Service Specification / Strategy - Short Breaks - Liverpool
Organisation / Liverpool City Council
Provider Lead / Carol See – Short Breaks Manager , Liverpool City Council
Date / 1.04.2016(reviewed annually)

Drawn by service user aged 18 years.

1.Population Needs
1.1 National/local context
Short Breaks Services are a key component of the achievement of independence, safety, dignity and well-being for children in Liverpool.
This specification aims to provide the highest level of service possible, whilst maximising the use of available resources to deliver positive outcomes for children and their families.
  • Local authorities are required by law to provide short breaks for families with disabled children. Short Breaks are part of the local authority’s ‘Local Offer’ for children with special educational needs and disabilities.
  • The purpose of this statement is to set out the range of short breaks services, ensuring there is appropriate choice, range and quality of short breaks to meet the needs of disabled children and their families.
  • Section 25 of the Children and Young Person’s Act requires local authorities to provide short breaks for families with disabled children. This statement details the range of services available, eligibility, and how families can access this support.
  • Children and Families Act May 2014. – This Act takes forward the government’s commitment to improve services for vulnerable children and support strong families; it came into force on 1st September 2014 and underpins wider reforms to ensure that all children and young people can succeed.
  • Short Breaks are part of Liverpool’s ‘Local Offer’, one of the key purposes of which is to ensure the involvement in the development of the offer from parents, carers, children and young people, early years, schools, colleges and specialist services in Children’s, Adults, Health and Social Care.
Our ambition is that families, particularly those with multiple and complex needs, will have access to co-ordinated Early Help in accordance with need as soon as difficulties are identified. The offer is on a model of graduated approach towards accessing services that arepersonalised, multi-agency, evidenced based and embedded within a whole family approach. Children and young people in those families will live safe, healthy and fulfilling lives and develop into responsible adult citizens, thereby breaking the intergenerational cycles of risk and vulnerability. Families will become more resilient and develop capabilities to prevent and resolve problems. The aim is to reduce demand for higher cost specialist services through a graduated plan of support recognising that there is a continuum of need,and achieve greater use of community based universal preventive services. Social capital and resilience within local communities will be identified and enhanced.
1.2 Projected Children’s Population Change in Liverpool
It is projected that that the population of children in Liverpool is due to rise approximately by 6.4% overall by 2030.
Age group / Projected Population / % Change
2014 / 2015 / 2020 / 2025 / 2030 / 2014 to 2030
Children / 0-18 / 88,900 / 89,000 / 92,000 / 94,900 / 94,600 / 6.4%
Source: / Crown copyright 2014 – Figures have been rounded
Notes - Figures are taken from Office for National Statistics (ONS) subnational population projections by persons, males and females, by single year of age. The latest subnational population projections available for England, published 29 May 2014, are full 2012-based and project forward the population from 2012 to 2037.
The projections do not take into account any policy changes that have not yet occurred, nor those that have not yet had an impact on observed trends
In addition to an increasing population in Liverpool there has also been an increase in :
  • Increase in children being diagnosed with Severe Learning Disabilities
  • Those with a diagnosis of Autism
  • The number of children with Special Educational Needs and Disability.

1.3 Evidence Base
Interventions are based on current evidence and best practice guidelines laid down by various organisations and Department of Health policies. The service provided should meet relevant national and local standards for health care and adult services. The following list identifies some of the relevant evidence but is not exhaustive and will inevitably change during the period of the contract.
  • Children and Families Act (2014)
  • Health and Social Care Act (2012)
  • Equality Act (2010)
  • Community Care, Services for Carers and Children’s Services (Direct Payments)(2009)
  • Aiming High for Disabled Children (2008)
  • Working Together to Safeguard Children (2015)
  • Department of Health (DH) National Service Framework (NSF) for Children (2005)
  • Choosing Health: Making Healthier Choices Easier (2005)
  • The Children Act (2004)
  • Every Child Matters: Change for Children (2004)
  • Carers (Equal Opportunities) Act (2004)
  • Carers and Disabled Children Act (2000)
  • Human Rights Act (1998)
  • Data Protection Act (1998)
  • The Children Act (1989)
  • UN Convention on the Rights of the Child (1989)
  • Local Authority Children and Young People’s Plans
  • Children’s Trust
  • Council for disabled children
  • Children’s Plan (DH 2007)
  • SEN Code Of Practice 2014
  • Care Act (2014)
  • Chronically Sick and Disabled Persons Act

2.Outcomes
Short Breaks Services contribute to a number of strategic outcomes that have been pre-defined both nationally and locally.
2.1NHS Outcomes Framework Domains and Indicators
  • Enhancing quality of life for people with long-term conditions.
  • Ensuring people have a positive experience of care.
  • Treating and caring for people in safe environment and protecting them from avoidable harm.
2.2 Public Health Outcomes Framework
  • Health Improvement.
  • Healthcare, public health and preventing premature mortality.
  • Giving children the best start in life (particular focus on emotional and cognitive development and includes first 1000 days and parenting).
  • Childhood obesity, promoting exercise and healthy eating whilst accessing a short break.
  • Readiness to learn and Readiness for School (particular focus on parents as child’s first educator and engagement with schools and Early Years Settings
  • Immunisations.
  • Early intervention (Early Help and EHAT).
  • Keeping children safe and protecting from harm (includes risk taking behaviours as well as safeguarding).
  • Vulnerable groups (children with disabilities, Looked after children, Young Carers)
2.3 Healthy Liverpool Outcomes
  • 15% reduction in avoidable hospital admissions
  • 71% increase in the measurement of quality of life for people with Long Term Conditions
  • Reduced health inequalities
  • Improved health outcomes
2.4 Children’s Summit
  • Emotional health and wellbeing
  • Development of a neighbourhood model
2.5 Local area strategic outcomes
‘Healthy Liverpool Prospectus for Change 2014’ has a vision for a healthcare system in Liverpool that is person- centred, supports people to stay well and provides the very best in care.
This vision is underpinned by a number of ambitious outcomes to be achieved by 2020, which include:
  • Health outcomes for people within Liverpool will have improved relative to the rest of England, and health inequalities within Liverpool will have narrowed.
  • The quality of healthcare received by Liverpool patients will be considered and of high quality.
  • There will be a new model of care which is clinically and financially sustainable for the long-term.
2.6Locally defined outcomes
  • Ensuring that all children /young people are able to continue enjoying treasured aspects of their everyday lives, feeling confident, respected by others and experience success and achievement.
  • To provide a swift efficient, child focused service that promotes inclusion and positive outcomes for every disabled child limiting the need for escalation to Children’s Social Care
  • That support needs are identified at the earliest opportunity, and wherever possible, every child is linked into leisure opportunities within their own communities via the provision of universal, specialist and targeted services.
  • That the child’s needs are supported, where possible, through the graduated approach intervention model, so that local services are accessed via SEND Early Help to meet need.
  • If the Short Break need is evidenced to be over and above the Local Offer, and all offers of short break support have been exhausted, consideration to Tier 4 statutory assessment may be pursued.
  • To provide all children and their families an opportunity to an ordinary life.
  • Children, young people and their families report an excellent standard of service delivery.
  • Quarterly feedback from service users with feedback used to shape service delivery.
  • Personal Outcomes Evaluation Tool (POET). This “In control” tool measures impact of Education, Health and Care Plan (EHC) for Children and young people with Special Educational Needs and Disability.
  • Preparing young people for adult life.

3.Short Break Service Aims and Objectives.
3.1Aims
  • The overarching aim of the service is to improve outcomes for children by enhancing the disabled child/young person’s ability to participate in everyday activities.
  • Accessing Short Breaks services enables the child to reach their maximum potential in their daily life; thereby enabling children/young people to develop their potential to enjoy and achieve, and develop their role in contributing to ordinary life in a positive way.
  • Reduce risk taking behaviours in community.
  • Increased presence of disabled children in community.
  • Safer and Strong communities, an awareness of community risks for children with Special Educational Needs and Disability.
  • Savings to NHS and Children’s Social Care through a reduction in the need for Tier 4 services and or hospitalisation.
  • Improved local economy as disabledyoung people and their families spend their disposable funds in the local community.
Short Breaks aims to provide services underpinned by the Social Model of Disability and Inclusion that reduce physical barriers and enable children and young people to:
  • Access to community based services.
  • Develop enduring friendships.
  • Recognise that there is a continuum of need and that, where necessary, specialist expertise should be brought in to support the needs of the child or young person, through a model of action and intervention.
  • Promote choice.
  • Promote participation in meaningful everyday activities.
  • Develop or maintain independence in all aspects of daily living.
  • Promote safe moving and handling within the Short Breaks settings.
  • Provide more opportunity for play and leisure.
  • Provide Parent/ Carers with a meaningful break from their caring responsibilities.
  • Prepare for adult life.
3.2 Objectives
The Short Breaks Service supports the integration across the NHS and Social Care landscape in Liverpool, in delivering measurable outcomes through robust service delivery and quality for Children, Young People and their families through:
  • Equitable service provision.
  • Improving and maintaining individuals’ health and wellbeing through increased independence, choice, control, dignity and quality of life within the local community
or Short Breaks setting.
  • Working in partnership, in a child/young person centred way with disabled children, young people and their families.
  • Assessing the impact of their needs to achieve positive outcomes, improve life chances and enhance social inclusion.
  • Responding to variable demand and prioritising accordingly in order to provide support at the right time in the right place.
  • Ensuring all children and young people are supported, managed and reviewed with care plans and evidence based pathways which address their individual needs, within the risk management framework of the service.
  • Using joint assessments and care plans where possible.
  • Safeguarding children and their families through identification and reporting of risk.
3.3Service Description and Care Pathways
The Short Break Service assesses and identifies disabled children’s support needs and endeavours to meet these through facilitated access to universal, specialist and targeted service provision.
Short Breaks Service provides swift efficient, child focused services that promotes inclusion and positive outcomes for every disabled child limiting the need to escalate to Children’s Social Care. Once it has been decided that a child with SEN would benefit from a service, a 4 step action process ’Graduated Approach’ will commence {Assess, Plan, Do, Review.}
The service delivers assessment and interventions in the most appropriate community settings across the city, which includes locations such as educational settings, Children’s Centres, youth service, and voluntary sector providers.
3.4 Graduated Approach











Liverpool City Council (LCC) and Liverpool CCG (LCCG) work in partnership and jointly commission the provision of services for children that may meet the thresholds of continuing care, with the aim of maximising independence and enabling children and young people to reach their potential in all areas of their daily life.
For those children that meet the Continuing Care eligibility, for care and support due to the complexity of their health, the Short Break service will aim to promote their inclusion within provision if their needs can be met by providing dedicated intervention at the level required.
For those children requiring continuing care that may require dedicated intervention, but could still have their needs met within the provision where they are included with their peers, a personalised support plan is identified. This enables the child to access, enjoyable and stimulating grouped based activities within a safe environment with their peers, enabling parent/carers to have a break.
The alternative for children with complex health needs is that the child is subject to a social care assessment enabling an individual care support plan can be procured. The short breaks offer provides value for money and can be sustained throughout the child/young person childhood which helps develop good family relationships, a circle of friends, and preparation for adult life.
For those children who need continuing care and whose multiple health needs are so complex that they require personalised bespoke care, a referral is made to the Disabled Children’s Team for an assessment of need. {Step Up to Tier 4}. In conjunction with a continuing care assessment, a support plan will be identified in consultation with the family and child/young person with a view to developing a support plan so the child can have a tailor made intervention care plan, which may incorporate overnight care.
When a child’s complex health needs, including behaviour, are over and above what can be clinically managed by the Short Break Service, all such care plan proposals are presented to a Resource Panel for consideration.
The panel consists of health representatives, involving CCG commissioners, Liverpool Children’s Services covering all age ranges of children, including the local Early Years Consortia.
The guidelines for continuing care are not prescriptive, if a child is not eligible for Continuing Care, it doesn’t mean that the Resources Panel cannot consider making an offer of support. In these instances a service may not be fully commissioned but consideration will be given, taking into account the Early Help Threshold and support available via the Early Help Offer.
In instances when an offer is made for a child that doesn’t meet the eligibility but it is felt that a service would be of benefit, this is acceptable providing the offer is supported by the Health representatives that are members of the Resource Panel.
Referrals for Short Breaks for individual disabled children, can be made direct on 0151 225 6020 to the Short Break Service. However, where a referral acknowledges that a disabled child is part of a family with siblings, they may benefit from an Early Help Assessment which should be undertaken by the referring professional to Careline, and managed through the Early Help process.

3.5 Referral Process

3.6 NHS Continuing Care Pathway

3.7 LSCB Levels Of Need


3.8 Assessment, Interventions and Transition
  • Disabled children wishing to access Short Breaks are assessed, enabling their individual support needs to be identified, and wherever possible, each child is linked into universal, specialist and targeted leisure opportunities within their own communities.
This includes Ofsted registered Short Breaks Provision which is delivered at Millstead School.
  • Short Breaks promotes the ability to do everyday tasks and therefore develop independence in the community.
  • Some children may meet Continuing Care eligibility for care and support as their needs are over and above the universal and specialist service offer,due to the complexity of their health. The Short Break service will aim to promote their inclusion within provision if their needs can be met by providing dedicated intervention, at the level required, in consultation with Health and Children’s Services.
This ensures a positive outcome for the child enabling them to access enjoyable and stimulating grouped based activities within a safe environment with their peers.
  • The short breaks offer provides value for money and can be sustained throughout the child/young person’s childhood which helps develop good family relationships and a circle of friends, enhances community participation and presence, and prepares for adult life.(Transition)
  • The purpose of the Short Break Service is to provide a swift efficient, child focused service that promotes inclusion and positive outcomes for every disabled childand their family, limiting the need to escalate to Children’s Social Care.
3.9 Short Breaks – Local Offer
Local authorities are required by law to provide short breaks for families with disabled children. These services are delivered as part of the local authority’s ‘Local Offer’ for children with special educational needs and disabilities.
The Local Offer sets out the range of short breaks services, ensuring there is appropriate choice, range and quality of short breaks to meet the needs of disabled children and their families. These include :-
  • The delivery of a range of opportunities for disabled children and young people to spend time away from their primary carers. These include day, evening, overnight or weekend activities, and can take place in the child’s own home, the home of an approved carer, residential or community setting.
  • That disabled children and young people are provided with the opportunity to learn new skills, have fun, make new friends, and have enjoyable experiences with or without their parents/carers. At the same time they provide families with a break from their caring responsibilities, giving parents/carers a chance to unwind rest or spend time with other children, and enable parent/carers a right to an ordinary life.
  • To offer Short breaks for as little as twohours up to and including overnight stays.As defined via consultation with Liverpool Families through the Aiming High for Disabled Children programme.
  • To ensure that every disabled child has the right to access inclusive Short Breaks, and that families have clear information about activities and ‘breaks’ available to them.
  • To meet the needs of disabled children through universal and inclusive settings. This means that every disabled child should be given the opportunity to access local community provision if they want to. For e.g. Brownies, cubs, youth clubs, dance clubs etc. These settings are required to make reasonable adjustments to enable disabled children to access, as required under the Disability Discrimination and Equality Act 2010.
  • To work in partnership with the Transition Team within Adult Services, to promoteearly planning and preparation for adult life.