Difficult questions require a ‘plan’: ‘transitions’ as an example.

Robert Graves’ in his autobiography ‘Goodbye to All That’ describes how he, his wife and their small children were in urgent need of a house to rent in Oxfordshire – but there was nothing available anywhere.

They decided that instead of running after anything that might be offered, that they would sit down and decide what would be ideal. They wanted an unfurnished house with a beamed attic, near to the river, in a village with shops within six miles of the city, that had a church with a tower (not a spire) and one that cost no more than 10 shillings a week. Having identified exactly what they wanted – they came across one such property almost immediately and moved in.

The point that I take from this story is that we should not run after what is being offered – we have to decide what we want, and having done this, it is more likely to become available.

This idea can be applied to many situations. In social care, it will be whenever you need a council or NHS body to do something that requires a significant change of arrangements and for which there is no ‘off-the-shelf’ solution. In the following example I consider a common situation – namely transition planning. The young person should of course be central to this process – but in this ‘post’ I look at the change from the perspective of the parent carer.

Transition planning as an example

You, the parent carer, will need to decide exactly what you want to happen when your son or daughter is ready to move to a different situation – for example when their period at college finishes. You need to sit down and say ‘this is what would be ideal’ – for example:

I want Jane to stay living with me at home but to have all the support she needs from people who have the appropriate skills and commitment to support her; – or
that Jack will live in a suitable supported living placement within a mile of my home and that I will continue to be fully involved in decisions about his care and support needs but that I want to go back to work / stop being a 24 x 7 parent carer and have an ‘ordinary life’ etc.

This may mean that the council will have to provide support on (possibly) a full-time basis. Inevitably it is likely to try and get away with providing as little as possible – but at law it must meet Jack and Jill’s needs. There is no duty on one adult to provide care for another adult. Social care assessments must ignore the input of carers (ie be carer blind) and this may therefore establish that your child needs a great deal of one-to-one support. Your carer’s assessment will identify that (for example) you want to go back to work, go back to college, spend more time in the pub, would like to live an ‘ordinary’ life etc.

Having identified what you consider is needed (for you and your child) you will have to put this in writing to the council. You will have to insist that the authority undertakes ‘person centred’ assessments with a view to ensuring that suitable support is available when the transition occurs. All too often this does not happen. A recent ombudsman’s report concerning Bromley ^[1] illustrates the point: in finding maladministration the ombudsman stated that the mother ‘was wrongly put in the position of having to care for her son when she had made it clear she could not do this’.

The council will try to find the least expensive way of meeting the need – but that cannot involve saying that you must continue to care and provide accommodation.[2] The council will commonly balk at the cost of providing an appropriate placement – while at the same time having nothing suitable available to offer: legally this is unacceptable.[3]

Putting in place a major ‘personalised’ care plan of this kind will take a lot of thought and time. It is something that will require planning – and of course many social workers have unmanageable case loads and are often having to focus on crisis cases rather than work of this nature. What is needed therefore is to send a letter / email to the manager / team leader (and copying this to the Director and senior solicitor) that spells out clearly what you require the council to do. For example that you require the authority to take steps ‘to prepare a plan (within [say] 2 months) explaining how this support will be actually available within [say] 4 months / when Jill leaves college’ etc.

We sketch out this approach on page 17 of the Cerebra Accessing Public Services Toolkit – under the section ‘Too difficult to think about’. You may have to do some / a lot of the project managing (ie identifying a care provider / supported living placement etc / working out what skills a suitable care assistant would need and so on) but there is a need for you to put in writing to the council what has to happen: that this is their legal duty as well as setting out timescales.

Obviously this is far easier for me to write than actually to do – so you will need support (emotional as well as practical) to make it happen. In general this support is best provided by a local organisation led by people who have actually experienced this process. It is also useful to have access to a guide as to how transitions should work – and the Disabled Children: Legal Handbook has a chapter on this (click here to down load this) and the Council for Disabled Children has a list of guides produced by other organisations (click here to download this). Cerebra is also a good source of information including its work on problem solving – for example it provides courses (free if you can convene a group) on this issue – click here for details.

Luke Clements

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