4.1 Children With Complex Needs Team |
Contents
- Criteria for Referral to the Team
- Referral Process
- Assessments
- Safeguarding Concerns
- Services to Disabled Children/ Children with Complex Care Needs and the Short Break Panel
- Legal Basis for Short Breaks (Reviews)
- Statutory Visits to Children in Receipt of Short Breaks
- Transition to Adults
- Equipment and Adaptations
- Disability Register
Appendix 1 - Access Guidance (Support, Services and Short Breaks for Families Caring for a Disabled Child in Wakefield)
1. Criteria for Referral to the Team
The criteria for the Children with Complex Care Needs Team (CCCNT) is where a child living in the Wakefield MDC area meets one or more of the following criteria at the point of referral:-
- Chronic or life threatening conditions;
- Technology dependant with a risk assessment for administering the treatment in the home or community;
- Community Nursing;
- In receipt of equipment in order to live at home (medical or care);
- Severe learning disability including severe challenging behaviour;
- Request/need for overnight respite care.
In order to qualify for an assessment there must be reasonable cause to believe that the disability is:
- Substantial i.e. there is significant impairment or loss of function affecting the child's ability to carry out essential daily living activities;
- Permanent i.e. the impairment is deemed to be life long and there may be further deterioration or the condition is terminal.
The team does not offer a service to the following conditions unless they are accompanied by a substantial and permanent disability as detailed above:
- Children with emotional and behavioural difficulties;
- Children with Attention Deficit Hyperactivity Disorder;
- Children with Specific Learning Difficulties e.g. subject of an SEN;
- Children with mental health issues;
- Children with allergies or skin conditions.
2. Referral Process
In cases where it is the clear assessment that the child will most appropriately receive services from the CCCNT then the case should transfer directly to them from Social Care Direct for an Initial Assessment to be completed (please see Transfer Protocol for Fieldwork Services).
Where there is some disagreement regarding the appropriateness of the referrals to the CCCNT the issue regarding allocation will be decided by the respective Service Managers.
3. Assessments
All children who meet the criteria for the Children with Complex Care Needs Team will receive an Initial Assessment of their need for services, which will be completed within 10 working days in accordance with the Assessment Framework.
The Initial Assessment will be carried out in consultation with the family, using information from other professionals as appropriate. It is the impact the disability has on daily living that is a key part of the assessment.
Where the Initial Assessment identifies the need for a Carer's Assessment, this will also be carried out by the Complex Care Needs Team. Under the Carers (Recognition and Services Act) 1995 carers are entitled to an assessment of their own needs. Any such assessment of carers should follow the guidance in the Assessment Framework. A Carers Alert Card will also be processed in consultation with the parents/carers.
Other additional specialist assessments will also be commissioned as necessary, such as the need for a Core Assessment where the child's needs are complex. The core assessment will be completed within 35 working days.
4. Safeguarding Concerns
If information is received or concerns are identified regarding a child already known to the Children with Complex Care Needs Team or a child who meets the team's criteria which indicate that the child is at risk of Significant Harm a Strategy Meeting / discussion will be held between the SCD Manager, Police Decision Maker, and the allocated SW / Team Manager from the CCCNT. The JIT will undertake all Section47 investigations on children and young people that are not open cases to the CCCNT. This intervention will be in accordance with the West Yorkshire Consortium Safeguarding Children Boards Procedures, (see in particular Section 5.3, Abuse of Disabled Children).
The Joint Investigation Team will work with the CCCNT in order to ensure that the Section47 investigation considers the specific needs of disabled children and the impact of the disability on the child/young person's ability to communicate and the child's specific vulnerabilities.
The CCCNT can provide advice on the specific needs of the child and the most appropriate manner in which to pursue the enquires and undertake the investigation.
If a Section47 investigation arises on a child whom is already an open case to the CCCNT, the Social Worker / Team Manager from the CCCNT will liaise with the SCD and the JIT to determine how the Section47 will be undertaken. This will be discussed and agreed via the Strategy Meeting / discussion.
Thus the JIT will provide:
- Specialist knowledge of safeguarding;
- Skills and experience of safeguarding processes;
- Application of clear safeguarding standards and procedures.
The CCCNT will provide the following:
- Specialist knowledge regarding the needs of disabled children and circumstances;
- Skills in communicating with disabled children;
- Knowledge of established relationships with other agencies working with disabled children.
Following the Section47 investigation the case will usually be allocated to the CCCNT. The CCCNT will determine the most appropriate course of action as advised following the completion of the Section47 investigation. This may lead to a child being made the subject of a Child Protection Plan.
The CCCNT will be responsible for implementing the Child Protection Plan for both the child allocated to the team and any other non-disabled child (ren) also living at the same household so as to minimise the number of professionals working with any particular family.
The CCCNT will also be responsible for managing all Legal Proceedings relating to any children allocated to the team and their siblings where they reside in the same household. This will include all assessments, Care Plans and reports in respect of any private and public law processes.
As and when a child with a disability becomes a looked after child, the CCCNT will remain the allocated team until case management responsibility transfer to either the Leaving Care Team or Adults Services as per the Transition Planning process.
5. Services to Disabled Children/ Children with Complex Care Needs and the Short Break Panel
See also Short Breaks Procedure
- The Short Break Panel can offer services ranging from overnight respite at Wasdale or Star House to services offered by the Home Based break Service.
The Home Based Break Service offer an alternative to the more traditional breaks in residential homes. Services that can be offered are:- Home Support Service;
- Family Link Service;
- Leisure Link;
- Sitting Service;
- Connect day and overnight care.
- If there is a request for an overnight short break services then a referral must be made to the Children's Complex Care Needs Team via Social Care Direct or, where the case is already active within Family Services, as per the Transfer Protocol for Fieldwork Services;
- Short Break services are allocated at a monthly panel meeting;
- Referrals can be received from any professional working with disabled children. This includes social workers, support workers, school and community nurses;
- Referrals must include an Initial Assessment, a Core Assessment and / or a CAF;
- Prior to a child being placed on the Agenda for the Panel a report should be submitted by the referring worker including child and family details; diagnoses; care needs; current family circumstances; benefits and outcomes expected from Short Break Service. The type of service envisaged, if relevant, may be indicated, although the Panel's role is to allocate to particular service(s). Short Break Service staff may make subsequent home visits to decide on the most appropriate way to meet the needs of the child and their family;
- Referrals should be sent (electronically if possible) to the Safeguarding and Family Support Administration Team. Electronic referrals should be password protected, with the password being sent separately;
- After initial screening by the Residential Services Manager a time will be allocated on the next available Panel and details will be sent to the referring worker;
- Referring workers must attend the Panel to present the case;
- Parents of the child in question may also attend the Panel, although this is not a requirement;
- Short Break services will be allocated at the Panel and, where a waiting list exists, priority will be given to very urgent need;
- The outcome will be confirmed in writing to the worker and parent.
6. Legal Basis for Short Breaks (Reviews)
Children may be provided with short breaks under the following legislation:
Situation 1
Under Section 17 Children Act 1989, in which case they are not looked after children, the 2010 Regulations do not apply and there is no requirement to appoint an Independent Reviewing Officer (IRO). A Child in Need Plan is required in accordance with the Assessment Framework. Reviews should be carried out at least every 6 months and more often if required.
Situation 2
Under Section 20 Children Act 1989, with short breaks of not more than 17 days each in the same setting and where the total number of placement days does not exceed 75 days in any 12 month period. In these circumstances, the child is looked after, an IRO must be appointed, and a Short Break Care Plan drawn up. The 2010 Regulations are modified (Regulation 48), so that Looked After Reviews and Social Work Visits are less frequent and the short breaks are treated as a single placement.
Situation 3
Under Section 20 Children Act 1989, where the short breaks exceed a total of 17 days per placement/75 days per 12 month period and/or take place in more than one setting. In these circumstances, the child is looked after, an IRO must be appointed and a Care Plan drawn up. The 2010 Regulations apply in full, including the provisions on frequency of Looked After Reviews and Social Work Visits.
The legal basis on which services are provided should be clear. The decision to provide a short break under Section 17 or under Section 20 should be informed by the assessment of the child's needs and should take account of parenting capacity and wider family and environmental factors, the wishes and feelings of the child and his/her parents and the nature of the service to be provided.
7. Statutory Visits to Children in Receipt of Short Breaks
Visits should usually be undertaken by a qualified social worker and always by a person with the skills and experience to communicate effectively with the child and fulfil the functions of the visit.
Situation 1
Good practice shall ensure that:
- The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter;
- Subsequent visits must take place at intervals of no more than 3 months for as long as the short breaks continue.
Situation 2
Visits should take place at regular intervals to be agreed with the Independent Reviewing Officer and parents/person(s) with Parental Responsibility and recorded in the Short Break Care Plan before the start of the first placement.
In any event:
- The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter;
- Subsequent visits must take place at intervals of no more than 3 months for as long as the short breaks continue.
Situation 3
Visits must take place:
- Within one week of the start of the placement;
- Thereafter, at intervals of no more than 4 weeks.
8. Transition to Adults
The CCCNT are committed to ensure that young people and their families are assisted to make a smooth and timely transition from Children's Services to Adult Services.
The Adult Services Teams most likely to be involved in Transition Planning are Adults with Learning Difficulties and Adults with Physical Disabilities.
In order to assist planning, the CCCNT will notify the appropriate Adult Services Team when a young person is approaching their 16th birthday and at the latest by the time the young person is 17 years old, and it is felt that services may be required. It should be noted that Adult Services operate their own eligibility criteria.
Where the child is ordinarily resident in another local authority area then the CCCNT should refer to the Adult Services within the relevant local authority.
If possible, the Transitions Social Worker in Adult Services will work alongside the CCCNT social worker to assist the transition process and agree plans for services post 18 years.
All young people eligible for services from Adult Services will be transferred when the young person reaches 18 years old.
9. Equipment and Adaptations
These services are provided by the Children's Occupational Therapy teams based at both Pinderfields and Pontefract General Hospitals.
The Children's Occupational Therapy Team provided a community based occupational therapy service to children with disabilities, their carers and families. This is done by assessing the functional needs of the child in their home environment. Daily living equipment can be provided where appropriate to aid independence and to support carers. The team also assesses needs which arise from housing situations and can facilitate housing adaptations.
10. Disability Register
Parents of children with disability and the child (depending of their age and level of understanding) will be given information about the Disability Register. The Disability Register is managed and maintained by WESAIL (Wakefield's Early Support Advice and Information Line).
Appendix 1 - Access Guidance (Support, Services and Short Breaks for Families Caring for a Disabled Child in Wakefield)
This document describes the support, services and short breaks that are available to families caring for a disabled child.
Services / support you can access without an Assessment.
- Information, advice and support from Wakefield's early support, advice, information and liaison service (WeSail) is available to all families. This service can be contacted on 01924 379015;
- Summer play scheme/ holiday activities;
- Support from Wakefield's Leisure Inclusion Project (Get Started) on 01924 239250;
- Carers Alert cards are available for all carers and ensure that plans are in place in the case of an emergency. (Ring WeSail).
Services / Support that require an Assessment
Where children and young people need more specialist support, this document provides guidance about the how short breaks are allocated - in terms of units and banding levels. If the banding level is not clear or where there are exceptional circumstances, a more detailed assessment will be completed by a Social worker and an appropriate level of support will be determined by the Short Breaks Panel. As needs change, then children can move between bands and access a different level of support. Each child is individual and family circumstances vary. The banding criteria act as a guide to the approximate services that maybe offered.
More about Units
Units are allocated for a year. All short breaks are subject to availability and discussion with service providers. Breaks available for children and young people in Band 2 and 3 will necessitate units from several providers.
1 UNIT = a 4 hour outreach/sitting or day-care session.
2 UNITS = An overnight stay where child at school the next day OR Full day's Day care (7/8 hours)
3 UNITS = Premium overnight stay - Friday/ Saturday night or in the Holidays.
ALSO
- From time to time, young people may have the opportunity of taking part in a particular project or pilot scheme as an alternative to regular short break provisions;
- Direct Payments or Individual Budgets (IBs may be available for young people 14+) are alternative ways of getting support.
FOR FURTHER INFORMATION Contact your social worker, health professional, Social Care Direct (0845 8503 503), the Family Information Service on (0800 587 8042) or WeSail (01924 379015)
Click here to view Families Caring for a Disabled Child: Basic Entitlement table
Click here to view Families Caring for a Disabled Child who may need more Specialist Support table
Click here to view Specialist Support Band 2 table
Click here to view Specialist Support: Band 3 table
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