Event Report
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Our recent Waiting Well Wednesday transitions event was very well attended and gave parent carers the opportunity to meet with senior social workers and other professionals such as SENDIAS and LiveWell. The session aimed to inform parent carers about how these professional services support our young people at the crucial age of 16, as they move from Children’s Social Care to Adult Social Care.
The session opened with two presentations, introduced by Anne Smith, who has overall responsibility within the Local Authority for social care for both adults and children, including all of the mental health services. She noted that it is one year since B&NES moved Social Care from HCRG back to being managed within the Local Authority.
You can find out more about the two key pieces of law that apply to young people as they pass the age of sixteen here:
The Care Act (2014)
The first presentation was an overview of the Care Act and how it’s applied in practice. The Care Act, which was updated in 2016 and again this year, is written in such a way that social workers can be involved at times of need and then step back when the need has passed, but be brought in again if the need arises. This can be usefully flexible, although he noted that in some cases it could be disruptive. Adult Social Care is there in the background for all of us from the age of 18. For example, some of us may not need any support until we are affected by a disability or illness – but any of us might need support at some point in our lives.
(Click on each of the following 4 headings to read more on each subject)
Principles of the Care Act
The Care Act has five key principles:
Promoting individual wellbeing
Wellbeing includes physical, mental and emotional health, which are essential for people receiving care. The Act aims to ensure an individual’s needs are met effectively.
Preventing needs for care and support
The Act aims to avoid the needs for care and support through early interventions and effective community resources.
Promoting integration of care and support
“Care and support” means the services provided to individuals to maintain independence and quality of life.
Providing information and advice
Promoting diversity and equality in access to services
Fair access is vital and allows individuals to receive care without discrimination.
You can see some of the statutory guidance about how Social Care should implement the Care Act on the government’s website, at https://www.gov.uk/government/publications/care-act-statutory-guidance
Safeguarding
In addition, Section 42 of the Care Act is about safeguarding, giving Social Care a duty to make enquiries if they have reason to think that someone has needs for care and support, is at risk of abuse or neglect, and is unable to prevent him/herself against possible abuse or neglect.
Process for getting support
Young people or their parent carers can now request a Needs Assessment directly, using the Adults Portal Link here: https://adults.bathnes.gov.uk/web/portal/pages/home
To start a Transitions referral, click on “Preparing for Adulthood Transition Team Referral”. You will be taken to a page with guidance on how to use the form. You’ll need to create an account before you can access the referral form.
- Request a Needs Assessment (sometimes called a Care Assessment or a Transitions Assessment)
- Assessment must be completed in an “appropriate and reasonable timescale”
- Each identified need is assessed against national eligibility criteria
- Creation of a Care and Support Plan, which sets out how the individual’s “eligible needs” will be met.
- Financial assessment – Social Care support is means tested and individuals may be required to pay a contribution towards their care costs.
- Care is delivered either directly or via Direct Payments
Transitioning from Children’s Social Care to Adult Social Care
If your child or young person is already receiving support from Children’s Social Care, their social worker or other professional may make a referral to Adult Social Care from as early as age 14. The referral is considered by a Multi-Disciplinary Team (MDT) including the current professionals involved in the young person’s care, and planning for the transition can take place with Adult Social Care supporting care and transition pathways. After the young person turns 16, in some situations Adult Social Care may start an early assessment. Otherwise, at the age of 17-18, the young person has their first Care Act Assessment. From the age of 18, if they have eligible needs, care and support can be arranged by Adult Social Care.
It’s worth being aware that Adult Social Care has different boundaries to its Children’s equivalent, especially around the issue of consent. Adult Social care aims to promote a young person’s rights above all else, including parental responsibility. This can be tricky to navigate, but social workers are bound to respect the young person’s views: for example, if they divulge information to their social worker which they don’t want to be shared with parent carers, the young person’s preference is respected.
A Transitions Assessment would be undertaken at the most appropriate time for the Young Person regardless of their age or referral. This assessment aims to understand the care and support needs of the Young Person, contribute to any Education, Health and Care Plan (EHCP), and (later on) to understand the Young Person’s needs once they turn 18.
A Transitions Assessment should be requested as part of the Education, Health and Care Plan (EHCP) Annual Review, if it is likely the Young Person will have care and support needs once they turn 18. A young person will continue to receive existing care and support from Children’s Social Care and/or SEND whilst the Transitions Assessment is undertaken.
You can request a Transitions Assessment directly online on the same link as the Care or Needs Assessment: https://www.bathnes.gov.uk/transitioning-childrens-social-care-adults-social-care
Mental Capacity Act (2005)
The second presentation was on the Mental Capacity Act (MCA), which is designed to support vulnerable people who may lack capacity to make certain decisions, due to the way their mind is affected by illness or disability, or the effects of drugs or alcohol. It underpins the work of all professionals in social care who are involved in the treatment and support of people over the age of 16 who are unable to make some or all decisions for themselves. The MCA also supports everyone who currently has capacity and want to plan for the future.
The starting point for the MCA is always the presumption of capacity. A person has to be assessed as lacking capacity before decisions are made for them, and even then the legislation demands that the person is placed at the centre of any planning, which must take their preferences into account and must be “in their best interests”. It can be termed “no decision about me without me”. The key principle is to support the individual to make their own decision.
(Click on each of the following four headings to read more on each subject)
Fluctuating capacity
Some conditions such as episodic illnesses, some neurodivergent conditions, and selective mutism, can mean someone has capacity that fluctuates from day to day or possibly more frequently. If this is the case and their capacity fluctuates throughout the day, the social worker will take a “longitudinal approach”, working out the balance between them having and not having capacity.
No decisions made under this legislation are irreversible: the key principle is to support someone in a way which makes the minimum infringement and wait for capacity to return.
Advance decisions
If someone is 18 or over they can make an Advance Decision about how they wish to be treated. For example, if someone is epileptic they can use an Advance Decision about how they want to be treated if they are temporarily unable to express their preference.
If someone is under 18, they can express their preference in their Care Plan, but in that situation it is an Advance Statement and not legally binding, although caregivers and professionals must still take the young person’s views into account and put their preferences at the centre of any decision.
Consent
If a child under 16 needs to make decisions about their care and support, the principles used by professionals to assess whether they have capacity to do so are known as “Gillick Competency”. The term originates in a legal case from the 1980s and it usually refers to medical advice, but the NSPCC has a useful introduction to other aspects it can apply to here: https://learning.nspcc.org.uk/child-protection-system/gillick-competence-fraser-guidelines
From the ages of 16 and 17 a young person is presumed to have mental capacity unless they have been assessed under the Mental Capacity Act or under Parental Rights.
There is free training available for parent carers about assessing someone’s capacity and best interests here:Free training on mental capacity for parent carers
https://www.edgetraining.org.uk/edge-events
You can book on to a session on mental capacity on the 10th October, and more sessions on related topics will be added over the summer, here:
https://www.edgetraining.org.uk/event-calendar
Support from BANES PCF
At the PCF, we are always looking for ways to support parent carers in our area. Please let us know if there are topics you would like to see covered in our workshops, and please do contact us for tailored advice and signposting.
Our Support Line is on 01761 502515 or you can email us at .
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