For additional guidance, see Safeguarding Disabled Children: Practice Guidance (Department for Children, Schools and Families, 2009).
This chapter was updated in November 2015 with reference to the Single Point of Access Panel.
- Criteria for Referral to the Integrated Disabled Children's Service
- Referral Process
- Child Protection and Other Cases Responsibility
- Services to Children with Disabilities and the Single Point of Access Panel
- Equipment and Adaptations
- Complex Case Panel
- Appendix 1: Eligibility Criteria
- Appendix 2: The Single Point of Access Panel
- Appendix 3: Access to Resources Criteria
- Appendix 4: Support to Families
- Appendix 5: NHS Continuing Healthcare Needs Checklist
1. Criteria for Referral to the Disabled Children's Service
The criteria for the Integrated Disabled Children's Service (IDCS) establish the threshold at which a referral in relation to a child with disabilities will be accepted by the Service.
Where a child has disabilities which appear to meet the criteria for specialist intervention, these cases will be referred through using the Early Help Assessment process.
The criteria are that the child or young person is a resident of Derby and:
- They have a moderate to severe learning disability.
To evidence the level of learning disability an Early Help Assessment is required with one or all of the following:
- Psychologist's report;
- A letter of diagnosis from a paediatrician;
- Any assessments undertaken on the child, e.g. Education, Health or Care Plan.
See Appendix 1: Eligibility Criteria to assist in determining whether the criteria are met.
A child who meets the above criteria will require a range of services to promote or safeguard his or her health, development and/or well-being and the intervention identified will aim to minimise the impact of the disability - see Section 5, Services to Children with Disabilities and the Single Point of Access Panel and Section 6, Equipment and Adaptations.
Where mainstream social workers hold cases of children who might be considered to be disabled but do not meet the criteria for referral to the IDCS, appropriate advice and support can be given by IDCS.
2. Referral Process
All children who would receive a service from the Light House are already known to a professional or professionals. The professionals involved with a child will know whether the needs of the child and their family are being met through their locality Multi Agency Team (MAT), and local service providers OR that the child and family need a specialist assessment by the Light House. It is the responsibility of this professional or professionals to complete an Early Help Assessment (EHA) (see Early Help Assessment and Processes) indicating the Lead Professional, then to forward the EHA to the Light House Single Point of Access.
All referrals should initially be made to the Single Point of Access Clerk (SPA). Upon receipt, all referrals are initially assessed by a Duty Manager on the same day. Where it appears that the criteria for the IDCS are met, the referral is discussed at the next Single Point of Access Meeting; which is held every Tuesday. If the referral does not meet the criteria; the SPA will either inform the referrer and/or signpost to another service.
If a disabled child is not known to any professionals to complete an Early Help Assessment, the IDCS will undertake a Social Care Single Assessment of their need for services, which will be completed which will be be completed within 45 working days (see Derby City Council Children's Services Assessment Protocol).
The Social Care Single Assessment will be carried out in consultation with the family, using information from other professionals as appropriate. The Eligibility Criteria (see Appendix 1: Eligibility Criteria) will be used to determine eligibility for each child who is assessed.
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 as part of the Social Care Single Assessment. Under the Carers (Recognition and Services) Act 1995, carers are entitled to an assessment of their own needs. Any such assessment of carers should follow the guidance in the Assessment Framework Diagram.
Other additional specialist assessments will also be commissioned as necessary, for example an Occupational Therapist (OT) assessment to determine the need for equipment or adaptation to the child's home. In the case of an OT assessment, it may be necessary to prioritise the starting time of the assessment on the basis of the urgency of the need, in which case the family will be advised in writing of the likely waiting time involved.
4. Child Protection and Other Case Responsibility
Case Responsibility when there are both disabled children and non-disabled children in a family.
Initial Child Protection Conferences / S.47 Enquiries
Where the family is closed or not known to People Services:
- If there are safeguarding concerns, then ICDS will investigate and take to Initial Child Protection Conference. At initial case conference, if the children are made Subject to Child Protection Plans, then IDCS will keep the case if:
- There are more disabled children in the family who are to be subject to a plan than non-disabled children;
- There is an equal no. of disabled & non-disabled children.
Where there are more non-disabled children, then localities will take key worker responsibility for all of the children. The IDCS will be commissioned to provide community support services to the disabled children in the family.
- If there are safeguarding concerns relating to a non-disabled child, then localities will investigate and take to Initial Child Protection Conference.
At the Initial Child Protection Conference, if the children are made subject to Child Protection Plans, then Localities will take the case if:
- There are more non- disabled children in the family who are to be subject to a plan than disabled children.
Looked after Children
Where children are placed together as a sibling group and there are equal or more disabled children, IDCS will assume case work responsibility for all of them. Where there are more non-disabled children Localities/ CIC will take case work responsibility for them all and commission services from IDCS. Where disabled children are placed separately, IDCS will hold case work responsibility.
See Section 6 of this manual for procedures relating to Looked After Children.
Child in Need
Where there are more disabled children or equal numbers of disabled and non-disabled children, the IDCS will assume case work responsibility for all of them. Where there are more non-disabled children, Localities will assume case work responsibility for all of them and commission services from IDCS for the disabled children as appropriate.
5. Services to Children with Disabilities and the Single Point of Access Panel
As a general principle, where children and families can receive mainstream services, these should be provided as a way of minimising the impact of disability and avoiding any unnecessary segregation.
Where the Social Care Single Assessment identifies that specialist services are required, these may be provided by health or voluntary agencies as well as the local authority. The assessment will make recommendations as to the package of services or equipment required to meet the child's needs.
Where the recommendation is for the provision of equipment and/or adaptation to a child's home, see Section 6, Equipment and Adaptations.
Any other package of services will be referred to the Single Point of Access Panel for approval.
The Single Point of Access Panel will allocate resources in accordance with the guidelines set out in Appendix 3: Access to Resources Criteria.
The Single Point of Access Panel meets weekly and is chaired by the IDCS Manager. If service provision is required on an emergency basis between Panel meetings, the IDCS Manager can approve such provision until the next available Panel meeting.
Referrals to the Single Point of Access Panel must be supported by a copy of Early Help Assessment (and any accompanying documentation) with a front sheet. The documents should be sent to the SPA Clerk before the Panel.
The services that may be included in a support package range from:
- The provision of 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 groups for parents/carers;
- Parenting programme's;
- Sibling support groups for children between 6 and 17 who have a brother or sister with disabilities;
- Social work support for the child;
- The Community Support Team, including complex health services e.g. providing support to a child who uses a gastrostomy tube or nasal gastric tube or is terminally ill;
- Short breaks providing overnight care through the Light House residential provision - see also Short Breaks Procedure;
- Support Services using Direct Payments - see the Direct Payments Procedure.
When services have been agreed, they will be incorporated into a Child in Need Plan - or, where the child becomes Looked After, a Care Plan.
6. Equipment and Adaptations
Derby City Council's Children and Young People's Department have a S.31 Pooled Budget, which has been established for the purchase and supply of equipment and technological aids. Therapists prescribe or recommend the equipment or aids required, and order to suit the child's individual requirements.
Derbyshire Children's Department and Derbyshire CCG's have a similar arrangement.
If equipment is required and any necessary approval has been obtained, it is provided by the Community Equipment Service on a permanent loan basis. Where appropriate an annual review will take place to confirm that it is still appropriate to meet the needs of the child. Stock items of equipment will be delivered within 2 days of a request. Items which have to be ordered will be delivered when available from the supplier.
Minor adaptations include the provision of handrails, grab rails and ramps. The OT service will arrange for the provision of these adaptations including obtaining quotations if specialist adaptations are required.
Children must have a substantial and permanent disability in order to be eligible for major adaptations. If major adaptations are required, there are different processes depending on whether the property is privately owned or occupied. Disabled Facilities Grants are available to owner/occupiers and privately rented properties. If a Disabled Facilities Grant is successfully applied for and the cost is in excess of £25,000, it will be means tested to determine whether a contribution is required.
7. Complex Case Panel
Where the support services include the provision of residential care or foster care and the child becomes Looked After, a referral will be made to the Complex Case Panel for approval and consideration of the division of responsibilities for the costs - see Appendix 4: Support to Families.
Reviews of Child in Need Plans / Care Plans for children with disabilities take place every 6 months. 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.
For information regarding reviews for children in receipt of short breaks, please see Short Breaks Procedure.
Reviews of children with disabilities who are Looked After on a full time basis will be as set out in the Looked After Reviews Procedure.
Where possible reviews will be combined with the child's annual review of their special educational needs. See also Children and Young People 0-25 with Special Educational Needs and Disabilities (SEND).
Children will be encouraged to participate in their own reviews.
Reviews are coordinated by the respite care social worker or the reviewing officer in the IDCS, and, where the child is Looked After, chaired by an Independent Reviewing Officer - see Looked After Reviews Procedure. Where necessary, changes to the Child in Need Plan will be made and the amended plan circulated to all involved as set out in Children in Need Plans and Reviews Procedure.
Appendix 1: Eligibility Criteria
Appendix 2: Single Point of access Panel
The Panel will meet weekly. It includes managers from these organisations/teams:
- Residential short breaks;
- Community and Home Support Team;
- Fieldwork Team;
- CCG Clinical Services Manager or delegated representative;
- Community Short Breaks;
- Community Learning Disability Nurse Team.
This meeting will consider:
- Assessments and care plans;
- Recommendations for provision where available;
- Family support packages to minimise child protection risks and avoid family breakdown / accommodation;
- Allocation of Direct Payments and DP budget allocation and record refusal of take up;
- Wishes and feelings of the child or young person;
- Needs of the carer;
- Service gaps;
- Shortfall, if any;
The aim of the panel is:
- To ensure the Direct Payments are offered where assessed as required;
- To provide support to parent/carers to enable them to care for and support their child;
- To facilitate or provide support for the child in their local community;
- To provide family based short breaks;
- To provide residential breaks where needed;
- To ensure consistency, transparency and equity in provision;
- To inform business planning and commissioning decisions;
- To manage unmet need if any;
- To maintain accurate record keeping.
The Panel will consider all children in need assessments completed by the Integrated Disabled Children Service (IDCS) where there is a recommendation for a resource/service which has a funding implication.
The Panel will ensure that all children and families have resources fairly allocated based on priority of needs within the existing resources of the agencies that the Panel members represent.
The Panel will identify appropriate resources and care packages and make recommendations as to their delivery.
The Panel cannot commit resources without agreement from agency fund holders.
Care packages which have resource implications can be agreed outside of the Panel by the IDCS manager in emergency situations. These need to be ratified by the next Panel.
The Panel will review all care packages that have a resource element on a regular basis.
There will be an opportunity at Panel meetings for members to identify cases as early alerts.
The Panel will only consider cases where papers have been previously circulated.
The Panel may identify gaps in provision as part of their work. This will be raised with the strategic directors for them to consider within the context of strategic planning for children with additional needs.
The Panel will inform all families of the outcome by letter.
Appendix 3: Access to Resources Criteria
The criteria for allocation of resources are based on the government guidance to local authorities for adult care. Derby have adapted this for use with children and will be piloting the amended criteria for children allocated to the Integrated Disabled Children Service. The guidance describes four bands of need Critical, Substantial, Moderate and Low.
- The assessing worker will need to give evidence as to how the child fits into the access to care criteria of need;
- The guidance gives maximum levels of support for each band and should not be the norm for all children within the band;
- The Single Point of Access Panel will be the determining body for agreeing the band and allocating resources;
- In assessing the allocation of resources, the Panel will take into consideration the support the family is receiving from other statutory agencies and non statutory agencies e.g. therapeutic services;
- The age of a child will be taken into account in allocating resources e.g. all children under 5 require parental supervision and disturbed sleep patterns are not uncommon for children under 5;
- Resources will not be allocated for 7/7nights;
- Support cannot be allocated to enable a parent to work;
- The allocation of resources for children in the low criteria will depend on the availability of resources;
- Where children are assessed as having continuing care needs the allocation of resources will be determined jointly with the Clinical Commissioning Group (CCG);
- All packages of care will be subject to regular reviews;
- Families should be made aware of the criteria and how their child's needs have been assessed;
- Where parents/carers opt for Direct Payments, they can use the allocation as flexibly as they wish but they must be used to meet the identified need e.g. if personal care is the identified need, funding should not be used for respite care.
Appendix 4: Support to Families
The Fieldwork Teams
Assessment and care planning and emergency responses for children are met through a team of social workers and children's practitioners.
The Fieldwork team provides for casework, care planning, safeguarding, short-term intervention and early intervention of younger children.
It provides casework, care planning, safeguarding, behavioural assessments, management and short-term intervention for older children. The team also ensures preparing for adulthood arrangements, direct payments and Independent Living. The team has good professional links with our Connexions and adult service colleagues.
Both teams are supported by the Community and Home Support Team and Residential Service.
The Residential Service
Residential breaks are provided to children following an assessment that indicates 'eligible unmet need' for such a service.
This service is intended to be child-centred, fun and meet the needs of children with complex needs, but will support parents who never get a whole night sleep. A child or young person may have a very high level of personal care needs which mean their parents are up during the night, or a child or young person only sleeps for a few hours and needs close, waking supervision at other times.
Children and young people stay over for 1 to 3 nights on average per month (see the Light House information leaflets entitled 'Parent and Carers' and 'Children and Young People').
The service has a team of residential child care workers and a nurse team. All staff are skilled and experienced in work with severely learning disabled children, in behavioural management and in work with children who have high personal care and technological needs. There will be a minimum of 3 staff members on duty through the night.
The service has a minibus and children and young people are expected to spend a considerable amount of their time with us engaged in activities in the community.
The building offers 10 beds, over two units. A 6 bedded unit that is fully equipped and tracked and a 4 bedded unit. Both units have full en-suite facilities.
The building also offers an IT room with 'assistive technology' and is fully accessible; 2 soft play rooms and 2 sensory rooms.
The building is well equipped with toys, craft and art materials, soft play equipment, outside play equipment and quad bikes.