Needs Assessment and Community Care: Clinical Practice and Policy Making

'Needs Assessment' is an enlightened approach to the assessment and diagnosis of mentally and physically disabled people. It involves the clear identification of the gap between the optimum fulfilment of a client's needs and what in practice happens, or can happen. The book draws together both the theory and research about needs assessment and clearly demonstrates their applications to practice.

* Practical and easily used tool for managing genuinely client-focused care
* Provides a basis for forward planning and innovation
* Takes account of health care accountability and quality control initiatives

"Few professionals, carers or clients would disagree that the practical implementation of community care has been beset with major difficulties. These often relate to the transformation of the rhetoric of policies, in particular, the pursuit of 'needs led' services into tangible services. Baldwin's stated aim is to provide a summary of 'some of the successful attempts to establish alternative services' that have sought to respond to the growing disenchantment with current services that are based largely on biomedical models. This aim is achieved in this comprehensive, readable, but also concise examination of the key issues to be addressed in providing high quality community services.

Integral to the direction and achievements of all services is how those people involved (both clients and professionals) define the concept of need. This is the starting point of the exploration of community care within this text. No assumptions are made about what need is, but rather a range of differing interpretations are presented and the implications for practice considered. These chapters will challenge all readers to review their personal, professional and policy definitions of need, and hopefully assist the reader to clarify this often vague but crucial concept.

A series of informative chapters bring together examples of successful service developments across the UK and a variety of continents including Europe, the USA, and Australia. The examples provided range across a variety of services for people with mental illness, people who are elderly, and people in rehabilitation services. The international perspectives in this text provide insights into how similar problems are faced in most countries, but how the responses can differ considerably. This wider perspective challenges any assumptions that exist about the 'right way' to plan and deliver services. The clear conclusions drawn at the end of each chapter focus the reader on the key lesson learnt and those issues remaining to be addressed further. A user perspective is evident throughout the deliberations of the contributors to this text, and this brings further challenges to be engaged in respect of the definition of need and how to respond to it most effectively.

This is not a 'how to do it book' as the title might suggest to some readers. It is, however, an important contribution to the debates about the nature of community, and indeed residential/hospital services. It provides a refreshing level of critique and discussion on pertinent points and moves well beyond much of the descriptive literature currently available. It does not seek to answer all the questions, but to prompt the reader to reflect, examine and challenge their own perspectives. Through assisting this essential process this text makes a valuable addition to the emerging literature reporting how some services have moved forward, whilst acknowledging their limitations.

Although not specific to people with learning disabilities it raises many pertinent issues for such services. It is a book with an interdisciplinary focus and should be read by students, practitioners, care managers, and policy makers involved in working with people with learning disabilities. There are important lessons to be learnt from the experience of others both at home and abroad." Owen Barr, Lecturer in Nursing/Learning Disabilities, School of Health Sciences, University of Ulster, UK