To be eligible for a service the child/young person must meet the following eligibility criteria:

1. The child/young person has a ‘permanent and substantial’ disability as defined in the Chronically Sick and Disabled Persons’ Act (1970).
   
   
2. The child/young person has had a long-term disability (in excess of twelve months) as defined in the Equality Act (2010) which relates to their request for assessment.
   
   
3. The disabled child/young person has the right to an assessment of need as defined in the Children Acts (1989) and (2004), and in line with the Community Care Act (1990).
   
   
4. The disability may be a physical or mental impairment but must be of a significant nature including severe physical impairment, severe learning disability and/or severe autism evidenced by supporting professional letters and/or attendance at a special school as requested. 
   
   
5. The disabled child/young person is ‘ordinarily resident’ in Staffordshire.
   
   
6. The disabled child/young person requires assessment for advice or recommendations about equipment or adaptations in order to assist with daily living activities in the home; in order to promote age-appropriate independence or to facilitate safe care.  For example, to access essential facilities for bathing, moving and handling, seating, inclusion in family life, and/or where existing/standard facilities are insufficient to meet the need.
   
   
7. The disabled child/young person requires assessment for advice or recommendations about equipment or adaptations in order to help keep him or her keep safe at home. For example, with stairs, sleeping, moving and handling and/or where existing facilities do not meet the child/young person’s needs.
   
   
8. Persons with parental responsibility require assessment, advice and/or equipment to facilitate caring for the disabled child/young person, and to ensure the safety of both the disabled child/young person and themselves in the home (e.g. moving and handling).
   
   
9. Relevant services to promote skill acquisition, provide behavioural strategies and ensure least restrictive approach have been accessed prior to the referral to the CDS OT team and are evidenced at point of referral. This includes (but is not limited to) LD nursing, CAMHS, autism service provider, local support team, health OT, hand therapy.
   
   
1. Referrals for children with sensory needs and/or challenging behaviour requesting a safe space or similar provision need to demonstrate active intervention from relevant services with evidence of sensory/behavioural strategies implemented alongside supporting letter from professionals involved advocating the need for provision.
   
   
2. Where the request relates to a disabled child who has the functional ability to complete the task identified but is unable to understand the task demand/is non-complaint/runs away, (such as transferring in/out of the bath or to/from the car) would need to demonstrate active intervention from relevant services with evidence of learning/behavioural strategies implemented alongside supporting letter from professionals involved advocating the need for the equipment/adaptation.
   
   
10. The Occupational Therapy Team do not assess children with a short term need or provide equipment for short term needs including that which is required to accommodate hospital discharge. It is an NHS responsibility to provide required equipment provision and training to ensure safe discharge.

1. Referral 

To ensure referrals are triaged appropriately a member of the occupational therapy duty team will complete a screening assessment for each referral which is then reviewed by a senior occupational therapist/occupational therapy manager and additional information sought as required, ahead of making a decision regarding acceptance and priority of the referral ( see Appendix A - referral acceptance process).

2. Allocation

Cases are allocated (Appendix B - referral allocation process) in priority order P1-P3, date order and then geographically as capacity permits.

Priority 1 – urgent need with significant risk identified (e.g moving and handling) and Looked After Children.

Priority 2 – active occupational therapy need identified.

Priority 3 – eligible for assessment with no imminent risk identified.

3. Assessment

Once allocated the occupational therapy assistant or occupational therapist will complete a holistic assessment exploring the needs of the child/young person within the home environment (see Appendix C - assessment process). Completion of the assessment may lead to advice, signposting, provision of equipment (Appendix D - equipment process), referral for adaptations funded via the disabled facilities grant (Appendix E - dfg process) or closure if no need is identified.

4. Review

Following intervention it is standard procedure for a review to be completed ( Appendix F - review process) which will explore effectiveness of the intervention and need for further input ahead of closure to the team. Where a reviewable risk has been identified such as but not limited to moving and handling provision, adult bed for child use or bed with high sides/ full enclosure the child may remain open to the team with frequent reviews (6 monthly or annual) until the age of 18.

5 Closure

If no active occupational therapy needs are present at the initial assessment or all active needs are met without reviewable needs identified then the case will be closed to the occupational therapy team and a re-referral would be required should a need arise in the future. 

In the eventuality that the occupational therapy team have identified a way to meet your child’s needs that you do not wish to progress and thus there is no active intervention ongoing from the occupational therapy team the referral will be closed.

Where the allocated worker has identified the need for equipment provision the process as per appendix D is to be followed. 

There is an expectation that refurbished and standard stock would be explored in the first instance and families are to be aware that they may not always receive a ‘new’ item but that any item provided would have been deep cleaned and safe use ensured.

Where refurbished or standard stock is unable to meet the need two quotes with close technical equivalents are required to be submitted alongside a clinical justification. This process ordinarily entails two separate home visits with product rep and child present to assess with proposed provision to ensure it best meets needs ahead of procurement. 

In the eventuality that a family wish to purchase alternative equipment to meet the assessed need a direct payment can be agreed to the value of the provision proposed by the occupational therapy service on the condition that the family evidence that the item will meet needs in the same capacity as that which has been proposed. In the eventuality that the item is available in refurbished stock the financial contribution would be nil. Any service, maintenance, repairs and disposal of equipment purchased via direct payment is the responsibility of the parent/carer and not that of Staffordshire County Council.

Adaptations under £1,000.00 are funded via the equipment process noted above. 

Adaptations exceeding £1,000.00 are funded via the disabled facilities grant (DFG) which is overseen by each district/borough council who commission external providers to carryout the works on their behalf at the district/borough’s discretion.

The role of the occupational therapy team, as outlined in appendix E, is to identify the assessed need, submit a referral to the relevant provider and to appraise plans proposed to ensure they will meet need. 

Any adaptation funded via the disabled facilities grant are underpinned by the Housing Grants, Construction and Regeneration Act (1996) which advises that to be eligible for DFG funding the adaptations proposed must be ‘necessary and appropriate’ whilst being ‘reasonable and practicable’. The legislation gives no consideration to storage or the wider needs of the non-disabled family and focuses exclusively on ‘the disabled occupant’ with emphasis towards ‘access’ to specific facilities. This it is not uncommon for families deemed to be ‘overcrowded’ and adaptations declined where the disabled occupant has a room that could be adapted to meet needs but would leave sibling without a bedroom.

Whilst awaiting adaptations where there are no other active OT needs the child’s referral will be transferred from the allocated OT to a DFG holding list and reviewed on a 6-8 weekly basis via telephone by a member of the OT duty team.    

The occupational therapy team are not responsible for commissioning the provision of adaptations funded via the disabled facilities grants and thus any questions or concerns regarding this should be directed to the commissioned provider or direct to the relevant district/borough council representative.

1. Housing grants, construction and regeneration act (1996)  available:

• For further information ahead of a referral please contact the Children’s Disability Service OT Duty team via email:

Email: childrensotenquiries@staffordshire.gov.uk or

Telephone: 01827 782232 . 

Additional information in relation to this policy can be sought from Children’s Disability Service OT Manager Lisa-Marie Forry via: Lisa-Marie.Forry@staffordshire.gov.uk or telephone: 01782 485535.

Appendices available on request by emailing localoffer@staffordshire.gov.uk or via the SCC intranet if you have access.

1. Will you assess children in settings other than their home? 
   
   Residential Establishments, Schools? 
   
   The responsibility for equipment and adaptations in residential settings and schools are their responsibility.
   
   Separated Parents? 
   
   Provided the child meets the Eligibility Criteria and where the person has parental responsibility, or is officially recognised as providing care, we will assess and, where appropriate, loan portable equipment in a second home environment. Where feasible to transfer equipment between properties (such as sling provision) this would be the expectation. Adaptations to the second property would only be considered at the discretion of the local borough council in exceptional circumstances. 
   
   Disability fostering service short-breaks? 
   
   We assess and make recommendations/provide for disabled children attending Staffordshire County Council Disability Fostering Service (short-breaks), both at home and at the short break placement.
   
   
2. If a child is ordinarily resident in Staffordshire but long term fostered out of county, will they be eligible for service from Staffordshire County Council OT?
   
   Yes.  We retain responsibility for the service to the child.  In practice we may buy the assessment service from the local OT service and fund the work recommended by them.
   
   
3. If a child is ordinarily resident out of county but long term fostered in Staffordshire, will they be eligible for a service from Staffordshire County Council OT?
   
   No. The child remains the responsibility of the placing authority. In practice we may reach an agreement whereby we will assess and charge the placing authority for this service.  It would be the placing authority’s responsibility to provide any equipment recommended, but it is sometimes possible to access a DFG for the foster carer’s home.
   
   
4. Having assessed a child at home, will we provide equipment for use by/train non-SCC carers other than household members, for example, a carer employed via Direct Payments/Agency Carers?
   
   No. We do not assess for/provide in these circumstances as the responsibility lies with the Employer.
   
   
5. Can OTs assess a child for items for use outside the home, e.g. car seats?
   
   No. We only assess the child’s needs within the home.
   
   
6. If a child has been assessed and requires a specialist bed, but currently shares a bunk beds with a sibling, can the OT provide for both children
   
   Only if both children meet the eligibility criteria and both have been recommended a specialist bed.
   
   
7. Can I access a Disabled Facilities Grant (DFG) to provide an additional bedroom as my disabled child is unable to share with their sibling?
   
   Adaptations funded via the DFG are underpinned by the Housing Grants, Construction and Regeneration Act (1996) which stipulates ‘access to’ for the ‘disabled occupant’ and thus would deem the disabled child to have a bedroom, should they be able to access it safely, therefore identifying the difficulty as overcrowding and not a disabled need.
   
   In circumstances relating to a disabled need, with sufficient supporting evidence adaptations of this nature can be explored.
   
   
8. What happens when a child (open to Occupational Therapy) needs a Social Work Referral? 
   
   Where a case is held by the Occupational Therapy Team only and a request for a social work assessment is received by the First Response Team (FRT):-

•  FRT will complete a Contact and Referral form and assign to the appropriate Social Work Team.
  
  
• Where a case is held by the Occupational Therapy Team only and the Occupational Therapist identifies a need for Social Work Assessment:-
  
  
• The Occupational Therapist will raise a ‘Request for Service’, to be assigned to the appropriate Social Work Team.