Agenda item

Supporting children with additional needs

For the committee to consider the support offered to children with additional needs and their families.

Minutes:

The Head of Service Starting Well introduced and gave an overview of the report, which showed progress in relation to the sufficiency of short breaks available to children, young people and their families within Herefordshire. The report identified opportunities for further development and confirmed how the service was moving forward to co-produce the Local Offer.

 

It was explained that following the SEND inspection the service had challenged itself to answer the following four questions:

 

  • How do we publicise information re short break services at a universal, targeted and specialist level and how effective are we in doing so?

 

  • Are we assured that there is transparency and equity across the system giving opportunity to children of all ages, disability and level of need?

 

  • Are we using the services that we have in place efficiently and do they offer safe, flexible and cost-effective choice to families?

 

  • How are we going to develop increased sufficiency that delivers flexibility and choice for families ensuring that they can access a short break safely and easily?

 

The Head of Service Starting Well provided an overview of the response from the service to the questions.

 

The Chair invited comments and discussion from the committee in relation to the report. The key points of the discussion are detailed below:

 

  1. The committee asked for an outline of the main issues around recruitment in short breaks and foster care placements.

 

  • The Head of Service Starting Well explained that recruitment remained a key challenge, particularly for complex needs and overnight care, it was pointed out that a dedicated fostering post was currently vacant due to staff illness. Task-and-finish groups and marketing initiatives were underway and a collaboration with ‘Shared Lives’ was being explored to extend support for young people

 

  1. The committee enquired about feedback provided by families regarding short breaks.

  • The representative from Parent Carer Voice (PCV) explained that parents had welcomed improvements relating to prepaid card usage and spending guidance. Families especially appreciated broader and clearer guidance on how and where to spend allowances, and a direct debit function - added via a new provider - had been well received.

 

  1. The committee asked whether supply for short breaks was currently meeting demand

  • The Service Manager Children with Disabilities stated that regarding group-based short breaks there was enough capacity in numbers, but not always in fit, such as location and appropriateness for child.

 

  • Families in areas such as Ross-on-Wye and Leominster were underserved due to the centralisation of provision in Hereford.

 

  • It was explained that regarding overnight provision there was a clear gap due to staffing issues at the NHS-run Osborne Court, which had paused service. The local authority and Integrated Care Board were urgently reviewing options for children with complex health needs.

 

  1. The committee asked if the council was able to work with economic development colleagues to grow a local provider market?

 

  • The Head of Service Starting Well stated that a market engagement strategy was launching in April/May and open-ended questions would be sent out to local and regional providers about appetite and feasibility.

 

  • The council was part of a 14-strong local authority regional partnership sharing provider innovations.

 

  • Procurement rules were being simplified to support small and informal providers, such as those run by parents or in community halls.

 

  1. The committee asked how the council was supporting personal assistant (PA) development, and how it was listening to their needs?

 

  • The Head of Service Starting Well explained that the hourly rate had been raised from £13.80 to £14.31 and new training and continuing professional development offers were in place for PAs.

 

  • There had been a collaboration with schools to grow the PA pool. For families hiring PAs privately, the council had limited structured engagement, but recognized the need to develop this while respecting family autonomy. The service was looking to create a pool of trained, available PAs with shared information on availability and skillsets.

 

  1. The committee asked whether services were quality assured and equitably accessed?

 

  • The Head of Service Starting Well pointed out that work was ongoing to gather qualitative and geographic data such as the child’s age, needs and where they lived.

 

  • The QA team was embedded in commissioning to work directly with providers beyond current requirements, and transparency in decision-making and data monitoring was improving.

 

  1. The committee asked whether families were breaking down due to a lack of short breaks, and whether there was any data relevant to that.

 

  • The Service Manager Children with Disabilities confirmed that there had been no recent cases where families had broken down solely due to a lack of short breaks.

 

  • When crises emerged, multi-agency support packages were put in place in relation to mental health, education and social care.

 

  • Short-term breaks were used tactically to alleviate crisis risk. Family breakdowns were typically multi-factorial and not attributed only to short-break availability.

 

  1. In relation to social needs and peer relationships for teens with SEND, the committee enquired how the council was replicating the social environment lost with Old Ledbury Road, especially in regarding teenagers.

 

  • The Head of Service Starting Well explained that this had been recognised as a gap and that current short breaks did not always foster social interaction or friendships.

 

  • The aim was to create peer-based group activities and overnight options, but providers preferred block-booked arrangements and families preferred flexible, personalised care. Trying to strike a balance between provider viability and family choice was ongoing.

 

  1. The committee considered whether it would be possible to explore a last minute-style booking model to utilize spare care capacity?

 

  • The Service Manager Children with Disabilities stated that there was not currently such as system in place, but acknowledged it was an innovative idea and the council would be willing to explore tech-based, flexible booking systems in future market development work.

 

  1. The committee enquired about family involvement in service design and whether families could be more involved in trade-off decisions around block bookings and flexible services.

 

  • The Head of Service Starting Well pointed out that this was already being discussed with Parent Carer Voice and other stakeholders.

 

  • It was acknowledged that other local authorities had successfully used collaborative funding discussions and that informed co-design was essential when making decisions about how to spend limited funding.

 

  1. The committee asked whether community groups were better positioned than formal providers to respond flexibly?

 

  • The Head of Service Starting Well suggested this was possibly the case in relation to targeted or universal support, but less so for complex health needs.

 

  • Safer Communities grants had received an unprecedented level of interest and the council was following up with grantees to explore conversion into longer-term short break provision.

 

  1. The committee asked if the council was tracking long-term outcomes from changes in short breaks provision?

 

  • The Service Manager Children with Disabilities stated outcome tracking was not explicitly longitudinal yet, but the service was starting to build better data to track impact in relation to service use, PA employment and parent satisfaction.

 

  • It was pointed out that the ‘Visible and Valued Week’ in May would serve as a community benchmark to build awareness and confidence.

 

  1. The committee acknowledged the substantial work and progress in developing and improving the short breaks offer for children and families, and thanked all contributors for their feedback and involvement.

 

At the conclusion of the debate the committee discussed potential recommendations and the following resolution was agreed.

 

Resolved:

 

1. That the committee note the report.

 

Supporting documents: