South Tyneside multi-agency transition into adulthood protocol & pathway for young people with learning difficulties and/or learning disabilities

Transcription

1 South Tyneside multi-agency transition into adulthood protocol & pathway for young people with learning difficulties and/or learning disabilities (LLDD) November 2013

2 Contents Page No Foreword 3 Section 1: What is this protocol and who is it for? 4 Section 2: What does good transition look like? 5 Section 3: Transition pathway 6 Section 4: Transition timetable 7 Section5: Roles & responsibilities 11 2

3 Foreword The transition from childhood into adulthood is a time for hope, for celebration, for change and a time of challenge for all young people. They will be making decisions about their careers, their continuing education, their social life and where they want to live. For many young people having access to timely information, guidance and advice can help them to meet their goals, whilst others might need support from a range of services. Disabled young people and their families have repeatedly told statutory organisations that transition into adulthood can be a very stressful time in their lives where good practice in transition is not sufficiently well embedded. Recent policy and guidance produced by a number of organisations all state that there is a need for agencies to work together to provide careful preparation, multi-agency planning and excellent communication to ensure that disabled young people get the support they need so they can move from child, to young person, to adult as seamlessly as possible. This Transitions Protocol and Pathway provides the framework for how services in South Tyneside will work together to ensure the best outcomes for all young people with learning difficulties and/or disabilities as they move into adult life. There have been significant changes in the Council s responsibilities including the local authority taking responsibility for the commissioning of post 16 education and schools taking on responsibility for careers advice. There have also been significant changes in how health care services are commissioned following the recent reorganisation of the NHS and the establishment of the NHS South Tyneside Clinical Commissioning Group. This presents significant opportunities to build on the arrangements outlined within this protocol, in particular, the establishment of personal health budgets for children with continuing care needs by 1 st April 2014, will form part of these developments. There will be further significant changes in how local authorities work with health partners following reforms to the Special Educational Needs and Disability (SEND) process, currently going through parliament and due to be implemented in September This protocol and pathway will therefore be updated during 2014 in the light of these reforms and other local developments. Helen Watson Corporate Director Children, Adults and Families South Tyneside Council. Christine Briggs Director of Operations NHS South Tyneside Clinical Commissioning Group 3

4 Section 1: What is this protocol and who is it for? This South Tyneside multi-agency transition into adulthood protocol and pathway is for all young people with a learning difficulty and/or disability (LDD), aged years who have a statement of Special Educational Needs (SEN) and some who are placed on School Action Plus of the SEN Code of Practice and for their families and any professionals involved in transition. The SEN Code of Practice and the Guide for parents and Carers is available at: 581% Whilst this protocol describes a process that brings together professionals from different agencies to meet the needs of those young people who have the most complex needs, this would be too intensive for some young people and for them, a more appropriate, simplified process will be used. A person is described as having a learning difficulty and or disability if he or she: Has a significantly greater difficulty in learning than the majority of people of his or her age; or Has a disability that either prevents or hinders him or her from making use of educational facilities of a kind generally provided for people of the same age in schools or other educational establishments within the area of the local authority. This definition can include children and young people who have a physical or sensory disability. A strategic transition into adulthood protocol and pathway is needed in South Tyneside to ensure services are brought together, with a clear and transparent commitment to making the transition process work for young people and their families. This protocol will identify key milestones in the process and the roles and responsibilities of those involved, thus ensuring that seamless transition is achieved for young people and their families. It should transform their experiences and the effectiveness of local support. This protocol and pathway must be owned and understood by all those who have a part to play in its implementation. We have therefore involved partner agencies, young people and their families in its development and will continue to do this as it is updated over the coming year. 4

5 Section 2: What does good transition look like? Transition can be an exciting time of new opportunities, choices and increasing independence. It can also be a time of great anxiety, confusion and uncertainty for young people with LDD and their families as they move from familiar arrangements, services and people into the unknown. For young people and their families, it is a crucial time to think carefully about their life, what they want now and in the future. Current policy and guidance makes it clear that young people and their families should play a central role, with planning starting early and with all agencies working together. By listening to the young person and their family about what is important to them, a person centred approach to transition planning can make a real difference to the outcomes that are achieved. In discussion with families and young people with LDD it is clear that good transition involves: Opportunities to make choices and take risks throughout childhood; Good co-ordination and communication between the agencies responsible for services for children and adults; Effective participation by young people and their families within existing multi-agency transitional planning systems; Adequate choices and opportunities at the point of school leaving and after for young people with LDD; Good information available at the right time in an understandable format. Some young people with a LDD do not have sufficient understanding and communication skills to make their views known. In this situation it is essential that those working with them have the necessary skills to facilitate the involvement of the young person. Referral for independent advocacy may also be appropriate, particularly when there is a conflict between the young person s views and others involved. Transition planning for young people means putting the young person at the centre of the process and addressing the following issues: What is important to the young person now and for the future, what are their aspirations? Could they have higher aspirations? What is practical and possible for the young person? What support do they need? This can create a significant challenge through the tension that can exist between what is available and what would fully and best meet a young person s needs. Some of these issues can only be resolved through the process of commissioning appropriate services or through enabling people to have a personal budget which enables them to arrange their own services to meet their assessed needs. Transition planning should help the young person to discover and create the future they want. This should lead to more people using college courses or other day activities in preparation for paid work, moving into their own housing or other independent living accommodation, having their own personal budget, employing their own support staff, enjoying full and healthy lives and being contributing members of their own community. 5

6 Section 3: Transition pathway Year 8 Pupil services works with schools and partner agencies to identify young people who need an extended transition plan. (pages 7 & 11) SYP will arrange a 1:1 interview with the young person and their family to provide further advice and guidance. (page 15) Year 9 School convenes transition review inviting all relevant professionals, the young person and their family. Lead from Services for Young People (SYP) identified. (pages 7 & 15) School produces initial Transition Plan Parents can contact Parent Partnership Officer for independent advice and support at any point in the SEN process (page 11) Referral to CADS if social care support required (page 13) Year School convenes annual reviews of Transition Plan (pages 8-10) SYP commences Learning Difficulty assessment (page 15) Refers to local education or training provider Children Act assessment (age 0-18) or Community Care assessment (age 18+) undertaken if required School updates Transition Plan Refer for welfare benefits advice as required (page 16) Seeks approval for funding of specialist post 16 placement if required Young Person remains at school Young Person leaves school Provision of health care transfers to adult services at age 18. However, this varies with some professionals and can occur between ages of (page 9-10) Education or training provider assumes responsibility for reviewing progress and ongoing support needs. Support from SYP can continue up to age 25 6

7 Section 4: Transition timetable Year 8 (age 12/13) Pupil Services will work with schools and partner agencies to identify those young people who have complex needs and will require significant extra support from more than one agency which could best be delivered through an extended transition plan. Year 9 (age 13/14) This is the start of the formal transition process. The Year 9 annual review of the Statement of SEN takes place at school and must include the formal beginning of transition planning. Young people are supported in advance of the review in order for them to fully understand and maximise the potential opportunity of it so they are able to make an informed contribution. Discussion will take place to explore what is important to the young person now and for the future, including, what are their aspirations? What is practical and possible for the young person? What support do they need? The review is called by the Head Teacher of the school and must be attended by the young person and their family (or chosen representative), school staff, and a representative from Services for Young People (SYP). Where the need for an extended transition plan has been identified and there is involvement from a children s social worker, school nurse or learning disability nurse, these practitioners should also attend. If there is no current social work involvement, but it is thought likely that the young person will require social care support as an adult, then a social worker should also be invited. The young person and their family should be asked who else should be invited to the transition meeting. The meeting should focus upon what is important to the young person, what support they need and what is working and not working in their life. The initial transition plan is developed with an action plan that details who will undertake what activity and by when and agreement is reached regarding how the plan will be monitored and updated. Services for Young People have responsibility to oversee the implementation of the plan and will appoint a Young Person s Lead, unless it is agreed that someone else would be more appropriate. If it is identified that the young person and their family might have unmet social needs then a referral should be made, with the consent of or by the parents, to the Children and Adults Disability Service (CADS) for an assessment. Where a young person has a statement of SEN, the Young Person s Lead from Services for Young People will arrange a 1:1 interview with the young person and their family to provide further advice and guidance. The Parent Partnership Officer can offer parents independent advice and support about post 16 education or any other issue concerning SEN. Following the review, the school has responsibility for writing and holding the transition plan. Where there are complex needs and the involvement of other professionals, it is more likely to be in the young person s best interests that a multi agency plan is agreed by all those involved. 7

8 A copy of the review and plan should be sent to Pupil Services and to all those attending the meeting. Year 10 (14/15) The school is responsible for identifying review dates and circulating invitations to the family and involved professionals at least 6 weeks before the review date. The transition plan is reviewed and updated to address any further education, health or social care issues that need to be included. The young person and their family should be supported to review their plan, explore post 16 options, make changes and agree who will undertake what actions. For those in their penultimate year of schooling, the Young Person s Lead from Services for Young People will begin the Learning Difficulty Assessment (LDA) process for all young people with a statement of SEN and for others for whom this would be appropriate. This assessment will identify the support needs of the young person as they leave school and take up other educational options. If social care needs to be involved in planning for the future a formal referral should be made to the appropriate service if they are not already involved. Year 11 (15/16) The school is responsible for identifying review dates and circulating invitations to the family and involved professionals. The transition plan is reviewed and updated to address any further education, health or social care issues that need to be included. For those in their penultimate year of schooling, the Learning Disability Assessment will commence. Where the young person is planning to leave school in the next academic year, the meeting considers progress on the LDA which must be completed by the end of the Autumn Term in their final year. The draft LDA is sent to suitable providers for them to undertake an assessment on how they can meet each student s educational and support needs. Where the draft LDA recommends provision through a specialist college, a Specialist College Planning meeting, comprising professionals from the local authority and potential providers will scrutinise applications and look at whether or not a young person s needs can be met locally. The annual review meeting in the final year at school should take place early in the academic year to enable updated agreed actions to be implemented before the young person leaves school. Where the LDA recommends that the young person s education, training and support needs can only be met by an Independent Specialist Provider, then approval will be sought from the High Level Needs Panel, comprising Senior Managers from the Children s Services and Health related services. The Mental Capacity Act applies to young people from the age of 16 and an assessment may need to be carried out with young people from this age who are unable to make some or all decisions for themselves. 8

9 There is a useful booklet about the Mental Capacity Act called Making decisions, a guide for family, friends and other unpaid carers available from the Office of the Public Guardian on Entitlement to some welfare benefits changes at age 16 and a referral to the welfare rights service should be considered. By the final review meeting it must be clear what will happen when the young person leaves school. The Young Person s Lead is responsible for ensuring the young person knows what will happen and where they are moving on to when they leave school. The young person should have up to date key contact information to ensure ongoing planning. Where the young person is staying in education, the annual reviews of the statement of SEN will continue. At each review from Year 11, the need for a Learning Difficulty Assessment should be considered for those who do not have a statement of SEN. Year 12 (16/17) Where the young person has remained at school for education the Head Teacher is responsible for arranging the annual review. When young people leave school, the statement of SEN lapses and responsibility for reviewing their progress and ongoing needs devolves to the post-16 education or training provider. The Young Person s Lead from Services for Young People should continue to support the young person in their new learning environment until the age of 25. The Equality Act 2010 applies to education and training providers and should ensure that the young person is not discriminated against. For example, it is unlawful for education providers to discriminate against disabled pupils, students and adult learners. The law also requires that reasonable adjustments should be made to remove any physical barriers that prevent disabled people using services, or to working conditions or the work place to assist a young person with disabilities do a job. Where the transition plan recommends that an adult age 18 or above may be in need of social care support, the local authority has a duty to carry out an assessment of the person s needs. The relevant care management team will undertake the assessment of need in line with Fair Access to Care criteria. A financial assessment will also be undertaken to identify if a client contribution will be required under the fairer charging policy. Where appropriate a direct payment can be made to enable the young person to arrange services to meet their assessed needs. Where the person does not meet the criteria either for an assessment or services, signposting and advice will be given. Medical support for children and young people at school is provided by Children s Health Services. Many children with disabilities will have regular contact with paediatricians, who are doctors who work specifically with children and as a result, children and their families often build up established relationships over time with certain consultants and healthcare professionals. 9

10 As children leave school their health support needs to be transferred to Adult Health Services. This means that when a person is 18, they are no longer able to access paediatric services and therefore the consultant will no longer be able to remain involved. Depending on the sort of healthcare service the young person is receiving and when they leave school, the transfer to adult health services may occur earlier, from the age of 16, or later, up to the age of 19. Health and medical support for over-18 year olds is provided through the General Practitioner (GP) practice, Specialist Community Learning Disabilities Health Teams and where required General Hospital and out-patient services. Year 13 (17/18) Where the young person remains within a school setting review arrangements are as set out previously. Where the young person is planning to leave school at the end of the next academic year, the Learning Difficulty Assessment should be completed by the end of the autumn term in the final year of school. The Children and Adults Disability Service (CADS) is a lifespan service for people with a learning disability and includes social workers experienced in work with children and in work with adults. Transfers between workers will take place flexibly at an appropriate stage in the young person s life and will always involve a period of joint work. The different legal frameworks for children and adults will be managed sensitively so as to minimise unnecessary disruption. Young people with a sensory or physical disability will transfer to a social worker within the Older Persons and Physical Disability team flexibly and in a planned way at an appropriate stage in the young person s life Where the young person is receiving welfare benefits, or might be eligible to claim, a referral to the Welfare Rights Service should be considered. Year 14 (18/19) The final school review takes place which updates the transition plan. The Learning Difficulty Assessment must be completed prior to the young person leaving school. Age Where needed, Services for Young People continue to provide advice and guidance up to age 25 and young people who are Looked After are entitled to ongoing support under the Children Leaving Care Act

11 Section 5 - Roles & Responsibilities South Tyneside Council Schools Many young people with LDD receive their education in one of the authority s 9 mainstream secondary schools. There are also 4 special schools in South Tyneside that can accommodate children and young people with LDD. Schools carry the responsibility to co-ordinate the formal transition process and are well placed to bring together other key agencies and work with young people to ensure their views are at the heart of the process. The Head Teacher has responsibility for implementing the transition process including liaison with the Health, Social Care, Pupil Services and Services for Young People. Special Educational Needs Co-ordinator (SENCO) Every school has an appointed SENCO who is a teacher with additional responsibility to record and update information with regard to the young person s special educational needs, whether or not they have a statement of SEN. They liaise with parents and relevant professionals in other agencies, arrange educational facilities and resources and advise the teaching team ensuring that individual educational plans are in place. They monitor the young person s progress in educational settings, arranging formal reviews as required and provide information about a young person s educational needs to key staff in further education meetings. Parent Partnership Service The Parent Partnership Service offers free independent information, advice and support to families whose children have, or may have special educational needs (SEN) and/or a disability. The service operates on an outreach basis across the Borough and aims to enable parents/carers to make informed decisions about their children s education by providing information and advice on a wide range of issues. Parents can contact directly at any point in the SEN process. Tel: parentpartnership@southtyneside.gov.uk Pupil Services Pupil Services co-ordinates the formal assessments of children and young people with Special educational Needs (SEN). This service produces the Statements of SEN which clarify what a child s needs are and the provision required to meet those needs. This service also co-ordinates the Annual Reviews of all children with Statements. Children who are identified in school as having special educational needs usually have their needs met by School Action within their local school. Some children require greater assistance than their school can offer, in which case schools can seek support or statutory assessment from this service. 11

12 Whilst mainstream schools are now responsible for funding Inclusion Support for individual pupils up to 6,000, applications for top up funding above this level can be made to the Local Authority; these are dealt with by Pupil Services. This service also determines the Authority s placement of children with SEN in a special school or unit. Pupil Services also determines whether special equipment/resources or transport is required for children with special educational needs. Pupil Services Chuter Ede Education Centre, Galsworthy Road, South Shields, NE34 9EG Tel: Educational Psychology Service The Educational Psychology Service offers a range of expert advice, support and intervention to children and their families/carers and schools, other professionals and voluntary organisations in South Tyneside. The aim of the service is to help children and young people with special educational needs or disabilities get the most from their education. The service is staffed by Educational Psychologists, Specialist Teachers and Emotional Resilience Officers. Support that the team can offer includes: Meeting school staff, parents and carers to listen to and discuss their concerns. Observing and assessing children to identify their strengths and difficulties. Talking with children to understand their views about difficulties they may have. Offering professional opinions about learning or behaviour to staff who work with children. Training for schools and other professionals. Working with other agencies and services. Referrals must be made through the SENCO in the school Educational Psychology Service Chuter Ede Education Centre Galsworthy Road South Shields NE34 9UG Tel: educationalpsychologyservice@southtyneside.gov.uk 12

13 Children and Adults Disability Service (CADS) The Children and Adults Disability Service (CADS) provides specialist social care support to families of disabled children and to adults with a learning disability. The team works with children from birth who have a permanent and substantial impairment, typically needing input from a number of agencies on a lifelong basis. Disabled young people continue to be supported through the transition to adulthood. For those who have a learning disability, CADS can continue to provide services throughout adulthood whereas those with a physical disability and no learning disability will transfer to the Older Person s and Physical Disability Team in a planned way and at an appropriate time before they are 25 years old. CADS includes a part time Occupational Therapist who works with children and their families. Following an assessment of need, services may be provided directly through the Council, or through Direct Payments and Personal Budgets. These are available to parents of disabled children from birth to age 18 and to disabled adults from the age of 16 to enable them to arrange their own services to meet assessed need. CADS provides a range of social care opportunities and provisions for disabled children, young people and their families, including help with daily living, short breaks and safeguarding. Whilst some of these are available without an assessment, higher levels of support are only available following an assessment involving the child or young person and their family. This support is then regularly reviewed to ensure that it remains appropriate and continues to meet need. CADS provides a full care management service for people with a learning disability, from the age of 18 including assessment of need; support planning; implementation and reviewing of support plans. CADS works closely with parents and carers who are also entitled to an assessment of their own needs. Referrals can be made direct by parents and disabled adults or by professionals, Children and Adults Disability Service Jarrow Town Hall Grange road Jarrow NE32 3LE Tel: Requests for support concerning young people age 0-18 should be made via Child Referral and Assessment Team 38 Laygate Place South Shields NE33 5RT Tel:

14 Requests for support concerning adults age 18 or over should be made via Adult Social Care Contact Centre Jarrow Town Hall Grange Road Jarrow NE32 3LE Tel: Older Persons and Physical Disability Team There are two Older Persons and Physical Disability Teams in South Tyneside, East which is based at Charlotte Terrace and West which is based at Hebburn Civic Centre. Both Teams include Social Workers and Occupational Therapists, Social Work and OT assistants and their client group is from 18 plus. The sensory worker for the Hearing Impaired is based in East Team and the Rehabilitation worker for the visually impaired is linked to West Team but is seconded to Sight Service and is based at their premises. Sight Service is a Third Sector Organisation for People with Visual impairments within South Tyneside and Adult Social Care also commission them to provide their own rehabilitation worker 0.5 ft to provide assessments, rehabilitation training and to provide small items of equipment. Adult Social Care also commission Action on Hearing Loss to carry out assessments for loop systems and other low level pieces of equipment. Action on Hearing is a third sector organisation for People with Hearing Impairments which is also based in the same venue as Sight Service. East - Charlotte Terrace, South Shields West - Hebburn Civic Centre Requests for support concerning adults age 18 or over should be made via Adult Social Care Contact Centre Jarrow Town Hall Grange Road Jarrow NE32 3LE Tel: Occupational Therapy The Occupational Therapy Team is team is divided across the two Older Persons and Disability Teams and CADS. The main aim of this service is to maintain or increase the independence and safety of a service user or carer in their own home for both adults and children. This includes all aspects of personal and domestic activities of daily living, mobility and moving and handling issues. This independence and safety is promoted through: Giving Advice The provision of a range of equipment eg chair raisers The provision of minor adaptations ie grab rails, banister rails 14

15 The provision of major adaptations ie through-floor lifts or down-stair extensions Requests for support concerning young people age 0-18 should be made via Child Referral and Assessment Team 38 Laygate Place South Shields NE33 5RT Tel: Requests for support concerning adults age 18 or over should be made via Adult Social Care Contact Centre Jarrow Town Hall Grange Road Jarrow NE32 3LE Tel: Services for Young People Services for Young People offer information, advice and guidance to young people and their families about Post 16 education, training and employment opportunities from age 13 25years. Young Person s Leads (YPLs) will attend Annual reviews from Year 9 (Transition) onwards to offer advice and information and to start to gather information about the young person s holistic needs. This information helps identify the most appropriate provision and support for the young person when they leave School/College. YPLs work closely with parents, young people and other relevant professionals, (social workers, educational psychologists, health professionals etc) to identify the young person s needs and to ensure a smooth transition from school. YPLs will arrange appropriate visits/assessments to post school/college/training provision and will keep other Professionals updated regarding the young person s plans for leaving school. The YPL will also initiate and coordinate any applications to local colleges, training provision (including Internships, apprenticeships etc). For some young people whose needs are not able to be met locally, YPLs will initiate and coordinate applications to specialist colleges. In the young person s final year of school YPLs will draw up a Learning Difficulty Assessment (LDA), which outlines the young person s views and wishes about their education/training/employment and will give a detailed account of what support will be required for them when they leave school and move to their next placement. The document is completed with parents and young people and once agreed and signed by parent and/or young person, it will be shared with relevant providers to ensure the appropriate support is in place for the young person. 15

16 Services for Young People Gordon House Gordon Street South Shields NE33 4JP Public office with drop-in facility Services for Young People Ocean Rd Community Centre South Shields NE33 2DW Tel: South Tyneside Welfare Rights Service This service provides general advice on social security benefit entitlement, debt concerns, employment rights and housing problems for South Tyneside residents. South Shields Town Hall & Civic Offices Westoe Road South Shields NE33 2RL Tel: NHS Services Specialist Health Visitor The specialist health practitioner for children and young people with additional support needs works with multi-agency colleagues in supporting families of children and young people up to the age of 19, offering information and liaising with local agencies and services. Referrals are made through the child s health visitor, school nurse or paediatrician. Specialist Health Visitor South Tyneside NHS Foundation Trust Palmer Community Hospital Wear Street Jarrow NE32 3UX Tel School Nurses School nurses work in partnership with a school to create an environment that promotes healthy living, as well as responding to the needs of individual children. The key responsibilities of a school nurse include: 16

17 Assessing the health needs of the whole school community and developing a health plan. Providing confidential health advice for individual children. Supporting, counselling and referring children experiencing mental health problems. Supporting vulnerable children and those with disabilities through individual health plans and working alongside teachers, social workers, education welfare officers and other professionals. Contact through the child s school. Children s Speech and Language Therapy (SALT) The Speech and Language Therapy service provides assessment and intervention for children presenting with a range of speech, language and communication difficulties and/ or feeding/ swallowing difficulties. Speech and Language Therapy assessment may form part of a multi professional assessment and diagnosis pathway. Specialist Clinical areas within the service- Special needs- additional and complex needs, autism spectrum disorder Paediatric dysphagia (eating/ drinking and swallowing problems) Dysfluency (Stammering) Hearing Impairment Specific Language Impairment Pre-school/ Early Years School age mainstream Children and young people from birth to school- leaving age can be referred to the service for assessment. Intervention and therapy packages involve the SLT working in partnership with the child, parents/carers and other appropriate professionals /agencies. For young people where specific, ongoing SLT needs are identified at their final transitional review, onward referral can be made to the Speech and Language Therapy Service for adults linked to the Community Learning Disability Team. Specific needs may include further support with communication using a communication device or with ongoing Dysphagia management/feeding Plans. Speech and Language Therapy Dept Stanhope Parade Health Centre Gordon St South Shields NE33 4JP Tel: ChildrensSpeechandLanguage@stft.nhs.uk 17

18 Children s Occupational Therapy Service The South Tyneside NHS Foundation Trust provides occupational therapy assessment and treatment for children and young people with a physical disability, learning disability or a developmental disorder until they reach their 18 th birthday. The service aims to promote the health and well-being of children and young people by increasing independence and encouraging active participation and social inclusion in activities of daily living. Activities of daily living include: Self-care tasks washing, dressing, eating, personal care Play/leisure - playing with toys, participating in hobbies/interests, accessing leisure facilities School - taking part in school activities Occupational therapy aims to reduce any barriers to participation in an activity by working closely with the child and their family, other services and the wider community to develop the child s abilities, to modify the task, to adapt the environment through providing small pieces of equipment or, a combination of these. The Children s Occupational Therapy Service works closely with the Occupational Therapists in the Adult Learning Disabilities Team during the transition period. Referrals to the service are accepted from any health professional such as a Paediatrician, GP, Physiotherapist, Speech and Language Therapist or School Nurse. Children s Occupational Therapy Service South Tyneside NHS Foundation Trust Palmer Community Hospital Wear Street Jarrow NE32 3UX Tel: Special Needs Physiotherapy The team provide Physiotherapy assessment and treatment for children who have a general delay, disorder of movement, disability or illness, which may be improved, controlled or alleviated by physiotherapy intervention. Our philosophy is to enable children to achieve their maximum potential for independence, and to enable them and their carers to handle confidently their disability within the home and the wider community. Children may be seen within the hospital, school and community setting, and may be offered therapy on an individual basis or as part of a group. The examples of conditions seen are:- Developmental & Neurological Disorders e.g. Gait Problems (toe walking, intoeing, etc.); cerebral palsy; developmental delay (delay in achieving milestones such as sitting, standing, walking etc.); learning disabilities; infections of the brain, spinal column and peripheral nerves; Erbs palsy; developmental co-ordination disorder (dyspraxia) and genetic conditions. Congenital Abnormalities e.g. talipes (clubfoot); Arthrogryposis; Spina bifida Disorders of Bones, Joints, Muscles, & Skin e.g.muscular dystrophies; torticollis 18

19 The Paediatric Team work closely with the physiotherapist from the Adult Learning Disabilities Team, and are actively involved in the medical, social and educational transition process. This ensures good continuity of care, and a more seamless introduction into adult services generally. Referrals are accepted from any health professional for example GP, Paediatrician, health visitor, school nurse. Contact: Special Needs Physiotherapy South Tyneside NHS Foundation Trust Palmer Community Hospital Wear Street Jarrow NE32 3UX Tel Specialist Paediatric Dietetic Service The service gives advice and nutritional assessments for children up to the age of 18 who may have allergies, diabetes, feeding problems or weight problems. The service provides: Monthly Feeding clinics for pre-school and school age children, these are multidisciplinary clinics that include a Paediatric Dietitian, Speech and Language therapist and a Paediatrician. Weekly out-patient clinics. Home visits when required. Once a young person becomes 18 years old the dietetic care is transferred to the adult Dietetic Team based at STDH. Referrals can be made by health [professionals working with the child Nutrition and Dietetics Service Edythe Browne House South Tyneside NHS Foundation Trust, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL. Tel: Children s Community Nursing Team (CCNT) The Children s Community Nursing Team (CCNT) at South Tyneside Foundation Trust provides direct nursing care to children and education for families and other professionals to allow the children to be safely nursed in other environments. The service provides liaison between agencies and support to families with children with a medical or nursing need. The service provides care for children aged between 0-16 in full-time education, 19 years if they fit the special needs criteria. However the 19

20 needs of year olds attending school, (Not college or in the work place) are currently being discussed. Hours of working are 08:00 18:00 seven days a week. Referrals can be made by professionals working with a child. Children s Community Nursing Team Maternity Block Floor 1 South Tyneside NHS Foundation Trust, South Tyneside District Hospital, Harton Lane, South Shields, NE34 0PL. Tel: Fax: Community Children & Young Peoples Service (CYPS) The Children and Young People s Service (CYPS) is provided by the Northumberland, Tyne and Wear NHS Foundation Trust and incorporates both the Child and Adolescence Mental Health Service (CAMHS) and the Children s Learning Disability Community Nursing Team. CYPS provides a single service to children and young people aged 0-18 years living in South Tyneside who present with mental health difficulties. This includes children and young people who may have a learning disability and those living in a range of difficult and challenging circumstances. Children and young people with a learning disability who are referred into the service will have an assessment of their health care needs, by the appropriate clinician working within the multi-disciplinary LD network. Following this appointment they will be allocated a care coordinator who will provide the appropriate input, which may be in response to Challenging Behaviour, Mental Health, Developmental Delay, Social and Emotional difficulties. The service works with professionals from both adult and children s services across the local authority, health and education to discuss, plan and review individual interventions. A comprehensive transition support package can be provided to those young people who are approaching their 18th birthday and who may need continuing support as adults. Training, consultation, support and advice can also be provided to front line staff working in targeted services for children. Referrals can be made by professionals or young people and their families. The South of Tyne Children and Young People s Service Monkwearmouth Hospital Newcastle Road Sunderland SR5 1NB Tel: Fax: CYPS-SOT@ntw.nhs.uk 20

21 Community Learning Disabilities Team for Adults The Community Learning Disabilities Team for Adults is provided by South Tyneside NHS Foundation Trust and Northumberland, Tyne and Wear NHS Foundation Trust. The team works with adults who have a learning disability to offer specialist health care intervention, advice and support, which cannot be met within mainstream health services. A person must be 18 or over to receive a service from this team and be registered with a South Tyneside GP practice. The team includes community nurses, clinical psychologists, occupational therapists, speech and language therapists, a consultant psychiatrist and physiotherapy. Examples of services provided by the team include: Assessment of health care needs Assessment of mental health Health action plans Mobility assessments Moving and handling assessments Daily Living skills Continence promotion Support to manage challenging behaviour, including anger management Support in relation to mental health needs Assessment and support regarding epilepsy Support to develop independence and social skills Support in relation to sexual health and relationships Support to parents who have a learning disability Loss and bereavement work Communication assessments Improve communication skills Dysphasia assessment Health promotion (individual/group work) Self-esteem and confidence building Accessible information Keeping safe advice Referrals can be made by professionals or young people and their families. Community Learning Disabilities Team Entrance B First Floor, Elmville Short Breaks Monkton Hall Jarrow NE32 5NN Tel: