Chronically Sick and Disabled Person's Act 1970 for Disabled Children

This document is the Nottingham City Council CSDPA policy for specialist social care services for disabled children in Nottingham. This should be read in conjunction with the "Guide for Professionals on how to access social care services".

The document sets out to inform practitioners on how to ensure that the CSDPA is appropriately considered, applied and implemented.

This document does not fully interpret the whole legal framework of the CSDPA; if there is any uncertainty about how the CSDPA should be applied, then advice must be sought from the Council's Legal department.

The provision of social care services is governed by law. That law consists of primary and secondary legislation (i.e. Acts of Parliament and Rules and Regulations) together with government guidance which must be followed by local authorities save in exceptional circumstances.

In some cases local authorities have a duty to act which means that they must do so; in others they have a power to act, i.e. the law enables them to do something, but it is discretionary.

The Chronically Sick and Disabled Persons Act (CSDPA) 1970 places a specific duty on local authorities to provide the support which a disabled child is assessed as needing when it comes within the scope of the CSDPA. This will include arrangements for the provision of assistance for an eligible disabled child for adaptations to their home, or the provision of any additional facilities designed to secure greater safety, comfort or convenience. This also includes the provision of equipment. Such assessments are usually undertaken by the child's Occupational Therapist (OT) on behalf of Children's Services.

There is no age distinction under the CSDPA so it applies equally to adults and children. The National Service Framework (NSF) also relates to Disabled Children and devotes one of its themes to 'Equipment and Adaptations' subsequently this also sets a number of standards;

• 'Disabled children and young people should have the equipment and housing they need for their health, well-being, development and social inclusion; and for their families' health and well-being;
• Disabled children and young people should have access to the equipment they need in all the settings in which they find themselves.

Section 2 CSDPA 1970 - Provision of welfare services

Section 2 CSDPA 1970 provides a list of services that local authorities must provide to disabled children. The list can be summarised as follows:

• Practical assistance in the home;
• Provision (or assistance to obtain) radio, TV, library or other recreational services;
• Provision of lectures, games, outings, recreational or educational activities outside the home;
• Provision of services or assistance in obtaining travel to and from the home to participate in any of the activities mentioned;
• Assistance in arranging adaptations or provision of additional facilities to promote "safety, comfort or convenience";
• Facilitating the taking of holidays;
• Provision of meals in the home or elsewhere;
• Assistance in obtaining a phone and any special equipment necessary to use it.

Thus the CSDPA forms the basis for the provision of a whole range of services including equipment, adaptations, home helps, meals on wheels, etc. As the CSDPA is vague in specifying "assistance", it is not necessarily the case that a local authority must pay for the rental and installation of a telephone, for example.

There are some services that disabled children and their families need that do not fall within the wide range of services provided for in the CSDPA. One of those is the provision of accommodation for children placed away from their family home for which a power is expressly provided for by S.17 (6) and S.20 (4) of the Children’s Act (CA) 1989. In particular the provision of residential and fostering short breaks.

The CA 1989 remains the statutory framework underpinning the local authority's responsibilities and involvement with all children and their families. Disabled children can and should access services through Part III of the CA 1989. All disabled children are children 'in need' for the purposes of section 17 of the CA1989.

The duty on local authorities under S17 of the CA 1989 is to provide a range and level of support services for children in need in their area, where possible to support them in the context of their families.

All work with disabled children and their families in the context of the CA 1989 should be based on the following principles:

• The welfare of the child should be safeguarded and promoted by the provision of services;
• A primary aim should be to promote access for all children to the same range of services;
• Disabled children are children first;
• Recognition of the importance of the parent and families in children's lives;
• Partnership between parents and carers and local authorities and other agencies.

The views of children and parents should be sought and taken into account.

A 2009 High Court case R (JL) v Islington LBC confirmed that residential and other overnight short breaks could not be provided underS.2 of the CSDPA 1970. Usually they would be provided for under S.17 (6) or S.20 (4) of the CA 1989. Please see the Short Breaks - Threshold and Access Criteria for further details.

The language of the CSDPA reflects the times in which it was legislated. Examples of the range of services which can be accessed under the CSDPA are:

• Support at home, for example with personal care or eating;
• Home based short breaks such as a sitting service;
• Support to access the community such as after-school clubs or play schemes. This includes community based short break services, such as linking;
• Assistance with travel to access the community;
• Help with adaptations to the home and equipment to secure “safety, comfort or convenience”;
• Help with the costs, or provision, of holidays, meals and/or telephones.

In order to decide whether or not to provide services to a disabled child, Children's Services must carry out an assessment. The aim being to ascertain the needs of the disabled child and his/her family. Although the CA 1989 does not specifically state that disabled children have a right to an assessment, the Courts have held that there is a public law duty on Local Authorities to carry out an assessment. Disabled children should therefore be assessed under the CA 1989 even if any services they subsequently receive are given under other community care statutes such as the CSDPA 1970.

The Local Authority should also have due regard to their duties under the Equalities Act 2010 in reaching this decision.

The government guidance Framework for Assessment of Children in Need and their Families directs Children's Services to undertake assessments "in an open way and should involve those caring for the child, the child and other significant persons". The particular needs of the child must be taken into account - that is in relation to health, development, disability, education, religion, racial origin, and cultural and linguistic background". Section.2 of the CSDPA states that if a local authority is satisfied through assessment that it is necessary to make arrangements for amongst other matters, the provision of practical assistance in the family home to meet those assessed needs of the disabled child, the local authority is under a specific duty to make those arrangements. The local authority cannot delay or streamline those services for financial reasons. If those services are not available for whatever reason, the local authority must provide a suitable substitute service in the interim, while urgent steps are taken to commission the identified service required.

Reference should always be made to the relevant case law summaries.

Direct Payments can be used by a family to pay for the services, but the Direct Payment must be sufficient to cover the cost of that service. A local authority cannot insist that a family has a Direct Payment.

If a parent or carer as a result of their own disability has their own social care needs then a referral should be made to Adults Services to assess their needs as a disabled person and parent.

In addition, The Children and Families Act 2014 places a duty on local authorities to undertake a parent carers needs assessment (see Parent Carers Needs Assessment Policy).

Under CSDPA the local authority must also find out:

• How many chronically sick and disabled people there are in the area;
• Who they are;
• What help it can give them.

This duty is fulfilled by the provision of a disability register. Parents may register their disabled child by following this link: www.nottinghamcity.gov.uk/localoffer.

Children/young people and their parents can make a complaint about any aspect of the process. Information about the complaints process should be provided on request. Any member of staff contacted about a complaint should take the details of the complaint and notify the line manager and the Complaints Team, which can also provide advice and support in dealing with complaints.

The Complaints Service can be contacted:

Social Care Complaints Service,
Loxley House,
Station Street,
Nottingham
NG2 3NG
Tel: 0115 8765974
Email: socialcarecomplaints@nottinghamcity.gov.uk.