Critically review theoretical models of assessment

For this assessment criterion, you will be required to critically review a number of theoretical models of assessment.

The care planning process involves gathering information and assessing the needs of an individual so that a package of care services can be provided that meets their needs. As a lead adult care worker you will, most likely, be involved in care planning and so should have a good foundation of theoretical knowledge with which to develop your assessment process.

It is important to point out that there is no universally-accepted, single theoretical model that dictates how assessment should be performed and so your own assessment process will be made up of theory, models, standards, legislation, your own preferences and your organisation’s values, policies and procedures. This means that there can be flexibility and your approach and the way that assessments are carried out will vary between organisations.

Questioning, Procedural & Exchange Models of Assessment

Smale et al identified three general approaches to assessment in their publication ‘Empowerment, Assessment, Care Management and the Skilled Worker‘ (2003). They were the questioning, procedural and exchange models, each of which has a different working dynamic between the assessor and the person being assessed.

Questioning Model

In the questioning model, the assessor is considered to be the expert and will ask the individual questions to build an overall picture of their needs. Then they will offer services to meet their needs. A good example would be visiting your GP when you are ill and explaining your symptoms. The doctor will ask questions to obtain more information before prescribing a treatment plan based on their expertise.

Procedural Model

In the procedural model, the assessor takes a more bureaucratic role, going through checklists provided by their organisation or agency. The information will then be fed into a system and measured against set criteria to ascertain if the individual is entitled to services and what those services would be. An example would be filling in an online form to see if you are eligible for funding. The system takes your information and tells whether you are eligible based on a set of criteria.

Exchange Model

Finally, the exchange model of assessment involves the individual being assessed as an expert on themselves and their own needs, which results in a much more collaborative approach to the assessment process. The assessor proposes solutions, but the individual has much more choice and control over which care services they receive. A comparative example might be explaining what you need from your next laptop to a salesman in a computer store and them presenting a number of options to you based on your requirements.

Summary

The exchange model is preferred as it fits in with the personalisation agenda and supports person-centred and outcomes-based practices. However, it is not without its critics – some practitioners feel as though they have been demoted from an expert to simply a facilitator. The questioning model does ensure that the assessor’s professional judgment is valued, however, it can make individuals feel oppressed and devalued. The procedural model can also mute the voice of the individual and be inflexible (e.g. it can only be used to process clearly defined information and does not take into account ‘grey areas’).

Models & Frameworks

Models and frameworks can guide the assessment process. Although they are usually procedural, there should be enough flexibility to account for unique circumstances and needs and the professional judgment of the assessor. Some examples of models and frameworks that are currently being used include:

• The Assessment & Eligibility Process Map (SCIE)
• The Single Assessment Process for Older People
• National Framework for Children and Young People’s Continuing Care

By reading how assessment is performed in other areas of care, you may gain insights or ideas that can be used to improve your own assessment systems and processes.