The Government plans to transform adult social care in England. Future services will place more emphasis on prevention and enablement, and promoting personalisation and choice. Self-assessment is one possible facilitator of this agenda. However, little is known about its utility in social care. This evaluation examined how eight local authorities employed self-assessment in the provision of community equipment and adaptations, and explored the implications for service delivery.
Method:
A multiple case study was employed, using a mixed methods approach. This drew on internal documents, management interviews, and service user and administrative records.
Findings:
Self-assessment was primarily used to facilitate service access. Although the authorities differed in the way in which they operationalised self-assessment, professional staff were almost always involved. The differences between people receiving self and traditional assessments were modest, but the people undertaking self-assessments in preventative services formed a particularly healthy subgroup. There was little consensus about the items suitable for provision through self-assessment.
Conclusion:
The concept of self-assessment was variously interpreted and not all its possible uses were explored. Nevertheless, the evaluation suggested that self-assessment can facilitate access to community equipment and adaptations and has the potential to extend the population traditionally served by social care services, thereby addressing the preventative agenda.
ArkseyHHepworthDQureshiH (2000) Carers' needs and the Carers Act: An evaluation of the process and outcomes of assessment. York: University of York Social Policy Research Unit.
3.
BanniganKBonifaceGDohertyPNicolMPorter-ArmstrongAScuddsR (2008) Priorities for occupational therapy research in the United Kingdom: Executive summary of the POTTER project. British Journal of Occupational Therapy, 71(1), 13–16.
4.
BauldLChestermanJJudgeK (2000) Measuring satisfaction with social care amongst older service users: Issues from the literature. Health and Social Care in the Community, 8(5), 316–24.
5.
BownsIChallisDTongMS (1991) Case finding in elderly people: Validation of a postal questionnaire. British Journal of General Practice, 41(344), 100–04.
6.
BrittleNLettKLittlechildRSackleyC (2007) The disability profile of adults who receive adaptive equipment from local authority occupational therapy services. British Journal of Occupational Therapy, 70(11), 479–82.
7.
JohnstonBurke ROnwuegbuzieAJTurnerLA (2007) Towards a definition of mixed methods research. Journal of Mixed Methods Research, 1(2), 112–33.
CarterMF (2003) The relationship of a self-reported assessment of need in mental illness to insight. Journal of Mental Health, 12(1), 81–89.
10.
ChallisDHughesJClarksonP (2007) Enhancing the efficiency and effectiveness of assessment in community care self assessment pilot projects: Interim report. Discussion paper no. M155. Manchester: PSSRU, University of Manchester.
11.
ChallisDHughesJClarksonPTuckerSO'SheaSBrandCAbendsternMWenbornJ (2008) Enhancing the efficiency and effectiveness of assessment in community care. Volume II. Self assessment pilot projects: User needs and outcomes. Discussion paper no. M178. Manchester: PSSRU, University of Manchester.
12.
College of Occupational Therapists (2007) COT/BAOT briefing 84. Occupational therapists as facilitators of telecare. London: COT.
13.
College of Occupational Therapists (2008) Health promotion in occupational therapy. London: COT.
14.
College of Occupational Therapists and Housing Corporation (2006) Minor adaptations without delay. London: COT.
15.
CurtisLNettenA (2006) Unit costs of health and social care 2006. Canterbury: PSSRU, University of Kent.
16.
Department of Health (2005) Independence, well-being and choice: A vision for the future of social care for adults in England. London: The Stationery Office.
17.
Department of Health (2006a) Our health, our care, our say: A new direction for community services. London: The Stationery Office.
18.
Department of Health (2006b) Self-assessment schemes put patients in control (press release). Available from: dhmail@dh.gsi.gov.uk.
19.
Department of Health (2008) Transforming social care, LAC (DH)(2008)1. London: DH.
20.
Department of Health (2009) Shaping the future of care together. London: DH.
21.
Department of Health and College of Occupational Therapists (2008) Occupational therapy in adult social care in England: Sustaining a high quality workforce for the future. London: The Stationery Office.
DuffyS (2004) In control. Journal of Integrated Care, 12(6), 7–13.
24.
DuffyS (2005) Individual budgets: Transforming the allocation of resources for care. Journal of Integrated Care, 13(1), 8–16.
25.
EllisK (1993) Squaring the circle. User and carer participation in needs assessment. Birmingham: University of Birmingham/Joseph Rowntree Foundation.
26.
FACE Recording and Measurement Systems (2005) The core assessment and outcomes package for single assessment, version 5.0 (CD). Available at: http://www.face.eu.com/ Accessed 02.06.10.
27.
GriffithsPUllmanRHarrisR (2005) Self assessment of health and social care needs by older people: A multi-method systematic review of practices, accuracy, effectiveness and experience. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R and D (NCCSDO). London: King's College.
28.
HancockGAReynoldsTWoodsBThornicroftGOrrellM (2003) The needs of older people with mental health problems according to the user, the carer and the staff. International Journal of Geriatric Psychiatry, 18(9), 803–11.
KatzSFordABMoskowitzRWJacksonBAJaffeMW (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185(12), 914–19.
31.
LoganPAAhernJGladmanJRFLincolnNB (1997) A randomized controlled trial of enhanced social service occupational therapy for stroke patients. Clinical Rehabilitation, 11(2), 107–13.
32.
LyonsRAWarehamKLucasMPriceDWilliamsJHutchingsHA (1999) SF-36 scores vary by method of administration: Implications for study design. Journal of Public Health Medicine, 21(1), 41–45.
33.
MandelstamM (2003) Using the law to develop and improve equipment and adaptation provision. Edinburgh: Scottish Executive.
34.
MountainG (2000) Occupational therapy in social services departments. A review of the literature. London: College of Occupational Therapists.
35.
NHS Information Centre for Health and Social Care (2008) Personal social services survey of adults receiving community equipment and minor adaptations in England, 2007–2008. Leeds: NHS Information Centre.
36.
NicholasE (2003) An outcomes focus in carer assessment and review: Value and challenge. British Journal of Social Work, 33(1), 31–47.
37.
NolanMPhilpI (1999) COPE: Towards a comprehensive assessment of caregiver need. British Journal of Nursing, 8(20), 1364–72.
PhilpI (2000) EASY-care: A systematic approach to the assessment of older people. Geriatric Medicine, 30(5), 15–19.
40.
QureshiH (2006) Self assessment: How does it work, is it effective and how can it be promoted? Ripfa outline 2. Totnes: Research in Practice for Adults.
41.
RileyJ (2007) Enabling everyday lives. A report into occupational therapy in social services departments in Wales. London: College of Occupational Therapists.
42.
SackleyCLettKLittlechildR (2009) Equipment provision by local authority occupational therapy teams using the Fair Access to Care Services eligibility framework: A vignette and interview study. British Journal of Occupational Therapy, 72(6), 259–65.
43.
SmeethLFletcherAEStirlingSNunesMBreezeENgEBulpittCJJonesD (2001) Randomised comparison of three methods of administering a screening questionnaire to elderly people: Findings from the MRC trial of the assessment and management of older people in the community. British Medical Journal, 323(7326), 1403–07.
44.
TullochAJMooreV (1979) A randomized controlled trial of geriatric screening and surveillance in general practice. Journal of the Royal College of General Practitioners, 29(209), 733–42.
45.
WaltersKIliffeSOrrellM (2001) An exploration of help-seeking behaviour in older people with unmet needs. Family Practice, 18(3), 277–82.
