Getting social care services for children with additional needs

(reference:  Contact: For families with disabled children)

When you and your family need help to support you in caring for a child with additional needs, an assessment of needs is undertaken by social services to gather information about your child and family, so they can make a decision about what help you may need. This process of assessment is referred to in the Children Act 1989 and in the statutory guidance “Working Together to Safeguard Children”. This guidance tells local authorities what they must do to meet their legal responsibilities to families with disabled children. It’s up to each local authority to decide how much detail is needed in each assessment so what’s required of you varies depending on where you live, but the maximum time frame for any assessment is 45 working days from receiving a referral.

You should be told how the assessment will be carried out, and be given information about what services are available, not just those which are actually provided by social services departments e.g. a local play scheme.

What is an assessment of needs?

It is very important to remember that the starting point is your child’s needs, regardless of whether services exist to meet them. The Working Together to Safeguard Children guidance emphasises the importance of the assessment being child and family centred. The approach should also be holistic, addressing the child’s needs within their family and wider community. So, as well as your child’s disability and health needs, social services should also consider other aspects of your child’s life, for example, education and religious or cultural needs.

Preparing for an assessment

Try to find out exactly what your local will be wanting and the amount of detail they require, particularly as this varies between authorities. Ask questions so you understand what’s required before you start. Maybe you know someone who already gone through the process. See what they say about it. Remember forewarned is forearmed.

It’s always useful to make a list of questions in the preparatory phase so you don’t forget to ask something important. You are entitled to have a friend or advocate with you. The social worker may also want to speak to your child’s health visitor, doctor or school to help them get a full picture of their needs.

What to expect at an assessment

A social worker will usually come to your home to talk to you. They should ask you for information about your child, for example, sleeping patterns, eating habits, how your child communicates, what activities they enjoy and whether you have any other children to look after. Don’t be worried about asking for clear information about the focus of the assessment as it proceeds. If you’ve had a good preparatory meeting you should know about this already. It is an opportunity to have a conversation about how to meet your child’s needs. But do remember that the assessment should be based on yours and your child’s needs and not based on services already available.

What if an assessment has been carried out in the past?

When services are already being provided, the assessment should be reviewed regularly but if your circumstances have changed, you can ask for a re-assessment or review in the same way you ask for an assessment

What if I’m refused an assessment?

If your child is disabled (and in need of services) you can’t legally be refused an assessment. You don’t need to have a diagnosis for your child to get an assessment or help from social services. It can sometimes take time before a diagnosis can be made for a number of reasons but if your child needs help or support, an assessment of their needs should still be made. You should make a complaint if this doesn’t happen.

An early help assessment

This is often referred to as the Common Assessment Framework (CAF), which is another way that children and families can be assessed and receive services. But it is important to note that this process does not replace the detailed assessments under the Children Act described above. The duty to assess under the Children Act remains. However following High Court decision R (L and P) v Warwickshire CC, the judge ruled that the Local Authority could choose to assess a child under `Early Help’ assessment instead of carrying out more detailed Children’s Act assessment. The CAF can be used if you, or someone who works with your child, would like them to receive extra help and benefit from co-ordinated support from more than one agency (for example education, health and housing). It will help to identify your child’s additional needs, and other workers required to support your family. If you and your child agree, a worker will ask you both some questions to find out what help and support you might need. This information is recorded on a form. Once you’re satisfied with the information on the form, you’ll be given a copy of it. Based on the information you both provide, everyone who can help your child should work together to provide the support they need. A ‘lead professional’ will be appointed who should keep you informed, listen to your views and support you. They will also co-ordinate all the services supporting your child. You should be allowed a say in who should be the lead professional. Further information on how the CAF operates in your area should be available from your Local Authority and is usually on their website.

Your needs as a carer

Any assessment of your disabled child should take into account the needs of the rest of the family members, including parents and siblings, and consider their needs as carers and their capacity to continue with caring. However, the aim of a carer’s assessment is to give you a chance to tell social services about the things that could make looking after your child easier for you. This may result in getting services or direct payments to meet your own assessed needs. Examples of services that can be provided include help with driving lessons, housework and gardening.

A carer’s assessment focuses on you as a parent and your needs. Social services should discuss issues like the help you need and whether there is anyone else who helps, or if you are your child’s only carer. The carer’s assessment should also consider your wellbeing which includes the following elements:

  • Personal dignity and respect
  • Physical and mental health and emotional well-being
  • Protection from abuse and neglect
  • Participation in work, education, training or recreation
  • Social and economic well-being
  • Domestic, family and personal relationships
  • Suitability of living accommodation
  • The individual’s contribution to society.

All carers have a right to ask for an assessment of their needs at any time. For example if your needs have changed (you may wish to take up education, training or employment) you can apply in the same way as asking for an assessment for your child.

Parents should use the Children and Families Act 2014 to ask for an assessment. The Act also gives strengthened rights to assessments for parent carers, young people and young carers regarding work, education and leisure. An assessment for a sibling, known as a young carer, is triggered where there is an `appearance of need’. That means it is not necessary for the young person to request this, so any assessment of you or your disabled child should take into account any brothers and sisters.

The Carers (Recognition and Services) Act 1995 and Carers (Equal Opportunities) Act remain in force for other family members who are providing ‘substantial and regular’ care to a disabled child. For example a grandparent, aunt or uncle who provide care, but who do not have parental responsibility for the child. Substantial and regular care is usually defined as 35 hours or more care per week. Always put your request in writing and keep a copy of your letter or email. Or you can ask your GP, health visitor, community nurse, paediatrician or voluntary organisation to contact social services to ask for an assessment on your behalf.

Tips for attending meetings with social services

  • Be prepared
  • Keep copies of everything like letters or emails you’ve written about your child to the authorities, as well as those they send you.
  • Keep everything in a file, making sure you read everything you think might be relevant before the meeting to refresh your memory.
  • Make notes: it’s easy to forget something so having a few notes handy at meetings with professionals will help to make sure you cover all the points you want to make.
  • Listen to what the professional workers have to say too and make notes of what is said.
  • Take someone with you: If you have a partner, make sure you both attend any meetings with professionals. If that’s not possible, or you are a single parent, take a friend or someone from a local support network.
  • Don’t be frightened to ask if you don’t understand what’s being said. Ask questions until you do.
  • Keep calm: Don’t lose your temper if things are going wrong.
  • Try to give reasoned, counter arguments.
  • Follow up: Compare notes and draw up a summary of the main points made at the meeting, what was agreed, and what still needs to be agreed.

After the assessment

After social services have carried out an assessment, they need to reach a decision about whether you and your family are in need of services, and which services are needed. They may decide there is no need for services, which could result in your case being closed with no further action taken.

If you disagree with this decision, you can challenge it using the Local Authority’s complaints procedure.

Or they may decide that there is a need for services and these should be provided. The Local Authority will then produce a plan of services, called a ‘care plan’.

The care plan

In many Local Authority areas, a panel decides the package of services that may be offered. A care plan should be agreed between social services and you and your family, to meet any identified needs. The plan should give details of:

  • What services will be provided
  • For how long the services are needed
  • What the local authority plans to achieve by providing the   services
  • What each person and agency is expected to do
  • The date of the next review.

Importantly, the care plan should be reviewed regularly to make sure any services remain appropriate. It is important to seek advice if your needs change or your Local Authority has told you a service is no longer available.

Eligibility criteria

Services available under both the Children Act and the Chronically Sick and Disabled Persons Act should be provided when there is an assessed need, and services are necessary to meet those needs but in practice, most Local Authorities use eligibility criteria to help them make this decision. There are many disabled children in an area who need help but social services have limited financial resources. Using eligibility criteria for deciding who has a ‘need’ for services is a way they can prioritise, to make sure the people most in need get help. The criteria are different from one Local Authority to another, and this means if you move to a different Local Authority area you may no longer qualify for the same help.

For example, one of the services listed under the Chronically Sick and Disabled Person’s Act is ‘holidays’. This doesn’t mean every disabled child must be given a holiday each time they ask. There will be local eligibility criteria. It might say for instance, that holidays will normally only be given if a child has not had a holiday for five years and there is a risk of family breakdown if it’s not given.

When an assessment shows you meet the criteria

Once your child’s assessed needs match the local eligibility criteria, the Local Authority has a duty to provide or arrange services to meet those needs. For example, if your child has not had a holiday for five years and you could show that your family is under such stress that family breakdown is possible, there would be an obligation to fund the holiday, regardless of the Local Authority’s financial difficulties. However, the Local Authority can take its resources into account to decide how it will actually meet the needs. It might limit the type of holiday it provides, or it might arrange for another organisation to do so. It could even apply for a charitable grant to fund the holiday. When you don’t meet the eligibility criteria If the service is not actually assessed as a need (perhaps seen as only useful), or if it is assessed as a need but does not fit the local criteria, the Local Authority has no actual obligation to provide or arrange the service. They should still try their best to meet the need, for example by contacting a local charity or voluntary agency for help. If the decision is that services aren’t needed, or that you don’t fit the eligibility criteria, you should be given clear reasons. This is to help in case you want to challenge the decision using the complaints procedures

Don’t be fobbed off. If you hear statements like, ‘Our Local Authority no longer provides short breaks’ or, ‘We don’t do carers’ assessments in this Local Authority’, these statements are unlawful and you should have good grounds for a complaint. In fact, the Local Authority should not put a blanket ban on any service and should always consider the needs of the individual child and family. The Court has already decided that a Local Authority can’t ‘unlawfully fetter its discretion’. This means they must always be prepared to consider requests that don’t fit into their eligibility criteria. Using the holiday example it would be illegal for a Local Authority to say, ‘we never give holidays to children unless they have not had one for five years’. They can say, ‘we don’t usually give holidays’ but they must always listen to any reasons you have about why you should be treated as an exception.

Cutting back on services

When commissioning or changing services for disabled children and families, the Local Authority must consult with local parents via their local parent carer forum. This is a group of parents and carers of disabled children who work with Local Authorities, education settings, health providers and others to make sure the services they plan and deliver meet the needs of disabled children and families. If you are told a service is being cut or changed, get in touch. You can also sign up to your local forum just to receive news for families with disabled children.

Decisions on closing down certain services and facilities have also been successfully challenged in the courts because of an Authority’s failure to carry out a proper consultation. Other successful challenges refer to duties under human rights and disability discrimination legislation.

What if you’re unhappy with decisions?

Under the Children Act 1989 ‘Representations Procedure (England) Regulations 2006’ there are is a whole host of circumstances where parents and carers can complain.

Grounds for complaint are:

  • Service quality or appropriateness
  • Delays in decisions being made or services being put in place
  • How services are delivered (or not delivered) including the way complaints are dealt with
  • The amount of help given,
  • How frequently a service is provided,
  • Any changes made to services or how much you are asked to pay
  • The attitude or behaviour of staff
  • How eligibility and assessment criteria are applied
  • A local authority policy which impacts on you or your child
  • Any aspect of the assessment, reviews or care management.

Similar rights exist in respect of complaints about adult social care services.

Who deals with a complaint?

Each Local Authority has a ‘designated officer’ who receives all complaints, called the complaints manager. They don’t have to handle all stages of the complaint but are responsible for administering the scheme to make sure complaints are dealt with swiftly and effectively.

How quickly can I expect a complaint to be dealt with?

Time scales are summarised below but you can ask the Authority to respond sooner.

Stage 1 – Local resolution

You should bring your concerns to the attention of the person providing the services locally. The Local Authority should consider mediation at this stage, and all other stages. They should make a first attempt to resolve matters within 10 working days. This can be extended by another 10 days, for example if an advocate needs to be appointed. If the matter isn’t resolved, or if there is agreement for an investigation to take place, then the complaint should go to Stage 2 if you request it orally or in writing.

Stage 2 – Investigation

The Local Authority should arrange an investigation that produces a report and a decision within 25 working days (or sometimes, in extreme circumstances, this can be extended to 65 working days).

If the matter is still not resolved then you can ask for a panel to consider your complaint. The investigation will be undertaken by a nominated complaints officer.

Stage 3 – Review Panel

The person making the complaint can ask for the matter to go to a Review Panel within 20 working days of receiving a Stage 2 decision. This is a meeting of three independent people who will consider the complaint and make recommendations. The process of holding a Review Panel must follow certain time limits.

Dissatisfaction with the outcome of a Review Panel?

The Local Government Ombudsman (LGO)

If, after a Review Panel has considered your complaint, the matter is still not resolved then you can take your complaint to the Local Government Ombudsman. There are two LGOs in England that deal with complaints from different parts of the country. The Ombudsman can investigate complaints against principal councils (not town, parish or community councils) and certain other bodies. By law, they must look for ‘maladministration’ by a local authority.

Maladministration is a term that describes the actions of a government body that can be seen as causing an injustice.

Examples include:

  • Delays
  • Incorrect action or failure to take any action
  • Failure to follow procedures or the law
  • Failure to provide information •inadequate record-keeping   •failure to investigate
  • Failure to reply
  • Misleading or inaccurate statements
  • Inadequate liaison
  • Inadequate consultation, and
  • Broken promises.

The Ombudsman will decide whether the Local Authority has done something wrong which has directly affected you and caused you an injustice. They won’t investigate a complaint against the Local Authority simply because you disagree with it.

Where you can see a review of complaints against your Local Authority

Each year the Local Government Ombudsman sends an annual review to all local authorities (LAs) about complaints made about them to the ombudsman. This is a useful way of assessing the LA’s performance in dealing with complaints. The review includes statistics but also lists a few cases that have been investigated and reported. To see your LA’s review letter visit: www.lgo.org.uk/informationcentre/councils-performance

Taking legal action

Judicial review

If your complaint is very urgent and you can’t wait for the complaints procedure to resolve the matter, you can apply to the courts for a Judicial Review. Judicial Review is a procedure where the High Court looks at the way a decision was reached to see if it was legally correct. You can also apply for Judicial Review if you have exhausted the complaints procedure and are still unhappy with the outcome. To do this you will need legal assistance. If you have a low income, you may qualify for legal aid. In addition, some solicitors offer a free first interview.

Other ways to complain

Contact your MP for help.

Ofsted is the Office for Standards in Education, Children’s Services and Skills.

They inspect and regulate services that care for children and young people, including children’s homes. They also inspect services that provide education and skills for learners of all ages. Ofsted have some powers to investigate concerns about services they inspect.

Healthwatch England is the consumer body for users of health and care services. They have the power to raise concerns and influence the policy of health and care providers. You can contact your local Healthwatch, which may be able to offer advice and support with your complaint.

The Care Quality Commission regulates and inspects children’s homes that provide healthcare performed by a qualified healthcare professional. It also regulates and inspects home care agencies that provide services for children.

Both Ofsted and the Care Quality Commission value hearing about any concerns about the care provided by services they inspect. If you’re concerned about the care your child is getting, do share it with them, as other parents may have reported concerns too. It helps them build up a picture of what is going on in a local area and may trigger an investigation if parents are reporting bad practice.