Complex Care Needs Team
AMENDMENT
In November 2021, this chapter was updated throughout in line with local practice.
Contents
- Criteria for Referral to the Team
- Referral Process
- Assessments
- Safeguarding Concerns
- Services to Disabled Children/Children with Complex Care Needs
- Legal Basis for Short Breaks (Reviews)
- Statutory Visits to Children in Receipt of Short Breaks
- Transition to Adults
- Equipment and Adaptations
- Disability Register
- Appendix 1: Access Guidance (Support, Services and Short Breaks for Families Caring for a Disabled Child in Wakefield)
1. Criteria for Referral to the Team
Eligibility for referral to the children's complex care needs service:
The children's complex care needs service provides support for children and young people where:
- The disability or complex health need has a substantial and long-term effect on their ability to carry out day-to-day activities; and
- There are significant difficulties in meeting needs within their family, broader support networks or through local universal provision.
Definitions
Whilst eligibility decisions are based on individual need and professional judgement, including to what extent the impairment affects their lives and the lives of those who live with and care for them, it is likely that the child or young person will fit into one or more of the following definitions:
- A significant, permanent and enduring physical disability;
- A significant global learning disability;
- A severe and enduring communication disorder;
- Autism with a significant global development delay and may have challenging behaviour; and / or a significant sensory impairment;
- A chronic or life threatening condition.
2. Referral Process
In cases where it is the clear assessment that the child will most appropriately receive services from the CCNT then the case should transfer directly to them from Social Care Direct for a Single Assessment to be completed (please see Transfer Protocol for Fieldwork Services).
Where there is some disagreement regarding the appropriateness of the referrals to the CCNT the issue regarding allocation will be decided by the respective Service Managers.3. Assessments
All children who meet the criteria for the Complex Care Needs Team will receive a Single Assessment of their need for services, which will be completed within 45 working days from the point of referral.
The Single Assessment will be carried out in consultation with the family, using information from other professionals as appropriate. It is the impact the disability has on daily living that is a key part of the assessment.
Where the Single Assessment identifies the need for a Carer's Assessment, this will also be carried out by the Complex Care Needs Team. A Carer's Alert Card will also be processed in consultation with the parents/carers.
Other additional specialist assessments will also be commissioned as necessary.
4. Safeguarding Concerns
If information is received or concerns are identified regarding a child already known to the Complex Care Needs Team or a child who meets the team's criteria which indicate that the child is suffering or likely to suffer Significant Harm a Strategy Meeting/discussion will be held between the SCD Manager, Police Decision Maker, and the allocated SW/Team Manager from the CCNT. The Complex Care Needs Team and Locality Team will jointly undertake all Section 47 investigations on children and young people that are not open cases to the CCNT. This intervention will be in accordance with the West Yorkshire Consortium Safeguarding Children Boards Procedures, in particular Abuse of Disabled Children.
The Locality Team will work with the CCNT in order to ensure that the Section 47 investigation considers the specific needs of disabled children and the impact of the disability on the child/young person's ability to communicate and the child's specific vulnerabilities.
The CCNT can provide advice on the specific needs of the child and the most appropriate manner in which to pursue the enquires and undertake the investigation.
If a Section 47 investigation arises on a child whom is already an open case to the CCNT, the Social Worker/Team Manager from the CCNT will liaise with the SCD and the Locality Team to determine how the Section 47 will be undertaken. This will be discussed and agreed via the Strategy Meeting/discussion.
Thus the Locality Team will provide:
- Specialist knowledge of safeguarding;
- Skills and experience of safeguarding processes;
- Application of clear safeguarding standards and procedures.
The CCNT will provide the following:
- Specialist knowledge regarding the needs of disabled children and circumstances;
- Skills in communicating with disabled children;
- Knowledge of established relationships with other agencies working with disabled children.
Following the Section 47 investigation the case will usually be jointly allocated to the CCNT and Locality Team. The CCNT will determine the most appropriate course of action as advised following the completion of the Section47 investigation. This may lead to a child being made the subject of a Child Protection Plan.
The CCNT will be responsible for implementing the Child Protection Plan for both the child allocated to the team and any other non-disabled child(ren) also living at the same household so as to minimise the number of professionals working with any particular family.
The CCNT and Locality Team will be jointly responsible for managing all Legal Proceedings relating to any children allocated to the team and their siblings where they reside in the same household, unless this specifically relates to the child's disability. This will include all assessments, Care Plans and reports in respect of any private and public law processes. This will include all assessments, Care Plans and reports in respect of any private and public law processes.
As and when a child with a disability becomes a looked after child, the CCNT will remain the allocated team until case management responsibility transfer to either the Leaving Care Team or Adults Services as per the Transition Planning process.5. Services to Disabled Children/Children with Complex Care Needs
- The Short Breaks panel can consider requests for services ranging from overnight respite or non-residential short breaks for a range of social and leisure opportunities which may be provided by the Home Based break Service or via a request for direct payments;
- When Short Break services are agreed via the Short Breaks panel they are then passed across to the appropriate Service for allocation or action;
- Referrals can be made through the Early Help Hubs or via any existing social worker;
- Prior to a child being placed on the agenda for the Panel an assessment of unmet need should be undertaken and the information from this submitted by the referring worker including a Care Support plan with appropriate outcomes;
- The outcome of the Short Breaks panel will be confirmed through a written panel decision to the referrer.
6. Legal Basis for Short Breaks (Reviews)
Children may be provided with short breaks under the following legislation:
Situation 1
Under Section 17 Children Act 1989, in which case they are not looked after children, the 2010 Regulations do not apply and there is no requirement to appoint an Independent Reviewing Officer (IRO). A Child in Need Plan is required in accordance with the Assessment Framework. Reviews should be carried out at least every 6 months and more often if required.
Situation 2
Under Section 20 Children Act 1989, with short breaks of not more than 17 days each in the same setting and where the total number of placement days does not exceed 75 days in any 12 month period. In these circumstances, the child is looked after, an IRO must be appointed, and a Short Break Care Plan drawn up. The 2010 Regulations are modified (Regulation 48), so that Looked After Reviews and Social Work Visits are less frequent and the short breaks are treated as a single placement.
Situation 3
Under Section 20 Children Act 1989, where the short breaks exceed a total of 17 days per placement/75 days per 12 month period and/or take place in more than one setting. In these circumstances, the child is looked after, an IRO must be appointed and a Care Plan drawn up. The 2010 Regulations apply in full, including the provisions on frequency of Looked After Reviews and Social Work Visits.
The legal basis on which services are provided should be clear. The decision to provide a short break under Section 17 or under Section 20 should be informed by the assessment of the child's needs and should take account of parenting capacity and wider family and environmental factors, the wishes and feelings of the child and his/her parents and the nature of the service to be provided.
7. Statutory Visits to Children in Receipt of Short Breaks
Visits should usually be undertaken by a qualified social worker and always by a person with the skills and experience to communicate effectively with the child and fulfil the functions of the visit.
Situation 1
Good practice shall ensure that:
- The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter;
- Subsequent visits must take place at intervals of no more than 3 months for as long as the short breaks continue.
Situation 2
Visits should take place at regular intervals to be agreed with the Independent Reviewing Officer and parents/person(s) with Parental Responsibility and recorded in the Short Break Care Plan before the start of the first placement.
In any event:
- The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter;
- Subsequent visits must take place at intervals of no more than 3 months for as long as the short breaks continue.
Situation 3
Visits must take place:
- Within one week of the start of the placement;
- Thereafter, at intervals of no more than 4 weeks.
8. Transition to Adults
The CCNT are committed to ensure that young people and their families are assisted to make a smooth and timely transition from Children's Services to Adult Services and agree plans for services post 18 years.
The CCNT will determine which young people would be appropriate for co-working.
This would generally be those young people with an identified disability with an Education Health and Care plan and whom is likely to be eligible for adult services going forward due to the complexity of their needs. Not all young people with an EHCP would meet this criteria.
This is likely to be when a young person is approaching their 16th birthday, though if appropriate in specific circumstances it may be sooner and at the latest by the time the young person is 17 years old, and it is felt that services may be required.
It should be noted that Adult Services operate their own eligibility criteria based on the Care Act (2014) and unmet needs.
Where the child is ordinarily resident in another local authority area then the CCNT should refer to the Adult Services within the relevant local authority.
All young people eligible for services from Adult Services will be transferred when the young person reaches 18 years old if not in education or may remain with the transition worker up to 25 years if they meet the service criteria and an Education Health and Care plan remains in place. A young person would transition to Adult Services when the EHCP ceases and/ or an appropriate adult care package is established and reviewed ( normally after 6 weeks of commencing the package).
9. Equipment and Adaptations
These services are provided by the Children's Occupational Therapy teams based at both Pinderfields and Pontefract General Hospitals.
The Children's Occupational Therapy Team provided a community based occupational therapy service to children with disabilities, their carers and families. This is done by assessing the functional needs of the child in their home environment. Daily living equipment can be provided where appropriate to aid independence and to support carers. The team also assesses needs which arise from housing situations and can facilitate housing adaptations.
10. Disability Register
Parents of children with disability and the child (depending of their age and level of understanding) will be given information about the Disability Register. The Disability Register is managed and maintained by WESAIL (Wakefield's Early Support Advice and Information Line).
Appendix 1: Access Guidance (Support, Services and Short Breaks for Families Caring for a Disabled Child in Wakefield)
Services/support you can access without an Assessment.
- Information, advice and support from Wakefield's early support, advice, information and liaison service (WeSail) is available to all families. This service can be contacted on 01924 379015;
- Activities that are universal can be found on the councils Local Offer;
- Carer's Alert Cards are available for all carers and ensure that plans are in place in the case of an emergency. (Ring WeSail).
Services/Support that require an Assessment
Where children and young people need more specialist support an assessment of need and a care and support plan will be undertaken with the parent carer and child/ young person by an agreed LA officer (e.g. Early Help Hubs, Complex Care Needs Team).
This will then be submitted to the Education Health and Care Panel for a decision.
FOR FURTHER INFORMATION Contact your social worker, Social Care Direct (0345 8 503 503), the Family Information Service on (0800 587 8042) or WeSail (01924 379015).