Transcript Single Assessment Process in Devon, Torbay and Plymouth

Implementing the Single
Assessment Process across
the South West Peninsula
Basic awareness
What is the Single Assessment
Process (SAP) ?
Originated from the National Service Framework
(NSF)Older People Standard 2: Person Centred Care
-a single agreed approach to assessment for health /social care
-type of assessment is appropriate to needs
-agencies do not duplicate assessment
-effective contribution by range of professionals/agencies
-resulting in a single holistic service or care plan
-contributed to and agreed by all (including the person)
In South West Peninsula SAP will cover all adults 18+ except mental
health
Who will be using SAP?
All health & social care staff
 South west peninsula partnership
 All organisations using same tools and
eSAP system
 PCTs, adult social care,acute
trusts,(Devon doctors,SWAST eSAP)
 For full list of partners see SAP website

“Don’t you people talk to
each other?!”
National guidance
“Provides a rigorous framework
that will lead to convergence of
assessment methods and results
over time irrespective of the tools
chosen for local use”
What is an
assessment?
- it involves the gathering of information about the
health and social status of the person,analysis of that
data, and the making of a professional judgement to
meet the person’s needs
-within SAP this is always carried out with the person
being assessed and is proportionate to need.
SAP
4 types of assessment

Contact

Overview

Specialist

Comprehensive
Contact Assessment
Not every contact needs one
-an initial contact if needs recording
-multi-agency referral form
-basic personal information
-difficulties, risks & significant life events
-any staff member who is trained
-not necessarily professionally qualified
-may be partially completed and added to
Overview
-More detailed assessment
-At any stage in SAP
-More complete picture of an individual
-Incorporates core information
-Includes information on providers/agencies
-Risk triggers
-Identifies need for further assessment
Specialist
-Specific difficulties identified at
contact/overview
-One or more specialist professionals
-Unstable,unpredictable or complex needs
-Specialist tools/scales/measures -each
profession
SAP Health needs assessment (HNA) is the only specialist
assessment in place across the SWP and on eSAP – other
specialist assessments will be carried out on existing tools
or using FACE second line tools but not on eSAP) – e.g
Care Programme Approach for Mental health , Housing,
Speech & language etc
Comprehensive
( in the SWP a process not a tool)

Contributions from different professionals /
teams
 Co-ordinated by appropriately skilled
professionals
 Evidence base for detailed care planning
 Includes all domains of overview / specialist
 Intensive & prolonged level of support /
treatment
 Complex care packages
- e.g. residential/nursing care
Care Plan
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The Care plan is joint agency and identifies
what care or treatment is in place and who is
providing this.
Includes contingency plan for emergencies
Diary sheet shows who visits/when
Copy should be given to service user &
record that this has been done
No longer needs service users signature
Review
All care plans should set review date
 A review should take place with the
person and their carer
 The review tool is to record this and set
next review date
 FACE review form includes headings
from overview assessment

Making the links with SAP

one
assessment
across health
& social care
it can impact
on all this
and more….
Falls
Managing
long term
conditions
Medicines
Mental health and
specialties
Fair access to Care
(FACS)
Intermediate
Care
Continuing
Care/Funded Delayed discharge
nursing care
Person centred
What is FACE ?

FACE stands for : Functional Evaluation of
Care E environments
 FACE is a national SAP tool supplier
accredited by Dept Health
 Each partner in the SAP south west
peninsula has bought a licence to use the
SAP FACE tools.
 SAP is still the same as ever – FACE just
provide the tools to use
Protecting & Sharing Information
-Don’t you people talk to each other!
 -Information can be shared providing the
person has given written or verbal consent
and this is recorded once on the :
“Consent to share and protect your
information” form
 Use other assessment tools to check still
applies with every new assessment
 Agreed protocol in place across the health &
social care agencies in SWP – see website

What FACE tools replace

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FACE tools will replace most existing
documentation and SAP home-grown tools
some SAP tools were previously numbered
like SAP 1
Now all tools are known by their name
Not all FACE tools will be on eSAP
Only these key tools will need sharing across
agencies
FACE tools on eSAP
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Background & Contact Assessment
Overview
Care Plan
Review
Learning disability Core Assessment
Consent to share and protect information
Heath needs assessment ( HNA) – SWP
version
What is eSAP?
SAP can’t work without IT!
 eSAP enables assessment and care plan
information to be stored electronically ,
shared with professionals across health and
social care and sent to each other
 This is possible using your own computer and
your organisation's IT system
 Web based browser- very safe & secure

Benefits of eSAP
In addition to being better for the service users and
carers…….
 Reduction in delayed transfers of care
-Improved communication/access to information

Reduction in unplanned admissions
-Better information /improved risk management/
decisions -reduce unnecessary admissions

better
Better use of workforce
-Reduce duplication and staff time spent in recording.
-Easier and faster transfer of information between agencies.
-More appropriate use of skills

Less faxing , photocopying, storage
Personal held record

Folder (usually yellow) held in person’s home

Contains SAP documentation, communication sheet
diary, self-care information

Enables service user and carer to be and kept
informed professionals to communicate

Useful for emergencies

Flag on eSAP will show it is in place

Issued by PCT providing following criteria is met:
Criteria for Person Held Record
complex care packages delivered in own home
treatment and care by number of practitioners / agencies
known to request frequent unscheduled care
have required a number of unscheduled admissions to
hospital
at ‘risk’ of needing emergency care
managed for a ‘long term condition’ or ‘complex care
pathway’
palliative diagnosis including malignant or non-malignant
Single Assessment Process
For further information contact:
SAP Programme Team
Email: bruce.oconnor @ exeter-PCT.nhs.uk
:Tel: 01392 687142
Website address
www.devon.gov.uk/sap
Or staff area- www.devon.gov.uk/sap-pro
(all tools, guidance , newsletters etc)