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Transitions

Transitions

 

'Transition' is the process when a child/young person is preparing to move towards adulthood. 

Parents/Carers and their child/young person may find this a challenging and difficult time particularly when additional learning needs are part of the equation. Successful transition is vital to the child /young person's emotional development and therefore careful planning is required.

This page will provide you with further information on the process of transitioning to adulthood and services that can help and support with this.

Supported Decision Making

What is Supported Decision Making?

A young person with a disability and/or special educational needs may have questions about how they can be prepared and supported to make decisions about their future. Under Part 3 of the Children and Families Act 2014, the right to make requests and decisions applies directly to disabled young people and those with special educational needs over compulsory school age (the end of the academic year in which they turn 16) rather than to their parents.

Parents, or other family members, can continue to support young people in making decisions, or act on their behalf, provided that the young person is happy for them to do so, and it is likely that parents will remain closely involved in the great majority of cases.


How can I support a young person to make a decision?

1. Provide relevant information

  • Does the person have all the relevant information they need to make a particular decision?
  • If they have a choice, have they been given information on all the alternatives?

2. Communicate in an appropriate way

  • Could information be explained or presented in a way that is easier for the person to understand (for example, by using simple language or visual aids)?
  • Have different methods of communication been explored if required, including non-verbal communication?
  • Could anyone else help with communication (for example, a family member, support worker, interpreter, speech and language therapist or advocate)?

3. Make the person feel at ease

  • Are there particular times of day when the person’s understanding is better?
  • Are there particular locations where they may feel more at ease?
  • Could the decision be put off to see whether the person can make the decision at a later time when circumstances are right for them?

4. Support the person

  • Can anyone else help or support the person to make choices or express a view?

Making a best interests decision

After all steps have been taken to support someone to make their own decision, if the person is assessed as lacking capacity to make that particular decision, then a ‘best interests’ decision must be made.

The person who makes the ‘best interests’ decision is called the ‘decision maker’. Who the decision maker is will depend on the situation and the type of decision.

  • For most day-to-day decisions the ‘decision maker’ is likely to be the person who is supporting the person.
  • If it is a decision about healthcare it will be the relevant health professional.

Whoever is the decision maker, it is important they talk with others involved with the person, and involve the person themselves as much as possible, to get a good understanding and therefore make the best decision they can.


Best interests checklist

The Mental Capacity Act sets out a best interests checklist, which must be followed when making a best interests decision:

  1. Will the person regain capacity?
  2. Involve the person.
  3. Consult all relevant people.
  4. Consider all the information.
  5. Do not make any assumptions.
  6. Consider past, present and future wishes.
  7. Always pick the very least restrictive option.

The full checklist is in the Mental Capacity Act Code of Practice.


Involving the person you are making a best interests decision for

When a best interests decision is being made, the person must still be involved as much as possible.

Mencap and BILD’s Involve Me resources offer some creative ways to ensure people remain at the heart of decision making. There are guides and a video to show how the preferences of people with profound and multiple disabilities can be captured and used to influence decisions about their lives, even if they lack capacity to make the decision themselves.


Independent Mental Capacity Advocate (IMCA)

If a person has no family or friends for the decision-maker to ask about important decisions like serious medical treatment or changes of accommodation, then an Independent Mental Capacity Advocate must represent the person’s views.

They are a legal safeguard for people who lack the capacity to make big decisions. Read more on Independent Mental Capacity Advocates.

In Nottinghamshire the organisation Powher provide independent mental capacity advocacy services.


How can I find out further information?

The Preparing for Adulthood (PfA) orgnisation have produced a factsheet on this subject to ensure young people can be supported through decision making to create positive outcomes as they prepare for adulthood. Read the Preparing for Adulthood Factsheet or by clicking on the icon below:

PfA Factsheet:
The Mental Capacity Act 2005
and Supported Decision Making

 

 

 

 

 

 

 

The Mental Capacity Act 2005

What is mental capacity?

Mental capacity is the ability of a young person over the age of 16 to make their own decisions. This means being able to:

  • understand information given to them in relation to a decision
  • remember the information long enough to make a decision
  • use or weigh up the information available
  • communicate their decision in any way which can be recognised

If they are unable to meet these criteria, they are considered to be ‘lacking capacity’. This can include young people with learning disabilities, mental health problems or brain injury.

When a young person over the age of 16 has been assessed as lacking mental capacity, there may be many different people and agencies involved in making decisions on their behalf, depending on the complexity of the situation. This includes parents, medical and educational professionals and other agencies.

The Mental Capacity Act 2005 (MCA) provides a clear framework for parents on who should be consulted in the decision-making process and when (for example in life-saving treatment).

The 5 main principles of the Mental Capacity Act:

  1. Always assume the person is able to make the decision until you have proof they are not.
  2. Try everything possible to support the person make the decision themselves.
  3. Do not assume the person does not have capacity to make a decision just because they make a decision that you think is unwise or wrong.
  4. If you make a decision for someone who cannot make it themselves, the decision must always be in their best interests.
  5. Any decisions, treatment or care for someone who lacks capacity must always follow the path that is the least restrictive of their basic rights and freedoms.

It's also important to remember that a person may have capacity for some decisions but not others, or they may not have capacity right now but may regain it in the future with support. This means all capacity decisions should be regularly reviewed to make sure they still reflect the person's ability to make decisions.


When a young person ‘has capacity’

In law, young people aged 16 and over are presumed to have capacity. They can consent to, or refuse, treatment in their own right, including hospital admission.

They can refuse access to their medical records and not give consent for clinicians to disclose information to parents.


Under 16s

The MCA does not apply to under 16s. In order to decide whether a child under 16 is able to consent to their own medical treatment, without the need for parental permission or knowledge they are assessed to establish if they are competent to make such decisions. This assessment is referred to as ‘Gillick Competence’. 


Further information

You can find out more information on the Mental Capacity Act by reading the Preparing for Adulthood Factsheet or by clicking on the icon below:

PfA Factsheet:
The Mental Capacity Act 2005
and Supported Decision Making

 

 

 

 

 

 

 

 

Video for Parents/Carers

Nottinghamshire's Transitions Pathway for Children and Young People with SEND aged 13-25

Nottinghamshire County Council have developed a transitions pathway to provide, information, advice and guidance on what should be happening at different stages as a young person makes their way towards adulthood. It also contains a range of information once a young person becomes an adult including employment and training opportunities, post 16 education and independent living. The pathway is fully interactive and has an introductory video to explain how you can use it and get the best out of it. To access the pathway please click here for the SEND Local Offer website or on the pathway picture below:

Transition pathway

Nottinghamshire County Council - Preparing for Adulthood Team

What does the service do?

Nottinghamshire County Council have a Preparing for Adulthood Team, which is made up of Social Workers and Community Care Officers who provide planning, assessment, advice and support services for young people preparing for adulthood. They work with young people who have an impairment and require social care support that cannot be accessed through community services already in place.

The Preparing for Adulthood Team can work with young people whether they have received services from children's social care or not.

The team works with young people to help them be as independent as possible. This might be through community support, short term support, specialised support including support into employment and/or any assistive technology.

The Preparing for Adulthood Team can help with:

  • being independent;
  • being part of the community;
  • getting the right support;
  • giving support to carers including short breaks;
  • helping with safety and risks.


Age range

Young people can be referred to the Preparing for Adulthood Team between the ages of 14yrs-17.5yrs. If a young person is older than 17.5yrs, at the time they are referred, the referral will be passed to the relevant adult team.


Who can make a referral to the team?

Referrals can be made by anyone including parent/carers, person's GP, education support providers or community services.


How do I make a referral?

To contact the team you will need to call the Council's Customer Service Centre on 0300 500 80 80 (open Monday to Friday 08:00am to 6:00pm).


Further information

For further information you can click on the following link: Moving to Adult Services or watch the video below:

Transferring to Adult Social Care Services

What happens if I need on-going support when I turn 18?

If you need continued care and support when you turn 18 you will move from children's social care services to adult social services. You will need to complete a Care and Support Assessment to see if you are eligible for care services as an adult. Find out further information on Nottinghamshire County Council's website.

Usually, your school or the children's social care services will recognise your need for an assessment and make a referral to Notts County Council. If not, then you can contact Nottinghamshire County Council's Customer Service Team.


What is a Care and Support Assessment for?

The assessment will decide if you are eligible for care and support. It will also detail the transition to adult services plan and will include outcomes, views and wishes that matter to you. If you have been assessed as eligible for care and support, a care and support plan will need to be created. The purpose of the plan will be to decide how your assessed eligible needs will be met and to put you in control of your care. Find out further information on Nottinghamshire County Council's website.


What do I need to do if I need ongoing help with equipment/adaptations at home?

If the Integrated Children's Disability Service (ICDS) Occupational Therapy Team is currently working with you, they will make a referral to the Adult Occupational Therapy Service 28 days before your 18th birthday and a worker from both the Children's and adult's team will work together to help you have as smooth as transition as possible. Your ICDS OT worker can give you a "17+ leaflet" about the Occupational Therapy transitions process. Find out further information and contact details on the SEND Local Offer website.

You can find out further information on the SEND Local Offer website and/or you can read the Adult's OT Factsheet.


Notts Help Yourself Website

The Notts Help Yourself website also provides a wide range of information on adult social care including help in your home and the community, equipment and living aids, suport for carers, housing needs and financial advice.


How can I access further advice and information on adult social care support?

If you need further advice and information on accessing adult social care support you can contact Nottinghamshire County Council's Customer Service Team.

Transferring to Adult Health Services

What is the difference between children's and adult health services?

Here are some useful points and tips about transferring to adult health services:

  • One of the main differences between children's and adult health services is the amount of independence you will be given.  This means that you will need to learn about your condition, so that you can be more involved in your care and make decisions for yourself.
  • You will be given information about your condition and know how to keep yourself well.  Although this can be scary, it is also good to have more control over your health and the care you are given.
  • When you are asked to make decisions about your health, you will be given all the information you need to make the right choice.  you can always ask questions and let the health staff know if you are not sure about anything.  They will make sure that you understand everything that might be involved.  If there is something you are not sure of you can always ask them to write it down for you.
  • Although you, rather than your parents or carers, will be asked to make decisions, you can still ask their advice before making your choice.
  • During appointments or admissions, doctors, nurses and other staff should spend more time talking to you rather than to your parents.  Lots of people take family members, carers or friends along for support at important appointments.
  • If you go into an appointment on your own, you can still ask your parents/carers for advice on what questions to ask before you go into the clinic room.  It can sometimes be useful to bring a written list of questions with you to appointments.
  • If you are admitted to an adult hospital, you might not be able to have someone stay overnight with you.  Although the visiting times might be shorter, your family, carers and friends will still be able to visit you and speak to you on the telephone.

Is there further information available on transferring to adult health services?

The NHS offer information and guidance regarding transferring from children's to adult health services, which includes mental health services, and this can be accessed on the NHS website.


Support in hospitals

There are Learning Disabilities Nurses in the hospitals.  They help people with a learning disability to:

  • understand about their health
  • understand their treatment
  • prepare for hospital visits and hospital stays
  • make sure things go well in hospital

They also help hospital staff to understand the needs of people with learning disabilities.

Contact details:

  • Queens Medical Centre and City Hospitals - 0115 924 9924 ext 62562
  • Kings Mill Hospital - 01623 622515 ext 6091
  • Bassetlaw Hospital - 01909 502933
  • Derby Hospital - 01332 340131 ext 88611
  • Chesterfield Hospital - 01246 516261

Community Learning Disability Teams (CLDTs)

Community Learning Disability Teams include a wide range of health and social care specialists such as: Social Workers/Community Care Officers, Physiotherapists, Occupational Therapists, Speech and Language Therapists, Psychologists, Psychiatrists and Nurses.

The Specialist Learning Disability Nurses based in the teams will provide information and advice to adults with learning disabilities covering a wide spectrum of health related issues. Find out more on the NHS website.

The team provide specialist assessment, advice, treatment and support services for adults with a learning disability and their carers.

Across Nottinghamshire County Council, there are seven community teams based in:

  • Ashfield
  • Bassetlaw
  • Broxtowe
  • Gedling
  • Mansfield
  • Newark
  • Rushcliffe

For further information please visit Nottinghamshire County Council's website.

If you have Asperger's Syndrome and live in Nottinghamshire there is a variety of support available from individuals and local organisations.  The Council also has an Asperger's Team and you can find out more on Nottinghamshire County Council's website.


Easy read guides

You can find out information on the Easyhealth website on a range of health topics in an easy read format, from asthma to going into hospital to X-rays.


The Community Children's and Young People's Service (CCYPS)

The Community Children's and Young People's Service (CCYPS) along with the Preparing for Adulthood (Transition) Health Leads have developed information on general (universal) changes a young person may experience as they go through adolescence. This can be found here Preparing for adulthood (nottinghamshirehealthcare.nhs.uk) 

Independent Living

Nottinghamshire County Council Independent Living Support

The need for Independent Living is assessed by taking into account many factors such as the young person’s wishes, the family’s ability to continue to support the young person, the level of support available etc. There is a limited supply of independent living places and these are therefore only available to those young people and their families where staying at home is no longer an option.

The Preparing for Adulthood Team can undertake a Care and Support Assessment and a Carers Assessment and can take this to accommodation panel if this is felt to be appropriate. If Independent Living is agreed by panel, the Housing with Support Team are likely to become involved to try and find suitable accommodation with the appropriate level of support.


Who can make a referral to the team?

Referrals can be made by anyone including parent/carers, person's GP, education support providers or community services.


Age Range

Young people can be referred to the Preparing for Adulthood Team between the ages of 14yrs-17.5yrs. If a young person is older than 17.5yrs, at the time they are referred, the referral will be passed to the relevant adult team.


Who can make a referral to the team?

Referrals can be made by anyone including parent/carers, person's GP, education support providers or community services.


How do I make a referral?

To make a referral, you will need to contact Nottinghamshire Council's Customer Service Team.


Further information

You can watch the video below:

Find out further information on the Nottinghamshire County Council website.

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