Community Care Assessment
An assessment of needs may be made on the application of the carers, the person concerned, or may be undertaken by the trust where a person in need of care has come to its attention. Under the Children Order as amended in 2002, trusts are under a duty to assess the care and support needs of persons needing care until they are 21.
The Trust will determine the level of assessment required. It will have regard to the particular circumstances and need. After an initial screening process, they will determine how comprehensive the procedures ought to be. There is guidance.
A comprehensive assessment should include physical, mental, and social functioning. This should include physical and mental health; capacity to undertake the activities of daily life; contribution of informal carers; social network and support; housing; finance; and environmental factors.
Other agencies and professions involved in a person’s care should be brought into the procedure. This may include doctors, social workers, family members, occupational therapists, community psychiatric nursing staff, social security officials, home care assistants, and voluntary workers.
The Department has a single tool for assessing the health and social care needs of older persons that seeks to standardize and streamline assessment and care planning processes, so as to simplify access to community care services. It is designed to be a holistic, person-centered assessment.
Upon completion of the assessment, the person and their carer are informed of the result and given the name of a contact for further discussion. They are not obliged to provide written copies of the assessment but are recommended to do so when assessed on request. This is effectively required under data protection legislation.
In the context of housing, both the Housing Executive and trusts have duties in relation to assessment. The Housing Executive has duties to those who are found to be homeless. A person may be homeless if it is not reasonable for them to continue to occupy their current accommodation.
A person who is homeless, other than intentionally and in priority need, must be provided with secure accommodation generally after some time in temporary housing. Reasonable offers of housing must be made but they need not be in the person’s area of choice.
The Housing Executive does not have obligations to adapt homes to meet the needs of their tenant. It has operated a disabled facilities grant scheme which is open to tenants, landlords, and owner-occupiers. The Executive carries out assessments of need following recommendations from the trust and may provide assistance under the grant aid scheme for that purpose.
In practice, the Housing Executive may carry out adaptations to its own homes, as recommended by the trust without a formal recommendation.
Registered housing associations may adapt their properties so they can access the departmental funding on the basis of social services recommendations.
There is a duty to meet the needs of children for accommodation under the children’s legislation. This may require an assessment to be carried out. There is a duty on the trust to assist in arranging adaptations of homes or facilities designed to secure greater comfort, safety, and convenience where either is necessary to a person’s housing needs. This forms a basis of community, occupational therapy assessments.
The Housing Executive may assess needs and carry out adaptations notwithstanding that the statutory duty is with the trust.
Resources may be relevant as to the ability of the trust to allocate or provide particular services. This may be a legitimate consideration. Services should not be generally withdrawn arbitrarily. A reassessment of needs will generally be required.
Other legislation has been interpreted by the superior courts in the United Kingdom to the effect that the lack of resources is not relevant.
Once a person’s needs have been assessed, the trust must determine whether they will be met by the provision of a service. In some cases, there is a duty to provide services and in other cases, a power. If there is a duty, the trust cannot refuse to meet an assessed need on grounds of a lack of resources. In the case of power, it must exercise its discretion properly. The policies must be fair, reasonable, and non-discriminatory.
When the legislation creates a mandatory duty, it must be performed within a reasonable time. Where a person has been on a waiting list for a prolonged period, they may be able to challenge the failure to take action, particularly, where the risks and needs are accused.
Once a comprehensive assessment has been completed and a decision taken about the care that should be arranged, the trust is obliged to design appropriate carer arrangements. This may be done in consultation with carers and care professionals.
The needs and wishes of the person and their carers are the starting point, and the trust should aim to provide and arrange services that meet those particular needs.
A care manager is responsible for designing and assembling a package of services tailored to the person’s need. They should be managed and monitored over time.