LawsOn Thinking 202 Oakbrook Road Sheffield South Yorkshire

S11 7ED

T. 01142 991617

E. info @la wsonth inking.com

W. la wso nth inking.com

Brian Lawson Registered in Engl and and Wales , Company registration No. 05738138

11th June 2017

City of York Council

Development Workshop

Building a Centre of Excellence for Disabled Children and Young people in

York

Prepared for: Participants Prepared by: Brian Lawson

Date: 12th June 2017

York City Council

Development Workshop

12th

June 2017

2

1 Introduction, Eoin Rush:

We know from feedback that there are some arrangements and services that work well and are highly valued

and we also know that there is more to do.

Parent and carer feedback nationally and often echoed here in York highlights a wish for:

more safe places to go to, a need for a named worker to help families navigate ‘the system’ fewer uncertainties about entitlement fewer cliff edge transitions more engagement and participation in the development of local services even more joining up of services

Overall, local feedback from parents and carers suggests we do well here in York but always with room and

ambition to do even better.

So today we have a great opportunity to talk together parents/ carers professionals and strategic leaders to

describe what we think better will look like.

What changes or developments can we make locally to improve the experience and life opportunities for all

our children and young people?

When I have the opportunity to meet and speak with parents, sometimes at an event and sometimes as a

result of a complaint so many comments begin with:

Why can’t you? Why isn’t there any? What about?

Often these questions point the way to better arrangements.

For professionals also there are sometimes frustrations about the way we do things and I hear if only we

could? Quite a lot.

So today is a great opportunity to ask these questions together and to begin to imagine how we might

sometimes work differently. The flyer for today’s event describes a Centre of Excellence – it does not describe

what this is – it might be a building that houses some of services previously not available in one place, it might

be a safe place to go or it might also be a place where our pooled knowledge about what works and what is

most valued by children and young people and their parents and carers is shared and constantly updated.

From my perspective that is the task for today.

I have no doubt that this will be the first of many such discussions over the next few months while we build a

shared picture of the best arrangements for York.

I can tell you that there is a commitment from Members and senior managers to listen carefully and to use the

learning and messages from these sessions to shape the development of our Centre for Excellence here in

York.

York City Council

Development Workshop

12th

June 2017

3

2 Looking back and looking forward:

Service/Structure

Pre diagnosis support. Children Society PACT was present in the city. Anxiety around transition. More flexibility for parents (but more information required about the

local offer). Care Act. Deaf Unit at Hemplands. ASC Unit Jo Ro. Haxby Road. Sat. at Applefields. Parents consultation – signposting of info. Local offer. Snappy. More children centres.

Capacity/Staffing/ Waiting lists

Parents were waiting up to two years for a service. Contracted carers. CAMHS waiting list, 1 year. Criteria – behavior waiting lists longer e.g. The Island. Consistent staff – 16- 60! Community SB workers – base for more activities, peers, friendship and less admin staff. Community short breaks workers. Parent mentoring. More SB workers. PACT workers – The Children Society. Staff – lots of people with short breaks. Positive workers. Sickness.

Funding/Financial

More money, less stress. More resources. 5 years of austerity – Health and NHS- lack of money and voluntary

sector reduced. Funding cuts. Personal budgets / direct payments. Comprehensive resourcing of services (non-stat services declining).

York City Council

Development Workshop

12th

June 2017

4

Children and Young People’s Needs

Reduction of services for increase autism need. Increase in mental health and autism needs. Children more challenging – small amount of children. Trends come and go, buzz words change, we have fit into boxes – but

young people don’t! Flexibility in transition; accommodating for young people’s needs,

avoiding drop off at 18. Preparing YP for independence. Problem solving according to needs – flexible. Aiming high for disabled children.

Development

Gaps – training for RB. PA’s developing services. New Education and Health plan; involving parents and carers

throughout, focused on the child’s needs, greater involvement between professionals and families.

Local offer updated and developed.

First FIRST – Developed new service, more pro active than CAMHS, hands

on, multiple services put together.

The Glen House

The Glen provided more day care. Glen – building challenge. The Glen House. High demand, service not grown – The Glen (beds), respite centre –

name.

EHCP Joined up EHCP meetings. EHCP’s – integrated working. 0- 25 EHCP.

Short Breaks

Short breaks service has developed. Online self-referral form for parents – short breaks. Aiming higher; 100 hours of short breaks, less beaurocratic. Short breaks, meaningful experience for young people.

Online Offer

York website much better. Online self-referral form for parents and developed with parents –

short breaks. SB enquiry forms – online, less boundaries.

York City Council

Development Workshop

12th

June 2017

5

3 Vision pictures:

York City Council

Development Workshop

12th

June 2017

6

York City Council

Development Workshop

12th

June 2017

7

York City Council

Development Workshop

12th

June 2017

8

4 World Café Exercise: Exploring key areas of development and feasibility:

How do we maintain and enhance the

quality of our services?

Maintain: - The Glen service. - Salaried/working conditions/job security. - Good supervision, peer support.

Enhance: - Pooling budgets; needs lead not resource lead. - Pooling; Training, expertise, experience, information, environment, space. - Consistency of staffing for First too; stability, trust, security, knowledge of child/young person and levels. - Contracted – CSBW, not casual and committed to York. - Flexibility and awareness of changing need. - The Glen and CSBW – outreach into community.

Maintain and enhance: - Invest in people you have. - Continuity. - Utilise skills –skills match. - Invest in training – same training for all. - Funding/fairer and better pay/ recognition – how hard, how well. - Stability to keep well trained staff. - Peer to peer working across teams/service. - Bespoke care plan. - Opt in/opt out. - Flexibility. - Quality support and advice for the workforce. - Keep child at the centre. - Ground up! - Use of skilled people in the home. - Creativity. - Consultation with parents/children. - 6m reviews of service (short breaks). - Good leadership.

Staffing: - Consistently good working practice, experience to be valued and training, contracts – CSW for carer progression, innovative leadership, joined up working – children services/ adult services/ Health/ Education, sharing our practice – past and present recognition, learning from other Authorities and clinical research, family centered.

Building: - Room flexibility across all services, thinking about all services design, think inter personal relationships/dynamics, individual requirements, utilise resources, common information sharing for professionals and families – virtual centre of excellence, learning from other projects.

York City Council

Development Workshop

12th

June 2017

9

What happens to young adults and

beyond?

Share resources, share budgets, share experience. Join budgets 18- 40, 40- 50, 50 – end of life to eliminate dropping

over cliffs! Local offer post 16/18 – adult. What percentage of people – crisis at 18 years plus? Limited opportunities. Square peg! What does young person want? Coordinated team children/transition/adults. Local or out of area? Social worker in adults. Personal budgets. How do we find out? LA coordinators. Communication. GAPS. Meaningful engagement. Work experience – where to find info? Access to work. Adult short breaks. Peers and friendships lost over transitions. Where do children go when they are 18+? – in past years there is

info that is not shared or celebrated. Local – near friends and family. Lots of changes for a young person as a teen. Young people’s right 16- 25 year olds. Money – flexibility needed. OFSTED/CQC issues – flexibility needed. Age is just a number – 18 is arbitrary. Carries on in education/move on independent living. Health. More transparency. Develop life skills/independent living – at an appropriate age and

stage – not necessarily 16/17.

York City Council

Development Workshop

12th

June 2017

10

What facilities do we need locally to support our most complex children

well?

Facilities needed: - Family residential provisional catering for wide range of need – modelling approach. - Outreach to community and education? - ‘Safe’ place for parents/carers (supported by professionals). - 24/7 support. - Fully multi-agency working space (incl. safeguarding). - ‘Place’ for siblings (groups/support). - Training facilities (multi-agency) – all staff approach. - Emergency/crisis accommodation (to include families). - School facilities (weekends/hols); sensory, cooking, hydro, school buses. - Short breaks (places to go); friendships, economy of scale and collective trips. - Schemes (not always buildings). - Sufficiency of short break workers – hours. - Health (ward 17); Glen nurse – also team leader, our of hours – advice for community workers. - Multipurpose building; contained areas as well as pods, specific rooms – sensory, hydro facilities, w/ch accessible rebound – wipe clean surfaces, ceiling track hoists, car parking, outside space – safe space, sensory/quiet, space to run, w/ch accessible swing and roundabouts, w/ch accessible kitchen and facilities for independent skills.

What do we mean by ‘complex’?: - Physical health/complex. - Complex behaviour (home and/or school).

What do we need?: - Multi-agency approach. - Modelling approaches. - Physical environment which caters to need. - Consistency of place/people/approach. - Flexibility (fit service to child and family).

York City Council

Development Workshop

12th

June 2017

11

How do we provide support very differently?

Service funding Shared systems. Professionals training. Virtual centre of excellence. Accessibility of training – more flexibility about delivery e.g.

weekends/out of hours work. Invest time. EHCP format in place for those who don’t meet criteria. Linking funding into voluntary sector. Support pre diagnosis to prevent crisis expectation. Identify gaps – don’t reinvent the wheel. Support families. CAMHS private assessment. Listening to parents more effectively. Consistent approach. More than one child with needs. Re-naming or re-thinking the name – short breaks. Being creative about how we use short breaks. Training of the inclusion of everyone in skills sharing - should be

viewed as essential mandatory training, could this be part of the hub – one stop shop for information?

Services particularly geared around non-verbal children. Maximising technology for friendship and communication. Pooled budgets – proper personal budgets. Early intervention and flexibility. Expanding on sensory and therapy sessions. Holistic approach for entire family/siblings ‘Martin House’ model –

overnight stays. All abilities/community projects and services. Short breaks – provision, flexible e.g. home based support. A ‘hub’ divided into sensory environments, dynamically assessed,

secure but universally accessible – not just a physical space but a city wide provision.

A lovely building that’s exciting for children and young people- want to use.

York City Council

Development Workshop

12th

June 2017

12

What do we mean by a Hub Model?

Location – safe, quiet, central. Accessibility - parking and accessible by bus, mini bus. Space – space for out of school, green space, community groups,

family room, meeting space – professionals, office space – open access, clinics, kitchen area, day activities, sensory room, parent space, family residential – siblings, self-contained if needed, outdoor space.

Activities – sports, ‘base’ – community short breaks, community short breaks, adult short breaks, vol sector/after school activity groups., residential short breaks – autism, complex health.

Functionality - Flexibility/adaptability for different ages/needs, independence training support, outreach.

Operating Model – Goals, needs orientated within specific timescales. Social/family network around the child, get the community short breaks bit working first, crisis beds when needed.

Key questions to consider - What is SB? avoid spreading resources too thinly, large open access inclusive Vs specialist provision. - Pods, self-contained and separate areas. Needs analysis to ensure future proofing. - No. of beds – 0- 25 more capacity needed, careful not to build a big residential unit/institution or hospital.

Additional thoughts and ideas - Within own family but someone carrying out ‘care’ tasks, siblings, pooled resources.

York City Council

Development Workshop

12th

June 2017

13

6 Next steps: a. Report of the Stakeholder Event to be written up and circulated to all attendees

b. Task and finish groups to develop the detail and plans c. Continue to engage and communicate with staff and parent groups

d. Develop a second film with disabled children and young people

York City Council

Development Workshop

12th

June 2017

14

7 Feedback:

York City Council

Development Workshop

12th

June 2017

15

York City Council

Development Workshop

12th

June 2017

16