as a process. This would require multiple ongoing interactions between the assessor and person + carer. This would overcome some of the issues about how long to assess needs for when a person has fluctuating needs, and would allow people who are not sufficiently articulate at the initial needs assessment to feed back on whether the support they are receiving is actually meeting their needs and promoting their well-being. It may also allow issues about abuse and inadequate services from new outside providers to come to light.

  38. Anonymous says:

    People who are terminally ill need to have access to professionals who have specialist knowledge and experience of end of life services and of working with dying people. People undertaking such assessments need to be trained in having open but sensitive conversations, have a clear grasp of the relevant legislation and guidance and ethical issues in relation to advance planning and decision making, an understanding of disease trajectores and synptom management and a realistic grasp of the resources avaialble.

  39. Anonymous says:

    Blind and partially sighted people require both a specialist assessor and a specialist assessment which best understands their needs. Specialist assessments which understand the challenges faced by blind and partially sighted people are needed. These must be carried out by staff that are specifically trained to understand the needs of blind and partially sighted people.

    • Anonymous says:

      Assessments for British Sign Langauge (B.S.L)users should be carried out by people who understand the culture and issues. BSL clients who also have sight loss should have specialist assessors who can assess holistcially, understanding both the hearing loss and the sight loss aspects and how they impact on each other.

  40. Anonymous says:

    there is also an image problem with how Social Services see carers. Mostly people who are old and no longer economically active so the support available is mostly in the form of coffee mornings or outings during the day when as an economically active person who works 30 hours a week a cares for my terminally ill husband, day outings and coffee mornings are no use to me. I am a young professional whose career prospects are being thwarted by my caring responsibilities and yet I do not seem to fit the “carers perconceived image” therefore do not qualify for support. This needs to change. I need support to continue working otherwise I and my family will have no other course of action but to depend on benefits, something I refuse to do. This is not appreciated by Social Services as the expectation is that I should give up work altogether. It’s a catch 22.

  41. Anonymous says:

    Q13 The requirement for specific specialist training should be broadened to assessors of anyone with a severe communication difficulty such as people with profound learning disability, autism and dementia – who may have limited or no verbal communication. Specialist training should also be required for assessors of people with Asperger syndrome where the disability makes interaction and communication problematic for the individual so needs could easily be missed by a generic assessor.

  42. Anonymous says:

    Is Q13 the only one for needs assessments? I want to make a more general point about assessments:
    The Act’s provision that a needs assessment “must include an assessment of the outcomes that the adult wishes to achieve in day-to-day life” must not be seen by the local authority assessors as a requirement to delve intrusively into people’s life choices regardless of how competent they are to manage their own lives.
    For many people who are competent to manage their own affairs, the only ‘outcome’ to be considered is the removal of the barriers to ordinary life that their disability presents. What they do with their lives when freed of those barriers is not a matter for the council, and the guidance should direct authorities away from crossing this line for assessment purposes.

    • Claire Rhodes says:

      Hi – it’s the only posed question in this section. But please feel free to post your wider comments here too. The questions posed in this consultation are a guide, but they’re by no means meant to restrict views. Wider views on any of the sections, guidance or regulation chapters are very welcome. Thanks

  43. Anonymous says:

    Carer assessments are a specialist piece of work to be carried out, not as a ‘sidecar’ to the Social Care assessment of the cared for person but as a bepsoke and separate assessment of the Carers needs. Practical experience of over 1600 Carer assessments has taught me that the value of a Crer assessment is not easy to measure. The time spent with the Carer and the attention spent to their unique situation is of paramount importance. Feedback from Carers repeatedly highlights the value of having a professional, separate from the cared for person’s worker, to listen to the Carer and to take action to meet their needs. A large part of the skill required to meet Carer’s needs is not the provision of services from a statutory body but is most often the information, advice & services provided by alternative sources. Such provision is almost impossible to ‘box’ or label. It can vary from benevolent fund referrals to practical local advice unique to the situation in hand.

    The mantra that Carer’s assessments should be ‘everyone’s business’ is false. Experience has shown that Carer’s need expertise not 5 minutes from an overworked social care professional.

    Under rated and undervalued may be labels attached to Carer Assessments by some but not by all. I care passionately about Carers, the assessment of their needs and meeting those needs. More resources need to be directed towards Carers or the NHS & social care services will collapse under the resultant strain.

  44. Anonymous says:

    Ambulance staff should be able to make an emergency needs assessment in certain situations.

    Patients are increasingly being left at home following treatment by paramedics, with or without follow up from other services depending on the individual circumstances. This puts ambulance crews in an ideal position to evaluate the needs of a patient, which may now have changed meaning new or additional support I needed, but at present other than a GP referral there is no way o initiating this.

    All to often we are called to patients and document our concerns, only for them to become regular users of the 999 system as they appear to not receive any follow up regarding any aids to daily living and other care support we have identified they may benefit from.

    This is frustrating for us, detrimental to the patient and costly to the NHS, so emergency needs assessments by paramedics would be a welcome move.

  45. Anonymous says:

    Carers assessments tend to be lip service only… especially for those who care for someone with ‘hidden’ or invisible disabilities. There needs to be a sea-change and carers need to be offered real tangible support that will really impact positively on their quality of life. The best way of doing this of course is to ensure that the person they care for is eligible for respite care. so the carer gets a break and is able to concentrate on him / herself for a short while. I cannot foresee this happening as the reality is respite care is being cut…

  46. Anonymous says:

    It is not so much a case of requiring further specialists to assess…. there is a great need for those who do the assessments to be trained in and have understanding of many and varied conditions and disorders. Learning Disability is a very complex area… as is autism, and many others.. people who have no awareness or understanding are not really in a position to assess needs. Someone may present really well superficially which tends to mask the severity of the impact on their life of their disability.

  47. Anonymous says:

    A person can be in denial or suffering from mental health problems making them uncooperative or unable to explain problems or symptoms a specialised assessor would be able to access the problems already happening plus future problems this form of assessment would improve the well being for the carer as well as the user.

  48. Anonymous says:

    To date Financial Assessors in Cornwall have lacked understanding of LD especially where people present with Autistic behaviours. The majority of people with LD/Autism are unable to understand the Assessment process and this further assessment falls as an additional administrative duty for Carers to complete. This legislation is inappropriate for people with a lifelong LD condition.

  49. NW says:

    Specialist training to promote understanding of how a person’s disabilities may impact on their ability to complete essential tasks and the impact of disability on their or their carers well-being. A generic assessor is likely to miss or even dismiss key evidence of need. Someone used to working with older people with physical care disabilities may not understand the needs of an 18 year old with psychosis.

    OT or Physiotherapist assessment can be vital in clarifying a persons needs where there is a degree of additional complexity.

  50. Charlotte says:

    If the person being assessed uses a specific form of communication such as makaton, it would be important for an assessor to be trained in this method of communication.

  51. Jan Saunders says:

    The key word is ‘entitlement’ A Social Worker during an assessment will make it clear that you are not entitled until she/he says so. The assessment process needs to preclude an assessment by a Social Worker as their personal opinions come into play. If the assessment is to be paid on the points system then give the assessed person the right to do their own assessment on paper to be sent to the computer for ‘its’ assessment for award. An assessment is laborious and tiring for the Client and some other method should be optional rather than several hours of ticking boxes with an often bored Social Worker.

  52. Jo Minchin says:

    If the person being assessed has autism, the assessor needs to be very experienced in working in that field and not just playing lip service to the condition.

  53. D Perry says:

    if the person being assessed had specific communication needs or visual or hearing impairment the person carrying out the assessmetn may require specialist skills in the persons method of communication.