Barry Ruffell wrote:
> It would be rash to claim that W. Sussex will buck trends and provide
> genuine needs-led assessments, but there is at least some
> awareness of the problem and a wish to do better. You have to start
> somewhere. Let me know if you have found a Local Authority that has
> got it right - we could all learn from them.
>
Alas I have yet to find a local authority who got it right, however, you
may be interested to read how one local authority got it wrong.
About five years ago a metropolitan district council in the North of
England tried to pilot a user-led assessment process. Designed by disabled
people it aimed to enable service users to complete their own community
care forms either on their own, or with the assistance of social services
staff. The forms were essentially blank sheets of paper with various topic
headings with sub-headings of Strengths and Needs and sub-sections for the
service user's views, their carer's views and the views of staff. These
new forms replaced 'tick-box' assessment forms.
It was common for the 'Needs' section of the form to be used by staff to
describe a service useršs situation, rather than recording what the service
user said they needed to achieve their aims. For example,
"Suffers with arthritis in hips, legs and arms. Unable to transfer from
chair, bed to zimmer frame unaided. Is very unsteady on feet, has tendency
to fall, has done so on number of occasions. Has wheelchair for outside
use."
My view is that neither service users or staff had the language (or
discourse) to express 'needs' from a (any) social model perspective - nor
had they the opportunity or organisational support to develop such a
perspective. Furthermore, in informal discussions with staff it became
apparent that some of them did not have basic writing skills - they
couldn't spell, summerise or put a simple sentence together.
As part of the assessment process some disabled people, who had been
trained as advocates by other disabled people, made themselves available to
those service users going through an assessment. It soon became apparent
that this voluntary system did not work - the potential conflict with
professionals, the time and knowledge required (all unpaid) became
impossible barriers for the advocates to overcome. They either adopted the
individual model perspective used by the professionals or got out.
In addition, the allocation of services and the services themselves were
fundamentally individual in design and intention. Ultimately, an assessment
can only be as good as the services it leads to, and if those services
don't address the social construction / creation of disability directly, an
assessment will be a waste of time. Unless, of course, the assessment
process can be seen as a politicising service in itself.
Regards.
Alden Chadwick
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