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CIPFA North West Audit Group

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1 CIPFA North West Audit Group
Transitions Workshop CIPFA North West Audit Group

2 Introduction and Agenda
Introduction and Background Education Health and Care Plans Practitioner Perspective (Trafford MBC) New Special Education Need Code Provisions Audit Perspective (Manchester City Council) Audit Perspective (Warrington Borough Council) Conclusions and Next Steps

3 Background What do we mean by “Transitions”?: Who does this cover?:
The transition from school to adulthood for children with SEN or disabilities The provision of advice and information about what can be done to meet or reduce the needs they are likely to have Helping them to achieve the best outcomes in employment, independent living, health and community participation Who does this cover?: Young people who are likely to have care and support needs when they turn 18 Why is it important now? Legislation and changes to SEN Code of Practice will place new responsibilities on local authorities and partners from 1 September 2014

4 Background Key Legislation:
Children and Families Act 2014 Part 3: Children and Young People in England with Special Educational Needs or Disabilities Replaces existing SEN legislation in the Education Act 1996 Brings together separate arrangements for children in schools and young people in post-16 institutions and training up to the their 25th birthday Integrated Education, Health and Care Plans to replace Statement of Special Educational Needs Duties under the Act inform the new SEND Code of Practice Is the key legislation that we are interested in going forward Majority of Act, and requirements of CoP, come into force 1 September 2014

5 Background Care Act 2014 if a child, young carer or an adult caring for a child is likely to have needs when they, or the child they care for, turns 18, the local authority must assess them if it considers there is “significant benefit” to the individual in doing so. The child, carer or parent may also request an assessment when the child approaches 18 The assessment should give information about eligibility, what can be done to meet or reduce their needs and an indication of the support they will get Requires local authorities to work to promote the integration of adult care and support with health services Single national eligibility criteria for adults This is regardless of whether the child or individual currently receives any services. The “significant benefit” rule also applies to the child’s request for an assessment, which means that they do not have to wait until they are 18. The idea is to minimise the risk of the “cliff edge”, where there is a sudden move into adult provision, or when services stop at different ages. These assessments can be combined with any other assessments being carried out, e.g. a healthcare assessment – this could then become part of an EHC plan. There is more detail in these two Acts that relates to transitions and EHCs – this is provided in the next few slides as we talk about the new EHCs and the revised SEN CoP

6 Education, Health and Care Plans
Who will be entitled to request a plan? Any child or young person who has had a Statement Any young person with a Learning Difficulty Assessment who remains in education or training Eligibility for new plans largely the same as currently for SEN Statements – extended to include year olds Will cover 0-25 Focus still on education, but will have increased emphasis on health and social care support LA must issue draft plan within 20 weeks of receiving request for assessment Eligibility in pilot EHCs is similar to previous Statements, with the exception of the increased age range. Is where the special educational provision required to meet the child or young person’s needs cannot reasonably be provided from within the resources normally available to mainstream early years providers, schools and post 16 institutions About a quarter of a million children have a statement or LDA at any one time. About 25,000 children have new statements each year LDA is an assessment under s139 of the Learning and Skills Act. Similar to a statement, but is specifically for yp moving into post-16 education or training

7 Education, Health and Care Plans
What should they include? The SEN identified through the EHC needs assessment The outcomes the child is expected to achieve The special education provision in place at school The name of the school Any health and social care provision needed The child’s and parents’ / guardians views and aspirations Details of any SEN and outcomes to be met by Direct Payments, where relevant SEN Code of Practice does not set out a proforma, but there are certain key requirements – Pathfinder authorities are developing example plans Note that there is a right for the child / parent to request a particular school, mainstream or special, FE or sixth form college or independent school. The LA must comply with the preference unless it is unsuitable for age, ability, aptitude or SEN, or is an inefficient use of resources. Health care provision could be speech and language therapy, occupational therapy, physiotherapy and mental health services Social care provision could include support for independent living. LA must consider any request for a PB. Are structured like other PBs, i.e. can have a DP, a “virtual budget” or a third party to hold the money on your behalf. The details of how this will work, particularly the latter, are not yet known. SHOW THE SLIDE RE: EHC PLANNING PATHWAY – DIAGRAM HAVE AS HANDOUT ALSO

8 Key Areas Practitioner Perspective
Financial Planning for Transition Planning for needs under different legislation Education ending incurs costs often not thought about Predictions verses actual costs 8

9 Key Areas Practitioner Perspective
Person Centred Planning Expectations of individuals and their families Care Act implications Different resource allocations Care co-ordination Carers needs 9

10 New SEND Code Provisions re Transitions
Key messages: Person-centred planning – aspirations and outcomes, direct consultation with children and their families LAs and CCGs – shared vision and strategy derived from EHC plans and other information, leading to joint commissioning Develop pathways into employment, independent living, participation in society and good health Local Offer must include support in preparing for adulthood Co-operate with schools, colleges and other post-16 providers Go through some of the things that LAs must do under the Code Note that the Local Offer will be mainly funded through the schools’ delegated SEN budgets

11 New SEND Code Provisions re Transitions
LA services must co-operate to help C&YP prepare for adulthood, e.g. housing, social care, economic regeneration EHC reviews at Yr 9 and after must focus on preparing for adulthood – clear, ambitious outcomes including: Support for higher education / employment Support preparing for independent living Support in maintaining good health Support in participating in society After compulsory school age, young people can make their own representations Aspirations for independent living should be encouraged even before Yr 9 After 16 – e.g. requesting an assessment, personal budget, appealing to Tribunal. Can still be supported by their parents. Note that Mental Capacity Act applies.

12 New SEND Code Provisions re Transitions
Schools and colleges must co-operate with EHC plan reviews from Yr 9 High quality study / pathways into employment Consider five day a week packages LA must make young people aware, through their Local Offer, of support available to them in Higher Education and support any DSA application LA must pass on EHC plan to the HE institution Local Offer must identify support and provision for year olds with SEN, regardless of whether they have an EHC plan Must co-operate even if CYP wants to go to a different establishment Study – must be stretching - not repeating what they have already learnt Pathways to employment – work-based learning such as apprenticeships, traineeships, supported internships. Schools or Colleges may be able to get Access to Work funding. Also developing communication and social skills, , using assistive technology and independent travel. Five day a week packages – may be more than one provider and be outside education, including volunteering, work experience and health and care activities, e.g. physiotherapy HE – may include Disabled Students Allowance Note that if yp is going to an HE institution outside their home LA, consideration must be given to how they might continue to get support in both locations

13 New SEND Code Provisions re Transitions
LAs and CCGs must co-operate to ensure alignment of care plans and adult health services Must be joint commissioning of services to meet EHC plan outcomes LA must carry out an adult care transition assessment where there is significant benefit and the yp is likely to have care / support needs after they turn 18 This must take place at the right time for the individual Transition assessment must involve the yp and must include their outcomes, views and wishes Funding provided by EFA / LA Transition to adult mental health services should have regard to The Mental Health Action Plan, Closing the Gap The care assessment applies to yp with SEN turning 18 or their carers, regardless of whether they have an EHC plan. The transition assessments should take place at a time when it is of significant benefit to the child, not just at 18. This is under the Care Act 2014 Transition planning must fit in with annual reviews of EHC plans – will essentially be the same content

14 New SEND Code Provisions re Transitions
Assessments for adult care / support must include: Current needs Whether these needs will still exist after they turn 18 What these needs are likely to be, and which are likely to be eligible needs LA must provide information and advice about provision and support for ineligible needs LAs must continue to provide children’s services until the yp’s needs as an adult have been identified LAs must put in place statutory care and support plans for yps with eligible needs, and must meet these needs Essentially, an LA can meet its statutory duties around transition assessment by including these elements in the annual review of the EHC. Include information on ineligible needs in the Local Offer. Decision over adult needs may mean: They don’t have need for adult care / support They do have these needs and the LA begins to meet them Have needs but not eligible or needs already being met. This means that the LA can continue to provide children’s services after 18 Care and support plans under Care act This will then form the “care” element of the yp’s EHC plan. This must include any adult care reasonably required by the yp’s learning difficulties or disabilities

15 New SEND Code Provisions re Transitions
Any adult with eligible needs will have a care and support plan that must include a personal budget LAs must follow the SEN CoP guidance on personal budgets Young people with SEN should have the information they need to make the transition to life beyond school / college LA must continue to maintain the yp’s EHC plan as long as they remain in education or training, or for as long as they need it As soon as transition planning identifies potential eligible needs, LAs should consider providing indicative PBs Not just school / college leavers with EHCs. Should include information about local employers, further training, where to go for advice / support. Annual review prior to ceasing EHC plan should agree the support and specific steps needed to help the yp engage with services and provision after they leave education

16 Key Risk Areas – Manchester Perspective
Social Work Sufficiency of evidence to support actions and decisions Finance Personal Budgets Corporate budget for Transition Commissioning Engagement – Customer, Family and Partners Evidencing involvement Managing expectations Social Work includes: Collection, recording and retention of information Decision making and timeliness of activity Reporting / communicating actions and outcomes – inc partners Management assurance framework Finance includes: Personal Budgets Accuracy and completeness of payments Appropriateness of spend Consistency with EHC / Support plans Management information – monitoring and reporting Corporate Resourcing Entrance and exit to/from transition Capacity Commissioning Identification of key requirements – what does success look like? KPI’s Evidence/outcome based – qualitative measures (person centred) Incentivisation – ensure shared goals Links to JSNA Customer and Family Engagement Considering mental capacity - ability to make decisions – particularly around fluctuating capacity Funding – changes in eligibility between childrens and adults partners 16

17 Possible Audit Approach - Manchester
Casework Compliance Assessments/reviews, EHC/support plans Evidence of engagement with customers and families Evidence of management oversight and challenge Finance System/Risk Based Reviews Personal budgets – eligibility verses appropriateness of spend Commissioning – governance arrangements /approach Developing System Work Transformation arrangements – changes to protocols and policies, integration of Children’s and Adults. Skills gap – potential gap in the transfer of a child to adult social worker 17

18 Audit Issues Governance issues:
How does the LA ensure it is fulfilling its duty to co-operate? Is there a Programme Board for this area – what is its scope? Is there clarity over strategic decision-making? Do children’s and adult services work together effectively? Are there identified officers for key issues? Are there effective links between operational and strategic objectives Working together – can be a danger that transitions is still just seen as an education matter. This should be addressed from the top down WBC include Transitions in its Disabled Children and Young Peoples Strategy – but everything in it is amber at the moment. Go through some of the items in the Strategy Identified officers – e.g. for developing local offer, Designated Health Officer at CCG to assist in identifying / supporting SEN children. More widely, there has to be clarity over who key decision-makers are. Show the slide with our governance structure – have this also as handout One of the key problems can be the number of different groups / initiatives within partners’ structures – can be overlap of responsibilities – may be lack of clarity over who is responsible – may also make it more difficult to get intelligence from the front line up to the strategic planning and commissioning process. We had a Transitions Strategic Group – has been superceded by the “Preparation for Adulthood” project group, but this is not exactly the same remit. We have a Transitions Operational group that still meets – but where will this report to and will it get a clear steer? A “unified” initiative like Transitions can potentially get lost amongst reorganisations of adults / children’s services. Have all authorities now gone through this structural change?

19 Audit Issues Commissioning Issues:
Does joint commissioning cover all relevant areas? Are Parent Carer Forums and other bodies involved in planning the local offer and commissioning services? Does the commissioning cover: Securing needs assessments and the provision identified in EHCs Agreeing personal budgets Advice and information on provision Processes for dealing with complaints / dispute resolution? Is all-age commissioning being considered? Joint commissioning must cover services for C&YP with SEN or disabilities, with or without EHC Local authorities and CCGs should engage with local Healthwatch organisations, patient representative groups, Parent Carer Forums, groups representing young people with SEN and disabilities and other local voluntary organisations and community groups. Services will include specialist support and therapies, such as clinical treatments and delivery of medications, speech and language therapy, assistive technology, personal care (or access to it), Child and Adolescent Mental Health Services (CAMHS) support, occupational therapy, habilitation training, physiotherapy, a range of nursing support, specialist equipment, wheelchairs and continence supplies and also emergency provision. They could include highly specialist services needed by only a small number of children, for instance children with severe learning disabilities or who require services which are commissioned centrally by NHS England (for example some augmentative and alternative communication systems, or health provision for children and young people in the secure estate or secure colleges). All age commissioning being looked at in authorities for LD, Mental Health. As an example of all-age commissioning in other areas – putting a variation in the contract with one of our social housing providers to take someone before 18 This also ties in with issues around pooled budgets. Stockport have an all-age team?

20 Audit Issues Commissioning Issues:
Are children and young people and their parents / carers involved in shaping the local offer ? Does the Joint Health and Wellbeing Strategy / JSNA make reference to Transitional arrangements? Has there been a proper assessment of needs ? Do they cover the full range of services / support available? Is there a clear link between the JSNA and the Local Offer? Does the JSNA identify gaps in provision and how they will be addressed? WBC has found that sending out questionnaires to cyp and parents / carers isn’t a very effective means of getting information from them – need to engage more actively. Are currently inviting children and their parents / carers to a “fun event” for consultation, in conjunction with the Warrington Wolves foundation and hosted at the rugby stadium. The sessions will outline what the ‘Local Offer’ is and how to get involved, there will be:  - an interactive website consultation session, - opportunities for children and young people to give their views using the funky iMac suite, - sports activities such as seated volley ball, - coffee and cake for parents and carers. Can be issues around conflict of needs and provision – if c&yp wants to go to a specialist FE college out of borough, which is more expensive than providing them with a supported tenancy in the area – how is this decision made? Our JSNA has a chapter on Transitions, but it is currently too data-focused and does not really identify the needs of c&yp and identify gaps in provision. It is felt that it is not clear enough about pathways, e.g. where can children go when they leave the special school setting? Probably doesn’t properly address issue of out-of-authority provision versus developing local provision. Is there unmet need that we don’t know about? Is there an issue about children who may not be eligible under FACS criteria? Again, the delivery of services must be needs-led and tailored to delivering outcomes, rather than being provision-led. And as said before, the Local Offer must include information on transitional arrangements and on the adult care and support system. Our Local Offer is likely to be more of an Internet-based resource than a single document.

21 Audit Issues Delivery Issues:
What are the transition plans for changing to EHCs How are EHCs going to be approved? Are there SMART objectives tied specifically to outcomes and meeting c&yp needs? Do these measure the success of joint working? Is there a review process to check EHC plans and ensure consistency? Is there proper consideration of the needs of looked after children / children in need, care leavers, c&yp educated out of area or at home Arrangements for phasing in new plans – govt has suggested that children with existing statements be transferred to new EHC plans within three years of Sep, and those with LDAs within two. This should not be seen simply as a re-badging, but should be a proper review under the terms of the new SEN CoP. The normal rules in relation to changes / appeals will apply. Govt proposes that LAs publish a local transition plan. WBC are looking at 16 and under EHCs to go to the Statementing Panel and the post-16 EHCs to go to the High Needs Panel We don’t really have defined Pis for this area yet – still under development Re consistency – we have had an issue where the staff in schools who provide advice have been signposting c&yp to unsuitable provision (e.g. may be that they are not eligible under FACS, or WBC does not provide it). TSWs thought that this has become a bigger problem since the abolition of Connexions. There is also the concern that child social workers may not be fully aware of some of the relevant legislation, e.g. Mental Capacity Act applies to those – is this taken into account when looking at decision-making, e,g. around things such as finance / housing. Our schools have very variable approaches to current transition planning – the paperwork varied a lot and some of them just do not buy into person-centred planning. If they don’t do this properly, this makes more work for the Transition Social Workers, who then have to pull the required information together. About 70% of looked after children have some form of SEN, many likely to have an EHC. Child’s personal advisor will therefore need to be involved in the EHC / transition plan at an early stage. May be a transition from being looked after to returning home, or living independently

22 Audit Issues Delivery Issues:
How are children requiring transition plans identified and recorded? Is there adequate resourcing to support transition planning? Is there a programme of training for practitioners, to help them advise c&yp and make correct decisions? Have transport and housing issues been properly addressed? Are children with complex needs prioritised? Are there effective arrangements in place where c&yp transfer provision? WBC have central record of c&yp requiring transition plans. This details key workers, nature of need, current school, whether they are high needs, etc. This has been used as a basis for discussion with adult social care to identify who may be eligible for adult services, so that they can plan (for service delivery and financial commitment). Currently planning to purchase the Capita SEN module to provide formal IT support for EHCs. WBC currently have two dedicated Transition Support workers, but they have a very big caseload between them. Are planning to recruit 6 more staff to start in Sept, to deal with the admin, liaison with schools, pulling information (e.g. other reports) together for EHCs. Housing and transport are two areas that may not be properly integrated into the transition planning, or may provide problematic. We have engaged our Housing section, but this has not yet delivered any real outcomes. Transport issues can be key when informing the decisions on whether the LA will support a c&yp’s choice of provision that is further away than provision that can meet their needs. At WBC, decisions on post-16 education transport funding are taken by the Transport Panel without reference to whether the c&yp has a Transition Plan. But the Local Offer should make these policies known. Code says that transport costs may be provided via a personal budget and included in an EHC as part of the special educational provision, however, there have been arguments that this is incorrect (see paper from IPSEA). We prioritise consideration of children with complex needs at TOG meetings – is this appropriate (children with PMLD can be the highest cost cases)?

23 Audit Issues Delivery Issues:
Is provision being reviewed for suitability? Has consideration been given to delivering personal budgets? Are there processes in place for converting existing plans into EHCs? What effect will changes to SEN funding have on the ability to deliver? How are children and young people without an EHC catered for – will they have access to transitional provision? Can be issues where there is a lack of provision within the borough, e.g. for Warrington lack of services for visual impairment, deafness, day care is not suited to the needs of young people. The FE colleges can provide appropriate equipment and put on courses that yp might want, but the atmosphere is not suitable – e.g. the canteen is too busy / noisy. Have lessons been learnt from previous experience of PBs? At WBC, currently looking into PBs for children / LD – looking at issues such as having third parties hold the funds, payment cards. Any feedback from the SEN pathfinders? Is there the capacity to manage the transition of current plans into new EHCs? Not really an expert on the funding arrangements, but it seems that many schools are getting less SEN funding – change in criteria to assume that some provision can be effectively done through good mainstream provision. Children with, for example, just one disability, may not be eligible for an EHC, but how do we identify their needs as they approach adulthood? May not be eligible under FACS – how can we prevent them falling back into requiring adult social services?

24 Conclusions Timescales for implementation
Transition is not a discrete system Managing expectations is key Partnership working Its not just individuals with EHC plans Budget, budget, budget Timescales for the Protocol is Sept 14 – transitional arrangements become effective for children at key points not a wholescale change for everyone in Sept. Managing expectations – communicating with families throughout the process to assist and enable them to identify and access appropriate services. Financial implications – both at an operational and strategic level with commissioning. Budget management reliant on effective planning around future requirements to assist children into adulthood. Prevention and Intervention still play a part. 24

25 Next Steps Bite size chunks
Audit approach taken will depend on your local assessment of risk Need to consider the level of integration between the Children’s and Adult’s social work teams.

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