Health and Social Care

418HSC – Working in Health and

Social Care
 Today’s
Learning
Intentions
• Define needs and expectations.
• Understand how to get support and
social services in England
Needs
• What are needs? How do we
understand human needs?
• Please read ‘Maslow’s Hierarchy Of
Needs’ on AULA page and
summarise the key points of your
interest.
• Discuss with your classmates about
your understanding of the theory.
• Interpret what it means to social
care as well as how it can be
related to person-centred care
delivery
Maslow’s Hierarchy Of Needs (Mcleod, 2024)
Patient Expectations in
Social Care Practice

the need to be listened to

the need to receive clear explanations

and instructions about their condition

to be treated by staff who show

care/concern/compassion and

to be treated by staff who are

professional in their work
Health

• Medical Model
• Social Model
• Holistic Model

Health and Social Care Needs may include:

• Felt needs – individuals are conscious of their needs.
• Expressed needs – when needs become demands.
• Normative Needs – defined according to professional
norms and standards.
• Comparative needs – in relation to eligibility criteria.
Health and Social Care Needs

• 1. Felt Needs
• Example: Jane, a 45-year-old woman, feels increasingly isolated and lonely after her
children moved out for college. She is consciously aware of her need for social
interaction and companionship. She desires to join community groups or social clubs to
alleviate her loneliness.
• 2. Expressed Needs
• Example: Tom, a 60-year-old man with chronic back pain, feels the need for pain relief
(felt need) and expresses this by visiting his doctor and asking for medication or
physical therapy. His felt need has turned into an expressed need, as he is actively
seeking help.
Health and Social Care Needs

• 3. Normative Needs
• Example: According to professional standards, all children under the age of 5 should receive regular
vaccinations to prevent diseases. This is a normative need defined by health professionals and public
health guidelines. Even if some parents are not aware of the importance of vaccinations, health
professionals identify this need based on established norms and standards.
• 4. Comparative Needs
• Example: Two communities are compared to identify needs. In Community A, every household has
access to clean drinking water. In Community B, some households lack access to clean drinking water. By
comparing the two communities, it is identified that the residents of Community B have a comparative
need for improved water supply systems to ensure all households have access to clean drinking water.
Activity:
Brainstorming
Can you think of more
examples of the above
needs?
 wanting to discuss several major problems,
all in one standard consultation

Examples of prescription to be given without a

unrealistic consultation

expectations of
patients would ability to call the physician 24 h a day for
include: any problems and

thinking that the physician will always know

the exact diagnosis at first consultation and
start treatment immediately
 that they should not allow patients to
manipulate them with unreasonable
To manage demands
unrealistic
expectations and
unreasonable they have to take a step back and
assess why certain requests are put
requests from forth. This exploration can also enhance
patients, health communication skills
and social care
professionals
they need to explain clearly in simple
would know: terms, avoiding medical jargon, why
certain treatment and management is
necessary
 Physicians’ logic may not be obvious to patients
and our decision making can be complex, thus,
Managing the need for explanation

unrealistic
expectations, they need to be clear as to why further tests and

unreasonable consults are needed

requests from
patients, health that a patient's request for a second opinion from
another physician is acceptable and,
and social care
professionals
would know: that as a last resort, the patient can be referred to
another physician for care, if both parties cannot
come to an agreement and see eye to eye.
Getting help and
support in
England
What is social care and support?
• They're services to help you if you:
• need practical support because of
illness or disability
• care for someone receiving social
care and support
• Social care and support is usually paid
for by:
• people who need services and
their families
• by the local council's social
services department
(NHS, 2021)
Getting help and support
in England
Types of social care and support include:

• help at home from a paid carer

• meals on wheels
• having home adaptations
• household gadgets and equipment
• personal alarms and home security systems
so you can call for help (for instance, if you
have a fall)
• different types of housing, such as supported
living services and care homes
(NHS, 2021)
Getting help and support in England

If people want the

People can arrange council to arrange or
care and support pay towards the care,
privately themselves. the following steps will
take place:
 Getting help and support in England

Needs Assessment

Care Plan

Financing
 • A needs assessment is for adults (18 years and over) who may
need help because of a disability, ill health or old age. It must
look at a person’s physical, mental and emotional needs, with
a clear duty on the local council to consider the following:
• the person’s needs and the impact they have on their
care
• the things that matter to the person, for instance, a need
to help with getting dressed or support to get to work
Needs Assessment • the person’s choices and goals, for example if they wish
to take up a new activity or maintain relationships, and
preferences for their day-to-day care
• the types of services, information, advice, facilities and
resources which will prevent or delay further needs from
developing, helping the person stay well for longer (for
example, the local council may offer the person a period
of reablement to reduce needs and regain skills, before
completing the assessment)
• the needs of the family of the person being assessed
 Needs Assessment

A needs assessment could be the first

A needs assessment isn’t a test that
step towards getting help and support
someone can pass or fail. It’s a chance
with daily life. It’s provided free by your
to talk to a trained professional about
local council or trust, and looks at what
getting support. The person being
help someone might need with their
assessed can talk about any difficulties
care and how they could get it. It can
they have in looking after themselves,
mean someone receives services or
and how that affects them.
direct payments to help them.
When should an adult
receive a needs
assessment?
• The duty for local councils to assess an
adult with care and support needs is
triggered by the appearance of need, and
must be carried out regardless of the level
of those needs or the person’s financial
resources. This is called a needs
assessment. Even if you as the carer are
providing all the care the person needs,
they are still entitled to a needs
assessment. As a carer, you are entitled
to be involved in the assessment if the
person you care for wishes.
(AgeUK, 2024)
Activity
• Read Care Act factsheets and
Assessment of needs under the Care Act 2014
• Discuss Local Councils’ Responsibilities related to the
filed of health and social care
 • The Care Act introduces national rules for
How will the local deciding who is eligible for care and
support.
council decide if • But it will still be for local councils to make
the adult is eligible the decision about whether or not the
needs of the person you care for meet the
for rules and so whether they have what the
law calls eligible needs.
their support? • Importantly, the fact that an adult’s needs
are currently being met by a carer is
irrelevant in deciding whether or not they
meet the eligibility criteria.
• There are three questions the local council
will have to consider in making their
decision:
Three questions the • Does the person have care and support
needs as a result of a physical or mental
local council will condition?

have to consider in • Due to care and support needs, is the

person unable to achieve or meet two or
making their more desired goals or outcomes?
• Is there, or is there likely to be, a
decision significant impact on the person’s
wellbeing?

• If the answer to all three questions is yes,

the person will have eligible needs for care
and support.
Does the person have care and
support needs as a result of a
physical or mental condition?

• This can include physical, mental,

sensory, learning or cognitive disabilities
or illnesses, substance misuse or brain
injury. There is no need for a formal
diagnosis.
Due to care and support needs, is
the person unable to meet two or
more desired goals or outcomes?

• The desired goals or outcomes are:

• eat properly and maintain proper nutrition
• maintain personal hygiene
• manage toilet needs
• dress appropriately
• able to use and move about the home safely
• maintain their home in a fit and proper state
• maintain and develop relationships with family and
friends
• take part in any education, training, work or
volunteering
• be able to participate in social activities, hobbies
and make use of public transport and local services
• look after any children they have responsibilities for
Continue

• In considering whether or not they can achieve the above outcomes, the
law states that the local council must take into account any difficulties they
have. They will be considered unable to achieve the outcome if they:
• need assistance to achieve the outcome
• can achieve the outcome unaided but experience significant pain,
distress or anxiety
• can achieve the outcome unaided but doing so endangers, or may
endanger, their health and safety or another person’s
• can achieve the outcome with assistance, but it takes significantly
longer than would normally be expected.
 Is there, or is
there likely to
be a significant
impact on the • ‘Wellbeing’ is defined in the Care Act. The definition is very
broad and includes things like personal dignity; control
person’s over your day-to-day life; participation in education, work
or social activities; relationships with other people; having
wellbeing? suitable accommodation; and protection from abuse and
neglect.
• There is clearly some overlap with the list of outcomes
above.
 • ‘Significant’ is not defined in law, and so should be given its everyday,
Is there, or is normal meaning. If you think the effect is noticeable or important,
this could count as significant. Although the Care Act does not define
there likely to what counts as a significant impact on wellbeing, it does list a
number of things that the local council must take into account when
considering the issue
be a significant
impact on the • the adult is best placed to judge their own wellbeing
• the adult’s views, wishes, feelings and beliefs
person’s • the importance of reducing existing needs, and preventing or
delaying the development of needs
wellbeing? • decisions should be based on the adult’s circumstances, not
assumptions about them
• the adult is able to participate as fully as possible in decision
making, balancing the needs of the carer and the person being
carer for
• the need to protect people from abuse and neglect, ie what to
do if you are worried that a vulnerable person is at risk of harm
or neglect
• any restrictions on a person’s rights or freedom should be kept
to the minimum possible.
Is there, or is there
likely to be a
significant impact • If the adult’s level of need changes
because of their condition (for example, if
on the person’s there are days when tasks can be
completed and days when they cannot),
wellbeing? the local council must take this into
consideration to gain a full picture of the
adult’s level of need
Care Plan
• The care and support plan must include:
• details of the needs identified in the
assessment
• which needs meet the eligibility criteria
• which needs the local council is going to meet,
and how
• the outcomes that the person you care for
wants to achieve
• the personal budget available (the amount of
money that the local council has worked out it
will cost to arrange the necessary care and
support for them)
• information about direct payments
• information and advice on what can be done
to reduce their needs,
• and to prevent or delay the development of
needs in the future.
Reading Activity
• Read the source from AgeUK at
https://www.ageuk.org.uk/information-advice/care/arra
nging-care/care-needs-assessment/care-plans/

• Understand are plans in health and social care

The local council will carry out the
financial assessment as follows:
• Step 1: They decide what support to provide and how much this will be.
• Step 2: They check if you have capital above a certain amount
• The upper capital limit means that if you have capital over this
amount, you will pay the full cost for any support you receive – for
2024/25, the figure is £23,250. The lower capital limit means that if
you have capital below this amount, it should be ignored – for
2024/25 the figure is £14,250.
• – If your capital is between the lower and the upper limits, £1 a week
for every £250 over the lower capital limit is taken into account as
income. For example, if you have capital of £4,000 above the lower
capital limit, £16 a week will be taken into account as income.
• – The value of the home you live in should not be taken into account
as capital – unless you move into residential care in which case the
value of the home you used to live in can sometimes be taken into
account as capital. There are certain exceptions so do seek further
advice.
 Financial Assessment
Continue
• Step 3: They work out how much income you
have coming in:
• – When deciding how much income you
have, only some income is taken into
account. Certain types of income are always
ignored, including: earnings; the mobility
component of Disability Living Allowance
(DLA) and the mobility component of
Personal Independence Payment (PIP).
• – They can treat disability-related benefits,
such as the care component of DLA, the daily
living component of PIP or Attendance
Allowance as income. However, if they do,
they should deduct any ‘disability-related
expenditure.’
Financial Assessment Continue
• Step 4: To ensure that you have enough money to live on, the local council has to leave
you with a protected amount:
• – For carers and for non-residential support for the person you care for, this amount
is called the Minimum Income Guarantee (MIG). MIG is equivalent to Income
Support or the Guarantee Credit element of Pension Credit (plus any relevant
premiums excluding the severe disability premium) plus a buffer of 25%. See this
gov.uk page for the rates.
• – For residential care for the person you care for, this amount is called the Personal
Expenses Allowance (PEA). PEA is normally a set amount, but it can be increased in
certain circumstances – for 2024/25, the PEA is £30.15 a week.
Financial Assessment
Continue
• Step 5: If you have income (including income from
capital) above your protected amount, this is the
amount you will have to pay (up to the actual cost
of the support)

• Note: Only the person receiving the support

can be charged. As a carer, you cannot be
charged for support provided to the person you
care for (replacement care for example), and
the person you care for cannot be charged for
support provided to you as a carer.
Activity 1
• Have an exploration on local social services through
https://www.gov.uk/apply-needs-assessment-social-
services

• Take notes on how to get needs assessment in the

local council where you are based in (e.g., Barking
and Dagenham).

• You may visit more resources online and on AULA to

fully understand the process.
Activity2: Role Play

--Getting Support Scenario

• Steps involved: need assessment, care
plan development, and financial
assessment.
• The roles involved: 1 client (individual
seeking care), 3 healthcare professionals
(social worker, care planner, and
financial assessor).
Instruction
•Each group will act out the process from the initial contact with the local council to the
development of a care plan and financial assessment.

•Please fully immerse yourselves in your roles, asking and answering questions as your
characters would. (I will pick up groups to showcase their plays… LoL)

•Suggest a timeline:
•10 minutes for the initial contact and need assessment
•20 minutes for developing the care plan
•10 minutes for the financial assessment
•10 minutes for a final meeting to discuss the care plan and financial implications

•Documentation: Each group should document your service providing procedure using
the provided assessment, care plan and financial assessment templates.
 • Group Reflection:
• Each group discusses and writes a summary of
role play, including key challenges and
outcomes. (I will ask you to share in class).

Activity: • Reflection Questions:

1. What did you find most challenging about

Role Play your role?

2. How did the process of assessment and
planning feel from your perspective?
3. What insights did you gain about the social
care process?
4. How can we make sure person-centred care
delivery in the process?
References
Mcleod, S. (2024). Maslow’s Hierarchy Of Needs.
https://www.simplypsychology.org/maslow.html

NHS. (2021). Introduction to care and support.

https://www.nhs.uk/conditions/social-care-and-support-
guide/introduction-to-care-and-support/

AgeUK. (2024). Care needs assessment.

https://www.ageuk.org.uk/information-advice/care/arra
nging-care/care-needs-assessment/