Support for Disabled Parents and Young Carers - Protocol Between Children’s and Adults Social Care

• Parent refers to anyone with legal Parental Responsibility for a child or children;
• A child is a person up to the age of 18 years;
• A young carers means a child or young person under the age of 18 years who is caring for, or making a significant contribution to the care of, a disabled parent as defined above. Young people qualify for a "carer's assessment" at 16 years of age;
• A young adult carer means a young person aged 18-24 who is caring for or making a significant contribution to the care of a disabled parent;
• "Disabled parents" includes parents with a:
• Learning disability;
• Physical or sensory impairment;
• Long-term and/or chronic illness;
• Mental illness;
• Drug or alcohol related difficulty.

The definition is intended to cover disabled adults who:

• Have a child or children of their own;
• Provide parenting to other children in the household;
• Are pregnant;
• Are considering becoming a parent.

• There are some disabled parents who may need services from ASCHPP to support and assist them in their parenting role, but whose children are not in need of any services from the CFCS. In all cases disabled parents are people who are likely to have a permanent and substantial disability and who would be assessed as eligible for social care support. For details of the County Council's current eligibility threshold see Eligibility and Fair Access to Care Services (FACS). However, when making a decision about eligibility for social care support, staff must always take account of any caring responsibilities undertaken by children or young people under the age of 18. Paragraph 101 of the Guidance on Eligibility Criteria for Adult Social Care, England 2010 states:
• "Councils should be mindful in applying these criteria that the provision of community care services should ensure that children are not expected to undertake inappropriate levels of caring responsibilities" (page 33);
• This means that where children and young people are providing inappropriate levels of care for a disabled parent, particularly personal care, the parent must be assessed as eligible for a personal budget;
• Where one parent works, support will be provided to cover their working hours. The family will be expected to take responsibility for the care of their own children outside working hours, including when the working parent is on annual leave.

• There are some disabled parents whose children may be in need of services from CFCS, in addition to parenting support from adult services. It may be that the parenting they are able to provide, as a result of their disability or illness, cannot completely meet the needs of the child. Section 17 of the Children Act 1989 defines a child as being 'in need' if they are unlikely to experience 'a reasonable standard of health or development' without assistance, or if they are disabled.

• Support provided to disabled parents as a community care service falls within the ASCHPP's normal charging arrangements and assessment staff in particular should ensure that parents are fully aware of the financial implications for them. See the staff guidance on fairer contributions for further information.

• There are certain parenting tasks that are universal and that are required to meet the needs of any child. These tasks derive from the needs of the child, not from the capacity of the adult to meet them. They apply in families, whatever the circumstances and should therefore be included when considering roles and responsibilities under the, Guidance on Eligibility Criteria for Adult Social Care, England 2010;
• The day to day activities associated with these tasks will vary according to the age and stage of the child and general circumstances. If the activity would generally be considered typical care for a child of a similar age, for example, dressing a 2 year old or attending a school parents evening for an older child, it is considered to be part of a universal task;
• The universal tasks for any parent are to ensure their child:
• a) Is physically cared for - this includes meeting the child's day to day physical needs for adequate and appropriate food, drink, warmth, shelter, rest, clean and appropriate clothing, adequate personal hygiene and social presentation, positive routines and appropriate medical, dental and optical care. For older children this includes providing information about physical and sexual health, substance misuse etc;
• b) Is safe - this includes meeting the child's needs for a secure environment by adequate protection from hazards, harm or danger, in and out of the home and from contact from unsafe adults or other children and from self-harm;
• c) Is cared for emotionally - this includes meeting the child's needs for encouragement and praise, appropriate physical contact and comfort, feeling valued and special, having a positive identity and having secure, stable and affectionate relationships with significant adults;
• d) Has opportunities to learn and socialise - this includes promoting the child's needs for learning and intellectual development, encouragement, ensuring attendance at school, college or preschool, cognitive stimulation, promoting social and educational opportunities, interacting and responding to the child's language and play;
• e) Receives guidance about behaviour - this includes giving guidance and discipline which meets the child's needs for learning and understanding appropriate social behaviour, managing their own emotions, and to develop an 'internal model' which will help them become responsible and autonomous adults;
• f) Lives in a stable secure environment - this includes meeting the child's needs for consistency and for developing and maintaining a secure attachment to their carer/s and keeping in contact with other family members or other significant people;
• From the Framework for Assessment of Children in Need and their families 2000.

• New referrals for assessing the needs of disabled parents should be directed to the Customer Services Centre, where they will be passed to the Adult Access Team for screening. If safeguarding issues are apparent the Nottinghamshire and Nottingham City Safeguarding Children Partnership Procedures must be followed;
• A referral can be made without consent, where failure to make that referral or to share information would place a child at risk of significant harm. However, every endeavour should be made to obtain consent if it is judged that such discussions do not place a child or vulnerable adult at risk;
• Staff in the Adult Access Team, should ensure that cases are given high priority as they may involve the wellbeing of a child. The referral should indicate clearly that it is for a disabled parent;
• The request for an assessment should be routed to the appropriate team, which is determined by the primary impairment of the parent(s). See the staff guidance on referrals for more information.

• A community care (SDS) assessment must be completed and should take account of the circumstances and needs of all family members. A carer's assessment relating to the care of the disabled parent should be offered where relevant. A carer's assessment should not be completed in relation to the care of children by the children's parents;
• Families where a young person is acting as a carer may experience a significant amount of guilt and shame about their circumstances and in some instances, seek to cover up the extent to which a young person is caring. Assessments must be carried out in a sensitive way, which allows the family to be open about their situation, whilst being careful not to undermine the parents or invalidate the young carer's experience;
• The Social Services Inspectorate recommends the need to cross-reference information and the following recommendations have been adopted for this guidance:
  
  Adult services teams must routinely record that there are children in the family when assessing a disabled or mentally ill adult. A case note alert on Framework should be sent to any team who are shown as 'involved' with the child;
  
  Children's teams must record the presence of a disabled or mentally ill adult when undertaking a Child and Family Assessment;
  
  A case note alert on Framework should be sent to any team who are shown as 'involved' with the parents;

• Assessors should not assume that children or young people will undertake caring or household duties to a greater extent than they would if neither parent was disabled. Assessors should seek to establish the nature and extent of a young person's caring when assessing a disabled parent;
• Any child care assessment where a child is identified as a "young carer" should automatically trigger a community care assessment of the disabled parent's support needs by the ASCHPP;
• Where it is difficult to achieve a satisfactory working partnership arrangement with the parents it is important that they should be assisted to access advocacy services.

6.2.1 The co-ordination of assessments

• Adult teams will co-ordinate assessments where there is no indication of child safeguarding concerns and the parent needs support to carry out universal parenting tasks, including:
• Physical care, hygiene and nutrition;
• Emotional care and support;
• Care and laundering of clothing;
• Maintaining an acceptably clean and safe household;
• Meeting health needs;
• Support in education (including homework).

Encouragement and support for the intellectual development of children through, for example, doing reading practice with the children of deaf or visually impaired parents where there is no one else to do it.

Encouragement and support to take part in social and recreational activities outside the home.

• Adult teams will coordinate a joint assessment with staff from CFCS (and other agencies as necessary) where the worker from adult services identifies;
  
  Complex needs within the family situation, affecting a child's development; and/or
  
  A role for the involvement of CFCS;
• Consultation between services must begin immediately and a lead worker must be identified. A decision will be made by Team Managers about the appropriate recording of assessments and care plans;
• CFCS will coordinate the assessment where the disabled parent:
  
  Needs support to prevent the child/children suffering significant harm or to facilitate resumption of parental responsibility following safeguarding proceedings; or
  
  There is a risk of significant harm to a child in the family; or
  
  The child/children's needs are complex and/or there is a child with disabilities in the family and the child’s needs meet the threshold for level 4 intervention.

• The resolution of disputes will take place through the relevant Team Managers;
• Disabled parents should always receive a copy of the record of outcome of assessment; and of any support plans.

6.2.2 Early Help Assessment Framework and Early Help Unit

• Any professional working with a family can contact the Early Help Unit for advice and support and may find this a useful way of engaging support from children's services, where the young person does not meet the child in need criteria;
• The Early Help unit can contacted on 01623 433500 or early.help@nottscc.gov.uk.

• A personal budget will be offered to eligible people, either as a managed service, a direct payment or a mixture of both. If taken as a direct payment, the parents must be made fully aware of what is involved for them. It must be remembered that direct payments can only be used to meet a need of the parent (adult) NOT the child. This means that ASCHPP cannot provide a direct payment to help a child to do a leisure activity, but can fund the aspects of the activity which are a usual part of parenting, for example, transport to the activity and supervision whilst there. For further information see Direct Payments for Adults and Direct Payments for Community Equipment.

• Adult care staff should be aware of the provision for families in Children's Centres: There are 48 Children's Centres in Nottinghamshire and ALL parents and ALL children under five can access services and support. Sometimes parents just want the company of others, sometimes they need information about services, and sometimes the Children's Centre staff may be able to help on the spot. There will be play and early learning designed to appeal to young children available through Children's Centres. All the buildings are fully accessible, and the Centres welcome children and parents of all abilities and needs. Parents are very actively encouraged to become involved in the planning, delivery, management and evaluation of services - there will always be something of interest for all parents to do. The Children's Centres' provision will include the more targeted services for families in need of specialist support previously offered by Social Services' Family Centres;
• To find out if there is a Children's Centre in a particular area, ring the Children's Information service: Freephone 0800 781 2168. Staff can then liaise directly with the local Children's Centre to see what can be offered to a particular family.

• Many schools now offer parenting classes, family learning opportunities and information and advice for parents on a wide range of issues. Schools are grouped into" families" and each family has its own extended support co-ordinator. Further information about activities and support can be found by contacting individual schools or the Early Help Unit (contact details included in 6.2.2 above).

• This service provides one to one and group support to young carers and their families, a helpline for young carers, their families and professionals and information and advice. This can be accessed via contact with the Early Help Unit;
• Parentline Plus - offers a wide range of information, advice and support on all aspects of being a parent over the telephone. Also offers a six week telephone Extended Support programme where parents can access additional support.

• Adult services occupational therapy (OT) staff should be involved early in the assessment process to make sure that aids are provided where necessary. This means, for some women, an assessment during pregnancy.

• There are a range of independent advocacy services in the County.