Where’s Tom? How to create an assessment that is about a person

Research shows that professional concerns often drown out what people think is important in their own lives. The tool ‘Sorting important to and important for’ helps to make their voices clear.

I recently did some training with practitioners and managers, who work in adult social care in a local authority. The training was on effective recording. One of the main aims was to ensure that when people wrote about someone, their voice was really evident in the record.

As part of this we looked at how to make sure the person’s voice came through in an assessment of their need for care and support. I asked the groups to look at a real assessment and to talk about what the impact of the assessment might be on the person it was about – Tom. This included how it would feel for Tom to read it and how close it would feel to his experience. Generally people found that Tom’s voice wasn’t clear enough. Some of what mattered to him came through but other things were murky. Also, they thought that Tom could be hurt by the way some things were written and by the long list of problems that were identified.

I then asked the groups to rewrite the same assessment using the ‘Sorting important to and important for’ tool. I came across this tool through Helen Sanderson Associates a few years ago when they were doing a project to use person-centred approaches with older people. The tool is very simple and looks like this:

Important toImportant for
    

The groups put in the left-hand column everything that the assessment said was important to Tom, and in the right-hand column everything that the assessor had identified as important for him.

They were able to clearly see what was important to Tom and how this contrasted with the assessor’s (and other people’s) views in the other column. The imbalance between Tom’s voice and the other voices became obvious. The groups could identify the conflicts between what Tom wanted in his life and what others wanted for him. They could also see where the assessor was making assumptions about what was important to Tom.

The groups identified that they could use the tool to enable positive risk taking. If they found that there was something that was important to Tom but this meant that something important for him couldn’t happen, they could discuss with Tom whether the important to outweighed the important for.

The ‘Sorting important to/ important for’ tool is a valuable way of thinking differently about assessment. Using this tool with someone helps to ensure that you capture what really matters to them. When you write about someone, you immediately start to define them. As you decide what to write, you set the limit of what will be known about that person. Arguably, this process is always oppressive. However, if their voice comes through clearly then what is known is at least some of the truth about that person.

Helen Sanderson Assosiates Sorting important to/ important for

Joseph Rowntree Foundation (2012) The right to take risks: Service users’ views of risk in adult social care

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