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Understanding Conversational Assessment

Jim Thomas Programme Head Workforce Innovation Skills for Care

We all want to have lives that fulfil us; having an illness, disability or impairment does not alter that.

Because fulfilment means something different to everyone, the ways in which people are supported through assessment to manage their lives in ways that help them to achieve this are different. One of the keys to this in any care assessment is being flexible, and taking a lead from that person.

In everyday life conversation is the way we learn about people around us, and build rounded pictures of those we are close to. By using conversation as the way to understand people we find out all sorts of things that would be lost if we just followed a form. Conversational assessment provides a platform for people to talk about themselves, not only the parts of their lives where they need help, but their aspirations, the things they are good at, experiences they have had, the people they care about and what matters to them. It helps others to get a proper picture of who they are.  Listening to what people say to us helps us to see them within the context of their own lives, and tells them that we are interested in them, not just their needs.

Skilled conversational assessment draws all of these things out through conversations; workers are able to talk with the person, to find out what matters to them, what they would like to achieve, and the ways they would like to be supported. By talking to each other the person and the worker can build a picture of the skills and experience that can be drawn on, as well as any established networks that can become part of any support needed.

The relationship between the person who may have social care or health needs and the worker is critical. For people to speak honestly, and with confidence, they must feel secure, and trust each other.

In conversational assessment, the relationship between worker and the person is one of equals, in which both recognise the other’s contribution, and understand the constraints and concerns of the other person. Listening properly to the person, giving them the time they need and acting on what they say are all ways to show that they are valued.

Conversational assessment begins with a blank sheet, and follows a direction that is led by what is important to the person. This does not mean there is no structure or accountability, but it does mean that workers do not prejudge what will be the main concerns and priorities of the person they are working with, nor the ways in which they would like their needs to be met.

Conversational assessment is still structured assessment, that structure comes from the person’s priorities, the statutory responsibilities of the agency the worker represents, and any practical constraints placed upon the worker, such as the organisation’s eligibility criteria.

Skilled workers have a detailed understanding of the things that need to be included in the discussion, and by using prompts and checklists are able to contribute to the shaping of the discussion. Conversational assessment can be very informal, but the worker maintains a formal responsibility to act on the outcomes of the assessment.

People do not compartmentalise their lives according to the boundaries of the organisations with whom they interact.  During a conversational assessment discussion will frequently cross the organisational boundaries within which workers operate.  Not only will social care and health boundaries disappear, but people will place themselves in the communities they live in, and some of the things that matter to them will be best supported by those communities.

Conversational assessment is important because it enables people to describe their lives in ways that mean something to them. However, conversational assessment is just the first step in supporting people in accordance with these views.


Edel Harris





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