On initial referral and screening

You have been asked to undertake an initial screening to determine whether a full assessment should proceed. You will make a recommendation on this to your manager.

  • You may only consult one family member at this stage.
  • You may only consult two other professionals at this point.
  • You may only consult two data sources now.

Consult one family member:

I am having to ask Sophie and Celeste to do too much for me. I am worried about my parents too, because they have relied on me in the past. Can you get me some help?

My children are fine. It is just me who needs help. You will not have to speak to anyone other than me, will you?

I would prefer that you did not speak to the children or to their school. And my parents do virtually nothing for me now – they have problems of their own. You can speak to my doctor if you wish.

Have you asked Evelyn for permission to speak to the children? Her consent is ordinarily necessary as she has parental responsibility.

Have you asked Evelyn for permission to speak to Richard or Betsy? Evelyn has a right to privacy, and you do not yet know whether they have a carer role that would entitle them to information.

Has Evelyn given you permission to talk to me?

Evelyn’s condition was finally diagnosed six months ago but she has been ill for longer. Her prognosis is poor. She has lost much physical mobility and this will continue to deteriorate although at what rate is difficult to predict. At the moment she is in a plateau phase but this will not last forever. The impact on Evelyn has been quite devastating. She has consulted me about depression, refusing medication but agreeing to see a psychologist who provides counselling at the health centre. I rarely see her children.

I have visited the home on several occasions because Sophie has been missing school or arriving late. Things improve for a while and then slide back. She has too many responsibilities for a child her age.

Sophie and Celeste used to come to youth club regularly. Now Sophie, when she does come, seems tired and preoccupied. Celeste has practically stopped coming after several fights with other young people, quite out of character for her.

Sophie has begun missing school or arriving late and tired. Her work is suffering and she seems preoccupied with things that are happening at home. Celeste has recently begun to act up in class, sometimes bullying other children. The standard of her work has fallen.

Evelyn feels devastated by her own diagnosis and by her parents’ failing health. She feels caught up in a no-win situation in relation to the children – she has to rely on them to do things she feels she should be doing herself, and feels they are missing out on things as a result. At times she seems to despair.

I have provided some minor aids and adaptations to enable Evelyn to continue with practical and care tasks at home.

I have no information about this family. There is a long waiting list for a Disabled Facilities Grant.

No information contained on the register.

Records that Evelyn has previously expressed concern about her parents; notes that the Education Welfare Service has visited the home and that both schools involved have asked whether social workers are involved because of concerns about the children.

In the time available, you discover a reference to the Disabled Parents Network, but you have yet to follow this up. www.disabledparentsnetwork.org.uk

In the time available, you recall that young carers may be children in need under the Children Act 1989, but you have yet to follow this up.

You recall from your training how care-giving can impact on relationships within families, and the importance of recognition and support for carers. www.carersuk.org

In the time available you identify a local MS group.

In the time available your research finds references only to national organisations. You have no other details at this stage. www.shapingourlives.org.uk

These advise you of the discretionary duty to assess Evelyn under section 47, NHS and Community Care Act 1990 and of the assessment duties in respect of young people in need or requiring protection under the Children Act 1989. The procedures do not clarify whether community care services would cover support to Evelyn as a parent.

Think of any Acts of Parliament that you judge relevant at this stage of the case.

Think about which guidance documents would be relevant at this stage of the case.

At this stage of the case, with the information you have, the following 9 Acts are relevant. How many did you identify correctly?

  1. NHS and Community Care Act 1990 - section 47 discretionary duty to assess where there appears to be a need for community care services.
  2. Disabled Persons Act 1986 - section 4 absolute duty to assess a disabled person.
  3. Children Act 1989 - section 17 and schedule 2 powers and duties towards children in need.
  4. National Assistance Act 1948 - section 29 definition of disability relevant to the decision about use of the 1986 Act.
  5. Human Rights Act 1998 - duty to positively promote people’s rights.
  6. Data Protection Act 1998 - what information can be shared between agencies in what circumstances.
  7. Carers (Recognition and Services) Act 1995 - assessment duty towards carers (including children of any age) providing regular and substantial amounts of care.
  8. Carers and Disabled Children Act 2000 - assessment duty towards carers whether or not the cared-for person is being assessed.
  9. Disability Discrimination Act 2005 - a duty to counteract discrimination and promote equal opportunities.

The following 5 pieces of guidance are relevant at this stage of the case.

  1. Care Management and Assessment: Practitioners Guide, 1991
  2. Community Care in the Next Decade and Beyond: Policy Guidance, 1990
  3. The Community Care Assessment Directions 2004
  4. Carers and Disabled Children Act 2000 and Carers (Equal Opportunities) Act 2004: Combined Policy Guidance, 2005
  5. Fair Access to Care Services 2002

Make your decision:

The correct decision is to assess. Evelyn is a disabled person who has referred herself. There is an absolute duty to do an assessment, derived from section 4, Disabled Persons Act 1986. It is unclear at the moment to what degree Evelyn is providing care to her parents, but she may qualify for a carers assessment in that capacity. Depending on who you consulted, you may have information relating to the degree to which Sophie and Celeste might be children in need. Fair Access to Care Services will inform the assessment of Evelyn. The Framework of Assessment of Children in Need and their Families will inform any assessment of Sophie and Celeste.

You may wish to reflect on whether all the information you gained came to you with Evelyn’s permission, or whether those involved broke any data protection principles in divulging information to you without Evelyn’s consent.

It is also important to note that the s4, Disabled Persons Act duty to assess the needs of a disabled person may be omitted from agency policies and procedures, despite the strength of the mandate it provides for assessment on request.