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6.1 Children with Disabilities Team

ADDITIONAL GUIDANCE

For additional guidance, see Safeguarding Children: Practice Guidance (DSCF 2009) which is available on the Department for Education website.


Contents

  1. Criteria for Referral to the Team
  2. Referral Process
  3. Assessments
  4. Child Protection Cases
  5. Services to Children with Disabilities and the Resource Panel
  6. Equipment and Adaptations
  7. Complex Issues Panel
  8. Statutory Visits to Children in Respite Care
  9. Reviews
  10. Disability Register

    Appendix 1 - Eligibility Checklist
    Appendix 2 - Resource Panel Terms of Reference and Membership
    Appendix 3 - Access to Resources Criteria
    Appendix 4 - Children Continuing Care Process


1. Criteria for Referral to the Team

1.1 The criteria for the Children with Disabilities Team establish the threshold at which a referral in relation to a child with disabilities will be accepted by the Team.
1.2 Where a child has disabilities which appear to meet the criteria and call for specialist intervention, these cases will be referred by the Referral and Assessment Team to the Children with Disabilities Team.
1.3

The criteria are that the child is a resident of Hillingdon and:

  • Has a substantive and severe physical disability; and/or
  • Has a substantive and severe learning disability; and/or
  • Has complex health needs; and/or
  • Has a severe Autistic Spectrum Disorder.

(NB “substantive” implies a level of need, significantly different to that of a child of a similar age, where the disability has a profound effect on the child’s development.)

See Appendix 1 - Eligibility Checklist to assist in determining whether the criteria are met.

1.4 The child meeting the above criteria will require a range of services to promote or safeguard his or her health, development and/or well-being and the intervention identified will aim to minimise the impact of the disability – see Section 5, Services to Children with Disabilities and Section 6, Equipment and Adaptation.
1.5 Where mainstream social workers hold cases of children who might be considered to be disabled but do not meet the criteria for referral to the Children with Disabilities Team, appropriate advice and support can be made available from the specialist Children with Disabilities Team.


2. Referral Process

2.1 All referrals should initially be made to the Referral and Assessment Team. Where it appears that the criteria for the Children with Disabilities Team are met, the Referral and Assessment Team will transfer the referral to the Children with Disabilities Team within 24 hours. In cases of doubt, consultation will take place with the Children with Disabilities Team Manager and advice sought as to whether the criteria for transferring the case are met. Where there are child protection concerns, see Section 4, Child Protection Cases
2.2 Where there is a dispute, the matter should be discussed between the relevant team managers with a view to resolution.
2.3 Where the dispute remains unresolved, the matter should be referred to the relevant Service Managers with a view to resolution.


3. Assessments

3.1 All children who meet the criteria for the Children with Disabilities Team will receive an Assessment of their need for services, which will be completed within 45 working days in accordance with Working Together 2015.
3.2 The Assessment will be carried out in consultation with the family, using information from other professionals as appropriate. The Eligibility Checklist (see Appendix 1 - Eligibility Checklist) will be completed for each child who is assessed.
3.3 It is the impact the disability has on daily living that is a key part of the assessment.
3.4 Where the Assessment identifies the need for a Carer’s Assessment, this will also be carried out. 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.
3.5 Other additional specialist assessments will also be commissioned as necessary, for example the need for an Occupational Therapist (OT) assessment to determine the need for equipment or adaptation to the child’s home. In the case of an OT assessment, it may be necessary to prioritise the starting time of the assessment on the basis of the urgency of the need, in which case the family will be advised in writing of the likely waiting time involved.
3.6 Parents of children with disability and the child (depending of their age and level of understanding) will be given information about the Disability Register - see Section 10 Disability Register.


4. Child Protection Cases

4.1 With new referrals (i.e. where the case is not open to the CWD Team) where the primary concern is child protection, i.e. that the child is at risk of Significant Harm, the Referral and Assessment Team will retain responsibility for the child's case, and appropriate advice will be provided by the Children with Disabilities Team relating to issues arising from any disability. The assessment process and any instigation of a Section 47 Enquiry will remain the responsibility of the Referral and Assessment Team until such time as the case is formally transferred.
4.2 The Referral and Assessment Team will also undertake all Section 47 Enquiries in respect of children who are already open cases in the Children with Disabilities Team, although the allocated social worker from the Children with Disabilities Team will co-work the case.


5. Services to Children with Disabilities and the Resource Panel

5.1 As a general principle, where children and families can receive mainstream services, these should be provided as a way of minimising the impact of disability and avoiding any unnecessary segregation. 
5.2 Where the assessment identifies that specialist services are required, these may be provided by health or voluntary agencies as well as the local authority. The assessment will make recommendations as to the package of services or equipment required to meet the child's needs.
5.3 Where the recommendation is for the provision of equipment and/or adaptation to a child’s home, see Section 6, Equipment and Adaptations.
5.4 Any other package of services will be referred to the Resource Panel for approval. See Appendix 2 - Resource Panel Terms of Reference and Membership.
5.5 The Resource Panel will allocate resources in accordance with the guidelines set out in Appendix 3 - Access to Resources Criteria.
5.6 The Resource Panel meets monthly and is chaired by the Children with Disabilities Team Manager. If service provision is required on an emergency basis between Panel meetings, the Children with Disabilities Team Manager can approve such provision until the next available Panel meeting.
5.7 Referrals to the Resource Panel must be supported by a copy of the Assessment Record with a front sheet. The documents should be sent to the administrator 10 working days before the Panel meeting and will be circulated by the administrator to Panel members 5 working days before the meeting.
5.8 The social worker and/or assistant team manager should attend the Panel during consideration of the case.
5.9

The services that may be included in a support package range from:

  • The provision of information on activities, clubs, playgroups and play schemes;
  • The provision of advice and information about other organisations which may be able to offer help and support;
  • Support groups for parents/carers;
  • Parenting programmes such as Triple P, Stepping Stones;
  • Sibling support groups for children between 6 and 17 who have a brother or sister with disabilities;
  • Social work support for the child;
  • The Outreach Service, including complex health services e.g. providing support to a child who uses a gastronomy tube or nasal gastric tube or is terminally ill;
  • Short breaks providing overnight care through the Family Link Scheme or residential provision – see also Section 8, Statutory Visits to children in respite care;
  • Support Services using Direct Payments - see the Direct Payments Policy.
5.10 When services have been agreed, they will be incorporated into a Child in Need Plan - or, where the child becomes Looked After, a Care Plan.


6. Equipment and Adaptations

6.1 Children must have a moderate need (see Appendix 1 - Eligibility Checklist) and permanent disability in order to receive equipment via the Community Equipment Service or minor adaptations (i.e. adaptations costing under £1,000). There is no cost for such services. However, the provision of items of equipment over £1000 must be approved by a panel of clinical specialists.
6.2 If equipment is required and any necessary approval has been obtained, it is provided by the Community Equipment Service on a permanent loan basis. Where appropriate an annual review will take place to confirm that it is still appropriate to meet the needs of the child. Stock items of equipment will be delivered within 2 days of a request. Items which have to be ordered will be delivered when available from the supplier.
6.3 Minor adaptations include the provision of handrails, grab rails and ramps. The OT service will arrange for the provision of these adaptations including obtaining quotations if specialist adaptations are required.
6.4 Children must have a substantial and permanent disability in order to be eligible for major adaptations. If major adaptations are required, there are different processes depending on whether the property is privately owned or occupied. Disabled Facilities Grants are available to owner/occupiers and privately rented properties. If a Disabled Facilities Grant is successfully applied for and the cost is in excess of £25,000, it will be means tested to determine whether a contribution is required.


7. Complex Issues Panel

7.1 Where the support services include the provision of residential care or foster care and the child becomes Looked After, a referral will be made to the Complex Issues Panel for approval and consideration of the division of responsibilities for the costs – see Appendix 4 - Children Continuing Care Process Flowchart.


8. Statutory Visits to Children in Respite Care

8.1 Children in respite care for 120 days or less per year will receive social work visits at a minimum within 4 weeks of the child being placed and thereafter once every 12 weeks alternating between the placement and the child’s own home.
8.2 Children in respite care for 120 days or more per year will receive social work visits at a minimum within 7 days of the child being placed and thereafter once every 12 weeks alternating between the placement and the child’s own home.
8.3 A Statutory Visit Form will be completed after every visit.


9. Reviews

9.1 Subject to 9.2 and 9.3 below, reviews of Child in Need Plans/Care Plans for children with disabilities take place every 6 months. Reviews are conducted more frequently where circumstances require it, e.g. where there has been a significant change in the child's circumstances or with the resource or resources involved.
9.2 Children in receipt of respite care for 120 days or less per year will have their first review within three months of the first overnight respite, then after 6 months in the first year. Thereafter, the review will take place every 6 months but every other review will be a paper review. The reviews will consider the Essential Information Record Parts 1 and 2, the child’s Care Plan/Child in Need Plan and Placement Plan.
9.3 Children in receipt of respite care for 120 days or more per year will have their first review within one month of the first overnight respite, then every 3 months in the first year. Thereafter, the review will take place every 6 months. The reviews will consider the Essential Information Record Parts 1 and 2, the child’s Health Assessment, Care Plan, Placement Plan, Personal Education Plan and, where relevant, Pathway Plan.
9.4 Reviews of children with disabilities who are Looked After on a full time basis will be as set out in the Looked After Reviews Procedure.
9.5 Reviews where possible will be combined with the child’s annual review of their special educational needs.
9.6 Children will be encouraged to participate in their own reviews.
9.7 Reviews are coordinated by the respite care social worker or the reviewing officer in the Children with Disabilities Team, and, where the child is Looked After, chaired by an Independent Reviewing Officer – see Looked After Reviews Procedure. Where necessary, changes to the Child in Need Plan will be made and the amended plan circulated to all involved as set out in Child's Plans and Reviews Procedure.


10. Disability Register

10.1 The Disability Register holds information about children with disability and is a legal requirement for all local authorities.
10.2 Parents are asked whether they wish to supply information about their child for inclusion on the register.
10.3 The register is used to plan and develop services for children with disabilities and also to assist Adult Services with information on future service needs.


Appendix 1 - Eligibility Checklist


MODERATE SEVERE
PHYSICAL
  • Generally walks and functions independently, but with some limitations (e.g. slow walking, poor balance asymmetry);
  • Some difficulty in changing positions;
  • Occasionally uses aids or assistance, may use a wheelchair;
  • Delay in the physical acquisition of motor functioning that can be countered by specific therapies;
  • Some difficulties in play, writing, drawing, dressing;
  • Some communication impairment;
  • May require occasional help and supervision in completing self-care tasks.
  • Unable to walk independently;
  • Daily postural management required;
  • Primarily uses a wheelchair for mobility;
  • Permanently restricted motor functioning requiring aids and adaptations;
  • Consistently requiring assistance when reaching, eating, writing, dressing;
  • Communication difficulties consistently requiring the need for technological aids;
  • High care needs requiring constant help and supervision;
  • Major adaptation required to help with daily living activities and/ or to assist the carer.
LEARNING
  • Identified Specific Learning Disability (e.g. Dyslexia);
  • Moderate Learning Difficulty;
  • Some delay in the acquisition of language skills;
  • Some delay in learning self-help and care skills.
  • Psychometric/Developmental assessment reveals Severe and/or Profound Learning Difficulty;
  • Severely delayed language development;
  • Major reliance on others for care needs.
HEALTH
  • Known persistent problem, under control;
  • Well controlled symptoms;
  • Regular treatment required and managed well;
  • Intermittent limitations of normal activities.
  • Serious, deteriorating illness;
  • Major difficulty with the control of symptoms;
  • Palliative care required;
  • Daily interruption of normal activities requiring co-ordinated multi-disciplinary case planning.
AUTISM
  • Diagnosed with Aspergers and/or Attention Deficit Hyperactivity Disorder;
  • Sometimes aggressive or difficult to manage;
  • Being restless and/or destractable;
  • Some delay or difficulty with using speech in a socially interactive manner.
  • Behavioural problems requiring some extra support or supervision;
  • Some difficulty in relating to other children and/or adults;
  • Diagnosed with a Severe Autistic Spectrum Disorder;
  • Aggressive behaviour possibly causing significant injury to self or others;
  • Constant adult supervision required;
  • None or very little speech but able to communicate basic needs;
  • Unable to function alone or in a group without considerable help, support and supervision. Unwilling or unable to relate to other children and/or adults.


Name of Child:


Comments:


Appendix 2 - Resource Panel Terms of Reference and Membership

1. Membership 

  • Service Manager, Children with Additional Needs;
  • Team Manager/Assistant Team Manager, Children with Disabilities Team;
  • Unit Manager, Merriefield Ave;
  • Unit Manager, Howletts Lane;
  • Family Link Coordinator;
  • Outreach Service Coordinator;
  • Representative from Child Development Centre;
  • Crossroads Care.

2. Frequency of meetings

  • Monthly for 1 ½ to 2 hours;
  • Each case to be allotted 10 minutes;
  • Papers to be circulated 5 working days in advance to all Panel members.

3. Terms of Reference

3.1 The Panel will consider all children in need assessments completed by the Children with Disabilities Team where there is a recommendation for a resource/service which has a funding implication.
3.2 The Panel will ensure that all children and families have resources fairly allocated based on priority of needs within the existing resources of the agencies that the Panel members represent.
3.3 The Panel will identify appropriate resources and care packages and make recommendations as to their delivery.
3.4 The Panel cannot commit resources without agreement from agency fund holders.
3.5 Care packages which have resource implications can be agreed outside of the Panel by the Children with Disabilities Team manager in emergency situations. These need to by ratified by the next Panel.
3.6 The Panel will review all care packages that have a resource element on a regular basis.
3.7 There will be an opportunity at Panel meetings for members to identify cases as early alerts
3.8 The Panel will only consider cases where papers have been previously circulated.
3.9 The Panel may identify gaps in provision as part of their work. This will be raised with the CWAN executive for them to consider within the context of strategic planning for children with additional needs.
3.10 The Panel will inform all families of the outcome by letter.


Appendix 3 - Access to Resources Criteria

Guidance to the allocation of resources for children with disabilities

Critical – when

  • Life is, or will be, threatened;

    and/or
  • Ssignificant health problems have developed or will develop; and/or
  • There is, or will be, little or no choice and control over vital aspects of the immediate environment; and/or
  • Serious abuse or Neglect has occurred or will occur; and/or
  • Vital social support systems and relationships cannot or will not be sustained; and/or
  • Vtal family and other social roles and responsibilities cannot or will not be undertaken.

Allocation of hours guidelines – to be agreed at Resource Panel

Maximum 16 hours per week support in the home.

Maximum additional 80 hours for school holiday support (based on 10 weeks holiday).

Maximum of 4 hours per week for children referred to complex health care project.

Additional support hours above guideline requires agreement of Head of Service.

Overnight respite – equivalent to one night per week 52 nights per year.

Over 10 days per month (120 days per year) and or over £600 per week will require agreement at Access to Resources Panel/Head of Service.

Substantial – when

  • Abuse or Neglect has occurred or will occur; and/or
  • There is, or will be, an inability to carry out the majority of personal care or domestic routines; and/or
  • Involvement in many aspect of education or learning cannot or will not be sustained; and/or
  • The majority of social support systems and relationships cannot or will not be sustained; and/or
  • The majority of family and other social roles cannot or will not be undertaken; and/or
  • The children has severe challenging behaviour; and/or
  • There is a need to prevent children becoming looked after.

Allocation of hours

Maximum of 8 hours per week support.

Maximum additional 40 hours for school holiday support (based on 10 weeks school holidays).

Maximum of 26 overnight respites per year.

Additional support hours above guideline requires agreement of Head of Service.

Moderate – when

  • There is, or will be, an inability to carry several personal care or domestic routines; and/or
  • Involvement in several aspects of education or learning cannot or will not be sustained; and/or
  • Several social support systems and relationships cannot or will not be sustained; and/or
  • Several family and other social roles and responsibilities cannot or will not be undertaken;
  • To support parent to spend time with other children.

Allocation of hours

Maximum of 4 hours per week.

Additional 30 hours to be used for school holiday support.

Maximum of 13 overnight respites per year.

Additional support hours above guideline requires agreement of Head of Service.

Low – when

  • There is, or will be, an inability to carry out one or two personal care or domestic routines; and/or
  • Iinvolvement in one or two aspects of work, education or learning cannot or will not be sustained; and/or
  • One or two family and other social roles and responsibilities cannot or will not be undertaken;
  • School holidays – to support families with activities.

Allocation of hours

Maximum of 3 hours support per week.

Additional 20 hours to be used for school holiday support.

Additional support hours above guideline requires agreement of Head of Service.


The criteria for allocation of resources are based on the government guidance to local authorities for adult care. Hillingdon have adapted this for use with children and will be piloting the amended criteria for children allocated to the Children with disabilities Team. The guidance describes four bands of need Critical, Substantial, Moderate and Low.

  • The assessing worker will need to give evidence as to how the child fits into the access to care criteria of need;
  • The guidance gives maximum levels of support for each band and should not be the norm for all children within the band;
  • The Resource Panel will be the determining body for agreeing the band and allocating resources;
  • In assessing the allocation of resources, the Panel will take into consideration the support the family is receiving from other statutory agencies and non statutory agencies e.g. Crossroads care and therapeutic services;
  • The age of a child will be taken into account in allocating resources e.g. all children under 5 require parental supervision and disturbed sleep patterns are not uncommon for children under 5;
  • Resources will not be allocated for 7/7nights;
  • Wherever possible, young children should not be separated from their families. For this reason overnight respite away from a family environment should not be considered for children under 10 unless the children are within the critical band and there are extenuating family circumstances;
  • Support cannot be allocated to enable a parent to work;
  • The allocation of resources for children in the low criteria will depend on the availability of resources;
  • Where children are assessed as having continuing care needs the allocation of resources will be determined jointly with the Clinical Commissioning Groups (CCG’s);
  • All packages of care will be subject to regular reviews;
  • Families should be made aware of the criteria and how their child’s needs have been banded;
  • Where parents/carers opt for Direct Payments, they can use the allocation as flexibly as they wish but they must be used to meet the identified need e.g. if personal care is the identified need, funding should not be used for respite care.  


Appendix 4 - Children Continuing Care Process Flowchart

Click here to view Appendix 4 - Children Continuing Care Process Flowchart.

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