Inside the Children’s Disability Service: specialist social work in action
Inside the Children’s Disability Service: specialist social work in action
Based on a conversation with Charlotte (CDS Duty and Assessment PM) and Fay (CDS Duty and Assessment SW), Children’s Disability Service.
The Children’s Disability Service can be perceived as a bit of an unknown entity amongst Children’s Services. The work we do differs greatly from locality teams in some areas and is similar in others. In locality, you’re managing huge numbers of children coming in with varying needs and family factors, which then go on to be met by a number of different areas of the service. Within the CDS team, we have very specific eligibility criteria and the level of information needed to ascertain if children meet our thresholds is far greater, and this takes time.
Because we’re a level 4 service, we usually receive referrals where families are in crisis and in desperate need of some support. Our job is to assess that child’s needs alongside a holistic assessment of the family, with a focus on the parent carer role and the impact of caring for a child with severe cognitive disabilities.
The team have an extensive knowledge base around the young people we work with, as we have been supporting some of them for many years; we can observe how things have changed over long time periods and we undertake a lot of learning in this process.
The network around the child
One of the starkest differences in CDS is the size of the professional network around the child − the number of multi-disciplinary professionals involved is often well into double figures. This includes specialist school staff, school clinical services, and NHS staff, such as occupational therapists, speech and language therapists, dietitians and community paediatricians. They may well have medical specialists working with them too, for example, around rare genetic conditions.
All these professionals will have their own support plans in place for that child, so there is a vast amount of information to navigate, collate and manage. We do a great deal of co-working with Children and Young People’s Continuing Care (NHS) and we refer to each other as colleagues, even though they are part of the NHS − we’re essentially one big team due to the level of collaborative working.
Complexity of basic needs
The work of the CDS team is highly time consuming and detailed. Careful consideration and understanding of need is required in terms of our legal duties. Failure to recognise the intricacy of the child’s needs can result in complex and multiple complaints. Meeting the care needs of this cohort of children involves specialist intervention in basic areas of a child’s life. For example, for feeding, sleeping and toileting, there are usually several services involved, leading on those areas. These basic needs often have their own complexities. For example, lots of children we work with are PEG or JEG fed, which requires specialist support.
Children with complex cognitive disabilities and autistic children often have challenges around sleep, and we support parents with managing routines and with respite care, to avoid carer burnout.
Some of the children we work with may go long periods, even weeks, without sleeping at all, therefore understanding the lived experience of the parents, carers and siblings is essential to our work.
Relationship skills
Every child we work with has a very different functioning profile, and it takes time to truly understand each individual child’s needs. In addition to this, every family has a different set of social and cultural needs, and relationship-building skills, as with other social work teams, are fundamental to our role. This is vital in building trust, particularly when the families we work with often have such a high number of professionals involved with them, so that our families understand that we are there to support them.
Creating Disability Support Plants
As with other social work teams, we assess each family we work with using the Child In Need family assessment format, however, these assessments are usually extremely detailed to capture the complex needs of the child and the impact of these needs on the wider family. A Disability Support Plan for the child is then developed based on the assessed needs. Each child’s Disability Support Plan is reviewed and updated at least annually, and the review may take up to 6 months to complete, owing to the amount of information we need to review and consider. We must obtain agreement for all our plans from the CDS panel. Parameters of need and the costs of support are explored and discussed in great detail. Some care packages are mind-blowingly expensive, due to the complexity of the child’s disabilities and social care needs.
Working creatively
CDS Social Workers are passionate about going above and beyond to try and capture something of each child’s experience, however they communicate, the challenge being that the vast majority of children we work with are non-verbal. Our Social Workers do an amazing job of capturing the child’s experience within family assessments, and within any direct work recorded on Liquidlogic.
We’re always looking for new ways to support our families, and the service is ever-changing. When workers go to meet new families, they send an A4 profile of themselves beforehand, often using PECS, with photos and some of their favourite things on it. We also give achievement certificates and prizes for our young people, and we do them regularly and whenever they are merited, however small the achievement.
Misconceptions about CDS
It can be surprising just how many children with additional needs there are in East Sussex; many of them are in specialist services, where they are not as visible as children in mainstream settings. The reality is that the service holds a vast number of children in the service review system, alongside current allocations and managing the front door to CDS every day. The FST side of the service holds all the children we work with on longer term CIN and CP plans, as well as all our Children We Care For.
The benefits of moving to CDS
Many people have little idea about the Children’s Disability Service before they join. It’s an amazing experience to join from another part of the service because you’re learning something very new and using such a varied skill set, while also drawing on your existing social work knowledge and skills − it refreshes you completely.
Even several years into working with CDS you are meeting new specialists and learning about new medical conditions. CDS is a small, close-knit team with hands-on managers who offer plenty of daily support.
Helping other teams
The team holds a huge amount of specialist knowledge. Duty workers within CDS run consultations with locality social workers, early help key workers and education, and this is happening a lot more than previously. We would encourage people to contact CDS for consultations or advice − we are here to help.
