Aiming High for Disabled Children
SALFORD NEEDS ASSESSMENT
Version 2. 18/09/2009
Version 3. 6/10/2009
Author: Anne Hayton
Debbie Fallon
Date:
September 2009
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Contents
EXECUTIVE SUMMARY
3
CONCLUSIONS AND RECOMMENDATIONS
3
INTRODUCTION
5
Population Analysis
6
1. Total Population
6
2. Disabled Children Population
6
Disabled Children’s Register
6
3. Special Educational Needs Population
10
4. Disability Living Allowance – Claimants – Feb 2009 (Source: DWP)
12
Trends/Prevalence
13
INTELLIGENCE GATHERED FROM CUSTOMER FEEDBACK
13
Introduction
13
Method
13
Findings
14
Strengths of current short break service provision
15
Barriers to accessing existing services
16
Service Specific Consultation
18
INTELLIGENCE GATHERED FROM PROFESSIONALS
19
INTELLIGENCE GATHERED FROM THE DISABILITY RESOURCE
ALLOCATION PANEL
23
Disability Resource Allocation
24
IDENTIFYING SERVICE GAPS AND FUTURE REQUIREMENTS
26
CONCLUSIONS AND RECOMMENDATIONS
29
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Executive Summary
The needs analysis has drawn on a range of data collated around disability,
children with Special Educational Needs Assessments and Prevalence of
disability. It has used information from the recently formed Disability Resource
Allocation Panel which allocates resources to families requiring targeted or
specialist support. It brings together the findings from a whole range of
consultations with children and young people and their families and the
professionals working with them.
We recognise there are gaps in the information and work has already begun
on addressing this problem. However this assessment does start to give a
better picture of the issues facing those tasked with developing services for
children and young people with disabilities.
Conclusions And Recommendations
1. Current available data has given us an indication of the numbers of
disabled
children whom we need to be targeting in Salford under the
Aiming High Short Break Care Programme. As the data collation
systems improve, we will have better information about where these
children live, their gender, ethnicity, and type of disability. The disability
register needs to be brought up to date and a system re-introduced for
its maintenance and awareness raising with professionals and families.
Systems need to be developed to gather information on children under
the age of 5.
2. Through consultation, parents, children and young people have said
that they want to be able to access community based services. Salford
needs to be developing plans to make universal services more
accessible, and increase the amount of school holiday activities.
3. However, families in or near to crisis (evidenced through the Disability
Resource Allocation Panel) are requiring high levels of support in the
family home and through overnight breaks. Plans need to be
developed to provide these service but also to avoid families getting
into this position in the future.
4. Parents and professionals have both indicated they want better
services to provide support in the family home. Evidence from the
Disability Resources Allocation Panel is showing that current in-house
provision is stretched and unable to meet demand, and we have to
spot purchase support from other agencies on an ad hoc basis. The
development of a Preferred Provider List of agencies should start to
address some of these issues. In addition, there needs to be clarity
around the role of Salford’s Family Support Service, in meeting the
needs of those families with children with more complex disability.
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5. Overnight provision from Salford’s in-house short break residential and
fostering services is not meeting the current levels of demand, with the
result that resources have been commissioned for those families who
have reached crisis point from the Independent and Private Sector.
The provision of overnight respite care is currently being reviewed.
6. Further work is required to ensure the needs of Minority Ethnic Groups
and other groups at risk of exclusion are being addressed.
7. Finally, there is a need for better communication, and a more skilled
and confident workforce.
The challenge for Commissioners is to ensure families requiring intensive
specialist services are supported, but adequate resources are still directed
towards non specialist, universal services allowing the “transformation” to take
place. How Salford will go about doing this can be seen in the
Commissioning Strategy, Delivery Plan and Workforce Development Plan.
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Introduction
This report collates much of the information currently available in Salford in
relation to children with disabilities. It starts a process of needs analysis which
will be an ongoing and dynamic piece of work. It will hep assess where we
have strengths and where we need to develop or improve service and
settings. This information will be used to identify Salford’s priorities for use of
the Aiming High funding and how we will go about developing “transformation”
in Salford, as expressed through the Delivery Plan and the Commissioning
Strategy. It will also identify gaps in our information systems and where we
need to focus attention in the future in relation to information gathering.
The report will cover,
 Population analysis and trends and prevalence
 Customer feedback through extensive consultation
 Intelligence gathered from professionals
 Intelligence gathered through resource allocation and waiting lists
It will then summarise the information to,
 Identify service gaps and future requirements
 Make recommendations and conclusions
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Population Analysis
The population analysis is based on data sources that are currently available
and which include:




1. Salford Population – from Office for National Statistics Mid Year
Population Estimates 2007
2. Disabled Children Population – from Annual Report from Salford’s
Record of Disabled Children & Young People 2004/05
3. Special Educational Needs Population – from DCSF publication “SEN in
England Jan 2009”
4. Disabled Living Allowance – from Department for Work & Pensions time
series analysis Feb 2009
1. Total Population
The total population of Salford is 219,200 of which 49,200 are aged 0 to 18,
approximately 23%




Aged 0 to 5 is 15,800, 32%
Aged 6 to 10 is 11,500, 23%
Aged 11 to 15 is 13,200, 27%
Aged 16 to 18 is 8,700, 18%
The highest proportion of children are in the 0-5 and the 11-15 cohorts
2. Disabled Children Population
If the proportion of severely disabled children follows the national estimate of
1.2% of the total population of children then, based on the 0-18 population
total above, this would give an estimate for Salford of approx 5% severely
disabled children.
Disabled Children’s Register
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The following tables take information from the last Annual Report of the
Disabled Children’s Register 2004-2005 and the last update of the Disabled
Children’s Register December 2008.
Table 1. Age of Children on the Register
Disabled Children’s
Register
Annual report 04/05
Aged
No
%
0 to 5
65
15%
6 to 10
133
31%
11 to 15
184
42%
16 to 18
47
11%
Disabled Children’s
Register
Update Dec 2008
Aged
No
%
0 to 5
29
8%
6 to 10
95
26%
11 to 15
159
44%
16 to 18
77
21%
If the general Salford population is compared to those on the Disability
Register in table1 it shows that those aged 0-5 are under represented on the
register. 32% of the total child population is aged 0-5 but only 15% and then
8% are on the Register.
An under representation will not be unusual because children are not always
diagnosed until development delay has been detected and various tests
carried out. They are therefore unlikely to be onto the register until later.
However the drop between the two periods is more likely to represent the
register not being kept up to date and parents not being encouraged to
register.
The largest group on the register are the 11-15 year olds at 42% and 44%
which is an over representation of the general population of 27%. However
the proportion will be larger than it actually is due to the under representation
of 0-5 year olds. When we look at the number, 184 and 159 we can start to
see the size of the challenge. This age group can be difficult to provide
services to, as they become bigger moving and handling issues become more
prominent and those with challenging behaviour can become more difficult to
manage.
Table 2. Primary criteria.
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Disabled Children’s Register
Moderate Learning Disability
Severe Learning Disability
Physical Disability / Chronic
Illness
Total
Annual Report Update Dec 2008
2004/2005
No
%
No
%
195
45%
164
46%
124
29%
115
32%
110
429
26%
81
360
22%
The Primary Criteria for registration was 195, 164 for Moderate Learning
Disability, 124, 115 for Severe Learning Disability and 110, 81 for Physical
Disability/chronic illness. It is likely the last two groups are those needing to
access service through the Aiming High Programme.
Table 3. Additional criteria
Disabled Children’s Register
Visual Impairment
Epilepsy
Hearing Impairment
Update
Annual Report December
2004/2005
2008
106
69
59
44
57
51
The additional criteria possibly highlight areas where staff may require training
or awareness raising. Further information will be required.
Table 4. Personal attention required (beyond that normally provided for a
child of their age)
Disabled Children’s Register
Annual Report Update December
2004/2005
2008
Challenging / Hyperactive
Behaviour
271
220
Using Toilet / Toileting Needs
237
186
Eating / Drinking
183
142
Using Wheelchair / Special Buggy
133
104
Getting In / Out Of Bed
129
101
Lifting
113
93
Total exceeds 429, 360 as children can be in multiple categories
The personal attention requirements indicated that 271, 220 children need
help with behaviour and a significant number need help with personal care
needs. Again this will raise issues for staff training.
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Table 5. Diagnosis
Disabled Children’s Register
Autistic Spectrum
Cerebral Palsy
Down’s Syndrome
Other (approximately 70 different
in this category
Undiagnosed
Total
Annual Report
2004/2005
No
%
77
18%
74
17%
44
10%
106
128
429
Update
December
2008
No
%
78
22%
42
12%
33
9%
30%
25%
123
84
360
34%
23%
The Diagnosis Criteria provides limited information as 128, 84 have no
diagnosis and there were106, 123 recorded as other which includes
approximately 70 different diagnosis. What this does tell us is a significant
number of children have no diagnosis and of those that do their needs will be
very diverse and complex due to the huge spectrum of disability.
We have used the latest figure for Autistic Spectrum of 22% to predict
services in the LAIMP. As there will be some under reporting we have used
the figure of 25%
Table 6. Ethnic Origin
Disabled Children’s Register
Annual report 04/05
Disabled Children’s Register
Update Dec 2008
Ethnic Origin of
Disabled Children
Ethnic Origin of
Disabled Children
No
%
No
%
White
(95%
includes 2%
409
recorded as
Jewish)
White
327
91%
Asian
Black
Chinese
Mixed
Other
Total
6
0
3
9
2
429
Asian
Black
Chinese
Mixed
Other
Total
9
3
0
13
8
360
3%
1%
0%
4%
2%
1%
0%
1%
2%
1%
95% and 91% were reported as white. The general population in Salford for
children is currently around 93% White British. The data suggests the number
of children from Ethnic Minority groups is increasing (apart from Chinese).
Research suggests disability is more prevalent in some Ethnic Groups so we
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should expect the proportion to be higher than the general population. This
needs to be considered when service planning.
3. Special Educational Needs Population
Table 7. Special Educational Needs
The table below shows where these children were placed
Special Educational Needs 2009
Early years education settings
Resourced provision in maintained
mainstream schools
SEN units in maintained mainstream
schools
Maintained mainstream schools
Maintained special schools
Non-maintained special schools,
independent special schools and
other independent schools
Hospital schools and pupil referral
units
Educated other than in school
Awaiting provision
No
With held
(based on a
number fewer
than 5)
%
With held (based
on a number fewer
than 5)
44
4.2%
0
353
506
0.0%
33.5%
48.0%
103
9.8%
10
16
With held
(based on a
number fewer
than 5)
0.9%
1.5%
With held (based
on a number fewer
than 5)
Table 7 shows the children with a statement are placed across a wide range
of Education Provision and table 8 shows that Salford has more children than
the national average in Maintained Special Schools and fewer in Maintained
Mainstream Schools. There are 1,054 children with a statement of SEN of
which our statistics suggest 590 will be severely disabled.
Table 8. Comparison of Placements of Statemented SEN Children to
National (England) Average
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Placement
Early years education settings
Resourced provision in maintained mainstream
schools
SEN units in maintained mainstream schools
Maintained mainstream schools
Maintained special schools
Non-maintained special schools, independent
special schools and other independent schools
Hospital schools and pupil referral units
Educated other than in school
Awaiting provision
Salford
x
4.2%
National
0.4%
3.9%
0.0%
33.5%
48.0%
9.8%
3.1%
47.0%
36.6%
5.4%
0.9%
1.5%
x
0.9%
1.2%
0.3%
Table 9. Type of Need
Type of Need
Specific Learning Difficulty
Moderate Learning Difficulty
Severe Learning Difficulty
Profound & Multiple Learning Difficulty
Behaviour, Emotional & Social Difficulties
Speech, Language and Communications
Needs
Hearing Impairment
Visual Impairment
Multi-Sensory Impairment
Physical Disability
Autistic Spectrum Disorder
Other Difficulty/Disability
No
136
672
162
27
580
%
6%
27%
7%
1%
24%
382
16%
54
2%
27
1%
Withheld, Withheld,
number
number
les than
les than
5
5
72
3%
172
7%
156
6%
The number of pupils attending maintained Primary, Secondary and Special
maintained schools in Salford with Statements of SEN or at School Action
Plus by Type Of Need is 2450
Table 10. Comparison of Type Of Need (Statemented & School Action
Plus)
To National (England) Average
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Type Of Need
Specific Learning Difficulty
Moderate Learning Difficulty
Severe Learning Difficulty
Profound & Multiple Learning
Difficulty
Behaviour, Emotional & Social
Difficulties
Speech, Language and
Communications Needs
Hearing Impairment
Visual Impairment
Multi-Sensory Impairment
Physical Disability
Autistic Spectrum Disorder
Other Difficulty/Disability
Salford
6%
27%
7%
1%
National
12%
25%
4%
1%
24%
23%
16%
15%
2%
1%
x
3%
7%
6%
2%
1%
0%
4%
8%
4%
Table 10 shows the types of need are very similar to that of the national
picture. The information in tables 9 and 10 is of limited use for Aiming High
Planning because there are 2,450 children included in the figures as School
Action Plus is included. The vast majority of these children will not be targeted
under Aiming High.
4. Disability Living Allowance – Claimants – Feb 2009 (Source:
DWP)
Total of Higher, Middle, Low & Zero rate awards (breakdowns not available)
 Total number of entitled claimants in Salford is approx 17,700 which is 8%
of the total population of Salford.
 Nationally (Great Britain), the proportion is approx 5%
 Total number of entitled claimants aged 0 to 17 in Salford is approx 1,740
which is approx 0.8% of the total population of Salford, and approx 10% of
the total number of claimants.
 Nationally (Great Britain), the proportions are approx 0.6% and 12%
respectively.
 The age breakdown of the 1,740 entitled claimants in Salford aged 0 to 17
is as follows:
o Under 5 = 270
o 5 to under 11 = 580
o 11 to under 16 = 660
o 16 & 17 = 230
Again the information is of limited value, in this case because the number,
1,740, far exceed those targeted through Aiming High and it is not possible to
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break down the rates awarded which would be more useful. However the 1116 year olds are the largest group, not dissimilar to the disability register.
Trends/Prevalence
NHS Salford Diana Nursing Team is currently supporting a group of 40
children, all of whom have multiple and complex health needs. Every year this
number increases by around 10. This suggests that over the next five years,
there could be around 90 children in Salford within this cohort.
In terms of the implications for resources, the demand is going to increase,
and long term planning around short break services beyond 2011 needs to
take this into account.
Nationally the prevalence rate for children on the autistic spectrum is around
1%. Applying this figure to the Salford child population would give a total of
492. However, not all of these children will be in need of a disability short
break service. Stated previously there are currently 78 children on the
Disability Register in this category
Intelligence Gathered from Customer Feedback
Introduction
Throughout the development of the Aiming High Programme, Salford has
carried out extensive consultation with parents, children and young people.
Full details are documented in the report produced by Jackie Caffrey
September 2009, “Making Your View Count”. (link)
Method

There have been two questionnaire survey’s of parents, taking place in
October 2008 and May 2008.
Towards the end of 2008, over 200 questionnaires were circulated to
parents of disabled children. Two separate questionnaires were
designed in recognition of the different needs and access to service of
pre- school and older children. One questionnaire was distributed to
families with a disabled child aged 0-5 years, and one to families with a
disabled child 6-16 years. The purpose of the questionnaire was to
capture their experience and uptake of short break care services and
begin to map gaps in provision based on unmet need.
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In May 2009 questionnaires were circulated to parents about how they
would like to see holiday play schemes provided. Twenty four
questionnaires were returned, of which 10 were from parents from the
Jewish community.







Visits to parents groups at Salford Children’s Disability Social Work
Team, Springwood Primary School, and the Aiming High Parents
Forum.
Joint stakeholders events for parents and professionals in November
2008 and January and July 2009.
Parental representation at the Aiming High Steering Group and in
commissioning processes.
Review of short break care (overnights) by Rob Finney and Dawn
Lundergan interim report September 2009 (link).
Feedback from parents through the Commissioning Team’s provider
reviews in relation to externally commissioned residential beds.
Crossroads Caring for Carers Customer Satisfaction Report 2009 (link)
Extensive consultation with children and young people between
December 2008 and June 2009 by Barnardos, documented in their full
report produced by Muir Hunter in July 2009 (link)
Findings
76 families responded to the first questionnaire and of these only 43 were
receiving any kind of support. Parents responding to the summer holiday
questionnaire generally expressed a preference for services to be provided
locally.
In relation to revenue expenditure,
Both children and their parents felt:




Greater communication was needed, with more information sharing
exercises and information provided in easily accessible formats. The
publicity of future events, schemes or support should be spread wider
and to include all disabled children and their parents. A greater sense
of inclusion was needed both as parents, parent to parent and how
disability is perceived in the community as a whole.
Further, more robust education and training should be in place for staff
members to meet the differing needs of disabled children, particularly
those with ASD.
Training, education, additional staffing and support services should be
put in place to support mainstream services to enable disabled children
to access their service.
A variety of quality short break care resources and services should be
developed that give children and young people a range of activities and
venues in which to participate within, particularly out of school and
leisure activities (LAIMP 147) and more holiday and play schemes.
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
Services should be accessible and in locations close to families and
with transport provided that is inclusive and in plentiful supply. They
need to be reliable.
Parents had some specific requests that differed from those highlighted within
the children’s feedback:




Some parents requested integrated resources with mainstream
services
Whilst some parents requested very specialist services for children with
specific disabilities or faiths groups such as through childminding or
nursery provision
A core theme from most parents was that they felt that there should be
more practical support provided in the home either financially or as
services such as domiciliary support.
Resources should be in plentiful supply so that many children can
access short break care and over a variety of days and times,
supporting a range of age groups and abilities.
Strengths of current short break service provision
The young people interviewed throughout the consultation consistently
reported very positive experiences of short break care with only a few
exceptions. Staff and facilities were all rated highly with the main drawback
being a shortage of provision. Time spent away from families was raised as
an issue, particularly for younger children and developing relationships with
workers is also difficult when they first access a service.
Where short break services are provided, young people and families report
benefits from time out and respite and often the young person’s social and
independence skills have developed through accessing services.
Young people report very positively about specialist services they access and
said they have very positive relationships with carers. All staff and facilities
rated at least 4/5 and were usually described as brilliant or very good.
Where young people have accessed the same service for a number of years,
strong bonds and relationships have developed through this contact and
appear to have strengthened the child’s emotional resilience. As they get
older and their needs change, it has also served to develop the young
person’s independence from their family therefore they are well placed to
receive enhanced care outside of the family throughout adolescence and
beyond.
Young people in receipt of short break services have been enabled to access
positive activities with the support of carers which they might not otherwise
have accessed. Examples of such activities are trips to Blackpool, trips to
other seaside resorts and SPACE – a resource for disabled children.
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Some of the young people reported good experiences of accessing
mainstream services and that the support provided met their needs.
Negative feedback came particularly from and about young people with very
complex needs. Services have been unable to respond to the needs of the
most complex young people and often carers feel they have been left with the
responsibility at times when they most need a break, placing large amounts of
stress on both the young person and the rest of the family.
For 2 of the young people, their access to short break services had been
terminated and they were unsure why. While they had accessed services
they had enjoyed them and they would like them again in the future if they
were available.
Barriers to accessing existing services
The children and young people consulted very clearly state that lack of
information is a primary barrier in knowing about and accessing both
mainstream and specialist services. They do not know what’s on in their
localities and a common perception is that mainstream services are not for
them. Young people in specialist schools reported information about
mainstream provisions is not always advertised or circulated to them through
their schools.
Young people have very mixed experiences and perceptions of mainstream
services. More able CYP tend to access a number of mainstream provisions
but have some difficulty in getting support for their needs once there. In
addition, they face the same barrier as most young people such as transport,
cost, young people friendly and these are often exacerbated by their disability.
Those with more complex learning or behavioural needs do not get
opportunities to access mainstream services and are often excluded from
specialist services due to lack of understanding of their needs.
Where services have been identified for young people, young people reported
these don’t run often enough. When asked about summer activity, “nothing”
was a common response. Very few young people reported having more than
3 or 4 days of planned activity over the summer.
Where assessments have taken place in early childhood, there is little
evidence of services developing over the years to meet changing need.
Disabled young people often have to rely on parents choosing or approving
the facilities they access. There are barriers from parents and young people’s
point of view around getting involved in activities, these issues include
relevant training of workers, fear of being bullied, staff ratio to enable them to
take part, and activities that meet the needs of young people
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Specific feedback from the disabled children consulted also requested that:



They would like to have their support provided by people other than
their parents and family members
They enjoyed spending time with other children and this was a key
factor in the development of new services
They enjoyed the services and support they currently receive and were
often confused and didn’t understand when their support stopped
suddenly.
A number of comments were made by families regarding ASD children. There
was a consensus that children with ASD are limited regarding the services
that they can join in. It was felt that there was a lack of specialist training
which impacted upon staff ability to manage behaviour, and an
acknowledgement that children with ASD require specialist provision and may
not easily fit into mainstream services.
Fit City Centres (LAIMP160) were the preferred venue in which to run
activities .However parents from the Jewish community want services that are
culturally appropriate and provided from venues such as Jewish schools.
Parents from the Jewish community also expressed a preference for services
at the weekend, and services that any non disabled siblings could also use.
In relation to capital expenditure the following themes have been documented:

Toilets and changing facilities

Use of facilities at Chatsworth School and Springwood School

Transport- this is a major issue that prevents children and young
people from accessing services

Sensory rooms and equipment

Soft play areas

Playgrounds

Loan facility

Purpose built play centre

Suitable venues that have access for children and young people

Adapted respite homes
Parents want to be able to attend a centre which is accessible and welcoming
for children with disabilities.
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Service Specific Consultation
Overnight Stays
The specific consultation in relation to overnight stays raised the following
issues although it should be noted at this point (2/9/09) the majority of the
interviews having taken place were with parents using The Grange and not
the fostering service.

The general feedback so far is that the families who use the Grange
are very happy with it. The majority are scared that this might be taken
away from them and they were concerned that this would leave them
without adequate support. The majority of families are desperate to
keep overnight care, as they say that this is the only kind of real break
that they get.

There is very differing amounts of support available post 18 and it
would seem to be down to individual social worker’s good practice or
otherwise to determine how much families understand what their post
care options are.

It is a common theme that the families that use The Grange often do so
as they see the carers there as professional and not taking the place of
them as parents. Many families were concerned that using foster care
would feel like ‘giving away’ their child and this would be emotionally
traumatic for them. Those families who had a mixed provision however,
with both The Grange and foster care, spoke highly of the foster carers.

The families spoke highly of the amount of facilities at The Grange and
most said that they felt that there was a reasonable level of flexibility
but a significant minority complained of being cancelled last minute,
which was very inconvenient. There was also a significant minority who
felt that thee was too much of a range of children. For example, a
family whose son has aspergers and needs lots of outdoor activities
struggled to get this when other children with greater physical
disabilities were attending also.

Not many seemed to wait too long for a service and most commented
positively on the fact there is good consistency of staffing.
Other Feedback
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18
Feedback through the other sources raised issues around Foster Carers not
managing certain behaviours.
Feedback on externally purchased overnight stays has been very mixed with
some parents extremely happy with the provision and others raising concerns
or actually making complaints.
Crossroads feedback was from carers across the whole service so included
those caring for adults as well as children. The issues raised in relation to
service gaps that would seem relevant to children were,
 Time to shop without the disabled child, and
 Babysitting at short notice
Intelligence Gathered From Professionals
Discussions have taken place with a range of professionals on a group and
individual basis, regarding the need for short break services in Salford. This
includes Salford’s own staff and those from the independent and voluntary
sector.
Early Support Team
Since the establishment of Children’s Centres in Salford, there have been
changes to the processes around the allocation of funded day care places for
children in need, including those with a disability.
Parents with young children with a disability want nursery day care for their
children for social reasons, rather than to support them as working parents.
(LAIMP 146 and 160)
Community Paediatric Service
Out of school provision for children with the more complex health needs is
dependent upon there being enough trained staff to facilitate the sessions.
The Saturday clubs and after school clubs at Chatsworth High School for
example, can only run when there are enough school staff available.
School nurses provide training for school based staff, but Salford needs to
think about a wider training programme in order to extend the pool of staff
available.
There are a number of factors that need to be taken into account if Salford are
to use non- specialist premises, for example nappy disposal, arrangements
for incineration etc.
The ASD group is desperate for facilities to use, for example swimming pools.
Transport is an issue for enabling disabled young people to access activities.
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19
Manchester Jewish Federation
There are approximately 10,000 Orthodox Jewish people living in Salford and
many are large families with 6-7 children. Having a large family increases the
possibility of children with a disability. Most of the women have a child each
year and this contributes to poor health for the mother, and a decrease in
parenting capacity to meet the needs of both disabled and non disabled
children. Risk of having a disabled child is also higher due to the numbers of
older women having children and the fact that many refuse ante natal
screening.
Project Smile has experienced a high demand for support hours as they
provide culturally appropriate professional support. The project has had to
raise its threshold for services, and reduce the hours of provision.
It is easier to provide care via the local community for younger children, but as
children get bigger and more difficult to physically manage, this is not always
possible.
There is a gap in terms of professional overnight respite away from home
Those children from large families who are in transition and` lacking the
basic life skills, would benefit from one to one support or attending an
appropriate group.
Ethnic Minority and Traveller Achievement Service
There is a teacher based within this service who works with children from the
traveller communities.
There are four main sites in Salford, with a community of around 600-800.
The largest group is the Irish Romany, with showmen being the second.
The locations for these are;
One in Lower Broughton and one on the Duchy Estate for showmen
One on the Duchy Estate for Irish/ Romany
One on Clegss Lane
There are also housed traveller communities, mainly Irish but also Czech.
These are based in Little Hulton, Swinton, Eccles and Broughton. These
communities get support via local Catholic churches, and access services
such as education. There are around 100 children from the housed traveller
communities attending Salford Schools.
The challenges to service providers arise from;



Need to understand the different groups and traditions
Communities are difficult to access, and need to get to know you first
Erratic lifestyles
Giving families a break IN Salford
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
Disabled children and their families can tend to be isolated and
ostracised.
However, both the EMTAS Service and the Health Visiting service have
established relationships with the different communities, and are a conduit for
information.
As far as short break services are concerned, we would need to start with
universal services based on whole family experiences, for example fun days
and stay and play days. It is highly unlikely that there would be a demand for
overnight short breaks.
Communication needs to be via the EMTAS service
Further Information From Professionals
The most recent consultation event with professionals and parents was held
on 6th July 2009. The following key themes emerged

Flexible services needed


Services provided are very good, but they are too thinly spread.
Invest new money wisely so that services can continue even if funding
is reduced in future years

Workforce training particularly around complex medical needs and
children with ASD is necessary

There needs to be better use of current facilities in special schools

Personal assistants to take children to community activities are
required

Activities that are based around the whole family are required

Collective activities for families who have problems in common need to
be developed

Families need improved information accessible in a number of formats
and languages

Culturally appropriate staff who can meet individual needs are required
to provide a short break service

Salford need suitable venues that have access for children and young
people

Residential breaks are necessary for some families
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
Families shouldn’t have to travel out of borough for services

More Direct Payments are necessary

Salford needs to develop more carers to assist families on a daily basis

Salford needs to invest in more child minders

Saturday morning groups are required

Parents should be included in decision making

Families want consistency and continuity of carers
Capital
The following areas have been highlighted by professionals for use of the
capital budget.

Use of facilities at Chatsworth School and Springwood

Transport

Use of Fit City facilities

Sensory rooms and equipment

Soft play areas

Disabled changing facilities

Playgrounds

Loan facility

Stores

Family changing room and toilets

Soft play areas

Purpose built play centre

Suitable venues that have access for children and young people

Adapted respite homes
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Intelligence Gathered From The Disability Resource
Allocation Panel
As part of the transformation of short break care services for disabled children
in Salford, we have established a Disability Resources Allocation Panel.
Though still in development, the panel has been meeting regularly since May
2009. The purpose of the panel currently is to;

Allocate specialist short break resources to families of children with a
disability, who have been assessed as level 3 or above on Salford’s
Thresholds for services.

Consider applications for Direct Payments.

Ensure decision making is consistent and transparent.

Look at ways of enabling children and young people with a disability to
access universal services, through provision of additional resources
such as support workers or specialist training for staff.

Maintain an overview of resources, and collate information about
unmet need.
Salford is one of the pathfinder authorities for the use of an Audit Commission
process known as “Outcomes Driving Commissioning”. Part of the process of
applying for short break services through the panel, includes the completion of
the Outcomes Driving Commissioning Toolkit, a document that identifies
those services that a child needs to achieve the best outcomes, and analyses
what is available and what is missing.
Over the past four months, the information from the Outcomes Driving
Commissioning Documents presented to the panel has identified the following
gaps in service provision,







Overnight respite care
Domiciliary support during the school holidays
Intensive support around implementing visual aids and behaviour
management strategies
Extensive activities in the early evening and at weekends
Places to take a child that are accessible e.g. swimming pools
Adapted caravan for families to stay in
2-1 support for child during play activities
Given that the cases that are presented at panel are those where there is a
high level of need, and services are required as a matter of urgency, it is
interesting that some of the services identified are mainly universal services.
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The Outcomes Driving Commissioning Document is a useful tool. It can
provide an emerging picture over time, and can illustrate how lack of key
services leads to family crises and intensive specialist interventions.
There has been a growing trend to spot purchase residential overnight care
and domestic support from the private and voluntary sector, because the
current services in Salford have not been able to meet the child and family’s
needs.
Disability Resource Allocation
Table 11. The type of provision supported through the short breaks budget,
for children in Groups A and B, and the allocation of Direct Payments.
TYPE OF
SERVICE
GROUP A
Short break
residential
Befriending
service
Domiciliary
support
Summer
activities
Other leisure
activities
Nursing care in
child’s home
Direct Payments
Total
5
3
GROUP B
OTHER or
not
specified
5
1
1
1
2
2
1
5
1
1
2
9
TOTAL
2
5
2
23
27
25
41
The above table indicates that we have had to provide residential overnight
accommodation for five young people, mainly due to difficult behaviour,
impact of their behaviour upon their carers, and an assessed high risk of
family breakdown. We approached the private and voluntary sector for this
provision, as the needs of the children / young people in question could not be
met In-house due to lack of provision. All of the children placed in these units
are on the autistic spectrum. In addition, we are also starting to spot purchase
domiciliary and outreach support, as it appears that the In-house Family
Support Service is unable to meet their needs.
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Table: 12. Age range and gender of children and young people allocated
short break services through the Disability Resource Panel.
Age
0-5
6-10
11-13
14-17
Total
Number
3
5
3
5
16
Male
2
5
3
3
13
Female
1
2
3
Table 13. Age range and gender of children and young people who have
been allocated direct payments
Age
0-5
6-10
11-13
14-17
Total
Number
3
8
5
9
25
Male
1
7
3
7
18
Female
2
1
2
2
7
It is of interest that there are a higher number of requests for services/ direct
payments for males than for females and the bulk of the requests are for
children aged between 11 and 17. This will also raise issues for the transition
to adult services.
The children and young people who are on the waiting list for short break
fostering, and who are coming to the attention of the Disability Resources
Panel, are those with ASD/ difficult and disruptive behaviour.
However, we need to ensure that the needs of those children with multiple
and complex health needs don’t get overlooked.
Waiting Lists for Service
Traditionally there is a waiting list for overnight breaks. The Grange, the inhouse residential unit, does not have a waiting list at present. This seems to
be because available places were recently allocated and some children are
being placed with other providers. There remains a waiting list for overnights
with foster carers, 17, which are unlikely to be allocated unless there is a
major development within this service area.
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Identifying Service Gaps and Future Requirements
This assessment has identified the following issues and service needs which
will be addressed through our Commissioning Strategy, Workforce
Development Action Plan, and Short Break Care Delivery Plan.
Key Issues for Future Planning
PO1.
Salford needs to establish why there has been no reporting of
the Disability Register since 2004/05 and to plan how to bring it
up to date and make it a useful tool again.
PO2.
Salford needs to develop other systems for gathering
information on the under 5’s via NHS Salford and the Early
Support Team.
PO3.
The large number of children in the 11-15 age group needs to
be considered in service planning and training for staff.
PO4.
22% of those children on the register (2008) were diagnosed as
having Autistic Spectrum. This has been rounded this up to 25%
for Service Predication in the LAIMP.
PO5.
The diversity of Salford’s Minority Ethnic population needs to be
considered along with the high numbers of Jewish people living
in the City.
PO4.
When considering extended school provision the range of
settings children are placed in needs to be considered.
C1.
More provision. Disabled young people would like access to
more activities both mainstream and specialised. Ideally
services would be provided in their locality but they would be
prepared to travel if necessary.
C2
Transport is a critical issue faced by disabled young people and
their families and is a major barrier to accessing services.
C3
Better information about services needs to be provided at the
right time, in the right location and in an accessible format. This
may mean using several different methods such as websites,
posters in schools and leaflets sent to home. Mainstream
services need to remember to advertise their services in special
schools. Salford needs to encourage the use of its Information
Service, SKIP.
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C4
Support provided needs to be flexible so that young people’s
needs can be met in a variety of different settings. Currently,
young people have limited choice due to location and abilities of
the carer who supports them.
C5
Children with severely complex needs are excluded from both
mainstream and specialised services due to lack of experience
in dealing with this level of need. Services need to develop to
accommodate the most complex child in order to provide
inclusive services.
This would in turn enable them to
accommodate less complex children more easily.
C6
More support is required in the home to help with a range of
tasks.
C7
Staff and carers need to be skilled and experience so they are
confident working with children with disabilities.
P1
Increased range of service that are more flexible and responsive
with properly trained staff e.g. child minders, Saturday groups.
P2
Greater use of existing venues and ensure these are accessible
with appropriate facilities.
P3
Greater use of direct payments
P4
Family based activity
P5
Residential breaks
P6
Culturally Sensitive Services
D1
There is a demand for overnights stays in residential provision
as fostering is not available.
D2
Domiciliary support is required in the school holidays and 2:1
support required for play activities, and support for implementing
use of visual aid.
D3
There is a need to support family holidays
D4
External provision is being purchased due to lack of In-house
resources.
D5
The bulk of demand for support and services is for children in
11-13 and 14-17 age groups. This confirms the trend suggested
in the population section.
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S1
There needs to be a further development of the fostering service
so the waiting list can be reduced or families offered alternative
provision
Service gaps have been summarised and broken down into the areas
specified below;

Care in the child’s home- specifically,
Practical day time support from domiciliary agency
Specialist one to one support for ASD children
Parenting support for example implementing routines, and
supporting with communication
Service availability at peak demand times, particularly evening
and weekend
Support worker to take child to activities

Overnight breaks for children in groups A and B
Skills training for staff
Adaptations to carers homes
The current in house overnight provision is unable to meet the needs of both
children with complex needs, and those with ASD/ difficult behaviour.

Community based provision
Sport and leisure/ Fit City
Pre – school including play group, nursery and child minding
Extended Schools
Holiday Play Schemes
Youth Service

Training
Skills training around medical interventions
Awareness raising and skills development for working with
children with ASD ( See Workforce Development Plan). Link

Services to meet the needs of the Jewish Community
Care in the child’s home that is culturally appropriate
Overnight breaks away from the child’s home

Information and Communication
Variety of media
Different languages
Different formats
Accessible to children with learning disability
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Conclusions And Recommendations
8. Current available data has given us an indication of the numbers of
disabled children whom we need to be targeting in Salford under the
Aiming High Short Break Care Programme. As the data collation
systems improve, we will have better information about where these
children live, their gender, ethnicity, and type of disability. The disability
register needs to be brought up to date and a system re-introduced for
its maintenance and awareness raising with professionals and families.
Systems need to be developed to gather information on children under
the age of 5.
9. Through consultation, parents, children and young people have said
that they want to be able to access community based services. Salford
needs to be developing plans to make universal services more
accessible, and increase the amount of school holiday activities.
10. However, families in or near to crisis (evidenced through the Disability
Resource Allocation Panel) are requiring high levels of support in the
family home and through overnight breaks. Plans need to be
developed to provide these service but also to avoid families getting
into this position in the future.
11. Parents and professionals have both indicated they want better
services to provide support in the family home. Evidence from the
Disability Resources Allocation Panel is showing that current in-house
provision is stretched and unable to meet demand, and we have to
spot purchase support from other agencies on an ad hoc basis. The
development of a Preferred Provider List of agencies should start to
address some of these issues. In addition, there needs to be clarity
around the role of Salford’s Family Support Service, in meeting the
needs of those families with children with more complex disability.
12. Overnight provision from Salford’s in-house short break residential and
fostering services is not meeting the current levels of demand, with the
result that resources have been commissioned for those families who
have reached crisis point from the Independent and Private Sector.
The provision of overnight respite care is currently being reviewed.
13. Further work is required to ensure the needs of Minority Ethnic Groups
and other groups at risk of exclusion are being addressed.
14. Finally, there is a need for better communication, and a more skilled
and confident workforce.
The challenge for Commissioners is to ensure families requiring intensive
specialist services are supported, but adequate resources are still directed
towards non specialist, universal services allowing the “transformation” to take
place. How Salford will go about doing this can be seen in the
Commissioning Strategy, Delivery Plan and Workforce Development Plan.
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