Personalising assessment and support planning in adult social care

The process through which the social care system identifies the needs of individuals and plans their support is central to the system’s effectiveness in terms both of outcomes for individuals and making the best of public resources. Despite political and professional leaders having long been persuaded that the process must be rooted in the uniqueness of individual need, it has not become the norm. This thesis addresses the reasons why it has proved so difficult, and the learning to inform a strategy for it become the norm.

The thesis arises from a personal learning journey spanning 25 years. Evidence accumulated through action research, quantitative and qualitative methods along with case studies shows that the narrative that places responsibility on the failure on practitioners is not correct. Their practices are those required by a system, politically mandated and managerially delivered, rooted in the paradigm used to reconcile needs and resources. Neither do funding levels account for the failure.

If practitioners are to deliver support plans that respond to the uniqueness of individual need a new, rights-based paradigm to address the reconciliation of needs and resources will be required. It would replicate the political-professional dynamic upon which the NHS was founded whereby professionals are responsible for identifying need and the political system’s responsibility to provide the resources thus identified and made transparent.