Quality statement 1: Care and support needs assessment

Quality statement

People's personal strengths, preferences, aspirations and needs are discussed when they have a care and support needs assessment.

Rationale

A care and support needs assessment that focuses on the person's strengths, preferences, aspirations and needs helps people to highlight the outcomes that are important to them. During the assessment, the person can identify how their needs impact on their wellbeing and ability to live an independent life, as well as on their goals and preferred outcomes. This ensures that they have autonomy in deciding what is important to them. They can then agree a care and support plan that supports them to achieve their goals and outcomes, with agreed timescales to review the plan to ensure it is still suitable for their needs. This is particularly important for people whose condition means that their needs can fluctuate.

Quality measures

Structure

a) Evidence of local arrangements to ensure that care and support needs assessments include documented discussion with the person on their strengths, preferences, aspirations and needs.

Data source: Local data collection, for example staff training records and care and support needs assessments protocols.

b) Evidence of local arrangements to ensure that people who have substantial difficulty with involvement and no appropriate individual to support them, as defined by the Care Act 2014, have enough time with an independent advocate before the care and support needs assessment takes place so that they can prepare for it.

Data source: Local data collection, for example records of independent advocacy use and surveys on the experience of people who have had a care and support needs assessment.

Process

a) Proportion of care and support needs assessments where a discussion and agreement of the person's strengths, preferences, aspirations and needs is documented.

Numerator – the number in the denominator where a discussion and agreement of the person's strengths, preferences, aspirations and needs is documented.

Denominator – the number of care and support needs assessments.

Data source: Local data collection, for example care and support needs assessment records and surveys on the experience of people who have had a care and support needs assessment.

b) Proportion of care and support needs assessments where people who have substantial difficulty with involvement and no appropriate individual to support them, as defined by the Care Act 2014, have access to an independent advocate.

Numerator – the number in the denominator where people have access to an independent advocate.

Denominator – the number of care and support needs assessments where people have substantial difficulty with involvement and no appropriate individual to support them, as defined by the Care Act 2014.

Data source: Local data collection, for example care and support needs assessment records, independent advocacy records and surveys on the experience of people who have had a care and support needs assessment.

Outcome

a) Satisfaction of people with the extent to which the care and support needs assessment promoted their interests and independence.

Data source: Local data collection, for example surveys on the experience of people who have had a care and support needs assessment.

b) Satisfaction of people using adult social care services with the support they receive to achieve their self-defined outcomes.

Data source: Local data collection, for example audits of care and support needs assessment records and surveys on the experience of people who have had a care and support needs assessment.

What the quality statement means for different audiences

Social care practitioners (such as social workers and occupational therapists) who are carrying out care and support needs assessments focus the assessment on the person's strengths, preferences, aspirations and needs, agreeing these with the person, to identify the outcomes that are important to them. They find out what people want from their day-to-day life and their long-term goals and have a good understanding of all the services available that can help them achieve this.

Commissioners (local authorities) ensure that they commission services that focus care and support needs assessments on the person's strengths, preferences, aspirations and needs. Their services ensure that the care and support needs assessment focuses on the person's strengths, preferences, aspirations and needs, and how these impact on their wellbeing. They ensure that the practitioners carrying out the assessments have been trained to make the assessment person centred. If people having the assessment would like an independent advocate, or they would benefit from having one, arrangements are made to ensure they are present and have had time to talk to the person about the assessment before it takes place.

People having a care and support needs assessment are involved fully in the assessment, with an independent advocate if they need one, based on the Care Act 2014. This gives them the opportunity to explain and agree their personal strengths, preferences and needs, what they would like to be able to achieve in their day-to-day life, and their long-term goals.

Definitions of terms used in this quality statement

Care and support needs assessment

The aim of the care and support needs assessment is to understand the person's needs and goals. After carrying out the assessment, the local authority should consider whether any of the needs identified are eligible for support.

The assessment:

  • focuses on the person's needs and how they impact on their wellbeing

  • focuses on the outcomes they want to achieve in their day-to-day life

  • involves the person and, if they want, their carers in discussions and decisions about their care and support

  • takes into account the person's personal history and life story

  • takes a whole-family approach

  • takes into account the needs of carers

  • takes into account the person's housing status, and where and who they want to live with

  • is aimed at promoting their interests and independence

  • is respectful of their dignity

  • is transparent in terms of letting people and their families and carers know how, when and why decisions are made

  • takes into account the potential negative effect of social isolation on people's health and wellbeing.

[Adapted from NICE's guideline on people's experience in adult social care services, terms used in this guideline and recommendations 1.3.3 and 1.3.4]

Equality and diversity considerations

People who are having a care and support needs assessment may have several needs, for example help with communication. Services should ensure that people have the help they need, for example through an independent advocate or communication aid, to participate fully in the assessment.

People should be provided with information about the care and support needs assessment that they can easily read and understand themselves, or with support, so they can communicate effectively with social care services about the assessment and understand the outcome of the assessment. Information should be in a format that suits their needs and preferences, for example Braille. It should be accessible to people who do not speak or read English, and it should be culturally and age appropriate. People should have access to an interpreter or independent advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.

People aged 18–24 who are in transition between children's and adult services may still be cared for under children's services. The assessment should take account of this and ensure there is continuity in their care during the transition process.

Assessors should be confident discussing and assessing the specific needs of people of all sexual orientations, taking this into account when planning people's subsequent care.