Charisse Monero, Assistant Director – Commissioning gave a presentation on Progression to Adulthood.
In the presentation the following main points were made:
· The Progression to Adulthood (PTA) Strategy was developed in 2019/2020 and was a joint strategy between Children’s Services and Adult Social Services. The Strategy set out a range of needs, aims and aspirations to support and improve how young people with SEND were enabled to progress into adulthood. This included goals and aspirations, information, health and wellbeing, housing, and data and commissioning.
· A Programme Board had been established to oversee the strategic direction, delivery and implementation of the PTA programme.
· The progression to adulthood programme of work responded to the strategy and aimed to be focused around the key national preparing for adulthood outcomes, with key workstreams being: 1) Health and wellbeing; 2) Independent living; 3) Community inclusion; and 4) Goals and aspirations (education, training and employment)
· The PTA service was being developed to make it meaningful and ensure it had an impact on those making the transition.
· Overall good progress had been made in ensuring young people making the transition were supported.
· Funding was identified to pilot a progression to adulthood team and a pilot team had been set up to proactively undertake care act assessment and provide transition support for young people with: 1) Social emotional and mental health needs; 2) Autistic spectrum conditions; 3) Sensory needs; 4) Complex health needs.
· The pilot started in December 2020/January 2021 and was funded for a year. A mid-point review and evaluation had been commissioned to consider impact, through undertaking discussions with the PTA team, engaging with wider social work and health practitioners and obtaining the views from young people and families. So far the team had worked with 80 young adults with a complex range of social care and mental health needs.
· Collaborative working had been strengthened across Children’s Services and Adult Social Care to ensure young people that would otherwise ‘fall through the gaps’ were being supported.
· The team had enabled timely assessments for young people with complex Mental Health needs, preventing escalation, and higher costs in the future.
· The team built confidence of young people, enabled stability and supported employment outcomes.
· 10 cases had been sampled to understand impact. These had identified positive working relationships with young people and their new practitioners/social workers. The team had undertaken mental health capacity assessments, and deprivation of liberty safeguards and ensured there was a full range of PTA outcomes for young people including housing, education/training/employment, health and community inclusion.
· Young people and their families had stated that: 1) the team had helped with education independence, helped to work on cv and guide towards employment and college; 2) assessment of need was very good; 3) having someone to turn to and pick up pieces was really important and; 4) parents found carer assessment really helpful.
· Areas for development were: 1) assessments as there was some frustration at the number of assessments; 2) strengthening joint working between services and collaborating earlier to enable earlier intervention.
· The plan for the next 12 months included; 1) developing relationships with the wider system; 2) strengthening the partnership with the leaving care team; 3) diversifying disciplines within the team from predominantly social workers to include more mental health input; 4) identifying further opportunities for strengthening shared ways of working between children’s and adults to shape shared ways of working; and 5) strengthening the skills of the workforce in relation to autism and mental health, particularly as prevalence, complexity and severity of need in relation to autism meant demand was outstretching demand.
· There was an aim for a permanent social care team to be in place from 1 April 2022 with an Annual Learning and Impact report produced in February 2022.
In the discussion the following main points were made:
· A member stated that as part of the SEND Transitions scrutiny, members had met with parents of children with SEND and parents had stated they felt isolated and stated that there had been no contact from Adult Social Services in relation to support for the family and siblings. The officer advised that the PTA worked with other services and had a family approach and the pilot provided an all age early intervention and prevention offer from birth to late adulthood. Families who required additional support were given the opportunity to be signposted into services.
· In response to a member’s question about the size of the cohort, the officer advised that for those aged 16, 17 and 18 there were approximately 100 young people in each group with EHCPs. Approximately 50% could live independently with support and the other 50% required more support. The project worked with young people aged 17-25. The demand on services would become greater in the future with higher rates of autism in the primary cohort and a larger cohort at primary level (approximately 120 each year).
· In response to a member’s question about the roles of staff in the pilot team and how the team worked with the Leaving Care team, the officer stated that there was a Team Manager, Senior Practitioner and seven social workers. Consideration was being given to expanding the team to include Mental Health and community elements. Work took place with the Leaving Care team to ensure continuity and joint planning took place.
· In response to a member’s question about the length of time of the average intervention and the support that was given to young people in transitioning out of the programme, the officer advised that currently the average intervention lasted 6-9 months. Going forward, it was anticipated shorter, 16 week interventions could be offered to young people with less complex needs in addition to a longer term programme for those with more complex needs. The 16-week programme would aim to create independency and empower a young person to access services in a shorter time frame. Before a young person left the programme, work took place with other services on an exit pathway to ensure a safe transition out with the young person being able to live independently.
· In response to member’s questions about the percentage of males and females in the cohort and the percentage of children with autism who had Asperger’s, the officer reported that across the cohort there was approximately 67% males and 33% females and in the cohort of young people with autism, it was approximately 60% males and 40% females. Post-Covid there had been more girls presenting at Tier 4 (the highest level of hospital admissions) in relation to mental health. Asperger’s was at the higher functioning end of the autism spectrum and although data was not broken down into types of autism, approximately 20% of young people on the spectrum were at the higher-functioning end of the spectrum.
· In response to a member’s question about whether the team worked with the police, the officer stated that work had been undertaken with the police and health colleagues to raise awareness about autism. 130 young people had received police orders and of these 20% had a diagnosis of autism. More work would be done to raise awareness and provide support for these young people.
· In response to a member’s question about how young people with the most complex needs could be supported after their intervention programme ended, the officer advised that it was important to ensure there was not just a whole family response but also a whole system approach with progression to adulthood being a shared endeavour and responsibility between education, social care and health services providing wraparound support. A diverse menu of support would be provided and interventions would have a life course approach and provide a safe landing into community services.
· A member reported that parents had raised concern that ensuring their children’s needs were met had been a battle and parents who had English as an additional language or were disadvantaged might not have the needs of their children adequately met. The officer stated that work was taking place to create an environment of cultural inclusion. Co-production workshops would be run in the lead up to the launch of the new service and the service wanted to reach out to harder to reach families and hear from bilingual families and disadvantaged groups as part of this. There would be multi-communication channels to enable parents to communicate.
· It was suggested that work on the transition to adulthood should start aged 13-14. The officer agreed that thinking about transitions at this stage could help avoid exclusions and the need for statutory interventions and officers would be taking this forward. Early transition preparation was part of EHCPs.
· In response to a question about how success of the programme would be measured, the officer advised that case studies would be examined. In addition, there would be key performance measures with baseline, mid-point of intervention and end of intervention measurements taken as well as measurements 3-6 months after the intervention to check transitions into employment, education and secure housing had been successful and that outcomes had been sustained without support. This would give a comprehensive evaluation. The Chair suggested that measurements should also be taken after 1 year, 2 years and 5 years. The officer stated that consideration could be given to undertaking these measurements as part of a longitudinal study.
· In response to a member’s questions about how the voices of parents could be heard and how parents could be brought together to support each other, the officer stated that there was a need to link into existing groups. A Parental Engagement Strategy was being rolled out and there was a SEND Parents’ Forum funded by central government.
· Members stated that some parents did not know that support services existed and felt they did not have support. Part of this could be due to the digital divide. The officer stated that she would take this away as an area for development. It was possible to utilise existing services e.g. community services, schools and children’s centres to make information available.
· An officer stated that the Islington SEND Community Support Service provided independent advice and Islington published its local SEND offer. Facilitating access to services, supporting parents and carers and responding to needs early could help prevent escalation.
· Officers were thanked for their presentation.
1) That members of the Committee be invited to co-production workshops.
2) That officers consider more ways to ensure the voices of parents were heard.
3) That officers consider measuring the success of the programme at 1 year,
2 years and 5 years after the end of each intervention.
4) That the presentation be noted.