Comprehensive Needs Assessments
Tailored Planning for Positive Change
Assessment and Transition Planning
At Happy Futures, we know that moving into a new support service is a significant step. Our assessment and transition process is designed to make that journey as smooth, positive, and well-planned as possible. From the very first referral, we take a person-centred approach, ensuring the individual is at the heart of every discussion and decision.
Once a referral is received, our focus is on understanding the individual and carefully assessing whether we can safely and effectively meet their needs. A detailed transition plan is developed where appropriate to support a safe and sustainable move into our services. We work closely with the individual, their family, friends, current support team, and relevant professionals to ensure the process is fully informed and tailored to the person. By co-producing plans in this way, we help ensure that any transition is positive, realistic, and centred on what matters most to the individual.
Prior to any move, we complete a detailed assessment of need using a multidisciplinary approach. This includes gathering and reviewing information about the individual’s cognitive, emotional, behavioural, social, and practical support needs through documentation, professional input, observations, and conversations. We aim to understand not only the areas where support is required, but also the person’s strengths, personality, communication style, routines, preferences, and aspirations. This includes identifying any behaviours of concern, possible triggers, and the strategies that are most effective in supporting the individual well.
Using this information, we develop a person-centred plan that outlines the support required, tailored strategies, and realistic goals. The transition period also allows time for the new team to begin building relationships with the individual before they move, helping effective support to start from day one. Plans are regularly reviewed and updated throughout the process to reflect any changes and to ensure the right support is in place at the right time.
A thirteen tier approach, ensuring consistent support across the organisation
At Happy Futures, our assessment process is about more than determining whether support can be provided. It is about understanding the whole person, listening to what matters to them, and creating the right foundations for safe, meaningful, and person-centred support.
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Step 1. Receiving The Referral
We receive the referral and acknowledge it promptly. This may come from a local authority, ICB, case manager, family member, or another professional involved in the individual’s care and support.
Step 2: Reviewing The Initial Information
We review the documentation provided, such as assessments, care plans, behavioural support plans, risk assessments, and health information. This helps us understand the individual’s needs and whether we may be able to provide the appropriate support.
Step 3: Making Initial Contact and Gathering Further Information
We often arrange initial conversations with the referrer and other key people involved in the individual’s care. This may include family members, social workers, advocates, clinicians, or current support staff. These discussions help us gain a clearer understanding of the individual and identify any additional information required.
Step 4: Booking The Assessment
If the referral progresses, we arrange a formal assessment. We work with those involved to identify a suitable time and location for this, ideally in a setting where the individual feels comfortable.
Step 5: Involving The Individual Throughout The Process
Co-production is central to our approach. We involve the individual as much as possible during the assessment, using communication approaches that work best for them to ensure their voice is heard.
Step 6: Getting To Know the Individual
During the assessment, we focus on understanding the person as an individual. This includes learning about their likes, dislikes, routines, interests, communication preferences, and what they hope for in the future.
Step 7: Identifying Support Needs
We explore the areas where support is required, including daily living skills, communication, emotional wellbeing, behavioural support, community access, health needs, sensory needs, and risk management.
Step 8: Internal Review of the Assessment
Once the assessment has been completed, it is reviewed internally by the relevant teams. This helps us determine whether we are able to meet the individual’s needs safely and effectively, and what resources or support model may be required.
Step 9: Identifying a Suitable Property or Service Model (if required)
Where accommodation is needed, we work to identify a suitable property that aligns with the individual’s needs, preferences, and long-term goals. This may include considering accessibility, environment, compatibility, and any adaptations required.
Step 10: Liaising with Professionals and Referrers
We maintain open communication with the referrer and relevant professionals throughout the process. Where appropriate, professionals such as Occupational Therapists or clinicians may be invited to view potential properties or contribute to planning.
Step 11: Developing a Transition Plan
If it is agreed that we can meet the individual’s needs, we develop a detailed transition plan. This outlines the steps required to support a successful move, including visits, introductions to staff, timelines, and any preparations needed.
Step 12: Building Relationships Before the Move
Where possible, members of the new team will spend time getting to know the individual before they move. This helps build trust and familiarity so that support can begin effectively from the first day.
Step 13: Ongoing Review
Throughout the transition and beyond, plans are reviewed and adapted as needed. This ensures the support provided continues to reflect the individual’s needs, preferences, and goals.