1. THE NATIONAL AUTISTIC SOCIETY
REVIEW OF PROGRESS AGAINST THE NAS
REPORT 2008 FOR HALTON BOROUGH
COUNCIL
APRIL 2012
2.
3. 3
Contents
1 PURPOSE .....................................................................................................................7
1.1 Background.............................................................................................................7
1.2 The Scope of the Review........................................................................................7
2 EXECUTIVE SUMMARY ...............................................................................................8
3 INTRODUCTION ......................................................................................................... 10
4 PROGRESS AGAINST THE RECOMMENDATIONS IN THE NAS REVIEW 2008...... 12
4.1 Develop an Autism Service Development Group to include all stakeholders to
develop a more strategic approach to meeting the needs of people with an ASD............ 12
4.1.1 A Strategic Lead for Autism ........................................................................... 12
4.1.2 The ASC Strategy.......................................................................................... 12
4.1.3 Strategic Development of support networks for those with ASC..................... 13
4.1.4 The ASD Strategy Group in Halton ................................................................ 13
4.1.5 The Autism Strategy (Draft) ........................................................................... 14
4.1.6 Member-led Scrutiny Review of Autistic Spectrum Condition for Adult Services
15
4.1.7 Recommendations: Autism Strategy Group and Autism Development Group 19
4.2 Develop opportunities for extended school day and short breaks specific to the
needs of children and young people with autism. In adulthood, there needs to be low level,
preventative services such as social groups, befriending and investment into Community
Bridge Builders................................................................................................................ 19
4.2.1 Children‟s Services ........................................................................................ 20
4.2.2 Adult Services................................................................................................ 21
4.2.3 Recommendations: Short Breaks for children and young people with autism. 21
4.2.4 Children‟s Services ........................................................................................ 21
4.2.5 Adult Services................................................................................................ 22
4.3 Enhance the communication system with parents to ensure they are aware of
provision within education and social care that is available for them. There needs to be
information for families about the transition process, and about what services are likely to
be available as people move into adulthood. ................................................................... 22
4.3.1 Children‟s Services ........................................................................................ 23
4.3.2 Adult Services................................................................................................ 25
4.3.3 Recommendations: Communication Systems with Parents............................ 25
4.3.4 Recommendations: Comprehensive Overview for Parents of What Is Available
To Meet the Needs of Their Child with Autism and the Wider Needs of the Family ...... 26
4.4 Increase staff capacity to provide a training strategy which includes basic autism
awareness for all staff working with people with ASD, and for relevant staff across the
professions at a higher level, with systems for dissemination. This needs to be embedded
as part of induction. Funding for autism training should be ring fenced. Some training
should be jointly delivered across LD, MH and Further Education. .................................. 26
4.4.1 The implementation of training across different levels is clear in both children‟s
services and in adult services. ..................................................................................... 26
4.4.2 The Autism Development Service.................................................................. 28
4.4.3 Autism Champions......................................................................................... 29
4.4.4 Recommendations: Autism Training Strategy ................................................ 29
4. 4
4.5 Consider the appointment of a Family Support Worker / ASD Information officer to
help parents to navigate the system within Halton. This service could be commissioned
from a third party to ensure objectivity. ............................................................................ 29
4.5.1 Children‟s Services ........................................................................................ 29
4.5.2 Recommendations: Children‟s Services......................................................... 30
4.5.3 Adult Services................................................................................................ 30
4.6 Widen the menu of provision for children with autism within Halton schools. For
example, consider Resource Provision attached to dedicated staff can support the pupils
and influence the whole school........................................................................................ 30
4.6.1 PROVISION FOR CHILDREN AND YOUNG PEOPLE WITH ASD AS A
CONTINUUM WITHIN HALTON BOROUGH COUNCIL .............................................. 34
4.6.2 Recommendations: Resource Bases............................................................. 34
4.6.3 Recommendations: Special Schools as Part of the Continuum of Provision in
Halton 34
4.6.4 Recommendations: Autism Accreditation....................................................... 35
4.6.5 Recommendations: FE and Independent Living As Part of the Continuum of
Provision for Young People with ASD in Halton Borough Council ................................ 35
4.7 Ensure that transition planning for all on the autism spectrum is timely and well
monitored at every stage from early years to adult .......................................................... 37
4.7.1 Children‟s Services ........................................................................................ 37
4.7.2 HALTON MULTI-AGENCY TRANSITION STRATEGY FOR YOUNG PEOPLE
AGED 14-25 2010-2013............................................................................................... 38
4.7.3 Information for parents and young people about which services are available to
them 38
4.7.4 Halton Photo Voices ...................................................................................... 38
4.7.5 Individualisation in the transition planning process......................................... 41
4.7.6 The Supported Assessment Questionnaire.................................................... 43
4.7.7 Use of Data to inform commissioning............................................................. 43
4.7.8 PERSON CENTRED PLANNING .................................................................. 44
4.7.9 Outcomes ...................................................................................................... 45
4.7.10 Transition Recommendations: Transition Planning ........................................ 45
4.7.11 Adult Services................................................................................................ 45
4.8 Assess the capacity of in borough residential services to support people with an
ASD. Consider local reprovision for out of borough placements ...................................... 46
4.8.1 Children‟s Services ........................................................................................ 47
4.8.2 Adult Services: Adult Residential services ..................................................... 48
4.8.3 Commissioning .............................................................................................. 48
4.8.4 Positive Behaviour Support Service............................................................... 48
4.8.5 Recommendations: Local reprovision for out of borough placements ............ 50
4.9 The Authorities should ensure that the Social & Communication Disorder Pathway
continues to dovetail with the Halton Pathway for School-Aged Children with ASD so that
parents do not experience a differential approach at later stage diagnosis. ..................... 51
4.9.1 Recommendations: Diagnostic Pathways ...................................................... 51
4.10 Halton BC consider identifying a senior manager in the adult social care team to
undertake a lead ASD role in relation to adults with ASD................................................. 52
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4.10.1 Impact:........................................................................................................... 52
4.10.2 Recommendations......................................................................................... 52
4.11 Invest time and effort in trying to establish a more harmonious relationship with
HAFS 53
4.11.1 Recommendations......................................................................................... 55
4.12 Classify all adults on the autism spectrum as potentially vulnerable adults so that
they do not fall between Learning Disability and Mental Health Services......................... 56
4.12.1 Recommendations......................................................................................... 56
4.13 The Adult Social Care teams work with the 5 Boroughs Mental Health Trust to
develop supported discharge plans for people leaving the services who may have specific
ASD needs. ..................................................................................................................... 57
4.13.1 Recommendations......................................................................................... 58
4.14 Develop a diagnostic pathway for adults which could be developed in partnership
with neighbouring Local Authorities and PCTs................................................................. 58
4.14.1 Recommendations......................................................................................... 60
4.15 Consider investment in lower level support such as befriending or social groups for
young people and adults with Asperger Syndrome as a preventative measure. .............. 60
4.15.1 Recommendations......................................................................................... 61
4.16 The authority should undertake an exercise to look at the profiles of young people
who are likely to come through transition in the next 5 –10 years, and, using person
centred planning approaches, try to plan for what type of adult provision will be needed for
those people with autism and complex needs. Dialogue then needs to take place with
prospective provider organizations to look at whether it is worth commissioning services
within Halton. This could either be done individually as a borough or through a consortium
with neighbouring boroughs............................................................................................. 61
4.16.1 Care Assessment, Planning Process and Person Centred Planning.............. 61
4.16.2 Recommendations......................................................................................... 63
4.17 The referral pathway into Community Bridge Builders needs to be clarified and
made transparent to all who use it. Access to ASD specialist advice should be developed
within the Community Bridge Builders service. ................................................................ 63
4.17.1 Learning and Employment Opportunities ....................................................... 63
4.17.2 Community Bridge Builders............................................................................ 64
4.17.3 Learning opportunities at college ................................................................... 66
4.17.4 Improved opportunities for employment ......................................................... 66
4.17.5 Recommendations: Community Bridge Builders Team .................................. 70
4.17.6 Recommendations: Learning Opportunities ................................................... 70
4.17.7 Recommendations: Improved Employment Opportunities Expand the social
enterprise model .......................................................................................................... 70
4.17.8 EXAMPLES OF GOOD PRACTICE............................................................... 71
4.17.9 CASE STUDY: ASD SPECIFIC FE PROVISION: THE RUG ROOM, and
PURPLE PHOENIX, CITY COLLEGE. NORWICH....................................................... 71
4.17.10 Purple Phoenix........................................................................................... 71
4.17.11 Autism specialist FE Provision: Parkside Pupil Referral Unit, Ipswich......... 72
4.17.12 Case Study: Good transition planning and links to adult services:
Nottinghamshire Adults with Asperger‟s Team............................................................. 74
5 Appendix 1: Documents provided by the Local Authority to support the Review........... 76
6. 6
6 Appendix 2: Summary of Recommendations 2012....................................................... 77
7 Appendix 3: Summary of Recommendations NAS Report 2008................................... 92
8 Appendix 4 : List of those seen during the course of the review 2011-12 ..................... 95
9 Appendix 5: Membership of the Autism Strategy Group............................................... 97
10 Glossary................................................................................................................... 98
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1 PURPOSE
The purpose of the review was to evaluate progress made against the
recommendations of the NAS report for Halton Borough Council in 2008. In addition,
the Local Authority asked for further recommendations to be made to extend the
progress already made.
The review was carried out by Jane Green, of the Education Support Service for
NAS, and Mandy Reddick, a NAS consultant.
1.1 Background
In 2008, the NAS was commissioned to undertake a review of provision within the
borough for children and adults with autism. This report was a response to the Local
Authority‟s concern to ensure they were optimising the use of current resources,
responding to the defined needs of individuals, targeting new resources
appropriately, adopting good autism practice and improving the relationship with
local parent representatives.
1.2 The Scope of the Review
The scope of the review included meeting with senior officials from the Borough
Council, all those connected with the Autism Development Service in Halton, and a
variety of stakeholders, including parents, teachers and teaching assistants.
The review was funded by Halton Borough Council.
The review was divided into two parts. Part One was centred on Children‟s Services.
This required the reviewers to investigate the current status of provision, activities
and resources, and establish whether there is a continuum of provision for children
and young people with ASD within HBC, and the progress there has been towards
this since the last review. This included meetings with stakeholders including the
Divisional Manager Inclusion; the Autism Service Development Group; service users:
parents, carers, HAFS, Parent Partnership Service; service providers: resource base
managers (primary and secondary); special school Head Teachers; CAMHS and
PCT re services and support; the Principal Educational Child Psychologists;
representatives from the SALT team; Family Support worker; HAFS, including the
Chairman, as well as attending a family support group and meeting HAFS parents.
The reviewers considered any reorganisation of education, including future planning,
and any regional planning to reduce out of borough placements by developing local
services. The reviewers also investigated the requirements of provision users with
the provision offered; data re ASD placements; diagnostic processes as well as
placement of all children with ASD; planning for Adult services based on current
PCPs, and Post diagnosis of ASD transition. There was a focus on support for
social activities for children and young people with ASD and Short breaks provision.
The universal application of Transition support: primary to secondary; secondary to
FE was also discussed. The response of the Local Authority to implementing an
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Autism Strategy and implementation for CPD for multi agencies in autism awareness
was also reviewed. The communication processes to inform parents of what was on
offer were investigated. The implementation of Early Bird and Early Bird Plus was a
focus, as was the impact of the multi-agency Diagnostic Pathway.
The review included reading of all relevant documentation including: Inclusion
strategy; ASD strategy; documentation provided by the LA. These documents are
listed in Appendix 1.
Part Two focussed on Adult Services. This included a range of meetings with HAFS,
ChAPS, Members involved in the Autism Scrutiny Review, the Practice Manager with
responsibility for autism, Halton Speak Out, ASC Training Sub Group, Community
Bridge Builders, Senior Commissioning Managers, Mental Health Commissioners,
PCT members, Independent Living Centre staff, Community Day Service Staff, and
the Operational Director with strategic lead for autism.
2 EXECUTIVE SUMMARY
This is a time of unprecedented difficulties facing Local Authorities. Since the
Comprehensive Spending Review, Local Authorities have seen their budgets
slashed, and have had difficult choices to make regarding the funding of local
services. In addition, Local Authority personnel and officers are currently undergoing
restructuring, which is widely expected to impact on team stability and capacity to
continue to deliver services at their current level. Nevertheless, those Officers met at
Halton Borough Council remained aspirational in planning service delivery, and
determined to continue to deliver improvements so that provision matched individual
need.
Since the last Review, the Government have published the Autism Act (2009), and
Fulfilling and Rewarding Lives: The Strategy for Adults with Autism (2010). While the
scope of the review was to measure progress against the recommendations in the
NAS report of 2008, this will of necessity also be viewed against the more recent
legislation and strategy. The vision for all adults with autism is as follows: „All adults
with autism are able to live fulfilling and rewarding lives within a society that accepts
and understands them. They can get a diagnosis and access support if they need it,
and they can depend on mainstream public services to treat them fairly as
individuals, helping them make the most of their talents.‟
The review team consider that Halton Borough Council have made progress against
the majority of the recommendations of the 2008 Review. The processes by which
children and young people are placed on the Diagnostic Pathway have improved; the
provision of a continuum of education for children and young people with ASD within
the borough has been extended; the reorganisation of special schools has
concentrated expertise for children and young people with ASD, there is a
Transitions support worker for those with ASD, and a family support worker.
Additional parent support groups are meeting the needs of a wider group of parents
of children with ASD.
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The Local Authority have appointed an Operational Director with a specific
responsibility for the strategic development of services for those with autism, and
adult services have appointed a Practice Manager with responsibility for those with
autism. The latter is introducing a system of Autism Champions which will further
develop understanding and knowledge as well as practice for those with autism,
raising the profile and awareness of Autism. The practice manger is also working
with other service areas and the voluntary sector to develop new services and build
on existing service provision to meet the needs of the Autistic population in particular
those with high functioning Autism or Asperger‟s.
The council have established a Positive Behavioural Support Service (PBSS) the
service has established a lifespan model to support children and adults with Autism
who challenge services, the team is staffed by Board Certified Behaviour Analyst,
the service has demonstrated good outcomes for individuals and has been
instrumental is reducing costs on behalf of the authority.
Member-led Scrutiny Review of Autistic Spectrum Condition for Adult with autism
who are of working age. This has provided a very helpful report with an action plan,
and the report will shortly be approved by the Executive Members for publication and
implementation. The Scrutiny review has enabled the member‟s a greater insight into
Autism and the particular issues those individuals with Autism face on a daily basis
as well as an understanding of how local services can continue to be developed to
meet the needs of the Autistic population of Halton.
The Review of the Autism Strategy is now in its final form, and this too is due to be
presented to Executive Members for formal adoption. This includes a wide list of
recommendations which through self-evaluation the Local Authority has identified as
priorities to develop. In this way the Local Authority will be able to map its own
improved services for adult services, aligned with the recommendations from this
report.
The Local Authority have an Autism Service which is implementing a wider range of
training, as well as coordinating outreach, and quality assuring the effectiveness of
the Autism resource bases. There is an Autism Strategy Group, with a wide ranging
committee of professionals; the signs are that there is some excellent provision
developing.
The Local Authority in 2009-2010 spent a total of £1.2 million on education provision
for pupils with ASD. In addition to this, the LA also maintains three special schools
which make provision for children and young people with ASD, aged 2-19.
Those areas where there is still further progress to be made include communication
with parents, developing parental information about and confidence in the continuum
of provision for children, young people and adults with ASD in Halton. Parents with
children with autism have had different experiences historically with understanding
what has been available to support them. Clarity of information and resources will
provide a springboard to developing parent understanding and access to information
about and support for their child‟s needs, the education options available to them,
and the on-going support channels and specialist resources pre and post diagnosis.
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The Local Authority has shown a willingness to work in partnership with all
stakeholders to develop improved services for children and adults with autism.
Developing this further to establish clarity of resources to support parents in their
choice of service and options for education will enable a higher level of parental and
carer confidence.
3 INTRODUCTION
The Review took place over four visits to Halton, which totalled eleven days for two
consultants, with report writing allocated ten days. The visits comprised visits to five
resource bases, three special schools, 3 meetings with HAFs, and a visit to their
family evening with meetings with parents. In addition, there were meetings with
HAFS parents as part of the review, meeting with ChAPs, and further meeting with
parents at two special schools, and as part of the resource bases. A meeting with
Halton Speak Out, The reviewers also met a range of Local Authority Officers (see
Appendix 4). Visits were also conducted to a range of services utilising a social
enterprise model that continue to develop within Halton.
The reviewers were given a range of reports (Listed at Appendix One). These
reflected work in progress, as some of the documents had yet to be adopted by the
Executive Members.
The reviewers found the process of examining progress made against the last
Review in 2008 to be transparent, helpful and supported by the LA‟s own robust self-
evaluation at every point.
The LA faces unprecedented challenges in the cuts to the budget required by the
government‟s implementation of fiscal management in the wake of the banking
collapses of 2009. This has meant that the LA is juggling services, restructuring the
organisation of services, and having to make difficult decisions about what services
will need to be reduced. In the face of this, the reviewers found that the LA is
innovative, extending services for autism, and committed to meeting individual need
as part of an increasing drive for personalisation. In comparison to the provision for
autism within Halton Borough Council in 2008, the current level of provision and
services has developed further.
We have met with HAFS, ChAPS, Parent Partnership, Light Relief, Halton Speak
Out, parents at The Grange, Cavendish School, Brookfields School, and Sims Cross.
In addition we have met with a variety of parents who are part of HAFS. In all of
these meetings we were able to discuss what was working and not working relating
to children and young people, as well as those issues faced by parents and carers of
adults.
There have been parental concerns about the absence of autism accredited
provision in schools in the borough. The findings of the review in 2008 made a
number of recommendations concerning this, which have been implemented.
Nevertheless, parental dissatisfaction is still sufficiently high for parents supported by
HAFS who then challenge the Local Authority to tribunal for an independent special
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school placement where parents have confidence that their child‟s specific autism
needs will be matched by provision.
In the course of the review the reviewers visited all three special schools, all of which
have achieved „Outstanding‟ in recent Ofsted inspections. There is very good
practice in all of them for autism; however, the LA does lack a through special school
designated for Social Communication needs and Autism for secondary aged children
and young people. We have recommended that this is addressed via re-designation
of Ashley School to include pupils up to the age of 19 years of age; this will address
pupils‟ needs in borough. It is worth mentioning that pupils with Autism at Ashley
School are already making above average expectations at the end of Key Stage 4. In
this way, the Local Authority will respond to parental concerns about the success of
autism specific provision. It is worth mentioning, however, that there are many
„Outstanding‟ schools within Halton and elsewhere in the country which successfully
meet the needs of pupils with Autism within a generic, all age special school.
Communication with parents continues to develop. HAFS are part of the Autism
Strategy Steering Group, and are therefore integrated into the decision making
process for strategic development for children, young people and adults with autism.
In addition, Halton canvas the views of parents via Carers‟ conferences. This is then
fed into action planning for further changes, based on what parents have said they
would like to see happening.
There is currently work being completed on providing parents‟ information leaflets
about the transition process, including which services are available on transfer to
adult services. However, this is restricted by changes in legislation affecting the
NHS, with the proposed transfer of funding powers to GP services. Until this has
been confirmed, the LA has not been able to finalise its information, given that it is
still unclear what referral routes parents will have to access for some services.
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4 PROGRESS AGAINST THE RECOMMENDATIONS IN THE NAS REVIEW
2008
4.1 Develop an Autism Service Development Group to include all
stakeholders to develop a more strategic approach to meeting the needs
of people with an ASD.
The Local Authority has embraced this recommendation. There has been a Strategic
Lead for Autism since 2010. There is an ASD Strategy Group which is multi
professional and includes representation from an Autism support group for those
with children with Autism. The Review of the ASC Strategy is in its final draft, and
awaits ratification by the Local Authority. Strategic developments include the pilot
outreach programme for those with Asperger‟s Syndrome as preventative low level
interventions, as well as the introduction of Autism Champions. The ASD Strategy
Group meets regularly and comprises a wide group of multi professionals and parent
representatives. In addition, Members have completed a Scrutiny Review of
employment provision for adults with ASD. In addition, Children‟s Services have a
well-established Autism Development Service.
The LA originally set up three working groups from the Autism Stakeholders group to
focus on Workforce Planning – Training and Development; Commissioning in
Transition; Meaningful Employment. These have been led by the Learning and
Development Manager, Divisional Manager for Independent Living, the Divisional
Manager for Community Services, respectively. It has now merged the Autism
Stakeholder and Strategic Group to become the Autism Spectrum Condition
Strategic Group in order to have cohesive approach to and practice in the service
delivery across children‟s and adult services.
4.1.1 A Strategic Lead for Autism
The Local Authority has appointed the Operational Director with a specific strategic
lead for autism. This appointment was made in September 2010. Since that time,
other significant appointments have also been made, including the Practice Manager
Autism in Social Care in September 2011. This has resulted in a more highly
coordinated delivery of integrated services for adults, and closer working between
children‟s and adult services. One example of this is the use of transition planning,
which feeds directly into the assessment process for adults.
4.1.2 The ASC Strategy
The review of ASC Strategy for Halton is in its final draft and is awaiting ratification
by the Local Authority
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4.1.3 Strategic Development of support networks for those with ASC
The Practice Manager for autism delivered a paper on 14th
December 2011 to the
Senior Management Team within the Communities Directorate on current support
networks available in Halton for people with ASC residing in the borough and
accessing out of area placements and the viability of returning the individuals to
Halton.
This report recommends that the SMT:
Autism sits within the generic care management team with the
exception of those with presenting mental health issues or subject to
mental health legislation should remain within the CMHT team based
on a joint assessment from adult social care and CMHT.
Autism Champions network be implemented borough wide.
The remit of Mental Health Outreach Team to cover Autism as a
preventive service – as a pilot this would need to be monitored for a 3 –
6 month period to determine demand and increased impact on the
service.
The development of preventative services which will meet the needs of those who do
not meet the FACS, (Fair Access Care Services, 2010) includes those with Asperger
Syndrome. This is a positive development which will have a wider remit than that
currently. The Local Authority will need to monitor the impact of this service, which
appears to meet the needs of a group whose needs are currently not met at all.
However, it is acknowledged that by providing this low level and preventative
service, there is a real potential to avoid later crisis and more intensive interventions.
There is the potential for this to provide a stronger network of contacts and support
through this pilot.
4.1.4 The ASD Strategy Group in Halton
It is clear from reading minutes (02.06.2011) of this group, that the reformulated
group has revitalised the strategic element of the group. There is wider
representation on the group including that of HAFS, thus ensuring that parental voice
is represented. The coordinated, multi-agency approach supports the
recommendation in the SEN Green Paper (DfE 2011) for more effective joint working
across agencies including the proposed introduction of integrated health, education
and care plans.
Young people with autism and complex needs require support from community
professionals from a range of different agencies. The development of integrated
multi-agency autism teams facilitates effective joint working protocols across social
care, health and education at a strategic and a practitioner level. This is happening
within the Autism Strategy Group in Halton, and the composition of the group is in
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line with the recommendations in the draft NICE guidelines re support for adults with
autism which is due to be published in its final form in June 2012.
4.1.5 The Autism Strategy (Draft)
The Review of the Autism Strategy (draft) 2011-2014 is awaiting ratification. The
Autism Strategy has been reviewed in the contexts of The Autism Act (2009) and
Fulfilling and Rewarding Lives (2010). Halton‟s Autism Strategy places the strategy
within the local and national context.
Within each section, the Autism Strategy tracks its progress within key areas,
including planning and commissioning services, based on thorough understanding of
the prevalence of autism, diagnosis and planning, commissioning and training;
support for families, support with accommodation, day time activities and friendships
and relationships; education and employment, and health and wellbeing. Each
section tracks progress within the LA to meet the requirements for each element,
and states its strategy to develop these services and approaches further.
For example, a key foundation for planning and commissioning services is
predicated on a thorough knowledge of data; the LA have as an improvement
objective to „Complete audit survey of adults to establish how many have a diagnosis
of autism or who present with typical features of the condition‟. With the forthcoming
NICE guidance on adult diagnosis, the NHS will implement their own revised adult
diagnostic pathway in 2012/13.
In the implementation of their Strategy, the LA will continue to work closely with other
stakeholders across Health and social care to ensure that awareness of and
understanding of autism is disseminated throughout all teams. For example, „GPs
and primary care practitioners are aware of the services available to people with
autism and the need for reasonable adjustments within their practices‟.
In ensuring the development of effective transition, the LA propose to extend
the opportunities for those with autism to be supported to make choices at
and beyond transition, and to implement further low level support and
preventative services. Halton also propose developing an advocacy hub,
ensure that „informal carers and/or family members are offered an
assessment for their carers needs, to ensure support for carers is in place‟,
and continue to promote the take up of direct payments and self-directed
support.
Provision of short breaks for families of children with autism and respite
support, and for families of adults with autism will continue to be offered as
required.
The LA is also reviewing its accommodation planning, including that for
„people with lower level needs – “vulnerable” not “complex” – including people
with autism spectrum conditions across the spectrum.‟ In order to facilitate this
at strategic level, there is a need for improved understanding of autism among
housing providers. There is an intention to increase accommodation options
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available to those with autism. This matches current work being undertaken
by the commissioners to identify phased options of accommodation to match
individual need and preference, including that needed according to different
levels of support in order to promote employment opportunities, the LA will
develop an Employment Pathway to address the needs of those with autism
in Halton, and actively promote the benefits of employing people with autism
to employers.
The LA has also published a Development Plan as an appendix to the
Strategy, which is a clear intention to fulfil the objectives outlined in the
Strategy.
4.1.6 Member-led Scrutiny Review of Autistic Spectrum Condition for Adult
Services
During 2011/12, a scrutiny review of Autistic Spectrum Condition for Adult Services
was commissioned by the Health Policy and Performance Board. The Scrutiny
Review topic group comprised of six Members from the Board, the Operational
Director (Commissioning and Complex Care), Principal Policy Officer from the
People and Communities Policy team, Principal and Practice Managers from the
Positive Behaviour Support Service and the Practice Manager for Autism. The
scrutiny review focussed on the working population of those with Autism.
The purpose of the review was to consider the services to support people with ASC
as part of the Local Authority implementation of the requirements in Fulfilling and
Rewarding Lives, the national strategy for adults with autism.
A range of meetings took place with a representative group of those responsible for
service delivery as well as those responsible for the strategic development of adult
services for those with autism. The focus on different aspects of provision for those
with autism within adult services enabled Members to further understand the
tensions between the aspirations of those leading provision and the funding available
to develop this further. The recommendations will support improving services in
Halton for people with ASC.
The reviewers were fortunate to meet Councillor Cargill who gave feedback on the
Scrutiny Review and Councillor Wright who gave feedback on the work she does
within the borough to raise the awareness and understanding of Autism.
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Recommendations from the Scrutiny Review included:
Autism Spectrum Condition Awareness:
a) Halton‟s Autism Strategy to be approved and implemented by the ASC
Strategic group, Senior management and Health Policy and Performance
Board, Children‟s Trust, and Halton and St Helen‟s Clinical Commissioning
Committee.
b) Implementation of the Autism Strategy to be monitored and updated via ASC
Strategic Group
Parents/Carers Perspectives
c) Continue to improve engagement with parents/carers, building on the work
that has already taken place;
Day Services
d) Continue and extend the work opportunities, both paid and voluntary, for
individuals with ASC in Halton, enhancing skills to achieve this;
e) Increase publicity about the good work which is being progressed in day
services
f) Source funding for new batteries for the shop-mobility scooters
Day activities for people with autism
g) Increase employment opportunities, both paid and voluntary, for individuals
with ASC
h) Maintain the Pan-Disability model within employment services;
i) Increase day service venues to replicate good practice within the service
across the borough as social enterprises, to complete the feasibility study in
2012;
j) Increase the awareness of the benefits of employing individuals with ASC to
local employers.
Employment and Autism
k) Further promote joint working between teams and inform team work priorities
and projects (employment, working and skills). (This will work at both elected
member and officer levels).
National Autistic Society
l) Increase low level support for people with ASC;
m) Increase local provision for individuals with Asperger‟s;
n) Increase awareness of ASC within workforce, eg teachers, social workers,
health colleagues etc
o) Collect data on the number of adults and children with ASC borough wide.
The Scrutiny Review‟s Action Plan already addresses these recommendations with
an evaluation schedule to monitor the implementation of these recommendations.
17. 17
The Councillors visited a range of social enterprise venues and commented on how
adults working in these venues have really developed in confidence. Councillors are
still visiting the adults, and maintaining the earlier links with them from their review.
The social enterprise model encourages adults, including those with autism to have
transition to meaningful activities, which are linked to employment. This is very far
removed from a day service model based on „sitting in a room making baskets‟.
The councillors interviewed were asked what gaps still exist within the current
provision for adults with ASC, and in their view the following remain as gaps:
There is still a gap for those adults with autism and the most complex
needs. The Independent living centre offers opportunities to share tasks in
making cakes, for example. There is a need to further develop provision for
this particular group.
GPs could be asked to give information on those with ASC. Information
on adults with ASC needs to be disseminated. Currently there are
approximately 80 adults in HBC with identified ASC, but national statistics
suggest the incidence of ASC in the whole population to be 1 in 100; this
means there are circa 1000 in the population, but less than 20% have been
identified.
Take up for health checks for people in Halton is very low. Marie will
discuss this with GPs about how to target those with ASC in particular.
There is a lack of consultation with parents. Marie will be asking „parents‟
forums‟ to seek the views of parents that can be sent as a short report or letter
to the different boards for consideration, information or raising awareness.
An older people’s group which has representation from pensioners does
not currently include adults with autism; this is a potential area for further
development.
Disseminating information about the understanding of autism is at an
early stage; Cllr Cargill is a member of the Patients forum and will be asking
questions about the implementation of understanding of autism in practice of
GPs, receptionists etc. This will be further disseminated.
The Councillors involved in the Scrutiny Review saw the personalisation agenda as
meeting people‟s individual needs via Halton Speak Out putting plays on at the
Brindley Theatre, and involving people with autism; they also heard about the
opportunities given to adults with autism and complex needs to write their own
poems. One young person wrote a song about being seen as an individual, and not
wanting to be put in boxes, or categorised because of their disability or difference.
18. 18
The Councillors had clear ideas about how the existing services might be better
publicised to parents and carers of adults with ASC. They have pledged the support
of elected Members to give a focus on adult services with ASC once the Scrutiny
Review has been accepted. Already, the Scrutiny Review has impacted on the social
enterprise model for day services. The following shows how the publicity about
existing services might impact on information for parents and carers of Adults with
ASC, whilst simultaneously disseminating information about ASC. It also shows how
the recommendations from the Scrutiny Review are being taken forward.
Shop-mobility shop will be opening in Widnes at the Market; will be a possible
opening for disseminating information about ASC. This is at the heart of the
community where it will be possible to gain more information.
Cllr Wright co-chairs the Adult Learning Disability Group with a young man
who is ASC.
Cllr Wright attends the People‟s cabinet as well. This means another forum for
dissemination of understanding about ASC.
Funding given from the Area Forum to replace some of the scooters in the
Runcorn Shop-mobility service is under way. This will revitalise the service to
the community, and has generated the plans to extend the service to Widnes.
Once the recommendations are accepted by the Executive Board, these will
then receive funding and enable planned actions to extend services and
understanding asbout ASC to take place.
In 2013 when the HBC is implementing public health changes, there will be a
focus on autism.
Data collection could come through asking GPs. This is to be further
investigated as a possible route to extending the current collection of data
about adults with ASC.
There is an intention to develop the practice of offering a mentor to support
adults with pan disability in employment.
HBC continue to show commitment to the most vulnerable people in the
community.
19. 19
4.1.7 Recommendations: Autism Strategy Group and Autism Development
Group
Publish a final version of the strategy
Coordinate the work of the autism service to incorporate multi services,
especially the work of SALT and the family support workers
Include parent representation on the Autism Strategy Group from sources in
addition to those from HAFS.
Develop the recommendations in the Scrutiny Review.
Continue to find robust means to collect data on the incidence of ASC in
adults so that the planning of services can be tailored to known needs.
4.2 Develop opportunities for extended school day and short breaks specific
to the needs of children and young people with autism. In adulthood,
there needs to be low level, preventative services such as social groups,
befriending and investment into Community Bridge Builders.
Halton Borough Council has developed opportunities for extended school day and
short breaks specific to the needs of children and young people with autism. All
special schools visited had an extensive programme of after school clubs, as well as
the opportunities for residential trips, including to Ashley‟s School Trip to China,
which had been accessed by a number of young people with autism. Short Breaks
are available through support groups, and through universal and targeted services,
according to need and request.
Halton Disabled Children‟s Service Short Break Statement states that Halton „is
establishing a system that enables all disabled children and young people to access
community based social and leisure activities.‟ This is being quality assured by
young people, including those with autism to ensure that facilities and activities are
accessible, that the activities have made reasonable adjustments to meet the needs
of young people with disabilities, and that the leisure activities span a range of
interests.
This is mirrored in Adult Services, which similarly aims to provide a range of social
and leisure activities within the community, in addition to employment opportunities.
Evidence of increased funding for, and engagement in the short break provision, is
that in 2010-11 the total number of short breaks from within the voluntary sector
taken by ALD carers was 155, whereas in 2011-12 (as at 30/11/11) this had
increased to 224.This represents an increase on 2010-11 of 45%.This illustrates the
impact of the Carers Consultation events as carers breaks are commissioned as a
result of those outcomes.
20. 20
There had been LA funding for children with autism and their families from the
Aiming High for Disabled Children which was awarded to HAFS for three years from
2009 to 31st
March 2012. This has supported the provision of short breaks and
respite within Halton by giving children with autism and their families the
opportunities to have days out together as families, attend specialist youth provision,
and have residential trips away.
Within the Halton Disabled Children‟s Service Short Break Statement document
there is a comprehensive list of all services which can be accessed by children with
disabilities and their families across Halton. Those which are available for those with
autism include ChAPS and HAFS. In addition, there are short breaks available at the
Inglefield Centre for children with complex needs; however, this is only available
through a social work assessment.
There are out of school clubs and Saturday morning and afternoon activities run from
Cavendish School and Widnes Children‟s Centre. Halton also provide summer play
schemes during Easter and summer holidays, with dedicated provision for those with
disabilities with additional support.
In Adult Services the Community Bridge Builder service has developed considerably
since the last review. This means that the service is reaching a wider group of
clients, including those with autism. The parameters of the service mean there is
coverage for individuals from 8 am to 11 pm seven days a week. The fact that there
is a waiting list for this service shows its popularity; it also indicates that it has further
potential to meet a wider population with additional funding.
4.2.1 Children’s Services
Aiming High for Disabled Children (DCSF 2007a) recognised that disabled
children had the right to the same opportunities to develop their potential as
all children, and that families with disabled children had a right to short breaks
from the responsibility of looking after their disabled child in order to lead a
normal family life. The report acknowledged that children with autism or
challenging behaviour were disadvantaged when they could not access such
services:
All young people will have access to a diverse and attractive local
offer of purposeful, engaging and exciting positive activities and
places to go that responds to their needs and supports their
personal development, including providing routes into more
dedicated support and guidance for those who need it.
Aiming High for Young People (DCSF, 2007a)
The Local Authority has provided funding to HAFS for short breaks 2009 to
2012 which it supplements with Lottery funding. This has resulted in a range
of days out and residential holidays for children and young people with autism
and their families. This is a valuable and valued resource.
21. 21
For 2012-13, the Short Breaks contract has been awarded to Core Children
Services.
The newly designated resource bases for pupils with Autism have provided a
very good range of extended school activities. All schools have a range of
clubs and activities which are either specific to children with ASD, or open to
them. The resource bases are situated in both Runcorn and Widnes.
Within the special schools, there are a wide range of clubs for children and
young people, as well as opportunities to take part in a wide range of trips,
both within the UK, and, in some cases, internationally.
The Local Authority has had an innovative approach in offering a Taking
Control pilot using Individual Budgets to deliver short breaks for families in
Halton. This took place in 2009-2010, and enabled ten families with children
with ASD and/or complex medical conditions who did not qualify for receiving
services from the Children with Disabilities team to access short breaks via
Individual Budgets. This has given the LA the opportunity to investigate the
impact of this service on families who would otherwise have had no short
breaks.
4.2.2 Adult Services
Community Bridge Builders Team (CBBT)
This service has been extensively developed since the last review.
The impact of CBBT is discussed further under Recommendation 17. This is
having a significant positive impact on users‟ well-being and interaction
within their local communities, and is a valuable and highly valued service.
4.2.3 Recommendations: Short Breaks for children and young people with
autism
4.2.4 Children’s Services
Clarify to parents whether the opportunities for short breaks are available to
those children in enhanced provision, as well as those with statements.
Investigate the opportunity of offering school accommodation during school
holidays for leisure activities for children with Autism utilising Halton‟s Special
Schools.
Consider the commissioning of Short Breaks (four night activity holidays with
family support) for children and young people with ASC. (Model to be offered
to HBC).
22. 22
4.2.5 Adult Services
Further extend the Community Bridge Builders Team service so that the
waiting list can be reduced, and the service can continue to make a significant
contribution to adult befriending services for those with autism.
Continue to support the work of the Carers‟ Service which is meeting the
needs of a wide range of parents and carers of children and adults with
autism.
4.3 Enhance the communication system with parents to ensure they are
aware of provision within education and social care that is available for
them. There needs to be information for families about the transition
process, and about what services are likely to be available as people
move into adulthood.
The reviewers met with a range of parents in different settings. This included
meeting parents from HAFS, within resource bases, at special schools, and those
invited to discuss transition to adult services as part of the review of adult services.
It was clear that individual families still lack clarity about the signposting of
information about provision within education and social care.
Parents are still in the process of understanding the impact of enhanced provision in
highly resourced specialist bases, although an 18 month statutory consultation was
implemented that encompassed: meetings with parents, schools and governors and
the public notices within the local press for 6 weeks.
Special schools in Halton are „Outstanding‟ in Ofsted inspection outcomes, parents
did not always know how each school makes provision for ASD, or how good the
outcomes are for some pupils with ASD. This is largely an issue of ensuring that
information which is published on individual schools‟ websites is updated regularly,
as well as the LA ensuring that it also includes information about how schools make
reasonable adjustments to ensure pupils with ASD are provided with an education
which takes account of individual needs, preferences and aptitudes.
Communication systems have been improved by the appointment of a Family
Support Information Officer in Children‟s Services; it is too early for this to have had
an impact on parental perceptions about communication systems generally. In
addition, it would seem to be appropriate to have a similar position in Adult services,
as there is currently no clearly defined communication route for parents and carers of
adult children with autism.
Halton Borough Council has provided a Transition Guide for Parents and Carers; this
guide has no specific information for parents and carers of children and adults with
autism but it is worth noting that the information covers all disabilities and services
for children and young people and as such children and young people with Autism
would benefit from the information and services.
23. 23
4.3.1 Children’s Services
The communication system with parents within the resource bases is
evolving. The parent support groups which are being established by the Local
Authority are offering a range of meetings during the school day. These
include information about autism, pampering sessions, and the opportunity to
meet other parents who can offer peer support. Light Relief, at Simms Cross,
Oakfield and The Grange Juniors, also attended by parents of children
attending the resource Base at the Infant School. Parent groups are due to be
initiated at The Brow, The Grange Secondary school and Palacefields
Academy. The Family Support Worker also makes weekly home visits to six
families.
Meetings with parents of children at the resource bases, as well as within the
special schools, showed acknowledgement of the progress made by their
child within that provision, appreciation of the flexibility of the school to meet
their child‟s individual needs, and gratitude for the openness of the school in
listening to them.
Light Relief, at Simms Cross, Oakfield and The Grange Juniors, also attended
by parents of children attending the resource Base at the Infant School.
Parent groups are due to be initiated at The Brow, The Grange Secondary
school and Palacefields Academy. The Family Support Worker also makes
weekly home visits to six families.
Light Relief offers parents of children with ASD in resource bases the
opportunity to share their concerns and to learn more about their child‟s
condition. The group utilises a range of activities to support parents to develop
strategies to manage their children, and to seek positive solutions to
challenges their child may be having. Parental feedback evaluations show a
high level of satisfaction with the groups.
Communication systems had fallen down in the past. This was true for some
parents in HAFS, where there was disquiet about the continuum of provision
within Halton. However, the strategic overview from HBC to create a full
continuum had not been fully communicated to all parents. This therefore
meant that some parents still felt they had not been adequately informed
about varying options for their child‟s education. This has had an impact on
parental confidence in the strategic planning for children and young people
with autism.
The new website regarding information for parents about provision for children
and young people with autism needs further development and marketing.
The addition of the Chairman of HAFs to the Autism Strategy Group should
enable the developments of autism provision to be disseminated to HAF
parents. However, the LA will need to ensure it has a channel for information
to all parents of children and young people with autism, so that all
stakeholders are kept fully informed of what is on offer for them, how to
24. 24
access it, and what they can do in order to make a contribution to the
strategy.
25. 25
4.3.2 Adult Services
As part of the review, the reviewers met with HAFS and ChAPS, as well as with
some parents to discuss Adults services and the transition between children and
adult services for those with autism.
In our meeting in November at the youth group, one family commented that there
was a gap in provision in Halton for those children who had been in 52 week
residential provision out of authority when the young person reached 19, and it was
proposed the young person returned to the LA. In the interim, this situation has been
resolved to the satisfaction of the parent, although the provision is still out of
authority.
It is difficult for a small authority such as Halton to provide in borough long term
residential care for those at the highest levels of need associated with ASD. While
currently there is no provision in borough to meet those complex needs, Halton
Positive Behaviour Support Service is working across teams to bring back individuals
who have been out of borough, at considerable savings to the Local Authority. This
is following a recommendation for the LA to continue the work with Dr Toogood, and
the setting up of the service has had an positive impact on the management of those
with very complex needs, and their placements within borough.
With the coordinated approach between transition and social care teams, with
mental health and commissioning teams, planning for appropriate placements in
borough is now in place. This means there will be a greater capacity with specialist
teams to support those with the most complex needs, as well as creating more
opportunities for developing local social links and independence.
HBC have recognised the gap in services for those with high functioning autism, and
the Practice Manager with responsibility for autism is intending to use the voluntary
sector to set up Pub groups to meet needs locally. There would also need to be
specific activity groups in order to reach those adults with high functioning autism
who do not wish to socialise in pubs.
The Carers‟ Centre is offering very good support to parents and carers of those with
Autism. Within the LA it is known that HAFS have 34 Carers who take care of people
with Autism. ChAPS have 45 carers who take care of people with Autism. Connect
have six service users with Autism who attend the group.
4.3.3 Recommendations: Communication Systems with Parents
Continue to develop the very promising support offered by resource bases to
parents.
Continue Early Bird and explore the development of Early Bird Plus.
Continue to maintain a central database to track children, young people and
adults with links made between the practices of different agencies.
Maintain the practice of a named contact for parents with children with ASC
who are on enhanced provision so that they can ask questions about
provision as they arise.
26. 26
Continue to ensure there is a channel for information to all parents of children
and young people with autism, so that all stakeholders are kept fully informed
of what is on offer for them, how to access it, and what they can do in order to
make a contribution to the strategy.
Consider implementing a Family Support Information Officer in Adult Services
as a central point of contact for families and people with ASC.
Reappoint a lead Officer for Transition as part of Adult Services.
4.3.4 Recommendations: Comprehensive Overview for Parents of What Is
Available To Meet the Needs of Their Child with Autism and the Wider
Needs of the Family
Extend the role of Parent Partnership Service to included information
about the continuum of provision, and the availability of the different levels
of provision according to need:
On the general Halton Borough Council website;
On a specific parent Information website;
Via schools‟ own websites.
Develop the work of the Carers‟ Centre as a channel for providing information
about what is available to support them to parents and carers of those with
ASD.
4.4 Increase staff capacity to provide a training strategy which includes
basic autism awareness for all staff working with people with ASD, and
for relevant staff across the professions at a higher level, with systems
for dissemination. This needs to be embedded as part of induction.
Funding for autism training should be ring fenced. Some training should
be jointly delivered across LD, MH and Further Education.
4.4.1 The implementation of training across different levels is clear in both
children’s services and in adult services.
There is a Strategy group for training for professionals in Halton. This group
was set up in response to the last review in 2008. The Strategy Group looks
at the wider delivery of training across agencies. The training for support for
parents and carers of children and adults on the Autistic Spectrum is being
introduced. Autism Training Strategy Group has a multi-agency membership
ensuring a shared knowledge, expertise and use of resources.
NAS have been commissioned to deliver accredited training. This includes a
training module at Masters Level via Canterbury and Christchurch
universities. 30 people have trained on this course.
The Local Authority – Division for Inclusion - commissioned a place for a key
individual from each resource base to attend. All passed.
27. 27
The Local Authority Division for Inclusion has also set up Autism Development
training opportunities which offer tailored training to school staff. This includes
the Inclusion Development Programme for Autism- three day courses in
autism awareness as well as ELKLAN. The latter offers Language Builders for
Verbal ASD, and includes primary and secondary language development.
This course incorporates multi-agency delivery over one afternoon for ten
weeks for a cohort of up to 15. This is open to Teaching Assistants, Teachers
and mainstream school staff. It covers practical support for teaching children
and young people with ASD, use of visuals, understanding the child with ASD,
and Theory of Mind.
This includes twilight sessions for TAs, teachers and general school staff. This
is also offered to the Portage service, to those in Adult services, and to
parents.
All school staff also have access to the free SEN training programme in
Halton.
NAS have been commissioned to deliver accredited training. This includes a
training module at Masters Level via Canterbury and Christchurch
universities. 30 people have trained on this course.
28. 28
4.4.2 The Autism Development Service
The Local Authority has also developed an Autism Service within Children‟s Services
which delivers training, support to schools and outreach as necessary. This is very
successful, although it is in its earliest stages. The model adopted of the outreach
service is yet to be fully implemented from the resource bases, although the
outreach ASD support from the central team is well-coordinated. The LA has also
employed the retired ex-Deputy Headteacher of Brookfields School to support the
ASD special schools to achieve and/or maintain NAS accreditation. Her role is also
to quality assure the resource base practice and outcomes. This is particularly
thorough and detailed. For example, the reports on the resource bases track the
professional training of staff, the recruitment and induction of staff, illustrating their
prior experience of working with pupils with autism, further training needs, together
with a detailed report on progress within the report base. The level of detail shows
that staff are appropriately qualified, with training which matches the autism needs of
the children. This includes as part of the Canterbury and Christchurch Accredited
training, PECS (Pictorial Exchange communication System) training, SPELL,
TEACCH, Elklan, social stories, IDP, Sensory issues and positive behaviour support.
Further training has been identified for Pivats, CASPA, Using colour semantics
resources and Language games. Early-Bird Plus training has also been identified as
a potential future route to follow.
The Local Authority has implemented a wide programme of autism awareness
training which those members of staff working within the resource bases also
access. The Autism Development Service is continuing to expand, and is well led.
In 2008 the NAS review highlighted the need for consistent and proactive training for
staff in all agencies. On recommendation of this HBC aimed to establish a
framework for autism training and promote quality training in the field of autism.
HBC have only recently started the framework.
HBC are aware of the need to support family carers with training and linking to
HAFS, ChAPS and other support groups. HBC are introducing ASC champions
training.
Halton has developed a training strategy for supporting people with ASC. Halton
have been supported by NAS in developing the strategy. The framework for autism
training identifies training for different groups of local services which have contact
with people with ASC at a range of levels. These include non-specific customer
facing staff, para professionals, professional staff, specialist professionals and
managers, planners and commissioners.
Autism awareness courses at different levels, according to the requirements of the
service, are currently in planning. Guidelines will be issued on the levels of training
required for each staff group. A training matrix will record and audit all staff training
records.
29. 29
4.4.3 Autism Champions
Adult Services are implementing Autism Champions across Halton. This is based on
a successful scheme run in Surrey, where, in response to people with autism
identifying a need that a key thing they require from services is expertise and
understanding of autism, a county wide network of expertise in ASC was set up.
Each team working with people with ASC identifies an Autism Champion, who is
then supported by their service to access training around ASC appropriate to their
service, and this training is then cascaded to their team. Champions have mentors
whom they meet with regularly to undergo training in the NAS SPELL approach.
Halton have begun the process of identifying the most appropriate professionals in
the first cohort of champions, ensuring an even distribution across Widnes and
Halton. This is due to begin in April 2012. HAFS, CHAPS and Halton Speak Out will
be invited to a planning event with key organisations to develop modules for Halton.
This process will support Halton'
4.4.4 Recommendations: Autism Training Strategy
To continue to provide opportunities for all new employees, and those who
are already working with children, young people and adults with Autism to
complete induction training in autism awareness. Individualise training
appropriate to role and responsibility. This includes teaching assistants and
midday supervisors, social workers, librarians etc.
Ensure teaching assistants have the opportunity to achieve NVQ Level 3 in
Supporting, Teaching and Learning.
To ensure that there is refresher training and details kept on a database
Implement the December 2011 ASC Training Strategy, with clear timelines
and identified lead personnel for each objective.
4.5 Consider the appointment of a Family Support Worker / ASD Information
officer to help parents to navigate the system within Halton. This service
could be commissioned from a third party to ensure objectivity.
A Family Support Worker has been appointed.
4.5.1 Children’s Services
Progress has been made helping to start a „Light relief‟ group for parents run by a
family support worker from a resource base. This has only recently started and
further impact of this resource needs to be evaluated. This group links in social
interaction for parents plus passing information about services and opportunities for
breaks and trips.
Halton‟s Positive Behaviour Support Service consists of Board Certified Behaviour
Analysts (BCBA), Care Managers and Support Workers, who use scientifically
validated, evidence, based practices to work with families and schools supporting
children with Autistic Spectrum Conditions. The service is working with children
30. 30
ranging from 4 to 16 years across the relevant educational and family settings
providing training, direct support in implementing behaviour change procedures, data
collection and maintenance. Early examples of progress have been recorded with
young people with autism in both primary and secondary provisions and in
mainstream and non-mainstream.
4.5.2 Recommendations: Children’s Services
To consider the use of more family support workers to link into families that
are experiencing issues and challenges with pupils before being on the
pathway
To link family support workers into education multi-agency meetings at
schools.
Family support workers or other name can remove barriers to learning
enabling families and pupils to access the services and supports that they
need. Some of the issues faced could be bullying, family issues or
challenging behaviour so work undertaken at school is continued at home
To work closely with the Education Welfare Service and other services
To facilitate communication links between education, health, social workers,
police
To consider the ways in which the Parent Partnership Service could further
support the mediation process for parents of children with autism at an earlier
stage.
4.5.3 Adult Services
To continue to develop multiagency workings across service area‟s sharing
information linking in to the ASC Strategy group membership.
4.6 Widen the menu of provision for children with autism within Halton
schools. For example, consider Resource Provision attached to
dedicated staff can support the pupils and influence the whole school
Autism is a spectrum condition and therefore requires a continuum of provision.
While many young people can cope independently in mainstream schools, others
benefit from resource bases attached to mainstream schools, or generic special
schools. Those areas that have autism accredited provision often rely less on
independent provision. Having sufficient resources, well trained staff and well
equipped accommodation. Appropriate staffing levels, accommodation matched to
need and high levels of training and skills, supports pupils to have their needs met
appropriately.
The continuum of services for autistic children and adults in Halton span the
following:
o Woodview Child Development Team (pre-school children)
o Early Bird parent training
31. 31
o Little Stars advice group includes parents of children with ASD
o CanBe service- consultation, guidance and support service for children
with disabilities and challenging behaviour, including a significant
percentage of children with ASC.
o Inglefield short break residential unit; this provides short breaks for
carers/parents, with 50% being for parents of children with ASD
o In 2010 the LA spent £1.25 million on provision for children and young
people with autism.
After consultation on statutory processes, the local authority has re-
designated six resource bases for children and young people with ASD.
These are situated at The Grange through School (key stage 1, 2, 3 & 4), and
at Sims Cross (Key Stage 1 & 2). In addition, there is a resource base at St
Peter and Paul (Key Stage 3 & 4)
All resource bases are for seven children or young people with a diagnosis of
ASD, Criteria for admission to Resource Base is a diagnosis of ASD. Have to
have a diagnosis. The Local Authority has also extended Outreach capacity to
support other schools in the localities.
The resource bases are funded at £764,000 for pupils aged 3 ½ yrs to 16 yrs
with a diagnosis of Autism.
Staffing: pupil ratios are in line with NAS guidance within each resource base.
There is one teacher and two teaching assistants, plus an outreach worker
attached to each resource base. This ensures that there is sufficient staffing
to support integration into mainstream classes as necessary. In addition, the
outreach worker working with the resource base team has a maximum of five
pupils which ensures that the work for outreach enables pupils to have a block
of time to focus on modelling with teachers and teaching assistants as
necessary.
Accommodation for pupils in the resource base is of a high standard. In the
BSF rebuilding of The Grange School, the resource bases for Infant, Junior
and secondary are planned to form a part of the SEN spoke, and have
extensive additional rooms to meet a wide range of social and emotional
needs of these pupils.
The re-designation of resource bases took effect from September 2011 and
already very good practice is emerging. For example, the highly personalised
planning for individuals meant that children in the resource base followed the
same curriculum as their peers in the mainstream class but a high level of
differentiation meant it was exactly tailored to meet their needs, In keeping
with Ofsted in SEN and Disability in Mainstream Schools (2011), planning was
shared with teaching assistants so that there was always a coordinated
approach to learning and teaching.
32. 32
In keeping with new provision, the resource bases are being audited regularly
and recommendations made it is planned that all resource bases will achieve
NAS accreditation over time.
The resource bases, with their Outreach and Inreach role, will work with local
schools to build their capacity and expertise in working with children and
young people with ASD. In the same way, the special schools will also work
with mainstream schools to offer them expertise, and to develop provision for
children and young people with ASD.
The re-designation of resource bases in Halton to meet the needs of children
and young people with ASD is based on the levels of diagnosis of ASD on the
Pathway. As diagnosis improves in Halton, as it is nationally, the numbers of
resource base places is higher in primary than in secondary. However, the LA
may wish to consider how it will meet the need of higher numbers coming
from primary to secondary in planning future numbers for secondary resource
bases.
The resource bases are part of the authority‟s Enhanced Provision, in which
pupils access the same additional level of provision as statement pupils, but
the funding goes to meeting pupil needs rather than into the statementing
process, there is an extensive menu of support for children and young people
with addition needs.
As part of the continuum of provision within Ashley School would benefit from
NAS accreditation and consideration of a specialist base to support children
with Social Communication Needs and Autism.
o Children with Autism with the most complex behaviour that challenges
services
o The base would be a short term treatment provision (perhaps
maximum of two terms)
o Opportunity for intensive behaviour analytic based treatment
o Links to PBSS (however; would need own staff)
o Philosophy- to give intensive treatment to reduce undesirable
behaviours and increase desirable behaviours and ensure successful
reintegration back into main school/alternative school provision
o To provide some outreach and maintenance to support to schools once
a child has reintegrated
o Will avoid children being placed in out of borough provision when local
school placements have failed/stated they cannot meet needs due to
high level of behaviour
o Joint working with PBSS and children at home (prevention of home
placement breakdown also)
o Maximum of 3 places within the unit at anytime
o Integration to occurs ASAP to prevent reliance on small unit provision
o Clear entry and exit criteria
o Time limit would prevent requests to attend unit as preferred option
33. 33
Special Schools and Enhanced Resource bases visited during the
course of the review demonstrated a variety of flexible learning
environments to meet the needs of children with autism. From individual
work stations which minimise distraction, to small group settings, the
child’s learning preferences can be met, while also offering
opportunities for whole group work and intensive one to one teaching
and support.
34. 34
4.6.1 PROVISION FOR CHILDREN AND YOUNG PEOPLE WITH ASD AS A
CONTINUUM WITHIN HALTON BOROUGH COUNCIL
4.6.2 Recommendations: Resource Bases
Continue to develop the provision in resource bases and to use the resource
base as a hub of expertise, both within the mainstream school in which it sits,
as well as to other mainstream schools through outreach.
Further embed processes for outcomes measurement so that small steps of
progress within school, as well as that reported by home, are recorded.
Consider the siting of a multi-agency team at the Grange School, both to
service the needs of children within the school, as well as the community.
Develop the links with PBSS including the use of behavioural management
and modification approaches so that there is consistency of approach.
4.6.3 Recommendations: Special Schools as Part of the Continuum of
Provision in Halton
Consider designating Ashley School as a Social Communication Needs and
Autism 11-19 special school. In this way, Halton Borough Council will be able
to meet the needs locally of all pupils with Social communication needs and
autism in Halton, except for those with autism and the most complex needs.
Consider providing an enhanced provision within Ashley School which will be
for a maximum of three pupils per annum for those pupils with autism who are
in crisis, and who need additional intensive support, including using PBSS
approaches. Entry and exit criteria would be clear, and schools could only
access this through a SLA. The referring school would also need to own the
MOST
• MAINSTREAM SCHOOL
• MAINSTREAM SCHOOL WITH OUTREACH SUPPORT
SOME
• MAINSTREAM SCHOOL WITHN A RESOURCE BASE
• MAINSTREAM SCHOOL WITH SOME TIME WITHIN THE MAINSTREAM
CLASSROOM AS WELL AS TIME IN THE RESOURCE BASE
FEW
• SPECIAL SCHOOL
• SOCIAL AND COMMUNICATION NEEDS AND AUTISM SPECIAL
SCHOOL
35. 35
child, and maintain links with the child in this duration so that approaches
could be implemented consistently on the child‟s return.
This will meet the needs of the pupils with the social and academic curriculum
linking in with short breaks and other extracurricular leisure/sport activities.
Improve the marketing of all special schools in Halton so that their information
includes pupil achievement, including benchmarked against national data for
similar cohorts.
Develop the links with PBSS including the use of behavioural management
and modification approaches so that there is consistency of approach.
4.6.4 Recommendations: Autism Accreditation
Ensure that Cavendish School attains its Autism Accreditation during 2012.
Support Ashley School to achieve the Autism Accreditation programme.
Investigate whether the resource bases are eligible to gain Autism
Accreditation in order to reflect their good practice for children and young
people with ASC.
4.6.5 Recommendations: FE and Independent Living As Part of the Continuum
of Provision for Young People with ASD in Halton Borough Council
Improve the transition of young people with ASC to college so that they are
able to make appropriate choices, and have appropriate support in college.
(Model to be discussed with HBC)
Ensure the progress of young people in college is tracked and supported by
an appropriate individual (e.g. a Transitions support worker from within the
special schools/outreach worker from the resource base etc.)
Extend the opportunities for independent living and functional living skills at
the bungalow at Cavendish School, and similarly at Ashley School, once re-
designated as a School for Social Communication Needs and Autism.
Increase the employment opportunities for young people with ASC through
Project Search or Prospects for example, or other employment opportunities
where coaching supports the young person to learn the job, and be supported
to be successful within it.
Ensure there is consistent communication between the young person with
autism, college and home using set proforma.
36. 36
Special Schools in Halton demonstrate excellent resources and have been
judged outstanding by Ofsted. Provision for children and young people with
autism has been, or is in the process of being, accredited by the National
Autistic Society.
37. 37
4.7 Ensure that transition planning for all on the autism spectrum is timely
and well monitored at every stage from early years to adult
The LA has written and published A Transition Guide for parents and young
people which clarifies the transition process. In addition, HBC has published
its Transition Strategy for young people aged 14-25, as well as an Inter-agency
agreement across Connexions, HBC, Halton and St Helens PCT, Bridgewater
Community Healthcare NHS Trust and the 5 Boroughs Partnership (September
2011) which addresses transition at each stage from 14, how it is managed, tracked,
those responsible, and overall monitoring and evaluation.
4.7.1 Children’s Services
Halton currently have two transition officers, one working 0 to 25 within the Division
of Inclusion the other working 14 yrs. to 25 yrs. within children‟s and adults social
care. The role is envisaged to follow a child through his/her journey, and to offer
inclusion and support with transition at each stage. Schools and settings will have
support to develop good transition arrangements, and to ensure that the pupil and
his/her parents/carers have appropriate support and information at each stage of the
process.
The Transitions Officer supports pupils in all formal and informal transitions from 0 –
25 years. This includes attending annual reviews for identified pupils with a
Statement or enhanced provision transition reviews and School Action identification.
Some pupils might not need extra support but will still have a person centred plan.
The transition officer helps to co-ordinate other transitions if not a formal one. They
use a transition process and follow the 7 week in transition to secondary school. A
transition plan is undertaken but photo voice has proved to a valuable tool although
Year 7 has been known to be more challenging to those pupils with autism than
other transitions.
The Transition Officer makes links to the next stage of the pupil‟s education path and
if they have the support of a teaching assistant then steps are made to make as few
changes as possible at this time. Sometimes teaching assistants are phased in the
previous term to make this transition less difficult. The Transition Officer formally
attends all Year 2, 5, 9 reviews as well as that in Year 11.
A lot of progress has been made to provide a continuous path of person centred
planning for children and young people. Examples of this were seen at the resource
base at The Grange and from personal reports from parents of children with ASD.
This is being used by education for children with ASD from Early Years to Primary
and transition to Secondary and College up to the age of 19. While young children
might have unrealistic views of what job they can do when older it is important to
acknowledge their wishes and this will help to motivate them to take part in the
planning.
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4.7.2 HALTON MULTI-AGENCY TRANSITION STRATEGY FOR YOUNG
PEOPLE AGED 14-25 2010-2013
Five key areas for ensuring young people make a successful transition from
children‟s services to adult services (The Transition Support Programme) are:
1. Participation of disabled young people and their families
2. Effectiveness of personalised approaches
3. Joint assessments processes within children‟s trusts and adult services
4. Realistic post 16 opportunities for living life
5. Strategic multi agency working
Evidence of greater participation is seen in the appointment of a Transitions
worker to ensure young people and their families are informed about and participate
in transition Reviews (at age 14). This has been very effective, and has informed
another points of transition, such as that from primary to secondary, and the
increasing use of Person Centred Planning from an earlier age within some schools
and settings.
Year 9 reviews
In the last review there was patchy use of Year 9 reviews. They are now being held.
The SEN team attend year 2, 5 and 9 transition reviews; PCPs are more commonly
used. The consultants saw the data collection methods which now track the
outcomes from Transition reviews which inform commissioning.
Speakout are commissioned to deliver minimum of 15 PCPs for those with most
significant t needs in social care; they also provide 2 training days on PCPs per year
for parents and staff. In addition CIN meetings are run on PCP basis and the
enhanced resource bases will be encouraged to use PCPs with training via HBC.
Adults services already use PCPs. The whole process of transition now relates to the
person, their values, needs and how to meet these; it is no longer forms led process.
4.7.3 Information for parents and young people about which services are
available to them
The Transition Guide
The Transition Guide supports young people and parents in understanding the
transition process from children‟s to adult services. This very helpfully includes a
useful information bank, including advice about benefits, supported employment, and
key contacts with their telephone numbers. The provision of autism specific support
is not included. This might be an area the local authority might consider including in
future editions.
4.7.4 Halton Photo Voices
The aim of the Halton Photo Voices project is to give young people a chance to
speak out about their experience of transition and change from a range of
perspectives and to encourage a more participatory approach to assessment and
provision of services. We nominated a small group of young people that was not
routinely or regularly involved by some of the person – centred work we have going
on in Halton, aiming to get an insight into the needs of the group and their hopes and
39. 39
dreams for the future. Each group runs four workshops supported by a professional
photographer, Adam Lee; they learn many photographic skills during the project and
used their new vocabulary as they talked about “macro-settings, freezing the
movement, self-timer, and flash” and so on. To practice photographic skills the
young people undertake a series of “treasure hunts” looking to take pictures of
shapes, colours, signs etc.
This part of the workshop gives the young people the chance to move around the
venue supported by their teaching assistant gaining one to one support and
attention. The young people shared their stories, experiences or difficulties they had
taking their pictures. Carrying out an activity of individually presenting their pictures
via white board helps to build confidence and gives group members their own voice.
As well as practical skills, the group really understood how to portray feelings and
situations through photographs, offering captions to title pictures they have taken. By
the end of the project each participant produces a scrap book containing ten
selected images, each captioned with a description and a name. The captioning
process is very important here as it allow the young people to describe and talk
about their images with their own voice and to formalize their ideas.
During one of the final workshops a child stated:
“It’s hard to choose which photographs are the best for my album - I like them all!”
At the end of all the workshops everyone comes together to celebrate along with
family, friends, parents, carers and schools to see the excellent outcomes for our
young people and is enjoyed by all.
Halton Photo Voices: communication about transition through photos
41. 41
Other information to support parents and young people about which services are
available to them at Transition is as follows:
o Adult Transition Coordinator would get involved with processes
o Information would be given about social care, the voluntary sector and
private providers
o A Transitions policy document and family friendly version are in the
process of being produced
o A DVD will follow to support families
o Difficult to identify when is the right time to supply this information
o Transition support services gained stage 3 rating
o Transition event on 29/2/12 will be open to parents and young people
to support information about employment, transfer to adult services,
with presentations from various organisations, including a presentation
on the use of Photo Voice with young people at transition. Over 300
people will be attending the event.
The personalised approach is seen in the use of Person Centred Planning, which
is seen across all disabilities and particularly through the use of Halton Speak Out to
do PCPs as part of transition planning for those young people at special schools who
do not find communicating their views about their future easy.
4.7.5 Individualisation in the transition planning process
The Transition tracking panel is a multi-agency panel. As young people move from
Year 9 there is a social care perspective. Young people are considered in the
operational group as well as discussed with various representative teams, which
meet monthly. They look at the interlinking between teams and ensure teams are
prepared for this. These teams have been established to ensure those in social care
have effective transition to adult services. The lead manager is part of the discussion
of key cases, and in particular where the complex needs panel in children‟s services
meets; this has representation from adult services, as well as health, finance and
commissioning. Cases are brought to this panel where it has been assessed that
there is a real need for highly individual in and out of borough packages. This will
include continuing health care. There is evidence that packages are coming through
to the operational managers‟ group earlier which shows there is a higher level of
responsiveness earlier than was the case at the last review. There is better pathway
planning across children‟s and adult services and expectations are higher of
continuing support needs.
In addition to Transition Reviews for all those who require it in borough, the
Transitions Officer tracks all out of borough placements; by doing this, HBC have a
good data set from the complete cohort from 14+ reviews which informs future
college and Post 16 places by collating the information of individual needs. This also
informs the considerations about which young people will return from out of borough
placements by early planning and commissioning of services. This results in
economies for the local authority that can make local provision appropriately, based
on this information.
42. 42
Outcomes of this include:
o Better seamless support between children‟s and adult services
o The Transitions Officer could identify the numbers coming through at
high functioning levels and therefore classified as vulnerable adults,
even though they currently have no social care needs; this could show
numbers coming through which might need services or befriending
services in the future
o There is a case study for one individual having support for building
social confidence which has resulted in greater confidence and access
to college
o Referral through mental health teams into adult services for
assessment
o Some young adults came through mental health route who have not
come through the transition route
In addition, the use of individual budgets has been very welcome, and the
consultants received an email from a parent who welcomed the use of individual
budgets and direct payments which extended her son‟s access to a wider range of
support than would have been the case otherwise.
Transition and self-directed selection of services means that young people are
allocated budgets according to their needs and they can choose either how to
use the budget or have a managed account. In this they have a virtual budget
managed by the HBC and contract with the provider. The funding for a young person
to access specific services at transfer to adult services is via budgets determined
according to need at Transition, and at 18 these are set up. If they are already at
school and college then the budget is smaller.
Day services and other support services are available once the young person leaves
the school and then budgets are adjusted accordingly.
Joint assessment processes are clear across the integrated transition working
across services; these service s include commissioning, adult services, Housing,
social care, mental health and health services.
Post 16 options and opportunities for living life are being further developed.
However, the implementation of recommendations from the Autism Scrutiny Review,
and the extension of employment opportunities through Halton‟s innovative social
enterprise model mean that there are realistic opportunities for adults with autism.
However, how dispersed this is across the population of adults with autism is
currently not known, because data is limited for the incidence of autism across Adult
services.
The strategic commissioning of services is clearly evidenced in meetings held
with a range of commissioners; this ranges from the planning of a range of
accommodation, including new builds, to offer a continuum of supported to
independent living.
43. 43
The Local Authority‟s Transition Strategy very clearly sets out what is going well
within the Borough, and what the next steps which the Borough will take in order to
strengthen and develop current working in transition.
An Inter-agency agreement across Connexions, HBC, Halton and St Helens
PCT, Bridgewater Community Healthcare NHS Trust and the 5 Boroughs
Partnership (September 2011)
This document clearly outlines the transition process and the responsibilities of
different services in contributing to this process.
4.7.6 The Supported Assessment Questionnaire
The Supported Assessment Questionnaire is undertaken before the person with
Autism is 18 if transitioning upwards or anytime afterwards. The person identified as
needing the questionnaire can be supported or the carers supported in completing it
for the identified person.
The Questionnaire can be supported by the Social Worker or social care worker with
parent carer or adult person. It is used to identify the needs of the person with
autism, and to write a personal budget and care assessment plan. It also used to
identify the needs and wishes of the identified person with autism and can be used to
inform the person centred planning. It is also used to help commissioning services.
The Supported Assessment Questionnaire is closely linked to Person Centred
Planning in that it looks specifically at the needs and wishes of the person, and
his/her budgets are influenced by this. An example of the Supported Assessment
Questionnaire was seen by the consultants. This related to an anonymised exemplar
of a young man with autism. His support needs were identified as well as his
preferences relating to daily living, caring, work and communication, for example.
Where the individual requires additional support for work, for example, the Support
Plan which accompanies this, together with the Person Centred Outcome Focus
Review, show how the individual‟s needs and preferences are integrated into a
highly personalised plan, together with the budget requirements and changes as
necessary. This shows how transition planning continues via person centred
planning and review once the individual has transferred into adult services.
4.7.7 Use of Data to inform commissioning
Halton‟s Transition Strategy uses good data collection to demonstrate the number of
young people coming through transition who are receiving or who are likely to
receive adult social care. This shows an increase from 2010-11 to 2011-12 by 50%
for those turning 18 who are still in school, and those leaving college. There are
more young people with ASC expected to leave school than those with other
disabilities. This is a result of improved identification and diagnostic processes.
Connexions are involved with 19 people with ASD aged 19-25. Of those, 11 (61%)
have Asperger‟s Syndrome. This will support the LA with the planning for these
young people in terms of low level support within the community and access to social
and leisure activities.