Providing community equipment and adaptations in adult social care: lessons from an evaluation of the use of self-assessment in five English local authorities

Whilst community equipment and adaptations promote the independence of millions of people, ongoing problems have been identified with the delivery of such services by local authorities. Self-assessment has been identified as one possible means of improving service effectiveness, giving service users more choice and control and providing faster, easier access to services. However, little is known about the use of self-assessment in social care. Against this background, this paper reports the findings of a mixed methods evaluation of the use of selfassessment in five local authority occupational therapy services. This drew on internal documents, management interviews, service user and administrative records, and a service user satisfaction survey. Important insights are provided about the operationalisation and possible functions of self-assessment in local authority occupational therapy departments; the characteristics of service users for whom self-assessment may be suitable (and those for whom it may not); the range of equipment suitable for provision via self-assessment; the costs of selfassessment; and service users’ experience of self-assessment. The results are discussed in the context of the relevant policy and legal framework and a number of important lessons are highlighted for service commissioners and providers.