Respite Allocation Toolkit & Decision Making
| Authority | Manx Care |
|---|---|
| Date received | 2023-12-18 |
| Outcome | Some information sent but part exempt |
| Outcome date | 2024-01-23 |
| Case ID | 3578638 |
Summary
The requester sought details on the review of the respite allocation framework, criteria for service reductions, and impact assessments for disabled children between October 2022 and 2023. Manx Care responded by providing a September 2023 referral toolkit and scoring matrix for respite services, though the outcome was noted as partially exempt.
Key Facts
- The Children with Disabilities (CwD) Team developed the respite allocation toolkit in September 2023.
- The toolkit references the NHS Continuing Healthcare Decision Support Tool Guidance 2022.
- Referral reasons include carer respite, socialisation, early intervention, overnight respite, and independence skills.
- A scoring system is used to assess needs, with 'High' rated at 10 points and 'Low' at 2 points.
- Assessment criteria cover care needs, sleep hygiene, supervision requirements, family support, and emotional support.
Data Disclosed
- September 2023
- October 2022-2023
- 10
- 8
- 6
- 4
- 2
- Less than 6 hours
- 16+
Original Request
Dear sirs, Please confirm when the respite allocation framework tool was reviewed between October 2022-2023 alongside the following information: 1) The specific factors or considerations that led to the decision to reduce children's respite services. 2) Details on the criteria or parameters that determine the increased threshold for accessing these services. 3) Any assessments, reports, or studies conducted to evaluate the impact of these changes on the well-being of children and their families. 4) Information on any alternative support mechanisms or services that have been put in place to address the needs of affected children and families. 5) Any communications, memos, or documents exchanged among relevant stakeholders discussing the reduction in respite services, amendments to the respite allocation toolkit and the rationale behind it. 6) a copy of the equality impact assessment (or similar demonstrative method) undertaken by the department in relation to its decision making for disabled children Given the Ofsted report, the independent short breaks review and recommendations in relation to improve short breaks. Please also provide copies of the following: 1) the actions the department has taken since the independent short breaks review. 2) any communication, memos etc by relevant stakeholders in relation to the short breaks review and actions required for implementation Many thanks
Data Tables (31)
| High | Medium/High | Medium | Low/Medium | Low | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10 | 8 | 6 | 4 | 2 | |||||||||||
| Care Needs | “Technical support” - tracheostomy, colostomy, illeostomy etc. Oxygen and suction. | Hoisting and/or problems due to weight and lack of Mobility. Complex medications & feeding i.e. time Consuming. | Dependent on main carers for hygiene, feeding i.e. Gastrostomy & NG feeds. To a higher level than would be expected for a child of that age. | Dependent on main carers for hygiene, feeding etc. slightly above expected for age | Able to undertake most personal care tasks independently with prompting/support | ||||||||||
| Sleep Hygiene | Requires significant care throughout the night for prolonged periods as a result of medical, feeding or behavioural needs. Use of a visual monitor required | Frequent need for physical support through the night – to re-settle, administer medication; feed or to turn | Frequently unsettled during the night. Less than 6 hours unbroken sleep per night. And/or Child not sleeping in their bed. | Generally sleeps well, can have unsettled nights – And/or Child is prescribed sleep medication | Child sleeps through night in line with what would be expected for a child of that age | ||||||||||
| Supervision required on a day to day basis | Constant monitoring Required due to health needs or behaviour, cannot be left alone whilst awake. | Frequent monitoring Required due to health needs or behaviour, cannot be left alone whilst | Regular monitoring required, more than expected for this age. Can be left alone in a safe | Regular monitoring required, more than expected for this age. Can be left alone in a safe environment | Regular or frequent monitoring required, due to age and as expected for a child of this age. Can be left alone in |
| Supervision |
|---|
| required on a day |
| to day basis |
| awake. | environment with monitoring equipment | a safe environment. | |||
|---|---|---|---|---|---|
| Family and Social Support | Unsupported main carer. No family or social support. | No family or social support from outside immediate family unit | Minimal family or social support | Some support by family and/or social network. | Well supported by family and/or social network. Current level of support is adequate. |
| Emotional Support | Significant illness of main carer/immediate family member i.e. mother father or siblings | Family difficulties requiring temporary extra support i.e. births, acute illness. | New equipment, new care needs or unstable condition causing frequent changes in care needs requiring extra support. | Extra emotional support needed. | Current level of emotional support is adequate. |
| Behavioural needs | Long Term Behavioural needs, child finds it difficult to function most of the time. Or Daily episodes of physical violence/ aggression or self injurious behaviour . Medication prescribed and or recommended. Awaiting CAMHS intervention. | 5-6 episodes of heightened behaviours per week, impacted by lack of sleep or other medical/ sensory needs. Medication prescribed and or recommended. Awaiting CAMHS intervention. | 3-4 episodes of heightened behaviour per week. Challenging behaviour can be managed by carers who know the child well. Behaviours are seen in more than one setting. | Some support in managing behaviour is required. Child can occasionally become overwhelmed and have “melt downs” or episode of challenging behaviour – infrequent and short lived | Infrequent or rare episodes of challenging behaviour observed |
| Family and Social |
|---|
| Support |
| Emotional |
|---|
| Support |
| Behavioural |
|---|
| needs |
| Communication Needs | Non Verbal dependant on carer knowing child well. No successful consistent method of communication | Limited methods of communication leading to regular difficulties in terms of behaviour | Successful means of communication in some settings; PECS, Sign Along, Total communication | Competent grasp of spoken language – able to use spoken language, sign etc. Able to get their needs understood | Child has a fluent language – spoken or sign. Able to communicate universally with others |
| Toileting needs | Doubly incontinent – dependant on carers for all continence needs to a higher level than would be expected for a child of that age | Early stages of Toilet Training. Support required to a higher level than would be expected for a child of that age | Continent most of the time with bladder. Support required to a higher level than would be expected for a child of that age | Child is usually continent with bladder throughout the day To an age appropriate level/as expected for age. | Child able to use the toilet independently without support to an age appropriate level/as expected for age. |
| Socialisation | No ability to access extracurricular activities due to health, behavioural or communication needs | Can attend specialist clubs but requires support. Struggles to initiate play independently | Can access specialist clubs with minimal or no support. Opportunities available are less than that of mainstream peers | Able to access mainstream activities and or clubs with support | Able to access a variety of clubs and or activities with no additional support |
| Childs condition and overall stability | Unstable. Progressive/degenerative disease. Child has had significant deterioration since | Unstable. Condition causes unpredictable events i.e life threatening | Usually stable. Non progressive condition but currently acutely unwell. | Stable. Non degenerative or non progressive diagnosis. Survival in to adulthood is | Stable Condition has limited impact on overall health and development |
| Communication |
|---|
| Needs |
| Childs condition |
|---|
| and overall |
| stability |
| Factors taken into account | Score | |||
|---|---|---|---|---|
| Care Needs | ||||
| Sleep Hygiene | ||||
| Supervision required on a day to | ||||
| day basis | ||||
| Family and Social Support | ||||
| Emotional Support | ||||
| Behavioural Needs | ||||
| Communication needs | ||||
| Toileting Needs | ||||
| Socialisation Needs | ||||
| Childs conditions and overall | ||||
| stability | ||||
| Total Points | Respite Allocation Braddan | Overnight Respite | ||
|---|---|---|---|---|
| * where issues with sleep have been identified* | ||||
| Less than 20 | No Services Required | No Services Required | ||
| 20 – 40 | 1 Session per month | 1 Session per month | ||
| 40-60 | 2 Sessions per month | 2 Sessions per month | ||
| 60-80 | Weekly Sessions | Weekly Sessions | ||
| 80 + | Weekly sessions + Outreach package of support short term | 2 Sessions per week | ||
| 90+ | Intensive package of support, 2 sessions per week + outreach support Reviewed after 6-12 weeks | Explore Shared care |
| High | Medium/High | Medium | Low/Medium | Low | Other factors Siblings with additional needs 2 Parents/ Carers working in the day time and/ or caring for a pre- school child or additional caring responsibilities 2 | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 10 | 8 | 6 | 4 | 2 | ||||||||||||
| Care Needs | “Technical support” - tracheostomy, colostomy, illeostomy etc. Oxygen and suction. | Hoisting and/or problems due to weight and lack of Mobility. Complex medications & feeding i.e. time Consuming. | Dependent on main carers for hygiene, feeding i.e. Gastrostomy & NG feeds. To a higher level than would be expected for a child of that age. | Dependent on main carers for hygiene, feeding etc. slightly above expected for age | Able to undertake most personal care tasks independently with prompting/support | |||||||||||
| Sleep Hygiene | Requires significant care throughout the night for prolonged periods as a result of medical, feeding or behavioural needs. Use of a visual monitor required | Frequent need for physical support through the night – to re-settle, administer medication; feed or to turn | Frequently unsettled during the night. Less than 6 hours unbroken sleep per night. And/or Child not sleeping in their bed. | Generally sleeps well, can have unsettled nights – And/or Child is prescribed sleep medication | Child sleeps through night in line with what would be expected for a child of that age | |||||||||||
| Supervision required on a day to day basis | Constant monitoring Required due to health needs or behaviour, cannot be left alone whilst awake. | Frequent monitoring Required due to health needs or behaviour, cannot be left alone whilst | Regular monitoring required, more than expected for this age. Can be left alone in a safe | Regular monitoring required, more than expected for this age. Can be left alone in a safe environment | Regular or frequent monitoring required, due to age and as expected for a child of this age. Can be left alone in | Unable to attend school regularly due to complex needs |
| Supervision |
|---|
| required on a day |
| to day basis |
| awake. | environment with monitoring equipment | a safe environment. | 4 | |||
|---|---|---|---|---|---|---|
| Family and Social Support | Unsupported main carer. No family or social support. | No family or social support from outside immediate family unit | Minimal family or social support | Some support by family and/or social network. | Well supported by family and/or social network. Current level of support is adequate. | Does not receive any other Respite 2 |
| Emotional Support | Significant illness of main carer/immediate family member i.e. mother father or siblings | Family difficulties requiring temporary extra support i.e. births, acute illness. | New equipment, new care needs or unstable condition causing frequent changes in care needs requiring extra support. | Extra emotional support needed. | Current level of emotional support is adequate. | |
| Behavioural needs | Long Term Behavioural needs, child finds it difficult to function most of the time. Or Daily episodes of physical violence/ aggression or self injurious behaviour . Medication prescribed and or recommended. Awaiting CAMHS intervention. | 5-6 episodes of heightened behaviours per week, impacted by lack of sleep or other medical/ sensory needs. Medication prescribed and or recommended. Awaiting CAMHS intervention. | 3-4 episodes of heightened behaviour per week. Challenging behaviour can be managed by carers who know the child well. Behaviours are seen in more than one setting. | Some support in managing behaviour is required. Child can occasionally become overwhelmed and have “melt downs” or episode of challenging behaviour – infrequent and short lived | Infrequent or rare episodes of challenging behaviour observed |
| Family and Social |
|---|
| Support |
| Emotional |
|---|
| Support |
| Behavioural |
|---|
| needs |
| Communication Needs | Non Verbal dependant on carer knowing child well. No successful consistent method of communication | Limited methods of communication leading to regular difficulties in terms of behaviour | Successful means of communication in some settings; PECS, Sign Along, Total communication | Competent grasp of spoken language – able to use spoken language, sign etc. Able to get their needs understood | Child has a fluent language – spoken or sign. Able to communicate universally with others | |
| Toileting needs | Doubly incontinent – dependant on carers for all continence needs to a higher level than would be expected for a child of that age | Early stages of Toilet Training. Support required to a higher level than would be expected for a child of that age | Continent most of the time with bladder. Support required to a higher level than would be expected for a child of that age | Child is usually continent with bladder throughout the day To an age appropriate level/as expected for age. | Child able to use the toilet independently without support to an age appropriate level/as expected for age. | |
| Socialisation | No ability to access extracurricular activities due to health, behavioural or communication needs | Can attend specialist clubs but requires support. Struggles to initiate play independently | Can access specialist clubs with minimal or no support. Opportunities available are less than that of mainstream peers | Able to access mainstream activities and or clubs with support | Able to access a variety of clubs and or activities with no additional support | |
| Childs condition and overall stability | Unstable. Progressive/degenerative disease. Child has had significant deterioration since | Unstable. Condition causes unpredictable events i.e life threatening | Usually stable. Non progressive condition but currently acutely unwell. | Stable. Non degenerative or non progressive diagnosis. Survival in to adulthood is | Stable Condition has limited impact on overall health and development |
| Communication |
|---|
| Needs |
| Childs condition |
|---|
| and overall |
| stability |
| Factors taken into account | Score | |||
|---|---|---|---|---|
| Care Needs | ||||
| Sleep Hygiene | ||||
| Supervision required on a day to | ||||
| day basis | ||||
| Family and Social Support | ||||
| Emotional Support | ||||
| Behavioural Needs | ||||
| Communication needs | ||||
| Toileting Needs |
| Socialisation Needs | ||||
| Childs conditions and overall | ||||
| stability | ||||
| Total Points | Respite Allocation Braddan | Overnight Respite | ||
|---|---|---|---|---|
| * where issues with sleep have been identified* | ||||
| Less than 20 | No Services Required | No Services Required | ||
| 20 – 40 | 1 Session per month | 1 Session per month | ||
| 40-60 | 2 Sessions per month | 2 Sessions per month | ||
| 60-80 | Weekly Sessions | Weekly Sessions | ||
| 80 + | Weekly sessions + Outreach package of support short term | 2 Sessions per week | ||
| 90+ | Intensive package of support, 2 sessions per week + outreach support Reviewed after 6-12 weeks | Explore Shared care |
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| Name: | Date of Birth: | |
|---|---|---|
| Factors taken into account | Score | |
| Care Needs | ||
| Supervision required on a day-to- day basis | ||
| Family and Social Support | ||
| Emotional Support | ||
| Childs condition and overall stability | ||
| Other factors | ||
| Total |
| Total points | Respite allocation |
|---|---|
| Less than 20 | 1 Overnight Per month |
| 20-29 | 2 Overnights per month |
| 30-35 | 1 Overnight per week |
| 36-40 | 2 Overnights per week |
| Over 40 | 2 Overnights per week |
Full Response Text
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
Referrals to Respite Services
Children with Disabilities Team
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
Reasons for Referral:
Please highlight all that apply
1. Carer Respite Day Time/ After School/ Weekend
-
Socialisation / Social Development
-
Early Intervention /Prevention
-
Overnight Respite
-
Independence/ Life Skills 16+
-
Outreach
-
Supporting children to cope with Change and or Transitions
-
Youth Club
-
Parents of Pre-Schoolers Support
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
High 10 Medium/High 8 Medium 6 Low/Medium 4 Low 2 Other factors
Care Needs
“Technical support” -
tracheostomy,
colostomy, illeostomy
etc.
Oxygen and
suction.
Hoisting and/or
problems due to
weight and lack of
Mobility.
Complex
medications &
feeding i.e. time
Consuming.
Dependent on
main
carers for
hygiene, feeding
i.e.
Gastrostomy &
NG feeds. To a
higher level than
would be
expected for a
child of that age.
Dependent on main
carers for hygiene,
feeding etc. slightly
above expected for
age
Able to undertake
most personal care
tasks
independently with
prompting/support
Siblings with additional needs 2
Sleep Hygiene
Requires significant care
throughout the night for
prolonged periods as a
result of medical, feeding
or behavioural needs.
Use of a visual monitor
required
Frequent need for physical support through the night – to re-settle, administer medication; feed or to turn
Frequently unsettled during the night. Less than 6 hours unbroken sleep per night.
And/or Child not sleeping in their bed.
Generally sleeps well, can have unsettled nights –
And/or
Child is prescribed
sleep medication
Child sleeps
through night in
line with what
would be expected
for a child of that
age
Parents/ Carers
working in the
day time and/ or
caring for a pre-
school child or
additional caring
responsibilities
2
Supervision
required on a day
to day basis
Constant monitoring
Required due to health
needs or behaviour,
cannot be left alone
whilst awake.
Frequent
monitoring
Required due to
health needs or
behaviour,
cannot be left
alone whilst
Regular
monitoring
required, more
than expected for
this age.
Can be left alone
in a safe
Regular monitoring
required, more than
expected for this
age.
Can be left alone in
a safe environment
Regular or frequent
monitoring
required, due to
age and as
expected for a
child of this age.
Can be left alone in
Unable to attend school regularly due to complex needs
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
awake.
environment with monitoring equipment
a safe environment.
4
Family and Social
Support
Unsupported main carer.
No family or social
support.
No family or
social support
from outside
immediate family
unit
Minimal family or social support
Some support by
family and/or social
network.
Well supported by family and/or social network. Current level of support is adequate. Does not receive any other Respite
2
Emotional
Support
Significant illness of main
carer/immediate family
member i.e. mother
father or
siblings
Family difficulties
requiring
temporary extra
support i.e.
births, acute
illness.
New equipment,
new care needs
or unstable
condition causing
frequent changes
in care needs
requiring
extra support.
Extra emotional
support needed.
Current level of
emotional support
is adequate.
Temporary changes eg. House move, parental/ sibling ill health
2
Behavioural
needs
Long Term Behavioural
needs, child finds it
difficult to function most
of the time.
Or
Daily episodes of physical
violence/ aggression or
self injurious behaviour .
Medication prescribed
and or recommended.
Awaiting CAMHS
intervention.
5-6 episodes of
heightened
behaviours per
week, impacted
by lack of sleep or
other medical/
sensory needs.
Medication
prescribed and or
recommended.
Awaiting CAMHS
intervention.
3-4 episodes of
heightened
behaviour per
week. Challenging
behaviour can be
managed by
carers who know
the child well.
Behaviours are
seen in more than
one setting.
Some support in
managing behaviour
is required. Child
can occasionally
become
overwhelmed and
have “melt downs”
or episode of
challenging
behaviour –
infrequent and
short lived
Infrequent or rare
episodes of
challenging
behaviour
observed
Safeguarding Concerns
4 Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
Communication
Needs
Non Verbal dependant
on carer knowing child
well.
No successful consistent
method of
communication
Limited methods
of communication
leading to regular
difficulties in
terms of
behaviour
Successful means
of communication
in some settings;
PECS, Sign Along,
Total
communication
Competent grasp of
spoken language –
able to use spoken
language, sign etc.
Able to get their
needs understood
Child has a fluent
language – spoken
or sign. Able to
communicate
universally with
others
NB. If a child is
between
catgories they
can be scored as
such,
i.e. 3,5,7,9
Toileting needs
Doubly incontinent –
dependant on carers for
all continence needs to a
higher level than would
be
expected for a child of
that age
Early stages of
Toilet Training.
Support required
to a higher level
than would be
expected for a
child of that age
Continent most of
the time with
bladder. Support
required to a
higher level than
would be
expected for a
child of that age
Child is usually
continent with
bladder throughout
the day To an age
appropriate level/as
expected for age.
Child able to use
the toilet
independently
without support to
an age appropriate
level/as expected
for age.
Socialisation
No ability to access
extracurricular activities
due to health,
behavioural or
communication needs
Can attend
specialist clubs
but requires
support. Struggles
to initiate play
independently
Can access
specialist clubs
with minimal or
no support.
Opportunities
available are less
than that of
mainstream peers
Able to access
mainstream
activities and or
clubs with support
Able to access a
variety of clubs and
or activities with
no additional
support
Childs condition
and overall
stability
Unstable.
Progressive/degenerative disease. Child has had significant deterioration since Unstable.
Condition causes unpredictable events i.e life threatening Usually stable.
Non progressive
condition but
currently acutely
unwell.
Stable.
Non degenerative or non progressive diagnosis. Survival in to adulthood is Stable
Condition has limited impact on overall health and development
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
diagnosis.
infections, frequent hospital admissions. Seizures requiring frequent medical intervention.
Progressive/ degenerative condition which will cause future deterioration.
Potential for rapid
deterioration in
condition.
Frequent Seizures
Need for future
interventions to
maintain stability
e.g. Surgery
likely.
Or
Potential for improvement of condition with appropriate treatment/therapies
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
Allocation Assessment Chart Childs Name:
DoB:
Factors taken into account
Score
Care Needs
Sleep Hygiene
Supervision required on a day to day basis
Family and Social Support
Emotional Support
Behavioural Needs
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare- decision-support-tool-guidance-2022.pdf
Communication needs
Toileting Needs
Socialisation Needs
Childs conditions and overall stability
Total Points
Respite Allocation Braddan
Overnight Respite
where issues with sleep have been identified
Less than 20
No Services Required
No Services Required
20 – 40
1 Session per month
1 Session per month
40-60
2 Sessions per month
2 Sessions per month
60-80
Weekly Sessions
Weekly Sessions
80 +
Weekly sessions + Outreach package of support short term
2 Sessions per week
90+
Intensive package of support, 2 sessions per week +
outreach support Reviewed after 6-12 weeks
Explore Shared care
Date Completed:
Social Worker Completing:
Developed by CwD Team September 2023, Ref. https://assets.publishing.service.gov.uk/media/635165f38fa8f554cb9dc2e8/NHS-continuing-healthcare-
decision-support-tool-guidance-2022.pdf
Referrals to Respite Services
Children with Disabilities Team
Reasons for Referral:
Please highlight all that apply
1. Carer Respite Day Time/ After School/ Weekend
-
Socialisation / Social Development
-
Early Intervention /Prevention
-
Overnight Respite
-
Independence/ Life Skills 16+
-
Outreach
-
Supporting children to cope with Change and or Transitions
-
Youth Club
-
Parents of Pre-Schoolers Support
High 10 Medium/High 8 Medium 6 Low/Medium 4 Low 2 Other factors
Care Needs
“Technical support” -
tracheostomy,
colostomy, illeostomy
etc.
Oxygen and
suction.
Hoisting and/or
problems due to
weight and lack of
Mobility.
Complex
medications &
feeding i.e. time
Consuming.
Dependent on
main
carers for
hygiene, feeding
i.e.
Gastrostomy &
NG feeds. To a
higher level than
would be
expected for a
child of that age.
Dependent on main
carers for hygiene,
feeding etc. slightly
above expected for
age
Able to undertake
most personal care
tasks
independently with
prompting/support
Siblings with additional needs 2
Sleep Hygiene
Requires significant care
throughout the night for
prolonged periods as a
result of medical, feeding
or behavioural needs.
Use of a visual monitor
required
Frequent need for physical support through the night – to re-settle, administer medication; feed or to turn
Frequently unsettled during the night. Less than 6 hours unbroken sleep per night.
And/or Child not sleeping in their bed.
Generally sleeps well, can have unsettled nights –
And/or
Child is prescribed
sleep medication
Child sleeps
through night in
line with what
would be expected
for a child of that
age
Parents/ Carers
working in the
day time and/ or
caring for a pre-
school child or
additional caring
responsibilities
2
Supervision
required on a day
to day basis
Constant monitoring
Required due to health
needs or behaviour,
cannot be left alone
whilst awake.
Frequent
monitoring
Required due to
health needs or
behaviour,
cannot be left
alone whilst
Regular
monitoring
required, more
than expected for
this age.
Can be left alone
in a safe
Regular monitoring
required, more than
expected for this
age.
Can be left alone in
a safe environment
Regular or frequent
monitoring
required, due to
age and as
expected for a
child of this age.
Can be left alone in
Unable to attend school regularly due to complex needs
awake.
environment with monitoring equipment
a safe environment.
4
Family and Social
Support
Unsupported main carer.
No family or social
support.
No family or
social support
from outside
immediate family
unit
Minimal family or social support
Some support by
family and/or social
network.
Well supported by family and/or social network. Current level of support is adequate. Does not receive any other Respite
2
Emotional
Support
Significant illness of main
carer/immediate family
member i.e. mother
father or
siblings
Family difficulties
requiring
temporary extra
support i.e.
births, acute
illness.
New equipment,
new care needs
or unstable
condition causing
frequent changes
in care needs
requiring
extra support.
Extra emotional
support needed.
Current level of
emotional support
is adequate.
Temporary changes eg. House move, parental/ sibling ill health
2
Behavioural
needs
Long Term Behavioural
needs, child finds it
difficult to function most
of the time.
Or
Daily episodes of physical
violence/ aggression or
self injurious behaviour .
Medication prescribed
and or recommended.
Awaiting CAMHS
intervention.
5-6 episodes of
heightened
behaviours per
week, impacted
by lack of sleep or
other medical/
sensory needs.
Medication
prescribed and or
recommended.
Awaiting CAMHS
intervention.
3-4 episodes of
heightened
behaviour per
week. Challenging
behaviour can be
managed by
carers who know
the child well.
Behaviours are
seen in more than
one setting.
Some support in
managing behaviour
is required. Child
can occasionally
become
overwhelmed and
have “melt downs”
or episode of
challenging
behaviour –
infrequent and
short lived
Infrequent or rare
episodes of
challenging
behaviour
observed
Safeguarding Concerns
4
Communication
Needs
Non Verbal dependant
on carer knowing child
well.
No successful consistent
method of
communication
Limited methods
of communication
leading to regular
difficulties in
terms of
behaviour
Successful means
of communication
in some settings;
PECS, Sign Along,
Total
communication
Competent grasp of
spoken language –
able to use spoken
language, sign etc.
Able to get their
needs understood
Child
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