Find out more about the importance of having what matters conversations with the individual and how those feed into the assessment process
What matters to the individual?
A 'what matters' conversation is a targeted conversation relating to any assessment process.
It refers to a skilled way of working with individuals to establish the situation, their current well-being, what can be done to support them and what can be done to promote their well-being and resilience for the better.
It's not an assessment in itself: it's a way of carrying out the assessment, with the practitioner having the right type of conversation to identify with the individual:
- how they want to live their life
- what might be preventing that
- what support might be required to overcome those barriers.
The importance of being equal partners in the conversation
A ‘what matters’ conversation is a discussion between equal partners (also known as 'co-production'), to identify, from the individual’s lived experience and the expertise of the practitioner:
- how the individual wants to live
- what is preventing those aspirations
- what support can be put in place to make aspirations a reality.
The ‘what matters’ conversation between the practitioner and the individual or carer is very important.
It may be the first time that someone has been asked to think about how they would like to live their life - what matters to them - or had a conversation about barriers they may face or what support could overcome those barriers.
Some individuals and carers may be very clear about what is important to them.
Others may need support to think this through, especially if they have never accessed care and support through a local authority or have been accessing services for some time.
Independent professional advocates can play a key role in ensuring effective communication between the two parties.
It can ensure that individuals and carers understand the process and can participate as equals.
Understanding the options available for care and support
People may expect services that focus on specific times of the day and tasks of personal care because it is what they’re used to or what they have seen others receiving.
They may need support to understand what their options are and to make their choices as an equal in the conversation.
Practitioners need to take time to listen, understand and support people to explore options and find solutions.
It’s important to remember that for individuals, the assessment process will be the same, no matter whether they decide their needs will be met best by using direct payments or through support from the local authority.
The journey is the same but the end product will be different, depending on what matters to each individual and how they choose to arrange any care and support they need. See the section 'What can direct payments buy’.
What makes a good care and support assessment?
The Social Services and Well-being Act (Wales) 2014 (the Act) and its Codes require practitioners to work with individuals as equals – sharing power and esteem by co-producing the ‘what matters’ conversation.
The Co-production Network for Wales defines 'co-production' as:
An asset-based approach to public services that enables people providing and receiving services to share power and responsibility, and to work together in equal, reciprocal and caring relationships.
It creates opportunities for people to access support when they need it, and to contribute to social change.
There is also a definition of 'co-production' as a "genuine partnership" in paragraph 4 of the Code of Practice for Part 10 of the Act.
The Act is a clear move away from a ‘time and task’, minimalist, ‘personal care only’ approach and encourages people to identify and insist upon whatever support they need to live the life they choose.
It is not enough for the practitioner to ask the individual “What matters to you?”
They should support people to understand what they are legally entitled to under the Act.
Preparation tips for practitioners and direct payments recipients
The practitioner and the direct payments recipient should agree a suitable time and place for the needs assessment.
This will help make it a positive experience for both parties.
Here are some preparation tips:
- All parties should be comfortable in the location
- Practitioners may need time to arrange for an independent advocate to work with the individual and attend the assessment
- To support the assessment process, the practitioner should give the individual information days or weeks in advance to consider how they want to live their lives, what support they already have in place and what barriers there are to them achieving their well-being outcomes
- In the case of joint assessments, ensure there is enough time to arrange for other people who are involved in the assessment to be present
- People may need time and prompting to consider what family or community support is available to them as well as how local authority support may further enable family or community support to happen.
Remember the ‘what matters’ conversation
The social care practitioner should have the skills to lead an outcomes-focused conversation that focuses on personal well-being outcomes when assessing whether an individual has eligible care and support needs.
The Welsh Government's National Outcomes Framework for People Who Need Care and Support and Carers Who Need Support describes personal well-being outcomes in detail.
It’s important to understand not only what matters to the person but why they matter.
And also what the barriers might be and why any proposed interventions or support will improve the person’s well-being, not just now but into the future.
For example, will a small intervention now prevent a larger intervention in the months or years ahead?
Mapping individual strengths
Strengths mapping is an approach which helps practitioners to understand what support is already available for people and what is missing.
It looks at what an individual can already do and what skills they have and tries to find ways of building on this.
A practitioner will talk to a person about what support needs they have and the different ways their needs can be met.
Together, they will talk about:
- what the individual can already do for themselves and what the practitioner can do to help
- what support already exists and whether or not it's suitable
- what matters to the person in supporting them to improve their well-being.
Accessing support - what is already available to the direct payment recipient?
Friends and family networks:
- what friends, family members and networks do people already access for care and support?
- are the individual, their carers and support networks happy to continue in this way or do other forms of support need to be found?
Remember, the Act is clear that carers are only carers for as long as they are able to be and want to be.
- are there any suitable activities or services that can support the well-being outcomes the individual has identified?
- is support needed to access those activities or services?
What is left that still needs support?
- this is what needs to be provided using direct payments or care and support services.
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