Social Care Children with Disabilities Team

SCOPE OF THIS CHAPTER

This chapter describes the role of Children With Disabilities Team and includes criteria for its services and its roles with other Children's Social Care Teams together with transfer of case responsibility arrangements.

RELATED CHAPTERS

Local Offer

AMENDMENT

In November 2017, this chapter replaced a similar previous chapter.

1. Eligibility Criteria

The Children's Act 1989 places a duty on Children's Services to provide and co-ordinate the provision of services to all disabled children. The overall provision of these services is a responsibility across Children's Services, and associated health and voluntary sector services. The Children with Disabilities Team provide specialist services to a defined group and these services may include support to access i.e. care or short breaks provisions if needed.

The eligibility criterion for the Children with Disabilities Team in Merton establishes the threshold at which a referral in relation to a child with a disability will be accepted for children requiring specialist social care service.

It is from birth to 18 years of age, that children living in Merton, who have a substantial and long-term disability, meet the eligibility criteria for services and support from the Children with Disabilities Team.

The definitions of substantial and long-term disability are as follows:

  • Substantial disability means a severe or profound in which the child requires significant support from another person or equipment to carry out basic functioning;
  • Long-term disability means existing indefinitely and not expected to improve i.e. 12 months or more.

The following table defines the factors taken into consideration when making a decision regarding eligibility. To be eligible for an assessment and/or support from the Children with Disability Team, the child's disability needs to meet at least three of the criterias.

CAPTION: disability
   
Disability Level of Disability
Severe Profound
1. Health
  1. Child requires daily specialist medical or nursing care;
  2. Child has regular admissions to hospital for treatment;
  3. Daily use of specialist equipment;
  4. Life-limiting condition;
  5. Requires intensive therapy programme;
  6. Health needs significantly impact on learning, development and daily functioning.
  1. Complex health needs which prevents participation in social and educational activities;
  2. Constant 24 hour support;
  3. Minimum provision of 1:1 specialist support;
  4. Condition is unable to be controlled by medication.
2. Education
  1. Child has a profound learning disability;
  2. Attends an educational provision for children with profound learning disability;
  3. Follows P levels of the curriculum.
  1. Child has a severe learning disability;
  2. Attends an educational provision for children with severe learning disability;
  3. Follows P levels of the curriculum.
3. Communication
  1. None or very little communication used but can communicate basic needs using any method;
  2. Significantly delayed processing skills which impacts significantly on the child's functioning ability.
  1. No verbal communication;
  2. Unable to communicate needs using any method;
  3. Unable to use communication aid;
  4. Severely delayed processing skills which impacts significantly on the child's functioning ability.
4. Behaviour associated with the disability
  1. Behaviour demonstrates significant risk to self or others;
  2. Requires monitoring, supervision and a structured programme for managing behaviour overseen by specialist services;
  3. Challenging behaviour which impacts significantly on community life and family/carers requires specialist provision to function socially or educationally.
  1. Profound challenging behaviour which impacts on the child's functioning and child poses a severe risk to self or others;
  2. Requires constant monitoring, supervision and a structured programme for managing behaviour overseen by specialist services;
  3. Frequent behaviour that may be of risk to the child and/or family/carers;
  4. No awareness of impact of behaviour on others.
5. Family and Social Relationships
  1. Limited ability to build and maintain friendships without significant support with all aspects;
  2. Total dependence on carer for social integration;
  3. Very limited awareness of impact of behaviour upon others.
  1. Inability to build and maintain friendships and relationships without constant support with all aspects.
6. Self-care
  1. Fully dependent on others for all personal care;
  2. Needs physical support with all personal care;
  3. Child requires specialist equipment to support all his/her care needs.
  1. Needs physical assistance with personal care;
  2. Needs a high level of supervision with all personal care.
7. Safety
  1. Needs constant supervision during the day;
  2. Child would place him/herself or others at risk without supervision;
  3. No awareness of danger to self or others.
  1. Needs constant supervision during the day and night;
  2. Does not have any awareness of danger to self or others.
8. Mobility
  1. Unable to walk and weight bear;
  2. May be able to stand or transfer with support;
  3. Able to manoeuvre self at least some of the time.
  1. Unable to walk and weight bear;
  2. Uses a wheelchair;
  3. Totally dependent on a carer for mobility.
9. Children under the age of 5
  1. Child is functioning around half the level of the expected age.
  1. Child requires significantly greater care and attention because of the profound nature of health or learning needs;
  2. Significant failure to reach development milestones.
10. Visual Impairment
  1. Mobility restricted without special provision;
  2. Unable to read large print without intensive educational assistance or aids;
  3. Severe visual field defect with impaired visual perception;
  4. Eligible for registration as blind or partially sighted.
  1. Mobility restricted without special provision;
  2. Requires education by non-sighted method;
  3. Eligible for registration as blind.
11. Hearing Impairment
  1. Severe hearing loss (71-95Db).
  1. Total or near hearing loss of hearing (>95Db).

The following are children who are unlikely to meet the criteria of the Children with Disability Team:

  • Social, emotional and behavioural difficulties due to social or environmental factors i.e. the behaviour is not associated with a disability;
  • A diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) unless in conjunction with severe to profound disability;
  • A diagnosis of high functioning Autism;
  • Children with mental health disorders unless in conjunction with a severe to profound disability;
  • Children who have a health condition unless in conjunction with a severe to profound disability;
  • Children who have learning difficulties unless in conjunction with a severe to profound disability.

2. Referral Process

All referrals to the Children with Disabilities Team are to come through the MASH Team and need to evidence the child's disability. The Managers of the Children with Disability Team in conjunction with the MASH Team manager will then make a decision if the criteria's are met or likely to be met. Where a referral is received and it appears that the criteria's are met or likely to be met, this would be progressed with a referral to the Children with Disabilities Team (see Merton Children and Families Hub).

When there is a need to transfer a case from another Social Care Team, a discussion is to be held between the Team Managers giving consideration to the Children with Disabilities Team criteria. Where the criteria is met, following the completion of the case file audit and providing that all is in order on the records, a plan for the transfer would be agreed, in line with the generic team transfer policy (see Case File Transfer Protocol).

3. Assessment Process

  1. Children who meet the eligibility criteria or likely to meet the criteria for the Children with Disabilities Team will receive a Child and Family Assessment (see Assessments) of their needs;
  2. The Single Assessment will be carried out in consultation with the child and the family using information from other core professionals as appropriate;
  3. The key part of the assessment will determine the impact of the child's disability on a day to daily living and the family's overall functioning;
  4. The assessment may identify that there are multiple complex needs arising due to a child's age and disability or as a result of their parent's current health. The assessment may also evidence that a child is at risk of Significant Harm and a Section 47 child protection investigation (Children Act 1989) may be required to be undertaken to determine the level of risk or harm the child has endured;
  5. The primary carer of the child with disability would be offered a carer's assessment. The information gathered through the carer's assessment would be considered in the child's assessment and in the overall recommendation of the assessment;
  6. Siblings of a child with a disability should be assessed in their own right or as part of the overall assessment process. Where a sibling of a child with a disability is assessed under Section 17 of Children's Act 1989 as being in need of services the Children with Disabilities Team will formulate if appropriate, a Child in Need Plan for the sibling and the sibling will be allocated within the Team to the Social Worker working with the family (see also Young Carers Procedure);
  7. Following assessment if the eligibility criteria's are met, recommendations of the assessment would be progressed. If eligibility is not met and there is an identified need for support, the children would be transferred following a discussion with a manager to the relevant non-disability specialist team;
  8. The Single Assessment will be reviewed and updated on a six monthly basis or conducted more frequently where circumstances require it, e.g. where there has been a significant change in the child's circumstances or with the resource or resources involved.

4. Child Protection Cases

  1. With new referrals, (i.e. where the case is not open to the Children with Disability Team), where the primary concern is child protection, following the Single Assessment carried out by the MASH Service, a discussion will take place between the relevant Team Manager within the MASH Service and the Children with Disabilities Team, as to when the case will transfer. If the criteria is met, the transfer should happen after the assessment is complete if the case is a 'Child In Need' (CIN), where appropriate at the first CIN review meeting, or if the case is Child Protection, at the first Core Group meeting, the receiving social worker/manager would be expected to attend the Child Protection Conference;
  2. The Children with Disabilities Team will usually undertake all Section 47 Enquiries, assessments and legal proceedings in respect of children who are already open cases;
  3. In cases where there is a child with a disability as one of a group of siblings under child protection procedures, this needs to be managed by the social worker in the Children With Disabilities Team unless the case is open at the time of referral, in another team. If the case open in another team the Children With Disabilities Manager needs to provide practical advice if needed.

5. Services to Children with Disability

As a general principle, where children and families can receive mainstream and inclusive services, these should be provided.

Child and Family Assessments are undertaken every 6 months. Where the assessment identifies that specialist services are required, these may be provided by health or voluntary partners and/or the Children with Disabilities Team. The assessment will make recommendations as to the kind of services that is required to meet the child's needs.

The level of support services that may be included in a care package for a disabled child and his/her family could include:

  • Information on activities, clubs, playgroups and play schemes;
  • The provision of advice and information about other organisations which may be able to offer help and support;
  • Support for the child in/outside the family home;
  • Day care and overnight short breaks;
  • Support services using direct payments.

When a care package has been approved, they will be incorporated into a Child in Need Plan - or, where the child becomes Looked After, a Care Plan or Short Break Plan.

6. Reviews

Reviews of Child in Need Plans for children with disabilities take place within 3 months of the start of the plan and continue to be reviewed on a 3 monthly basis. Reviews are conducted more frequently where circumstances require it, e.g. where there has been a significant change in the child's circumstances or with the resource or resources involved.

The review is usually chaired by the allocated Social Worker contacting all those involved in the plan. Where necessary, changes to the Child in Need Plan will be made with the collaborated agreements of the family and professionals and the amended plan circulated.

7. Visits

Children in Need Visits

Children who are held within the Children with Disabilities Team will be visited at the frequency laid down in the child's care plan however this would be within 4 - 6 weeks intervals. For many children receiving on going packages of support regular visits to see the child may be unwarranted. Regular reviews of the care packages will take place on a 3 or 6 monthly basis and the Allocated Social Worker will ensure that there is a clear statement about expected frequency of child in need visits.

Visits to Children on Child Protection Plans

Children who are on CP plans will be visited every 15 working days, unless it is specified within their CP plan that they need to be visited more frequently.

Looked After Children

Children who are looked after will be visited within one week of being in placement and there after every 6 weeks.