Special Educational Needs and Disability (SEND) Reforms: towards Integrated working

1. Special Educational Needs and Disability (SEND) Reforms: towards Integrated working Nottinghamshire Pathfinder Project Team January 2014

2. The presentation aims to cover • Experience of the Nottinghamshire pathfinder • Reflections and learning that may be useful to voluntary sector colleagues

3. Case study: Why change? A more integrated approach will benefit children and families Over 50 services have supported her since she was born Worst month ever was Dec 2009 – 24 appointments in 17 days - etched on their memory forever! 35 services are currently involved, with six monthly reviews, some more often 11 year old girl and her family Attending 6-12 appointments a month (each can be up to ½ a day out of school)

4. Nottinghamshire’s Education, Health & Care Plan Pathway

5. Pathway Step 1: The Local offer Nottinghamshire are developing a multi media approach to information provision about services/ resources for use by families & services with:- • an integrated website is now in place building on family services directory for all services to input and to access information. • a mobile phone ‘app’ version is available • access to face to face support through key working/ family supporters. • Involvement of parents/ carers & other key stakeholders in development, updates and review.

6. Pathway Step 2: Referral Referrals are accepted from anyone……. • parents • young people • professionals involved with the child or young person They are submitted to the Multi-agency/ integrated Hub The referral process seeks information about: • parental responsibility • the child or young person’s needs • the reason for the request • which services/agencies are already involved • whether a CAF is already in place

7. Eligibility criteria for an Education, Health & Care plan in Nottinghamshire An integrated assessment & plan may be needed for a child/ young person with SEN & disabilities aged 0 to 25 with needs over & above those met at universal/targeted level, such as:- • Severe/ complex long term needs affecting everyday life • requiring provision & resources not normally available • requiring intensive help & support from more than one agency • making limited or no progress despite high levels of support   • are above statutory school age with evidence of a graduated response (appropriate interventions, support & resources, available through the Local Offer, have already been put in place.)

8. Timeline 20 weeks maximum Stage 2 Referral Stage 3 My Story Stage 4 My Plan Collect professional reports, ‘All about me’ Wiki pilot Gather all information Decision Prepare for MAM, Populate template Multi Agency Meeting Consider outcome of MAM and produce draft 4 weeks max Consult with parents Proposed EHC Allocate Resources and Budget Amend and finalise 6 weeks max Issue Final 2 weeks max 2 weeks max 2 weeks max 4 weeks max

9. Hub and spoke delivery model- linking services Education All About Me Multi- Agency meeting Voluntary & Community Sector All About Me All About Me Health Multi- Agency meeting Multi- Agency meeting SEND Hub Multi- Agency meeting Multi- Agency meeting All About Me All About Me Children’s Social Care Adult Social Care

10. Integrated Hub structure

11. An Integrated Hub Hub manager Hub Commissioners from • Education • Health • Children’s social care • Adult Social Care: • Post 16: Plan coordinators: 3 teams covering North, central and south (District placement assessment team plus relevant others TBC)

12. Parent/ family involvement • Parent Partnership Hub • Parents working with central pathfinder team • Detailed person centred case studies used to support training and illustrate need for change • Voluntary sector involvement in development and implementation of pathway e.g. A Place To Call Our Own- APTCOO

13. Pathway Step 3- Gathering information for the plan: “My Story” Each family will be allocated a worker in the hub and spoke. Both have a role in developing the plan Hub: Plan coordinator to draw the plan together Spoke: Family supporter, identified in agreement with the family from one of the services closely involved, fulfilling key working responsibilities. They will know the family well & will help gather person centred information ‘All about me’ to support EHC planning

14. Step 4: Gather information for ‘My plan’ The ‘All about me’ information gathered by family supporter is shared at the multi agency meeting. This information includes: • Relationship circle • Working/ not working • Like and admire • One page profile. • What is important to maintain a child/ young person’s health, safety and wellbeing. Some children/ young people and families are also piloting a ‘Wiki’ which also holds this information

15. Making‘My Story’ interactive

16. Background: Wiki Research with collaboration agreement in place with University of East London Easy-build web site platform (Klik In) being piloted to create personalised ‘wikis’with multi media technology to help tell a child/ young person’s story Multi perspective understanding quickly gained through photos, video, documents, text and web links Piloting ‘wikis’ with some children and young adults Evaluation will be undertaken across the control groups to inform our next steps Any services can access the ‘Wiki’ with family’s permission

17. Why a wiki supports integrated working ... Reduce the times families explain their story Reflects a whole day and not just the part of it that most professionals are likely to see Shows simple techniques used to fit equipment or ways to help with activities or encourage independence e.g. positioning Shows all those supporting a child an insight into their life Useful source of family held information for all services providing care or support

22. EDUCATION VOLUNTARY SOCIAL CARE Kath Beastall- Keyworker Children's Disability Services Meadow House 01623 433675 Downs Syndrome Association Notts Downs Syndrome Speech Group Alex Holland 01623 433077 Educational Psychologist New life (car seat) Ash lea school/ hydrotherapy 0115 9892744 Dilys Whitehead-Occupational Therapist Meadow House 01623 433077 School for Parents 0115 9586641 Bleby School 01656 830203 Contract care-Short breaks away from home -awaiting a family placement Direct payments team SEN services- educational statement Judith West (Teaching assistant) Bleby School 01656 830203 Inclusion support services Visual Impairment Team – Sue Newman 0115 8546024 Occupational Therapist 0115 8831101 PDSS OTHERS Shelagh & family- School friends Motability- Car Alicia, Richard George & Millie Family friends: Paul (Dad) John & Rachel (Uncle/ Aunt) Mobility Services- outdoor chair/ buggy Fennel- Dog Grandad Will Hannah Hoist Company – Astor Bannerman 01242 820820 RELATIONSHIP CIRCLE Claire Godmother Kirsty- friend at school Lily (Twin Sister) Granny Beth Home adaptation Home Oxygen company – Air Liquide 0808 143 9993 Continence supplies Karen, Steve Anna & Peter Village friends Ruth (Mum) Nana & Grandpa (Dad's parents Live in London) Carin4Families- short breaks at home & overnight (Continuing Care) Rachel Gregory- QMC 0115 9249924 ext. 62738 Dr Thomas- Respiratory services QMC 0115 9249924 ext. 62395 Mrs Tambe Opthalmology CDC 0115 8831156 Mr Marshall- ENT Audiology Ropewalk 0115 9485591 Dr Marder Paediatrician CDC 0115 8831156 Jo Farquarson 0115 8831110 Physiotherapist-CDC Kate Sutton- Speech & Language Therapist) Stapleford Health Centre 0115 8835187 HEALTH Dentist 0115 9603572 Cardiology GP 0115 9664120 Orthotics/ physiotherapy Neurology Chiropodist Children & Adolescent Mental Health Services CAMHS Miss Eastwood- Orthopaedics Great Ormond St. 0207 4059200 Children's Community Nurses (CCN'S) QMC Sensory services

26. Pathway Step 5: An integrated budget There are a number of different options being tested, depending upon level of responsibility a family wishes to take. These include: • Direct Payment • Individual Service Fund • Independent Third Party There will be a phased introduction. This will be supported by the Plan Coordinators and may require some independent support from a brokerage service.  

27. Step 4 & 7: Multi-agency meetings/ Review • Once ‘Like and admire’ & ‘what is working/ what could be improved’ are shared, outcomes areidentified for the Education, Health and Care Plan. The actions required to achieve the outcomes are agreed, along with the budget. • This is progressed at an initial facilitated Multi agency meeting, attended by key services involved • Timescales for further reviews/ multi agency meetings are agreed as the EHC plan is put in place • Many reviews have been run as person- centred meetings using a ‘working/ not working’ and other such approaches/ conversations.

28. Learning/ Reflections so far…….. • Babies, children and young people with complex needs generally have very complex arrangements in place to support them. Working in a more streamlined/ integrated way is a challenge for all involved! • Integrated teams may well develop to support the EHC pathway and process. Voluntary sector services need to be linked in. • Person centred tools/ conversations have worked well with services in many different settings, including voluntary sector. • Case studies are a useful & powerful resource to help make the case for change, demonstrating unique input of each service & showing where support could be more integrated or ‘joined up.’ • Families/ young people who have tested the Wiki to date like to be empowered, holding and developing information themselves and choosing who they wish to share it with.

29. Thank you for your attention The end