Short breaks practice guidance; how to safeguard and promote the welfare of children in need using short breaks
- Introduction – Why do we need the guidance?
- Definition – short breaks
- The legal framework
- Assessment, planning and review
This guidance sets out existing requirements in Part 3 of the Children Act 1989 (“the 1989 Act”) about how to safeguard and promote the welfare of children in need and clarifies the application of these requirements in short break provision. It is part of the Government’s commitment in Care Matters to ‘issue statutory guidance (within the revised Children Act 1989 guidance) specifically on the issues of support/short break care to clarify the applicable regulations for different settings and arrangements. The guidance will set out the circumstances in which it would be expected that the child would be looked after’ (para 2.33).
It is necessary to issue this guidance on short break services for the following reasons:
- There is some confusion in the field about how legislation applies to short break provision and the corresponding guidance that should be followed. There is also a worrying degree of non-compliance with established measures designed to safeguard and promote the welfare of particularly vulnerable groups of children.
- Some of the requirements pertaining to looked after children are being applied mechanistically to short break provision without recognising that it is the parents, not the local authority, who have the main responsibility for looking after their child.
- Aiming High for Disabled Children (AHDC) requires a rapid rise in the amount of short breaks available to disabled children and their families. Greater clarity about the legal requirements is therefore timely, not least because the pattern of short breaks has changed substantially since the publication of the 1989 Act guidance. In summary there has been a shift away from longer periods in residential or foster care to shorter periods often in the child’s own home or community. Many of these services are now provided through direct payments.
- Practitioners and families will be aware of the particular vulnerabilities of disabled children. They are more susceptible to bullying, to abuse and to mental health disorders. Their families are more susceptible to higher levels of stress, lower levels of parental well-being and poverty. It is therefore particularly important that good services are available to these families and that the services are provided with appropriate levels of safeguards.
This document provides guidance on the family support provisions of the 1989 Act and the duties of local authorities to safeguard and promote the welfare of children in need. Local authorities should have a coherent approach for providing short breaks based on the requirements of Part 3 of the 1989 Act. Further guidance will be published in 2010 about the specific duty on local authorities (see paragraph 6(1)(c) of Schedule 2 to the 1989 Act) to provide services designed to assist individuals who care for disabled children to continue to do so, or to do so more effectively, by giving them breaks from caring.
This practice guidance describes an approach focussed on the needs of the child and family with a proportionate approach so that the level of administration and regulation increases in line with the levels of need of the family and the levels of services required to meet these needs. While the needs may be met in different settings with necessary differences in regulation, it will be helpful to providers, commissioners and families for short breaks to be viewed as one coherent package of family support, planned and reviewed as a whole. Simplicity will facilitate transparency for families and compliance from agencies.
This guidance recognises that some children in need, particularly disabled children, receive such a high level of short break provision that they are properly included in the same system of safeguards which applies to children who are looked after by local authorities. At the same time many children receive only a small amount of short break provision and this guidance encourages an approach where the regulatory requirements are appropriate and proportionate to the nature of the individual package of short breaks.
- sets out the statutory framework for the provision of short breaks;
- refers to the different registration requirements and inspection standards which apply to the different settings where short breaks might take place;
- emphasises the importance of assessment, planning and review to safeguard and promote the welfare of children in need;
- sets out the circumstances in which it would be expected that a child would and would not be looked after; and
- emphasises the role of parents and children in determining the shape of their family support service
It focuses primarily on disabled children who are the primary users of short breaks. However the legislation underpinning short break provision applies to all children in need and therefore so does this guidance.
2. Definition – short break services
Short breaks are part of a continuum of services which support children in need and their families. They include the provision of day, evening, overnight and weekend activities for the child, and can take place in the child’s own home, the home of an approved carer, or in a residential or community setting. Short break provision provides the opportunity for children to enjoy new experiences and develop relationships beyond the family as well as allows the child’s carer to gain a break from their caring obligations. This will normally mean the child and the main carer spending a short period away from each other, although some carers may prefer to gain a break without being in different location from the child.
A short break service is a specialist service and should not be confused with accessible universal provision.
3. The legal framework – Safeguarding and promoting the welfare of children in need
Part 3 of the 1989 Act sets out local authorities’ powers and duties to provide support services for children in need and their families. Section 17 of the 1989 Act requires local authorities to provide a range of services including accommodation to assist children in need. Section 17(1) gives the guiding principles of family support which should ‘safeguard and promote the welfare of children in need’, and ‘so far as is consistent with that duty…promote the upbringing of such children by their families’. The definition of children in need includes children who are disabled within the meaning of the 1989 Act. Local authorities provide a range of short break provision under section 17 of the 1989 Act.
Local authorities should always be clear about the legal basis on which services are provided and their decision should be informed by their assessment of the child’s needs and take account of parenting capacity; the wishes and feelings of the child and his parents; and the nature of the service to be provided.
3.1 The provision of accommodation – Sections 17(6) and 20(4) of the Children Act 1989
This guidance amends LAC(2002) 13, guidance on accommodating children in need, only in respect of providing accommodation to children for short breaks. The rest of this LAC continues to apply and is part of a wider process of reviewing and editing existing guidance and circulars.
Local authorities can provide short break accommodation under section 17(6) (a power to provide accommodation as part of a range of services) or under section 20(4) which states ‘A local authority may provide accommodation for any child within their area (even though a person who has parental responsibility for him is able to provide him with accommodation) if they consider that to do so would safeguard or promote the child’s welfare.’
Looked after status
A child is not “looked after” within the meaning of the 1989 Act if the child receives a short break under section 17(6) of the 1989 Act.
However, if the accommodation is provided-
(a) under section 20(4); AND
(b) for a continuous period of more than 24 hours,
then the child is “looked after” by the authority for the period in which the child is accommodated.
If the child is looked after, then the placement must meet the criteria set out in section 22C of the 1989 Act i.e. be a placement with local authority foster parents or in a registered children’s home; or other appropriate arrangements. In these circumstances, the placement must comply with the Care Planning, Placement and Case Review (England) Regulations 2010 (“the Care Planning Regulations”) which require the local authority to make short and long term arrangements for the child’s care (i.e. have a care plan) amongst other matters. Regulation 50 of the Care Planning Regulations specifies the arrangements which must be made in respect of a child who receives a series of short breaks in the same placement.
If the short break is for 24 hours or a shorter period, the child is not “looked after” even if the accommodation is provided under section 20(4).
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.
Guidance on the approach to be taken by local authorities when deciding to provide short break accommodation under section 17(6) or under section 20(4) follows on page 15.
3.2 The duty to provide short breaks (Paragraph 6(1)(c) of Schedule 2 to the Children Act 1989)
Section 17 (1) of the 1989 Act states that it is the duty of every local authority to safeguard and promote the welfare of children within their area who are in need by providing a range and level of services appropriate to those children’s needs. Clearly short break provision contributes towards this duty.
New paragraph 6(1)(c) of Schedule 2 to the 1989 Act now makes this explicit by placing every local authority in England and Wales under a new, specific duty to provide services designed to assist individuals who care for disabled children to continue to do so, or to do so more effectively, by giving them breaks from caring.
The new legal provision makes it clear that breaks should not just be provided to those carers struggling to maintain their caring role, but also to those for whom a break would improve the quality of the care they can offer. Short breaks should therefore not just be used as a crisis intervention, but should also be used routinely to help parents and carers to maintain and improve the quality of care they naturally wish to provide.
In addition, the new regulation-making power at paragraph 6(2) of Schedule 2 to the 1989 Act provides the Government with powers to make regulations that set out in detail how local authorities must perform the new duty. The Government intends to bring the new duty into force in April 2011, and to make regulations at the same time.
3.3 Regulation of short breaks for looked after children
The Care Planning Regulations are modified in their application to short breaks in recognition of the continuing active role played by parents. The modifications will reduce the administrative load and ensure requirements are more proportionate to the needs of children in short breaks.
Regulation 50 of the Care Planning Regulations allows for a series of pre-planned short breaks for a particular child in the same placement to be treated as a single placement for the purposes of applying the Care Planning Regulations. In addition, the planning arrangements required by the Care Planning Regulations are modified in respect of short breaks so that they are more appropriate for situations where the child’s parents are properly planning for their child’s future and the child is provided with a series of short breaks as a measure of family support. Regulation 50 only applies in those circumstances where no single placement lasts more than 14 days and the total of short breaks in one year do not exceed 60 days. Where children are away from their parents for longer periods the Care Planning Regulations will apply with full force to each separate placement.
Short break planning requirements
The purpose of the plan for a child in a short break is substantially different from the plan for a child who is looked after continuously. In short breaks the parents have primary responsibility for planning their child’s future, although the family may often seek advice and support from the local authority in meeting their child’s needs. The short break care plan therefore should focus on setting out those matters which will ensure that the child’s needs can be fully met while the child is away from his parents.
The short break care plan should address
- the child’s health, emotional and behavioural development including full details about any disabilities and specific communication needs the child may have, so that those caring for the child may do so safely and sensitively;
- arrangements for contacting the parents as necessary, in particular, an emergency contact number;
- the child’s leisure interests including activities the child particularly likes or indeed does not like; and
- how the carers, as appropriate, promote the child’s educational achievement. For example, visits undertaken by the carers with the child may complement the child’s school learning, or some help with homework may be required especially if the child goes to school directly from the short break before returning home.
In addition each short break care plan must include, as appropriate, information set out in paragraphs 3 and 4 of Schedule 2 to the Care Planning Regulations. There is not a requirement for a separate placement plan for children looked after in a series of short breaks but the short break care plan must address the following questions insofar as they are appropriate to the placement in question:
- the type and address of the accommodation and the name of the person responsible;
- how long the arrangement is expected to last and steps to take to end or change the arrangements;
- relevant aspects of the child’s history and information about his religious and cultural background and how such matters affect the child’s daily routine;
- any delegation of parental responsibility to the responsible authority or to those who have care of the child, for example in the case of medical emergency for a child with complex health needs, or participation in specific activities;
- financial arrangements for the placement; and
- when the child is placed with a person who is approved as a local authority foster parent, confirmation of the foster care agreement
Depending on the child’s specific conditions it will be necessary to undertake detailed risk assessments in respect of moving and handling, and specific training about certain medical procedures which the parents undertake at home. Detailed information about the child’s likes dislikes and routines can help the carers meet the child’s needs effectively and help the child adapt quickly to being away from home. Short breaks will only be successful in providing a positive new experience for the child and a genuine break for the parents if the carers have all the necessary information to meet the child’s needs fully and safely. This consideration should determine the amount of detail necessary to include in the plan under the headings above.
The short break care plan should be signed by the child’s parents, by the responsible authority, by those providing the care, and where appropriate the child or young person.
Parents must be fully involved in all aspects of agreeing the short break plan. As far as is practicable, children and young people should also be involved in agreeing the plan. Disabled children use a range of communication methods. It is essential that staff skilled in these different methods of communication ensure that the child’s voice is central to the process of assessment, planning and review which should ensure that the child’s needs are fully met.
The frequency of visits to children in short breaks is less than children who are looked after continuously. This recognises the fact that children go home after a short period in placement to their parents who are nearly always best able to see whether the placement is meeting their child’s needs or not.
The visits by the representative of the placing authority must take place at regular intervals, to be agreed with the child’s IRO and the child’s parent, and recorded in the child’s placement plan before the start of the placement. The first visit must take place within the first 15 days of placement or as soon as reasonably practical thereafter. Subsequent visits should be at intervals of no more than 6 months. The visit is an important opportunity for a representative of the authority to ensure that the placement is meeting the child’s needs.
Requirement to review and timing of reviews for short breaks
The plans for children in short breaks are reviewed less frequently than plans for other children. This recognises that the child is placed for relatively short periods in each episode of short break care. The first review for children in short breaks should take place within 3 months of the start of their placement. Subsequent reviews should be at interval of no less than 6 months. Local authorities may decide to convene earlier reviews in specific circumstances, for example at the request of the child, parent or carer, or in cases where the child is particularly vulnerable or where a child is provided with a high level of short breaks. The responsible authority should not make any significant change to the care plan unless the change has been first considered at a review.
Independent Reviewing Officers
The role of the Independent Reviewing Officer (“IRO”) for children looked after in a series of short breaks is likely to be more limited than for children looked after longer term. When working with children in short breaks it is important that IROs are sensitive to the close and active involvement of parents. Given this sensitivity parents as well as children and young people can highly value their contribution and independent perspective, especially in helping to resolve any difficulties with the placement.
3.4 Short breaks in different 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. In general there are two complementary approaches to ensuring that children using short breaks are safe and well looked after. First there are the assessment, planning and review requirements for individual children with additional regulatory requirements for looked after children. Second there are requirements imposed on service providers for the benefit of all children who use their services.
The following table shows the different requirements in different settings to safeguard and promote the welfare of children.
Outline requirements on settings where short breaks might take place
Full details are available from the Ofsted and CQC websites.
|Type of service||Registration, inspection, applicable standards||Notes|
|holiday play schemes||None for over 8s.
Play scheme provision for under 8s is likely to fall within the definition of early or later years childcare provision under the Childcare Act 2006 with consequent requirement to register unless exemptions apply
|Sitters, befrienders, personal assistants||No current registration requirements unless providing personal care||Subject to the passage of legislation DH has made provisions to exempt PAs from the requirement to register with CQC under specific circumstances.|
|Early years providers, includes childminding||Registration with Ofsted as a childminder or early or later years childcare provider is required by the Childcare Act 2006 for childcare provided to children under 8, unless exemptions apply.|
|Childminding 5-8 year olds||Ofsted: Childcare (General Childcare Register) Regulations 2008||Came into force Sept 2008|
CQC regulates under current domiciliary care NMS until October 2010 when new registration requirements come into force under Health and Social Care Act 2010
|Guidance about compliance with the registration requirements will be issued by CQC by 1st December 2010|
CQC regulates under Independent Health Care NMS, to be replaced from October 2010 by new registration arrangements
|Guidance about compliance with the registration requirements will be issued by CQC by 1st December 2010|
|Local authority foster care||Ofsted, Fostering Services NMS
Fostering Services Regulations 2002 as amended; Care Planning, Placement and Case Review (England) Regulations 2010
|New NMS to come into force April 2010
|Children’s homes and residential special schools
|Ofsted, Children’s Homes and residential special schools NMS The registration and inspection of children’s homes is governed by the Care Standards Act 2000 (CSA). The registration authority in respect of residential special schools is Her Majesty’s Chief Inspector for Education, Children’s Services and Skills (CIECSS).
|New NMS to come into force April 2010|
Providing care [accommodation] in the short break carer’s home
Whether the child is accommodated (overnight) in the carer’s home under section 17 or section 20(4) of the 1989 Act, best practice is that the child should be cared for by a an approved local authority foster carer. This does not necessarily mean the child is ‘looked after’ (that depends on whether accommodation is provided under section 20(4) and the child stays with the carer for more that 24 hours at a time – see 3.1 above), but rather that an approved foster carer is the most appropriate person to provide overnight accommodation care, away from the child’s home.
Childminders must be registered in the Early Years Register, for those caring for children from birth to the 31st August following their 5th birthday, and in Part A of the General Childcare Register, for those caring for children old than that up to their 8th birthday. There is no requirement to register to provide childcare for a child aged 8 or over, although voluntary registration on Part B of the General Childcare Register may be possible. The requirements for early and later years childminders are set out in regulations and include that the person must be suitable to provide early or later years childminding (as appropriate), and that the person must have an appropriate first aid qualification and must agree to have an enhanced CRB check done for themselves and certain members of their household. Early years childminders must also comply with welfare and learning and development requirements set out in the Early Years Foundation Stage.
[For further information please see
A practice has developed in some local authorities of providing accommodation for children in need with childminders who are not also approved foster carers for overnight short breaks. Although there are some similarities in the skills of childminders and foster carers, especially those who provide short breaks this is not recommended practice. Overnight childminding was enabled to meet the child care needs of parents working unsociable hours. It is not suitable for children who need local authority services to safeguard and promote their welfare. 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.
The recruitment of foster carers focuses on the whole family through the home study, rather than the individual as in childminding, although Ofsted check all members of the childminding household aged over 16.
Generally the longer the placement, the more the child is likely to be exposed to risk. Because foster carers look after children on behalf of local authorities, the children they look after tend to have higher levels of needs and they are away from home for longer periods, it is reasonable that there are different arrangements for the assessment and approval of childminders and foster carers. It is not appropriate for the local authority to provide overnight accommodation with childminders who are not also approved foster carers.
3.5 Direct payments
Direct payments for parents of disabled children and disabled 16 and 17 year olds were introduced through amendments to Part3 of the 1989 Act to ensure that the same principles and processes to safeguard and promote the welfare of the child apply, whether the needs of the disabled child are met through provision of a service or through direct payments.
Families with disabled children may opt for direct payments rather than receiving a service provided or commissioned by the local authority. They may wish to buy short breaks from a registered provider (for example day care, domiciliary care or overnight child minding) or employ a personal assistant to provide the short break. The full range of short breaks can be provided through a direct payment, including overnight care away from home, providing care in the child’s own home or accompanying the child to a leisure activity in the community.
Where a parent opts for direct payments, councils retain their responsibilities under the 1989 Act to assess and review the needs of disabled children and their families in the normal way. para 163, – Guidance on Direct Payments for Community Care, Services for Carers and Children’s Services, England 2009
‘Councils should work in partnership with parents to help them make arrangements that are designed to safeguard and promote the welfare of the child. The majority of parents will be both willing and able to do this, but local councils should only arrange a direct payment for a parent of a disabled child when they are satisfied this is the case.’ (para 145)
4. Assessment, planning and review
Good assessment, planning and review are essential to ensure the best outcomes for the children and their families.
Assessment, planning and review have to take place in real partnership with parents. In short break provision it is invariably parents who have parental responsibility, not the local authority. Social workers, accustomed to working with children who have suffered significant harm, where the local authority may have had to assume parental responsibility, have to remind themselves of the fundamentally different relationships with families for whom short breaks are provided. Parental responsibility is unaffected by local authority provision of short break accommodation under section 17(6) or section 20(4) of the 1989 Act. Arrangements can only be made for a child who is under 16 to be accommodated under these provisions with the parents’ consent.
Vol 2 of CA 89 guidance, para 2.1, states
‘Partnership with parents and consultation with children on the basis of careful joint planning and agreement is the guiding principle for the provision of services within the family home and where children are provided with accommodation under voluntary arrangements.’
A wide range of children with very different needs require access to short break services. The following diagram illustrates how as needs increase so will the levels of assessment, service provision, and safeguarding which are appropriate to the varying needs.
Assessment is the first stage in helping a vulnerable child. Assessment should be proportionate to the apparent need and so a tiered approach is appropriate for short breaks.
1. Informal assessment. ‘Informal assessment’ describes the situation where a relatively low level of short break provision is accessed through a simple qualification process, for example a holiday play scheme for disabled children, may ask for basic information from the family about their child and his impairments.
2. Initial Assessment to determine needs and nature of services required, addressing the dimensions of the Assessment Framework, which can include Carers assessment.
3. Core Assessment for more complex situations with more detailed assessment of the child’s needs in the context of parental capacity and wider family and environmental factors.
See Annex 1 for the core offer standards about assessment.
For relatively low levels of short break provision, a local authority provided or commissioned assessment will often not be necessary. For example an authority may provide some short break provision for disabled children who have been assessed through other processes, for example, access to existing local health or educational facility, receipt of higher level Disability Living Allowance, or locally agreed criteria. Alternatively, a provider of short break provision may hold simple eligibility criteria and a parent with a disabled child may make an application to the provider of the service very much as they would for a non-disabled child.
Under this scenario, parents will provide the information necessary to ensure that the service meets the needs identified by the family. The local authority will wish to ensure through a service level agreement and appropriate monitoring that the service is meeting the agreed priority needs and the children using the service are enjoying good outcomes. But the authority will not need to assess, plan and review the child’s access to such services on an individual basis.
If such arrangements are not meeting the child’s needs the parents have a right to request a more formal assessment of their family’s needs. The informal assessment is for situations where the family do not need or wish to have a more formal assessment and agree that their child’s needs can be primarily met without access to services triggered by a formal assessment.
Where it appears that a child has additional needs which are not being met through existing services, generally a CAF (Common Assessment Framework) will be completed. [see CAF: Practitioners’ Guide (CWDC 2009)]
This information will be the basis for the initial assessment, which should be carried out in accordance with the statutory guidance, The Framework for the Assessment of Children in Need and their Families. [DH/DfES 2000]
An initial assessment is defined as a brief assessment of each child referred to social services with a request for services to be provided. This should be undertaken in a maximum of 7 working days but could be very brief depending on the child’s circumstances. It should address dimensions of the Assessment Framework, determining whether the child is in need, the nature of any services required, form where and within what time scales, and whether a further more detailed core assessment should be undertaken. (para 3.9)
The Assessment Framework provides a systematic way to focus on the needs of children within their family and social context. A proportionate approach to assessment is required, making full use of assessments already undertaken for other purposes. The initial assessment will be sufficient in most situations where the trigger for the assessment is a request for a short break.
Parents of disabled children have the right to request an assessment of their own needs. Such a request indicates the need for an initial and possibly core assessment.
If there are concerns that the child is at risk of significant harm the procedures described in Working Together must be followed. Because of the particular vulnerabilities of disabled children an awareness of safeguarding issues is essential for those working with disabled children and their families. [See Safeguarding disabled children practice guidance, DCSF, July 2009.]
In the small number of situations where circumstances are more complex a core assessment will be appropriate in order to identify provision most appropriate to meet the identified needs.
Important information to be held by carers
All those providing short breaks for children should be given the information they need about the child’s likes and dislikes, any fears and anxieties, and about illnesses and allergies. Whether the short break is for a few hours or a weekend certain information is likely to be particularly important for disabled children,
- method of communication, in particular for non-verbal children
- medicines and medical equipment, many severely disabled children will have specific clinical needs, and
- risk management, which could include, depending on the child’s impairment, moving and handling, invasive procedures, and behaviour. (see The Dignity of Risk, NCB, 2004)
Under section 6 of the Carers and Disabled Children Act 2000 parents of, or persons with parental responsibility for, a disabled child have a right to an assessment of their needs as carers. ‘The needs of parent carers are an integral part of an assessment. Providing services which meet the needs of parents is often the most effective means of promoting the welfare of children, in particular disabled children.’ (Framework for the Assessment of Children in Need and their Families, para 1,29) The needs of the parents can be recorded under the dimension of family functioning of the Assessment Framework.
While there has to be a discrete focus on the needs of the carer the outcome of this assessment should be integrated with broader assessment of the disabled child and family. Carers assessments should not be conducted in isolation. [DN see example at annex 2]
4.2 Guidance on the approach to be taken by local authorities when deciding whether to provide short breaks accommodation under section 17(6) or under section 20(4)
Where accommodation is provided for a continuous period of 24 hours or more on any single occasion, it will be essential for the local authority to determine the legal basis on which accommodation is provided, as this will determine whether the child becomes a looked after child or not. The key question to pose is whether the acquisition of looked after status is likely to lead to better outcomes for the child or whether the assessment, planning and review process for other services for children in need will be sufficient. Before making and when reviewing a decision about whether to provide accommodation under section 17(6) or section 20(4) of the 1989 Act there should be a careful assessment of the child’s and family’s needs that addresses the following considerations:
- particular vulnerabilities of the child, including communication method;
- parenting capacity of the parents;
- 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 accommodation under section 17(6);
- whether short breaks are to be provided in more than one place;
- potential impact on child’s place in the family and on primary attachments;
- distance from home; and
- observation of child (especially non-verbal children) during or immediately after the break by person familiar with mood and behaviour of child (parent, school staff);
- views of the child and views of parents. Some young people and parents may be reassured by and in favour of the status of a looked after child. Other young people and parents may resent the implications and associations of looked after status;
- extent of contact between short break carers and family and between child and family during the placement;
10. the need for an Independent Reviewing Officer (“IRO”) to monitor the child’s case and to chair reviews
Example indicating use of section 17
An assessment of Sara’s needs has led to a package of care mostly provided at home but including a planned series of monthly overnight stays in the same residential setting with children her own age. Sara’s parents are resilient and resourceful – there are no concerns about their parenting capacity. The expected outcomes from the residential setting are increased social and leisure opportunities for Sara and the opportunity for her parents to take spend more time with Sara’s twin sister. Sara’s parents wish to be in touch with staff by mobile during each overnight stay and to collect her themselves so that they can see how she is in the home.
Where any child is provided with accommodation frequently (at least twice a month) for a continuous period of 24 hours or more, it will usually be appropriate for the child to be accommodated under section 20(4) of the 1989 Act and therefore to be looked after.
There will be some children whose package of short breaks will be such that their welfare will be best safeguarded by being a looked after child for the periods in which they are away from home. This will include children:
- who have substantial packages of short breaks sometimes in more than one setting;
- where there are lower levels of contact between the child and his family while he is away from home; and
- where family resources are very stretched and the family may have difficulties providing support to their child while he is away from home or monitoring the quality of care he is receiving.
In such cases, in consultation with parents, the local authority may decide to accommodate the child under section 20(4). Providing accommodation under section 20(4) has no effect on the parents’ parental responsibility and of course parents can remove the child from the accommodation at any time. They will retain overall responsibility for the health, education and longer term planning for their child although they may ask for assistance from the local authority. The assessment may have identified areas where additional support may be helpful.
Example indicating use of 20(4)
Amjad is 12 years old and the second of five children. Like his three year old sister he has severe learning disabilities. He has been having increasing outbursts of anger at home. Amjad’s father works away from home frequently and his mother becomes quite depressed when the demands of the family get on top of her. She has been asking for residential education for Amjad but he is making reasonable progress in the local day school. A substantial care package involving weekly overnight short breaks with a foster family has been agreed. It is agreed that Amjad will be looked after by the local authority because of the extent of his needs, the amount of time Amjad will be away from home, and the fact that his family’s resources are stretched to their limit.
Main differences between accommodation under section 17(6, under section 20(4) where regulation 50 applies and ,under section 20(4) where regulation 50 does not apply.
|If a child is provided with accommodation under section 17(6)
- the child is not looked after
- the Care Planning Regulations do not apply (and therefore there is no requirement to appoint an IRO)
- a child in need plan is required in accordance with the Framework for the Assessment of Children in Need
- it is good practice that reviews should be at least every 6 months or more often if required
|If the child is provided with accommodation in a pre-planned series of short breaks in the same place, under section 20(4) where regulation 50 applies
- the child is looked after
- modified planning arrangements apply and there must be a short break plan addressing those issues key to the safe care of the child
- an IRO must be appointed
- the child’s case must be reviewed within 3 months of the start of placement and then at intervals of no more than 6 months
the first visit must take place within 15 days of placement or as soon as practicable thereafter. Subsequent visits must be at intervals of no more than 6 months
|If a child is provided with accommodation under section 20(4) where regulation 50 does not apply
- the child becomes looked after
- the Care Planning, Regulations apply to the placement so the authority must make a care plan
- an IRO officer must be appointed and
- the child’s case must be reviewed regularly. The first review must be within 20 days of the start of the placement, the second no more than 3 months after the first and subsequent reviews no more than 6 months after the previous review
visits must take place in accordance with regulation 29
The provision of accommodation under section 17(6) or section 20(4) does not affect parental responsibility.
4.3 Planning and review
Where a formal assessment has taken place, the assessment should lead to a clear written plan that sets out all the services that are to be provided to meet the child’s needs and the arrangements made for the placement. The plan will
show how the short break will meet the needs of the child and family identified in the assessment. It will
- have clear and realistic objectives
- include ascertainable wishes of child and family
- follow consideration of options, including but not limited to direct payments
- state 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 communication methods, clinical needs, risk assessment including moving and handling, dietary requirements, behaviour management,
- 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 in paras 143 to 156 in the guidance on direct payments (September 2009)
- outline arrangements to review the plan
Where, following assessment it is agreed with the family that the child should be looked after under section 20(4) of the 1989 Act there are additional requirements about planning and review.
The plan should include all the information necessary to ensure the well-being of the child in the short break, and no more. Much information may already be available in the parent held child record. The plan should be made available as necessary in accessible formats.
A case review for a child who is not looked after should
- ensure service(s) provided meet needs identified in the plan and promote welfare of child
- focus on outcomes for the child and family (see AHDC: Short breaks implementation guidance, annex A )
- see the child’s development and progress in the round and therefore be a joint review with education and health whenever possible – see box below
- include ascertainable wishes and feelings of child and family
- take place at least 6 monthly.
Depending on the level of service for the child and family and the vulnerability of the child, local areas may wish to consider including an element in the review which is independent of the service provider and those with parental responsibility, similar to the role of the independent reviewing officer in the case of a looked after child. Having an advocate may be particularly useful for disabled young people moving towards adulthood.
A holistic review
Rachel is 12 years old and has spina bifida. Rachel has a statement of special educational needs and attends a unit at a mainstream school. She spends about two nights a month in a hospice usually with children her own age. With a dedicated assistant she attends the after school club twice a week and has a sitter once a week which allows her mother to continue to work part time. Overall the package is meeting the needs of Rachel and her family but there are occasional difficulties with transport between school and hospice or from the after school club which always seem to be someone else’s responsibility! It has been agreed that the SEN review will encompass a review of all aspects of Rachel’s care, with representatives from the school, the hospice, the after school club, the local authority, the PCT commissioner and the family. This will allow a holistic view of Rachel’s progress across the five ECM outcomes, resolution in the meeting of some of the difficulties of co-ordination and efficient use of time for both professionals and family.
A review will include a face to face meeting, including the social worker, a representative of the service(s) being used, parents and wherever possible the disabled child or young person. in some cases, regular review meetings may not be necessary. 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. In other cases a review might not have to be a meeting
Practice example of short break review
Raj is a 5 year old with cerebral palsy, very little speech and severe learning difficulties. He has a statement of SEN and regular reviews of his health and development. He has an occasional sitting service, usually two evenings a month. This arrangement has worked well over the last year. After 6 months a review meeting took place. As there have recently been meetings to address Raj’s overall educational and health development the short break review consisted of the following additional steps,
- the sitting service provided a report of the second 6 months of the service
- the social worker spoke with the parents to discuss whether the service was still working well and how Raj was responding
- the social worker spoke to the physiotherapist in the child development team who recently visited Raj while the sitter was present primarily to review whether the moving and handling advice needed updating as Raj was getting bigger. The physio was also able to comment on Raj’s positive responses to the company of the sitter which confirmed the parents’ view.
The social worker recorded these conversations and updated the children in need plan.
In every case it will be important to record the views of those involved in the review, decisions taken and the identity of the persons responsible for implementing them, and amend the children in need plan as necessary. Reviews should take the form of meeting when requested by the family. In all circumstances a face to face meeting should take place at least once a year.
Integrated Children’s System
We are aware of difficulties in the field about the use of the Integrated Children’s System materials for disabled children in short breaks. Lord Laming’s report (DCSF March 2009) recommended a review of aspects of ICS. Following completion of this work we should be in a position to offer guidance on the operation of ICS for children using short breaks.
Annex 1 Core Offer
Disabled children and young people receive child-centred multi-agency co-ordinated services from the point of referral through identification and assessment to delivery 2
Disabled children, young people and families can expect assessments that are:
• Holistic, multi-agency and co-ordinated, undertaken as far as possible in the same place at the same time, and be provided as early as possible with minimum waiting times
• Proportionate to the apparent need, guided by the views of the child and family, and centred on meeting their needs rather than on the pattern of current services
• Based on the necessary consent to share information and an understanding of the purpose and possible outcomes of the assessment
• Based on shared information, increasingly the Common Assessment Framework, as a platform for more specialist assessments, ensuring that families do not have to provide the same information time and time again
• Focussed on promoting the welfare of the child in the family context and recognizing that the needs of the family change over time
• Undertaken by staff with the right skills for onward referral or diagnosis, assessment, treatment and ongoing care and support.
Disabled children, young people and families can expect assessments to include:
• Consideration of mainstream, inclusive options as well as specialist services, including the offer of direct payments and support to manage direct payments
• Family support plan in Early Support for 0 – 4, and person centred transition planning for young people from 14
• Consideration of the need for a key worker or lead professional.
Good practice example of carer assessment prompts from Sutton.
Carers assessment prompts
These prompts are intended as practice guidance for staff undertaking assessments and reviews of the plans arising from those assessments. The carer’s assessment should be a discrete part of any assessment undertaken.
Remember many parents of disabled children see themselves as parents rather than carers and may not identify themselves as a carer.
- Describe caring role. Are there any parts carer finds difficult?
Breaks in social life
- How long has carer been caring?
- How often does the carer feel `off duty’?
Physical well being and personal safety
- Is the carer well? Receiving any treatment/ medication
- Is sleep affected? How
- Does caring present a risk to the carer’s health, for example, moving and handling
Relationships and mental well being
- Is caring having an impact on relationships with the disabled child, his or her siblings, partner and other members of the family, friends?
- What is the impact on mental well-being?
Practical and emotional support
- How much help does the carer get with caring? From who? Is this enough?
- Are there suitable community resources?
- How many roles does the carer have? E.g. wife, parent, work employee
- What impact does this have on caring?
Work, Education, Training and Leisure Activities
- What is the impact of caring on work, career and what are the carer’s wishes about future work?
- What are the carer’s wishes in relation to training, education and leisure?
- What alternative care services would help the carer to take up opportunities to participate in these activities,“
Future caring roles
- How does the carer see the future?
- What factors are likely to affect the willingness/ ability to care long term?
- If the carer suddenly became ill what would happen?
- What networks are there to provide practical support in an emergency
Access to information and advocacy
- What would make caring role easier?
- How does the accommodation impact on the tasks of caring?
Carer’s perspective and feelings about role
- Ask carer to describe how they feel about caring? Thinking about culture, gender, age
Summary of information and analysis
This should lead to agreed outcomes about services to be provided to the family and an agreed process for review which is an integral part of the assessment and children in need plan.
 The duty at paragraph 6(1)(c) and the regulation-making power at paragraph 6(2) were inserted into the 1989 Act by section 25 of the Children and Young Persons Act 2008.
 Section 22 of the 1989 Act sets out what the expression “ looked after” means and the general duties that the authority owes to a child who is looked after.
 a child ‘in need’ is defined in section 17 (10) as including disabled children.
 Section 6 of the Carers and Disabled Children Act 2000
 [Insert web link/ full reference]
 DH will shortly be publishing guidance on assessing the continuing care needs of children with life threatening or life limiting illnesses