Establishing an Integrated Multi-Agency Service to Support the Provision of Services to Disabled Children, Young People and their Families in North Lincolnshire

Consultation Document

Publication date: 10th December 2007

Consultation closure : noon 15th February 2008

Download a copy of this document, Appendix and questions (all PDF)

Establishing an Integrated Multi-Agency Service to Support the Provision of Services to Disabled Children, Young People and their Families

1 Purpose of the Document

This document sets out the proposals to establish an integrated service for Disabled Children Young People and their Families This service would comprise of the Local Authority's Children's Services (education and social care), Connexions and NHS Services in North Lincolnshire as set out in the "North Lincolnshire Children & Young People's Plan 2006-2009"

The purpose of the document is to consult with key people who are directly involved in providing/receiving such services and others with an interest in this area.

The people/organisations to be consulted should comprise:

  • Disabled children, young people and their families
  • Staff who provide services to disabled children (either on a full time basis or as part of their role) and their Trades Union representatives
  • Partner organisations providing services for disabled children.
  • Voluntary organisations which support and advocate for disabled children and their families

The decision to create an integrated service was made by the Children's Board and confirmed at its Executive Group on 28th September 2006.

This followed a number of consultations with disabled children and their families, the views from these consultations have been considered and, where still relevant, have been included in the development of this proposed model. The model therefore demonstrates how the outcomes of these consultations have been taken into account.

There is also a legislative context for integrating services for disabled children in the Children Act 2004, the Early Support Programme, and the National Service Framework (NSF) for children, young people and maternity services-2004. These are key drivers for change in how services are organised and delivered.

The Disability Project Group, on behalf of the North Lincolnshire Children's Board, has produced this paper. The membership of the DPG can be seen at appendix A.

The dates for the consultation period will be from week commencing 10th December 2007 for twelve weeks, finishing at noon on the 15h February 2008.

(NB it is recognised that as part of any implementation process, there may be a requirement for further and separate consultation processes, most notably regarding changes in the working arrangements for staff if there were to be any.)

All comments relating to the document should be forwarded to

David Lea

Service Director Learning, Schools & Communities

Hewson House

PO Box 35

Station Road

Brigg

North Lincolnshire

DN20 8XJ

or email david.lea@northlincs.gov.uk

 

A final paper following this consultation will be submitted to the Children's Board/Trust.

 

2 Outcomes of the New Approach

The reason for establishing an Integrated Children's Disability Service is to improve provision for disabled children and their families by providing co-ordinated help and support to those where there is a severe impact on their day-to-day living. It will also make it easier for families to know what services are available and to access them.

The Government now recommends that the term "Learning Difficulties and or Disabilities" (LDD) is used to define the group of children who should benefit from an integrated approach.

For a Joint Area Review, the Grade Descriptors used would be:

"The term learning difficulties and/or disabilities is used to refer to individuals or groups of learners who have either a learning difficulty in relation to acquiring new skills or who learn at a different rate to their peers. The term is used to cross the professional boundaries between education, health and social services and to incorporate a common language from 0 to 19. The Disability Discrimination Act defines that ‘a person has a disability if he or she has a physical or mental impairment that has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities'. Physical or mental impairments can include sensory impairments and learning difficulties. The definition also covers medical conditions that have long-term and substantial effects on pupils' everyday lives."

"Those designated with special educational needs (SEN) under current legislation (educational) all have learning difficulties and/or disabilities that make it harder for them to learn than most learners of the same age."

The intended "target" group for this proposed Integrated Multi-agency Service is a sub-set of the wider group of children and young people with learning difficulties and/or disabilities (LDD) as described above.

The "target" group will be defined by:

  • The complexity of their learning difficulty and/or disability...the Service will expect to work with the most complex cases
  • The range of agencies involved with the child and family. The Service will expect to work in those situations where there is multi-agency involvement.
  • The setting in which the child is supported. For the most part, it is expected that the Service will be involved with children and young people who attend specialist educational settings. However, this will not exclusively be the case.
  • There being an identifiable issue, which may appear to be "stuck" and makes the child more vulnerable and which needs targeted support in order to be resolved.

The integrated service will ensure a coordinated approach at a specialist level for children with learning/other disabilities and their families. It will also be able to provide targeted preventative services for children with additional needs that are complex and their families who need support at an early stage.

The changes, which should come about as a result of this integration, are:

  • An integrated assessment process leading to detailed assessment reports for parents with clear recommendations for intervention, including counselling as necessary
  • Personalised responses to a child/family's circumstances based on the family's priorities and wishes - children and their families will be actively involved in and supported to make informed choices about planning and developing services that affect them.
  • A coordinated approach which ensures there is a single plan centred on the child - a lead practitioner role will be established
  • A single service following one set of processes which will reduce delays
  • Early identification of possible needs which will enable the family to be provided with information and agencies to plan ahead

The Integrated Service will report to a newly established Service Board via the service manager and his/her managers. The Service Board will comprise representatives from the agencies responsible for providing and for commissioning education, health and social care for children. It will be able to provide an agreed multi-agency direction for the service and ensure a resolution process for any outstanding matters.

As such, the Service Board will have a role in ensuring that:

1. initiatives which are developed for "all children" properly support those with disabilities i.e. in relation to Parenting Support,

2. services and provision which support disabled people of "all ages" are appropriate for children and young people i.e. transport, the aids & equipment service, housing provision.

The Service Board will also form the strategic planning link with organisations providing and commissioning services for adults with disabilities.

The establishment of a Service Board for Children will necessitate a review of the structures currently in place to underpin joint working between the agencies and with children, young people and their families.

 

Question 1 - what will be the impact of this new arrangement on the service currently provided at the Child Development Centre?

Question 2 - what will be the impact of this new arrangement on the service currently provided by Kaleidoscope (NCH)?

Question 3 - how should this service be linked with extended services such as Children's Centres, Extended Schools and Colleges?

Question 4 - are there any other services that will be affected by this new arrangement?

 

3 Establishing a Successful Integrated Service

3.1 Key Features of the Team

In developing this model, the experiences of other integrated services have been taken into account. The features of a successfully functioning service, which will be built into the model, are:

  • Common goals and purpose
  • Common processes - the team will follow the Child in Need/Child with Additional Needs process (CIN/CWAN)
  • A common group of people to be served
  • A single line management arrangement
  • Commitment of staff to work in this model and respond positively to the challenges and opportunities of such an arrangement
  • Professional lines of accountability
  • Clarity of roles within the service, including the areas of overlap
  • Time to build the service
  • A single location for the core team members, to improve communication and coordination

3.2 Key Functions of the Service

The key function of the service will be to improve the provision to disabled children, young people and their families, working flexibly to meet the needs of the family. This will include commissioning/providing training to ensure disabled children are able to access good quality, inclusive activities provided by mainstream services.

More details about how the service will operate are outlined in section 4

The service will also have an important role in supporting the development of provision for the benefit of children, young people and their families in future. They will contribute to this by:

  • highlighting shortfalls in service provision, both within the core service and the outer teams
  • holding a database of children with disabilities mapped to the support which they receive and the shortfalls in provision - this will support forecasting and planning of service developments
  • Overseeing all plans for disabled children at key points - eg transition

The service will provide input to young people until their 18th birthday. They will agree transitional and joint arrangements. Where they continue to support young people beyond 18 years of age, they will do so in support of the relevant adult service and in line with their specific service requirements.

Question 5 - in line with the Government's view that services can be provided to disabled young people until they are 25 years old, how should/could this be achieved?

 

4 Outline of the Model

The new service will comprise a core group of practitioners whose role is to work with disabled children and their families in settings that are familiar to the child/young person. They will come together as a single team, managed by a person specifically appointed to this role.

The core service to disabled children and their families will be supported by an outer team of practitioners/teams who:

  • provide services to disabled people of all ages
  • provide services to children which, by definition, includes disabled children
  • provide adult services which may be required by family members

This outer team will, by necessity, be a "virtual" team that is drawn together to meet the needs of an individual child and his/her family

The core service will offer a time-limited service to those children/families who have specific needs, requiring a multi-agency input - ie the service will focus on a defined group of families. They will not be taking responsibility for all disabled children as it is important that children remain supported by the services already in place wherever this is appropriate. It is essential that the core service can respond promptly when children/families require their services and so their "caseload" will be constantly monitored. Access to the service will be on the basis that:

  • a Common Assessment Framework has already been completed
  • there are two more agencies involved in providing support to the child and family
  • there is an identifiable issue(s) which needs to be resolved

The service will not have a set length of time to offer support. For children with very complex needs, the time period that they remain supported by the core team may be long if there is a range of issues that need to be resolved. Nevertheless, planning and review of interventions by the service will be essential in determining ongoing input.

The core service will comprise some staff whose sole responsibility is to provide services to disabled children and other practitioners who have this responsibility as part of their role. For the latter group of practitioners, they will be included in the core service for the proportion of their time that they work with disabled children.

The service will be available for children and young people between the ages of 0 -18 years. Work is currently underway to determine the likely cohort of children who would be supported by the core service - this will be based on triangulating the numbers of children known to the two local special schools and other specialist services, those known to health practitioners and those who are being supported through the CWAN process.

Children accessing the service will have a range of impairments affecting their cognition/learning, communication/interaction, behaviour/social/emotional difficulties and physical/sensory skills.

Question 6 - what elements of current service provision are working well for children/young people and their families?

Question 7 - what improvements do you think will come about as a result of this new service being established?

 

5 Proposed Core Service Members

The members of the core service will be those practitioners who currently have a remit to provide support to disabled children and their families. It is recognised that this service may need to be further developed in future (in terms of both the range of practitioners and the capacity of it) but the new arrangement will need to start with the staff who are already working with this group of families.

The core service could include staffing input from:

  • Speech & Language Therapy
  • Paediatric Occupational Therapy - including those with a remit for major adaptations
  • Connexions
  • Paediatric Medical Team
  • Children's Outreach Team
  • Clinical Psychology
  • Specialist Play Service
  • Qualified Teaching Staff
  • Educational Psychology
  • Social Work
  • Health Visiting/Specialist Public Health Practitioners
  • Early Support coordinator - will either be a core member of this team or provide an agreed amount of dedicated support to the team.

The establishment of this core service meets a number of views raised in previous consultations either in full or in part:

  • that the Children's Outreach Nurse provision should be increased to full time (wte) and become part of the service; consideration is given for the funding of a school nurse co-located between the two special schools to meet the day to day medical and health needs of the children.
  • that Connexions be part of the service
  • that Social Workers from Children's Services become part of the service
  • the ES coordinator is part of this service
  • that Health Visiting and Specialist Public Health Practitioners are part of the service

Question 8 - are the practitioners who are included in the list above the right ones to meet the service's aims and purpose?

 

6 Single Management Arrangements & Professional Accountabilities

A service manager appointed specifically for this role will operationally manage the core service. The service manager will be appointed on the basis of a post specification and may come from one of a range of professional backgrounds.

The service manager will report directly to senior managers in one of the partner organisations.

Members of the core service will be drawn from a variety of professional backgrounds. Their professional accountability is recognised and, in light of this, they will retain links with their "home" organisations for the purposes of supervision/appraisal and training/professional development.

7 Employment Arrangements

Staff who are deployed to work within the core service will maintain their current employment arrangements. Any future potential changes to their working arrangements will be subject to a separate consultation period with full involvement of Trade Union representatives.

 

Feedback/Response Sheet : - if you would like to compleate the questions below you can download a form by clicking here (PDF).

Question 1

What will be the impact of this new arrangement on the service currently provided at the CDC?

Question 2

What will be the impact of this new arrangement on the service currently provided by Kaleidoscope (NCH)?

Question 3

How should this service be linked with extended services such as Children's Centres, Extended Schools and Colleges

Question 4

Are there any other services that will be affected by this new arrangement?

Question 5

In line with the Government's view that services can be provided to disabled young people until they are 25 years old, how should/could this be achieved?

Question 6

What elements of current service provision are working well for children/young people and their families?

Question 7

What improvements do you think will come about as a result of this new service being established?

Question 8

Are the practitioners who are included in the list above the right ones to meet the service's purpose?

 

 

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