Getting it right:
Assessments for black and minority ethnic carers and service users

Activity: Effective communication part two

CareNap

The exercise that follows is based on the CareNap E Single Shared Assessment tool. This assessment tool, or a variation of it, has been adopted on a Scottish wide basis. Areas explored by the Single Shared Assessment include self care and toileting, health, nutrition, mobility, mental health, social or community living and housing.

Introduction

We have already noted the importance of the assessment in identifying need as the first step in providing services. Assessments function as the gateway to a range of services provided by the local authority and, in many cases, they are an individual’s first experience of the social care system. It is vitally important to get the assessment right; how they experience the assessment can and will set the tone for how they feel they will be treated, more generally, in the social care and health system.

Prior to the introduction of the Single Shared Assessment, it was not unusual for statutory agencies to conduct their own assessment. Situations have arisen where individuals and families have been subjected to multiple assessments. Very often the information sought by the various agencies would replicate each other and impose additional stresses on the individual and their family.

The Single Shared Assessment sought to overcome this by capturing much more comprehensive information which could be shared by social work, health and housing providers.

Question 1 of 2

You have arranged to meet at the home of Mr and Mrs Choy with the community worker to carry out the assessment. Please select three areas of need for the assessment which you feel are most relevant. The next part of this activity will ask you to identify what cultural and other factors you will need to consider in relation to each need, and how these can be addressed.

Areas of need (choose three)

    • Is language support required?
    • Is the gender of the assessor important?
    • Has the referral come from a black voluntary sector orgisation/community support group which can support the individual or act as an advocate if required?
    • Have the ethnicity, religion and language support needs of the individual/main carer/next of kin/keyholder been recorded?
    • Does the care provided rotate between different members of the family (ie care may be provided in blocks of time at different locations throughout the year?)
    • Does the family intend to visit relatives outside the country for an extended period of time?
    • There may be difficulties in articulating need and identifying what support is wanted due to unfamiliarity/lack of knowledge about what services and supports are available
    • Are different aspects of care, eg personal care, provided by different members of the family due to gender restrictions?
    • If the need for support/specialist assessment has been identified, is the gender of the worker/assessor important?
    • Concerns about health may be expressed differently
    • Difficult to assess level of sensory impairment without specialist input, eg translinguistic assessment of speech impairment following stroke
    • Are there any specific needs relating to skin care?
    • Drug/medication regimes may be supplemented by alternative and traditional therapies/remedies
    • Religious observance, eg fasting, may affect any medication regime
    • The consumption of alcohol and tobacco products may be prohibited by certain faiths which may lead to non-disclosure
    • Are there any particular dietary requirements, eg halal food or cultural/religious traditions which dictate how food must be prepared?
    • Adequate food consumption may be affected by proximity of appropriate food outlets
    • Shopping opportunities may be limited as most retailers do not stock culturally appropriate foodstuffs, eg halal or kosher meats
    • Are there periods of fasting that must be observed by the individual?
    • If the need for support/specialist assessment has been identified, is the gender of the worker/assessor important?
    • Are there particular requirements for washing/bathing, eg use of running water?
    • Are there any specific needs relating to hair care?
    • Are there any religious or cultural traditions which influence the extent of physical contact permitted?
    • Concerns about mental health may be expressed differently
    • Cultural expectations may differ from the majority communities, eg the dream of ‘returning home’; the ‘extended family’
    • Overcompensation can result in adverse stereotypes
    • Patterns of interaction/communication may differ among communities
    • Three-way communication between the individual, interpreter/advocate and assessor may limit interaction
    • Patterns of socialising may be different, eg centred around places of worship/religious events
    • Gender requirements, eg the need for single-sex provision, may prevent participation
    • Opportunities for participation in wider community activities may be constrained by language and communication difficulties, lack of appropriate activities and the area, eg fear of racism
    • Roles within the household may be strictly defined
    • Safety and security may be affected by perceived or experienced threats of racism
    • Living patterns may differ, eg greater extent of multi-generational households
    • Housing/living conditions may be influenced by the impact of racism and descrimination, eg poorer access to housing market and public sector housing stock, poverty and unemployment
    • The installation of aids and adaptations may be influenced by requirements for religious observance, eg washing in running water
    • Lower levels of awareness of benefits entitlements will affect uptake
    • Access to benefits and pensions may be reduced due to higher levels of unemployment/patterns/nature of employment
    • Full recourse to public funds may be limited due to immigration status
    • Greater reliance on wage earners within household may affect the autonomy of individual
    • Carer’s entitlement to benefits may be affected by any sharing of care between family households
    • How will the individual be informed of the outcome of the assessment?

Tip

By clicking on the ‘further info’ icon opposite each area of need you can view a number of cultural and structural thinking points that you may want to consider.

Question 2 of 2

Now identify what cultural and other factors you will need to consider for each of your selected areas of need, and what action you, as the assessor, can take to address them.

1.

2.

3.

Answer

Suggested action points for your selected areas of need include:

Conclusion

Assessments function as the gateway to a range of services provided by the local authority and, in many cases, they are an individual’s first experience of the social care system. It is vitally important to get the assessment right; how they experience the assessment can and will set the tone for how they feel they will be treated, more generally, in the social care and health system.

In order to avoid situations where individuals and families could be subjected to multiple assessments by different statutory agencies, the Single Shared Assessment sought to capture a much more comprehensive set of information which could be shared by social work, health and housing providers. The assessment matrix (included in the supplementary written material for this section), or a variation of it, has been adopted on a Scotland-wide basis.