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4.3 Short Breaks: Assessment, Planning and Review

SCOPE OF THIS CHAPTER

Under the provisions of the Children Act 1989 (Schedule 2, paragraph 6(1)(c)), the Council must provide services designed to assist individuals who provide care for disabled children to continue to do so, or do so more effectively, by giving them breaks from caring. More detail on this duty is provided by the Short Breaks Regulations.

The duty from the Act and the Regulations is summarised in the national guidance as:

Local authorities must:

  • Ensure that, when making Short Break provision, they have regard to the needs of different types of carers, not just those who would be unable to continue to provide care without a break;
  • Provide a range of breaks, as appropriate, during the day, night, at weekends and during the schools holidays; and
  • Provide parents with a short breaks services statement detailing the range of available breaks and any eligibility criteria attached to them.

USEFUL RESOURCES

Calderdale Council Short Breaks for Children and Families

Friendship for All (The Children's Society) – this online resource aims to increase friendships for children who are in foster care or who use short break services.

AMENDMENT

In June 2016, this guidance was reviewed and updated throughout. It should be read in full.


Contents

  1. Introduction
  2. Eligibility Criteria
  3. The Legal Basis for Short Breaks
  4. Assessment
  5. Plans
  6. Short Break (Overnight) Planning Meetings
  7. Reviews
  8. Social Work Visits
  9. Short Break Settings
  10. Providing Care in the Child’s Own Home
  11. Providing Care in the Carer’s Own Home or in the Community


1. Introduction

The Local Authority’s position in relation to short breaks is set out in the Short Breaks Service Statement. Children requiring overnight short breaks will always be assessed by a social worker for a Section 17 or Section 20 arrangement or a Learning Disability Nurse for a Section 17 arrangement.

The assessment process will determine the amount of specialised short breaks the child is entitled to. The short break could involve:

  • Daytime care in the home or elsewhere;
  • Leisure activities outside of the home;
  • Services available to assist children in the evenings, at weekends and during school holidays;
  • Overnight Short Breaks: for a small number of children where this is an assessed need. This could be through a Breaks Away Carer or Linden Brook or through a Direct Payment arrangement.
These services are available for disabled children with needs at Continuum of Need Level 3-5, they will be arranged through the ‘Framework Agreement’ unless a Direct Payment arrangement is in place. If the child and family are in need of a short break; this will be sourced through the ‘Framework Agreement’ and will be tailored to meet the needs of the family and child or young person. The Framework Agreement is a legal term. It is a list of the organisations which have been approved to provide quality short breaks for disabled children and young people. These are the organisations from which the Local Authority will buy specialist short breaks for disabled children and young people.


2. Eligibility Criteria

All children can access universal services. Some children may require additional support in order to fully participate in those services. Children with the most complex needs may require specialist services.

Disabled children who require additional support can apply using the newly developed self –assessment forms. They are also entitled to an assessment of need from their lead professional. This may be through universal services or through more specialist services provided by the Local Authority or the NHS.

Disabled children are defined for the eligibility criteria as those children and young people aged 0-18 whose daily lives are substantially affected by one or more of the following: hearing impairment, visual impairment, learning disability, physical disability, a chronic/life threatening physical illness, communication disorder (including Autistic Spectrum Condition), consciousness disorder (e.g. epilepsy). Note: substantially affected is identified as lasting more than six months.

Disabled children can often access resources from universal services or from community based organisations. Targeted support may be available via a self –assessment process. In some instances an Early Intervention Child and Family Single Assessment may also be required.

The Disabled Children’s Team will provide assessments and resources for children with the most complex needs:

  • A moderate or severe learning disability; which could include a sensory impairment, Autistic Spectrum Condition or behaviours that challenge;

    or
  • A severe physical disability;

    or
  • A chronic or life limiting illness where there is an associated learning disability or severe physical disability.
Children who are awaiting a diagnosis and where it is evident to the lead professional that the child has a requirement for specialist services can be referred to the Disabled Children’s Team. Each situation will be considered individually to determine what, if any, services may be required in a child’s best interest.


3. The Legal Basis for Short Breaks

Children may be provided with short breaks under the following legislation:

  • Situation 1 - Under Section 17 Children Act 1989, in which case they are not Children Looked After, the 2010 Regulations do not apply and there is no requirement to appoint an Independent Reviewing Officer (IRO). A Child in Need Plan is required. Reviews should be carried out at least every 6 months and more often if required; or
  • Situation 2 - Under Section 20 Children Act 1989, with short breaks of not more than 17 days each in the same setting (where the total number of placement days does not exceed 75 in any 12-month period) and/or families have limited resources to support a child whilst the child is away and may not be able to fully exercise their Parental Responsibility. In these circumstances, the child is looked after, an IRO must be appointed, and a Short Break Care Plan drawn up. The 2010 Regulations are modified (Regulation 48), so that Looked After Reviews (see Section 7, Reviews below) and Social Work Visits (see Section 8, Social Work Visits below) are less frequent and the short breaks are treated as a single placement; or
  • Situation 3 - Under Section 20 Children Act 1989, where the short breaks exceed a total of 17 days per placement/75 days per 12-month period and/or take place in more than one setting. In these circumstances, the child is looked after, an IRO must be appointed and a Care Plan drawn up. The 2010 Regulations apply in full, including the provisions on frequency of Looked After Reviews (see Section 7, Reviews below) and Social Work Visits (see Section 8, Social Work Visits below).

In situations 1 and 2, the requirements which usually apply to Children Looked After in respect of health assessments and reports, and notification of placements, do not apply.

The legal basis on which services are provided should be clear. The decision to provide a short break under Section 17 or under Section 20 should be informed by the assessment of the child’s needs and 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.

The key question to ask in deciding whether to provide the short break provision under Section 17 or Section 20 is how to promote and safeguard the welfare of the child most effectively.

Before making, and when reviewing, a decision about whether to provide accommodation under Section 17 or Section 20, there should be a careful assessment of the child and family’s needs that addresses:

  • Particular vulnerabilities of the child, including communication method;
  • Parenting capacity of the parents within their family and environmental context taking into account any assessments undertaken on family members as carers under the Children and Family Act 2014 and the Care Act 2014, (See Section 4.2, Carer’s Assessment);
  • 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 the accommodation under Section 17;
  • Whether short breaks are to be provided in more than one place - where the child has substantial packages of short breaks in different settings, including residential schools and hospices, it is more likely to be provided under Section 20;
  • Potential impact on the child’s place in 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 behaviour of the child (e.g. parents or school staff);
  • Views of the child and parents - some children and parents may be reassured by, and in favour of, the status of a Child Looked After, while others may resent the implications and associations of the ‘looked after’ status. The child may benefit from having an Advocate;
  • Extent of contact between short break carers and family and 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 reviews.

It is more likely that the arrangements come within Section 20 where families have limited resources and may have difficulties providing support to their child while s/he is away from home or monitoring the quality of care. 


4. Assessment

4.1 Child’s Assessment

The child’s Assessment may be contained within the self referral form where the trigger for assessment is a request for a short break and this is for relatively low levels of short break provision so that it would fall within the Child in Need criteria.

Nevertheless, sufficient information will be required to ensure key information about the child is identified; the reason for the short break; contact and communication details of the person with Parental Responsibility and their ability to monitor the placement whilst the child is there; the child’s health and medical details and provision of urgent medical attention (if required); the child’s routines, likes, dislikes and current arrangements for the child, (e.g. School) together with behavioural issues and how these are usually dealt with by the family. There should be opportunities for the short break provider and parent and child to meet and discuss the child’s personality, routines, etc.

This information and the arrangements should be reflected in a Review of Service Plan together with the child’s understanding and views of them going into a Short Break situation and the caring arrangements to be provided by the Short Break provider.

Where children have higher level needs an Early Intervention Single Assessment or Single Assessment will be required.

Where the child is to be Accommodated under Section 20, the relevant Accommodation papers and ‘Consent’ details should be completed. A Care and Placement Plan should reflect the arrangements required. (See Section 5.2, Child Looked After Short Break Care Plan).

Where the child’s circumstances are more complex because of their social and /or health needs and they are receiving substantial levels of short break support (possibly in different placements), they will be Accommodated under Section 20; a Single Assessment will be required and should include a multi-agency approach.

Care and Placement Plans should be fully completed and recorded and include Consent, Health, Education and Contact Plans.

Where children become Looked After the Independent Reviewing Unit should be advised and appropriate arrangements made for a review, depending upon whether Regulation 48 applies, (see Section 7, Reviews).

4.2 Carer's Assessment

Parent Carer's have a right to have an assessments of their own under the Children and Families Act 2014; section 97 of the Children & Families Act 2014 requires local authorities to undertake a ‘parent carers needs assessment’:

  • On the appearance of need; or
  • Where an assessment is requested by the parent.

Where requested, then the Local Authority must assess whether that parent has needs for support and, if so, what those needs are. The assessment must include an assessment of whether it is appropriate for the parent to provide, or continue to provide, care for the disabled child, in the light of the parent’s needs for support, other needs and wishes.

The assessment must also have regard to:

  • The well-being of the parent carer; and
  • The need to safeguard and promote the welfare of the child and any other child for whom the parent carer has parental responsibility.

Following assessment, the Local Authority must then decide;

  • Whether the parent has needs for support;
  • Whether the child has need for support;
  • And if so whether those needs could be met (wholly or partly) by services under Children Act 1989, s17.

Services to be provided for parent carers of disabled children should be included in the Child in Need Plan and can be included in the Education, Health and Care Plan, if the child has one.

See also: Children and Young People Aged 0 - 25 with Special Educational Needs and Disabilities Procedure ‘Young Carers and Parent Carers of Disabled Children’

Young Carers Procedure

4.3 The Short Breaks Panel

The Short Breaks Panel consists of representatives from education, health, social care, and commissioning and partnerships. A service manager or senior member of staff will  chair the meetings.

The purpose of the Short Breaks Panel is to:

  • To ensure resources are being targeted to achieve quality outcomes for disabled children and young people;
  • To ensure that the short break is set at the right level and is linked to the child or young person’s view about what they want to do.

The panel will meet monthly to consider new requests for services and review existing packages.

The panel will also consider how services should be configured to maximise opportunities for disabled children and young people including the development of new services if appropriate.

4.4 Assessments Outcomes

Note: the outcomes include references to short breaks, it should be noted that not every assessment will identify that there is a need which would necessitate a Short Break service

Outcomes are linked to each disabled child and young person’s identified needs and may include some of the specific outcomes as listed below.

Disabled Children:

Key Outcomes Specific Outcomes for Disabled Children and Young People EG’s

Be Healthy

Promoting healthy choices, healthy lifestyles, improving physical, mental and emotional health.

Disabled children and young peoples’ confidence and self-esteem improve from the point of referral to Short Break Service Provider.
Disabled children and young people are active and take up opportunities to access physical activities.

Stay Safe

Helped to stay safe, feel safe and be secure. To have stability and to be cared for.

Disabled children and young peoples’ awareness of danger improves from the point of referral to Short Break Service Provider in line with their age and ability.
Disabled children and young people are safe from harm.
Disabled children and young people feel safe and secure within the environment.

Enjoy and Achieve

Achieve their full potential, are motivated to learn and enjoy recreational activities.

Disabled children and young people improve their social/interaction skills from the point of referral to the Short Break Service Provider.
Disabled children and young people take up opportunities to play alongside and interact with their peers.
Disabled children and young people develop new skills and build on existing skills from the point of referral.
Disabled children and young people access leisure opportunities equivalent to those their non-disabled peers would actually access.
Disabled children and young people’s learning needs and interests are met or exceeded.
Disabled children and young people’s achievements are celebrated and shared with parents and carers.

Make a Positive Contribution

Engage in positive behaviour and develop positive relationships. Develop self-confidence to deal with significant life events and changes.

Disabled children and young people contribute to Service design, delivery and evaluation.
Disabled children and young people contribute to the review of the service they receive.
Disabled children and young people are successfully encouraged to make independent choices.

Achieve Economic Well-Being

Develop skills and independence to live a prosperous and fulfilling life.

Disabled children and young people increase their independence in line with their age and ability from the point of referral.

Outcomes for Parents and Carers

For this Service, the expected outcomes for disabled children's’ parents/carers are:

  • Parents/carers experience less stress through the provision of Short Breaks for their disabled child(ren);
  • Parents/carers feel adequately supported through the provision of Short Breaks for their disabled child(ren);
  • Parents/carers feel happy and relaxed knowing that Staff will meet their child’s individual needs;
  • Parents/carers receive regular, planned, reliable Short Breaks;
  • Parents/carers may be able to access Short Breaks at short notice in response to a temporary crisis;
  • Parents/carers contribute to Service design, delivery and evaluation through parent satisfaction surveys;
  • Parents/carers contribute to the review of the service their disabled child(ren) receive.

4.7 Short Breaks and Contracts with Providers of Home/Community Support

  1. Once a needs assessment has been completed and a short break arrangement has been agreed, the Service Administrator, Disabled Children’s Team, will issue referral forms to accredited providers The initial referral will need to give sufficient information about the child’s level of disability and support needs so that providers can respond accurately. Referral forms will be anonymised and sent either by e-mail or fax;
  2. The provider is required to complete all sections of the referral form including the rates it proposes to charge but these rates shall not exceed the indicative prices submitted with their tender. The referral form must be returned within a 48 hour deadline or 2 hours for emergencies;
  3. If more than one provider is able to offer the services the decision to award the contract and issue a call-off agreement will be made on the basis of price. This will be signed off within a 48 hour deadline or 2 hours for emergencies;
  4. Commencement of services will be preceded by planning, preparation and introductions to the child and family with the provider. The referrer will convene a Planning Meeting attended by the child or young person (if not appropriate a method of representing the views and wishes of the child or young person to be achieved), family, providers, support worker, the referrer and any other relevant professionals whereby the agreement will be reached on the practicalities of delivering support and outcomes identified in the referral form. Any further training needs for the support worker will also be identified. The frequency of the review of the package will also be confirmed;
  5. The referrer will also advise families at the Planning Meeting of the cancellation and charges procedure;
  6. A call off agreement will be completed by the referrer and this will be sent to the Contracts Manager together with a copy of the referral form;
  7. A review of the short break service will be carried out in accordance with agreed timescales using the review form;
  8. New packages of support will be allocated using the above referral procedure;
  9. A review of current packages of support will be undertaken and transferred over to the new arrangement;
  10. For those packages of support which need to be presented at Short Break Panel the above procedure will still apply.


5. Plans

5.1 Child in Need Plan

Also see Child in Need Plans and Reviews Procedure. The provision of Short Breaks is included and reviewed within the Child in Need process.

This is applicable where daytime or overnight short breaks are provided under Section 17 Children Act 1989.

The Child in Need Plan should be in writing and set out clearly all the services that are to be provided to meet the child’s needs. Many families with disabled children receive a range of services to meet their child’s needs. Wherever possible there should be a single plan which includes the full range of family support services on a multi-agency basis. The plan will show how the short break will meet the needs of the child and family identified in the assessment. It will:

  • Explicitly detail the outcomes to be achieved and the actions required to achieve the outcomes;
  • Clarify the actions to be completed, either a target date or frequency. The actions should be specific, measurable, achievable, realistic and have set timescales;
  • Confirm who is responsible for the implementation of the action;
  • State the minimum visiting frequency required of the worker, including clarity as to the role and focus of the worker’s interventions (see Section 8, Social Worker Visits below). Have clear and realistic objectives so that progress and achievement and inclusion are measurable. These will then be reviewed as part of the Child in Need Review Meeting;
  • Include the ascertainable wishes and feelings of the child and views of the family. The child may benefit from having an Advocate;
  • State the nature and frequency of services, as far as is practicable, including health and social care in the same plan, especially if short breaks are provided from different agencies;
  • State the child’s health, emotional and behavioural development including full details about any disabilities and clinical needs the child may have and medications they may require;
  • State the child’s specific communication needs, especially for children who communicate non-verbally, and include the child’s likes and dislikes with particular regard to leisure activities;
  • Include the results of all necessary risk assessments which could include, depending on the child’s impairment, moving and handling, invasive procedures, and behaviour;
  • State contact arrangements for emergencies;
  • State commitments of professionals involved;
  • Refer to or summarise any other important documents about the child’s development;
  • Confirm those caring for the child have been selected following the advice set out in the guidance on Direct Payments (see GOV.UK Applying for direct payments);
  • Agree the date, time and place of the next 6 monthly meeting. The maximum ‘life’ of a plan is 12 months; if objectives have not been achieved within this timescale a new plan will be formulated.

The plan should include all the information necessary to safeguard and ensure the welfare of the child in the short break. The plan should be made available as necessary in accessible formats.

The plan is prepared in consultation with the child and his/her parent/carer and their views are recorded on the plan. The child, his/her parent/carer and all interested parties are provided with a copy of the plan.

The objectives of the plan and how they will be achieved are discussed with all interested parties e.g. other agencies, professionals and their details recorded.

Consultation forms should be used prior to subsequent Review meetings to collate the views of the child and others.

5.2 Children Looked After Short Break Care Plan

This is applicable where short breaks are provided under Section 20 Children Act 1989, (for those placements over 75 nights in a 12 month period).

Where, following assessment, it is agreed with the family that the child should be Looked After under Section 20 of the 1989 Act, there will be additional requirements about planning and review. In this situation the information compiled for the Child in Need Plan (as set out in Child in Need Plan above) will form the basis for the Short Break Care Plan required when a child is looked after under Section 20 and Regulation 48 applies (Situation 2).

In Situation 3, the Short Break Care Plan should be linked to the Care Plan, which should include all the key information about the child. These should not be separate plans which duplicate information.

The Short Break Care Plan must set out the arrangements to meet the child’s needs with particular regard to:

  • The child’s health and emotional and behavioural development, any disability, medical needs and medications;
  • The child’s specific communication needs;
  • Promoting contact with parents/anyone with Parental Responsibility;
  • Arrangements for contacting parents as necessary, in particular an emergency contact number; 
  • The child’s likes and dislikes regarding stimulation and leisure interests;
  • How the carers, as appropriate, promote the child’s educational achievement;
  • The name and address of the registered medical practitioner;
  • The type of accommodation, address, name of person responsible;
  • The child’s personal history, religious persuasion, cultural and linguistic background and racial origin;
  • The respective responsibilities of the local authority and parents/anyone with Parental Responsibility; any delegation of responsibility from parents to the local authority; the respective roles and responsibilities of the placement provider, social worker, Independent Reviewing Officer (IRO) and other staff employed or commissioned by the local authority to contribute to the plan for the child’s care; the respective safeguarding responsibilities of the provider and the local authority;
  • The expected duration of the arrangements and the steps to end them; arrangements for giving notice of intention to terminate the placement along with the local authority’s responsibilities for convening a review of the child’s Care and Pathway Plan where there is a risk of the placement being terminated;
  • Frequency of visits;
  • Financial arrangements for the placement;
  • When the child is placed with a local authority-approved foster carer, confirmation of the foster carer’s agreement;
  • The provider’s responsibilities for notifying the child’s social worker of any significant change in the child’s circumstances.

As far as practicable, the child should be involved in agreeing the Plan. 

The parents must be fully involved in all aspects of agreeing the Short Break Care Plan. 

The plan should be signed by the parents, the Local Authority, those providing the care/ the provider agency and, where appropriate, the child.

There is no requirement for a separate Placement Plan for short breaks.

Where required and appropriate please note ‘Ceasing to look after a child’, Children Act 1989 Guidance and Regulations Volume 2: Care Planning, Placement and Case Review.


6. Short Break (Overnight) Planning Meetings

This section applies to all children or young people who receive overnight short breaks through a residential short break service (Local Authority or external placement is) or through a fostering arrangement.

6.1 Introduction

At the heart of an effective Child in Need Planning Meeting there needs to be:

  1. A Single Assessment, which identifies the child or young person's needs and the outcomes to be achieved;
  2. A Child in Need or Short Break Plan which delivers clarity on outcomes and the services to be delivered to meet those assessed needs;
  3. A decision as to whether the short break will be provided under Section 17(6) or under Section 20 (4) of the 1989 Children Act.

6.2 Procedure Prior to the Planning Meeting

The Practice Manager in consultation with the allocated worker will agree under what legal basis the short break is to be delivered whether this is under section 17 or section 20 of the 1989 Children Act. This decision will be recorded on the child’s electronic file by the Team Manager for future reference (please also see Section 3, The Legal Basis for Short Breaks).

There should be a Child in Need Plan for children subject to Section 17 arrangements or a Short Break Plan for children subject to Section 20. These plans should clarify the needs of the child and the outcomes that are being sought from service. These plans should be made available to the meeting so that they can be considered and then revised accordingly.

The parents of the child must be fully involved in all aspects of agreeing a Short Break Plan or Child in Need Plan; it is therefore important that discussions have taken place prior to the meeting itself.

It is an expectation that children should also be involved in agreeing the plan. The child's voice should be central to the planning process just as it has been to the process of assessment itself; this ensures that the child's needs are fully met and preferred outcomes delivered. The plan needs to reflect a clear understanding of the child's preferred form of communication and therefore how the child's voice will be represented in future meetings.

The objectives of the plan and how they will be achieved are to be discussed with all interested parties e.g. other agencies, professionals.

The planning meeting needs to be held prior to the first overnight stay.

6.3 The Planning Meeting Participants will include:

  • The parent;
  • The child;
  • The residential key worker or Short Breaks Foster carer;
  • Anyone else considered appropriate or to have a role in the Plan, e.g. relative, school, health care professional.

The Planning Meeting will be chaired by the Social Worker for all arrangements made under Section 20. Community nurses will only chair Planning Meetings where these arrangements are under Section 17.

  • The purpose of the Planning Meeting is to discuss the Short Break Plan or Child in Need Plan. This will involve a discussion of the child’s needs, including their health and education, play, skill development and social needs, and how these are to be met as well as the outcomes that the child and family wish to achieve. Previous objectives should be reviewed and measured.


7. Reviews

7.1 Reviews - All Cases

No significant change to a Child in Need Plan or a Short Break Care Plan should be made unless it has first been considered at a review. 

In each case, whether children are provided with accommodation under Section 17 or under Section 20, the review should consider whether this continues to be the most appropriate legislative basis for the service provided.

A record should be kept, recording the views of those involved in the review, decisions taken and the identity of the persons responsible for implementing them. 

7.2 Children in receipt of Short Breaks under Section 17 Children Act 1989 (Situation 1) and under Section 20 Children Act 1989 (Situation 2)

A case review for a child should:

  • Ensure the service(s) provided meet the needs identified in the Child in Need Plan for Section 17 or Short Break Care Plan for Section 20 and safeguard and promote the welfare of the child;
  • Focus on outcomes for the child and family;
  • Be a multi-agency review whenever possible. Different elements of a child’s short breaks or plan should not require a separate review;
  • Include the ascertainable wishes and feelings of the child and the views of the family;
  • Monitor progress against the implementation of the plan and this is explicitly recorded with any concerns or changes to the plan;
  • Evaluate and respond to any new information received about the child;
  • Support the participation of The child and his/her parent/carer in the review process;
  • Engage interested parties/other agencies/professionals in the review process;
  • Discuss and offer the possibility of a Direct Payment, as a full or partial replacement of currently provided services. However, it should be noted that any Direct Payment that is proposed or provided will need to meet the identified assessed needs of the child.

There are a number of additional considerations for children who are receipt of a direct payment arrangement:

  • Ensure that the needs, as identified in the Assessment, are now met or are in the process of being met by the Direct Payment arrangement;
  • Consider whether the child’s welfare is safeguarded and promoted by the Direct Payment arrangement. Carers are to be encouraged to give particular consideration to the child’s views about how their intimate care needs are met;
  • Consider the results of any audit undertaken by the Support Planning and Brokerage Team and their advice, the Team will always be invited to the review;
  • Establish the level of support required from the Support Planning and Brokerage Team and if a new moving and handling assessment is required;
  • Review the decision to allow a close relative to be paid using Direct Payments to ensure the criteria continue to be met.

Reviews are less frequent than for Children Looked After in Situation 3.

  • The first review must take place within 3 months of the start of the first placement;
  • Second and subsequent reviews must take place at intervals of not more than 6 months;
  • Reviews may be convened earlier, e.g. at the request of the child, parents or carer; or in cases where the child is particularly vulnerable; or where the child is provided with a high level of short breaks or if the child’s condition is changing quickly, or there are changed family circumstances, or where there is a complex package of services including direct payments.

Generally it should be possible to include a review of short breaks with a review of other aspects of a child’s health, education or development, where some of the same people will already be together.

Having an Advocate may be particularly useful for disabled young people moving towards adulthood.

7.3 Children in receipt of Short Breaks under Section 20 Children Act 1989 (Situation 3)

The 2010 Regulations in relation to Looked After Reviews apply in full, and reviews will take place as follows:

  • The first review must take place within 20 working days of the first placement;
  • The second review must take place not more than 3 months after the first;
  • Subsequent reviews must take place at intervals of not more than 6 months.

For further details, see the Looked After Reviews Procedure.


8. Social Work Visits

Visits will be undertaken by a person with the skills and experience to communicate effectively with the child and fulfil the functions of the visit.

The expectations of visits to children in their short break arrangements are detailed below. In addition, there is a requirement that children are visited at home in line with the Department's minimum visiting standard for Children in Need, of once every eight weeks. It is essential that children are seen and spoken to regularly by their worker and this will often need to be more frequently than the minimum levels for visiting. Good practice is guided by professional judgement based on the needs of the child; children who are a continuum of need level III will usually need less intensive visiting. It is expected that the Child in Need Plan or Short Break Plan will detail the frequency required.

There are specific requirements in relation to visits to children at Linden Brook, Short Breaks Unit; these are in place to:

  • Ensure that the child’s allocated worker has up to date knowledge re how the child they are responsible for is progressing against the key outcomes outlined in the assessment and review;
  • Identify positives in terms of how the Unit is working with children and provide constructive feedback and professional advice where appropriate;
  • Identify areas of concern and to agree a plan with the Registered Manager and Team Manager to address these.

Social Workers and Learning Disability Nurses will undertake the following when they visit children who are in receipt of Short Breaks at Linden Brook:

  • Read the children's daily record, reading all entries since their last visit;
  • Read all the body charts on the file;
  • Read the Linden Brook Placement Plan;
  • Sign and date the child's daily record to state what has been read and complete the Inspection Sheet on the child’s file; the worker's title and name need to be printed;
  • Raise any concerns as a result of what has been read with the Registered Manager and Team Manager so that appropriate follow up action can be taken;
  • In addition to making observations of the child in the Unit include observations of the child's interaction with other children and the staff.

Situation 1

Visits may be undertaken by a qualified social worker or learning disability nurse where the nurse is acting as the Lead Professional and the focus is on the health outcomes of the child.

It is a key quality standard for visits to take place as follows:

  • The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter; 
  • Subsequent visits must take place at intervals of no more than 6 months for as long as the short breaks continue.

Situation 2

Visits should be undertaken by a qualified social worker and take place at regular intervals to be agreed with the Independent Reviewing Officer and parents/person(s) with Parental Responsibility and recorded in the Short Break Care Plan before the start of the first placement. 

In any event:

  • The first visit must take place within 3 months of the first placement day or as soon as practicable thereafter; 
  • Subsequent visits must take place at intervals of no more than 6 months for as long as the short breaks continue.

Situation 3

Visits should be undertaken by a qualified social worker and must take place:

  • Within the first 5 working days and then weekly until the first review;
  • After the first review visits should be a minimum of monthly. Once a placement is approved as long term visits are minimum of three monthly.


9. Short Break Settings

Following the assessment of the child and family, short breaks can be arranged in a number of settings which are subject to different registration and inspection requirements.

Outline Requirements on Settings Where Short Breaks Might Take Place

Hospices Regulated by the Care Quality Commission (CQC) under the Care Quality Commission (Registration) Requirements 2009. Hospices are Regulated and Inspected by the Care Quality Commission (CQC)
Local Authority Foster Care Fostering services are registered with and inspected by Ofsted. National Minimum Standards (2011)
Children's Homes Children’s homes are registered with and inspected by Ofsted. Quality Standards (March 2015)
Residential Special Schools Different regimes apply depending on whether the residential special school is maintained, non-maintained or independent. The National Minimum Standards Residential Special Schools (2015)


10. Providing Care in the Child’s Own Home

The key to providing safe care to children in their own homes is the same as to the provision of safe care elsewhere. It is essential that safe recruitment practices are followed and staff are properly trained and supervised and that the requirements of the Disclosure and Barring Service (DBS) are complied with.

Where the local authority provides a sitter or overnight carer in the child’s own home, the child is not being provided with accommodation by the local authority and the authority is therefore providing the short break service under Section 17 Children Act 1989.

However, care that is provided under arrangements made by the local authority and which is provided on a frequent, intensive or overnight basis comes within the definition of Work with Children or Regulated Activity whether or not it takes place in the child’s own home, and the requirements of the Disclosure and Barring Service in relation to Regulated Activities will apply.

Best practice is that the child should be cared for by an approved local authority foster carer. Childminders with whom the local authority places or wishes to place children overnight (or childminders wishing to take on such work) should be asked to apply for approval as local authority foster carers. It is not appropriate for the local authority to provide overnight accommodation with childminders who are not also approved foster carers.


11. Providing Care in the Carer’s Own Home or in the Community

It is essential that individuals providing care in their own homes are subject to full employment and personal checks, as well as safe recruitment methods, and that they are provided with induction and training.

There are no requirements for agencies to register with Ofsted or the Care Quality Commission if they provide services to support disabled children in the community or in their own homes, unless they provide Personal Care. If personal care is provided, services must register with the Care Quality Commission and comply with the relevant standards.

Regulated Activity under the Safeguarding Vulnerable Groups Act 2006 as amended by the Protection of Freedoms Act 2012 includes the provision of Personal Care: 

  • Assistance which is given to a child who is in need of it by reason of illness or disability and is given in connection with eating or drinking (including administration of parenteral nutrition); toileting (including in relation to the process of menstruation); washing, bathing or dressing; or any form of training, instruction, advice or guidance relating to the performance of such activities;
  • The prompting (together with supervision) of a child, who is in need of it by reason of illness or disability, in relation to the performance of any of the above activities where the child is unable to make a decision in relation to performing such an activity without prompting and supervision.

However any form of care or supervision provided for children on a frequent, intensive, or overnight basis including transporting (where the vehicle being used is only for transporting children and carers or supervisors), support given to children with accessing computer/gaming or other electronic devices comes within the definition of Regulated Activity and the requirements of the Disclosure and Barring Service (DBS) will apply.

Where families arrange care themselves by employing carers in a private capacity, funded by Direct Payments, they should be advised that direct payments cannot be spent on:

  • Employing someone without Disclosure and Barring Service and CPR checks or references; or
  • Someone subject to a drug or alcohol treatment requirement, youth rehabilitation order or released on licence.

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