Health and Disability Service

The criteria for the Health and Disability Service establishes the threshold at which a referral in relation to a child with a disability will be accepted on the basis that the child requires a specialist social care service.

Where a child has disabilities which appear to meet the criteria and particularly call for specialist intervention, these cases will be referred to the Health and Disability Service. The Service consists of three teams which include The Children’s Health and Disability Team, The Sharing Care Team and The Transitions Team.

The criteria are that the child must have a permanent or long lasting disability (diagnosed by a doctor or consultant) and be severely or profoundly impaired. Consideration will also be given to other children who have a significant number of moderate impairments.

The criteria do not include children diagnosed with ADHD or HIV or a psychiatric illness.

Where mainstream social workers hold cases of children who might be considered to be disabled, appropriate advice and support can be made available from the specialist Health and Disability Service.

All new referrals to the Health and Disability Services are initially made to the Referral Coordinator of the Service. Where a referral is received and it appears that the criteria for the Health and Disability Service are met, consultation will take place and advice sought as to whether the criteria for accepting or transferring the case are met. Where there are child protection concerns, see Section 4, Child Protection Cases.

Where there is a dispute, the matter should be discussed between the relevant managers with a view to resolution.

Where the dispute remains unresolved, the matter should be referred to the Service Managers with a view to resolution.

All children who meet the criteria for the Health and Disability Service will receive an assessment of their need for services.

The Assessment will be carried out in consultation with the family, using information from other professionals as appropriate.

It is the impact the disability has on daily living that is a key part of the assessment.

Additional specialist assessments will be commissioned as necessary from:

• Occupational Therapy;
• Sensory Impairment.

The assessment may identify that needs arise due to a child's disability or as a result of a parent's health or disability or a child may be in need of protection from abuse or neglect - see Section 4, Child Protection Cases.

The Health and Disability Service along with other key agencies will provide parents of children with disability and the child (depending on their age and level of understanding) with information about how support services may be accessed.

With new referrals (i.e. where the case is not open to the Health and Disabilities Service) where the primary concern is child protection, following the Single Assessment carried out by the Children’s Advice and Assessment Service, a discussion will take place between the relevant managers within the Children’s Advice and Assessment Service and the Health and Disabilities Service as to which team will hold responsibility for the case. Where the Children’s Advice and Assessment Service retain responsibility for the child's case, appropriate advice will be provided by the CWD Service relating to issues arising from any disability. However, the assessment process and any instigation of child protection procedures will remain the responsibility of the Children’s Advice and Assessment Service until such time as the case is formally transferred.

The Children with Health and Disabilities Service will usually undertake all Section 47 Enquiries, assessments and legal proceedings in respect of children who are already open cases. Consultation will take place with the Safeguarding Team when required.

In cases where there is a child with disability as one of a group of siblings under child protection procedures, joint working will occur between the Health and Disabilities Service and the Children’s Advice and Assessment Service as agreed between the respective managers.

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 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 kind of services or equipment that are required to meet the child's needs.

Any recommendation for the provision of equipment requires the approval of the Health and Disabilities Service Manager. If approved, equipment will usually be provided on a long term loan basis. Adaptation work through a Disabilities Facilities Grant can be carried out by referral to the local authority and the family will be given assistance with this.

The support services that may be included in a support package for a disabled child and their family 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 for the child in/outside the home;
• Day care services such as childminding as part of a plan to enhance a child’s social interaction and meet specific needs;
• Short breaks providing overnight care - see Short Breaks Procedure;
• Support services using direct payments - see the Direct Payments Scheme 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 or a Short Break Plan.

Reviews of Child in Need Plans for children with disability take place within 3 months of the start of the plan and thereafter at least annually. 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.

The review is usually conducted by the allocated worker contacting all those involved in the plan. The worker will then prepare a summary of the comments and observations made and present it to the Children with Disability Manager for approval. 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 - Practice Guidance.

For reviews of children in receipt of short breaks, see Short Breaks Procedure.