A blog from Caroline Coady, CDC’s Deputy Director of Social Care
Since the thought-provoking Research in Practice Transition conference our Deputy Director, Caroline Coady, has been considering the opportunity created through the transformation to Family Help to improve transition for disabled children and young people. Read more below and join us for the Council for Disabled Children’s new training on Family Help and what it means for disabled children and their families.
The challenge
Despite the array of legal duties relating to transition assessment, planning and support for disabled young people as they prepare for adulthood, this continues to be a time of significant challenge for families. Delays to, or lack of, transition assessments[1], confusion about eligibility for support post-18, and a different landscape of services and options leaves young people, families and practitioners with limited understanding of, and confidence in, what comes next. This can lead to deteriorating mental health for young people and families; escalating needs; and young adults, who have been supported in Children’s Services, falling through a gap. These young people often end up presenting to Adult Services in crisis requiring high support packages which are attempting to resolve challenges that could have been avoided with the right planning and the right support, at the right time.
Reimagining effective transition support through a lens of multi-agency Family Help
The legislative framework is not changing as a result of the Families First Partnership (FFP) programme guidance, although Law Commission Review of Disabled Children’s Social Care legislation has not yet published its final recommendations. This means that Local authorities will continue to have a general duty to provide support and services where children are deemed to be in need. Disabled children are defined as ‘in need’ under section 17 of the Children Act 1989 which means there is a clear requirement to consider how Family Help services will meet the needs of disabled children and young people and an opportunity to address some of the systemic challenges in relation to effective transition support.
For disabled young people to experience a successful transition to a fulfilling adult life it requires knowledgeable and dedicated practitioners, early person-centred planning, and well-coordinated and creative support. This needs to be a collaboration across education, health and care that is focused on the preparing for adulthood outcomes set out in the Children and Families Act 2014.
There are a series of opportunities, linked to the transition duties in the Care Act 2014 and the Children and Families Act 2014, that can be delivered differently via a Family Help model, as well as a range of questions that local authorities need to think about as they progress on this transformation journey.
Assessments and plans
The Care Act 2014 establishes the duty to assess individual children and young people, their parent carers, and young carers, where two conditions are met: when someone is likely to have needs for care and support; and at a time when it is of significant benefit to the young person or carer.[2] This duty to assess exists even where the likely needs may not be eligible needs under the Care Act 2014.
In addition, the Children and Families Act 2014 requires a focus on preparing for adulthood outcomes from the year 9 annual review of the Education, Health and Care plan (EHCP)[3].
Whilst all of these transition duties apply to the local authority, due to the variable team structures across the country there a range of different teams which hold responsibility for operationalising this. Duties arising from the Children and Families Act 2014 are often seen as being the responsibility of SEND teams and duties established in the Care Act 2014 are often seen as the responsibility of Adults Social Care.
The FFP guide is clear that disabled children and their families may need support that is different from other children and families who will be supported through Family Help. For example, they may require longer term support that is likely to be multi-agency, across education, health and care. This means that local authorities should consider using a more flexible approach to assessments for disabled children (where there are not child protection concerns) and that local partnerships should consider how a Family Help assessment and plan can fulfil the requirements of a transition assessment under the Care Act 2014, where the two conditions are met, considering this from Year 9 in line with PfA requirements under the Children and Families Act 2014.
In addition, the Family Help ‘front door’ should support children and families initial engagement with services and consider how to make this accessible and de-stigmatising. Some of the Families First for Children pathfinders have integrated family hubs and Family Help to support delivery, acting as a non-stigmatising front door[4]. However, for this to be effective for transition assessments and support, consideration will need to be given as to how Family Hubs can effectively engage disabled young people and those with SEN up to the age of 25.
Family Help Lead Practitioners (FHLP)
A range of evidence informed recommendations have been set out in the NICE guideline: Transition from children's to adults' services for young people using health or social care services; and the recent Ofsted thematic review on preparation for adulthood.
The NICE guideline quality statement includes:
- Young people who are moving from children's to adults' services have a named worker to coordinate care and support before, during and after transfer[5].
There are clear similarities in the description of the FHLP set out in the FFP guide and the recommendations about named coordinators for young people in transition.
This means that local partnerships should consider how FHLPs can be supported to effectively deliver combined Family Help and transition assessments from year 9 onwards, where the Care Act conditions are met, and how they can be supported to effectively coordinate multi-agency services and supports that enable young people to make progress towards the PfA outcomes.
Things to consider
- A FHLP supporting a disabled young person and their family as they prepare for adulthood will need:
- Support and oversight from a disabled children’s team or transition team social worker
- An understanding of the adults’ services eligibility and support available including universal and/or community-based support
For this to be effective there are a number of things that need to be in place.
- Workforce development plan needs to include a focus on preparing for adulthood (PfA) and transition, in the context of the relevant legislation, for FHLPs
- This could be developed and delivered by the DSCO (Designated Social Care Officer for SEND) where one is in post in partnership with Adults’ Social Care
- Development of a clear protocol setting out:
- A proportionate, tailored and strength-based approach to assessment for young people post-14 that fulfils the requirements of both the Family Help assessment and the Care Act transition assessment
- A needs-led eligibility framework
- A person-centred planning approach that is focused on PfA outcomes and fulfils the function of both a Family help plan and a transition plan under the Care Act 2014.
- Up to date, accessible information on the SEND Local Offer about post-16 and post-18 options for disabled young people across all of the PfA outcomes from universal to specialist services
[1] Care Act Statutory Guidance
[2]https://www.gov.uk/government/publications/care-act-statutory-guidance/care-and-support-statutory-guidance#Chapter16
[3]https://assets.publishing.service.gov.uk/media/5a7dcb85ed915d2ac884d995/SEND_Code_of_Practice_January_2015.pdf
[4] FFP Guide The families first partnership programme guide
[5] https://www.nice.org.uk/guidance/qs140/chapter/Quality-statements