Pathways to Support

Common Assessment Framework

Families needing support should contact their relevant professional. This may be a health visitor, teacher, therapist or consultant. In many cases additional needs can be identified through the Common Assessment Framework (CAF). A lead practitioner will assist families with a plan to meet these identified needs. Sometimes other professionals will be involved in shaping the plan this is called the Team Around the Child (TAC).

Specialist Support

As part of the Life Stages Service, we now have a Disabled Children and Young Adults Team that assists children and young adults with both learning and physical disabilities from birth to the age of 25.
Should it be felt that a CAF is not appropriate or that a plan identified through a CAF is not meeting a family’s needs a referral can be made to the Disabled Children and Young Adults Team.
The Disabled Children and Young Adults Team within Darlington Borough Council offers support to children and young adults with learning and physical disabilities. To decide what support is appropriate an Assessment of Need must be undertaken.
 
To ensure that services are targeting the appropriate children and young adults, an Eligibility Criteria is applied when deciding if services should be provided following assessment. This criterion is explained within the linked document ‘Eligibility Criteria’ and within the accompanying ‘Guidance Notes’. The intention of these criteria is to ensure that the Team do not simply consider the diagnosis that a child or young adult may have; they will instead look at the effects of their disability on their day to day life.

To be eligible for a service from the Disabled Children and Young Adults Team, children and young adults must meet the following criteria:

1. Be aged between 0 and 25 and be ordinarily resident in Darlington.
2. Have additional complex needs, or have a serious or life threatening illness.
3. There must be evidence that the child or young adult’s additional needs impact significantly on their ability to enjoy ordinary day to day activities.
4. The child or young adult must require a much greater level of day to day care to meet their needs than would usually be required for a person of that age.
5. They must require a high level of support in at least three of the following areas:
a) Personal care and supervision
b) Education or employment
c) Access to social activities
d) Communication
e) The physical environment
f) Condition management
6. The child or young adult’s condition is life limiting, or expected to last 6 months or more.

Referral to the Team can be made direct or through the Duty Team for Darlington Borough Council. When making a referral, professionals should give as much information as possible, including contact details for themselves and the family, and should be clear that they have consent from the family to make the referral.

When a referral is received, a worker from the team will undertake a specialist assessment which includes the worker visiting the family to identify needs and build a support plan. Needs are identified in 3 areas: a) arising from child’s disability, b) arising from parent/carer issues, and c) arising from the environment in which the family lives. For those families where a CAF has been undertaken a lot of this information will have already been gathered. It may also be appropriate to include those involved in the previous TAC meetings
The Social Care Coordinator uses three documents which families help to compile and retain. These documents are an Assessed Threshold of Needs, a Scale of Support and Child in Need and Family Support Plan.

Documents used in Assessment

Although these documents look complicated Darlington has retained them for assessment because they help us to look at family comparisons and to ensure that we are being fair.
Often people think that because their child has the same disability as another child, services and support will be the same. However, the assessment also identifies what particular strengths the family may have, the ways in which disability impacts on their lives and what supports the family has in place.   
So a family with a disabled child may be healthy and prosperous and well supported by their relatives and friends and their level of need may be limited to help with enabling the child to socialise outside the family. Another family may have a similarly disabled child but they are caring for their elderly relatives, or they cannot work due to caring responsibilities or their own health problems. Their level of need is therefore greater and may then include short breaks with support inside or out of the home.
 
Threshold of Needs
This document should be completed with the worker but you may have been able to complete most of this yourself.  The worker also seeks information from other professionals which helps to complete this threshold and helps to get different perspectives on the family. The columns have a scoring system and this should enable the service to look at scores and compare family profiles and support to monitor fairness. 

Scale of Support
This document gives an indication of levels of support based on scores and example profiles.  In the scale we have separated out complex health and physical disabilities from behavioural issues and the score for levels on behavioural issues are lower to achieve similar levels of support. This is because the threshold document has a bias for physical disability and parents helped us to identify this and amend. However if a child has physical and behavioural issues it is advantageous to the family to use the behavioural scale and this is agreed. We would hope that with good planning and interventions behavioural issues can be lessened and resolved and this would trigger a re-assessment using the Complex Health scale.

Child in Need and Family Support Plan
The child and family support plan has several purposes. It can be used as a ‘passport’ for disabled children who are being supported by different people at different times. It gives a lot of detail about the likes and care needs of the child and should be changed as the child develops. It should give enough information to enable a new carer/support worker to understand how to work with the child confidently and safely.
It is also used to detail the needs of the child and family, to describe the needs and to record intended outcomes of the service/support provision.
This helps with reviewing the support and gauging the effectiveness of the service/support.   If a service is not achieving the outcomes we need to be more creative and find better ways to support the family.
Personal Budget pilots have helped us to test the Child in Need and Family Support plans and work on outcomes for children and parent/carers. These will continue to be rolled out in the future as a move towards personalisation.