When carrying out an assessment, a local authority must consider whether the nature of the person’s needs calls for the involvement of a person who has specialist skills, knowledge or expertise (3(2)). If the local authority decides that such involvement is called for, it must either consult with a person who it considers will be able to provide those skills or that knowledge or expertise or arrange for the assessment to be carried out by a person with the required specialist skills, knowledge or expertise (3(3)). The Deafblind duties included in the Code of Practice on Assessment note: When an assessment of the needs of a deafblind person is required or requested, it must be carried out by a specifically trained person/team, equipped to assess the needs of a deafblind person (Code 3, 31). This means that local authorities must always arrange for the assessment of a deafblind person to be carried out by a person with the required specialist skills, knowledge or expertise. The Code also notes: Where a specialist assessment has been carried out, the presumption is in favour of the expert opinion in cases where the expert and generalist practitioner do not agree (Code 3, 30). This means that, in the case of conflicting observations, the opinions and recommendations of the specialist assessor carrying out the assessment of a deafblind person will carry greater weight than supporting information from other generalist practitioners contributing to the process. What level of training is appropriate to ensure that an assessor has the required specialist skills, knowledge or expertise? The Code sets out what level of training is appropriate: The type and degree of specialism required for assessing a deafblind person should be judged on a case by case basis according to the extent of the person’s condition and their communication needs. Specialist assessors for deafblind people should be trained in deafblindness at a minimum of OCN or QCF level 3 or above where the person has higher or more complex needs (Code 3, 53). This means that, for instance, a deafblind awareness course would not give sufficient knowledge of deafblindness for assessing a deafblind person. Nor would a Level 3
and safeguarding processes with assistance from an appropriate individual, but there is no appropriate individual available (Code 10, 47). Barriers to participating in decisions about personal well-being outcomes, and how to meet these, will include issues and situations that may impact on a person’s ability to: Understand relevant information Retain information Use or weigh information Communicate their views, wishes or feelings (Code 10, 55) Some deafblind people will be in this position, for instance if they have a learning disability or dementia. They may also have limited knowledge because of their difficulty accessing information and so need additional support to understand their choices. In all these situations a person will require the support of an advocate who is able to appropriately support them. Not all advocates will be able to support those with communication difficulties. It is essential that the advocate employed has an appropriate understanding of communication and sensory loss otherwise they will be unable to fulfil the role of advocate. A deafblind person who faces a barrier to participating solely because of communication barriers and accessing information caused by their sensory needs will not require an advocate. A person who can engage with the process with appropriate communication support or accessible information should be provided with this. They will only require an advocate if they are unable to engage with the process even with such support. It is possible that a person may require both an interpreter and an advocate. Eligibility Once the assessment has been completed, the next step is to determine whether the person meets the eligibility criteria. This should also be carried out by a person with training and expertise in deafblindness to ensure that the impact of those needs on outcomes and well-being is fully understood. Children and young people with MSI, as disabled children and young people, will always be presumed to have eligible needs. Local authorities will always work from:
The assessment of needs – including the extent to which there are people in the area who need care and support and the extent to which there are people whose needs for care and support are not being met The range and level of services required to meet those needs, including in a preventative way The Code states: Section 1 of the population assessment report must include specific core themes dealing with: children and young people older people health / physical disabilities learning disability / autism mental health sensory impairment carers who need support violence against women, domestic abuse and sexual violence (Code 2, 123) Sensory impairment is recognised as priority area and local authorities must report on both the extent and the level of services available to people with sensory impairments, including dual- and Multi-Sensory Impairment. In order to do so, local authorities should consult their registers of people who have sight and hearing impairments which, in combination, have a significant effect on their day-to-day lives, as required by the Act (Section 18c). The Code does, however, warn that local authorities and Local Health Boards should not solely rely on registers in relation to disabled children, disabled people and those with sensory loss (Code 2, 100). Data held on registers may not always be accurate and up-to-date because they often rely on self-referral. To support the production of the Population Needs Assessment Report’s findings on sensory impairment local authorities should also consider: The estimate of prevalence of deafblindness among the general population. Research by Professor Emmerson will help local authorities estimate the . Collating information from initial assessment data. The national minimum core data required as part of the assessment includes: