Chapter 44 – Victoria Mc Donagh (D3SOP4)
Domain 3 Standard of Proficiency 4
Be able to analyse and critically evaluate the information collected in the assessment process.
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KEY TERMS Assessment of needs Analyse to assess Critical evaluation Assessment process and tools
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Social care is … being able to offer and provide support to someone that empowers them within their own lives and story. Each individual is unique, with their own story and needs, and this should be at the centre of everything we do in practice. |
Analysing and critically evaluating the information collected in the assessment process is a central part of social care practice.
Regardless of the social care setting, some type of assessment will need to occur, in order to be able to support and work with the service user. This assessment may look different depending upon the setting you are in, which includes the different interventions and approaches underpinning the work there. An intervention is taking action or completing a task with a service user that is designed to improve their needs and situation. An approach can be described as a particular way of working with a service user or in a particular situation, for example using a person-centred approach. This in turn may inform the type of assessment carried out and the assessment tools used to support this process. Assessment tools act as a means for the social care worker to carry out a full analysis and evaluation with the service user to identify their needs and, most important, evaluate how the service can best support them. Before we consider what the assessment process may look like, we first need to consider the terms ‘analyse’ and ‘critically evaluate’ in relation to social care work.
Analyse to Assess
In social care work, we analyse or begin an analysis for assessment by having a conversation with a service user, listening to their story and gaining an understanding of their situation. By using an analytical perspective, a social care worker can identify a service user’s needs, or unmet needs. This may also allow a social care worker to identify goals with the service user and understand how the service can best support them. It can assist in assessing what intervention or approach may be appropriate or best to use. Barnard (2010) describes assessment as the second stage of a ‘critical thinking model’. The first stage is description, where information is gathered from talking directly to the service user and the people involved in his or her care and using all these descriptions and relevant records to help you understand the service user’s story, needs and situation. The final stage of the critical thinking model (Barnard 2010) is evaluation.
Critical Evaluation
Once we gain an understanding of and identify service user’s needs in the assessment process, we then need to engage in the evaluation stage. According to Barnard (2010: 85) critical evaluation ‘entails estimating the effectiveness, and therefore the value, of a particular strategy or action’. This can be identifying strategies in how to achieve identified goals and meet needs. Evaluating the information we gather contributes to our full understanding of the service user and their needs, but it also helps us to look at what might work, what has worked in the past and how we can keep moving forward. It provides a space for the social care worker and service user to understand the progress made and identify future goals or where goals may need to be altered. Needs are constantly changing and a flexible approach is essential to accommodate change and ensure we are reviewing and interpreting information correctly, and evaluating the information we gather.
Assessment Process and Tools
Many different types of assessment are used in different social care settings, for example the placement plan, a holistic needs assessment, and the strengths-based approaches including the good day/bad day tool (Sanderson et al. 2015), a strengths-based tool (Baron & Stanley 2019) and the decision-making tool (Sanderson 2021).
1 The Care Plan and Placement Plan
According to the National Standards for Children’s Residential Centres (HIQA 2018), every child entering the care of the state will have a care plan and a placement plan. The care plan includes all the relevant and important information on the child needed to support their placement, including family details and contact information, where they go to school and details about their educational, medical and social needs. The placement plan is shaped by the care plan and this document includes information on their day-to-day life, their needs, likes and dislikes and hobbies. The social care worker engages with the child/young person to identify their needs and goals for their care and all information is included in the placement plan. This is an assessment tool, which enables the child to understand their needs but also supports them in achieving their goals and identifying how these goals may be achieved. The placement plan can be described as a living document that should be used with the service user to review or analyse how things are going in achieving identified goals, and also for them to be able to evaluate progress made and how to move forward. For example, what is working well? Is there anything that is not working as well? Does something need to be changed/altered? This also reflects how the service user’s needs can change at any given time and the assessment process needs to be flexible to accommodate this.
2 Holistic Needs Assessment
Another type of assessment used by a social care worker is a holistic needs assessment, which can be used in a service working with those experiencing homelessness or at risk of homelessness. This type of assessment examines the service user as a whole, considering their needs from physical, social, psychological, emotional and spiritual dimensions (Schaffer et al. 2000). The assessment does not just focus on the problem/issue of homelessness, but considers all the different factors for that person, in order to understand the best way to support and work with them. Since it takes into account many different considerations of need and support required, this type of assessment may require the engagement of different professionals working together to support the service user.
3 Strengths-based Approach and Tools
As well as using assessment tools, social care workers draw on their own knowledge, skills and abilities, all of which shape their approach to practice. One example is a strengths-based approach, which is about working with the individual, placing them at the centre of their support and care needs. The service user is empowered to make decisions about their life. This approach encourages service users to find solutions and ways forward by focusing on what they can achieve, based on their strengths (Baron & Stanley 2019). Below are examples of different assessment tools and tasks a social care worker could carry out with the service user using a strengths-based approach:
Figure 1. The Who Am I assessment tool. Getting to know your own strengths
This assessment tool, which could be used with a service user in a mental health support setting, achieves a number of things. By first focusing on aspects of a person’s life that are more positive, it can help to remove the negative or unhelpful thinking often experienced. It takes the focus away from the ‘problem’ and looks at the strengths the person has. When an individual has a mental health issue, it can be difficult to see an alternative way of thinking. This tool can help to reframe an issue for someone by putting them at the centre and looking at what they can do, as opposed to what they cannot do. This tool also assists the social care worker to understand the needs of the service user, but it also helps to build rapport and a relationship. In analysing the needs of the service user, the tool goes further to evaluate them by asking questions such as ‘How would a family member or close friend describe you?’
Figure 2. Good day/bad day tool (Sanderson 2021)
Good Day/Bad Day
How do you know when you are having a good day?
What does it look like?
How do you know you are having a bad day?
What does it look like?
TASK 1
Watch the video on how to use the good day/bad day tool from Helen Sanderson Associates at https://www.helensandersonassociates.com/good-day-bad-day/
The good day/bad day tool could be used by a social care worker in a setting working with young people. This tool takes the focus away from a problem or an issue and looks at who the young person is and helps build a picture of that young person’s strengths. Tools such as this can be simple ways of beginning a bigger conversation or the start of creating a placement plan with the young person. They can often work very well with a service user who is more visual, as they can imagine and describe what a good day or bad day is. It can also be useful with young children – you can get them to draw a good day or a bad day. This simple tool can provide a snapshot of needs, and provide an opportunity to analyse and evaluate these needs.
TASK 2
Download the decision-making profile from https://www.helensandersonassociates.com/decision-making-profile/ and fill in the questions as shown in the sample below.
Decision-Making Profile
The decision-making profile could be used by a social care worker working in a disability setting. This tool can provide the social care worker and the service user with a good understanding of their needs and their story. It places the service user at the centre of their care and support. Again, this tool is looking not at what cannot be done, but at what can be achieved and how it can be achieved by that specific service user. This can be a very empowering task for a service user, as they are given the opportunity to be heard and also to develop their own self-awareness around their own needs and how they would like them supported.
From my own practice experience in working in the area of mental health, I have seen how using such tools can assist the assessment process and help the service user and the social care worker in developing goals and strategies to achieve them.
TASK 3
Apply one of the tools discussed above to your own life and goals. In a classroom situation, it could be useful to do this activity in pairs, taking turns toact the role of the social care worker.
This chapter has explored the proficiency and what it represents for analysing and critically evaluating information that a social care worker may gather during the assessment process with service users. The chapter has explained why a social care worker may engage with this process and has given examples and tools used to complete this process across different settings. However, what also requires consideration is what happens if a social care worker does not engage in this process. What happens if we do not analyse and evaluate? Service users can have many different needs, ranging from the basic needs of food and shelter to more complex needs, such as support with addiction. Sometimes service users may have a variety of support needs at the same time. Applying critical analysis and evaluation enables the social care worker to understand these needs and, most important, to understand how best the worker and service can support these needs. It allows the social care worker to be person-centred in their work with service users, to be able to empower and facilitate service users in their own lives. If we were not to take this approach, could we truly identify and meet the needs of the service user in front of us? We may miss needs or not support these needs correctly. This approach enables us to build a relationship with the service user and understand their journey. If we can understand this, then we can assist in providing appropriate support and care.
Here is a fictional case study to help students learn how to assess and critically evaluate within their practice.
Case Study 1
(Please note: this is a fictional case study featuring a fictional service user.)
Social Care Setting
The setting is a disability service that comprises a day service and has independent living units/houses for residents. The service is situated a short walk from a village. The service strives to provide a safe and homely environment for all in its care. It uses a person-centred and partnership approach, in which the individual is at the centre of their support and care needs. The service has links to the local community and provides a therapeutic setting in both its day and residential services. It has some large gardens, which are used as part of the programme for service users, to garden and grow vegetables. The service has access to many professionals, depending on the needs of each individual, including occupational therapy, speech and language therapy, physiotherapy, advocacy worker, social care worker, psychology and GP care. Each individual will be supported with an individual support plan to support their needs and goals.
Service User Profile
David is a 32-year-old man who has just started at the day service with a view to moving into one of the longer-term residential units. David has Down syndrome and his primary carers are his elderly parents, with some shared care from his siblings. The idea of a transitional approach was suggested by his social care worker, who has worked with the family in supporting them to meet David’s care and needs. This is to promote future planning for the time when David’s parents come to a point where they can no longer care for him. David’s family also want to empower David to become as independent as possible, as David has expressed this desire for his life.
David has experience of attending a previous community workshop, which had similar aspects to the day centre in this service. It provided a social outlet for David to meet new people and make friends. The community workshop also provided training and employment opportunities in the local community. David enjoyed this and loves the social aspect of attending such a group service. He also has experience of respite care for periods of one and two weeks, to provide his parents with a break from their caring role. David also attends weekly physiotherapy appointments. David’s family describe him as a kind and social person who loves a chat and a cup of tea. David also loves to cook and enjoys growing vegetables and listening to music. David has a very keen interest in sport, particularly rugby, and his favourite team is the Munster rugby team. At home with his parents, David lives as independently as possible and loves his routines. He a daily schedule and tasks and enjoys the routine and consistency this provides him with.
He likes to keep busy, and he carries out a number of chores and jobs around the house that support his daily living skills. David’s family have a dog, Rolo, and David has explained that he will miss Rolo when he moves into his new home.
David’s Current Individual Support Plan (ISP)
The service has completed an initial ISP with David to establish his support needs and goals, both as he begins in the day service and with a view to future transition to the residential part of the service. This is an initial ISP and will be reviewed again after a few weeks when David has settled into the day service. The following initial needs and goals have been identified with David.
- A key worker (social care worker) will be assigned to David to support his introduction and transition into the service.
- David has identified that establishing a routine in the service will be very important for him. The key worker will work with David on this.
- David would like to work in the garden and would like to learn how to grow vegetables. The key worker will link in with staff in the garden part of the service.
- David would like to make some new friends in the service who he can chat to. David will be supported with this by introducing him to the other people in the service.
- David has also identified that he would also like to do a baking course. The key worker will look into this with David and talk to the day service staff about this goal.
- David is also concerned about missing his family when he moves into the house full-time. The key worker and David will work on a transition plan, to make the transition as smooth as possible and support David in continued contact with his family.
Tips for Practice Educators
To facilitate understanding of this proficiency, complete the following activities.
Use the case study above to analyse and evaluate the relevant information needed for the assessment process with this service user. You can use the following questions:
- What does the assessment process and the individual support plan (ISP) tell us about the needs of the service user?
- What does the assessment process (ISP) tell us about the role of the social care worker in this particular setting?
- With the information you have of the service user, how does this help the social care worker to analyse and evaluate the needs of the service user? Why is it important to have such information?
- What do you think could be the impact if the social care worker did not analyse or evaluate the information gathered?
- Apply some of the assessment tools to this case study.
- Ask the student to apply some of the assessment tools to a fictional case study that is relevant to your social care setting.
- Using mind maps may be helpful to create links between analysis and evaluation within the assessment process.
Reflective Activity
- Think about a time you were supported to achieve a goal or something you are proud of. What do you think helped to achieve this? Was it a person?
- If someone were to gather information for your needs, what would be important for them to know? What would support you to analyse and evaluate your needs?
References
Barnard, A. (2010) Key Themes in Health and Social Care: A Companion to Learning. London: Routledge Taylor and Francis Group.
Baron, S. and Stanley, T. (2019) Strengths-based Approach: Practice Framework and Practice Handbook. London: Department of Health and Social Care.
HIQA (Health Information and Quality Authority) (2018) National Standards for Children’s Residential Centres. Dublin: HIQA.
Sanderson, H., Bown, H. and Bailey G. (2015) Person-Centered Thinking with Older People: Six Essential Practices. London: Jessica Kingsley.
Sanderson, Helen, Associates (2021) Decision-making Tool. Available at <http:// helensandersonassociates.co.uk/wp-content/uploads/2016/12/Decision-making-profile-copy.pdf>.
Schaffer, M.A., Mather, S. and Gustafson, V. (2000) ‘Service learning: A strategy for conducting a health needs assessment of the homeless’, Journal of Health Care for the Poor and Underserved 11(4): 385-99, doi:10.1353/hpu.2010.0746.
