Kerry Hancock, Programme Manager Pathfinder Support Team SEND Pathfinders Kerry Hancock, Programme Manager Pathfinder Support Team February 2013

Pathfinder core objectives The SEND pathfinders are working towards the following common objectives: To develop a new 0-25 assessment process and a EHCP which brings together the education, health and social care services on which children and young people who are disabled or have SEN and their families rely and focuses on improving outcomes; To explore how the voluntary and community sector could explore access to specialist expertise and introduce more independence to the process; To develop multi agency local offer; To ensure the full engagement of children, young people and their parents and families, schools and colleges; and To improve choice and control for children, young people and their families through the use of personal budgets and direct payments.

In addition… Many pathfinders have chosen to focus on particular issues, including: Whether a banded approach to funding can improve efficiency in allocating resources; How best to support parents from different backgrounds; and How best to support particular groups of children, such as young people going through transition towards employment and looked after children.

The SEND Pathfinders

Pathfinders Examples of family recruitment₁ 68 families 0 – 25 years Any child with a SEN or disability whose needs are not met by universal services Existing cases only Pathfinder 2: 48 families 0 – 25 years Most complex needs Both new and existing cases (small % new) Pathfinder 3: 9 families 0 – 19 years Those who would receive a statement or LDA Both new and existing cases Pathfinder 4: 40 families 0 – 19 years CYP requiring additional support from any of the 3 services Both new and existing cases ₁ Recruitment information from Dec2012

Assessment and Planning/EHCPs – Overview Progress made: Multi agency approach Working in co-production with parents and carers Now testing with over 600₁ families Person centred Positive feedback from families and professionals Consistent emerging practice across many areas ₁ Recruitment information from Dec2012

Assessment and Planning/EHCPs – Overview Challenges and areas requiring further development: Running two systems in parallel Further testing of paperwork ensuring its robustness when used as a statutory document Scaling up testing Increase the number of families involved Ensure coverage across the age range Including more new cases Testing the entire process e.g. reviews, disputes, transition

Assessment and Planning/EHCPs: Emerging practice On-going process, regular person-centred reviews. A ‘tell us once’ approach to sharing information Effective co-ordination between education, health and care services, aiming to secure joint agreement on key outcomes. Practitioners engaged and committed to single assessment and planning.

Pathfinder 1 Towards a co-ordinated assessment Features of the single plan Referral Assessment Planning All About Me What do people like and admire? What’s important to the child? What’s important for the child? What’s working well? What’s not working so well? Option of first person narrative Co-produced

Pathfinder 2 Example - Assessment and Planning New integrated model of working across specialist education, health and care services Aims to improve outcomes for children/young people and their families with SEN/disabilities Education Health Social Care

Pathfinder 2 Example - Assessment and Planning Phase 2: Listen and understand (e.g. Home visits, classroom observation) Phase 1: Preparation and consideration (e.g. First assessment team meeting) Phase 3: Analyse and Synthesize (e.g. Final assessment team meeting) Phase 5: Monitor and review (e.g. First review meeting) Phase 4: Agree and Allocate (e.g. Bring EHC plan back to Decision Panel) Includes professionals from education, health, and care services Clinical Psychologists Child and Adolescent Mental Health Service staff Community Paediatricians Community Support Workers Community Children’s Nurses Educational Psychologists Early Years Support Teachers Learning Disability Nurses Occupational Therapists Physiotherapists Portage Home Visitors SEN officers SEN Personal Advisors SEN Coordinators Social Workers Specialist Teacher Advisors Speech and Language Therapists

Pathfinder 2: Example - Assessment and Planning This is Tom, he is 2 ½ years old Due to a premature birth he has Chromosome deletion resulting in: Hearing difficulties Vision difficulties Epilepsy Unsafe swallow Profound & multiple needs After he was born he stayed in hospital for 6 months before he was able to come home. This is Tom’s Family They were very shocked when Tom was born early. Their primary concerns are: Maintaining his gastrostomy tube feed (safety) Accessing continence resources Having ideas for play at home Respite to gain a good night’s sleep Time for siblings Thinking about where Tom might go to pre-school Conflicting appointments Having to tell services their story over and over again Eye Unit Community Childrens Nurse Health Surveillance Checks Therapy Assessments Epilepsy Nurse Continence Nurse Short Breaks Assessment New-Born Hearing Check Initial Assessment Health Visitor Neurology consultant Ophthalmology consultant Continence Assessment Paediatric Assessments CCN Assessments Specialist Teachers – Hearing and Vision Social Care Core Assessment Respite services Child Development Unit Portage Assessments Portage Community Paediatrician

Pathfinder 2: Example - Assessment and Planning Application made by Community Paediatrician for an Integrated Assessment and EHC Plan Timely reviews ensure the EHC plan continues to meet Tom’s needs Key transition points anticipated and planned for (for example; when Tom starts pre-school) Single point of contact for Tom’s family during assessment stage More choice and control for Tom and his family about the services and how they are delivered (for example; Direct Payments) Health, Education and Social Care Professionals co-ordinating assessments to gain a better, holistic understanding of Tom’s needs Tell us once approach “All about me” owned by Tom and his family Outcome focused planning in partnership with Tom and his family Clear EHC plan of support for Tom in place PRIOR to entering education Lead Professional role identified to support Tom and his family for the duration of his EHC plan

Pathfinder 3 Example - Assessment and Planning Emerging practice: On-going process, regular person-centred reviews. A ‘tell us once’ approach to sharing information CYP and families at centre; involved in making decisions throughout. Effective co-ordination between education, health and care services, aiming to secure joint agreement on key outcomes. Practitioners engaged and committed to single assessment and planning. Draft process and plan developed by parents and practitioners from health, education and social care. Designed to focus on what children or young people feel is working or not working well for them and on what they want to achieve. Strong emphasis on developing links with the local community and on building family resilience. Families work together in groups to develop their individual plans: to develop peer support. Group sessions facilitated by person centred planners, who are also parents of disabled children.

Pathfinder 3: comments from parents ... · Meeting other parents Getting support needs – positive way Thinking about the future Hopes and dreams that helped me. Meeting other families Talking about our thoughts and feelings freely WE ARE NOT ALONE! Thinking about the future it’s not as bleak as we might have thought Finding out about services and other things that are out there to help us Time to think about o ur son’s future without constraints Confidence to take the next step towards planning for our son’s future in the community ie voluntary supported work placements Confidence to go forward with personal budgets and direct payments I have enjoyed talking about my little girl in a positive way Thinking about the future Using the things I have learnt to make some changes has helped me feel more in control

What is important for them now and in the future Examples - Education Health Care Plan Emerging practice Person centred, focussed on outcomes, specific about provision. Clear, concise, readable and accessible Support preparation for key transition points - “forward looking” Pathfinder 1, EHC draft contents: What is important for them now and in the future What is important for their family One page profile what is working/not working Shared action plan How we will know outcomes have been met Testing if it can replace…… Section 139a Initial/core assessment Community care assessment Statement of SEN Replacing need for SEN panel Carers assessment Health assessments In addition areas are testing how technology can be utilised. Greenwich is exploring how information technology can help families develop person centred plans, through the development of online ‘wiki’ profiles.

Examples - Education Health Care Plan Pathfinder 2 : EHCP, draft contents One Page Profile: What’s great about me My gifts and skills What’s important to me Good support outline Important people Family Profile My history How I communicate My dreams for the future (the BIG picture) My community connections Working and not working now From my perspective From the family perspective From ‘service’ perspectives My existing resources Family, friends and community Money – benefits, pocket money, grants etc Education resources Social services resources Health resources Other resources My outcomes for the next year Key themes and overview Education targets and strategies Home/community targets and strategies Other targets and strategies How I will use my resources Ideas from different perspectives How I / my family will stay in control How I/we will make decisions Action plan Review dates

Examples of key working approaches All pathfinders testing how families could be supported through the process Function v role Terminology - ‘key worker’ ‘mentor’ ‘trained facilitator’, ‘navigator’ Approaches being tested by pathfinders with representation across multiple services, VCS and parent carer representatives Emerging practice Keyworking approaches to provide a single point of contact.

Examples of key working approaches Bromley - Expanding the remit of the Early Years Key Worker up the age range. But also testing whether the key worker for young people aged 14+ should be fulfilled by VCS representatives. Each family is being supported by a key worker and the parent carer forum. Gateshead- Testing how a ‘system navigator’ (provided during the pathfinder by the VCS organisation Children NorthEast) can support families through the assessment and planning process. Manchester - A plan co-coordinator will support families through the process undertaking the function of key working and providing person-centred planning support. From a range of professional backgrounds, including a head teacher, teaching assistants, Connexions personal advisers, community nurses, adult social care managers and social workers. Rochdale- A ‘supporter’ will provide the key working function. These ‘supporters’ come from a variety of organisations or backgrounds, for example, social workers, members of the VCS or other parents, each understanding the specific circumstance of that family. Devon – Testing how a key worker from Devon’s Integrated Children’s Services will support families through the process coupled with a VCS ‘navigator’ to provide independence to the process.

Examples approaches - Local Offer Pathfinders are actively developing their local offer, with many focusing work initially with schools and colleges. In some areas, VCS organisations or parent partnerships services are taking a lead role in engaging services, parents/carers and young people in the development of the local offer: Emerging practice Collaborative working with parents and young people from the start Working with other services to ensure the local offer is informative and helpful (including schools, CCGs and health organisations) Building on existing requirements Making information easily accessible Nottinghamshire and Bexley Have commissioned VCS to support them in developing their local offer. Northampton & Leicester City, SE7 and Manchester Development of the local offer is led by parent partnership services and parent carer representatives. SE7 A working group of parent carers and parent partnership services has consulted with parent carers and practitioners to a agree a common set of principles for its local offer framework, covering all seven pathfinder authorities. An agreed set of questions have been issued to all schools and colleges to inform the local offer. Hartlepool and Darlington Developing school/college based local offer first. A number published including St Hild’s, all then linked via centre web-based resource.

Examples approaches - Local Offer Trafford- Building on existing and developing incrementally, publishing in real time. Currently, Trafford’s published early version local offer currently includes: Local Offer published on Trafford’s existing Child Services Directory website – 20,000 hits a month. Website includes a ‘shortlist’ function to collate and print relevant information and an ‘area search’ facility. The website act as hub platform to signpost to school websites and to other parts of the authority’s website. Trafford’s Local Offer is developed incrementally. The time taken to co-produce its local offer with families, has meant Trafford has focused on publishing its core service offering initially. This core is then being expanded incrementally. activities advice & support money & welfare education & SEN holiday activities transition travel & transport

Trafford Council Local Offer Example Link

Example approaches - Personal Budgets Emerging practice Exploring the funding streams, from education, health and social care, where they can offer choice and control. Testing how this control can be offered through use of notional arrangements and direct payments (including for SEN and health). Testing the support needed for parents and young people to take up and manage a personal budget. Pathfinders estimate by March 2013 approx 400 families will have been offered the option of a personal budget. Offered as a mixture of notional budgets, third party held and/or direct payments. Expectation of large increase during the pathfinder extension.

Example approaches - Personal Budgets Southampton plan to develop a notional budget for each EHC Plan. They are exploring the use of direct payments and third party payments for: - Continuing health care personal budgets - Statutory Short Break Funding - Aiming High Funding - Home to School Transport Direct Payments - Continence and Health Equipment Direct Payments - Flexible home schooling packages Bromley & Bexley, Wiltshire, Devon and Medway are developing ‘easy read’ guides and/or have held workshops with families and practitioners. Devon, Trafford, Greenwich and Southampton are exploring specific brokerage functions to support families. Kent & Medway – Existing 0 – 25 cross agency wheelchair service. Exploring how to use Access to Work funding from DWP to top-up or jointly commission a wheelchair through the wheelchair service to meet the needs of a disabled person within the context of the workplace offering more flexibility and choice. East Sussex – 5 pathfinder families with a health PB e.g. young man who will receive a direct payment of £200 per week; he will use this for a personal health care assistant.