Respite Care for Children and Young Adults - Ministerial Response - 11 June 2012

Findings

Comments

1

The lack of regular, sustainable respite care services for the majority of the user group  is  unachievable  based  on  the current system. The Panel believes that a  significant  number  of  families  who would benefit from respite care are not receiving  it  because  of  a  poorly managed approach to assessing demand. A sustainable and reliable respite care service  is  important  to  help  prevent families reaching crisis point due to the stress of full-time caring. [Section 3.1]

The Minister takes note of the statement and undertakes to improve the methods of assessing demand for families in need (see  response  to  Recommendation  1). The  Minister  agrees  with  the  Panel's concluding statement.

2

The  failure  on  the  part  of  Social Services  to  proactively  identify  and support those families in greatest need before  they  reached  breaking  point ultimately precipitated 2 separate family breakdowns  and  significant  disruption to the rest of the respite care service. [Section 3.2]

The Minister refutes the suggestion that any  breakdowns  are  likely  to  be  the result  of  departmental  failures.  The process  of  identifying  and  supporting families  at  these  difficult  times  is complex  and  the  margins  between  a family  appearing  to  cope  and  any eventual  family  breakdown  are  often very fine, however, the Minister agrees that  the  knock-on'  consequences  for other families need to be minimised or removed.

3

There is no comprehensive data on the number  of  children  and  young  people with disabilities in Jersey or the nature of their disability. This makes assessing current  and  future  demand  almost impossible. [Section 3.3]

The Minister is aware of work already under  way  across  State's  departments and the voluntary sector to establish the current range of data collection' (within services) so that recommendations can be  made  about  addressing  any  gaps' within,  and  across,  service  provision. The Minister and the Children's Policy Group (CPG) will take a keen interest in the outcome of that work to establish voluntary  data  collection  in  these specialist areas

4

There are only 3 small residential respite homes offering respite care specifically for children with special needs: Oakwell, Eden  House  and  Maison  Allo. Furthermore, there are 2 sites offering respite  care  services  to  adults. [Section 4.8]

The Minister notes the comment.

5

Outreach for children is delivered from the same resources as that allocated to residential  respite,  which  restricts available outreach during busy periods. [Section 4.8]

The Minister agrees with the statement but  would  point  out  that  one  of  the difficulties  is  that  a  small  island community inevitably only has a limited supply of specialist staff who have the necessary  skills  and  experience  to respond  to  a  wide  range  of  complex needs.  The  Minister  commits  to developing  local  expertise  and  to working with the third sector to look at opportunities  for  other  ways  of supporting the outreach needs of service users.

6

The  third  sector  makes  a  valuable contribution to funding and supporting respite  care  in  Jersey.  Social  Services and the third sector would benefit from improving their lines of communication. [Section 4.11]

As  stated  above,  the  Minister acknowledges  the  vital  role  that  the third  sector  plays  and  is  pleased  to confirm that:

• Regular meetings have been arranged for  her  Ministerial  Team,  senior managers,  and  third  sector representatives  to  ensure  more effective  communication  and  joint working.

• The  appointment  of  a  Director  of Service Redesign within H&SS with a  specific  remit  for  commissioning services  from  external  agencies including the third sector.

• The  development  of  a  Third  Sector Forum and recruitment of a dedicated executive officer' for that group is also  seen  as  a  very  positive  move forward and should benefit improving communications.

• The  appointment  of  an  Assistant Chief Minister with responsibility for Social Policy.

It  is  anticipated  that  initiatives  for developing links further are likely to be a key theme of the Action for Children Review.

7

The  Panel  identified  3  main circumstances  in  which  the  current supply of respite care is failing to meet the  needs  of  the  community;  during emergency and crisis situations, during the  transition  phase  to  adulthood,  and during school holidays and after school. [Section 4.16]

The Minister agrees with the analysis of where  the  pressure  points  arise  and commits to addressing the issues under the  recommendations  (see  response  to Recommendation 7).

8

Emergency  care  is  currently  provided within the 2 States-run respite homes. This  has  meant  that  when  a  respite home is being used for emergency care, other families who would have normally been  provided  for  were  not  able  to access essential and short-term respite. [Section 4.17]

The  Minister  accepts  the  comments made  but  would  point  out  that  it  is inevitably  the  staff  in  these  very specialist'  respite  units  that  have developed  the  skills,  experience  and family relationships for managing these very  same  children  and  young  people who then present with emergency needs. As pointed out when the Minister gave evidence to the Panel, maintaining and staffing  a  separate'  facility  for emergency care' does not present value for money and will remain a significant challenge for a small island jurisdiction. This said, the Minister accepts that this is  the  area  we  now  need  to  address. Developments  around  professional carers', family link' or linked families' are all initiatives that will be explored and may offer effective solutions.

9

The lack of long-term care facilities for children with complex needs means that respite homes have been used for this purpose,  to  the  detriment  of  other residents. [Section 4.18]

The Minister agrees with this analysis and outlines plans for addressing this in the recommendations.

10

Families  face  significant  challenges when their child reaches the age of 18 and  moves  from  Children's  to  Adult Services, especially as the system does not provide for a personal care plan or individualised budget. Instead, access to necessary  support  services  depend  on the resources available within the Adult Services  budget  at  the  time. [Section 4.19]

The Minister is committed to working with the Council of Ministers to explore the  most  effective  means,  across departments,  of  meeting  the  needs  of those children, young people, and their families who are most vulnerable and in need  of  support.  Whilst  all  clients receiving  services  already  have individual  care  plans;  further  work  is required,  with  a  variety  of  States Departments, to establish individualised budgets.

11

Once  young  people  leave  full-time education the range of available respite type  services  changes  dramatically. Furthermore opportunities available for young  adults  with  special  needs  in Jersey  in  terms  of  access  to  training, employment or day services are limited. [Section 4.21]

The Minister can confirm that over the last  2  years  significant  investment (£475K per annum) has led to effective adult  respite  services  being  developed and contracts for service provision are now in place. This consists of a range of residential  respite  beds;  outreach services;  specialist  sitting'  services; and  bespoke  support  for  individuals with  complex  needs  and  challenging behaviour.  Additional  to  this,  is prioritised  access  to  the  adult  day services,  as  an  essential  respite

provision.

The Minister also acknowledges that the States have made significant investment (circa  £700K)  to  enhance  appropriate specialist employment services through the Jersey Employment Trust.  

12

At  the  end  of  full-time  education  the personal commitment required from the carer increases dramatically. As a result some  have  to  give  up  work  which affects their ability to deal with the day to day financial matters that many of us take for granted. [Section 4.22]

The  Minister  notes  the  comment  and recognises the likely impact where this occurs.

13

The  Department's  perceptions  of  the transition  service  are  unrealistic.  The current transition system does not work properly,  reflecting  problems  with  the delivery  of  transition  support  by  2 separate services. [Section 4.23]

The  Minister  is  aware  that  this  is another area where Action for Children has  considerable  expertise  and anticipates that their report (due end of June 2012) will be helpful in identifying the  options  for  properly  developing local service provision across different areas, and involving a range of health, social care, and educational services.

14

Children  with  special  needs  are  at  a distinct  disadvantage  compared  with their  able  bodied  peers  in  terms  of choice  of  holiday  and  after-school activities.  This  places  an  additional burden on  the  carer,  who  is  trying  to balance work and family life with the needs of their child. [Section 4.24]

The  Minister  notes  and  accepts  the comments made. As previously stated, the  Minister  is  fully  committed  to working with the third sector to look at all  options  for  early  intervention  and specialist support of the type likely to be required to meet these identified needs.

15

The States do not have a duty of care to provide  respite  care  for  families  in Jersey,  nor  a  clear  social  policy  that enshrines  the  rights  of  the  most vulnerable in society. This is in contrast with almost every other UK jurisdiction, as well as the Isle of Man. [Section 5.1]

The  Minister  notes  and  accepts  the comments. She would advise that CPG has  initiated  a  structure  of  delivery groups'  to  bring  forward  appropriate proposals  under  their  Children  and Young  People's  Strategic  Framework' initiative,  one  of  which  is  a Performance and Planning Group'. One of their key responsibilities is to lead on development of initiatives which cut across all 6 working groups' and one of the  areas  already  agreed  for development  is  a  legal  review'.  The Minister  undertakes  to  ensure  the highlighted issues are considered by this group.

16

There  is  a  need  for  a  more  coherent, joined-up  approach  to  assessment  to address the holistic needs of the child

The Minister notes the comments and confirms  that  CPG  are  overseeing  the development  of  a  local  pilot  project'

and  the  family.  Eligibility  for  respite care  is  dependent  on  someone  being referred by a GP or by contacting the Special  needs  service  directly. Following  a  referral  to  the  Special Needs  team  an  Assessment  of  Need should  be  produced  by  the  Social worker  assigned  to  the  case.  The Department  is  looking  to  pilot  the Common  Assessment  Framework  as Jersey  has  not  yet  reached  the  point where  all  parties  contribute  to  one singular assessment. [Section 5.5]

for  the  Common  Assessment Framework, programmed to commence in September this year.

17

The referral process for respite care can be  intimidating  for  some  parents,  and without  the  support  of  an  advocacy worker some families may never be able to  access  the  necessary  support. [Section 5.7]

The Minister notes and recognises the impact  of  the  identified  issue.  The Minister believes this may be an area where  the  third  sector  could  make  a significant contribution and undertakes to explore the options whilst developing her plans for service improvement.

18

Some  professionals  working  with children with autism are concerned that clients are not receiving diagnosis early enough or, in some cases at all because of a squeeze on resources available for this client group. This also impairs the ability of the service to respond to new instances  of  need  as  they  arise. [Section 5.8]

The Minister strongly refutes the notion that any diagnosis would be delayed on financial  grounds  and  would  like  to clarify that the diagnostic process and management  of  resources  are independent of each other.

The  diagnosis  and  assessment  are provided by clinicians and professionals from  both  Health  and  Social  Services and  Education,  Sport  and  Culture  and the  process  is  audited  against  recent National  Institute  for  Health  and Clinical  Excellence  (NICE)  guidance. Children receive a diagnosis of Autism when they meet all the relevant criteria.

19

There is no evidence of formal criteria to  assess  a  family's  need  for  respite care, nor a written down Departmental policy with regard to how respite care should  be  accessed  and  delivered. Eligibility  for  respite  is  currently assessed  through  professional judgement and the severity of the family situation,  which  in  times  of  respite shortage  has  meant  that  families  are forced  to  breaking  point  to  access services. [Section 5.9]

The Minister notes the comments and accepts  the  value  of  being  able  to establish a framework for clear access criteria.  In  order  to  achieve  this, resources will be deployed to investigate best  practice'  in  UK  authorities,  in order to then establish a framework for Jersey,  so  that  a  written  departmental policy  can  be  ratified  by  the  end  of 2012.

20

Information about what respite services

The  Minister  recognises  that  her

are available and how to access them is minimal,  hard  to  find  and  poorly signposted by professionals. The Panel was told that the Department seeks to avoid  unnecessary  intrusion  into people's lives. However, this approach was felt to be a barrier to some families gaining access to services at an earlier stage. [Section 5.10]

department  should  be  more  proactive and  inform  the  public  about  available service  provision,  whilst  taking  into account  that  there  is  a  balance  to  be struck,  to  avoid  unnecessary  intrusion into  people's  lives.  Work  is  currently under  way  on  developing Communication  and  Engagement Strategies  (Recommendation  4  of Children's  Services  –  Improvement Plan 2012-2013') for all areas of service provision and the particular needs in this area will be a key component.

21

Social  Workers  currently  assigned  to work  with  families  of  children  with special  needs  are  held  in  very  high regard.  However,  there  is  a  lack  of Social  Workers  available  to  support those  parents  of  children  with  special needs. [Section 5.11]

The Minister is pleased to acknowledge and  endorse  the  value  of  staff  in  this area and notes the comment about level of service provision. Further comment on this issue is given in the response to Recommendation 22.

22

Whilst Oakwell is currently providing a good service in terms of quality of care, the Panel is concerned that the physical environment fails to meet modern day standards. [Section 6.1]

Work is currently under way, alongside Jersey Property Holdings, to review all physical  residential  environments  for children  and  young  people  within Children's  Services  (as  per Recommendation  21  of  CS  – Improvement  Plan).  The  Minister undertakes  to  ensure  that  all  respite' provision is included in that review and monies  to  improve  the  children's services estate, which including respite provision, have been requested via the Capital element of the States Medium Term Financial Plan.

23

The Panel was advised that when Eden House  was  constructed  in  2004,  it would not have passed UK inspection according to the minimum criteria laid down for Children's Homes that relate specifically to health and safety criteria for  children  with  Autistic  Spectrum Disorders  and  emotional  and behavioural  difficulties.  The  current refurbishment aims to address these key issues.  However,  the  building  is  only suitable  for  primary-school  aged children, not the adolescent group that is currently using it. [Section 6.2]

Please  refer  to  comments  under  22' above  –  this  review  will  also  look  at Eden  House  and  the  current  and  on- going needs of their client group.

24

There  are  less  adult  respite  facilities compared  to  children's  facilities,  and

It is agreed that there are less residential respite  beds  available;  however,  as

those that exist sometimes compromise the wellbeing of the client to cope with the existing provision. [Section 6.3]

identified in 11 above, there is a broader range' of services available for adults. These  services  reduce  the  need  for  a higher  number  of  residential  beds. Where there are concerns that any of the current provision would compromise the well-being  of  an  individual,  it  is expected  that  this  will  be  addressed through  the  re-tendering  process, currently  under  way.  This  process  is fully supported by representation from the  Carers  Association,  with  parents represented on the Panel.

25

Parents  highlighted  the  importance  of continuity in terms of staff caring for their children. The Panel recognises the importance  of  having  appropriately trained  staff  to  care  for  children  and young people with special needs in any setting – public or private. [Section 7.2]

The  Minister  notes  and  accepts  the comments made.

Recommendations

To

Accept/ Reject

Comments

Target date of action/ completion

The  Minister  for  Health and  Social  Services should  ensure  the following –

1

That  demand  is  properly assessed  by  undertaking research  aimed  at identifying all families who would benefit from respite care. [Section 3.1]

Accepted

Presently  Community  and Social  Services  commission specialist advice and support from Richard Mills, Director of Research with the National Autistic  Society.  Richard Mills  has  agreed  to  support this essential work in order to consider the most appropriate way  to  establish  the  data required  to  establish  need, and then to support agencies in  obtaining  the  required data.  This  can  be  achieved within  the  existing  contract, which is already in place.

Qtr 4 2012

2

That the Department adopts a more proactive approach to  assessing  demand  and develops  a  range  of  early intervention programmes to

Accepted

The  Department  will  be developing a range of early intervention  programmes'  as described in the white paper Caring for each other, caring

2013 on.

avoid  families  reaching crisis  point.  This  would prevent  disruption  to  the respite service and to other families  receiving  regular respite. [Section 3.2]

for ourselves', which is going to  be  laid  before  the  States for approval in autumn 2012.

There will also be a review of the  delivery  of  social  work services to focus on priority areas. – this will include the configuration of social work teams, use of Family Support Workers within families, and the  method  of  delivery  of respite care / outreach work.

Qtr 3 2012

3

An  information management  system  is developed  to  capture  the needs  of  the  island's families  who  care  for children with special needs. This data is captured from existing  sources  of knowledge  (i.e.  healthcare and  education professionals). Consideration  is  given  to using  the  next  Social Survey  to  gather comprehensive information about  individuals  with special needs. [Section 3.3]

Accepted

(cross-reference  with Recommendations  2  and  11 of the Children's Services – Improvement  Plan  2012- 2013')

The  above  referenced document  already  has  2 associated  recommendations that  seek  to  establish  a framework'  for  collecting, collating,  monitoring  and developing  performance, within all areas of children's services.  The  Minister undertakes to ensure that the needs  of  families  who  care for  children  with  special needs will be a key part of that development.

There  are  potential  data protection and rights' issues which  will  have  to  be explored  in  terms  of  using existing  sources  of knowledge', but the principle is accepted and the work on the information management system' will be progressed as outlined above.

The Minister is supportive of seeking  to  utilise  the  next Social  Survey  to  gather  the suggested  data  but  would highlight  the  fact  that  this could  only  be  done  on  a consensual'  basis  and  there may  be  individuals  and families who would not wish to  disclose  this  sensitive information.

The  Minister  undertakes  to ask CPG to approve a request to those organising the next

Qtr 4 2012

TBA

CPG Meeting: 27.07.12

Social Survey, so this can be considered for inclusion.

4

Residential  and  other respite  services,  including outreach, for both children and  adults  are  fit  for purpose and able to cater to both  current  and  future demand. [Section 4.8]

Comment

The Minister believes that the key  issues  identified  in  this report  are  likely  to  be supported  and  enhanced  by findings from the Action for Children Review that she has initiated,  and  which  will  be reporting back by the end of June 2012.

The  Minister  undertakes  to develop an appropriate action plan  for  addressing  agreed recommendations,  from across  these  two  reports, which  will  be  presented  to CPG  for  integration  within the  Children's  Services  – Improvement  Plan  2012- 2013.

Ultimately,  the  quality  and quantity  of  resources available will be determined by  the  States  Assembly's allocation of resources in the medium term financial plan, due  to  be  debated  in November.

End June12

CPG Meeting: 27.07.12

October 2012

5

A  formal  partnership  is entered into with the main third sector organisations in order  to  deliver  the necessary  improvements  to the range of respite services available  to  users. [Section 4.11]

Accepted

As stated above, the Minister believes  that  Action  for Children are likely to be very supportive  of  third  sector involvement  and  anticipates that  their  recommendations will identify areas which her officers  will  be  able  to develop  alongside  existing and  future  third  sector partners.

Comment – (cross-referenced with  Recommendation  12  of the  Children's  Services  – Improvement  Plan  2012- 2013')

There  is  already  a commitment  to  develop  a comprehensive commissioning  strategy  for children's  services'  and  the Minister  undertakes  to include  and  integrate  any agreed needs identified in this specialist area.

Qtr 4 2012

Qtr 4 2012

6

The Community and Social Services  Department  is properly  resourced  and staffed accordingly to meet both  current  and  future demand. [Section 4.16]

Comment

The  quality  and  quantity  of resources  available  will  be determined  by  the  States Assembly's  allocation  of resources in the medium term financial  plan.  The  Minister will set out her proposals in the White Paper and will seek the  Assembly's  support  to meet both current and future demand, due to be debated in the Autumn.

7

Emergency  care  facilities are  identified  as  soon  as possible to reduce the strain on respite care homes. This is  especially  important  for young  people  with  autism who  are  more  likely  to become difficult to manage in  the  home  during adolescence. [Section 4.17]

Comment

Action  for  Children  will  be delivering  their  report shortly.  In  addition  to  this, Community  and  Social Services  is  working  with Jersey  Property  Holdings  to review all of its buildings to clarify  the  future  needs  for service  delivery.  This  will include  any  provision  for specialist respite care, as well as  addressing  the  needs  of young people requiring long term care.

End June'12

Qtr 3/4 2012

8

Plans  are  prioritised  for alternative  sites  for  long- term care, and are in place as  soon  as  possible.  Any provision  to  take  into account  an  expansion  of demand and be able to cater for multiple crisis scenarios occurring at any one time. [Section 4.18]

Comment

Comments  in  7  above  are relevant to these issues, and in  addition  there  will  be specific  plans  to  deal  with any  immediate  situation which  may  require  UK placement.

As  pointed  out  when  the Minister gave evidence to the Panel,  maintaining  and staffing  a  separate'  facility for emergency care' does not present value for money and will  remain  a  significant challenge  for a  small  island jurisdiction.  This  said,  the Minister  accepts  that  this  is the  area  we  now  need  to address.  Developments around  professional  carers', family  link'  or  linked families'  are  all  initiatives that will be explored and may offer  more  effective solutions.

9

Transition  planning  starts as  early  as  possible  and Children's  and  Adult's Services  communicate

Accepted

Presently  a  senior  officer within  Community  and Social  Services  is commissioned  with

Qtr 3 2012

better to ensure services do not "drop off" at 18 years. Ultimately,  all  children with special needs to have a personal  care  plan  and individualised  wraparound budgets  that  follow  them throughout  their  lives  to ensure the transition period is as seamless as possible. [Section 4.19]

reviewing  the  existing Transition  Policy,  alongside key partner agencies, with an aim  to  improve  both  the process  and  the communication  required  at this critical time for families and individual young people.

With  the  inception  of  the H&SS  White  Paper,  and work  streams  across  the children,  adult  and  older adult service areas, there is a proposal  for  an  additional social  worker  within  the Adult Social Work Service to provide  a  lead  on  transition planning.

Whilst  the  Minister recognises  the  benefits  of individualised  wraparound budgets she would emphasise that  this  will  require  the support and co-operation of a number  of  other  relevant States departments.

Qtr 4 2012

10

Close  working  with  other government  and  third sector  organisations  is undertaken  to  further develop  the  range  of services  available  for young  adults  with  special needs.  Good  relationships with  local  employers  are fostered to ensure that there are opportunities for young adults with special needs to make  a  contribution  to society. [Section 4.21]

Accepted

Community  and  Social Services has, for many years, been an active participant in the  Jersey  Joint  Secretariat for  People  with  Special Needs.  As  a  multi  agency forum  this  has  provided  a good  opportunity  to  ensure that  there  is  both  good relationships  and  close working  across  all  relevant States  Departments  and partner agencies, in both the private and third sectors. This forum has played a positive role  in  actively  supporting significant  developments within  both  employment services and adult education services;  to  enhance  the opportunities  available  to young adults with disabilities. C&SS  are  committed  to continue  to  provide  positive involvement with this forum, and are actively involved in its  present  endeavours  to improve its role and purpose.

On-going

11

The parent's ability to work and care for their family is

Accepted

As  previously  indicated,  in recent years C&SS has been

On-going

supported  as  much  as possible  and  resources  for adult  respite  care  and outreach  are  increased where  appropriate. [Section 4.22]

successful  in  acquiring appropriate  resources  to establish  a  framework  of effective short break services. These  include  residential respite  beds;  outreach services;  specialist  sitting services;  and  specialist support  for  people  with complex  and  challenging behaviour. C&SS is presently completing  its  review  of these services and the second tendering  process  for  the continuation  of  this comprehensive  range  of essential  services  is  under way.  This  process  is supported  by  representation from  the  Carers  Association and  the  States  of  Jersey Procurement Department.

Along  with  this,  there  are significant  developments within  Adult  Day  Services, available through Community and  Social  Services.  This includes the completion of a process of  consultation  with service users, culminating in the  recently  published Heartfelt' report – The Big Say'. The aim is to improve the  quality  and  range  of support services available to people who rely on essential day time respite services.

12

A  standalone  Transition Team' is established to help parents  and  children navigate  the  difficult journey from Children's to Adult  Services. [Section 4.23]

Comment

As  indicated  in Recommendation  9: Presently  a  senior  officer within  Community  and Social Services is reviewing the existing Transition Policy along  with  key  partner agencies including ESC.

The aim is to improve both the  transistion  process  and the communication at what is a  critical  time  for  families and individual young people.

Whilst  the  Minister acknowledges  the  need  to improve  the  process  and  is committed  to  doing  so,  the Minister is reluctant to create another  stand  alone'  team.

Doing  so  would,  in  effect, simply  create  an  additional third  transition  point  for service  users  (i.e.  from Children's  service  to transition  team  to  adults services)

13

Where a childcare ratio is 2:1  or  above  within  the school  or  respite  facility, support is tailored to reflect that additional need in the home  environment. [Section 4.24]

Comment

All  support  packages, whether within school or the family  home,  result  from  a thorough assessment process. It  is  recognised  that  the school  environment  is  very different to the family home, and it is not always necessary to replicate support from one environment  to  another. Support packages need to be based  on  the recommendations  from  the assessment process

14

Resources are identified to fund  more  holiday  club provision,  in  conjunction with  the  third  sector  and Mont  à  l'Abbé  School. [Section 4.24]

Comment

The delivery of holiday club provision  is  currently organised through Education, Sport and Culture. Discussion will take place between ESC and  H&SS  to  address  the adequacy  of  current provision.

Qtr 3/4 2012

15

Community care legislation is  brought  in to  safeguard the  rights  of  vulnerable children  and  young  adults with  regard  to  respite  and other  support  services. [Section 5.1]

Accepted

The  Minister  advises  that CPG has initiated a structure of delivery groups' to bring forward  appropriate proposals  under  their Children  and  Young People's  Strategic Framework' initiative, one of which is a Performance and Planning  Group'.  One  of their key responsibilities is to lead  on  development  of initiatives  which  cut  across all  6  working  groups'  and one  of  the  areas  already agreed for development is a legal review'. The Minister undertakes  to  ensure  the highlighted  issues  are considered by this group for future  legislative development.

Qtr 1 2013

16

A  Common  Assessment Framework is introduced to make  assessment  quicker and  easier  to  understand,

Comment

(cross-referenced  with Recommendation  17  of  the Children's  Services  – Improvement  Plan  2012-

and  to  ensure  that  all relevant  parties  are involved at each stage. The Record  of  Need  is strengthened  to  ensure  the overall  needs  of  the  child are  met,  as  well  as  the educational  needs. [Section 5.5]

2013')

There  is  already  a commitment  to  develop  an Island  Assessment Framework'  and  a  pilot project  has  been commissioned  for commencement in September this year. This work is being undertaken  under  the umbrella  of  the  CPG,  with Community  and  Social Services  working  closely alongside  the  Jersey  Child Protection  Committee.  The outcome of this pilot will be evaluated  and  appropriate recommendations  submitted to CPG in due course.

The Children's Complex and Additional  Needs  Team commits  to  working  with colleagues  in  Education, Sport and Culture to explore opportunities  for strengthening  individual Records of Need, as they are produced  and  reviewed,  by that department.

Sept. 2012

Qtr 3/4 2012

17

Community  and  Social Services  are  re-named Community  Services  as part of a wider programme of  communication  about services  available  to members  of  the community. [Section 5.7]

Rejected

The  Minister  has  given thought  to  this  proposal  but would  point  out  that  many other  government  and  third sector/parochial  providers also  deliver  community services',  with  varying definitions  of  what  may constitute those services.

18

Advocacy  services  are established to help parents navigate  the  referral process  and  to  access respite. [Section 5.7]

Accepted

The  Minister  anticipates similar  proposals  from Action  for  Children  and awaits their recommendations concerning  the  possible remit,  availability  and funding  options  for  a  third sector provider to be active in this area of work.

Qtr 3/4 2012

19

The  current  criteria  for diagnosing  children  with autism  are  clarified.  The financial  consequences  are not  the  determining  factor when deciding the level of respite  required  by  a diagnosis.  Resources  are

Comment

As  noted  in  response  to Finding  18,  the  Minister strongly  refutes  the  notion that diagnosis is delayed on financial grounds.

The  diagnostic  process  and management of resources are

increased  to  allow  respite providers to respond to new clients  as  appropriate. [Section 5.8]

independent of each other.

The diagnosis and assessment are  provided  by  clinicians and  professionals  from  both Health  and  Social  Services and  Education,  Sport  and Culture  and  the  process  is audited  against  recent National Institute for Health and  Clinical  Excellence (NICE)  guidance.  Children receive a diagnosis of Autism when  they  meet  all  the relevant criteria.  

20

There  is:  (a)  a  formal policy  outlining  their approach to respite care and

(b)  a  set  of  detailed guidelines  for  professional gatekeepers' charged with assessment  and  referral. [Section 5.9]

Accepted

Action  for  Children  will  be asked  to  work  with  key service managers to develop the  necessary  policy  and guidance,  ensuring  that  it meets  current  national  best practice'.

Qtr 3/4 2012

21

A communications strategy is developed to outline all the respite support services available  to  parents  and how  to  access  them.  This information is to be made freely  available  to  all families caring for children with special need, as well as  being  uploaded  to  the Gov.je  website  and disseminated  to  all  health professionals,  educational establishments  and  parent support  groups. [Section 5.10]

Accepted

(cross-referenced  with Recommendation  4  of  the Children's  Services  – Improvement  Plan  2012- 2013')

Following  developments from  the  recent  Service Improvement Plan, a working group has been established to develop  a  communication and engagement strategy for all  areas  of  Children's Services.

Qtr 4 2012

22

At least 1x additional full- time  Social  Worker  post assigned  specifically  to children with special needs is  created.  Equally, additional  Support  Worker posts for this user group are created  to  relieve  the burden on Social Workers' workloads. [Section 5.11]

Comment

The Minister is awaiting the report  from  Action  for Children which will comment on the provision of services in this area. There is a further internal  assessment  of  the delivery  of  social  work services across the whole of the Children's Services. This will  make  recommendations for  the  future  allocation  of social work resources.

Qtr 3 2012

23

The  future  of  Oakwell  is decided  in  terms  of refurbishing  the  current site, or constructing a new

Accepted

A recent report has reviewed the  buildings  across  certain areas  of  Children's  Service and has commented on their

Qtr 4 2012

purpose-built facility in an alternative  location  in conjunction  with  the  third sector.  Any  plans  should take into account the rising demand  for  respite  care. [Section 6.1]

suitability. This process will now be  extended  to  include the facility at Oakwell. This will  ensure  an  independent assessment of the building at Oakwell  and  will  highlight specific recommendations for future provision.

24

Future  residential developments  for  any group  with  special  needs must  take  into  account minimum  environmental standards  in  the  early planning stages. The health and  safety  of  staff  and residents  is  not compromised  by  cost- cutting  measures. [Section 6.2]

Accepted

Since 2008, Community and Social  Services  has  made significant  progress  on  its strategy to improve the estate available  for  service provision.  This  has  resulted in the closure of a number of existing  properties,  and  the commissioning of a variety of more  appropriate  housing options.

This  strategy  has  also identified  significant  capital investment  for  the  period 2013–2015  for  new  build accommodation. Negotiations are  also  presently  underway with  both  the  Housing Department  and  Jersey Property Holdings in relation to appropriate developments.

2013 – 2015

25

Risk management for adult respite  services  are managed  according  to  the needs  of  the  individual rather  than  to  the  facility. Clients  of  differing abilities, ages and genders who  are  occupying  the same  residential  area should be appropriately risk managed  at  all  times. [Section 6.3]

Accepted

Within  Community  and Social  Services,  there  are robust processes in place for risk  assessment.  This  is imperative  due  to  the complex nature of the people who  rely  upon  the appropriate services.

Any concerns about potential risk  to  specific  adults,  are addressed through the social work assessment of need, in liaison with the Adult Respite Co-ordinator,  and  the relevant provider.