Care Act training: needs, outcomes and care and support
This theme explores the difference between needs, outcomes and care and support, the different types and the relationship between them, in the individual’s journey in compliance with the Care Act.
What are needs under the Care Act?
What are outcomes under the Care Act?
Care and support under the Care Act
- Referral, screening – presenting needs.
- Assessment – assessed needs.
- Determination of eligibility – to ascertain which assessed needs are eligible needs.
- Needs are different from outcomes/wishes/aspirations. The social care practitioner must ascertain whether the needs from the individual point of view are needs or outcomes from the legal/professional point of view.
- The legal duty is to meet eligible needs having regard to personal outcomes.
There are different types of outcomes.
Outcome of the intervention or process:
- The outcome of an assessment of needs is an appropriate and proportionate understanding of the individuals’ circumstances.
Personal (or desired) outcomes:
- Defined by the adult/carer and relate to ‘what does good look like for them?’ and are part of the assessment of needs or carer assessment around the nine areas of wellbeing. (i.e. To develop/maintain family and other personal relationships.)
- If I do not see my friends regularly, I feel that I do not have control over my own decision, I do not feel that I am able to contribute towards my personal relationships and it makes me feel sad.
Eligibility (or specified) outcomes:
- Eligibility or specified outcomes are defined by the eligibility regulations and must be used only when determining eligibility.
- Outcome of the intervention or process:
Social care practitioners need to explore the elements of the personal outcome not just the overall or the phrasing used when is phrased as a service or activity.
- I want to meet my friends in the pub each week - consider: is it the pub visit or the friends that are important to the individual. If it is friends, then the ‘pub’ element does not belong in the outcome phrasing.
Services and activities support achieving the personal outcomes, but they are not outcomes themselves.
- I want to meet my friends in the pub each week - going to the pub is a service or activity that supports achieving the outcome of meeting my friends.
Care and support
- Providing care and support is wider than providing services.
- Care and support can start from the individual and comprise an extensive number of options to explore in a collaborative way how best to meet the needs deemed as eligible. This is in line with strengths-based practice.
Services can support achieving the personal outcomes, but they are not outcomes themselves.
Find below a set of reflective questions that will help you embed the above key messages in your social care practice.
- Have you identified all the existing needs around the nine areas of wellbeing in the assessment of needs/carer assessment?
- Is it clear in your assessment what is the adult/carer view and what is your view? What is evidence and what is assumption?
- Is it clear in your assessment of needs/carer assessment what the adult/carer personal outcomes are in relation to the nine areas of wellbeing?
- Are the outcomes clear or do they have services, activities or methods of achieving the final result included?
- Do I need to explore with the individual the elements of their identified outcome to ensure that we fully understand what it is they are trying to achieve?
- Have you clearly determined which assessed needs are eligible needs and which ones are not? Do you have the evidence to support the professional opinion?
- Have you explored ALL options for provision of care and support to meet eligible needs?