Specialist Learning Support EVALUATION
Multidisciplinary and parents/carers evaluation on Suffolk’s Specialist Learning Support Service to support children and young people with complex health needs to facilitate their educational needs.
July 2014
Kate Wood Helen Hood
RGN/RSCN RGN/RSCN
Care Coordinator Deputy Care Coordinator
Contents
Page number
Contents2
1 Introduction 3
2 Aims and Objectives 5
3 Methodology5
4 Findings
- What schools told us 10
- What families told us 12
- What staff told us14
- Other agency feedback 19
5 Reviewing objectives21
6 Discussion 27
7 Recommendations 28
8 Appendices
- Questionnaire to Schools28
- Questionnaire to Parents
- Questionnaire to SpLSA staff
1. INTRODUCTION
In 2005 there was recognition by senior health care, education and social care professionals of the increasing number of children and young people with complex health needs who were not accessing formal education.
A pilot scheme was initially set up for three children/young people with complex needs who, due to advances in medical practices, were reliant upon technology and school staff were not able to meet their medical needs.
Three specialist learning support assistants (SpLSAs) were appointed and trained in the relevant health care interventions to be able support the children/young people in school.
If the child/young person was not able to access school due to their chronic condition then the learning support could be transferred to the child/young person’s home or other settings such as hospital.
The SpLSAs were funded jointly by education, NHS (commissioning) and in three cases, social care.
The team (including Care Co-ordinator role) are employed by Suffolk County Council but all have honorary contracts with Suffolk PCT to enable access to training, supervision, clinical governance and to facilitate joint working.
The pilot scheme was successful in respect of an increase in the child/young person’s attendance at school and the progress they were able to make.
It was recognised however that the role was potentially isolating and that a network of support, supervision and ongoing training was required.
In 2006
The appointment of a team of twelve SpLSAs matched 1:1 with children/young people with complex health care needs countywide.
The requirement for SpLSA is nursery nurse or NVQ level 3 equivalent in an appropriate area.
A Care Co-ordinator was also appointed to train, assess, supervise and co-ordinate the team.
The requirement for Care Co-ordinator is qualified children’s nurse.
In 2007A part time Deputy Care Co-ordinator was appointed, also a qualified children’s nurse.
The Care Co-ordinators and Specialist Learning Support Assistants are included in CYP inclusive services SEN team.
Threshold criteria for the service
Children and young people will haveexceptional and significant complex health needs and be reliant upon technologies for their survival. They also need to meet the eligibility criteria for Continuing Health Care funding.The children require constant supervision to ensure their safety whilst in school, and the delivery of specialist medical procedures to enable them to access the national curriculum.
Present
15 children/young people across Suffolk including mainstream and special schools have specialist learning support with a further 3 pending referrals.
Child/young person’s eligibility is reviewed at every quarterly panel meeting to ensure provision of specialist learning support is still required.
Current staffing levels
1 full time Care Co-ordinator (Grade 6 pt 40),
1 part time Deputy Care Co-ordinator 21 hours term time only (Grade 5 pt 28),
16 FTE SpLSA term time only contracts
2. AIM AND OBJECTIVES
Aim
To review whether the Specialist Learning Support team meets the needs of this small but complex cohort of children/young people, both in educational establishments and educationally at home.
Objectives
1.To review current practice and identify strengths and weaknesses.
2.To consult with other agencies and parents involved.
3.To make recommendations following analysis of the data.
3. METHODOLOGY
The design chosen for the audit was a survey method, which occurred in three stages.
Stage 1
In stage 1 of the audit, structured questionnaires (see appendix 1) were distributed to all schools in Suffolk who had a child or young person using the SpLSA scheme. Ten questionnaires were sent out with additional copies for class teachers to complete if possible.Eight were returned from six schools giving a percentage return rate of 60%.
Stage 2
Stage 2 of the audit involved collecting information from parents and carers whose children accessed the scheme, via structured questionnaires (see appendix 2)
Of thirteen sent out, five were returned giving a percentage return rate of 38%
Stage 3
Stage 3 involved questionnaires going out to the SpLSA team in Suffolk.
20 questionnaires were sent out, 10 responses, giving a percentage return rate of 50%
4.Findings
School responses
- The SpLSA service guidelines were explained to us
Four schools responded that they felt the guidelines for the specialist learning support team were explained to them. One school felt they had no understanding of the team’s guidelines
- We know who to contact if there is an issue regarding the SpLSA
All schools know who to contact if there is an issue.
- We feel the SpLSA is part of the school staff as well as being part of a wider team.
All staff felt that the SpLSAs were part of their team as well as part of the bigger county wide team.
- We have confidence that the child/young person’s medical needs are being met safely
Staff stated that the child/young people’s medical needs were being met safely.
- We feel training for additional staff members in the school is accessible
Staff agreed that the training for supporting staff in schools was easily accessible.
- We know the procedure for if the SpLSA is unwell.
Most schools knew the procedure for cover if SpLSA is absent. One school said that they did not have this information.
Overall, the general response to the questions was ‘agree’ or ‘strongly agree’.
Family responses
- My child has attended school more often since having a SpLSA.
Parents agreed that having the SpLSA meant that their child was more likely to attend school. For one family, this was not applicable as the child started school with a SpLSA already in place.
- My child has benefited from home learning in terms of educational progression.
Parents agreed that the home learning aspect of the service meant that their child benefited educationally from having a SpLSA. One family has yet to access the home learning support element.
- I feel confident my child’s medical needs are being met whilst they are in school.
All parents agreed their child’s medical needs are met safely in school.
- The SpLSA had been trained to an acceptable level.
All parents agreed that the SpLSA had been trained to an acceptable level.
- I was fully informed about the guidelines for home learning support
All parents felt they had been informed fully about home learning guidelines.
Overall, the general response to the questions was ‘agree’ or ‘strongly agree’.
Specialist Learning Support Assistant responses
- I felt adequately prepared to work 1:1 with a child with complex health needs
All staffresponded that they were adequately prepared to work with their child.
- The quality of training is acceptable
All staff responded that the training quality is acceptable.
- I feel part of a team
Most staff felt part of a team. One member disagreed.
- The level of supervision is adequate
All staff agreed that there is an adequate level of supervision.
- I know where to get advice if I need it
All staff responded that they know where to get advice from.
- Home learning guidelines make me feel safe when working in the home
All staff agreed they feel safe when working in the home. One staff member doesn’t provide home learning due to the needs of the young person she works with.
- The management of deployment of staff is acceptable
All staff except for one felt that the staff deployment was acceptable.
- I am able to access appropriate training
All staff agree they are able to access appropriate training.
Overall, the general response was ‘strongly agree’ with the questions.
ANSWERS TO AUDIT QUESTIONNAIRE FOR SCHOOLS
Question 1: The SpLSA service guidelines were explained to us.
Answers:
Their role became clearer the more meetings I had with members of the team.
Question 3: We feel the SpLSA is part of the school staff as well as being part of a wider team.
Answers:
There is variation between different individual SpLSAs
Support is a two way process
We really hope A and T feel part of the team
Question 4: We have confidence that the child/young person’s medical needs are being met safely.
Answers:
Attendance of school has increased.
Question 6: We know the procedure for if the SpLSA is unwell.
Answers:
Some pupils attend school, some pupils don’t. Not sure why – often it is a staffing issue.
Question 7: What improvements do you feel could be made to the service?
There should be better communication between the service and school. Risk assessments should be completed together. School should be involved earlier if there is a dispute.
Service excellent. Only problem when taking resources for home learning and then unable to return them or not in until following week
Question 8: What is the most useful part of the service?
Support on a 1:1 basis that allows child to come to school.
Fantastic service all round. Very good communication with managers of SpLSA service. Completely confident that pupils’ complex health needs are being met appropriately. Great weight off my shoulders. Keep up the good work. An invaluable service. Many thanks.’
There is excellent communication when staff are absent. It is also reassuring that the SpLSAs have such medical knowledge of individual students.
There is excellent communication with staff. The SpLSAs provide high quality care, are professional and handle medical emergencies calmly and with a high level of understanding of their charges medical and emotional needs.
Close liaison between team and school.
Additional comments:
Sometimes decisions are made that affect the school but not communicated until the decision has been made. This may affect attendance of pupil at school.
We value the contribution of the SpLSAs as part of the school team in enabling pupils to gain as much as possible from opportunities on offer. We also appreciate their flexibility and generosity with their expertise!
ANSWERS TO AUDIT QUESTIONAIRE FOR FAMILIES
Question 1: My child has attended school more often since having a SpLSA.
Answers:
Due to my child’s condition he can have many fits and therefore needs constant watching. It also gives me a lot more reassurance. And he needs medicines throughout the day.
T couldn’t attend without an SpLSA!
Question 3: I feel confident my child’s medical needs are being met whilst they are in school.
Answers:
My child needs medicine throughout the day and I know he receives them.
Question 5: I was fully informed about the guidelines for home learning support.
Answers:
Yes but seem to be too many changes for how many hours and days they do.
Question 6: How do you think your child would respond if they were asked if they liked having a SpLSA?
Answers:
Our child loves his SpLSA and would never manage without them at school and this is why home school learning is important to them as well to keep the routine.
My child loves his SpLSA
If A were able to tell us what she thinks I believe she would say she loves her 1:1 as she is friendly and kind. She keeps me safe and we have lots of fun together.
I think T would respond with a big thumbs up.
I think my child would like the fact that the team he has are friendly, kind and understand him, even though he can’t communicate verbally.
Question 7: What improvements do you feel could be made to the service?
Answers:
We have been very impressed with the service and have no worries with the service.
To ensure that further training of staff for absences as described with accompanying letter to this form.
Cover when SpLSA is off sick or for training.
We feel that it is a great shame that we are now on 3 days per week for 3 hours (home learning). When we started we had 5 days (full days). Also when the SpLSA are sick which happens and we do not have a problem with but feel they should have extra staff and if they cannot cover at school then maybe home tuition should be allowed. Also many disabled children are ill at school or come home from school ill and then not able or unsure if they should go to school the next day and then we are told that you have to wait until the 2nd day of illness, sometimes this is the second day! Also, why has it been changed that a parent/adult needs to stay at home, sometimes we need to get out for an hour if we have had our children ill at home we have put our faith in the SpLSAs so not sure why we wouldn’t leave them at our houses, I’m not suggesting leaving hours on end and going shopping for the day but when we have younger children to take to other schools it is very difficult. Also when our children are off school for other then been ill e.g. operations I think there should be leeway in this as our children still need occupying. Sorry for all that it’s just my views and I’m always very understanding in illness and I wouldn’t want my son to be without his SpLSAs they are outstanding people.
Additional comments:
A has only had a SpLSA since Oct 2013 when she started nursery. We are very pleased with how quickly and confidently our SpLSA has got to know our daughter and her needs.
ANSWERS TO AUDIT QUSTIONNAIRE FOR SpLSA’s
Question 1: I felt adequately trained to work 1:1 with a child with complex health needs.
Answers:
All training needed given to meet all needs.
Training covers all aspects of each child’s individual physical care requirements.
Sometimes I do feel we are doing nursing level care without the pay and complex training.
Strongly agree and I feel equally supported when it comes to training I feel less confident about i.e. tracheostomy care, not being made to do it.
Training is thorough. I have been told that I will only be asked to work with the child I have received training on when I feel confident.
I feel I am adequately trained for the specific children I work with but would not feel confident to work with the other children within the team.
Support and training available
Question 2: The quality of training is acceptable.
Answers:
Training available is regularly updated and child related.
The only way this could be improved is if we had the chance to perform the procedures a few times before doing them on our own but as many of these are emergency procedures it is not possible to do so.
Training is comprehensive and meets the level required.
All training updated with others training available.
I feel well trained on each child I work with.
Question 3: I feel part of a team
Answers:
I work in a school with other people from the team so have regular contact.
I am part of a team within the school I am in but I do not feel part of the SpLSA team.
I feel part of a team although I don’t see anyone sometimes there is always someone the other end of a phone.
Up to date emails sent with any happenings within the team.
Although the team is widespread we are aware of each other and are kept informed.
I think the nature of the job means you get stuck between teams and end up not feeling part of either. The schools don’t fully welcome us as part of their team (normally because we’re not there for the other pupils and I think most feel we are getting paid more to do an ‘easier job’) and it is difficult to feel fully part of our team as we are so spread out and can’t meet regularly (but at the same time it would be silly to waste money on mileage and extra hours to meet.
I think it is difficult to feel fully part of a team as we all work in such different places and move around a lot, given the situation I feel Kate and Helen do the best they possibly can to give us a feeling of being part of a team.
It is sometimes difficult to feel fully part of a team as we all work in a wide variety of settings and rarely see each other. However, some of us do meet more often and texting and email helps.