Pathway Plans and Reviews

1. Initial Contact

When a completed referral is received, the Pathway Team Worker will allocate the case to a Pathway Team Social Worker, who will contact the child's Social Worker to arrange a joint visit to the young person.

2. Making the Plan

The Pathway Plan will replace a young person's Care Plan and Single Assessment. Any Personal Education Plan or Careers Plan will inform and complement the Pathway Plan.

The Pathway Team Social Worker is responsible for co-ordinating and taking forward the Initial Pathway Plan, but the Locality Team Social Worker and Carers / Key Workers are expected to work with the Pathway Team Social Worker in providing the information required to complete the plan.

The young person should be referred to the Pathway Team when they are 15, in order that d the Pathway Plan is completed by the time they are 15 ½.

The Pathway Plan must be completed by within 6 weeks of the Pathway Team receiving a completed referral.

The Locality Team Social Worker, Pathway Team Social Worker and the Carers/keyworkers must take account of any other issues (e.g. exams) in the young person's life when planning the assessment.

Each young person will be central to drawing up their own Pathway Plan setting the goals and identifying how the Local Authority will help meet them, including any services being provided in respect of the young person's disability or needs arising from being in custody or as a result of entering the country as an unaccompanied asylum seeker. It should be written in a way that meets the needs of the young person, capturing their aspirations and key messages. Young people with particular language or communication needs should be provided throughout the process with appropriate interpretation, translation or advocacy support.

The Pathway Plan should also include:

• The plan for the young person's continuing education or training when they cease to be looked after - where the young person is no longer of statutory school age, the Pathway Plan may need to incorporate the goals and actions that were previously included in the PEP;
• How the Responsible Local Authority will assist the young person in obtaining employment or other purposeful activity or occupation, taking into account their aspirations, skills and educational potential to improve their chance of employability;
• The financial support to be provided to enable the young person to meet accommodation and maintenance costs; taking into account their financial capabilities and money management capacity, along with strategies to develop skills in this area;
• The nature and level of contact and personal support to be provided, and by whom, to the young person;
• Details of the accommodation the young person is to occupy (including an assessment of its suitability in the light of the young person's needs, and recording the considerations taken into account in assessing that suitability);
• Details of the arrangements made by the Responsible Local Authority to meet the young person's needs in relation to their identity, with particular regard to their religious persuasion, racial origin and cultural and linguistic background.

The Pathway Plan must address in particular:

• The young person's health and development building on the information included in the young person's Health Recommendation Plan;
• Education, training and employment. The Personal Education Plan (PEP) should continue to be maintained while the young person continues to receive full or part-time education. Information within the PEP will feed directly into the Pathway Plan. Pathway Plans must have an explicit focus on career planning, taking into account the young person's aspirations, skills, and educational potential;
• Contact with the young person's parents, wider family including siblings and friends and the capacity of this network to encourage the young person and enable them to make a positive transition to adulthood;
• The young person's financial capabilities and money management capacity, along with strategies to develop the young person's skills in this area.

The Pathway Plan must identify contingency arrangements that will come into effect to support the young person if, for whatever reason, the planned arrangements are not realised.

The Local Authority should have a flexible approach to supporting young people; It should be borne in mind that the it has a duty to accept young people aged 16 and 17 years back in to care if a young person's decision to move into semi-independent accommodation, leave care or decline leaving care services is subsequently identified as premature.

A Financial Pathway Plan where appropriate should be attached to the CASS Plan. This plan is placed in Documents on CASS.

Plans should not be made that the young person does not agree with. Exceptions to this should only concern the safety of the young person and others. 

If the young person will not or cannot participate in the process, the plan should be completed by the professionals concerned on the young person's behalf, but the young person's lack of involvement should be noted, including steps taken to remedy this.

Subject to the above, the following people should be involved.

• The school/college;
• GP/school nurse/designated nurse;
• Family members chosen by the young person;
• Independent Visitor (if appropriate and with the young person's consent);
• Any other agencies or individuals considered appropriate by the young person, the Social Worker, the Personal Adviser and the carers.

Where a transfer from Children's to Adult Services will be required, the Plan should specify who has responsibility for giving notice to Adult Services and liaising with them to ensure a smooth transition.

On completion and approval of the Pathway Plan, all parties involved including the young person should sign it.

A copy of the Financial Pathway Plan should be forwarded to the Finance Section who will process the necessary weekly payments.

The young person will be provided with a copy of the most up to date Pathway Plan and the contents must be explained.

The young person will have a say about with whom the Pathway Plan will be shared when they leave care. If information is to be shared with a person or agency that the young person has not consented to, they must be informed of this, with reasons, and be given the opportunity to challenge this decision and to be present when the information is shared.

Those who have a role in implementing the plan should have a copy of the Pathway Plan, at least, of the part relating to their contribution.

Pathway Planning Over 21 - Under 25

The Local Authority is required to offer all care leavers a Personal Adviser up to the age 25 and apply the corporate parenting principles when continuing support is agreed or requested.

However, the duty at this stage of a young adult's life is seen as different from the age 18 – 20 in that it enables the Local Authority to offer support to some individuals who may need continuing support in the transition process. The level of support and intervention will vary considerably; many at this stage of their lives will not require, or want, ongoing help and will not have a Pathway Plan. However, for others:

• There may be multiple issues which will require a Pathway Plan being fully completed and regular contacts, planning/co-ordinating meetings with partner agencies, etc.
• Care leavers may have single or specific issues where they require support and guidance, e.g.:
  • Pregnancy or becoming a parent;
  • Release from custody;
  • Mental health issues;
  • Risk of homelessness;
  • Debt, including rent arrears;
  • For advice or guidance on commencing education or training;
  • For advice or support following experience of domestic or sexual violence/abuse.

Where care leavers require support with single or specific issues, the Pathway Plan should be completed only in the relevant part that reflects the issues being dealt with.

3. Co-ordinating with Other Plans

Some young people will have other plans that are being made for them at the same time as the Pathway Plan is being completed. For example, some young people may have Personal Education Plans being completed by the Virtual School Team. Young people with disabilities may be involved in Person Centred Planning or Transition Planning with the Disabled Children's Team and Adult Services. In addition some young people will have an Education, Health and Care Plan. Discussions must be held with the SEND Team to ensure that both the Pathway Plan and the EHC Plan are integrated and complementary.

Where this is the case, care must be taken to communicate fully with other professionals involved and to co-ordinate the completing of the various plans, so that the plans complement each other. All young people should have a care plan, and the Pathway Plan should have the same status as the Care Plan and Single Assessment.

4. Completing the Pathway Plan

As part of the Pathway Planning process any risks should be identified in the Pathway Plan. Where appropriate a young person may already have a Risk Management plan in place completed by their placement. In these circumstances the Risk management Plan should be placed in Documents in CASS and referred to in the Pathway Plan. Risk Management Plans for young adults who have an allocated Social Worker from Adult Services will be that allocated Social Worker's responsibility to complete. The allocated Pathway Worker will obtain a copy and place this in Documents on CASS and reference this in the Pathway Plan. Where a risk is identified in respect of a young person under the age of 18 that is not addressed in an existing risk management plan this should be identified in both the Pathway Plan and Single Assessment report for a Child Looked After Review. In these circumstances the allocated Pathway Worker should complete the appropriate Risk Assessment (for example a CSE Risk Assessment) or complete a Risk Management Plan where the risk identified does not relate to an existing risk management process (for example a Risk Management Plan relating to the use of a moped by a young person under the age of 18).

Clear consideration should be given in supervision to the identification of risk in relation to young people over the age of 18; consideration should be given to the capacity of these young people and whether what they are doing constitutes an unwise choice as defined by the Mental Capacity Act 2005. If a young person over 18 is considered to be at risk of abuse reference should be made to the Safeguarding Adults, West and North Yorkshire and York Multi-Agency Policy and Procedures and the appropriate referral made. In addition to young people who have an Adult Social Worker, there will be young people subject to Probation supervision, MARAC, MAPPA, a Domestic Abuse Hub assessment or other appropriate adult agency assessment and plan. Such plans should be placed in CASS documents and be referred to in the Pathway Plan.

In respect of Eligible young people all Risk Management Plans should be considered at each Statutory Review by the Independent Reviewing Officer.

The Lead Professional should seek the young person's comments and attach these to the plan. The plan should be signed by the young person, and a Pathway Manager. If the young person does not choose to sign the plan, the Lead Professional should note this on the plan.

The plan should then be submitted on CASS to the Pathway Team Manager / Practice Manager for evaluation and sign off.

If the young person disagrees with any part of the plan, they may request a review of the plan by the Project Manager - Pathway Team. The Team Manager must respond within 2 weeks. If the situation is not resolved to the young person's satisfaction they should be advised of the Complaints procedure and assisted to make a complaint.

• The young person;
• The carers;
• The parents (with the young person's consent). 

Other professionals may also need parts of the Plan which contain tasks for them. They should be sent only the relevant parts of the plan.

If the young person does not wish their parent(s) to receive a copy of the Pathway Plan, the Lead Professional should inform the parent(s) that the assessment and plan has taken place.

The Lead Professional must ensure that copies of the Pathway Plan are kept on the young person's CASS Record.

5. Reviewing the Pathway Plan

The Pathway Plan must be reviewed at least every 6 months for care leavers up to age 21. Thereafter, until the care leaver reaches the age of 25, the issues that have arisen which affect the care leaver will dictate how often Pathway Plans will need to be reviewed and updated. However, as a minimum this should be at least every 6 months. A Pathway Plan Review should be held 1month after the young person ceases to be looked after.

Pathway Plan Reviews will be arranged by the Lead Professional. Where an, Eligible young person is still in care the Pathway Plan must be reviewed as part of the Statutory Child Care Review.

The Lead Professional will consult with the young person to establish how they would like such Pathway Plan Review to be conducted. It is acceptable for the Lead Professional to meet with the young person alone if this is the young person's wish. In these circumstances the Lead Professional should make contact with other professionals prior to the session to establish their views and progress. It is also acceptable for Pathway Plan Review to take place at the same time as statutory child care reviews, if this is the young person's wish. If this takes place, the Lead Professional should still complete a Pathway Plan Review form.

Pathway Plan Reviews should be held even if the young person refuses to participate in the review or if the young person refuses to have any contact with the Pathway Team. The Lead Professional should seek the views of the other professionals working with the young person in order to assess progress and recommend plans. In these circumstances it may be useful for the Pathway Plan Review to take the form of a meeting.

The Pathway Plan Review should address the following issues:

• Are the plans still reasonable and appropriate;
• Are services being delivered according to the plan;
• Are the tasks being completed within the timescales;
• Is the young person's accommodation appropriate;
• Is the young person receiving the correct financial support.

If actions in the Pathway Plan are no longer relevant, this should be stated and explanations given in the Pathway Plan review.

Where there is a Risk Management Plan completed by a Pathway Worker, this should be reviewed at every Pathway Plan Review, and amended if necessary. The Pathway Worker should encourage the young person to include their own comments about the plan. The plan should be signed by the young person and the Pathway Worker. If the young person chooses not to sign the plan, the Pathway Team Worker should note this on the plan.

The completed Review should be submitted to the Pathway Team Manager for evaluation and sign off.

Copies of the Form (or relevant sections) should then be sent to all parties who participated in the Review, either in person or post or email.

If the Relevant Young Person or Eligible Young Person moves to 'unregulated' accommodation (i.e. accommodation that is not regulated/inspected by OFSTED), the Local Authority must:

1. Arrange a review 28 days (or as soon as practicable thereafter) from the time the accommodation is provided; and
2. Determine at what intervals (not exceeding 6 months) subsequent reviews will be carried out;
3. Reviews should be brought forward where there is an assessed risk that a crisis may develop in a young person's life, for example:
   • Where a young person has been charged with an offence and there is a possibility of their being sentenced to custody, which will risk losing their accommodation;
   • Where a young person is at risk of being evicted from their accommodation or otherwise threatened with homelessness;
   • Where professionals are concerned about the parenting capacity of a 'Relevant' or 'Former Relevant' young person with there being a possibility that their own child may need to be the subject of a multi-agency safeguarding plan;
   • Where a young person requests a review.

Matters to which the Local Authority is to have regard in determining suitability of accommodation (under Schedule 2 to the Care Leavers Regulations 2010 and Schedule 6 of the Care Planning, Placement and Case Review Regulations 2010):

1. In respect of the accommodation:
   1. The facilities and services provided;
   2. The state of repair;
   3. The safety;
   4. The location;
   5. The support;
   6. The tenancy status; and
   7. The financial commitments involved for the relevant young person and their affordability.
2. In respect of the Relevant young person:
   1. Their views about the accommodation;
   2. Their understanding of their rights and responsibilities in relation to the accommodation; and
   3. Their understanding of funding arrangements.

It is good practice for a review to be held within 28 days of any change in the care leaver's accommodation.

Where a Relevant or Former Relevant Young Person enters custody, pathway planning must continue. The young person must be visited on a regular basis and it is good practice for the first visit to take place within 10 working days. The role must not be fulfilled by a YOT worker. The Local Authority must liaise with the YOT or Probation Service to support the young person emotionally, practically and financially while in custody. A review of the Pathway Plan should be carried out at least 1 month before the young person's release to give sufficient time to plan for their resettlement, including identifying suitable accommodation where the young person's placement had to be given up or has been lost and identifying who will collect the young person and the sources of support after their release.

In the event of a Relevant or Former Relevant Young Person breaking off contact and/or not engaging with the agreed support and advice being offered, a review of the Pathway Plan may take place by telephone, e-mail or letter, if agreed in advance by the relevant manager and the Personal Adviser. In these circumstances the Personal Adviser will attempt to negotiate a revised plan that is acceptable to all parties.

Where contact is lost, the emphasis of the Pathway Plan Review will switch to record how attempts will be made to re-establish contact and these efforts will be reviewed within the established system.

For those over 21 up to age 25 the frequency of contact between Personal Advisers and care leavers will vary depending on the nature of each individual's circumstances (see Pathway Planning Over 21 – Under 25).

Where a Pathway Plan is amended as a result of a review, the Personal Adviser will amend the Plan. Any necessary approval to the amended financial arrangements will be sought from a relevant Manager. Once the changes are approved, the Personal Adviser will send a copy of the amended Plan to the young person and, if applicable, other relevant professionals or agencies.