What makes an assessment appropriate and proporionate? - Ensuring assessment is appropriate and proportionate
Appropriateness requires the local authority to ensure the assessment process is adapted to the person’s circumstances, needs (communication needs, level of complexity, etc.) and preferences.
In order to ensure that the assessment is appropriate, it must be person-centred, collaborative and involve a transparent and understandable process. The assessment process is intended to be flexible, and can be adapted to ensure that the individual or their carer is involved as much as they wish to be and as is practicable.
All appropriate assessments are collaborative and should allow the adult with care and support needs or their carer to be able to:
- understand the assessment process
- understand the implications of the process for their condition and situation
- understand their own needs, outcomes and impact on their wellbeing
- start to identify options available to them
- understand the basis on which decision are reached.
If the individual or their carer has difficulty with any of the above, appropriate assistance should be provided.
In advance of the assessment, it may be helpful to give the individual or carer a list of questions to be covered: this helps them to prepare and to think about their needs and the outcomes they want to achieve in their day-to-day lives.
The timeframe over which to carry out the assessment should be appropriate and reasonable, taking into account the extent of urgent needs as well as whether and how needs might fluctuate. Local authorities should provide the individual with an indicative timescale for the assessment, and continue to keep the individual informed throughout.
Proportionality means that the assessment is only as intrusive as it needs to be to establish an accurate picture of the needs of the individual or their carer, regardless of whatever method of assessment is used – i.e. supported self-assessment, face-to-face assessment or other. This will involve:
- both hearing and understanding the initial presenting problem
- not taking this at ‘face value’
- ensuring any underlying needs are also explored and understood.
Needs may well differ in their breadth and depth, meaning:
- additional exploration of underlying needs may be required
- an individual or their carer may have needs which require more consideration only within some aspects of their lives
- individuals with a clear understanding of those needs and/or the care and support system may require less intensive assessment than someone who has recently developed needs and has less clarity about their needs and the care and support system.
The aim of carrying out assessment proportionately is to ensure that assessment is not overly burdensome and recognises the individual’s and their carer’s own knowledge and capacity.
Proportionate assessment and integration
Care Act guidance states that the care and support responsibilities of local authorities must promote greater integration with the NHS and other services (e.g. housing, the voluntary sector, adult mental health professionals, relevant professionals in the criminal justice system). Local authorities and their partners must focus on joining up around an individual, to avoid multiple assessments taking place at different times, which could be disproportionate.
An effective integrated assessment could mean:
- carrying out an assessment jointly with another body if the adult with care and support needs or their carer agrees
- the local authority carrying out an assessment on behalf of another body where this has been agreed
- local authorities and the NHS working together in a high quality, coordinated assessment.
See Chapter 15 of the Guidance for more information.