BASW England endorses NICE in calling for the recording of potential unmet need
Guideline NG216 NG216 Social work with adults experiencing complex needs on social work with adults experiencing complex needs was amended in January 2023 “to better align with the Care Act and clarify social worker and local authority responsibilities in relation to meeting eligible needs”. BASW England was instrumental in securing this recent amendment which is about addressing potential unmet need.
The guideline is described as covering “the planning, delivery and review of social work interventions for adults who have complex needs” and makes reference to the application of the Care Act in relation to needs assessment, risk assessment and care planning.
Recommendation 1.5.6 is that when social workers are writing or reviewing care plans, they should:
- take account of the person's wishes and preferences
- state how the person's eligible and non-eligible needs would be best met
- identify how arrangements will be made to meet eligible needs
- record any eligible needs which are unlikely to be met or only partially met, the reasons they cannot be met or only partially met and any potential actions that would allow them to be met in future.”
In planning how to meet eligible needs it is noted “that social workers may not always be able successfully to address the whole range of identified, eligible needs at the point when the care plan is written or reviewed”, and where this is the case social workers “should note when a need has not yet been met or is only partially met to make it explicit that the need has to be addressed to meet the local authority’s legal obligation”.
BASW England has developed guidance that complements this recommendation. An Ethical Approach to Meeting Needs in Adult Social shows how the BASW Code of Ethics can help social workers with decisions about resource allocation. The focus of the BASW guidance is to address a concern expressed by the Ombudsman that social workers “are sometimes at risk of having professional judgement overshadowed by the pressure to meet financially driven targets”. One of its aims is to provide support for social workers “to assert their professional judgement where there are concerns that financial pressures are leading to unjust decisions, and the needs of people who require care and support being unmet and under-met”.
The NICE guideline makes a number of other useful recommendations, much of them derived from qualitative evidence supported by the “experiential knowledge” of the committee of experts that advised on this guideline.
It is recommended that social workers “should inform the person being assessed about where and how they can access information about their rights under relevant legislation” (1.2.3). The rationale for this is that there is “evidence showing that people did not always understand the purpose of the needs assessment and what it would involve” and “that better understanding and knowledge (including of statutory rights) about social work assessments, both in terms of what is involved and the likely outcome, would reduce anxiety and stress for the person with complex needs”. The social worker’s role is “signposting to relevant resources”.
In the section on planning the assessment there is a recommendation that social workers “should consider arranging a preparatory initial contact before the assessment itself if it will help the person with complex needs to participate fully in their assessment”.
Recommendation 1.2.6 states: “Social workers should assess risks as part of a holistic process of assessing the person's strengths, needs and wishes.” 1.2.22 specifies that this should “take into account beneficial and harmful outcomes, and their likelihood of occurring. It is also recommended that there should be a “coordinated risk management plan” in “complex risk management situations involving potential risks of serious harm” (1.2.35), and there are subsequent recommendations about how this should work.