Short Breaks - Threshold and Access Criteria
Disabled children and young people have the right to ordinary family lives. This document is aimed at professionals and is specifically about short breaks for disabled children. It describes the threshold and access criteria for a range of short break services in Nottingham. The purpose of the document is to provide transparency, equity and to offer choice to disabled children, young people and their families.
Nottingham City also publish an Annual Short Breaks Statement for Parents/Carers of disabled children as part of Nottingham’s Short Breaks Duty. Short breaks are defined as a specialist service a disabled child and their family receive to support caring and promote positive activities.
Short breaks for disabled children are a broad range of specialist services designed to enable parents to care more effectively, prevent crisis and support disabled children and young people to have the same opportunities to play and socialise that other children experience.
Short breaks provide disabled children and young people with an opportunity to spend time away from their parents or primary carers, relaxing, having fun with their friends, experiencing the same range of activities and environments as non-disabled children and young people. Short breaks also provide parents and carers with a "break" from their caring responsibilities, giving them a chance to rest, spend time with partners and other children.
Short breaks can include day, evening, overnight, weekend and holiday activities. Making short breaks possible can range from supporting children and young people to join children's activities and services in their communities to providing specialist services, or a mixture of both.
All disabled children are eligible through the "local offer" to access universal services. This document describes the 4 pathways of small, some, lots of and exceptional support offer of short breaks via a graduated pathways approach.
We know that short breaks are highly valued by children and their families. Short breaks provide innovative ways of delivering services. In Nottingham we have moved to a family and person centred approached to the assessment, allocation and delivery of short breaks.
Whilst all disabled children are entitled to support; the needs of many disabled children can be met through the duties placed on local authorities to provide information, advice and guidance to families, and by referral to the universal and additional services provided by statutory, voluntary and private sectors. Therefore the level and type of support will depend on a range of factors: the unique combination of disability; the circumstances of the child’s home life and the wider social environment. This means that each referral must be assessed on its merits, thresholds will not be applied prior to an assessment of need.
Separate documents entitled "The Family Support Strategy and Pathway" describe Nottingham's support for all universal, additional and extensive provision. This applies to all vulnerable children, including disabled children and should be read alongside this document. There is also a policy on The Chronically Sick and Disabled Person's Act 1970, Direct Payments, Personal Budgets, the Disabled Children’s Team and Parent Carers Needs Assessments.
A very small number of children and young people whose needs are so complex that they cannot be met through specialist services, will be assessed for bespoke continuing care packages by a continuing care nurse (see Pathway 4).
Services to disabled children and their parents and carers are primarily provided under the Children Act 1989, although other specific legislation provides important duties and functions in relation to social care services for disabled children and their families and carers. These include:
- Chronically Sick and Disabled Persons Act 1970;
- The Children and Young Person’s Act 2008;
- The Children and Families Act 2014;
- The Breaks for Carers of Disabled Children Regulations 2011;
- The National Assistance Act, 1948;
- Carers (Recognition and Services) Act 1995;
- Carers and Disabled Children's Act 2000;
- Carers (Equal Opportunities Act) 2004;
- Housing Grants, Construction and Regeneration Act 1996;
- Human Rights Act 1998;
- Equality Act 2010;
- Care Standards Act 2000;
- Care Planning, Placement and Case Review (England) Regulations (2010).
In addition, Short Breaks statutory guidance is available on how to safeguard and promote the welfare of disabled children using short breaks.
For practitioners making a referral for short breaks, it is important to understand the current legal context and how the services are accessed.
To achieve a common definition of disability, Disabled Children's Services and its partner agencies, adopts The Equalities Act 2010 definition of disability. Section 6 (1)states:
"A person has a disability for the purposes of the Act if he or she has a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day to day activities".
It is estimated that 3922 disabled children live in Nottingham City that meet the Equalities Act definition of disability. All of these children and young people will be entitled to advice and support but will not all meet the threshold to access specialist short break provision.
Of these children and young people it is estimated that 899 have severe/complex and lifelong disabilities. Short breaks services have been designed to meet the needs of this group of young people and these are the children and young people likely to be already known to, or to be eligible for assessment by the Disabled Children's Team. (Joint Strategic Needs Assessment) 2016 (JSNA)
The threshold and deciding which statutory provision (see Appendix 2: Legal Status Checklist).
There are a number of statutory provisions under which a local authority may have either a specific duty or discretionary power to provide services to meet the assessed needs of disabled children. Once an assessment has been completed, it is important to consider which statutory provision is being used.
The application of eligibility criteria to short breaks and other services for disabled children and their families should be considered within the context of the requirements of the Chronically Sick and Disabled Persons Act 1970 (“the CSDPA 1970) and the Children Act (CA 1989).
The CSDPA 1970 imposes a specific duty on local authorities towards disabled people of all ages. Section 2 of this Act requires local authorities to consider whether it is necessary, in order to meet the needs of a disabled child, for the local authority to provide services of the type listed within section 2(1). These services include home based Short Breaks, practical assistance in the home (home care and sitting), help to take up recreational facilities outside the home (link work), assistance with travel and help with holidays. Where a family’s needs are fully met via the above services, a Personalisation Officer will provide a graduated response via Pathway 1 and 2. See Section 4 Pathways to Short Breaks.
If the local authority identifies that a disabled child will need a service from the list at Section 2(1), they must provide that service.
This places a local authority under a general duty to safeguard and promote the welfare of disabled children by providing support and services. This is not a mandatory duty and therefore a child in need may be eligible for services, but has no absolute right to them. Eligibility criteria can be applied in these circumstances.
An assessment should be undertaken for:
- Children who are unlikely to reach or maintain a satisfactory level of health and development or their health and development will be significantly impaired, without the provision of services;
- A child who is disabled.
All disabled children are children in need for the purposes of section 17 of the 1989 Act. Section 17(11) states:
'... a child is disabled if he is blind, deaf or dumb or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity...'
This definition is applied when deciding if a child should receive a statutory assessment of need.
Short breaks can be provided in a care home or foster placement under section 17(6) of the 1989 Act in order to discharge the general duty to safeguard and promote the welfare of children in need. Disabled children provided with short breaks under section 17 (6) are not Children Looked After. Eligibility criteria may be applied. The Care Planning, Placement and Case Review Regulations 2010 (2010 Regulations) do not apply. A Child in Need plan is required and a six monthly review will be required. A disabled children’s social worker or support worker will be allocated to oversee case responsibilities.
Short Breaks in a care home or foster placement can also be provided under section 20 (4) CA 1989 which gives a local authority a specific power and eligibility criteria can be applied. Planned overnight short breaks in a regulated setting can be provided under Section 20 (4) of the 1989 Act. In these circumstances the child is looked after in a series of short breaks, a short breaks care plan is required and an IRO must be appointed. The care planning, placement and case review recommendations are amended. A qualified social worker will maintain or oversee case holding responsibilities for the case. Statutory visits will apply (see Regulation 48).
N.B. Eligibility can only be applied after an assessment of need has been undertaken. Local authorities should always be clear about the legal basis on which short break services are provided. The decision to provide a short break under section 17(6) or under section 20(4) should be informed, following assessment, however, once the local authority has considered short breaks to be necessary, it must provide them. The assessment of the child's needs should take account of parenting capacity and wider family and environmental factors, the wishes and feelings of the child and his/her parents and the nature of the service to be provided (see Appendix 2: Legal Status Checklist).
If a disabled child falls under section 20 (1) of the CA 1989, the local authority must provide accommodation and therefore eligibility criteria cannot be used. This is a mandatory duty which cannot be interfered with.
Disabled children accommodated under section 20 (1) of the CA 1989 are Children Looked After and will not be classed as children in receipt of short breaks. This includes:
- Children accommodated in an emergency due to parents being unable to provide or arrange suitable / adequate care;
- Children accommodated for more than 17 days in a row;
- Children accommodated for more than 75 days in one year;
- Children accommodated due to risk of significant harm.
The 2010 Regulations apply in full. A qualified social worker will always maintain case holding responsibilities.
Short breaks are a continuum of services which support children in need and their families. The 2010 Regulations relating to short breaks have been amended to take account of planned overnight short breaks in a regulated setting. The provision of overnight short breaks should be based on an assessment of the whole family addressing both their personal and social needs. Short breaks occur on a regular and planned basis and should be part of an integrated programme of support which is regularly reviewed. No short break should exceed 17 days continuous care and total provision over a year should not exceed 75 days. If accommodation is needed which exceeds this then it should be provided under the specific duty of S.20(1) CA 1989 and is not classed as a Short Break.
Where the young person is not in the care of the local authority and placed in a series of short-term placements with the same person or in the same accommodation, the placement is not intended to last for longer than 17 days and at the end of the placement the young person returns to the care of their parent a care/support plan must set out the arrangements made to meet the young person's needs with particular regard to:
- Particular vulnerabilities of the child, including communication method;
- Parenting capacity of the parents within the family and environmental context;
- Wider family and environmental factors;
- The length of time away from home and the frequency of such stays - the less time the child spends away from home the more likely it is to be appropriate to provide accommodation under section 17(6);
- Whether short breaks are to be provided in more than one place - where the child spends short breaks in different settings, including residential schools, hospices and social care placements, it is more likely to be appropriate to provide accommodation under section 20 (4);
- Potential impact on the child's place and the family and on primary attachments;
- Observation of the child (especially children who do not communicate verbally) during or immediately after the break by a person familiar with the mood and behaviours of the child (for example the parent or school staff);
- Views of the child and views of the parents - some children and parents may be reassured by, and in favour of, the status of a looked after child, whilst others may resent the implications and associations of looked after status;
- Extent of contact between short breaks carers and family between the child and family during the placement;
- Distance from home; and
- The need for an independent reviewing officer (IRO) to monitor the child's case and to chair the reviews.
Safeguarding disabled children and young people is a priority and Regulation 48 of the 2010 Regulations applies to children in a series of planned short breaks placements, with more rigorous reviewing arrangements applied to disabled children who are Looked After.
The purpose of the plan for a child in a short break is substantially different from the plan for a child who is looked after continuously. Where a child receives s a short break the parents have primary responsibility for planning for their child's future. The short breaks care plan should focus on those matters that ensure that the child's needs are fully met while the child is away from their family. The short break plan must include information about:
- The child's health, and emotional and behavioural development including full details about any disabilities, clinical needs and medications the child may have;
- The child's specific communication needs;
- Arrangements for contacting parents as necessary, in particular, an emergency contact number;
- The child's likes and dislikes with particular regard to his / her leisure interests; and
- How the carers, as appropriate, promote the child's educational achievement.
In addition, where children are looked after, there are additional areas that must be included in the plan - see paragraph 3 of Schedule 2 of the 2010 Regulations.
Where Regulation 48 applies, the social worker must visit within 3 months of the first placement day and then at intervals of no more than six months. Reviews should take place within 3 months of the first placement day and then should be at intervals of no less than 6 monthly.
Short breaks provide opportunities for disabled children and young people to have the same opportunities to play and socialise that other children experience and enable their carers to provide care more effectively, through having a break from care. They include day, evening, overnight or weekend activities and take place in the child's own home, the home of an approved carer, a residential or a community setting (see Appendix 1: Types of Short Breaks). They are not designed to meet all of a disabled child’s needs and should be provided alongside a multi-agency package of support provided via appropriate universal, additional and extensive services.
We want to promote the wide range of activities available in Nottingham. Through consultation with children and disabled young people we know that they want to engage in ordinary activities. It is important to promote Nottingham's Local Offer (Children and Families Act 2014) which sets out the type and level of local service a disabled child and their family can access. All disabled children and their families are also able to access accurate and receive up-to date information on services through the Families Information Service (FIS) on 0800 458 4114 e-mail: fis@nottinghamcity.gov.uk.
Universal services are open to any child or young person who wishes to use them. They provide an opportunity to participate in a positive activity. These include: youth and play centres and projects; museums and galleries; children centres; libraries; parks and playgrounds; leisure centres and sports programmes. Children and young people are entitled to a minimum of 2 hours per week access to all Nottingham City Council youth and play sessions. Service providers are required to make all reasonable adjustments to eliminate barriers to inclusion. Referrals to universal service provision are by self-referral and a financial contribution may be required.
Where there are difficulties accessing universal services, to meet the local offer, disabled children and young people may require support to facilitate access. Support may be available via the Inclusion Support Grant, which Youth, Play and Leisure Services may access to support attendance of a disabled child in their local provision.
Nottingham City allocates its short breaks and home care services via a graduated pathway approach. This ensures those with the greatest need receive the largest amount of support (see Appendix 2: Legal Status Checklist).
Parents/carers and professionals can access a budget of up to £1,600 per year without assessment. To be eligible for the self referral route, the child must have a diagnosed or identified disability, and be unable to access universal/mainstream services without ongoing 1:1 support. Once in place, annual re-application for the package will be required to be made to the Short Breaks Co-ordinator. The decision maker for all Pathway 1 applications is the Short Breaks Co-ordinator (see Pathway 1 guidance).
This level of short breaks is provided for disabled children whose needs cannot be met by universal or additional services because they require ongoing 1:1 specialist support and the family need more than a small amount of support to maintain an ordinary family life.
This level of short breaks is available after a multi-agency assessment, i.e. CAF, EHC etc identifying the need for Short Breaks Services. The decision maker for Pathway 2 cases is the Team Manager of the Short Breaks Team or Team Manager of the Disabled Children’s Team (see Pathway 2 guidance).
This level of short breaks is for those disabled children with very high level of need. This will include those children who need very specialist overnight short breaks in a regulated setting.
This level of short breaks is available after a full specialist assessment, by a qualified social worker. The decision maker for all Pathway 3 cases is the Service Manager, Disabled Children’s Service.
This level of support is for the very few disabled children who have highly complex needs. Most will also have exceptional health care needs in addition to their disability.
This level of support is available after a full specialist assessment by a qualified social worker and/or a continuing care assessment by a qualified nurse. The decision maker for all Pathway 4 cases is the Continuing Care and Complex Needs Panel. Packages over £25,000 require the decision of the Director for Quality and Change.
Nottingham City Council has developed a Resource Allocations System to ensure resources are allocated to meet need in an equitable way to allow transparency and to give families the option of a personal budget allowing greater flexibility in how the family chooses to meet its identified needs.
The Resource Allocation System is not a replacement for a professional assessment of need and should not be used prior to an assessment being undertaken. The resource allocation is used to allocate an indicative budget across Pathways 2 – 4.
Once completed, the Resource Allocation Tool will identify an indicative budget. If the indicative Personal Budget is within Pathway 2, a support plan will be completed by the family with the support of a Personalisation Officer. If the indicative Personal Budget is within Pathway 3 or 4 and the family are only accessing internal or commissioned services, a care plan will be completed by the child’s designated social worker or disabled children’s support worker. If the family choose to access some or all of their Personal Budget as a Direct Payment, a support plan can be completed by the child’s designated social worker or disabled children’s support worker or by a Key Worker from the Key Worker Service.
Any plan must be approved by the appropriate decision maker for details on the Personal Budget Process across the different Pathways).
The family may choose to access some or all of their personal budget as a direct payment (see Direct Payments Policy and Procedure).
Where the family receive support from more than one agency, a joint support plan will be completed by a Key Worker from the Key Worker Service.
Nottingham City Council - Disabled Children and Young People resources allocation table
|
Assessed needs and Access criteria |
RAQ score |
Indicative Budget |
|---|---|---|
|
No support: |
<70 |
£0 |
|
Small support - Pathway 1 |
70-145 |
£1,600 |
|
Some support - Pathway 2 |
145-160 |
£3,500 |
|
161-170 |
£5,000 |
|
|
171-185 |
£6,000 |
|
|
Lots of support - Pathway 3 |
186-200 |
£7,000 |
|
201-210 |
£9,000 |
|
|
Exceptional support - Pathway 4 |
211-220 |
£11,000 |
|
221-230 |
£14,000 |
|
|
231+ |
£17,000 |
NB (1): If a parent or carer requires an increased level of support to assist in their parenting or care of a child, over and above what is deemed a short break, due to their own support needs; this must be assessed in the form of a Parent Carers Needs Assessment and/or an adult assessment of their own needs. It should be noted that the primary responsibility to enable a disabled parent to undertake their usual parenting responsibilities is an adult services one.
NB (2): If the child is in residential education sessions of care will be agreed on a pro rata basis, overnight short breaks will not be provided in these circumstances since this need is already met by provision of residential school.
A final budget and support plan for short breaks and home care services are agreed by a designated decision maker as identified in the Pathways to Short Breaks using the appropriate decision maker form (the forms are available within Liquid Logic). Once approved, the Personal Budgets Team should complete the request for services form to access all internal or commissioned services. If the family are accessing direct payments, the Personal Budgets Team will liaise with the dedicated worker and the family to arrange the set up of the payments.
N.B. (1): An indicative budget is not a ‘minimum’ nor ‘maximum’ budget, rather it is an up-front allocation of resources to assist a family to use an available budget in a more flexible way. The actual services may cost less or more than the indicative budget.
Any plan approved should clearly record the needs and outcomes identified, and the services to be provided. The plan should also clearly identify any other formal and informal support contributing to the overall support package. As part of the review process, the success of the provision in helping to meet the expected outcomes should be considered.
Prior to the review, the assessment and Resource Allocation (or in the case of Pathway 1, a re-application) should be considered to inform the need for a change in the services provided and the results presented to the review with any resulting recommendations for change. If there is a significant change in circumstances prior to the review a full re assessment should be undertaken and the case be presented back to the decision maker. In an emergency the Service Manager may agree temporary additional services pending final decision. Any care awarded for a temporary change in circumstances will be removed as soon as the situation has been resolved. A reduction in ongoing services provided cannot take place without a reassessment of needs and consideration of the implications of Equalities Act 2010. This list factors which a local authority is under a general duty to have regard to in carrying out this function, the most relevant factor is the need to advance equality of opportunity for Disabled Children.
Children/young people and their parents and carers 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 their 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
E-mail: socialcarecomplaints@nottinghamcity.gov.uk.
Crocus Fields - Residential short breaks
Crocus Fields offers residential short breaks to meet the individual needs of young people with severe learning disabilities with challenging behaviour, physical disabilities with complex care needs and autistic spectrum disorders with SLD and challenging behaviour who cannot, due to their impairment access any other short breaks provision. This could be weekend or midweek stays, or a mixture of the two. Occasionally day care can be provided when no other suitable day care is available or as part of a gradual introduction to overnight stays. It will not usually be agreed for a child under 10 years old to attend overnight at Crocus Fields.
Short Breaks Team - Family Care
Family care offers short breaks for disabled children aged 0 - 19 years who have a wide range of disabilities providing both day and overnight care with approved foster carers who are carefully matched with a child. This includes the provision of level 2 and 3 carers for young children who have highly complex needs.
Short Breaks Team - Link Work
Link Work offers community-based 1:1 or 2:1 support to enable a child / young person aged 3 - 19 years to access community activities. This service is not usually available to children under the age of 3 years. Link work is currently provided for those children who cannot access the community without 1:1 or 2:1 long term specialist support. Linking services are registered with CQC to provide personal care.
Short Breaks Team - Sitting Services
Sitting services offer support to disabled children aged 0 - 19 years with a range of disabilities in their own home whilst parents go out or take a break. Sitting services are registered with CQC to provide personal care in the families own home.
Home Care
Home Care provides practical care in the home for disabled children aged 0 - 19 years who have severe disabilities to enable parents to safely care for the child in the home. Homecare is usually provided when parents cannot safely manage all the disabled child’s practical care needs on their own due to a range of physical and social factors.
After school, weekend and holiday Short Breaks (Day Care Services)
Day care services offer support to disabled children aged 3-19 years with a range of disabilities in the school holidays, weekends or after school. A range of schemes are available depending on the needs of the young person. These schemes are targeted to those disabled children who cannot access mainstream holiday and after school provision due to the nature of their disabilities and support needs.
The Children's Development Centre (formally known as The Villas) - Residential short breaks
The Children's Development Centre offers residential short breaks to meet the individual needs of young people who are disabled and have complex health care needs who cannot, due to their impairment, access any other short breaks provision. This could be weekend or midweek stays, or a mixture of the two. Occasionally day care can be provided for very young children when no other suitable day care/nursery provision is available that can meet a child’s complex medical needs.
Nursing Home Care
Nursing home care/ Short Breaks Services is provided to children and young people aged from 0 - 19 years with complex healthcare or continuing care needs. Teams of health care assistants and children's nurses provide a package of care to children with complex health and nursing care needs, in their home and other community settings. This can be during the day or overnight.
Direct Payments
Direct Payments are available for children aged 0-19 years. They are payments made in lieu of certain services. They are for families who do not wish to just ‘access’ internal or commissioned services from the local authority or NHS. It enables families to maximise their choice and control over the types of short breaks and home care services provided, as they offer a great degree of flexibility to meet assessed need. Direct Payments are one method of delivering Personal Budgets.
Personal Budgets
Personal Budgets offer families and young disabled people greater flexibility and personalisation in the planning of and receipt of services to meet needs across Education, Health and Social Care. Personal Budgets have been introduced by the Children and Families Act from September 2014 for children who are eligible for an Education, Health and Care Plan. Once an assessment of needs has been undertaken and indicative budgets allocated, the family may opt to access the support they require as a personal budget. Some or all of this may be taken as a direct payment.
|
Q. Is the child provided with care in their own home or community? |
|
|---|---|
|
Yes The child is provided with a short break under S.2. CSDPA 1970. The 2010 Regulations do not apply. See Pathways 1-4 re visits and review requirements. |
No Continue to questions below. |
|
Q. Is the child provided with care that lasts less than 24 hours in a regulated setting? |
|
|
Yes The child is provided with a short break under Section 17 (6) CA 1989 the 2010 Regulations do not apply. See Pathways 1-4 re visits and review requirements. |
No Continue to questions below. |
|
Q. Is the child provided with care in a regulated setting that is providing care for more than 17 nights in a row or for more than 75 nights per year? |
|
|
Yes The child is Looked After under Section 20 (1) CA 1989. The 2010 Regulations apply in full to each separate placement, an IRO should be appointed, full looked after processes apply, visits should take place within 7 days of a placement and no more than 6 weeks for the first year, a care plan should be written. |
No Continue to questions below. |
|
Q. Is the child receiving more than 2 nights of care per month or 36 nights per year in a regulated setting? |
|
|
Yes The child is provided with short breaks under Section 20 (4), Regulation 48 applies, an IRO should be appointed, a short breaks care plan developed and visits should take place within 15 days and no more than six monthly. |
No Continue to questions below. |
|
Q. Is the care provided in the regulated setting as part of a complex package that means the child is cared for by multiple providers? |
|
|
Yes The child is provided with short breaks under Section 20 (4), Regulation 48 applies, an IRO should be appointed, a short breaks care plan developed and Visits should take place within 15 days and no more than six monthly. |
No Continue to questions below. |
|
Q. Does or can the parent maintain oversight of the child’s welfare during placement? |
|
|
Yes The child is provided with short breaks under Section 17 6) the care planning regulations do not apply. A CIN plan should be written and reviews chaired by a Team Manager or Senior Practitioner on a six monthly basis. Visiting frequency should be specified in the CIN plan. |
No The child is provided with short breaks under Section 20 (4), Regulation 48 applies, an IRO should be appointed, a short breaks care plan developed and visits should take place within 15 days and no more than six monthly. |
Last Updated: June 9, 2023
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