In this example reflective log, I will focus on the social work
PCF domain 4: RIGHTS, JUSTICE & ECONOMIC WELL-BEING
Task: Carers Assessment
Reflective Log | Carers Assessment
I carried out a carers assessment with X who cares for her daughter Y.
X has a caring role for her daughter Y who has a mild learning disability. Y is 26 years old and was born with a chromosome 18 deletion, which affected on her cognitive development and function. She experiences black outs occasionally and has a reveal device (cardiac) fitted which it is hoped may explain the black outs.
Y experienced sexual abuse by a male known to her brother several years ago and subsequently gave evidence in court. The whole traumatic experience affected on Y’s behaviour. She struggles to control her aggression and has hit out at her grandmother, her parents and her brother.
X manages Y’s finances and helps cook her meals, pick and drop her off at activities. X is gradually finding it difficult to care for her daughter and is finding it even more difficult to cope with her daughter’s frequent unpredictable behaviour following recent incidents involving the police.
X continues to struggle to find the time to take care of her own needs. She also cannot maintain her relationship with friends and families. X would like to have some respite in order to have some ‘me time’.
I turned up on time for our meeting. Upon arrival, X arranged for us to sit at a local café where the assessment took place. She was alone and seemed delighted to see me.
I explained to X that I would use any information discussed for agency purposes only on a strict need to know basis unless there was a need to share the information with other agencies. I clarified that the meeting was all about her and how we could support her in her caring role. I asked X to tell me how her day had been so far, and I felt that this served as an icebreaker.
I showed respect, empathy and authenticity by putting X at the centre of the meeting and encouraged her to express her views. I allowed X to express her views, and she was not restricted in terms of flow and communication. I felt relaxed and had control over the assessment process. I was also confident in asking the relevant questions. I felt I was in control because I had familiarised myself with her circumstances by speaking to other colleagues, aware of her situation.
When X was talking about her caring role for Y, she was teary. I offered her a tissue. I felt that she was emotionally drained not just because of her caring role for her daughter Y but also because she had a major part to play in caring for her elderly mum who lives a few miles away. In addition, she was worried about her son who had recently lost his job and gone through a divorce.
I made note of her needs, wishes and views on her current situation. Where views were not very clear, I clarified them with her. I also summarised and paraphrased her statements to show active listening skills.
I felt that I empowered and enabled X to express her views, wishes and wants through the discussion. X was encouraged to contribute, knowing that her needs and wants will be respected, acknowledged and adhered to. However, I felt that X may have misunderstood my role and assumed that I was there to fix most of the issues in her life, including those in relation to her son and elderly mother.
In future assessments, I will check that my role is clearly understood prior to the start of an assessment.
I also felt that it was important for the needs of X to be attended to as soon as possible to prevent them from escalating and reaching crisis point.
I recognised X’s rights, enabled and supported her to consider and pursue a range of options that could enhance her economic well-being. I analysed her differing needs and perspectives in relation to her caring role. During the meeting, I felt that I promoted social inclusion by trying to identify how we could help support X to engage with her social network fully.
What was not so good about the experience was the fact that sometimes, I felt that X was directing the conversation towards her elderly mother and son. I allowed her to talk about them for some time but tried to draw her back to the discussion relating to her caring role for Y.
I wrote up the assessment in a format that reflected X’s own words, needs and wishes. I practiced in an anti- discriminatory and anti-oppressive manner, focusing on strengths and positives with no misleading statements, ensuring that values and ethics of positive social work practice are upheld.
I believe the assessment tools we use within the team are designed to capture the needs of individuals and makes it easier to assess needs. It is user-friendly, and I feel that it covers all the relevant areas that can aid in identifying the needs of service users.
I thought the meeting was rushed as I was conscious of the fact that X was on her lunch break and I had limited time. In future assessments, I will arrange a more convenient time when there will be enough time available for the discussion.
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Theories and methods
Section 10 of the Care Act 2014 places a duty on local authorities to carry out assessments on carers who may appear to have needs for support regardless of the carer’s financial resources. Where the carer has needs for support, S10 (b) places a duty on local authorities to find out what those needs are and how they can be met. The local authority must also determine whether any of those needs meet the eligibility criteria under S (13).
Social workers are expected to complete person-centered, holistic assessments of eligible needs. Assessments are an integral part of practice as they provide the foundation for ongoing services and support a service user may require.
I assessed X to have needs for support as she is the primary carer for her daughter Y, who has a learning disability. Her caring role is affecting on her health and well–being as she cannot find time to attend to her own needs. Besides, her caring role is also affecting on her social life as she cannot find the chance to attend social events.
The Care Act 2014 promotes the well-being of individuals and encourages preventative measures which can range from wide-scale whole-population measures designed to promote health, to more targeted, individual interventions designed to improve skills or functioning for an individual lessening the impact of caring on a carer’s health and well being. X has expressed the need to have some respite to attend to her own needs. As a social worker, I will explore how this option can help support the needs of X to prevent her situation from reaching crisis point.
The Idea of assessment being the initial stage of an ongoing process is one that has been challenged. It can be argued that assessment in itself is the service, as it does not necessarily lead to intervention. Needs can be met through signposting and accessing community resources. While we sometimes see assessment as preceding intervention, increasingly assessment is being seen as a service in its own right (SCIE, 2003)
We use social work theory at every stage of the assessment process and gives us a basis for ethical and evidence-based practice. In my assessment with X, more than one method or theory was used, and this resulted in an interlocking of theoretical approaches. A contemporary approach within this is eclecticism–where concepts are adopted from various theories, and an amalgam is formed, which is used as a basis for practice. I was aware of the importance of establishing a trusting relationship to enable X to feel empowered and feel comfortable when discussing her needs and wants.
Relationship-based practice allows trust to be established between a service user and practitioner. This, in turn, empowers the service user to feel comfortable enough to discuss and reflect on their individual needs. The relationship must be honest while maintaining professional standards and boundaries.
Empowerment theory recognises the need to enable service users to have choice and control over their own lives. Zimmerman’s concept of empowerment suggests that there are three factors promoting change; Individual empowerment, organisational empowerment and collective empowerment.
All three factors are connected and work alongside each other. Getting X to take part fully was imperative when using the empowerment model. This was done by ensuring that X was at the heart of the entire process. I communicated appropriately and actively listened to her views and wishes. As part of the empowerment theory, I respected and upheld X’s human rights. However, X has a limited Article 8 right which may be breached for protecting health or morals, or for protecting the rights and freedoms of others.
Systems Theory also explains human behaviour as the intersection of the influences of multiple interrelated systems. Family systems are inherently involved in X’s issues, and I considered this when attempting to understand and assist X. Her well-being is deteriorating not only because of her caring role for Y but also because of her son losing his job and her mother’s deteriorating health conditions. However, once we can support her, manage the demands of caring for Y; it might give her more time to attend to other family issues.
Smale (1993) identified three models of assessment as the questioning model, procedural model, and exchange model. I felt that the assessment mirrored the exchange model, which assumed that X was the expert of her own problems. However, the questioning and procedural models are characteristic of ‘process-focused’ approaches.
It assumes that expertise in determining the nature and solution of problems is held not by the service user but primarily by the social worker (questioning model) or managers and policy-makers (procedural model). As both approaches cannot address the issues of service user empowerment and involvement, I did not use them in my assessment with X.