22.05.12 / Classification
1.2 Public
/ Committee1.2
FromPaul McCarthy / Title Of Report
Disabled Children in Redbridge, the Changing Picture of Need and Provision
.1 This Report Is Of Interest To All Members
1. Introduction and Background
1.1 This report describes the changes that have been taking place in relation to disabled children in Redbridge in recent years; it looks at the overall demographics and seeks to identify trends and issues in a systematic manner. The report looks in some detail at a number of the most important areas of activity in relation to services for disabled children.
1.2 Redbridge is an outer London borough with a population of approximately 267,700 residents in mid 2009, an estimated 12% increase since the 2001 census. It is the ninth most diverse borough in the London[1] and approximately 40% of its population hail from a minority ethnic background. It is estimated that there are 71,100 children aged 0 – 19 within the borough, making up 26% of the total population. Redbridge also has high levels of deprivation and affluence with Clementswood ward being considered the most deprived area and Monkhams ward being the most affluent. Males and females are equally represented in the borough.
1.3 In regards to numbers of disabled children, it is estimated that there are approximately 4,000 disabled children in the borough, 1,500 disabled children who would need some additional support to access some services and 853 severly disabled children that would need significant support to access services[2].
1.4 In order to create effective services that meet the needs of both disabled children and their parents/carers, it has been essential to consult with both of these groups in order to identify gaps in service provision. When commissioning services we have had panels of disabled children and young people evaluating the bids and parents have also sat on the adult commissioning panels. This has proved invaluable, as the new services that have been set-up have been very popular with everyone and have been able to offer a wide range of opportunities.
1.5 The following pie chart shows the breakdown of disabilities for children known to the Children with Disabilities Team (CWDT) in Redbridge. The chart shows that the largest percentage of children within the team are on the autistic spectrum and whilst the percentages for both autism and complex health needs have increased from the previous years, this is likely to be accounted for by better targeting of specialist services and the fact that disabled children with moderate to low level needs are able to self-refer to short break services and do not need to be known to the CWDT and have a care plan in order to access support.
2. Ethnicity
2.1 Redbridge has a changing demographic and this is clearly highlighted by comparing the breakdown of ethnicity for adults and for children, as demonstrated in the following pie charts.
2.2
2.3
2.4 The ethnicity breakdown for disabled children mirrors the above chart.
3. Age and Gender
3.1 The following diagram shows the breakdown of age and gender within Redbridge in comparison with the rest of the country[3].
3.2
3.3 Within the Children with Disabilities Team, 68% of the children are male and 32% are female.
4. Disabled Children in Redbridge
4.1 The Children with Disabilities Team (CWDT) was created approximately 13 years ago and initially worked with around 50 children and young people aged 0 – 19. The numbers of children known to the team has grown rapidly, though data in regards to this is only available from 2003 onwards. The following chart illustrates the changes in numbers from 2003 - 2012, however, it only shows the numbers of disabled children known to the team and does not include non-disabled siblings that the social care team may be working with.
4.2
4.3 The chart highlights a marked drop in numbers of disabled children known to the local authority over the past year.
4.4 The Early Intervention Grant (EIG) is a government programme that commits to improving the lives of disabled children and their families. The programme follows on from Aiming High for Disabled Children (AHDC), which was a three year government programme that took place between 2008 and 2011, aimed at transforming services for disabled children and providing additional funding for short break projects (this included both revenue and capital funding).. A requirement of the AHDC programme was that extensive data had to be collected in regards to disabled children and we therefore have much more detailed information from that date onwards. The Aiming High Strategy Officer has continued to collect data on a quarterly basis to ensure that we record the numbers of disabled children in Redbridge accessing short breaks, what type of breaks they attended and also broke down data into disabilities to a certain extent. Research undertaken under AHDC highlighted that children within the Autistic Spectrum and/or children with behaviour that could be seen as challenging (Group A), as well as children with life limiting/life threatening conditions and those that had multiple and complex disabilities (Group B) were not able to access short breaks. This, however, was national data and did not fully reflect the situation in Redbridge. On initially assessing the data, it was clear that whilst children within Group A were accessing more services than average, children within Group B were less represented. The following pie charts show the breakdown of disabilities within the team and then numbers accessing short break services in 2008. The charts highlight that children within Group B were largely accessing homecare services and after further research, this was largely limited to personal care packages, where two or more people were required and so did not provide a short break.
4.5
4.6 In 2012 it is apparent that disabled children in groups A and B were now being fairly represented across all services and that parents and carers are able to get access to appropriate short break provision.
4.7
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5. Numbers of Children Accessing Short Break Services
5.1 A Short Break is regarded as a service that provides families with a break from their caring role and was previously described as respite. It can be anything from an hour to a few weeks within a variety of settings, for example specialist centres, youth clubs, Children’s Centres and mainstream providers. The majority of disabled children in Redbridge were only able to access short break services through the CWDT, largely due to the cost of services. Consultation with parents showed clearly that they did not like to do this and a number of reasons were highlighted. There was still a stigma attached to the Local Authority and parents felt that it was a reflection of their parenting skills if their child needed a referral to “Social Services”, this was especially true for parents that had been known to the Local Authority themselves as children. There was a history of paediatricians making blanket referrals to a large number of agencies (Occupational Therapy, Speech and Language Therapy, CWDT etc) without fully explaining each agencies role to families, which then meant that families were confused and ill informed when being offered an assessment for their child. The biggest complaint, however, was that families felt that they had to beg for services. The process of accessing short breaks was lengthy, first a child had to have an assessment, this then had to be typed up and sent to the parents, a panel request detailing what short breaks were required and why they were needed was then drawn up with a care plan and this was presented to the Resource Allocation Panel, consisting of Social Care Managers, the Business and Finance Manager and an independent representative from a short breaks service. Once they had agreed on what level and type of short break service would best meet the need of the disabled child, the care plan would need to be sent to the service and the child would then need to be assessed by the short break provider in regards to staffing levels, care needs, what activities the child enjoyed etc. This process would take on average six to eight weeks and then if there were no places available, a child would be placed on a waiting list until a vacancy arose. With the introduction of AHDC we were able to enable parents to book sessions directly with providers, without having to be assessed or even known to the CWDT. Parents have found this very beneficial and a far larger number of children are now accessing short breaks services than in 2008.
5.2 With the implementation of the EIG and AHDC, data collation has become far more efficient and we are now able to accurately monitor the numbers of children accessing short breaks, including data on children that access services directly, without being known to the CWDT, as the following graph shows.
5.3
5.4 We have then been able to further breakdown this data into the different types of short breaks that children have accessed.
5.5. Details of how many overnight stays disabled children and young people have accessed over the past four years. The overnight breaks can take place in a variety of settings including respite centres, with short break foster carers, at an outdoor activity centre or within the child’s own home.
5.6
5.7 Details of how many homecare hours disabled children and young people have accessed over the past three years. These hours have been used for either personal care or for befriending support to enable children to access community facilities.
5.8
5.9 Details of specialist day services that includes weekend, holidays and after school clubs. All of these schemes are specifically run for disabled children and young people.
5.10
5.11 Details of non-specialist day services that includes weekend, holidays and after school clubs. All of these schemes are universal and not run specifically for disabled children and young people.
5.12
5.13 The number of children accessing services has increased greatly over the four years, with an especially notable increase in disabled children and young people accessing non-specialist day services. This has been achieved by working in conjunction with the Youth Service, in order that they can run integrated schemes for young people. The schemes run by Youth Services have proved to be very beneficial as they can offer a large number of young people access to mainstream services and have freed up spaces within our specialist provisions for young people that need a much higher level of care. Children’s Centres are also becoming more inclusive and provide a range of services to pre-school disabled children.
6. Age Range of Children known to the CWDT
6.1 The CWDT works with children aged from birth until they are leaving school at nineteen. If a young person leaves full-time education sooner, then their case will be transferred to adult services at eighteen. The peak age range for numbers of children within the team is between 12 and 18.
6.2 Disabled children, as with any child, need different levels of support at different ages. A baby with a disability, unless they have complex health needs, is unlikely to have higher support levels than any other baby. However, as they get older, their developmental milestones may vary greatly to those of their peers. At this stage they are much more likely to need additional support and short break services. The transition to secondary school and when a child reaches puberty are seen to be difficult times and this is reflected in the age range of children known to CWDT and the increase in service provision.
6.3 The following graph highlights how the different age groups access short breaks within Redbridge.
6.4
7. Early Intervention
7.1 The Aiming High for Disabled Children programme finished in March 2011 and has been replaced with the Early Intervention Grant (EIG). Whilst the funding is no longer ring fenced, as it was under AHDC, the council has agreed that it will still be used to provide services for disabled children. A requirement under AHDC was that all the funding should be spent on improving the quality and quantity of short break services and whilst it was vital to build up capacity within Redbridge, now that this has been achieved, we are in a far stronger position to work proactively with families in providing early intervention and support. The EIG enables us to do this and we have already commissioned Sleep Scotland training in order to support parents with managing sleep patterns. A range of professionals from different settings and parents have now been trained, so that different skills and viewpoints can be utilised when supporting families. We are planning on using this model in regards to behaviour support and play. Parents and carers can also access Expert Parents, which is a serious of information and training sessions, organised by Interface Parents Forum (in conjunction with Haven House Children’s Hospice). The sessions cover a variety of topics including legal rights, transition, behaviour support and short breaks.
7.2 Whilst we still need to commission additional short breaks and we will remain focused on ensuring that these innovatively meet the needs of disabled children and their families, we are now able to focus on additional early support as outlined in the Early Intervention Strategy.
7.3 The key areas for development under the Early Intervention Strategy are:
a) Children’s Centres – 3 hubs offering specialist services and support within a mainstream setting. Development workers are being employed in Children’s Centres and in Youth Services, to support parents and disabled children and young people with information, support and access to mainstream service.
b) FiND – Development of Informed Families to offer information and advice to professionals and parents.
c) Primary school age has a mainstream deficit, targeted provision to address this.