This article was written by Clare Barber, Director and OT at TACT based on her experience across many years of involvement in Trusted Assessor programmes. Please acknowledge Clare and TACT as the source if you use any material from this article.
What is a Trusted Assessor?
The role of Trusted Assessor resulted from a Department of Health project in 2005. The aim of the project was to reduce waiting times and get community equipment to service users more quickly and efficiently. The Trusted Assessor role and its competencies were defined along with guidance on when cases should be referred on to an OT.
Later in 2018 a pilot project was set up to apply the equivalent approach to reducing waiting lists for DFGs by enabling simple needs assessments for non-complex cases for major adaptations to be conducted by appropriately trained Trusted Assessors. The training course Trusted Assessors: Assessing and Adapting the Home, accredited at level four was created and rolled out.
How do I implement this in my organisation?
There are a number of things that should be considered and implemented before training staff to become Trusted Assessors. The following is not a definitive list, but will help to get your service ready for this new way of working.
What is involved with this type of change programme?
When implementing any changes in an organisation, you will often be confronted with some reluctance and push back.
Change management is the process of guiding change to fruition. Effective management is crucial to success. There are five main steps that should be followed:
- Preparation – ensure everyone involved recognises the need for change and understands the benefits. This will help to gain the essential buy in from the employees who will be helping to implement those changes later on and it can help to reduce friction and the potential for resistance.
- Plan – make sure you have spent time fully planning out details of the changes and who will be responsible for each step. Include who will need to sign off key stages and timelines you would want to keep to.
- Implementation – now it is time to implement the steps you have planned, remembering to take your staff and other stakeholders on the journey, empowering them to take necessary steps and ensuring any roadblocks are anticipated and mitigated.
- Embed – it is important to continue to champion the new ways of working and encourage staff who may be at risk of falling back into old ways of working.
- Review – it is important to look back and see if it has been successful and whether there is anything that could be done better.
And here is some further guidance on how you might achieve each step and important things to consider.
Ensure full collaboration
It is so important, before implementing any Trusted Assessor programme, that you communicate and discuss your plans with all involved parties and include them in the process.
An example of this was an HIA who invested time and money in training its staff to be Trusted Assessors but found they were unable to use their new skills as the local Occupational Therapy team had not been included in plans and had a number of concerns about the safety of the service users being assessed by what they saw as a non-professional. Awareness of the qualification and involvement in how the referring in would work post-training would have prevented this.
Where Trusted Assessor schemes have worked well, there has been clear collaboration and consultation from all parties including the local authority, HIAs and assessment teams.
When everyone is fully informed and consulted, policies and processes are discussed and agreed by all stakeholders, there is always a better chance of a positive outcome.
Each locality will have their own unique needs, populations, budgets and polices so one process or way of working will not suit all. For example, enabling Trusted Assessors to assess for stair-lifts may not be suitable for your area if the budget cannot be accessed by the team.
It is also important to consider whether you have the appropriate skills internally to successfully complete the process, for example managers with the skills to supervise Trusted Assessors along with trainers and mentors to help embed the new skills. You may need to work with external partners or commission additional resources to support the initial phases.
Consider all related policies and practice
Once you have discussed and agreed how to organise your Trusted Assessor programme, it is important to outline how the overall assessment process will work. Who will decide which assessments a Trusted Assessor can initially take on? Will a sign off be required for any equipment they recommend? Do your policies and processes allow for the role of Trusted Assessor as a prescriber of equipment and adaptations?
It is important to consider things like accountability, liability, insurance, recruitment, IT systems access and job descriptions.
Consider also your systems and paperwork, do your forms and IT systems lend themselves to this new way of working? Do they meet GDPR requirements and are they easy to complete and use?
Do you have easy communications with partners that you may need to link with such as GPs, physiotherapists, Occupational Therapists and other community services and do they recognise the Trusted Assessor role and what that entails?
Making sure you have all your processes in place and a clear policy will help you along the way. These of course can be revised as you work through the implementation and start to see the outcomes.
Lastly consider access, do you have good access to equipment through a community equipment store, can you implement agreements with partners to improve access to the things you may need?
Identify appropriate staff as potential Trusted Assessors
One thing that has become clear from the organisations that have developed Trusted Assessors, is that ultimately not all staff are suited to being Trusted Assessors.
One example of this was an experienced handy person that had worked in fitting adaptations for many years, had excellent feedback and a proven track record. However, this person has never had to complete any written or theory-based training and struggled to understand the concepts of assessment. He failed the exam that follows the training on multiple occasions, eventually leaving the organisation.
It is important to consider the skills, knowledge and experience of your staff but also their willingness and ability to learn new skills before deciding who would be appropriate to become a Trusted Assessor. Trying to enforce training and new responsibilities on those not suitable will only result in failure of the project.
To be a Trusted Assessor, assessing for major adaptations consider whether the person has the following skills:
- Do they understand their responsibilities according to legislation (for example The Mental Capacity Act 2005?)
- Do they have a basic understanding of common medical conditions and their impact on function?
- Do they have knowledge of other, cheaper and easier to implement interventions that could be tried before implementing a major adaptation?
- Do they know the basic measurements needed for those simple interventions, such as lower leg measurements?
- Do they understand risk assessment and why it is important and how evaluating risk can be challenging with people who may have fluctuating needs?
- Can they look at a person in a holistic manner and review all the relevant aspects of their lives to make an informed assessment?
Before decided that all people within a certain job role are suitable to become Trusted Assessors, ensure you do a full skills audit.
Remember to review staff contracts
Once you have identified who will be working as a Trusted Assessor as a part of their role, you may need to revise their contract of employment. Many contracts state that other duties required for the needs of the service are included but you may want to update this more specifically to reflect the new responsibilities.
Do not forget to consider items such as working conditions, uniforms, working hours and supervision.
For example: A Trusted Assessor programme was introduced which involved staff undertaking assessments, where needed, with the service users they were visiting – this was an additional new duty. Prior to implementation, they were expected to see 10 people per day, this proved to be no longer feasible when full assessments were being undertaken.
Think also about the type of work assessing involves – is this level and type of work consistent with their core role’s level and grading?
What are the training options?
Next you need to consider training your chosen staff and there are a number of options open to you.
1. Using internal / in-house trainers
There are obvious benefits to opting to train using internal staff as it saves on the potential costs of outsourcing external training. You have more control over what is taught and content can be tailored to be specific to your needs. You can include details of processes, IT systems, specific departments and useful contacts. It may also be an opportunity to involve other teams such as the local Occupational Therapy teams and so helps to build relationships, confidence and buy in from them.
The downsides are that the training would not be accredited or aligned to the national qualification and latest practice. The trainer may not be trained as a trainer and it may be an extra task on top of their existing busy workload. Lastly the training would not be tried and tested and continuously improved through feedback.
2. Using an external agency to deliver training
There will of course be costs and potentially time considerations with this option. You may need to release staff for full days and provide travel time too. It may require multiple staff to be off work at the same time attending the training and you may face having more generic course materials.
However, when using an external agency, they are often able to tailor courses to your needs. They can use content that has been tried and developed over time and their trainers are more likely to be able to deliver materials to meet all learning styles, giving a better chance of your staff taking on board the required learning.
Insist on the tailoring that you need and explore all learning formats.
Liability for competence lies with the training agency and they will provide a valid certificate for this.
3. Taking a blended approach
An excellent way to train staff is to use both approaches. Use an external agency for the initial training and then continue the training through on-the-job training.
Supporting Trusted Assessors
In TACT’s experience, completing a course and being signed as competent from a theory perspective is not enough to ensure strong and competent Trusted Assessors in the field. Ongoing support and supervision for the first six to twelve months is ideal. The following areas should be considered:
1. Assign a mentor
It is strongly recommended that all Trusted Assessors have an assigned mentor or experienced assessor (preferably an Occupational Therapist who is a band 6 or above) to turn to for advice to help embed their learning into practice. Supervisors can answer any questions and shadow assessments whilst the Trusted Assessor builds confidence. It is helpful when the mentor has either been on the training, or delivered the training themselves, so that they know what has been taught and have clear expectations of what is expected.
2. Use a competency framework
A competency framework is a document outlining the skills needed to be held to successfully complete a role such as a Trusted Assessor. These can be used by a mentor to observe and ‘sign off’ an area of competence once theory is observed to be embedded in practice.
3. Use a range of checklists and templates
Having a standard template for use in assessments with prompts on things to consider may really help to support a new Trusted Assessor in their role. These can be designed to tie in with your own policies, guidelines and practice and to link directly to the learning in any training they have completed.
4. The importance of good communication
It is important that managers are clear with their team of Trusted Assessors about what is expected of them.
Make sure as a manager that staff are confident and comfortable and that they clearly understand their duties and responsibilities.
5. Provide ongoing support
Having a mentor is a great step to helping to embed learning and help Trusted Assessors to build confidence and competence in their new role. There are a range of other ways to support them. Consider regular formal supervision, appraisals, team meetings and peer support opportunities in which Trusted Assessors can share tips, insights and share best practice. Try pairing up those with more technical skills with those who are more people-focused to share experiences. Give rewards for good progress and outstanding performance.
As a manager, show your commitment to the programme and support your team by taking the time to go out on joint visits with them, enabling you to notice skills, challenges and any concerns.
Allow Trusted Assessors more time initially to get used to the new way of working and understand that we are all different, every individual has a different preferred style of learning and will follow a different route to achieving competence in the role, once approach will not suit everyone.
6. Think about well-being and resources
It is important to consider the health and safety of the team. Being asked to complete new tasks that may not be a natural skill for the individual can invoke stress and cause anxiety.
For example: a person that has previously had limited contact with service users is now expected to communicate and interact on a personal level.
Make sure they are given all the resources they need to succeed and check in on them regularly to ensure their continued wellbeing.
7. Supervision is important
Regular supervision by an appropriate person is essential to new Trusted Assessors. They have probably learned a range of new skills, been asked to change their way of working, all of this may be unfamiliar. Ensure there is protected one to one time with their manager to review the new role and practices and this will ensure they grow into the role.
Regular supervision will also help identify any further learning needs, enabling the staff member to feel properly supported and this also helps to reduce potential risks to service users caused by poor assessments.
8. Resources and information to support the role
It is important to keep Trusted Assessors fully up to date with the latest information and best practice. You can do this by providing regular refresher training and attending relevant external events such as Foundations roadshows, the OT Show, NAEP Conference and meetings and the regional Occupational Therapy Adaptations Conferences (OTAC). Consider creating an organisational knowledge base to share skills and useful information and think about appointing champions to help engage and encourage continuous learning.
Some training providers also provide useful guides, so take advantage of these and share them with all Trusted Assessors.
9. Networking to share ideas
There are so many opportunities to network in this new virtual and actual in-person world. Reach out to other organisations like yourself and share information on projects and lessons learnt to compare experiences and insights.
Share your stories more generally, and use the expert networks that exist locally and nationally to help everyone improve.
Ongoing review
One of the most important things about implementing a Trusted Assessor programme is reviewing the outcomes, collecting feedback and making ongoing improvements.
Consider, have you achieved what it was you set out to achieve? What could you have done differently? What went well? What could you do to achieve better outcomes in the future? Involve all stakeholders in the process, include staff, service users, external teams, charity and voluntary teams and share your findings.
Talk to us
TACT’s programme managers and OTs are passionate about the ways in which Trusted Assessors and related roles such as Installers, Advisors and many others can improve access for older and disabled people to much-needed equipment and adaptations for the home. We are happy to have a no-obligation chat with you to share our insights, answer questions and act as an independent sounding board. We often take part in meetings and workshops and we are happy to contribute from an early stage in your early thinking.
More specifically, we can offer a range of support and resources for your programmes including many of the items mentioned in Clare’s article: assessment templates, competency checklists, supervision schemes, useful guides.
Get in touch.
Tel 01626 879528