Stockton-on-Tees Borough Council

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Cabinet Decision: 27th September 2007
Title of Item/Report
Altogether Better
A Five year strategy for improving the outcomes for children and young people with multiple and complex needs in Stockton on Tees
Record of the Decision
Members considered a report that detailed a series of recommendations underpinning a 5 year strategy for improving outcomes for children and young people with complex and multiple needs, following a wide ranging review of services.

The borough of Stockton on Tees was responsible for providing high quality services to 46,000 children and young people. Within that group were 1,800 who had particular needs, either physical, educational or emotional. Approximately 200 children and young people were looked after in public care and 200 were placed on the Child Protection Register.

It was noted that the needs of many of the 46,000 children and young people in Stockton were being met effectively. In order to guarantee an excellent service for all children and young people, it was considered timely to consider a review of provision of services for those with complex needs.

The Government's second Comprehensive Spending Review (CSR) was due to report in the autumn of 2007. It would set out national spending plans and priorities for the years 2008-09, 2009-10 and 2010-11. This CSR report would be informed by a series of policy reviews, one of which was a review of children and young people, building on the Government's strategy to improve their outcomes. A significant strand of this work was the disabled children's review.

Members were advised that the culmination of the national disabled children's review was the report ‘Aiming high for disabled children: better support for families (May 2007) which set out a range of actions and proposals to create a local and national focus on promoting the life chances of disabled children and their families. It was expected that the CSR would announce the funding to make the proposals a reality.

It was explained that a significant programme of work and policy reform had been put in place nationally to improve outcomes for disabled children and their families. This had been detailed in the first section of the Complex Needs Review, a copy of which was presented to Members.

It was recognised that locally there were a range of individually effective services in Stockton but that: coordination was sometimes haphazard; structures did not always support effective integration; there were some gaps in services and at times elements of duplication which impacted on cost effectiveness. It was noted that it mirrored the national picture for such services.

Members were advised that the review team set out to audit services for children with multiple and complex needs and their families and make recommendations that would improve outcomes in the following three priority areas:

Access and empowerment
Responsive services and timely support
Improving quality and capacity

The review initiated a phased process to ensure provision of services for children and young people with multiple and complex needs in Stockton-on-Tees is made ‘altogether better' with a long term goal of transforming their life chances. It was envisaged the process would have 4 phases. The work undertaken to date comprised phase 1, the Federation and re-configuration of the special schools and phase 2, the review of broader services for children with multiple and complex needs and corresponding recommendations. Phases 3 and 4, comprised the action planning and staged implementation of the recommendations.


Planning, Commissioning, Co-Ordinating and Delivering Services

1. Stockton Children's Trust Board (CTB) and partners accept and work to the agreed definition of ‘multiple and complex needs' presented by this review.

2. a clear and explicit commissioning strategy be developed, to include, for example, direct payments, transitions, early intervention, holidays and short breaks, and person centred planning.

3. a strategic lead for commissioning services for children and young people with multiple and complex needs be identified, to work directly to the Complex Needs Service.

4. multi-agency protocols and agreements be developed across services and agencies, to set out how partners will work together to support children, young people and their families from birth through to transition to adulthood.

5. a single point of contact/central team/base be established to co-ordinate the delivery of complex needs services for children and young people. The central team should include close and explicit partnership with the developing Federation of Special schools in Stockton.

6. the extent to which commissioning responsibility for complex needs remains with the CTB/Council, and the extent to which it goes out, to schools or the Federation, for example, be clarified and agreed.

7. an active database to enable a clear understanding of the population and its needs be established and maintained. The data base must be accessible, able to be interrogated, and co-ordinated, through dedicated MIS time.

8. the protocols surrounding Health Care and Social Care tasks, with a view to achieving better efficiencies and promoting inclusion (clinical governance) be reviewed and refreshed.

9. current eligibility criteria be reviewed and a range of appropriate services for the increasing population of high functioning ASD children and young people within the borough be established.

10. protocols be reviewed and clarity be established with partners in relation to the provision of services for looked after children and young people with complex needs.

11. policy/funding priorities be reviewed in order to establish permanence of funding to support and develop good practice that has previously depended upon grants (for example the highly successful Early Support Key Worker programme).


12. an information/communication strategy be developed and explicit linkages to the CTB Service Directory, to improve the management of information across and between Services and provide information to families at the point of need be ensured.

13. confidentiality/data sharing protocols across agencies be reviewed and refreshed, and a common process be agreed.

14. protocols and procedures to enable the views of children and young people with multiple and complex needs be developed, to be explicitly embedded within the developing PIC network and service design.

Residential / Respite Care

15. the recommendations of the ‘Short Break' Unit for Children with disabilities' report be actioned and a new respite/holiday/day care unit to replace current Piper Knowle and Hartburn Lodge provision be commissioned.

16. options for 52 week residential provision as a CESC/Health partnership alongside the Federation and King Edwin school be developed.

Workforce Development

17. A robust skills audit, alongside the developing Children's Workforce Development Strategy and ISA development be undertaken, to match workforce development needs to current and future context and population.

18. The key worker system operating within Early Support be supported and embedded, and be extended across the age range and into transition.

19. CPD and training policies be reviewed to ensure SEN and disability training pervades Children's Services staff initial training and continuing professional development.

20. the lead professional role be developed, and the roles and responsibilities of lead professionals as against key workers be distinguished between.

21. a common competency based appraisal system which is applicable across the range of statutory systems currently in operation be developed and agreed across agencies.

Council Issues

22. the developing transport strategy pays explicit attention to children and young people with multiple and complex needs.

23. the developing Parenting Strategy pays explicit attention to the needs of families supporting a child or young person with multiple and complex needs.

24. complex Needs Service work with Adult Services to develop and implement effective procedures around person centred planning, to support families and young people on transition from Children's to Adult's Services.

Referral Systems / Eligibility Criteria

25. CAF be used as the single referral method by all agencies, through to a single multi-agency complex needs panel, sited within the Complex Needs Team.

26. until such time as CAF is operational, all existing referral criteria be cross referenced to the agreed definition of ‘complex needs' referred to in the review.
Reasons for the Decision
The culmination of the national disabled children's review is the report ‘Aiming High for disabled children, : better support for families' (May 2007) which sets out a range of actions and proposals to create a local and national focus on promoting the life chances of disabled children and their families. In Stockton there are a range of individually effective services, but structures do not always support effective integration, there are some gaps in services and some elements of duplication. This review and the recommendations which follow are designed to improve the quality of outcomes and significantly improve the life chances for this vulnerable group of children and their families.
Alternative Options Considered and Rejected
Declared (Cabinet Member) Conflicts of Interest
Details of any Dispensations
Not applicable
Date and Time by which Call In must be executed
Not later than midnight on Friday 5th October 2007

Date of Publication: 01 October 2007

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