Single Shared Assessment Indicator of Relative Need: Operational Guidance Users Handbook

CLIENT DETAILS (Please complete in BLOCK CAPITALS)

Name: ------------------------------------

Gender: M / F

Date of Birth: ---- / ---- / ----

Local Authority Reference Number: ---------------------

NHS Reference Number: -------------------

Date of Completion: ---- / ---- / ----

SSA-IoRN Grouping: -------

Q1: When eating a meal, the person . . .
This question relates to a person's ability to obtain appropriate nutrition. This question does not concern the person's ability to cook or prepare meals.

Select A:

if the person eats using ordinary utensils without help, prompting or supervision, even if the meal must be prepared by someone else.

Select B:

if the person eats without help, prompting or supervision, but uses special or adapted utensils.

Select C:

if the person requires food to be cut up or its consistency to be modified in order to eat.

Select D:

if the person has difficulties eating a meal because of frailty, disability or lack of awareness and so requires prompting supervision and guidance.

Select E:

if the person requires physical assistance from another person in bringing utensils to the mouth.

Select F:

if, because of injury, disability or illness, the person must receive nutrition intravenously, by gastrostomy or by syringe.

Q2: When transferring from bed to a chair or wheelchair, the person . . .

This question relates to a person's ability to transfer from a position of lying down to a position of sitting in a nearby chair.

Select A:

if the person is able to transfer independently and safely without the use of any equipment or adaptations, e.g. bedrail, specially adapted chair.

Select B:

if the person is able to transfer independently but only with the use of equipment or adaptations, e.g. bedrail, specially adapted chair or chair specially selected (bought or supplied).

Select C:

if the person requires physical assistance from one person, irrespective of whether equipment is required.

Select D:

if the person requires encouragement, prompting or supervision, but does not require physical assistance; OR if the person uses any equipment or adaptation that requires one person to set it up or to supervise its use; OR if the person requires observation because of a risk or fear of falling; OR if the person has difficulties transferring because of frailty, disability or lack of awareness.

Select E:

if the person requires the physical assistance of two people, irrespective of whether equipment is required.

Select F:

if the person is confined to bed and/or does not sit in a chair because of illness, injury or physical disability.

Q3: When using the toilet or commode, the person . . .

This question relates to a person's ability to use the toilet/commode, that is to transfer on and off the toilet/commode, adjust clothing and maintain perineal hygiene. This question does not concern continence and bowel function (covered by question 12). But it does cover how the person manages a catheter or colostomy. It also does not concern a person's ability to get to the toilet/commode, only the ability to use it once they are there.

Select A:

if the person is able to use the toilet or commode independently without the use of any equipment or adaptations, e.g. raised toilet seat, hand rails, etc.

Select B:

if the person is able to use the toilet or commode independently, but only with the use of equipment or adaptations, e.g. raised toilet seat, hand rails. This includes those persons who independently manage a catheter or colostomy.

Select C:

if the person requires minimal physical assistance from one person to use the toilet or commode, but performs the majority of the tasks himself/herself, e.g. if the person needs a small amount of assistance in transferring on and off the toilet, or in adjusting clothing.

Select D:

if the person requires encouragement, prompting or supervision to use the toilet or commode because of a lack of motivation, fear of falling, confusion or memory loss, but does not require physical assistance; OR if the person uses any equipment or adaptation that requires one person either to set it up or to supervise its use; OR if the person has difficulties using the toilet because of frailty, disability or lack of awareness.

Select E:

if the person requires assistance with all aspects of using the toilet.

Select F:

if the person does not use the toilet or alternative receptacle because of physical disability or injury, or because he/she requires assistance to manage their catheter or colostomy.

Select A:

if the person requires no help, prompting or supervision from another person to perform the task AND does not require equipment or adaptations to do so.

Select B:

if the person requires no help, prompting or supervision from another person to perform the task, but uses equipment or adaptations to do so.

Select C:

if the person is able to perform the task, but because of frailty, disability or recent injury, finds it difficult to do so, even when using equipment or adaptations; OR if the person has difficulty with one aspect of the task (e.g. putting on socks and shoes, getting into a bath), even if they have no difficulty with another aspect (e.g. putting on trousers or shirt, washing themselves once in the bath).

Select D:

if the person:

• lacks confidence or motivation to perform the task, but is able to do so when prompted or encouraged. This includes, for example, someone who requires clothing to be laid out for them, but is able to dress themselves once this has been done; OR

• will not perform the task without someone present because of a fear of falling, a phobia or other anxiety disorder; OR

• has forgotten how to perform the task, or is unable to perform it safely because of cognitive impairment or confusion. This includes, for example, someone who may leave the bath water running if they are not reminded to turn off the tap.

Choose this option if the person generally does not require physical assistance with the task, but nevertheless (for whatever reason) often requires someone to be present in order to perform it themselves.

Select E:

if the person:

• requires physical assistance or support from others (for whatever reason), even if it is minimal; OR

• requires physical assistance for one aspect of the task (e.g. putting on socks and shoes, getting into a bath), even if they require no assistance for another aspect (e.g. putting on trousers or shirt, washing themselves once in the bath); OR

• does not perform the task because of disability.

Select A:

if the person requires no assistance, prompting or supervision from another person to perform the task AND does not require equipment or adaptations to do so.

Select B:

if the person requires no assistance, prompting or supervision from another person to perform the task, but uses equipment or adaptations to do so.

Select C:

if the person is able to perform the task, but because of frailty, disability or recent injury, finds it difficult to do so, even when using equipment or adaptations.

Select D:

if the person:

• lacks confidence or motivation to perform the task, but is able to do so when prompted or encouraged; OR

• has forgotten how to perform the task, or is unable to perform it safely or appropriately without supervision because of cognitive impairment or confusion. (This includes, for example, a person who may be physically able to cook, but who might leave a pot on a lit burner and walk away from it, or who might eat out-of-date food. It also includes someone who is physically able to shop, but who cannot do so appropriately without supervision) OR

• is physically able to perform the task, but usually neglects himself/herself because of a mental health need or cognitive impairment.Select this option if the person generally does not require physical assistance with the task, but nevertheless (for whatever reason) often requires someone to be present in order to perform it themselves.

Select E:

if the person:

• requires physical assistance from others to perform the task (for whatever reason); OR

• requires physical support from others to perform the task (for whatever reason), even if it is minimal
  (e.g. flask left containing hot drink)

• can not perform the task without assistance because of a lack of training (e.g. someone who needs prepared meals to be provided because they do not know how to cook, but who is able to reheat the meals once provided); OR

• does not perform the task because of disability.

Qstn A:

Agitation/Restlessness - Agitation/Restlessness may include, for example, pacing, unable to sit for a period of time or unable to settle to a particular task.

Qstn B:

Disturbance/Distruption - Disturbance/Distruption may include, for example, a person waking a spouse/relative during the night or a person making excessive contact with family/neighbours for no reason.

Qstn C:

Verbal aggression - Verbal aggression may be directed towards other people, animals or objects.

Qstn D:

Resistiveness - Resistiveness may include not only a person's active refusal to co-operate with their care, but also to situations where a person apparently agrees to receive care, but then is consistently out when the care worker arrives, etc.

Qstn E:

Relationships - Key relationships are considered to be those which are significant to the person, or which are necessary for their care. They may include individuals such as a spouse, a daughter or son, a carer, a member of the social work services team, a nurse or a doctor, for example.

Qstn F:

Risk - Risk of harm might include, for example, dangers relating to accidental explosion, fire, poisoning (including medication, food or carbon monoxide poisoning), disorientation out with the home, self neglect leading to reduced activity, abuse (e.g. emotional, verbal, physical, financial, sexual), etc.

Select A:

if the person is fully continent, does not require, or rarely requires assistance from another person OR if the person is independent with pads or other continence aids, equipment or adaptation OR if the person requires a prompt to take the oral medication on a daily basis to maintain healthy bowel function such as laxatives, forming agents, e.g. methylcellulose or antimotility drugs, e.g. codeine phosphase OR if the person requires prompting, supervision or assistance to maintain a healthy bowel function or to manage problems relating to faecal incontinence, but on average, less than once a week.

Select B:

if the person requires prompting, supervision or assistance to maintain a healthy bowel function or to manage problems relating to faecal incontinence, on average, more than once a week OR if the person requires assistance at least once a week during the day or night for stoma care.