Ensuring Fair Access to Support for Severely Disabled Children
Aim
The document aims to describe how a variety of specialist resources are allocated to disabled children and young people whose support needs cannot be met by universal and local services. The information is to ensure families and professionals have greater understanding and clarity about how to access services and how decisions are made.
Principles
All disabled children are entitled to support. The level and type of support needed will depend on a range of factors. The unique combination of disability, the circumstances of the child’s home life and the wider social environment means that each referral for services must be assessed on its merits. The Framework for Assessment of Children In Need and their Families provides the basis for assessing the impact of any impairment on family life and considers the child’s developmental needs, the parents’ parenting capacity and family and environmental factors. The following diagram summarises the main features.
Five different levels of support can be offered. The routes to accessing support are designed to be flexible and it is likely that families will move between levels over time as their needs change and also as services within the community become more inclusive. The types of services that can be provided at the different levels are outlined in the service menu below.
Different assessment processes are described which aim to ensure services are allocated fairly and where they are most needed. We aim to ensure that assessment is kept to the minimum required and is in proportion to the level of services needed.
Services already in place, even if provided by other organisations, will be taken into account when determining the level of service to be provided. This is to ensure resources are fairly distributed.
All assessment and allocation processes are guided by the council’s legal duties and powers to provide services for disabled children and their families. (1)
Access to Services
Any family seeking support should first of all contact the Health and Disability Team Referral Coordinator (tel 01904 555693). The Referral Co-ordinator has specialist knowledge of disabled children’s services and will ensure the enquiry is dealt with in the most appropriate way.
City of York Council uses a staged approach, outlined below, when assessing need and determining levels for support required. Children and young people who meet the following Access Criteria are eligible to access disabled children’s services, support and advice via the Referral Co-ordinator.
Access CriteriaChildren and young people with a permanent and substantial impairment or illness which has a profound effect on their health, development and social functioning.
Substantial impairment is defined as lasting more than six months. However, there may be exceptions to this for example, where a child has a life limiting illness or where a child has had a severe accident.
It is likely that the child or young person’s additional needs impact on the families choices and their opportunities to enjoy ordinary life; and the degree of planning and support required to meet their needs is much greater than that usually required to meet the needs of most children of a similar age.
It is likely that the child or young person will need support in some of the following areas:
· The physical environment
· Education
· Communication
· Personal Care, supervision and vigilance
· Specialist resources including information and communications.
· Medical or therapeutic treatment and condition management
It can include being substantially affected by one or more of the following:
· A hearing impairment
· A visual impairment
· A learning disability
· A physical disability
· A chronic/life threatening physical illness
· A communication disorder (including autism)
· A consciousness disorder (e.g. epilepsy)
Level 1 – Advice and Information
The needs of many children may be met by providing information, advice and guidance. This could include referral to universal services such as childminders, after school clubs and community groups which all children have the right to access (2). It could also include referral to groups and services especially for disabled children.
The Referral Co-ordinator or a Lead Professional may be able to provide the information and advice required. A Lead Professional is someone already likely to have regular contact with the child and family. York’s Family Information Service can also provide information about universal services (tel 01904 554444)
If the needs of a child or family cannot be met in this way, one of the following approaches will be taken.
Level 2 - Basic short breaks entitlement
All children who meet the Access Criteria have a basic entitlement to approximately 100 hours per year short break support, if it is required to enable them to participate in enjoyable activities within their local community. A short break is any service that allows a disabled child to have an enjoyable break away from their main carer and gives their main carer a break from their caring responsibilities.
The aim of the basic entitlement is to achieve the same level of participation that could be expected for a non disabled child and improve quality of life.
Assessment for the basic short breaks entitlement will be kept to the minimum and aims to confirm the level of disability. This could be done with reference to for example, an existing assessment such as a CAF (Common Assessment Framework), a specialist assessment by any involved specialist worker or lead professional, receipt of other specialist services, receipt of higher rate disability living allowance.
Basic level services are reviewed every six months to check that the services continue to meet all needs or whether different or additional services are required. A lead professional will be identified to ensure this happens.
In situations where further services are required, a more detailed assessment may be needed. Families are entitled to further assessment where a child is considered “in need” under the Children Act 1989. This could be an Initial or Core Assessment, depending on the situation and level of support required.
Level 3 - Medium level support
This level of support is provided where families and carers are assessed as requiring additional support to maintain an ordinary family life. Support may be needed to prevent or alleviate stress within the family. Additional support may be needed for the child or young person to enjoy positive and enjoyable activities.
An initial assessment is carried out by a member of the Health and Disability Social Work team and may be sufficient to determine the level of services required. In some cases, a more detailed assessment, called a Core Assessment may be needed.
Level 4 - Higher level support
This level of support is required to alleviate significant levels of stress within families. Services are required in order to enable parents to provide adequate care and meet the developmental needs of the child or young person. The aim is to support families and carers at the greatest levels of need and ensure they can have a significant breaks from their caring responsibilities.
Access to this level of support requires a detailed assessment called a Core Assessment and this will be carried out by a member of the Health and Disability Social Work Team.
Where services are provided following a Core Assessment, a social worker will be involved with reviewing the services every six months.
Footnote
1. The local authority has the following discretionary powers under the Children Act 1989.
Under Section 17 there is a power to provide services to safeguard and promote the welfare of children considered in need. Section 17 (10) (11) refers to disabled children as in need and provides a definition of disabled children for the purposes of the Act.
Under Section 20(4) the local authority has the power to provide accommodation if this safeguards or promotes a child’s welfare.
Duties to provide services for disabled children include:
Section 20(1) of the Children Act 1989 gives local authorities a duty to provide accommodation in situations where there is no-one else able to provide suitable accommodation or care.
Section 6(2A) of the Carers and Disabled Children Act 2000 gives local authorities a duty to assess the needs of carers taking into account their wish to undertake work, education, training or leisure opportunities.
The Chronically Sick and Disabled Person’s Act 1970 Section 2 which determines situations where all assessed needs must be met.
Providing advice, information and guidance meets duties outlined in paragraph 1 of Schedule 2, Children Act 1989 and section 12 of the Childcare Act 2006.
2. The Disability Discrimination Act Amendments 2005 require all public bodies to have due regard to encouraging the participation of disabled people in public life and to promote equality of opportunity
Service Menu
Level OneAdvice and Information about community and mainstream provision.
Assessment Stage One
Needs may be met by providing information, advice and guidance. Including signposting to universal services.
Examples of services
Schools, Connexions, GP, Youth Services, School Nurses, Children’s Centre, Health Visitor, leisure centres, childminders, out of school clubs, voluntary and community groups.Other support
CANDI parent’s forum is available to support all parents with a disabled child at any stage.Level Two
A basic entitlement of 100 hours short breaks support
For any eligible disabled child where support is needed to participate in enjoyable activities within their local community.
Assessment Stage Two
Common Assessment Framework or equivalent to ensure needs are met. Services will be reviewed every six months with the involvement of a Lead Professional.Examples of services
Level one as above plus:Short Break Services for example,
Community Short Breaks for example : Sharing Care, Wilf Ward, PACT, Crossroads.
Direct Payments.
Bridging support to access mainstream services.
Youth Service Mentoring Scheme.
Other resources may include:
Portage, Early Support, Pre-school teachers, specialist teaching team, Educational Psychology team Parent Partnership Service, Education Welfare Service, Lead Professional, CAHMS, paediatrician & other specialist medical support.
Level Three
Medium Level SupportFamilies and carers need more support to maintain an ordinary family life. Support may be needed to prevent or alleviate stress within the family. Additional support may be needed for the child or young person to enjoy positive or enjoyable activities.
Assessment Stage ThreeInitial or in some cases, core assessment. Services reviewed every six months with the ongoing involvement of a social worker from the Health and Disability team.
Examples of services
Level One and Two Services above plus
Short Breaks: Sharing Care overnight and day time visits.
Level FourHigher level support
To alleviate significant levels of stress within families. Services enable parents to provide adequate care and meet the developmental needs of the child or young person. Support for families at the greatest levels of need and to ensure significant breaks from caring responsibilities.
Assessment Stage Four
Core assessment required. Review every six months with the involvement of a social worker.
Examples of services
Level One, Two, Three plusShort Breaks: the Glen overnight residential provision.
April 14th 2010