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The importance of appropriate assessment

VOICES case study 4

I have supported a client for the past fifteen months who has lived in independent accommodation for around 20 years and has their own mortgage. My client has struggled to maintain their property since a family bereavement. Family members were responsible for all aspects of the property, as well as assisting my client greatly, to complete all activity of daily living tasks. This would include managing finances, cleaning, shopping and cooking. It became apparent that since the recent bereavement my client had accrued large sums of debt, and as a result, was in the process of having their home repossessed. There was also significant risk of exploitation due to vulnerabilities and a diagnosis of Autism.

The current living environment was extremely cluttered and unhygienic; the house was dirty and there was a strong odour throughout. My client also has a dog and acknowledges having difficulties maintaining their home unassisted.

My client is extremely vulnerable and there have been numerous occasions, where exploitation has occurred, resulting in abuse. For example, my client has had their mobile phone and other high value items taken by people that my client would perceive as being ‘friends’.

My client had a diagnosis of dyscalculia, which caused great difficulty where managing money is concerned, stating that they are able to manage money when this was led by another person, in the form of being told how much surplus cash is left to spend each week.

Originally referrals were made to the mental health service and the learning disability team for further support. It could not be decided which service would be best suited for my client’s needs. This process took nearly three months until it was decided that, the learning disability team would take responsibility of my clients support needs.

After a few weeks of the learning disabilities involvement with my clients supports needs it was felt that the support provided was not sufficient as the contact with the learning disability team was not regular. It was deemed that my client had capacity to make decisions and that their involvement would be very short and minimal.

I made a decision to have involvement from an occupation therapist to carry out an assessment to identify my clients support needs, made possible through my client’s personal budget, that could be shared with my client’s allocated worker in the learning disability team. Some of these recommendations were:


–       Is housed in alternate accomodation that meets their cognitive needs and addresses their level of ability to complete activity of daily living tasks. It is thought that a supportive accommodation environment would be sufficient to meet needs, as this would enable to focus on meeting basic occupations, such as self-care and productivity.


–       Receives support to manage finances.  May require an appointeeship, due to risk of vulnerability and history of exploitation in the past. Will benefit from a social care assessment of financial needs, which is completed using simple language to enable an effective assessment to take place. The use of visual aids would be beneficial to support the assessment process, as well as short simple sentences and long pauses to enable time to process information.


–       To consider the need for a Sensory Processing assessment, to determine any difficulties with Sensory Processing Ability.



After the assessment the learning disability team saw the need to evaluate the level of support required. I believe the assessment report spoke in a language that I was unable to portray. The assessment was a tool used to open an opportunity for services to work together in a productive way best suited for my client. The working relationship between all services involved have changed dramatically in the best interest of my client. Services are now in more regular contact and all have actions that need to be addressed. It has created a better working relationship between services with the learning disability team taking the leading role in the support plan. A robust action plan is now in place to support my client’s needs.

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