Practice example: Strengths-based approach in assessment

Background

Mr R is a man in his late 60s living alone since the death of his wife. Mr and Mrs R had been married since they were both 18. 

Mr R is retired. He previously worked as an engineer in the aerospace industry, taking relatively early retirement at 60 due to an increase in the severity of rheumatoid arthritis (diagnosed in his 20s) and a desire to spend more time with his wife.

The couple were known to the local authority due to Mrs R’s physical health problems. Mr R acted as her carer and, with additional support from Mrs R’s personal assistant, continued working until retirement. Mr R’s needs had been supported following a carer’s assessment, however his physical condition was never significant enough while his wife was alive to require a needs assessment in his own right.

Mr and Mrs R had a very small circle of friends and no significant relatives. Despite her physical illness, Mrs R was more outgoing and better able to form friendships. Mr R is shy and awkward in social situations; most of his relationships were formed through his workplace and did not extend beyond work.

Mr R has a son and daughter, one of whom lives abroad and the other lives 300 miles from the family home. While both enjoy a good relationship with their father, visits are infrequent, but loving and fulfilling when they do occur.

Following the death of his wife 18 months ago, Mr R has become increasingly depressed and isolated, rarely leaving his home and having little social contact with friends. He is neglecting his personal hygiene and his home is becoming increasingly messy, with unwashed plates and evidence of spoilt food in the kitchen. He is not eating properly and largely feels there is no point to anything any more. He is not taking his pain medication regularly and is experiencing increased lack of mobility due to his arthritis.

His only daily social interaction is with his neighbour, Mrs S, who has been friends with Mr and Mrs R for 30 years. She ‘pops in’ regularly throughout the day to check on Mr R, but limits the extent she helps because she does not wish to intrude on what she recognises as his very private nature. Mrs S doesn’t feel comfortable offering him personal care. She regularly talks to Mr R’s children to update them on their father’s condition. Mrs S is fit and capable, being some years younger, and would like to provide more support to Mr R around the home but does not know how to begin the conversation about his needs without offending him.

In the past Mr R helped out at the local Scouts and Guides and volunteered in his children’s school when his shift patterns allowed. This allowed him to be close to his children and also helped him overcome his shyness, as he was acting in what he saw as some form of official capacity.

His son and daughter have become increasingly concerned about their father’s state of mind and physical condition, which is confirmed by their regular contact with Mrs S. Being familiar with the local authority support from their mother’s case, they have requested a social care assessment for Mr R.

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

Mr R faces social isolation which is contributing to the deterioration in his mental health. He feels lonely and without a social network. Adopting a strengths-based approach in the assessment allows the assessor to work with Mr R to recognise not only the problems he faces but the:

In Mr R’s case the assessor considered the following.

Proportionate

Appropriate

Determining eligibility

Outcomes

Determination. The outcome of the assessment is that Mr R has eligible needs for formal services.

Condition 1. Mr R’s needs arise from both physical and mental impairment.

Condition 2. Mr R is unable to achieve two or more of the eligibility outcomes, including: managing and maintaining nutrition; maintaining personal hygiene; being able to make use of the home safely. He has also disengaged with others around him and this may impact on maintaining relationships in the future.

Condition 3. As a result, there is a significant impact on Mr R’s wellbeing, particularly in relation to physical and mental health, emotional wellbeing and personal relationships.

Next steps

How the adult’s eligible needs might be met

A care and support plan is put in place for Mr R. The intended outcome is to support a level of independence and social contact that had existed in Mr R’s life before the death of his wife.

The assessment identified that within the extent of his eligible needs an appropriate source of support for Mr R is the strength of his limited relationships with his former work colleagues and the extent to which he is able to engage in the community. This is discussed and agreed with Mr R, drawing on his own resources in this way:

Taking account of the eligible needs which cannot be met from Mr R’s own resources, services and support provided by the local authority include:

Reflection points