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3.1.4 Transitions - Disability Service


Contents

1. Introduction
2. Year 8 (12/13 Years Old)
3. Year 9 (13/14 Years Old) 
4. Year 10 (14/15 Years Old)
5. Year 11 (15/16 Years Old)
6. Year 12/13/14 (16 - 19 Years Old)
7. Changes to the Preparing for Adulthood Process (with effect from 1 April 2015)
8. Looked After Children in Transitions 
9. Safeguarding Issues 18 - 19 Years of Age


1. Introduction

This Transitions Procedure is designed to bring together the documentation developed within Cambridgeshire to provide a clear single pathway for young people with disabilities in transitions, and other vulnerable young people meeting eligibility criteria, from children’s to adult disability services.

Children with disabilities currently transfer to adult services within Cambridgeshire at 19 years of age. Their education under their statement of educational needs can be provided up until and including the year of their nineteenth birthday. Social Care Services provided through Children’s Service end at a young person’s nineteenth birthday and following assessment under the community care act and fairer access to services legislation continues from this point with Adults Disability Service.

The following documentation will guide people through the social care process for enabling a smooth Transition from children’s to adult services. It denotes the roles of professionals involved and the monitoring systems in place (Transitions Board, Steering Group and Area Review Groups), to ensure that this occurs to meet young people with disability and their families needs.

It shows how and when information will be given to and gathered from young people with disabilities and their families to assist them to plan their future. It explains how this will be an individualised process with the young person at the centre through the use of person centred approaches that will also enable services to be developed to meet these young peoples future needs. This process will lead to young people and their families having a clear indication of how their future needs will be met 6 months prior to their nineteenth birthday and transfer to adult services.


2. Year 8 (12/13 Years Old)

Joint planning process will be begun in conjunction with the Education Department within Children and Young Peoples Services and 18 - 25 Team to identify young people likely to require community care support in adulthood (Community Care Act).

Disability Children’s Social Care Managers to coordinate an annual meeting between Special Schools, 18 - 25 Team Additional Needs Advisors and Transitions Social Workers/Care Managers and Special Needs Officers to add details of young people with future social need spreadsheet.

Statutory Assessment & Resources Team (STAR Team) will liaise with Transitions Service to identify young people in independent provision, out of county provision and in other local authority schools that will require social care support in adult life.

The 18 - 25 Team will meet with mainstream schools and the education other than at school services and will determine the level of the career service input required for young people post 14 years of age. These meeting are known as the Early Identification of Need meetings.

The Transitions Team will share the information gathered with the manager from Adult Services who has a lead role for transition for their Area.


3. Year 9 (13/14 Years Old)

A Transitions Information pack will be distributed at the beginning of the Year by the Student Assessment Service to all year 9 students with a Statement of Educational Need. This will include a quality feedback questionnaire.

A 14+ Transitional Review of Education, Health and Care Plans and those with additional centrally funded educational support will take place and will explore educational options, Social Care / Health Care issues and appropriate involved professionals are invited to attend or submit a report. The 18 - 25 Team have the responsibility for overseeing the implementation of the transition action plan resulting from this review.

The 14+ Transitions Review will specify the need for a referral to the Social Care Transition Team for assessment of need. The 14+ Review paperwork will act as this referral and be forwarded from Statutory Assessment & Resources Team (STAR Team) to the Transitions Service.

The Transitions Team will write to any young person and their family where young people have previously been identified as likely to require social care support in adult life but have not been referred via the 14+ review. This letter will suggest that a referral is made to the Transitions Team.

Additional Needs Advisors will begin Learning and Skills Council ‘Learning for Living and Work’ paperwork (previously known as Improving Choice) for those young people with complex educational needs.

Young people’s need for Social Care Transitions Planning will be reviewed in the annual meeting with Special Schools chaired by the Disabled Children’s. This will continue from years 8 to 14).


4. Year 10 (14/15 Years Old)

Area based meetings reflecting the Adult Team structure will consider year 9 young people likely to require community care in adulthood. These Meetings will be convened by Adult Services and supported by the Transition Team. These meeting are known as Area Transitions Review groups and will be held termly.

Area Transitions Review Group Meetings will always be attended by Additional needs advisors, Transition Social Workers/Care Managers. Area Disabled Children’s social care/ Adult Team and Specialist Health representatives.

The Area Transitions Review Group will use a traffic light system to prioritise the allocation and planning of future work.

The Area Disabled Children’s Social Care Managers will always assume case responsibility and act as case holder up to the age of 19 years for young people with disabilities. The Transition Team role at this stage is likely to be limited to acting as an advisor to young people and their families and providing appropriate information.

Area meetings will reconvene at the beginning of each term to consider progress and agree further actions with named leads for actions required.

Area Meetings may include referral to the Transitions Social Workers /Care Manager for assessment of young people in years 10 and 11 where concerns have arisen or increased. It will also include checks that young people becoming 19 in next 12 months have not been missed and have their care needs addressed.


5. Year 11 (15/16 Years Old) and Onwards

The Transition Team will offer information visits to young people with Disabilities and their parent carers. At this visit they will establish a date to assess future needs.

In the final year of compulsory education all young people with a Education, Health and Care Plan and with School Action or Action Plus (identified through the EIN process) who are believed to be leaving school to go into post 16 education or training must have a Section 139a Assessment. This is carried out by Connexions and is a written report of the young persons educational or training needs and provision required to meet them.

Improving Choice applications for additional Learning and Skills Council(LSC) funding within Further education will be coordinated by the the careers service. This application is to be completed using the LSC ‘Learning for Living and Work’ paperwork and will meet the requirement of the completion of a section 139a assessment.


6. Year 12/13/14 (16 - 19 Years Old)

The Transitions Service will provide information on young people possible future needs to Adult Service in time to aid the budget planning cycle. This is likely to be in March/April.

The Transition assessments will generally be undertaken post 16. The priorities for allocation to the Transitions Team will be:

  • Disabled children who are looked after full time;
  • Educational Residential placement (placed away from home) over 120 nights a year or subject to a Care Order;
  • Disabled young people who require or are likely to require a complex package of social care;
  • Disabled young people who require their post 19 accommodation needs to be clarified or identified;
  • Disabled children who are accommodated including those in of county LSC funded young people;
  • Disabled young people in “specialist placements” Disabled Young people will be considered for assessment whose circumstances are such that they are likely to require their community care needs supported as Under the Community Care Act within adult life;
  • Young People who have high functioning Autism/Aspergers Syndrome who meet eligibility under ‘fairer access to care services.

The Transitions Team will undertake Transitions Specialist Assessments with young people and their families and these will include the identification of eligibility under fairer access to care services. The Child and Family Teams will remain case responsible for meeting the young persons current social care needs during this process and will work alongside the allocated worker from the Transitions Team.

All assessments completed by the Transitions Team for all young people over 16 will be on adult services special assessment format - including adult eligibility criteria and will include the statement ‘As this assessment was completed prior to the young person’s 19th Birthday, if their circumstances change this assessment and the eligibility criteria will be adjusted. Any recommendations made will need to be agreed by the relevant Adult Manager.

The Transitions Team will offer carers assessment and complete this if requested by a young person’s parent/carer(s).

The Specialist Transitions Assessments will be signed as agreed by Team Manager for Transitions and passed to the Locality Manager for Adult Services for co-signing and agreement in regard to identified care needs. This should be completed within ten working days of receipt. To avoid confusion this process will be completed before the young person or their representative sign the assessment as a completed document unless co-signing has not been completed within the agreed time.

The Transitions Team will identify as part of the assessment if there is a need to establish if a young person needs further referral for assessment of whether they meet the access criteria for the Learning Disability Partnership Health/Specialist Services (LDP). They will liaise with the LDP area integrated teams to agree the professional from the LDP who will be responsible for undertaking a Health Access assessment.

Should the young person or their carers wish to amend any element of the assessment, agreed alterations this will need to be acknowledged by the two co-signatory managers. If agreement is not achieved this should be noted.

The Transitions Team will work with the young person and their parent carers to develop a social care plan to meet their future social care needs following the specialist assessment process. 6 months prior to the young person 19th birthday this will be taken for agreement to the relevant adult panel by the allocated Transitions Team worker

Prior to the young person’s 19th birthday there will be a multi agency exit/Look After Child review / children in Need meeting to maintain the smooth handover to the Transitions Team from the Disabled Children’s Social Care Managers, The Disabled Children’s Social Care mangers will be responsible for the co ordination of this meeting.

At the young person’s 19th Birthday the Transitions Team will become case accountable from the Disabled Children’s Social Care Managers for the young person until the first 6 weeks review of their adult care package/support plan.

The Transitions Team will coordinate a review of service 6 weeks after a young person’s 19th birthday and the relevant adult team who are to become case responsible at this point will allocate a worker to attend this review and take on case accountability. This review will act as a handover meeting for young people and their parents to the adult team from the Transitions Team.


7. Changes to the Preparing for Adulthood Process (with effect from 1 April 2015)

As from the 1st April it is planned that support will start early in school to prepare for life in adulthood.

Children’s Disability Services will do this for children with a learning disability open to them up to 18 and a new Learning Disability Partnership Young Adults Team will take over and continue to support until up to 25 as needed.

For other young people Adult Teams (Physical Disability, Mental Health, Sensory, Autism and Adults Support Team (formally Vulnerable Adults)) will start to work with young people at age 16 to assess and develop adult support plans in readiness for the move to adult support.

For young people with learning disabilities who do not need social care before 18 new Learning Disability Partnership Young Adults Team will start to work with young people at age 16 to assess and develop adult support plans in readiness for the move to adult support.


8. Looked After Children in Transitions

8.1 PRE 19 Yrs

A Young Person supported within the Disability Social Care Service will remain with the Service until their 19th birthday and then transfer to Adult Services.

The 18 - 25 team - Children’s Social Care will act as a consultant/advisor to the Disability Units and Self Directed Support Teams pre 19. The Social Worker within the Disability Service will have the responsibility to complete a needs led assessment (ICS) this assessment will formulate the Pathway Plan (ICS).

The needs led assessment needs to be completed within three months of the young person turning 16 years of age and the pathway plan as soon as possible thereafter. The pathway plan will need to be reviewed every 6 months OR if there is a significant change in circumstances OR at the request of the Young Person.

8.2 Staying Put

All Young People cease to be legally 'Looked After' on their 18th birthday. However for children who remain in placement 18 - 19 years of age minimum statutory visits every 8 weeks should take place. It is the Independent Reviewing Officers discretion to continue to chair statutory child care review meetings or not. If reviews are to continue then the worker would need to complete all relevant ICS LAC paperwork. If the young person is in receipt of leaving care support and are in a "staying put" placement, the statutory visit timescales are every 8 weeks. More often than not visits are more frequent dependent on presenting need.

The Transition Team through their assessment will identify the accommodation needs of the young person post 19 and seek funding through adult services as appropriate.

If a Looked after Child requires a change of residential placement post 17 years of age or a young person becomes looked after aged 17 then Children's Placement Team will liaise with the Contracts/Placement Team in Adult Services for them to gain a view in principle as to whether Adult Services would continue to fund the placement post 19 years of age.

If a child is in a foster placement post 17 years of age and either wants or is assessed that it is in their best interests to remain in that placement post 18 (and up to their 21st birthday) then this should be fully explored in the young person's statutory child care review following their 17th birthday. The Social Worker should then take the request to CAM Panel for a 'Staying Put' agreement.

Young People with a disability aged 18 to 19 years of age supported by the Disability Unit / Self Directed Support Team will continue to be funded by the CYP Resources Team. Year 1 Full foster care rates to 19 will be paid by the CYP Resources Team

Otherwise the setting up of a staying put placement remains the same as for any other young person who wishes to remain in their placement post 18. Please refer to staying put procedures.

8.3 Post 19 YRS

If a young person is going to be going through the transitions process and their assessment concludes that they are going to be eligible for LDP, AMH, PD or vulnerable adults then this should be the main service to offer provision of case management once the young person reaches 19 and incorporate leaving care elements in the care planning process.

 This will have advantages of not duplicating services, as from experience to date where there is a PA allocated to a young person who is in receipt of a service from adult services whether it be from LDP, AMH, PD or vulnerable adults, there is duplication in care planning.

The details of the requirements are contained within the LAC procedures and the 18 - 25 Service Children’s Social Care could be contacted for advice when required.

Where a young person is not going to go through the LDP, vulnerable adults, PD or AMH route due to ineligibility to Fair Access To Care then such young people will transfer to the 18 - 25 team as per any other young person who are eligible for leaving care support. However as with the LAC units, if the young person is open to them, the Disability Units will be responsible for the completion of needs led assessments and pathway planning between the ages of 16 and 18 years of age.


9. Safeguarding Issues 18 - 19 Years of Age

When a young person is subject to a Child Protection Plan up to their 18th birthday:

  • Adult Safeguarding Lead (Transition Team to advise of named lead for appropriate Locality) should be invited to the final Child Protection Conference. They will then advise whether the issue will move to SOVA (Safeguarding of Vulnerable Adults) process at conference;
  • Adult Safeguarding Lead will record on adult SOVA paperwork action plan agreed (and will liaise with the County SOVA Lead via adult monitoring document);
  • Safeguarding Action Plan will be reviewed and updated within the Child 'in Need' Meeting process by the Social Worker every 3 months;
  • The Transition Worker will record and address ongoing risks within the Transitions Assessment and Support Plan;
  • The Transition Worker will discuss ongoing and potential risks to the Adult Care Manager within the young person's post 19 6 week review.

When there are new safeguarding issues for a young person aged 18 - 19 years:

  • Children's case responsible worker will action the Safeguarding of Vulnerable Adult Procedures (SOVA) by making a referral to the Contact Centre;
  • The case will then be allocated to the 'Safeguarding Lead' within Adult Services who will liaise with the children's worker to arrange a joint Child 'in Need'/Safeguarding of Vulnerable Adult meeting where appropriate;
  • Adult Safeguarding Lead will record on adult SOVA paperwork action plan agreed (and will liaise with the County SOVA Lead via adult monitoring document);
  • Safeguarding Action Plan will be reviewed and updated within the Child in Need Meeting process by the Social Worker every 3 months;
  • The Transition Worker will record and address ongoing risks within the Transitions Assessment and Support Plan;
  • The Transition Worker will discuss ongoing and potential risks to the Adult Care Manager within the young person's post 19 6 week review.

Further Reading

CCinform: The online resource for professionals working with children and families.

Research in Practice

To view Internal Processes please refer to Cambridgeshire County Council Internal Intranet.

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