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Contents

1. Process
2. Assessment Questions
3. Assessment Score
4. Services Available
5. Family Support Assessment Review
6. Signatures
7. Child in Need Plan
8. Discretion and Variation
9. Safeguarding
10. Enabling a Child to Remain in or Return to their Own Home
11. Dealing with Disagreement

1. Process

The Family Support Assessment is an assessment tool to determine whether an individual child and their family require a respite service. It is usually carried out after an Initial Assessment when a family have been identified as requiring a break from caring.

The Family Support Assessment is an assessment for children who have a severe, profound and / or multiple disability as defined by the Children with Disabilities eligibility criteria.

First, an Initial Assessment of need is undertaken by a worker from the Children with Disabilities Service. This establishes whether there is a need for support. The assessment is undertaken with the child and their parents/carers, supplementary information from the child's school and other sources will also be sought and considered alongside the information given by the child's parent / carer.

The Children with Disabilities Service officer will also discuss with the parent/carer what short-break services may be available and appropriate.

Most Family Support Assessments are carried out at the Children with Disabilities service office. However, we may occasionally request to visit a family at home for a review if the service has not seen the child within the previous year. It is also expected that the service sees all young people aged 16 and over, in conjunction with their parent / carer, in order that they can participate in their Family Support Assessment review and as their transition to adulthood will also need to be discussed. The views of the young person are significant in determining the type of care package received.

Once the Family Support Assessment form has been completed, this will be checked by the Family Support Co-ordinator. The Service Manager will endorse and sign the Family Support Assessment, providing that they are satisfied with the information and/or evidence provided. If this is not the case, the Service Manager will defer a decision pending further specified action and the parent / carer will be informed.

Once the Service Manager has endorsed and signed the Family Support Assessment, the Family Support Co-ordinator will contact the parent/carer and discuss and set up the services agreed in conjunction with them and the provider/s. A copy of the Family Support Assessment and a covering letter detailing the services agreed will be sent to the parent/carer.

2. Assessment Questions

During the assessment the child (if present) will be asked questions on the following issues;

• Their views on respite services
• What they would like to do

The parent/carer will be asked questions on the following issues;

• Their views on their requirement for respite services
• Their child's communication and social needs
• Their child's personal care needs, including mobility and medical care
• Their child's behaviour
• Their own / family needs
• Other environmental factors which may affect their ability to care

3. Assessment Score

The assessment is to ensure that the allocation of services to each family is as fair as possible. A family may choose from a range of services for which they are eligible. However, some services may have waiting lists. The range of options will be explained when the assessment has been completed.

The minimum assessment score for a family to be eligible for respite services is 8. The maximum assessment score achievable is 27.

The below chart shows how assessment scores are translated into service points;

Assessment Score	Service Points - for 1 year
8	16
9	17
10	18
11	19
12	20
13	22
14	23
15	24
16	27
17	30
18	33
19	36
20	39
21	42
22	45
23	48
24	54
25	60
26	66
27	72

Service points are to be used within the year following the family support assessment.

The Family Support Assessment is split into groupings as follows;

• 8 years and above
• 5 - 8 year olds (who receive half of the service points)

This is because the needs of the children generally become more demanding as they get older.

Respite services for children under five are assessed only in exceptional circumstances and the resulting service points are halved. This is because a certain level of care is expected from the family of an under five regardless of disability.

The service points for  children and young people attending boarding school are also halved as they spend limited time at home.

4. Services Available

1 service point is equal to either:

• 1 night at NCH House on the Hill
• 1 night Family Based Respite Care or
• 2 days at Saturday Club
• 2 days at The Ravensbourne Project Coombe House
• 12 hours Direct Payments
• 12 hours domiciliary care

These services can only be accessed through a referral from the Children with Disabilities Service following a Family Support Assessment.

• NCH House on the Hill is an overnight respite centre in Lewisham for children with disabilities from ages 8 - 18. It is run by The National Children's Home (NCH), a children's voluntary agency, but is funded by Lewisham Council. It contains 6 bedrooms for children, some with special adaptations (e.g. hoists, disabled bathrooms, specialist baths and wheelchair access). House on the Hill also has a soft play room, sensory room, sensory garden, messy play room, two courtyards, dining room and an IT room and the service are in the process of adding a conservatory which will double as a music room. Children who attend are given a full NCH assessment of needs prior to their first stay. They are then slowly introduced to the centre, staff and other children during day visits until they feel comfortable enough for their first overnight stay (for some children this can 3/4 days, others can take 6 months). Each child has a Key Worker and all children are fully supervised. There are waking night staff and a stand-by night staff. Children sometimes go on day trips and there are lots of activities at the centre. During an overnight stay the child will be classed as a 'Looked After Child' (LAC) as they are the responsibility of Lewisham Council and will be subject to LAC reviews every 6 months. A family must use a minimum of 24 points at House on the Hill. This is because it is recommended that a child needs stability and continuity in care and should stay regularly to maintain familiarity with the unit and it's staff.  Over 16's will only be referred to House on the Hill in exceptional circumstances as the settling in period required may bring them nearer to the transition age where other resources will be more appropriate.
• Family Based Respite Care is overnight respite provided by carers in their own home (Most carers are based in Lewisham Borough, but some live outside). All carers will have been approved by the Lewisham Fostering Panel. Children with disabilities are 'linked' with a suitable carer and initial meetings between the carer and the family are set up to see if they all get on.  The child is then slowly introduced to the carer's home by day visits until they feel comfortable enough for their first overnight stay (for some children this can 3/4 days, others can take 6 months). During an overnight stay the child will be classed as a 'Looked After Child' as they are the responsibility of Lewisham Council and will be subject to LAC reviews every 6 months. The Family Based Respite carer is also subject to a 6 monthly review.
• Coombe House is a fully equipped day centre in Catford for children with disabilities and is run by The Ravensbourne Project. There is a  sensory room, garden, soft play room and quiet room and children are fully supervised and participate in a vast number of activities including arts and crafts, dressing up and board games. Coombe House is open a mixture of Saturdays and Sundays throughout the year and some days during school holidays.

If a family cancel a service with any of the above providers (with or without notice) they risk losing their point allocation for that service. Cancellations which will not result in a loss of points are generally deemed to be;

• Sickness during the respite service or on the morning of the service provision.
• Cancellations due to illness of the child advised by the parent / carer with advance notification of 48 hours.

Any points which may be 'rolled over' for these reasons must be used within the next quarter only and only where the Provider can offer the service without disruption to staff or other service users.

If a service is required by a family in an emergency, the decision over provision will reside with the Service Manager. Emergencies are generally deemed to be;

• Death of an immediate family member or primary carer.
• Serious illness of parent / carer or sibling where no family member or friend can be found to substitute care.
• Safeguarding of the child (decision to be made by CwDS).

After the emergency, it will be decided by the Service Manager whether the service will be funded as an extra provision or whether it will be managed within the family's allocation of services.

Any other reasons for cancellations or emergencies can be considered by the Service Manager.

It will not usually be permitted for services to run consecutively (e.g. For a child to go straight from House on the Hill to Coombe House on a Saturday). Any such service will need to be agreed in advance with the Service Manager.

• Saturday Club consists of two clubs, an 8 - 12 year olds and a 13 - 18 year olds club. These alternate weekly, so one Saturday is the younger group and the following Saturday is the older group. The child will therefore attend one club fortnightly. When a younger child reaches 13 they will automatically transfer to the older club. If a place is not available they will remain in the younger group until a place is free. Saturday Club is based in Ladywell but the children are often out on outings and activities which include visits to the park and museums, bowling, cinema etc.
• Domiciliary care is provided by agency workers, usually through Crossroads or Excelcare. The care worker comes into the family home at regular and agreed times each week / fortnight and looks after the child whilst the carer has a break. The carer can stay indoors with the child and carry out regular play or educational activities or can take the child out e.g. to the park, library, swimming or other sports activities. Domiciliary care services must be used as per the agreed schedule and hours will only be 'rolled over' if the agency have been unable to find a carer.
• Direct Payments are payments paid directly to an account for the parent / carer who can then employ their own carer for the child. This could be someone they know who is willing to provide care, a specialist in the child's disability, or a mentor for the child. The Direct Payments scheme is run by an agency called Freewood Care Outlook and they can assist the parent / carer with recruitment of their carer, obtaining CRB checks and employers legalities and can even hold the bank account in the parent's name. Children of 16 and over can hold their own Direct Payment account if they are able. Direct Payments may be accumulated (e.g. For use in school holidays) but this must be agreed in advance with the Family Support Co-ordinator and Service Manager.

All of the above services will be provided on a regular basis as a family have been assessed as needing a particular level of service. If a service is misused by a family the Children with Disabilities Service can withdraw services with or without notice.

Families can also self-refer to the following services:

• Carers Lewisham
• Contact-a-Family
• Mencap
• Signal
• SCOPE
• Lewisham Autism Support
• School holiday playschemes
• After school clubs
• Connexions

5. Family Support Assessment Review

The level of support services for which a family is eligible will be reviewed annually, and more frequently if a child or family's circumstances change. The eligibility criteria and Family Support Assessment points system will be reviewed and set annually in accordance with the annual budget.

6. Signatures

After a Family Support Assessment or review, the parent / carer will be asked to sign the form to agree that the information they have provided is correct. They will also be asked whether they agree to information in the assessment being shared with service providers who may be involved in their child's care and whether they agree to further information being sought from other professionals working with their child.

7. Child in Need Plan

After each Family Support Assessment or review, a Child in Need plan will be completed and sent to the parent / carer and the service provider. A copy will also be kept on the child's file at the Children with Disabilities service.

8. Discretion and Variation

While service provision for each Family Support Package will normally be determined by the outcome of the Family Support Assessment, the Service Manager for the Children with Disabilities Service has the discretion to allocate services taking into consideration any extenuating circumstances. The reason will be clearly documented on the Child in Need Plan with timescales indicated and will be reviewed regularly.

9. Safeguarding

Services may be provided in the home as part of an agreed child protection plan to safeguard a child. The level of service will depend on the individual circumstances, will be time-limited and must be authorised by the Service Manager for the Children with Disabilities Service.

10. Enabling a Child to Remain in or Return to their Own Home

Services may be provided in the home as part of an agreed plan to prevent a child from becoming looked after or to facilitate their rehabilitation home from care or an NHS setting. The level of service will depend on the individual circumstances, will be time-limited and must be authorised by the Service Manager for the Children with Disabilities Service.

11. Dealing with Disagreement

If the parent/carer disagrees with the outcome of the Family Support Assessment this will be reviewed by the officer who completed the assessment or the review and additional information will be considered.

The completed Family Support Assessment will be checked by the Family Support Co-ordinator and the Service Manager at the Children with Disabilities Service and the parent/carer informed of the outcome.

If the parent/carer remains dissatisfied with the outcome, the internal procedure for dealing with complaints will be followed and a complaints, compliments and comments leaflet will be given to the parent/carer. Alternatively, you can request a leaflet by telephoning 020 8314 6930.

The Data Protection Act 1998 allows individuals a general right of access to find out what information the London Borough of Lewisham holds about them. To request access to information held on you contact Central Registry on 020 8314 6848 and ask for Form AR1 to be sent to you.

End