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4.1.1 Services for Children with Disabilities


Contents

  1. Introduction
  2. Definition of Disability
  3. The Legal Framework
  4. Aims of Service
  5. Criteria
  6. Assessment
  7. Safeguarding the Welfare of Disabled Children
  8. Access to Specialist Short Break/Family Support Services
  9. Review

    Appendix 1: Screening tool for assessing whether threshold criteria is met

    Appendix 2: Factors to be taken into account when allocating Services from Bridges to Disabled Children and their Families

    Appendix 3: Pathway to specialist services or short breaks funding

    Appendix 4: Bolton's Strategy for Special Educational Needs and Disability (SEND) 2014-2018


1. Introduction

All children, whether or not they are disabled, should have access to universal services. The authority is working towards eliminating discrimination and promoting equality of opportunity by building capacity in all services so that they are accessible to all children. However it recognises that in order to meet specific needs and to ensure that disabled children are not disadvantaged, a mixture of universal and specialist services will be required.

This Policy relates to the provision of specialist social care services for disabled children and young people and their families in Bolton. These services include both the specialist social work fieldwork team and the provider services, collectively known as BRIDGES. (See also Bolton Policy and Guidance for the Provision of Children’s Beds and bed Related Equipment in the Community (2015))

It also includes the provision of funding to support short breaks for disabled children and young people in universal, targeted or specialist settings.

For the purpose of delivering effective, well-targeted services, and in accordance with our duty to promote disability equality, clear eligibility criteria need to be in place. The primary purpose of this procedure is to define the eligibility criteria, set out how we will assess levels of needs and how the Authority will contribute to meeting those needs.


2. Definition of Disability

This policy uses the Disability Discrimination Act (DDA) definition of disability as a starting point:

'a physical or mental impairment which has a substantial and long term adverse effect on his ability to carry out normal day to day activities.'

Within this context 'normal day to day activities' should be seen in comparison to other children / young people of the same age.

'Substantial' means more than minor or trivial.

'Long term' is taken to be of more than 12 months.

'Impairment' might be cognitive, sensory, physical or mental.

Young people with long term health conditions and complex health care needs where these have a substantial effect on their ability to carry out normal day to day activities are included.

Young people with severe disfigurements including skin diseases are automatically included in DDA.

Children and young people covered by this definition will have widely varying needs. These needs will depend not only on the type and degree of their impairment and that impairment's affect on capacity under DDA (e.g. understanding, learning and concentration, mobility, physical co-ordination, manual dexterity and perception of risk of physical danger). They are likely to depend on other factors such as age, ethnicity and family circumstances; and will change over time.


3. The Legal Framework

Services currently operate within legislation which includes the Disability Discrimination Acts (1995 and 2005), the Children Act 1989 and 2004, the Chronically Sick and Disabled Persons Act 1970, the Carers and Disabled Children Act 2006 and Childcare Act 2006

All disabled children are Children in Need for the purposes of Section17 (1) of the Children Act 1989.

Currently the Authority has a duty to:

  • Assess the needs of disabled children and to safeguard and promote the welfare of disabled children by providing a range and level of services appropriate to those children's needs;
  • Provide services including short breaks under its duties and powers contained within Part 3 of The Children Act 1989 (Local Authority Support for Children and Families);
  • Provide services under section 2 of the Chronically Sick and Disabled Persons Act (CSDPA), if, following an assessment, they are judged to be necessary;
  • Ensure that disabled children are not treated less favourably than their non-disabled counterparts, in line with DDA requirements. This will be achieved both by supporting disabled children and young people and their families to have access to local universal provision and specialist or targeted provision where appropriate;
  • Write Short Breaks Statement which tells families about the range of short breaks service available, any eligibility criteria they use to decide who is entitled to get a short break, and how the range of short breaks is designed to meet the needs of local families with disabled children. (Breaks for Carers of Disabled Children Regulations 2011).


4. Aims of Service

The service works with children and young people from 0-19. From 14 it will engage with YAT (Young Adults Team) with a view to planning for the future and transfer of case allocation to YAT or an adult team as appropriate, no later than a young person's 18th birthday.

It aims to:

  • Safeguard and promote the welfare of disabled children and young people with significant additional support needs so that they enjoy a valued childhood; achieve ECM outcomes and are helped to make a positive transition into adulthood;
  • Support parents in their parenting role, recognising the additional pressures placed on them to universal provision.

Children's Services will currently provide direct services or funding to meet the social care needs of disabled young people who are at school until their 19th birthday. If a young person is not at school it will be their 18th birthday or school leaving date whichever is the later.


5. Criteria

The purpose of these eligibility criteria is to enable service allocation to be fair, clear and equitable

Whilst the criteria for service are necessarily constructed around the adverse effects of a young person's impairment, the service aims to root its practice in the social model of disability seeking to replace disabling features of the physical and social environment with ones that are enabling. It forms part of a range of services including those provided by health and education which support disabled children and their families to be fully included in the 'Bolton family'.

Because of the breadth of DDA, it does not serve as a 'free standing' or effective criterion for identifying those children and families who need specialist support. Using Government guidelines of 7% of the child population, there are an estimated 4,000 young people in Bolton who qualify under DDA. All service providers would be expected to make 'reasonable adjustments' for this group but the majority of them will not require or benefit from specialist services, and in some cases inappropriate 'labelling' will have an adverse effect on the outcomes for children.

In determining criteria, it is necessary to consider/ assess the impact of any impairment on both the young person and the family. A medical diagnosis e.g. 'ASD', 'Cerebral Palsy', 'ADHD' does not give enough information to determine needs as each spans a wide spectrum of effect/ impact.

The service is intended to work with severely disabled children and young people from 0-18. DCSF have approximated this to the receipt of high rate of Disability Living Allowance (DLA). However we recognise that many children, who do not meet this threshold because they do not have care needs at night, do have very substantial support needs during the day which can affect their life chances. All children, to be eligible for specialist disability services, will either be in receipt of; or eligible for, the middle or high rate of the care component of the DLA. This is a necessary but not sufficient criterion.

The child/young person will be assessed as having:

  • An impairment or combination of impairments which might be cognitive, physical, sensory or communication which have a substantial impact on a young person's functioning, particularly in relation to young people of the same age; and which results in care needs which are significantly and consistently in excess of children and young people of the same age such that there is a clear and continuous effect on the family's ability to lead an ordinary life;

    or
  • An ongoing illness or organic disorder, where this has a substantial impact on a young person's functioning and care needs which are significantly and consistently in excess of children and young people of the same age such that there is a substantial and continuous effect on the family's ability to lead an ordinary life.

Families of young people who have:

  • Conduct disorders or behaviour difficulties which arise as a result of life experience rather than impairment;
  • Additional health needs such as asthma, eczema and epilepsy (unless that condition is persistent and leads to significant loss of function and care needs as above);
  • Intermittent mental health difficulties, or psychosis;
  • Do not meet criteria as outlined above and will be redirected to a more appropriate service


6. Assessment

Any assessment should be proportionate to need. All families of disabled children are entitled to an assessment of need under s.17 of Children Act 1989. When requested this will be undertaken by the specialist social work team. Not all families wish to engage with or need a social work service; where threshold criteria are met, we are working towards families being able to access some short break opportunities directly, i.e. without further assessment, depending on resources available. These will include out of school/ holiday provision.

A screening tool has been developed which can be used by agencies or families as part of a self assessment to judge whether threshold criteria are met - see Appendix 1: Screening tool for assessing whether threshold criteria is met.

Parents are encouraged to register their child on The Record, the Authority's database of disabled children. This will give them access to regular information about services.

Where a disabled child has a key professional assigned from another agency and they are able to identify a support need clearly through use of the {Common Assessment Framework] (CAF) with a parent or carer, or through a specialist assessment and there are no indicators that a specialist social work service is required, they should be able to refer directly to short breaks/ family support services. If a social work assessment has not been undertaken, any referrals to services must be supported by an up to date CAF agreed with parents.

An assessment of need will take a holistic/ integrated family based approach using the Framework of the Assessment of Children in Need and their Families (DOH,2000) identifying and analysing the needs of both children and their parents. It is likely that any services identified following the assessment will be aimed at offering support to parents to meet their needs as carers (i.e. those tasks which are beyond the typical parenting role for a child of that age) and enabling them to sustain that role. As such this should incorporate a Carers Assessment without the need to complete a separate document.

Where an identified social care service is required following an assessment of need families will be offered the option of a direct payment as an alternative.

It is recognised that the impact of any impairment will change over time, and current circumstances of the young person and their family should inform an up to date assessment.

It cannot be assumed that a significant impairment which has a relatively low impact on a family and young person when they are very young has an equally low impact as they grow up. Nor should it be assumed that once a child is in receipt of specialist services they will need to remain so until adulthood.


7. Safeguarding the Welfare of Disabled Children

Where there are areas of concern about a family  that includes a disabled child in its membership but are not specific to that child, a Single Assessment should be carried out by the relevant locality team to ascertain any specific need. The specialist disability social work team will offer advice and guidance and if appropriate will co-work such assessments.

In respect of disabled children who are not open cases to the specialist fieldwork team, any Section 47 Enquiry (child protection enquiry) will be undertaken by the appropriate locality team. The specialist team will undertake any Section 47 Enquiries and subsequent action in respect of a child who is an open case to the team. They will also be responsible for undertaking Section 47 Enquiries in respect of a sibling of a disabled child who is open to the team.

Where there is a need for ongoing social work involvement / further assessment, the relevant team managers will decide which team should take case responsibility. In cases of dispute, resolution should be based on whether the primary needs identified arise from a young person's impairments and parental capacity to meet those additional needs.

The specialist social work team will take as their priorities:

  • Those disabled young people where there are potential risk factors in safeguarding the child's welfare due to parental capacity or environment;
  • Those disabled young people where there is indication that ECM outcomes are not being met as a result of additional needs arising from their impairments;
  • Those disabled young people where there are significant concerns about the emotional and physical health of the parents and their ongoing capacity to care;
  • Those disabled young people whose impairments and family circumstances indicate the potential for a complex package of multi-agency support which needs regular co-ordination and review;
  • Those disabled young people who might need to be Looked After away from home as part of a support package or are at risk of needing to be Looked After full time due to factors above.

In cases above where the locality team takes a lead, advice and consultation will be available from the specialist social work team through the duty officer.


8. Access to Specialist Short Break/Family Support Services

For pathway see Appendix 3: Pathway to specialist services or short breaks funding.

Families and any professional undertaking an assessment should always explore the availability of universal services to meet the needs of children including the opportunity to enjoy some time away from home in positive activity, before a referral is made to specialist services.

The service is also working with providers who can offer targeted support, for example through holiday schemes. These will be advertised and accessed directly. Attendance will be recorded for statistical purposes and to ensure equality of access.

Where specialist social care short break or family support services are indicated referrals will be discussed at a resource allocation meeting. Families should always be made aware that one option is a direct payment in lieu of a specific service. Direct payments allow parents and young people themselves as they get older, to have control over how and when support is delivered. They can provide an important element of flexibility. At present the allocation meeting only accepts requests for direct payments where the assessment has been agreed by a member of the specialist fieldwork team.

A meeting takes place weekly and will consider all new requests for short break / family support from BRIDGES and significant changes to support packages. It also discusses requests for a direct payment in lieu of service and on occasion requests for social care support to be provided from external agencies. In discussing referrals and the level/ type/ priority for support the meeting will be guided by the assessment and the identified level of need/ concern about the young person's welfare. In doing this the meeting has also developed a tool, 'Factors to be taken into account when allocating services from Bridges'. This is designed to help the process and decision making be as transparent as possible and can be shared with parents. (See Appendix 2: Factors to be taken into account when allocating Services from Bridges to Disabled Children and their Families).

Families with a severely disabled child who need support in an emergency, for example due to sudden illness/ bereavement should be able to access immediate support through the social work duty system in consultation with a manager.


9. Review

This PPD will be reviewed in light of the new duty to provide short breaks announced in the Children and Young Persons Act 2008, no later than 07/2011.


Appendices

Click here to view Appendix 1: Screening tool for assessing whether threshold criteria is met

Click here to view Appendix 2: Factors to be taken into account when allocating Services from Bridges to Disabled Children and their Families

Click here to view Appendix 3: Pathway to specialist services or short breaks funding

Click here to view Appendix 4: Bolton's Strategy for Special Educational Needs and Disability (SEND) 2014-2018

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