The development of a transitions service offered by Hammersmith & Fulham Council demonstrates the good practice set out in several key domains of this outcomes and improvement framework.
The development of a transitions service offered by Hammersmith & Fulham Council demonstrates the good practice set out in several key domains of this outcomes and improvement framework. It particularly shows that good governance, leadership and management have led to more efficient and effective structures, systems and business processes. These enable a better understanding of demand and use of prevention and early intervention approaches, in the context of young people’s transition from children to adult services, and also supports implementation of the care and support system model.
A service review created the opportunity to hear the views of young people coming through transitions, and their parents. It heard about the way in which they prepared, guided and supported through transition from children to adult services. They were outspoken and clear in their critique: pointing to the services as being un-coordinated and providing too little, too late. Efficiency and effectiveness were compromised by an over complex pathway involving unnecessary transfers of responsibility and missed opportunities to promote independence earlier in adulthood.
A member-led task force working co-productively with families was established to consider how the council could improve the experience for young disabled people through transition. By considering what parents and professionals thought a good transition experience would be, it formulated proposals for a new service model – a ‘Preparing for Adulthood’ team that aims to:
- Ensure that every young person, without exception, would have a transition plan
- Improve transparency and engagement with young people and families throughout the transition process
- Monitor the implementation action plan, together with individual reviews, to continually test the service methodology
- Performance measurement seen as fundamental to developing the service
- Improve the cost effectives of previous arrangements
- Empower professionals to do their jobs effectively and efficiently.
- Improve the housing pipeline so young disabled adults had suitable housing available when they needed it.
The new service has generated better outcomes through improved ways of working, structures and processes and creating opportunities to address cost pressures through use of different service models, including housing-based options, and improving joint working. Better and earlier planning for individuals has realised cost savings as well as delivering better outcomes for people with a learning disability.
Leadership, governance and management
H&F Council established a Member-led multi-stakeholder transitions taskforce to look at all aspects of transitions processes, including education, housing, mental health, leisure, employment with the aim of redesigning pathways and services
- The task force’s purpose was to deliver one of the Administration’s key manifesto pledges: that ASC and children’s services work together
- The political leadership of the taskforce was an important factor that allowed barriers to progress to be overcome
- CCG involvement is important as it enables better access to health services including MH service in adolescence
- Co-production was important to the development of the new service, following recommendations of the Disabled People’s Commission (DPC).
- The development activity included an all-day Transition Conference organised by Parents and jointly delivered with Transition stakeholders
- By embracing co-production, the taskforce process helped ensure that its diverse membership collectively owned its conclusions and recommendations.
- The chair of the DPC, worked with officers and parents and acted as critical friends. This helped officers to evaluate, address mistakes and make changes as necessary.
- Hammersmith & Fulham was a progressive borough for children’s work and mainstream schools had expressed an interest in exploring work pathways.
- Planning of the new service was assisted by the knowledge and experience of key managers in children’s and adult social care services and in education.
Efficient and effective structures, systems and business processes
A main recommendation of the task force was to establish a specialist Adult Social Care/Children’s Services transitions team which would also have input from a health care professional to better link with NHS services It recommended that transition team members would:
- Be jointly managed by Adult Social Care and Children’s Services though a “matrix” arrangement
- Operate a case management model for individuals “in transition”, in which each young person has a named worker to co-ordinate support and provide continuity/consistency for them, and their carer’s. This will help them access pathways and services appropriate for their needs. Different pathways now exist for young people with:
- ASD only
- Complex support needs including people covered by the transforming care partnership
- Moderate support needs
- Low level support needs
- Work with each individual ideally from age 14 (although often in practice it is 16) until they are ready to transition into adulthood with support from ASC. Support from the transitions team is not expected to continue after age 25
The team has now been in place 2½ years and feedback from young people and from carers is now positive. People have welcomed
- Having a named social worker allocated to each person as case manager
- The person-centred approach enabled by the 14 to 25 age range
- Improved support to access and participation in education and work
The Transition Service (from Children’s to adults services) will form part of a new structure which brings LD and Mental Health ‘specialist’ services together to better integrate services and more specifically will support young people transitioning through the mental health pathway; Care Leavers and those with autism and currently do not meet eligibility criteria/thresholds for services locally
Another key characteristic here is the value of the co-production on improving outcomes at transition – the work in developing the SEND Local Offer Website with parent/carers and young people; the ongoing co-production with Parents Active (the local Parent Forum) and of our local employment pathways (and specifically supported internships) further made a significant and positive impact on our work around transitions.
Enabling the local care and support workforce
H&F Council has undertaken several workforce development activities across Children’s and Adult Social Care, including those focused on working Inclusively with people with disabilities. West London College have hosted a Parents Active led event to develop a better understanding of the services and support the Council offers at Transition.
There have been numerous workshops delivered in schools and to SEN key workers, teachers and SENCO’s to better publicise the SEND Local Offer and specifically the transition pages within it.
The national “Preparing for Adulthood” team delivered workshops to a range of staff around better preparing families for transition.