Well we are nearly at the end of another year and the ‘season of goodwill to all’ is upon us. Timely, therefore for us to be considering what the central principle of The Care Act 2014, ‘wellbeing’ is and how in reality this will change how organisations and practitioners approach needs assessment and service provision.

The National Health Service and later, organised social care services, were established to improve the health of the nation so that everyone could enjoy good health or a state of ‘wellbeing’. However, ‘wellbeing’, like all ideas or concepts, is not set in stone. If we are to turn the rhetoric, or words, into reality we need to question what it means to different people in different circumstances and enable us to think through the implications and arrive at some conclusions so that ‘wellbeing’ becomes a reality that is consistent and fairly applied.

So what does ‘wellbeing’ mean? Who decides? Is it the same for everyone or do we have different interpretations?

Wellbeing has been described as a dynamic or changing state where someone is able to develop their potential, work productively and creatively, build strong and positive relationships with others, and contribute to their community.

Wellbeing improves when a person is able to fulfil their personal and social goals and achieve a sense of purpose in society.

Other definitions talk about wellbeing in more subjective or personal terms.

For the person it is about feeling good, having a sense of vitality or zest for life and the desire and ability to participate in activities that are meaningful to them and which give them a sense of independence and purpose.

It is also about having inner strength and resilience to cope with changes as well as every-day life.

Another aspect is having a sense of being connected to others and having different types of social and personal relationships.

In terms of who decides, more recent definitions have resulted from research which has involved consultation with a wide range of people to draw out common interpretations.

Within the context of The Care Act 2014, wellbeing is defined as a broad principle which relates to nine areas of the person’s life. These are:

• Personal dignity (including treating the individual with respect)
• Physical and mental health and emotional wellbeing
• Protection from abuse and neglect
• Control by the individual over day-to-day life (including over care and support provided and the way in which it is provided)
• Participation in work, education, training or recreation
• Social and economic wellbeing
• Domestic, family and personal relationships
• Suitability of living accommodation
• The individual’s contribution to society

Local authorities will be required (as it is a law) to promote a person’s wellbeing although how that happens will depend on circumstances. It will be essential, however, that an assessment of the person’s needs is centred on them and focuses on the aspects of wellbeing that particularly relate to the person and assess how their needs impact on these.

Some aspects of wellbeing will be more important to the person than others and the local authority and the person undertaking the assessment will need to have a flexible approach which ensures the assessment and care planning process focuses on those aspects.

So to think about what this means in practice I would like to leave you with some questions to think about and hopefully they will help you to understand how the concept of wellbeing will change how both assessments of need and service provision could change.

Questions for you to consider….

What does ‘wellbeing’ mean to you?

How well do the definitions above fit with your ideas of what ‘wellbeing’ is?

Has your definition changed over time or in different circumstances?

What factors influence your interpretation? What do your answers tell you about understanding ‘wellbeing’ in terms of assessment and providing services?

You might want to discuss these questions with your colleagues to see if you all think alike and if not how different your ideas are and what that means to the choices you each make.

I wish you all a healthy and happy festive season

Until next year……