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3.2 Transition Protocol - Children and Young People with Disabilities

SCOPE OF THIS CHAPTER

This document sets out the current protocols in place in the London Borough of Ealing for all agencies concerned with young people with learning difficulties and disabilities who are making the transition from Children's to Adults Services. The Multi-agency Transition Board reports to the Directors of Children and Families and Adults Services. The Transition Board reports to the Children and Young Peoples Board, LD Partnership Board and Health and Well Being Board.


Contents

  1. Vision
  2. Aims of the Protocol
  3. Who is the Protocol for?
  4. Government Framework
  5. Key Partners
  6. Procedures
  7. Guidance for Transition Reviews for Young People with Statements of Special Educational Needs

    Appendix 1: Key Measures

    Appendix 2: Legislation, Regulations and Guidance


1. Vision

1.1 To maximise life opportunities for young people with learning difficulties and disabilities people aged 14-25 years in order to promote inclusion, choice and control.


2. Aims of the Protocol

2.1 To provide support to young people with learning difficulties and disabilities and their families promoting a smooth transition from childhood to adult life.
2.2 To actively involve young people with learning difficulties and disabilities in their own transition planning and promote and encourage young people to make their own choices and decisions about the future and use flexible approaches to meeting need, such as personal budgets.
2.3 To provide support which addresses the variety of different needs for young disabled people and their families and that address cultural and religious needs.
2.4 To utilise all available resources creatively and clearly identify budgetary responsibilities.
2.5 To coordinate the multi-agency processes for young people aged 14-25 with complex needs, learning difficulties and disabilities,  so that they are supported in their  transition to adulthood and to achieve their maximum potential in education, health, development and well being.


3. Who is the Protocol for?

3.1 This protocol applies to all young disabled people from the ages of 14 -25 years (physical, learning and/or sensory disabilities) who need support in making the transition to adulthood and who will have difficulty in one or more areas in living independent adult lives.
3.2 All young people with Statements of special educational needs resident in Ealing.
3.3 Children and Families and Adult Social Care Services have different eligibility criteria. Some children and families who have received a package of support from Children and Families may not be eligible for the same care package from Adult Services. Such families should be directed to other sources of support e.g. Connexions, Voluntary Sector where appropriate. In order to reflect the trend for young people to move from school to education, employment and training and the information, advice and guidance in relation to the Connexions Service, the transition process is to be extended to include college leavers at age 18.
3.4 The guidance 'Valuing People Now' focuses in particular on the needs of learning-disabled young people but does so in a framework that applies equally to all disabled young people. This protocol will be applicable therefore to all young people with learning difficulties and disabilities.


4. Government Framework

4.1 'Valuing People Now', the Government White Paper for People with Learning Disabilities, states as one of its key objectives, the need for local authorities to ensure that effective arrangements are established for enabling young people with learning disabilities to move smoothly from children's to adult services in all relevant agencies.  Furthermore it states that as young people with learning disabilities move into adulthood, local authorities need to ensure continuity of care and support for the young person and their family; and to provide equality of opportunity in order to enable as many disabled young people as possible to participate in education, training or employment.
4.2 The Care Planning, Placement and Case Review Regulations (England) 2010 apply to all looked after children under the age of 18 to safeguard and promote the welfare of LAC and children placed away from home.
4.3

Departmental Commitment

The council are committed to ensuring timely and seamless transition of services for children and young people with special needs. Therefore the service has identified key measures to ensure continuous improvement in services and outcomes for young people. (See Appendix 1: Key Measures)


5. Key Partners

5.1
  • Children, young people and their families;
  • Children's Services- Children and Families;
    • Social care;
    • ESCAN;
    • Youth and Connexions;
  • Schools and Colleges and other employment, education and training providers;
  • Adults Social Care Service;
  • Housing;
  • Health - PCT;
  • Employment services, including Job Centre Plus;
  • Voluntary Sector.


6. Procedures

6.1

Annual Review of the Statement of Special Educational Needs (Year 9)
  6.1.1 An Annual Review brings together the parents, the pupil, the school, the LA and all the professionals involved to consider the progress made by the pupil. Amendments are then made to the description of the young person needs and abilities, to the long-term objectives in the Statement and to the provision required to enable the young person to meet their objectives. The school or educational provision convenes the annual review each year.  Plans for transition must be started in Year 9 (age 13/14) and a Transition Plan drawn up at the Annual review. This is then reviewed each year as part of the Annual Review.
  6.1.2 The Connexions service and professionals from agencies that may play a major role in the young person's life after school are invited to the Review in Year 9 together with the young person and their family so that together they can draw up the Transition Plan
  6.1.3 The purpose of the Transition Plan is to plan coherently for the young person's transition to adult life. It should focus on the young persons aspirations and interests and draw together information from a range of individuals and agencies both in and outside of school.
  6.1.4

The Transition Plan is drawn up in a collaborative way using a person centred planning approach that is participative, holistic and inclusive as described in the SEN Code of Practice 2001.

The school should send out the Transition Plan with the Annual Review Report to the family and all relevant agencies, within two weeks of the review meeting.  The Transition plan must then be reviewed annually or more frequently and updated as needed to reflect the evolving plans for transition.
  6.1.5 Connexions usually take responsibility for overseeing the delivery of the transition plan but at the review meeting it may be agreed that the school or another agency will take this role.
6.2

Social Care (Children and Adults services) Assessment
  6.2.1 At the Year 9 and subsequent reviews, it will be agreed that either the Educational Social Worker (ESW) at the special school, the Children's Transition Social Worker (TSW) or Connexions worker will be the one to identify if a young person is considered eligible for multi-agency transition support. Eligibility is based on an assessment of whether the young person is likely to need access to social care services during adult life.  Those assessed as likely to need that support will be supported by the children's transition worker until their 18th birthday. For those children educated out of borough the transition plan will be undertaken by a Connexions worker in the host authority in partnership with Ealing Connexions service.
  6.2.2 Dependent on above, a decision will be made as to who (if anyone) should attend review.
  6.2.3 At a year 9 review, young people and families are to be given an information pack by the connexions worker on the transition process and services, including sources of support, even if young person does not meet the eligibility criteria for Social Care services e.g. Connexions, Voluntary sector. The website for families with disabled children will also have this information on it.
  6.2.4 Important information from the school Transition Plan is to be fed back via the school to TSW or the Monitoring group. ESW's/TSW'S should attend reviews if particular issues arise.
6.3

Multi-agency Transition Monitoring Group

The transitions monitoring group meets weekly at ESCAN  to monitor progress on individual young people in transition from children's to adult services, to ensure that care plans are in place for all young people that need them, to identify resource implications for young people approaching transition and consider commissioning implications.
6.4

Post-16, Post-18 and Post-19 learners moving on from education
  6.4.1 Transition planning should actively involve young people.  Person Centred Planning should be introduced for all young people in transition at the Year 9 review.
  6.4.2 SEN Administration Team manages and maintains records of all children with a Statement of special educational needs. The service will provide details of all children in year nine and above (including the category of need) to the transition SW. this information will be discussed in the transition monitoring meetings.
  6.4.3 Advice and information is available to families about community resources for young people reaching adulthood and where they can go for support (either Adult Social Care Services or if not eligible/appropriate then elsewhere - ContinYou -Ealing Parent Partnership Service, Connexions, voluntary sector etc.).
  6.4.4 The transition worker will assess children and young people who meet the criteria for services from the children with disabilities social work team (this would include school leavers in their last year of full time education - Year 11, 12, 13, 14 at age 16, 17, 18 or 19 to formulate a school leaver's plan.  This should be in parallel but closely linked to the Transition plan and pathway plan (if appropriate) rather than duplicating them and take a multi-agency approach).
6.5

Transfer of cases between Social Work Teams
  6.5.1 Where young people require continued support from adult services, transfer of social work cases between children and adult social work teams will take place when the young person is aged 18 years.  Where children have previously been looked after, the role of leaving care team will be agreed between all professionals and stated in the transfer summary.
  6.5.2 The Adult TSW (from Learning Disability Team) or a representative from the physical disability team will attend school/looked after children reviews etc. for young person 6-12 months prior to their 18th birthday.
  6.5.3 A Joint visit to families by children and adult team workers (where appropriate) will take place no later than  three months prior to 18th birthday to discuss transfer to adult services.
  6.5.4 Individual transitional meetings will be held if necessary to review progress. This should be combined with last school annual review or looked after review.
  6.5.5 A detailed transfer summary will be completed by children's social worker highlighting action required and funding arrangements, including Direct Payments/personal budgets at least one month before the young person's 18th birthday.
6.6

Looked After Children
  6.6.1 In accordance with the Care planning, placement and Care Review procedures 2010 children who are "looked after" either for short breaks (respite) or full time will have six monthly looked after children's reviews and transition arrangements should be a key area to be discussed when the young person is in school Year 9 and thereafter annually.
  6.6.2 Under the provisions of the Children (Leaving Care) Act 2000, all young people who are looked after should have a pathway plan - mapping their pathway to independence including further education, training and employment.
  6.6.3 The Pathway Plan (PWP) should be initiated when a young person reaches the age of 16 and be completed within 3 months. The lead officer for completing the PWP will be the nominated transitions lead in the leaving care team and will involve the transitions worker. The plan will avoid any duplication of the transition plan as there is some overlap between the two plans. They may refer to each other. The plan will consider the role of the leaving care team post 18.
  6.6.4 The transitions monitoring group will identify the children who are required to have a pathway plan and inform the leaving care team manager at least 12 weeks prior to the young person's 16th birthday.
  6.6.5 The pathway plan and the transition plan and an assessment under the Mental Capacity Act where appropriate, will be used by Adult Services to inform the Community Care Assessment carried out   when the young person reaches the age of 18.
  6.6.6 Transition plans and Looked After Children reviews should be combined wherever possible in order to avoid duplication and co-ordinate transition planning.
  6.6.7 Some young people in care will not be known to the Children with Disabilities team and may need to transfer from the Leaving Care Team to Adult Disability Teams.  These should be highlighted by the Annual review of Statement but if not the Leaving Care Team should highlight these cases and bring to the attention of the weekly transitions Monitoring Group.
6.7

Health Needs
  6.7.1 For young people with a learning disability and additional complex health needs, transition will involve a named health facilitator, identified at the Year 9 review who will   act in a coordinating role in relation to handovers to relevant consultants in the health service.
  6.7.2 The various professional disciplines (psychology, physiotherapy, speech and language therapy, occupational therapy etc) will have their own arrangements for the handover of cases, however the Transition social worker and the named health facilitator will have a role in ensuring the process is co-ordinated and effective.
6.8

Funding Issues
  6.8.1 The transitions social worker will ensure that transition plans include clear financial information, costs for services and clearly identified funding streams with the appropriate authorisation.
  6.8.2 The transition workers in both adult and children's teams will be jointly responsible for producing a report by January 31st each year summarising the likely costs of individual support packages for the next financial year which will be presented to the relevant Assistant Directors in Adults Services and Children's Services for information purposes.


7. Guidance for Transition Reviews for Young People with Statements of Special Educational Needs

7.1 Following the Year 9 Annual Review a Transition Plan must be drawn up for each young person with a Statement of Special Educational Needs. This must then be updated in subsequent years until the young person leaves school.
7.2

Aim of transition planning
  7.2.1 To help the young person prepare for a successful transition to adult life. To ensure that all agencies are working together with the young person and family to plan for this transition.
7.3

Key Guidance

Detailed guidance specifying the role of different agencies is contained in:

  • SEN Code of Practice DfES 581/2001;
  • SEN Toolkit DfES 558/2001;
  • SEN Handbook Ealing Guidelines for Good Practice.

Documents to be used:

  • Ealing's Annual Review document;
  • Ealing's Transition Plan template.
7.4

Key Responsibilities
  7.4.1 For young people attending school, the LA expects the head teacher at the young persons school to take responsibility for ensuring that a Transition Plan is made. This responsibility is often delegated to the Connexions PA and SENCO.
  7.4.2 For young people not at school the LA is responsible for the Transition Plan and ensuring a review meeting is convened.
7.5

Timescale
  7.5.1 The Transition Review Meeting must be held during Year 9. In practice this will usually be held as part of an extended Annual Review of the Statement of Special Educational Needs.
7.6

Prior to the Annual Review/Transition Meeting
  7.6.1

A referral needs to be made to;

  1. The Connexions PA who should meet with the young person/family and prepare a personal action plan -this will form the basis of the Transition Plan;
  2. The Educational Psychologist who may meet with the young person/family and carry out some reassessment where appropriate;
  3. Any other relevant professionals.

7.1

Pupil's Views
  7.7.1 The Transition Review should use a 'person centred planning'  approach. The pupil's views need to be sought and recorded and arrangements need to be made to enable them to attend and participate in the review meeting.
7.8

Those invited to the Review Meeting
  7.8.1

The SEN Code of Practice states that the head teacher must invite the following people to take part in the annual review meeting in Year 9:

  • The child's parents/carers;
  • The pupil;
  • A relevant teacher (e.g. year head, SENCO, Special Needs Support teacher);
  • A Connexions Personal Adviser;
  • Any person the LA specifies in the Statement (in Ealing this would always include the Educational Psychologist);
  • Any person the head teacher considers appropriate;
  • A representative of the social services department.
  7.8.2

The head teacher should also invite the following if relevant:

  • Health service representatives;
  • Other closely involved professionals (e.g. CAMHS).
7.9

Transition Plan
  7.9.1 The aim of the Transition Plan is to plan coherently for the young person's transition to adult life. It should focus on the pupils aspirations and interests for living and working and  needs to reflect the discussion held during the annual review in year 9.
  7.9.2 The Transition Plan should focus on strengths and needs and cover all aspects of the young person's potential and the progress they have made in achieving their longer-term objectives.  Clear responsibility for different aspects of the plan should  be allocated to specific agencies and professionals as relevant.
  7.9.3 Transition planning is a continuous and evolving process and the Transition Plan will therefore change over time.  The first plan is drawn up after the year 9 annual review and it should then be reviewed and updated at each subsequent annual review or more frequently until the young person leaves school.
  7.9.4 The Transition Plan should be forwarded together with the Annual Review.


Appendix 1: Key measures

  • Increase number of person centred transition plans to ensure improved individual outcomes as identified with ECM;
  • Increase the use of self-directed support;
  • Increase the use of personal budgets/direct payments;
  • Increase the number of young people in education, employment and training;
  • Taking up of paid employment or other active occupation;
  • Increase in 13-25 year olds participating in the activities in their leisure time;
  • Engagement with other relevant services/sources of support, housing, benefits, voluntary sector;
  • Increase in the number of young people in supported living.


Appendix 2: Legislation, Regulations and Guidance

  • The Education Act 1996 as amended and revised Code of Practice for Children with Special Educational Needs 2001;
  • Support and Aspiration: A new approach to special educational needs and disability Green Paper March 2011;
  • The Disabled Persons Act 1986;
  • White Paper - Valuing People 2001;
  • Children Act 1989;
  • Children Act 2004;
  • Valuing People Now 2008;
  • Mental Capacity Act 2007;
  • National Assistance Act 1948;
  • National Health Service and Community Care Act 1990;
  • Carers and Disabled Children Act 2000;
  • Carers (Recognition and Services) Act 1995;
  • Learning and Skills Act 2000;
  • Human Rights Act 2000;
  • Equality Act 2010;
  • Health Act 1999;
  • The Asylum and Immigration Act 2000;
  •   The Care Planning , Placement and Case Review (England) Regulations 2010;
  • The Care Leavers (England) Regulations 2010;
  • Putting People First (guidance) 2008;
  • Transition: Moving on Well, DoH 2008;
  • Transition getting it right for Young People, 2006;
  • Children and Disabled Carers Act 2000 and Carers ( Equal Opportunities) Act 2004 Combined Policy Guidance 2005;
  • Children and Disabled Carers Act 2000 Practice guidance 2001;
  • LAC(2002)13 Fair Access to Care Services: Guidance on eligibility criteria for adult social care;
  • Fairer Contributions Guidance -Calculating an Individual's Contribution to their Personal Budget DoH 2009;
  • National Service Framework for Long Term Conditions;
  • Framework for the Assessment of Children in Need and their Families.

Link Documents:

Children's Services Procedures;

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