«Updated on 28 July 2015 Foreword This document has been produced by the Department for Work and Pensions (DWP) to provide guidance for providers ...»
Risk and Safety 3.2.13. When considering whether an activity can be undertaken safely it is important to consider the risk of a serious adverse event occurring.
However, the risk that a serious adverse event may occur due to impairments is insufficient – the adverse event has to be likely to occur.
Support from other people 3.2.14. The assessment takes into account where claimants need the support of another person or persons to carry out an activity, including where that person has to carry out the activity for them in
its entirety. The criteria refer to various types of support:
3.2.15. A number of descriptors also refer to another person being required to complete the activity in its entirety. These descriptors would apply where the claimant is unable to undertake any of the activity for themselves, even with help.
3.2.16. Activities 7 and 9 refer to Communication support and Social support, which are defined in the notes to the activities.
3.2.17. The assessment does not look at the availability of help from another person but rather at the underlying need. As such, claimants may be awarded descriptors for needing help even if it is not currently available to them – for example, if they currently manage in a way that is unreliable but could complete it reliably with some help.
Aids and appliances
3.2.18. The assessment considers a claimant’s reliance on aids and appliances in order to be able to complete an activity safely, reliably, repeatedly and in a timely manner, as set out in section 3.3 of this guide. Owning or using an aid or appliance is not necessarily an indicator that a claimant requires that aid or appliance in order to complete an activity. The HP must assess whether there is a genuine need for an aid or appliance and whether or not the claimant could complete the activity safely, reliably, repeatedly and in a timely manner without the use of an aid or appliance.
3.2.19. In this context:
Aids and appliances may also include mainstream items used by people without an impairment, where because of their impairment the claimant is completely reliant on them to complete the activity.
3.2.20. When considering whether a claimant needs to use an aid or
appliance, the HP should apply the following logic:
3.2.21. Under Descriptor B, consideration should be given to whether the claimant can carry out the activity on the basis of their ability whilst wearing or using any aid or appliance which they normally wear or use, or could reasonably be expected to wear or use. If the claimant is able to carry out the activity in these circumstances then Descriptor B will be appropriate. If not, then consideration should be given to whether the claimant must rely on prompting, supervision or assistance in order to complete the activity, in which case a higher descriptor may be more appropriate.
3.2.22. Where a claimant chooses not to use an aid or appliance which he or she could reasonably be expected to use and which would enable them to carry out the activity without prompting, supervision or assistance, Descriptor B will also be appropriate - in other words they should not be awarded a higher descriptor if using an aid or appliance would remove the need for prompting, supervision or assistance.
3.2.23. It is reasonable to expect a claimant to use an aid or appliance in the
3.2.26. The HP should make suitable comparisons across activities regarding the level of functional ability present. For example, if a claimant cannot chop vegetables without an aid due to weakness in their hands then it would be expected that they would struggle to undertake other activities requiring similar dexterity. Similarly – if a claimant drives a car but says they are unable to complete other activities requiring similar dexterity, the HP should explore this with the claimant.
3.2.27. The HP should also consider the variability and fluctuation of a claimant’s health condition and the effect on their needs. Where there is variability, the HP should consider what the need is on the majority of days. For example, if a claimant can usually prepare food unaided, but occasionally needs to use an aid due to a particularly acute period in their condition, they will not be assessed as needing to use an aid as this is not needed most of the time.
3.2.28. Mobility Activity 1 refers specifically to “orientation aids”, which are defined as specialist aids designed to assist disabled people in following a route, for example long canes.
Assistance dogs 3.2.29. We recognise that guide, hearing and dual sensory dogs are not ‘aids’ but have attempted to ensure that the descriptors capture the additional barriers and costs of needing such a dog where they are required, to enable claimants to follow a route safely. Mobility Activity 1 therefore explicitly refers to the use of an ‘assistance dog’.
Assistance dogs are defined as dogs trained to help people with sensory impairments.
‘Unaided’ 3.2.30. Within the assessment criteria, the ability to perform an activity ‘unaided’ means without either the use of aids or appliances; or help from another person.
3.3. Reliability 3.3.1. Central to the application of all the activities within the PIP assessment is a consideration of the manner in which they are undertaken. If an individual cannot reliably complete an activity in the way described in a descriptor then they should be considered unable to complete it at that level and a higher descriptor selected. For example a claimant may be able to complete an activity unaided, but in a manner that is unsafe; they require supervision in order to do so safely and therefore should be awarded the higher descriptor which refers to supervision.
3.3.2. Considering reliability involves looking at whether the claimant can
complete the activity as described:
3.3.3. Judgement and experience will be required to determine whether something is “reasonable” or “acceptable”. More information on these issues is set out below.
3.3.4. This applies to every activity within the assessment.
5. Safely means in a manner unlikely to cause harm to themselves or to another person, either during or after completion of the activity.
3.3.6. When considering whether an activity can be undertaken safely, it is important to consider the risk of harm occurring. However, the risk that harm may occur due to impairments is insufficient – the harm has to be likely to occur.
3.3.7. The risk of harm occurring also has to be higher than that for a nondisabled person completing the same activity. For example, most individuals will occasionally burn or scald themselves slightly while cooking; you must consider whether the claimant is at a notably greater risk of burning or scalding themselves as a result of their health condition or impairment.
3.3.8. Harm includes damage to an individual’s health. For example if carrying out an activity could cause a substantial and sustained worsening of a claimant’s condition, meaning it is not safe for them to do it at all, the individual should not be considered able to complete the activity safely at the level described in the descriptor.
Given the nature of the activities within the assessment this is likely to be rare.
3.3.9. As made clear in legislation, harm is in relation to an individual or another person and therefore does not include damage to property.
Damage to property may, however, be relevant to whether an activity can be completed to an acceptable standard or repeatedly.
3.3.10. The regularity with which any risk occurs is also important, for example if an individual has forgotten to take their medication at times in the past but ordinarily manages to remember unaided there is unlikely to be a risk to their safety.
3.3.11. Even if the impact of the risk is significant, it must still be likely to occur. For example, everyone is at risk of injury if they fall but for some the likelihood of falling is much higher, so the risk of injury occurring is higher. For example a claimant with a balance problem may have difficulties getting in and out of the bath safely without help from another person because of the risk of falling. Another claimant with a balance problem also at risk of falling may be able to use the bath safely with the aid of a grab rail. You must consider whether the risk of the adverse event is great enough to require continuous supervision for the duration of the task.
3.3.12. The following situations highlight examples for each activity where there may be a potential risk to the safety of the claimant or others.
This list is not exhaustive and further consideration would be required as to the level of risk and whether mitigation, such as suitable aids and appliances, would be possible. Any risks presented by the claimant should be considered.
3.3.13. Preparing food
To an acceptable standard 3.3.25. This term is not defined in legislation, which means it should have its ordinary meaning, i.e. that activities should be carried out to a standard that is acceptable.
Repeatedly 3.3.26. Repeatedly means as often as the activity being assessed is reasonably required to be completed.
3.3.27. How often the claimant needs to complete each activity is not specified. The HP should consider how often they would normally expect each activity to be completed, for example you would normally expect an individual to prepare food three times a day, but to heat food only once a day. In most cases the HP should use this norm as a benchmark when considering whether the claimant can complete the activity repeatedly.
3.3.28. However, some individuals may need to complete an activity more frequently as a result of their health condition or impairment. For example an individual with colitis may need to go to the toilet more frequently. In these cases the HP should consider whether it is reasonable for the individual to complete the activity more frequently as a result of their health condition or impairment, and if so what the reasonable number of times is in their individual case. It should then be considered whether or not the claimant is able to complete the activity that number of times.
3.3.29. Where the act of completing the activity means the individual is unable to repeat the activity again, within a period when they could reasonably be expected to do so, they are likely to be considered as not completing the activity repeatedly. For example, an individual can prepare their breakfast, but the exertion of doing so leaves them exhausted and they are unable to prepare their lunch as a result, but by the evening they have recovered enough to prepare an evening meal. Because, after preparing breakfast, you would reasonably expect someone to be able to prepare a meal again by lunchtime, in this example the individual cannot be considered able to complete the activity repeatedly.
3.3.30. Consideration should also be given to whether an individual is able to repeat a task on subsequent days. For example an individual may be able to fulfil the ‘Moving around’ criteria one day, but the exertion of doing so means they are unable to do so the following day. When considering repeatability over longer periods of days and weeks, the HP should apply the rules governing fluctuating conditions (set out in regulation 7 of the Social Security (Personal Independence Payment) Regulations 2013) and consider whether which descriptor applies on the majority of days in that period.
3.3.31. Symptoms such as pain, fatigue and breathlessness should be considered when determining whether an activity can be carried out repeatedly. While these symptoms may not necessarily stop the claimant carrying out the activity in the first instance, they may be an indication that it cannot be done as often as is required.
3.3.32. The following situations highlight examples where an individual may be considered unable to repeatedly complete a descriptor in the way
described due to the impact this would have: