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Assessment and Goal Setting Under The Social Services and Well-being Act 2014
"Be a shade braver!" said my last blog...a reference to the primacy of the person-centred focus and increased therapeutic ambition of the Social Services and Well-being Act (SSWA). "But..." it continued..."how will this be realised?" Therein lies the challenge to services, not least because of the financial constraints of this austere age, which will see a reduction in publicly funded services. How can we empower the service-user to 'own' their 'live' support-package, and support them towards goals which they have designed, when resources seem to more scarce?
At the outset of any professional care and support process there has to be an assessment. To my mind, the professional practice around social care assessment is one area which will have to see considerable development under the new arrangements. The SSWA makes it clear that assessment is not just about 'needs.' We must take into account preferences, strengths and abilities. Such attributes are often wholly more motivating and inspiring than plugging away at something which an individual is told they must learn to do.
The Person-Centred Approach
Having come from a mental health nursing background, and having more recently practiced in Cognitive Behaviour Therapy, I became used to pulling all of the domains of assessment into an overall 'formulation' which tells a brief story of the individual's circumstances as they see and understand things. This seems like a useful approach to SSWA assessments - a kind of "where are you at now, what do you need, what would you like and what needs to happen?" approach. Another critical aspect and product of the assessment (and formulation) would then be goal-setting, in the person-centred and "shade braver" way.
It is easy to write about in a short article about this, but not so easy to achieve in practice. Why? Because achieving a truly person-centred approach requires professionals to sometimes set-aside judgements which they may automatically make, such as risk assessment, management and achieving best-interests for example. Furthermore they need to display a high level of communication skills, empathy and self-awareness. Furthermore, it requires them to step outside of their professional and organisational mind-set in order to 'get alongside' and see the life of the service user through their own eyes. This requirement for greater empathy is going to increase the use of advocacy within services. It is a 'big-ask' for any professional to be able to perform all of these attitudinal and mind-set manouevres.
It begs further questions: Who will be conducting SSWA assessments? What will their preparation be? Is there training available to support the 'new' assessment practice? What will be the specifications and audit criteria for a truly person-centred and outcome focused support-plan?
These are some of many SSWA related questions which I will attempt to address in my next couple of articles.
Paul Rees – QCS Expert Welsh Care Contributor