Short breaks practice guidance; how to safeguard and promote the
welfare of children in need using short breaks
Contents
1.
2.
3.
4.
Introduction - Why do we need the guidance?
Definition – short breaks
The legal framework
Assessment, planning and review
1. Introduction
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:
1. 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.
2. 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.
3. 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.
4. 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.
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Family Support
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 Act1) 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.
This guidance:
 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.
1
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.
2
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
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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 Act2 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
2
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.
4
need3 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 preplanned 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
3
a child ‘in need’ is defined in section 17 (10) as including disabled children.
5
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
1. 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;
2. arrangements for contacting the parents as necessary, in particular, an
emergency contact number;
3. the child’s leisure interests including activities the child particularly likes
or indeed does not like; and
4. 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:
1. the type and address of the accommodation and the name of the
person responsible;
2. how long the arrangement is expected to last and steps to take to end
or change the arrangements;
3. 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;
4. 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;
5. financial arrangements for the placement; and
6. 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
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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.
Consultation
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.
Visits
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
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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
holiday play schemes
Sitters, befrienders,
personal assistants
Early years providers,
includes childminding
Registration, inspection,
applicable standards
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
No current registration
requirements unless
providing personal care
Notes
Subject to the
passage of
legislation DH has
made provisions to
exempt PAs from the
requirement to
register with CQC
under specific
circumstances.
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.
8
Childminding 5-8 year
olds
Domiciliary care
Hospices
Local authority foster
care
Children’s homes and
residential special
schools
Ofsted: Childcare
(General Childcare
Register) Regulations
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
Came into force Sept
2008
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
Ofsted, Fostering Services New NMS to come
NMS
into force April 2010
Fostering Services
Regulations 2002 as
amended; Care Planning,
Placement and Case
Review (England)
Regulations 2010
Ofsted, Children’s Homes New NMS to come
and residential special
into force April 2010
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).
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
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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
http://www.dcsf.gov.uk/localauthorities/index.cfm?action=content&contentID=17571&category
ID=75&subcategoryID=106 ]
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.
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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)
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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.
Low
Low
Many services are
registered- quality
and access
assessed locally
Not a ‘social care’
case
Children in Need
under S.17
Local offer
Level of need
Self-assessment or
CAF
Targeted services
Low level of overnight
short breaks
Initial assessment
Core assessment
Children in need
plan- regular review
of package
Child is Looked
After-but with lower
level planning
requirements
Regular overnight short
breaks in the same setting
High levels of support,
substantial overnight
short breaks
Full Looked After
Child planning
requirements apply
Children provided with
short breaks
accommodation under
S.17 (6)
Looked after children
provided with short
breaks provision under
S.20(4), where regulation
50 applies
Looked after children
provided with
accommodation under
S.20 where section 50
does not apply
High
Level of service, assessment & safeguarding
Access to universal
services
High
A proportionate response to ensure children are safeguarded effectively without unnecessary intrusion into family life
4.1 Assessment
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
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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.
Informal 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.
Initial 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]
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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 needs4. 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 Together5 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.]
Core assessment
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
4
Section 6 of the Carers and Disabled Children Act 2000
5
[Insert web link/ full reference]
14

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)6
Carers Assessment
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:
1. particular vulnerabilities of the child, including communication method;
2. parenting capacity of the parents;
3. 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);
4. whether short breaks are to be provided in more than one place;
6
DH will shortly be publishing guidance on assessing the continuing care needs of children with life
threatening or life limiting illnesses
15
5. potential impact on child’s place in the family and on primary
attachments;
6. 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);
7. 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;
8. extent of contact between short break carers and family and between
child and family during the placement;
9. distance from home; and
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.
16
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)
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
If a child is provided
with accommodation
under section 20(4)
where regulation 50
does not apply
-
the child is not looked
after
-
the child is looked
after
-
the child becomes
looked after
-
the Care Planning
Regulations do not
apply (and therefore
there is no
requirement to appoint
an IRO)
-
modified planning
arrangements
apply and there
must be a short
break plan
addressing those
issues key to the
safe care of the
child
- the Care Planning,
Regulations apply to
the placement so the
authority must make a
care plan
17
-
-
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
-
an IRO must be
appointed
-
an IRO officer must
be appointed and
-
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 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
the first visit must take
place within 15 days
of placement or as
soon as practicable
thereafter.
visits must take place in
Subsequent visits
accordance with
must be at intervals of regulation 29
no more than 6
months
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
1. have clear and realistic objectives
2. include ascertainable wishes of child and family
3. follow consideration of options, including but not limited to direct
payments
4. 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
5. state communication methods, clinical needs, risk assessment
including moving and handling, dietary requirements, behaviour
management,
6. state contact arrangements for emergencies
18
7. state commitments of professionals involved
8. refer to or summarise any other important documents about the child’s
development
9. 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)
10. 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 coordination and efficient use of time for both professionals and family.
19
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.
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Annex 1 Core Offer
Assessment
Disabled children and young people receive child-centred multi-agency coordinated 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.
21
Annex 2
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.
Carers role

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?
Wider responsibilities


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,``
22
Future caring roles


How does the carer see the future?
What factors are likely to affect the willingness/ ability to care long term?
Emergencies/alternative arrangements


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?
Accommodation

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.
23