Assessments and care plans for children in Northern Ireland
Children with disabilities have a right to an assessment under Article 18 of the Children (NI) Order 1995. The Health and Social Care Trust (HSCT) then has a duty to provide any services necessary to meet their needs.
Your child may be entitled to an assessment of their needs even if they do not yet have a formal diagnosis of autism. This is because article 18 of the Children (NI) Order 1995 applies to all ‘children in need’. A child is in need if:
- he or she needs the support of local authority services to achieve or maintain a reasonable standard of development or health
- he or she needs the support of local authority services to prevent the impairment of or further harm to their development or health
- he or she is disabled.
What is an assessment?
An assessment allows the HSCT to collect information about your child and your family and to identify any needs for support that you may have. A social worker will carry out the assessment. They will need to meet with you and your child, usually by visiting you at home so you do not have to worry about taking your child to an unfamiliar environment.
How do I ask for an assessment?
To request an assessment, you should write to your local HSCT. You can use our template letter. Be sure to delete any statements which do not apply to your child. To make sure that the letter is received by the right person, it may be helpful to take the following steps:
- Phone your local HSCT and ask which team deals with requests for Children (NI) Order 1995 assessments for autistic children. Ask for a postal address of the relevant team and don’t be put off from getting this. If necessary, explain you’re writing a letter about your child’s disability and about his/her need for an assessment and wish to send it to the appropriate team so you need an address. For many HSCTs the first point of contact is a call centre. The person who answers the phone will not necessarily know much about autism and they may not understand the urgency of your situation.
- If possible, find out the name of the team manager of the team you’re writing to so you can address the letter to him/her, but if this proves too difficult, address the letter to the Team Manager.
- Send the letter, remembering to put a date on it and keep a copy of it (whether a paper photocopy or on your computer).
- Wait for a response from the team you wrote to. If you’ve not heard back within a few weeks, phone the team and ask for an update.
- If you haven’t had any success finding out the team responsible, address the letter to the Director of Social Services who will probably not reply to you directly but will pass it on to the right person.
The assessment process
Although it is not statutory guidance, meaning it does not have to be followed, most HSCTs will use the Understanding the Needs of Children in Northern Ireland (UNOCINI) Framework to complete their assessments. Upon receiving a referral children’s services should decide what response is required. If the decision is to take no action you should be notified promptly and given reasons for this.
If the decision to do something is made, a social worker should contact you to carry out an initial assessment. An initial assessment will help children’s services identify whether or not your child is in need, what services may be needed and whether the case is urgent or not. They will need to see and speak to your child at this stage.
After this they may decide to carry out a pathway assessment. A core assessment will be much more thorough and will require social services to fully evaluate the level of your child’s needs and the help you as parents are able to offer as well as the services your child might need. They may liaise with other professionals with whom you have contact to find out more about your child. At the end of this time they should inform you of what services, if any, they are going to provide, and you should be given the opportunity to respond to this. You should also be informed that you are entitled to use the HSCT's complaints procedure if you’re unhappy with the way the assessment has been conducted or the decisions made.
In Northern Ireland there is no set timescale to follow during the assessment process. All trusts use slightly different methods of assessment, so it’s hard to predict exactly what questions they will ask. It’s important that they get as full a picture of your family’s situation as possible.
Eligibility criteria
Health and Social Care Trusts are allowed to operate eligibility criteria to decide which team will assess a child’s needs. Sometimes autistic children do not meet the threshold for assessment under the disabled children team's eligibility criteria. In these cases it is a good idea to ask to see the children in need team's eligibility criteria as well. Someone should be assessing your child's needs whether it is the disabled children’s team or the children in need team. If you are told you do not meet either team's eligibility criteria you have the right to complain using your trust's complaints procedure.
It is also lawful to use eligibility criteria to ensure that services are provided to families in the most need. Often these will be attached to services provided under the Chronically Sick and Disabled Person’s Act. Not every child will be entitled to everything on the list and the trust can use eligibility criteria to decide which children can access a service. However, they cannot have blanket policies such as ‘we never provide holidays’ or ‘we do not give respite to children under eight years of age’. Similar statements to these have been challenged in court and found to be unlawful. Health and Social Care Trusts have to consider each individual case and decide whether there is a need for the service.
The UNOCINI Family Support Plan
Once the assessment has been completed the social worker should draw up a ‘UNOCINI family support plan’. In Northern Ireland there is no legal requirement for your HSCT to provide a written copy of this but guidance states that a written copy should be provided if it is requested. We would suggest always asking for a written copy. The plan, also referred to as a care plan, outlines the needs that have come to light through the assessment process and the services that will be offered to your child as a consequence. The plan will not list services that need to be obtained from other statutory bodies, such as the health authority or local education authority, although it may make reference to the fact that you will be approaching these departments for further help. Below is an example of how a Care Plan may look:
-
Mon-Fri 7.30-8.30am
- Need to be met: Helping Ben to get ready for school while Kathy (Ben’s mum) helps her daughter get ready and gets herself ready for work.
- How need will be met: Care attendant will support Ben to carry out daily personal tasks and get ready for school.
- Need met by: Sunshine Care agency.
- Expectation of need being met: Ben will learn to carry out tasks in the morning with the 1:1 support he needs. Kathy can then get herself and her daughter ready.
Mon-Fri 3.30-5pm
- Need to be met: Helping Ben to de-stimulate after school to prevent him from presenting distressed behaviour towards his mum and sister.
- How need will be met: Support with homework and activities.
- Need met by: Neighbour who Ben is familiar with and gets on with. Arranged through Direct Payments.
- Expectation of need being met: Ben will have the 1:1 support he needs to de- stimulate after school which will allow Kathy to come home from work and deal with evening tasks including making dinner etc.
Care package to be reviewed in eight weeks time by social worker.
In an emergency contact Children’s Disability Team Duty team on 0897 555 555 [Example].