The Child Health and Disabilities team (CHAD) is situated in front-line Children’s Services. The team caseload is 206 children (March 2021), who tend to have profound disabilities. Eligibility for the service is determined at a scrutiny board, based mostly on complexity. Cases are allocated due to a RAG rated system of need – red, amber and green. All children are children in need (CIN). Eligibility criteria are set out below. Children are visited at least ever six weeks. The team offer a consultation service to the rest of Children’s Services. Care and support packages for children are agreed at the CHAD Resource Panel.
All case thresholds have been reviewed resulting in an increase of the number of children made subject to CP plans and LAC status.
The work undertaken within the team has significantly improved the working relationships with the Preparing for Adulthood Team and the SEND service. The CHAD Team is regularly represented at different forums including Special School Head Teachers meetings and Engaging with Parents during Covid meetings.
Criteria for CHAD
The criteria for services from the Child Health and Disability Team are:
- A significant visual impairment;
- A significant hearing impairment;
- A profound communication impairment;
- A severe learning disability;
- A significant physical disability;
- A life-threatening condition or significant chronic illness;
- Global developmental delay - This is a term which would usually apply to young children who have severe delay in all areas of their development.
The child/young person will have a permanent and substantial disability which significantly affects, or is predicted to affect, everyday functioning over the child/young person’s development;
AND/OR
A severe or life-threatening health condition or impairment which significantly affects, or is predicted to affect, everyday functioning over the child/young person’s development;
AND
Complex family circumstances which affect the child/young person’s ability to reach their potential, resulting in their social functioning being significantly impaired without the provision of specialist services.
The child's disability must be the presenting concern for the case to transfer to CHAD. For cases where one or more children have a disability, but the presenting concerns are not related to their disabilities, CHAD will offer consultancy and advice to the social workers involved.
Any child diagnosed with Asperger’s, ADHD, HIV or a psychiatric illness will only be eligible for referral to the Child Health and Disability Team if they also have other disabilities which meet the criteria.
A package of support is determined following an assessment. Packages of support must focus on individual need and the particular circumstances of each family. The Assessment of Need is assessed on the basis of two components: the level of disability and any social and parenting issues identified through a social work assessment.
The type of service and support offered to a child and family, will be explored during the assessment and depends on:
- the level of the child’s disability;
- the impact of the child’s disability in being able to care for themselves and keep safe;
- the impact of the child’s disability on family life;
- the ability/skills of the parents;
- any additional problems the parents might face - housing, finance, domestic abuse, physical or mental health problems and substance misuse;
- the wishes of the child and their family.
Carers' assessments
Parents or persons with parental responsibility for a child with disabilities have a right to an assessment of their needs as carers under section 6 of the Carers and Disabled Children Act 2000. The needs of carers will be considered within a Child and Family Assessment at the time that the request is made for a carers assessment if the Local Authority is satisfied that the child is a person for whom it may provide services under Section 17 Children Act 1989. The Child and Family Assessment is a holistic assessment that takes into account the whole family’s needs and circumstances but primarily focuses on the child’s needs and considers support for parents or carers based on the needs of their child.
If the parents or carers require support in their parenting role, due to their own disabilities, a referral will be made to Adult Social Care.
Children in Need Plans
The CHAD team will work with families (including siblings if required) where it is identified that support services are needed and are not available at the Universal or Early Help levels. This includes provision of short breaks away from home and help for those families who are at risk of breakdown without the provision of specialist support services. Level of support, including the visiting pattern, will be assessed on an individual basis but visits will be made no less than six weekly.
Safeguarding/Child Protection/Court
The CHAD team will respond to any child protection enquiries where a case is open to a social worker and any siblings that are not open would be considered in the initial enquiries and, if required, a referral to MASH will be made.
Any Child Protection referrals on closed cases need to be referred to the MASH – including those concerning families where the disabled child as defined above is part of a sibling group. The MASH team will make a decision based on the criteria outlined above as to whether the referral will be passed to the CHAD Team or the Assessment Team. In cases where there is a sibling group in which one or more child has a disability, consideration will be given to the presenting circumstance and how this impacts on the sibling group as a whole. For example, in cases of domestic abuse or neglect which affect the whole sibling group, the primary practitioner will be allocated from within Children and Families First Service, and a secondary practitioner will be allocated within the CHAD team to meet the needs of the child/young person with a disability.
Children/young people transferred from other local authorities
The principles outlined within the CHAD eligibility criteria will equally apply to cases being transferred from other Local Authority areas including those families with disabled children who are the subject of a Child Protection Plan. A transfer-in protocol will apply. 73 | P a g e
Looked After Children (Long term residential/educational placements)
The CHAD team will continue to support children and young people with disabilities (and their siblings if already open) whilst they are subject to care proceedings and until permanency has been achieved. At this point, the team will liaise with the Children in Care teams as per the transfer protocol to arrange transferring the siblings and, if appropriate, the child or young person with a disability. Children or young people with complex needs who are subject to a care order and Section 20 agreement and in an educational residential placement and in transition to adulthood will remain within the CHAD team, however a PA from the Care Experienced Young People’s Team will be allocated after 13 weeks in care.
If a looked after child has any level of disability - even where the criteria for the team is not met - a social worker from the CHAD team will liaise with the allocated social worker during an assessment period.
Stepping down / Stepping up (signposting)
As any child, children with disabilities may be accessing support from different levels as their needs will change. However, all children accessing short break provision will be supported via the CHAD team.
Where a child or young person is supported through universal or early help services and new needs or concerns are identified, contact should be made with the MASH.
Escalation process
In any cases where issues are being raised, a specific case discussion with the relevant team managers should take place in relation to which team is best placed to meet the child’s needs. Any disagreements in respect of this should be escalated to the Service Manager.