MINUTES of the meeting of the TRANSITION TEAM TOPIC GROUP held on Thursday 13 January 2011 at 10.00 AM

ATTENDANCE

Members of the Topic Group

N K Brook, C A Mitchell, L J Newlyn, M A Watkin, A D Williams

Also in attendance

EldfridBecker, Transition Co-ordinator

Naomi Bignell, Senior Transition Team Nurse

Fiona Brown, Service Development Manager, Learning Disability Employment

Fiona Corcoran, Democratic Services Officer

Dave Cox, Person Centred Planning Co-ordinator

Alan Cutteridge, Commissioning Manager
Sue Darker, Assistant Director: Learning Disability and Mental Health

Will Fletcher, Learning for Living and Work Implementation Manager

Sue Gale, Head of Community Learning Disability Service

Rose Geraghty, Transition Team Manager

Patricia Halliday, Learning Disabilities and/or Disabilities (LDD) Strategy and Commissioning Manager

Andy Lawrence, Community Solutions Area Manager

John O’Loughlin, Acting Head of Inclusion Services

Jill Pegram, Parent/carer

Sheila Reynolds, Disabled Children’s Services

Natalie Rotherham, Scrutiny Officer

John Short, Aiming High Transition Development Officer

Julia Suslak, Parent/carer

Margaret Wilson, Senior Employment Adviser

Lindsey Wright, Transition Co-ordinator

1. / APPOINTMENT OF CHAIRMAN AND VICE-CHAIRMAN
1.1 / It was noted that M A Watkin had been appointed Chairman and
L J Newlyn had been appointed Vice-Chairman of the Topic Group for the duration of its work.
2. / GENERIC TOPIC GROUP INFORMATION
2.1 / The generic topic group information was noted.
3. / REMIT OF THE TOPIC GROUP
3.1 / The Group noted its remit and scope.
4. / SCRUTINY OF THE TRANSITION TEAM
4.1 / The Group received a series of presentations and took evidence from a number of witnesses during the course of the day. The main points arising from witness evidence and Member debate are summarised below. Presentations from witnesses and background information provided to Members may be viewed at

4.2 / Introduction – Sue Darker, Adult Care Services (ACS) and John O’ Loughlin, Children, Schools and Families (CSF)
  • Since the scrutiny in November 2006, significant progress has been made. The management of processes was examined as a result of the recommendations from the 2006 scrutiny and the Transition Team for young people aged 14 to 25 was created. It was felt that many changes take place for a young person between these ages so it was important that one team they are working with remained constant during this period.
  • The work of the Transition Team involves very close working between CSF and ACS.
  • Recruitment for the Transition Team was carried out jointly by CSF and ACS.

4.3 / In general discussion the following points were made:
  • Although CSF and ACS have two different information sharing systems, a decision was made that professionals from both departments would be able to access the Integrated Children’s System (ICS). Each department continues to use its own data system and data is migrated from CSF to ACS.

4.4 / Overview of Emerging Challenges
John Short, Aiming High Transition Development Officer
The Group received a presentation which outlined areas for development where work is being carried out. These areas include forward planning, young people with borderline needs, knowledge of respective departments by ACS and CSF staff, Mental Health and Wellbeing, accommodation and placement planning, maximising income and out of area placements. The full presentation can be viewed on the Herts Direct website (please see web link at paragraph 4.1.)
4.5 / In general discussion, the following points were made:
  • There is involvement from parents in most cases, including Children Looked After. Less than 5% of children in care have no contact with their parents.
  • It was suggested by a Member that more information about transition could be passed to the Fostering Panel.

4.6 / . Patricia Halliday, LDD Strategy Manager
  • The Group received a presentation outlining the essential factors required in order to manage demand and supply to enable young people with a wide range of learning difficulties and disabilities to achieve their full potential. These factors included the need for robust and accessible information, a single multi-agency assessment, person centred transition plan and accessible local services.
  • The importance of giving young people and carers a voice to inform service development was highlighted.
  • A DVD and information pack for young people has been produced as a result of feedback from the previous scrutiny. Copies of the DVD and pack were circulated to Members.
  • All young people have a transition review in year 9 and transition support is offered to all children in the county, including the most vulnerable. The role of the LDD Strategy Manager is to extend opportunities for young people. This work is linked to the Developing Specialist Provision Locally (DSPL) work.

4.7 / In general discussion, the following points were raised.
  • It was noted that there were a range of work placements and apprenticeship programmes, including a car valet enterprise linked to NorthHertsCollege. Next year Herts Constabulary will be offering four places for office based apprenticeships. The importance of offering a wide variety of work placements to suit a wide spectrum of individuals was emphasised.
  • The Aiming High for Disabled Children project will be coming to an end in summer 2011 and the goal is for the single transitional assessment to be in place for September 2011. It was noted that this goal is considered to be achievable provided the correct resource is in place to support it. The single transitional assessment has already been embedded for young people with very complex needs but the aim is to implement it for all young people.
  • In response to a question from a Member regarding sexual health issues and education for young people, it was noted that the Health Facilities team in ACS have worked closely with Health professionals and produced a DVD providing information for young people, which officers offered to send to Members of the Topic Group.
/ Sue Gale
4.8 / Health and Social Care Transition Team for Young People with Learning Disabilities and/or Disabilities – Andrew Lawrence, Area Manager and Sue Gale, Head of Learning Disabilities Service
  • The achievements since the creation of the team in 2010 were highlighted, including the total of 493 cases handled, of which 296 are active and the 20 compliments from satisfied families.
  • The key challenges for the team to respond to include:
-Managing expectations of young people and families
-Increased demography and complexity of needs
-Sustaining team performance and skill levels
-Access to resources for those with complex needs
-Accessible value for money local services for people with complex needs
  • Solutions to the challenges in this area have been identified and include better partnerships focussed on community solutions locally, an integrated referral pathway, transition strategic group and partnership commissioning for ACS and CSF.
  • There has been a significant degree of engagement with the Private, Voluntary and Independent (PVI) sector and work has been done to consider ways in which young people can be supported. A monthly forum is held with representatives of the PVI sector, in which ways of moving forward are considered.
  • There are structures for accountability, including the Transition Strategic Group, Learning Disability Partnership Board (LDPB) Sub-group and the Citizen Representatives who are involved in recruitment.

4.9 / In general discussion the following points were raised:
  • There is a good relationship with Primary Healthcare Trust (PCT) but some difficulties can arise due to differences in the regulations between adult and children’s continuing care. All the professionals involved work together to achieve the best result for the individual. When disagreements occur, the necessary discussions can take place due to the strong relationship that has been developed.
  • Schools also have a responsibility to find out what a child’s aptitudes are and what they will need to enable them to achieve.

4.10 /
  • A case study was outlined, illustrating the good relationship between teams and partner agencies. The case study involved a safeguarding alert and showed how social workers from the disabled children’s team and transition team and police worked together to ensure the young person’s safety, evaluate their situation, liaise with their family, assess their needs and put in place ongoing provision including an alternative placement and transport to school.
  • The Transition Team work closely with Special Educational Needs (SEN) teams and are given access to copies of statements which can be very helpful, particularly in borderline cases.
  • Youth Connexions have a robust procedure of intervention if a young person discloses that they may be at risk.
  • A second case study was outlined, showing how the Transition Team responded to an alert from a Housing Association relating to a young person who was not known to CSF or ACS. A social worker and a nurse visited the young person, who was also provided with relevant contact details for advice and support and useful information.

4.11 / Margaret Wilson, Senior Employment Coordinator
  • The duration of the post of Senior Employment Coordinator is two years and its purpose is to ensure employment is, and remains, on the agenda at the beginning of the transitional stage.
  • The project aims to offer information and guidance to young people, inform and advise transition staff team on employment issues, assess individuals for the most appropriate pathway to employment and create a comprehensive database of employment based activities in the county.
  • The post works closely with Youth Connexions, the Learning for Living Framework Team, Moving On groups, Work Solutions and external agencies and organisations.
  • A case study was outlined, in which young a person’s work placement led to the offer of paid employment.

4.12 / EldfridBecker and Lindsey Wright, Transition Co-ordinators
  • The structure of the Transition Team was outlined and shown in a presentation, which can be viewed on the Herts Direct website (please see web link at paragraph 4.1.) The team works with young people from 16 to 25 years with learning disabilities and physical disabilities.
  • The transition plan for a young person starts at 16 and a needs and an outcome assessment is conducted to ascertain Fair Access to Care eligibility. In some cases, young people are sign-posted to other agencies. Carers’ assessments and reviews are conducted by the team. The team works with CSF and Youth Connexions and is linked to specific schools.
  • Person centred planning is implemented in order to focus on the young person’s aspirations, wishes and hopes for adult life.
  • Between the ages of 16 and 18, a young person will be given a comprehensive assessment of needs and their transition plan will be outlined to include social care and education. They will also be allocated a social worker within the Transition Team. Care and support planning will commence, followed by the commissioning of services.
  • Between the ages of 18 and 25, the commissioned services a young person is accessing will be reviewed and regulated based on their changing needs.
  • At the age of 25 an individual will be referred to the Community Learning Disability Team or Older People Physical Disability Team covering the area they live in, if necessary. They will be supported as appropriate to go into employment, day activities and independent living.

4.13 / Naomi Bignell, Senior Transition Team Nurse
  • Nurses in the Transition Team work with community paediatricians, GPs and special school nurses among other professionals in the areas of psychology, psychiatry, speech and language and specialist dental services.
  • The work of the Transition Team can highlight differences in the NHS services for children and adults. There are also differences in the way services are run in the two halves of the county covered by the Primary Care Trusts in Hertfordshire. For children and young people, being on an adult ward in hospital can be a frightening experience. Paediatricians provide holistic care for children but there is no equivalent for adults, so young people can be referred from one consultant to several different specialists.
  • ‘My Purple Folder’ has been introduced for young people and is designed to help them to identify the services that are available and get annual health checks.
  • Care plans are created that can support individuals and enable them to access the workplace.

4.14 / In general discussion, the following points were made:
  • Youth Connexions work with young people based on the skills that they possess, while also considering opportunities for education and qualification such as Skills for Life qualifications.
  • GPs receive funding for completing an annual health check for a young person with a disability. Training on dealing with patients with learning disabilities is offered to all GPs in the county, which is facilitated by a Senior Liaison Nurse and an adult with Learning Disabilities.
  • The Transition Team in Hertfordshire is often called upon by other authorities who wish to learn from it. The structure of Transition Team is unique to Hertfordshire. Officers examined models for transition in a number of other authorities and found there was significantly less hands on, integrated work.

  • Excerpts from the Ideas 4 Life DVD were shown and Members commended officers for the high quality of the DVD’s content and style.

4.15 / Jill Pegram, Parent/carer
  • Jill Pegram thanked the Transition Team for their work and was pleased with the support and outcomes for her son.
  • The family were contacted by the Transition Team when her son was doing his A Levels. The assessment process was tactful and the parents appreciated being listened to.
  • The Transition Co-ordinator liaised with the Disability Team at the university and responded rapidly when plans were changed.
  • The benefits of having a key worker were acknowledged, highlighting the importance of being able to contact a named person about a wide range of issues and queries.

4.16 / Julia Suslak, Parent/carer
  • The assessment was completed a few weeks after her son’s 16th birthday. Throughout the assessment process, the key worker was very thorough, professional, friendly and open.
  • Despite fears that final report may be a very formal document containing a great deal of jargon, the parents were very pleased to find it was a very warm document, written in clear language and included anecdotes which reflected their son’s personality and brought the document to life. The parents felt that this document would give them and their son a voice when it was put before a panel.
  • A continuing healthcare assessment was carried out by the Senior Transition Team Nurse, who was friendly, professional and reassuring.
  • The need for a list of options for services and provision to be made accessible to everyone was highlighted. It was noted that work is underway to create a list of this kind and research is being carried out into the standard and cost of facilities. Officers noted that it would be best for this kind of list to be web-based so that it can be updated regularly. There was discussion of the need to not only create a list of services but also tell providers what services are needed to meet demand.
  • There was feedback that parents/carers could benefit from a written document, provided at the beginning of the transitions process, giving clear structure, timeline, processes and a route map of how the process works and progresses. This would be particularly reassuring for parents/carers who may feel that they have been left alone after they have got the report. It was noted that work is currently underway to create a timeline document that starts from year 9 and this work was nearing completion.
  • Jill Pegram and Julia Suslak are both members of the Parent Carer Involvement Board. It was highlighted that the Board could have asked more parent/carers for their views to feed back to this Topic Group. It was agreed that the final report of this Topic Group would provided to the Board in order to gain feedback from parents and carers.
/ Natalie Rotherham
4.17 / In general discussion, the following was noted:
  • The report produced by the Transition Team for each young person would be constantly reviewed and updated in response to the changing needs of the individual.
  • There is a 360 evaluation of the Transition Team and a public review of the team, which includes feedback from parents and carers and feedback forms are used after assessment and review. In addition to this, there is a group organised and run by young service users at OaklandsCollege that provides feedback. It is hoped that this group could be replicated in all colleges in the county. In future it is hoped that there could be a Young Disabled Person representative to the county’s Youth Parliament.
  • The different methods of providing self-directed support were clarified.