Practice example: Specialist support - deafblind adult

Background

Mr B is 58 and until four years ago enjoyed normal vision and hearing. As a consequence of a traumatic accident at home, which was judged not to have been anyone’s fault, he now has severe hearing and sight loss. His vision and hearing deteriorated rapidly following the incident, and now he sees only through a limited field in the centre of both eyes, and has no hearing in the left ear and very little in the right.

Mr B is extremely depressed and emotionally vulnerable. He feels his life has been ‘turned upside down’ in a way that feels sudden and final. He has had rehab and health support and is considered to be stable.

Mr B lives alone in a modern house close to the centre of a busy market town, which he previously shared with his wife, who is now deceased. Prior to his accident he had a small and active group of friends, worked as an accounts technician and took part in regular social activity, including playing golf. He has no immediate family close by; his son is very supportive but lives 200 miles away with his young family, which along with work commitments prevents him from offering any meaningful care to Mr B.

Mr B feels unable to cope in social settings he previously enjoyed because they are too noisy for his hearing aids. As a result he has withdrawn from contact with his circle of existing friends.

Following the closure of a local group for deafblind people two years ago, Mr B has no social contact and is feeling increasingly isolated. He has become a virtual recluse in his own home for personal safety reasons, as well as concerns over unexpected visitors. Mr B has been known to the local authority since the onset of his condition, when he was assessed and his needs deemed eligible, and he has had an annual review relatively recently. However, Mr B’s needs appear to have changed in the three months since the last review, due to increased isolation and depression. Following a recent stay with his father, Mr B’s son has requested another review.

The review is conducted and finds that Mr B’s needs have changed, so an assessment is arranged. The assessment is conducted in Mr B’s home, where he feels most comfortable. Mr B’s son arranges time off from work to be in attendance. As Mr B suffers from hearing and sight loss, the Care and Support (Assessment) Regulations 2014 and good practice require that a specialist assessor conduct the assessment. In this case a specialist assessor would be one who has received appropriate training in the deafblind condition. This is important because it will help to ensure that Mr B’s needs and desired outcomes are fully understood in the context of his situation as well as ensure the assessment process takes Mr B’s needs fully into account.

Mr B expresses the outcome he would like to achieve as: ‘I would love to be able to go out again and to have someone to have grown up conversations with, and to be useful to someone else.’

Preparing for an assessment

When preparing to make an assessment it is useful to ask yourself the following questions in relation to the legal duties for the Care Act 2014.

Ensuring the assessment is proportionate and appropriate

Proportionate

Appropriate

Determining eligibility

  1. Do the needs for care and support arise from a physical or mental impairment or illness?
  2. Do these needs mean the adult is unable to achieve two or more of the listed outcomes?
  3. As a consequence of being unable to achieve the outcomes, is there, or is there is likely to be, a significant impact on the adult’s wellbeing?

Outcomes

Determination. The assessment was conducted by a specialist assessor who as a minimum has training to QCF or OCN Level 3 in the deafblind condition. The outcome of the face-to-face assessment is that Mr B has eligible needs.

Condition 1. Mr B’s needs arise from physical impairment.

Condition 2. Mr B is unable to achieve two or more of the eligibility outcomes, including: developing and maintaining family or other personal relationships and making use of necessary facilities or services in the local community.

Condition 3. As a result, there is a significant impact on Mr B’s wellbeing, particularly in relation to his mental health, emotional wellbeing and domestic, family and personal relationships as well as his ability to make use of community services.

Next steps

How the adult’s eligible needs might be met

The following are being considered for Mr B.

Reflection points