BCAS Assessment Process
What Happens at an Assessment?
Through our assessments we aim to find out as much as we can about the individual, this helps us to identify a communication aid and mounting solution (if appropriate) that is tailored to the person’s needs and wishes. Our assessments are friendly and we aim to gather the majority of information through informal discussion.
The assessment process usually follows a four or five step process.
- Assessment appointment – an opportunity to get to know the individual and try out devices and software
- Loan Period – the individual can borrow appropriate equipment to try out in the home/school environment.
- Review appointment – A decision is made as to whether the equipment is suitable or not
- Mounting appointment – if needed equipment can be mounted to wheelchairs or to provide access to the device whilst in bed or in a chair.
- Provision of equipment – if a device has been successfully identified and the individual meets the service specification criteria, we may be able to provide the equipment on long term loan
Assessments at BCAS are carried out by an interdisciplinary team of experienced Speech and Language Therapists, Occupational Therapists and Technical Support Staff.
Our appointments for adults mostly take place within the patients own home, a nursing home or hospice. Children are also seen at their home, at Claremont School, Henleaze or at another school at request. We do also carry out appointments at the Bristol Centre for Enablement, where any local therapists or support staff are welcome to attend.
Who carries out assessments?
Assessments at BCAS are carried out by a multi-disciplinary team of experienced Speech and Language Therapists, Occupational Therapists and Technical Support Staff.
What is an Emergency Appointment?
Emergency appointments are offered for people with Motor Neurone Disease (MND) who need to be seen as a priority, at short notice. BCAS schedules on average two emergency assessments a month, and they are scheduled for people with MND who meet the following criteria:
• Are deteriorating rapidly
• Are no longer able to rely on their speech
• Hand function has deteriorated to the extent that they would find it difficult to use communication equipment that is accessed by touch e.g. tablets, Lightwriters.
Referrals are made by the local Speech and Language Therapist, after which a series of 3 appointments will be made:
• An initial appointment where BCAS will assess the client and prescribe equipment that will be left for a trial period at that appointment
• A review appointment that will take place 4-6 weeks later
• A second review appointment that will be scheduled 6 weeks after the first review appointment. This appointment may not always be needed if everything is agreed to be working well at the first review.
The person with MND, the local SLT, other key professionals and people in the person’s life should attend. The appointments are usually run by a BCAS Occupational Therapist and Assistant Practitioner.
During the initial appointment the person will be assessed with different devices and access methods depending on their needs. As far as possible, equipment will be left for the person with MND to trial at the end of the initial appointment.
How long is each appointment?
An initial assessment usually lasts between two to three hours. Review appointments usually last between one to two hours. Mounting appointments can take up to three hours.
We are aware that these appointments are lengthy and therefore we make sure that there are regular breaks and refreshments offered. In some cases we may split a session over two appointments if appropriate.
Who should attend the appointment?
The person should be accompanied to the appointment by their local speech and language therapists. They are also encouraged to invite other people who are directly involved in their care, or play an important part in their life, such as family members, teachers, carers or occupational therapists.
Where do assessments and reviews take place?
The majority of adult assessments take place at the Bristol Centre for Enablement at Highwood Pavilions. The majority of child assessments take place at Claremont School in Henleaze. In some circumstances where specific criteria are met, BCAS can offer a home visit. Video conferencing may also be possible for some parts of the assessment process.
As part of the new commissioning arrangements through NHS England BCAS has a contract with Dame Hannah Rogers Trust (DHRT) in Newton Abbott to supply specialist communication aid services to people living in the far South West of the region. People living in this area will receive their assessments through DHRT who will be working closely with BCAS to deliver those services. Go to www.discoverhannahs.org to find out more about DHRT and the work they do.
What happens at an assessment appointment?
Through our assessments we aim to find out as much as we can about the individual, this helps us to identify a communication aid that is tailored to the person’s needs and wishes. Our assessments are friendly and we aim to gather the majority of information through informal discussion.
These discussions may focus on some of the following aspects:
- Communication skills – expressive skills, literacy skills, symbol recognition
- Physical abilities
- Sensory skills
- Cognitive abilities
- Previous experience of technology
- Where the person wants to communicate
- Where communication breaks down
- How an aid might be useful to individual Support networks
- Lifestyle and interests
These discussions and information from the referral form allow the therapist to identify devices and software which may suit the individual’s needs. The individual is then able to try out these devices and software within the session. If there is a particular device that fits the person’s requirements, a loan period will be agreed. If mounting is needed a mounting assessment will take place.
What happens during a communication aid loan period?
The loan period allows the person to try out the device in all areas of their lives. Goals will be set for the loan period in order to establish the positive and negative aspects of the device and its suitability. Devices can be loaned for a period of 4 – 6 weeks. We offer support during this period.
This may include:
- Programming the device with individualised vocabulary/photos
- Trouble shooting
- Training in how to use the device and program software
- Practice sessions offered face-to-face or via video conferencing (depending on location).
The Review Appointment
Following this loan period, a review appointment will take place to discuss the outcome of the loan period and the goals set. We ask for feedback from the individual and their carers, therapists or teachers.
The outcome of this discussion could lead to one of the following:
- Another loan period using the same equipment to help explore it further
- A loan period may be organised for a different piece of equipment
- Supply of equipment for long term use.
- The person may decide that device or software offered does not suit their needs and would therefore be discharged.
What if a device needs mounting?
When appropriate, mounting assessments are offered to allow devices to be attached to wheelchairs, or to be available whilst in bed or sitting in a chair. These sessions are offered as part of a Communication Aid Assessment.
Through discussion with the individual and their carers and a detailed risk assessment, our experienced therapists take into account a number of different factors that may influence how or where a device might be mounted, for example:
- Device e.g. size and weight
- Type of wheelchair used
- Where the device will be used
- How the wheelchair will be transported
- How the wheelchair is propelled
- An individual’s weight, height, posture etc.
Appropriate mounting equipment will then be shown and demonstrated. Like a communication aid loan the individual can then trial the mounting equipment at home for a loan period of 4-6 weeks. At the end of this period the equipment is reviewed. In conjunction with the therapists, individual and their carers a decision is then made about the appropriate mounting solution. If the mounting assessment is running alongside a communication aid assessment, the success of the mount is taken into account when reviewing the device and vice versa.
he outcome of these discussions could include:
- Another loan period using the same equipment to help explore it further
- A loan period may be organised for a different piece of mounting equipment
- Supply of mounting equipment for long term use.
- The person may decide that the mounting solution offered does not suit their needs and would therefore be discharged.
If an appropriate mounting solution is found, the mounts are then fitted by the therapist. Training is given on how the mounts can be attached and removed and how they should be stored.