A Research Study of Habilitation Service Provision for Children and Young People With a Vision Impairment in Wales May 2016

Peter R Jones

Blind Children UK Cymru, Building 3, Eastern Business Park, St Mellons, Cardiff, CF3 5EA

1. Executive Summary

Blind Children UK Cymru became part of the Guide Dog family in 2013. Blind Children UK Cymru supports children and young people (CYP) who are blind and partially sighted and their families, by offering habilitation training and support services. Training and support in mobility, orientation and independence skills are currently delivered via the “Movement Matters” programme (a summary of this programme is provided in Appendix J). Blind Children UK Cymru advocate that all CYP with vision impairment (VI) in Wales should have access to habilitation training that adheres to the Quality Standard in the Delivery of Habilitation Training1 as and when they require it. (The Quality Standards provide a baseline for habilitation practice and stipulate the skills, knowledge and understanding needed by those delivering such training and what they might be expected to deliver; they also include the expected learning outcomes for the children and young people with sight loss being trained) (Miller. Et al, 2012). In 2012, a report entitled “Growing up and Moving On”2 revealed that provision of habilitation services across Wales was very inconsistent with 10 Local Authorities providing no services at all (Kelleher 2012). The present study was commissioned by Blind Children UK Cymru with the objectives to investigate the present levels of habilitation for blind and partially sighted CYP within Wales as reported by Local Authorities, to build additional links with Heads of Social Services and commissioners of services and to inform partner organisations in the sight loss sector and the Welsh Government. Underpinning these objectives is a real desire by Blind Children UK Cymru to improve services in Wales for CYP with VI.

 

The key findings are that gaps in service provision have increased since 2012 which means there has been a continuing deterioration in the level of support provided by Local Authorities to CYP in Wales who are visually impaired. The evidence gathered supports these key findings:-

 

·        There is a concern that Local Authorities are not properly identifying all CYP who have a visual impairment, when comparing their reported data, with Office for National Statistics, ONS, prevalence data;

·        Across the whole of Wales there are only 8.6 FTE

children’s habilitation specialists with10 Local Authorities not employing any. We estimate the number employed, directly or indirectly, should be between 15 -19 FTE to meet need.

·        The number of specialist teachers of the visually impaired has declined by 12 per cent since 2012 whilst the caseload of children has shown a small increase.

·        Specialist social workers (visual impairment) have virtually disappeared in Wales with only 3.2 FTE remaining and these are primarily assigned to adult teams.

·        The vast majority of rehabilitation officers who support children work primarily in adult services.

·        Only 55 per cent of Local Authorities use the National Sensory Impairment Partnership, NatSIP, quality framework for determining eligibility for services. Only the Gwent and Cardiff services report involving parents and children in the decision making process.

·        A person-centred approach involving the CYP should be at the heart of decision-making of all local authorities.

·        Fifty per cent of Local Authorities provide no service or a reduced service in school holiday time.

·        The data collection work demonstrated that there was often a disconnect between education and social services with regard to co-operation and co-ordination of habilitation services.

·        Overall levels of service do not appear to match the expectations of the emerging Social Services and Well-being (Wales) Act Codes of Practice in terms of children’s habilitation services.

2.  Introduction

There are an estimated 40,000 (CYP) aged up to 25 years with a vision impairment of sufficient severity to require specialist support in the UK. Of these approximately 25,000 are under 16 years old:

·        England – 34,000 (approx. 21,400 aged under 16)

·        Scotland – 3,235 (approx. 1,970 aged under 16)

·        Wales – 1,935 (approx. 1,180 aged under 16)

·        Northern Ireland – 1,260 (approx. 810 aged under 16)

 

Source: RNIB 2013³

 

The key to empowering and supporting CYP with VI to achieve their maximum potential lies in the delivery of comprehensive habilitation training and support services as per the Quality Standards with particular emphasis on intervention, post diagnosis, in the early years. Investing in the early years and maintaining support through into adulthood is imperative if CYP are to be given the best opportunity to become independent, autonomous and employable adults.  Habilitation is referenced in the new Code of Practice and guidance on the exercise of social services functions and partnership arrangements in relation to part 2 (General Functions) of the Social Services and Well-being (Wales) Act 2014. Paragraphs 185-186  of the Code state:-

 

Habilitation is central in enabling children and adults with a disability to live as independently as possible as it is key to acquiring and developing skills that otherwise would have been learnt incidentally. It is vital where an individual has been unable or delayed in developing those skills. Identifying preventative services that help people to learn, keep or improve skills and functional ability is integral to promoting well-being. As with reablement, effective habilitation should support physical, sensory, social and emotional needs and be delivered in partnership between the local authority and the Local Health Board. Habilitation support may differ from standard reablement services and require a different approach; one that focuses on the specific support may differ from standard reablement services and needs of the individual and their family. As a result, a more structured programme of support may be required, and for a longer period of time. Effective reablement and habilitation should be delivered in partnership between the local authority and the NHS.

 

Blind Children UK Cymru strongly supports the Welsh Government’s stance about the importance of delivering habilitation as set out in their new Statutory Code.

3.  Methods

The Children’s Habilitation Survey was conducted by Blind Children UK Cymru’s Team with assistance from Guide Dogs’ Strategy and Research Team and Nicola Crews, Consultant and Education Advisor RNIB Cymru. A survey was produced to capture a snapshot of habilitation services available from the 22 Local Authorities in Wales in June/October 2015.The bilingual survey was voluntary and was conducted by means of a postal questionnaire, followed by two postal reminders. The survey was sent to the Chief Executive in each Local Authority in the hope that this would encourage joint responses from education and social services (given both can provide habilitation services). There was also extensive follow-up work either by telephone, email or face-to-face meetings with the person who completed the survey to try to ensure that the returned data was as accurate as possible. The fieldwork took place between June 2015 and November 2015.  Copies of the questionnaires are available from Peter Jones at Blind Children UK Cymru (01189 838 746).

 

The final response rate was 100 per cent although a number of Local Authorities submitted combined returns which reflected local partnership working arrangements. This is an exceptional response rate for a voluntary survey and we would like to express our deep gratitude for this to all the Local Authorities in Wales.

4.  Results

Number of children with a visual impairment and number accessing habilitation services – Appendix A

The total number of CYP with a visual impairment in Wales, identified in this survey, is broadly comparable with the figure reported in the 2012 Kelleher report at around 1,500. It is a concern that the ONS prevalence data from 2012 estimates the number should be 1,935. This is a shortfall of 22 per cent and may imply that Local Authorities are not identifying all CYP who have a visual impairment. 23 per cent of CYP with VI accessed habilitation services in the 6 month period prior to the survey form being completed. The highest percentage of CYP who received a service was in the 5-11 age range at 33 per cent and the lowest percentage was in the 17-19 age range at 14 per cent. For 0-4 year olds the figure is 24 per cent. The other age ranges are all within the range of 19-29 per cent which is close to the overall average of 29 per cent. The evidence is inconclusive as to whether any special support is provided to assist with additional support when a CYP is making a transition between different settings or schools. What is clear is that around three quarters of CYP in Wales with VI, did not receive any habilitation support in the 6 month period prior to when the survey form was completed.

 

More than half the CYP receiving support had a statement of special educational need. The Welsh Government will need to take this into account if they introduce the proposed ALN legislation which will replace statements with individual development plans. For CYP who are visually impaired there is always going to be a need for external specialist

support to be provided from outside the school environment and we would suggest that any new Welsh ALN legislation must make this clear.

Are habilitation services available for children and young people with vision impairment in Local Authority – Appendix B

Every Local Authority claimed that they provide habilitation services. Eight Local Authorities provide no service or only a limited service during school holiday times. One Local Authority, Ceredigion reported there was no service available due to the absence of a mobility officer.

Another Local Authority, Gwynedd, does not provide an ‘in service provision’ but buys in services from external partners.

Number of children’s specialists – Appendix C

According to the survey responses there are 8.6 (FTE) children’s habilitation specialists employed by Local Authorities in Wales. Eight Local Authorities do not have a children’s habilitation specialist although of these Gwynedd spot purchases services from Blind Children UK Cymru and the North Wales Society for the Blind. This is an alarming gap in service provision given the statutory Social Services Code of practice guidance issued by the Welsh Government (see above). The survey did not attempt to check if the reported children’s habilitation specialists were adequately qualified. However a snapshot of members of Habilitation VI UK in Wales taken in October 2015 shows there were 16 people working in Welsh Local Authorities. This is broadly comparable with the 8.6 FTE reported in our survey and suggests that numbers reported are adequately qualified. We also believe, as a result of our data follow-up work, that all the children’s habilitation specialists are adequately qualified.

 

The number of FTE mobility specialists reported is even lower at 7.1 FTE. Fifty per cent of Local Authorities do not employ mobility specialists.

 

Every Local Authority employs specialist teachers of the visually impaired. The figure reported is 36.5 FTE which is a decrease of 12 per cent since Elaine Kelleher’s report in 2012. This continuing staffing crisis is being addressed. A new All Wales Sensory Group has been set up to address some of the common staffing / training / practice issues. This is a new group, set up under / reporting to ADEW (Assistant Directors of Education in Wales). It comprises representatives from RNIB Cymru, Sense Cymru, NDCS Cymru, the Welsh Government (Infrastructure, Curriculum, Qualifications and Learner Support Directorate) and nominated representatives from across the Sensory Impairment sector of the Local Authorities. Support for the group has been good, evidencing the recognition of the current staffing crisis and the desire to work together to look for solutions.

Number of specialist social workers (visual impairment) – Appendix D

The majority, 82 per cent, of Local Authorities do not employ specialist social workers for people with visual impairment. There has been a significant decline in the overall number of FTE staff in this category since 2012 falling from 8.7 to 3.2 FTE.

Number of rehabilitation officers (visual impairment) – employed by Local Authority or purchased from a non-Local authority agency – Appendices E and F

The total number of rehabilitation officers, FTEs, employed in Wales to work with children and young people is recorded as 15. This compares to 16.9 reported in 2012 which is broadly comparable. It is reported that the vast majority of these rehabilitation officers work primarily in adult services.

Eligibility criteria and who decides if a service is to be provided – Appendix G

Fifty five per cent of Local Authorities use the National Sensory Impairment Partnership, NatSIP, framework for determining eligibility for services. All other Local Authorities use some form of needs led assessment. There is a mixed picture across the Local Authorities with regard to who decides if a service is to be provided. Nine Local Authorities confirm that the Qualified Teacher of the Visually Impaired, QTVI, plays a significant role in the decision making process. Rehabilitation officers and habilitation specialists are also cited as taking part in the decision making process. There is much evidence of joint assessment between social services and education. Only the Gwent service, which comprises 5 Local Authorities, and Cardiff mentions discussions with service users (children, young people and parents) in the decision making process.

Settings for habilitation services – Appendix H

The majority of Local Authorities provide habilitation services for children and young people in all settings as defined by the Quality Standards. The exception is Ceredigion who report that they only provide a service in educational settings.

When habilitation services are available for children and young people – Appendix I

All Local Authorities provide habilitation services in term time. Six Local Authorities do not provide any services in holiday time and another 5 provide a reduced service. This means that 50 per cent of Local Authorities provide either no service or a lesser service during the school holidays.

5. Discussion

The survey was sent to the Chief Executive in each Local Authority in the hope that this would encourage joint responses from education and social services (given both can provide habilitation services). This happened in some cases but for many there was a silo effect with only one service providing data. The responses from the data collection work suggest that there is often a disconnect between education and social services demonstrated by a lack of clarity between the services in terms of who was providing what services to CYP with VI. An education specialist in one authority provided the following comment which sums up the disconnect – “I’d be very interested in further contact with colleagues about social services support for children with visual impairments currently, as this is an area that we find very challenging - have been told that we would need to refer children via a standard Child in Need process, and only if there were concerns around Child in Need issues, as well as their disability”. CYP with a visual impairment should not have to rely on a child in need referral to access habilitation services.

 

The survey was conducted in the midst of severe and ongoing challenges to Local Authority budgets in Wales. In terms of the habilitation services to CYP the evidence gathered appears to be bleak.

 

The data collected via the survey highlights that Local Authorities are unlikely to be properly identifying all CYP with VI when compared to other data sources eg ONS prevalence data. What is clear is that since 2012 there has been a significant deterioration in the levels of support provided by Local Authorities to CYP who are visually impaired.

 

All Local Authorities claim that they provide habilitation services, although 8 admit they provide no service or limited service during school holiday times. Against this one has to consider that there are only 8.6 FTE children’s habilitation specialists working in Wales. This, in turn, has to be considered against the fact that there are potentially 1,500 CYP who need this service. Eight Local Authorities do not employ a children’s habilitation specialist although one of these does spot purchase from third sector providers. Data was not gathered on whether these staff are adequately qualified although our follow-up work suggests that they are.

 

Blind Children UK Cymru know from many years of experience of service delivery that a fully qualified habilitation specialist in a 5 day per week contract is able to work with around 40-50 children per year (a mixture of short, medium and longer term interventions). The inference from the forthcoming expanded NatSIP criteria for allocating habilitation support is that all children with visual impairment should have an assessment from a qualified habilitation specialist. On that basis Blind Children UK Cymru would suggest that, ideally, Welsh Local

Authorities should be working towards 1 qualified habilitation specialist per 100 children and young people with a visual impairment or possibly 1 qualified habilitation specialist and 1 qualified habilitation assistant per 150. The Welsh Local Authorities identify around 1,500 children and young people with a visual impairment (compared to 1,900 estimated by

ONS) The current level of 8.6 FTE qualified habilitation specialists employed by Welsh Local Authorities cannot meet the needs of 1,500 – 1,900 children and young people. Either staffing levels need to increase or better partnership working need to be organised with suitable third sector providers.

 

The number of mobility specialists is only 7.1 FTE and 50 per cent of Local Authorities do not employ any. The picture is even worse for specialist social workers for the visually impaired with only 3.2 FTE now working in Wales. It appears that challenges to social service budgets means that specialist services for CYP who are visually impaired are on the verge of disappearing. CYP who are visually impaired need access to qualified, professional staff and services with relevant expertise who understand the needs and are able to conduct comprehensive assessments and provide the support required.

 

Alongside this the numbers of QTVIs in Wales continues to decline although a new All Wales Sensory Group is looking at this. The number of rehabilitation officers in Wales working with children and young people has remained relatively stable since 2012 although the staff engaged in this work are primarily employed within adult services.

 

This marked decline in overall staffing levels since 2012 does suggest that challenges in Local Authority budgets is having a drastic effect on the services available to support blind and partially sighted CYP. It cannot be stated strongly enough that services are at a tipping point and serious action needs to be taken to improve the commissioning and provision of services.

 

It was encouraging to note that more than half of Local Authorities use some form of assessment criteria such as the NatSIP framework for determining eligibility and there is evidence of joint working between specialisms in the decision making process. It was disappointing that only the Gwent and Cardiff service mentions clients (parents and children) taking part in the assessment process. This is at odds with Welsh Government regulations that expect an assessment process that is CYP centred, supporting CYP’s rights to have respectful conversations about their well-being, and to exercise a strong voice and control in decisions about the services they receive.

 

In most parts of Wales habilitation services are provided in the home, at school and in public environment as per the Quality Standards. However service is poor across Wales during school holiday periods which is very concerning. The support children need to develop, and become proficient in independent living skills must be consistent and is not dependent on the school calendar. This lack of service for 25 per cent of the calendar year needs to be addressed.

6. Conclusion

In respect of the first objective the survey results provide a detailed snapshot of the September/November 2015 levels of habilitation for blind and partially sighted CYP within Wales. An additional consequence of conducting the survey is that it has raised the profile of the ‘Movement Matters’ service provided by Blind Children UK Cymru and opened a dialogue with many of the Local Authorities in Wales. The report will provide Local Authorities with an opportunity to evaluate their existing capacity in relation to children’s habilitation specialists with a view to identifying opportunities for collaboration in providing these services.

 

The report will be shared with all the third sector organisations working with people with sight loss in Wales. The ongoing decline in the services available to CYP will come as no surprise to them. The report provides up-to-date evidence to support campaigns to ensure that CYP with sight loss have access to the services they need to promote independence and quality of life. The report also highlights the critical state of habilitation services. There are clear indications that in parts of Wales staff with specialist skills are being lost and they are proving very difficult to replace.

 

Finally the results of this survey provide a wake-up call to the Welsh Government and Local Authorities. The Social Services and Well-being (Wales) Act 2014 and associated Codes of Practice are very much about addressing problems early to prevent them escalating and threatening a person’s well-being and independence. Unless something is done to address the identified critical shortfalls in service provision, based on Local Authorities own data, many CYP in Wales with visual impairment will fail to achieve their full potential and will be unable to take advantage of life chances.                                            

7. References

1     Miller, O., Wall, K., & Garner, M. (2011), Quality Standards: Delivery of Habilitation training (Mobility and Independent Living Skills) for Children and Young People with Visual Impairment. London: Institute of Education, University of London & RNIB. 

2     Growing Up and Moving On – Service Provision for Children and Young People with Visual Impairment in Wales, Elaine Kelleher, sponsored by Sight Support (September 2012) 

3     http://www.rnib.org.uk/knowledge-and-research-hub-research-reports/evidence-based-reviews

 

 

 

 

 

 

 

 

 

Appendix A - Number of children with a visual impairment and number accessing habilitation services

Local Authorities

Children and young people with visual impairment with a statement

Children and young people with visual impairment without a statement

In last 6 months how many children and young people have accessed habilitation services

Percentage of CYP who have received Habilitation training during the last 6 months.

Anglesey & Gwynedd

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

 

0

28

6

2

1

 

 

6

17

16

0

0

 

 

 

0

0

4

1

0

 

 

0

0

18

50

0

Bridgend

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

0

10

11

5

0

 

13

26

36

0

18

 

5

9

2

2

2

 

38

25

4

40

11

Cardiff

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

19-25 years

 

 

 

 

 

0

63

34

11

0

 

 

18

34

11

0

0

 

 

 

 

 

7

51

26

3

0

 

39

53

58

27

0

 

 

0

Carmarthenshire

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

3

47

16

10

10

 

                

7

38

21

1

0

                                      

                  

                  

            

 

1

16

4

1

3

 

10

19

11

9

30

 

Ceredigion

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

 

0

0

2

0

0

 

0

2

1

1

0

 

0

0

0

0

0

 

0

0

0

0

0

Conwy

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

0

3

2

1

0

 

 

0

2

0

4

15

 

0

0

0

0

0

 

0

0

0

0

0

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

 

 

 

 

25*

131*

84*

18*

0*

 

 

 

 

 

0

0

0

0

0

 

 

 

 

 

13

94

49

2

0

 

 

 

 

 

52

72

58

11

0

Merthyr Tydfil

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

0

4

2

2

0

 

2

4

4

0

0

 

 

0

2

1

1

0

 

0

25

17

50

0

NPT

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

3

27

10

6

0

 

9

31

14

0

0

 

3

10

8

0

0

 

25

17

33

0

0

Pembrokeshire

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

2

4

2

1

2

        

4

12

13

2

0

 

5

4

0

0

2

 

83

25

0

0

100

Powys

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

0

5

4

5

24

 

 

1

0

0

0

0

 

0

3

3

3

3

 

0

60

75

60

13

RCT

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

3

16

9

2

0

 

19

27

16

2

0

 

2

7

8

0

0

 

9

16

32

0

0

Swansea

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

6

32

25

0

0

 

10

24

24

2

0

 

3

18

14

0

0

 

19

32

29

0

0

Vale of Glamorgan

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

0

37

20

25

0

 

2

0

0

0

0

 

0

0

2

0

0

 

0

0

10

0

0

Wrexham, Denbighshire and Flintshire

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

 

 

 

7

30

43

8

4

 

 

 

15

42

24

2

0

 

 

 

4

16

11

1

4

 

 

 

18

22

16

10

100

 

Total

0-4 years

5-11years

12-16 years

17-18 years

19-25 years

Overall Total

 

49

437

270

96

41

893

 

106

259

180

14

33

592

 

43

230

132

14

14

433

 

28

33

29

14

19

29

*unable to provide breakdown between statement and non-statement

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix B - Are habilitation services available for children and young people with vision impairment in Local Authority

 

Local Authorities

Yes

No with reasons

 

Anglesey/

Gwynedd

Anglesey - No ‘in service’ provision. Mobility provided by

Mobility Officer from North Wales Society for the Blind based

in Anglesey Social Services. Gwynedd – Service commissioned by North Wales Society for the Blind for elder children or Blind Children UK Cymru for the young children. This is arranged by Derwen specialist’s children’s services.

-

Bridgend

Generally yes. Provision is via Education and/or Social Services depending on individual services. There’s no formal agreement. Education has had their own Mobility Specialist up until recently - you would need to confirm with Education what their provision now is. Re younger children Education usually take the lead re any habilitation, but we might be involved with daily living skills/mobility for older children. Education refers to us for all children if adaptions/lighting assessment required.

-

Cardiff

Social Services - there are two mobility officers. A referral is made via a visual impairment Teacher. Education – there are two qualified children’s habilitation and mobility specialists who together make up a full time post. 

-

Carmarthenshire

Yes.

-

Ceredigion

Yes but mobility officer is currently on long term sick leave.

-

Conwy

Yes, either through habilitation offered in school or in the community and in some instances through specialist college placement.

-

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

Yes. Limited service in school holidays. Newport stated that

they “receive exceptionally limited referrals for children with

a visual impairment”. This would suggest that the referral

pathway in Newport - particularly via local health professionals - may not be working.

-

Merthyr Tydfil

Yes. Provided via a service level agreement with RCT.

-

NPT

Yes. During term time all children who require it receive mobility and orientation training. This term we have also started to offer a programme of independence and everyday living skills. Again this is only provided in term time as we work in education settings.

­-

Pembrokeshire

Yes.

-

Powys

Yes Referrals can be direct, from education and health practitioners or via the Children with Disabilities team to Adults VI habilitation officer.

-

RCT

There are 4 Rehabilitation Officers (VI) based in the

Sensory Services Team in Adult Services. Our role with

children and young people is to undertake the registration

(severely sight impaired / sight impaired) following receipt of

A Certificate of Visual Impairment from the Hospital Eye

Service. This is a statutory duty. We undertake an

assessment and provide information and advice. We liaise

with colleagues in the Education Department because

whilst we can provide mobility and independence training,

the staff within Education have the qualifications and far

greater expertise in working with children and young people.

Our approach is to work together and we would be able to

provide training, for example, during school holidays, if our colleagues in Education were to request this.

 

-

Swansea

Yes.

-

Vale of Glamorgan

Yes.

-

Wrexham, Denbighshire and Flintshire

Yes.

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix C - Number of children’s specialists

 

Local Authorities

Number (FTE) of Children’s habilitation specialist

Number (FTE) Mobility Specialists 

Number of Specialist Teachers of the Visually Impaired

Anglesey/Gwynedd

0

0

2

Bridgend

1

0

2

Cardiff

1

1

6.5*

Carmarthenshire

0.6

0

2

Ceredigion

0

0.6

0**

Conwy

1

0

2.5

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

1

0

5

Merthyr Tydfil

0

0

2

NPT

               0

0.5

1.6

Pembrokeshire

0

0

0.9

Powys

1

1

3

RCT

2

1.5

2.5

Swansea

1

0

2

Vale of Glamorgan

0

1

1.5

Wrexham, Denbighshire and Flintshire

 

1.5

3

Total

8.6

7.1

36.5

* Also employ 4.6 VI teaching assistants with Braille qualifications – these are not attached to specific children in school but work across the service to support access and building capacity within schools. They also will support with mobility and habilitation when appropriate.

** shares approx. 0.2, FTE, specialist teacher support from Carmarthenshire.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix D - Number of specialist social workers working with CYP

 

 

Local Authorities

Number (FTE) of specialist social worker (visual impairment)

Adult services

Children’s services

Anglesey/Gwynedd

0

0

0

Bridgend

 1

1

0

Cardiff

0

0

0

Carmarthenshire

0

0

0

Ceredigion

0

0

0

Conwy

0.7

0.7

0

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

0

0

0

Merthyr Tydfil

1

0.5*

0.5*

NPT

               0

0

0

Pembrokeshire

0

0

0

Powys

0

0

0

RCT

0

0

0

Swansea

0

0

0

Vale of Glamorgan

0.5

*

0.5

Wrexham, Denbighshire and Flintshire

0

0

0

Total

3.2

2.2

1

 

*1 FTE covers adult and children’s services – breakdown of time not provided.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix E - Number of Rehabilitation Officers (visual impairment) – employed by Local Authority working with CYP

 

Local Authorities

Number of rehabilitation officers (visual impairment) – employed by the LA

Adult services

Children’s services

Anglesey/Gwynedd

0

0

0

Bridgend

 2

2

0

Cardiff

0

0

0

Carmarthenshire

4*

4*

0

Ceredigion

0

0

0

Conwy

0

0

0

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

0

0

0

Merthyr Tydfil

0

0

0

NPT

               0

0

0

Pembrokeshire

2

1**

1**

Powys

3

3

0

RCT

0

0

0

Swansea

0

0

0

Vale of Glamorgan

0

0

0

Wrexham, Denbighshire and Flintshire

0

0

0

Total

11

10

1

 

*includes an assistant carrying out low level assessments

** 2 FTE posts work with adults and children – no separate breakdown provided

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix F - Number of Rehabilitation Officers (visual impairment) – purchase arrangement with non - Local Authority agency working with CYP

 

Local Authorities

Number of rehabilitation officers (visual impairment) – purchase arrangement with non – Local Authority agency

Adult services

Children’s services

Anglesey/Gwynedd

0

0

0

Bridgend

 0

0

0

Cardiff

0

0

0

Carmarthenshire

0

0

0

Ceredigion

0

0

0

Conwy

1

1

0

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

0

0

0

Merthyr Tydfil

0

0

0

NPT

               0

0

0

Pembrokeshire

0

0

0

Powys

3

3

0

RCT

0

0

0

Swansea

0

0

0

Vale of Glamorgan

*

0

*

Wrexham, Denbighshire and Flintshire

0

0

0

Total

4

4

*

 

*reports some spot purchase of children’s services but amount not specified.

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix G - Eligibility criteria operated and who decides if a service is to be provided

 

Local Authorities

Eligibility criteria

Who decides if a service is to be provided

 

Anglesey/Gwynedd

Certificate of visual impairment registration; poor use of functional vision, visual fields, depth perception and binocular co-ordination as noted in specialist medical reports; suitability for provision following appropriate assessment by relevant agencies.

Service is provided according to need.

Bridgend

 Within social services ‘substantial sensory impairment’ but it’s all down to the information at point of referral and presenting issues; NatSIP criteria alongside functional visual assessment, Also mobility/habilitation assessment.

Any queries re service provision would go to the community Independence/Wellbeing team manager for decision; QTVI functional assessment, assessment by mobility/habilitation officer.

Cardiff

Based on predominant need. All children who qualify for access to the visual impairment service are eligible for access to the habilitation element of this provision. Amount and timing of input depends on parental wishes, child’s wishes, point of transition, need, assessment by habilitation specialists.

Habilitation specialists, in consultation with parents, QTVIs, school and the child.

Carmarthenshire

Adult services work with any adult with a VI over 18 who would wishes to access the service. They do not need to be SI or SSI necessarily. Children's Services will carry out an assessment of Habilitation needs on any CYP with VI  (with reference to the QS for Habilitation Services for CYP  with VI; QS for CYP with Sensory Impairment (WAG 2005); QS for CYP with VI: Information for Commissioners & Service Planners)

Service provision is determined following assessment of need by the Habilitation Officer/Rehab Officer. Where it is indicated that a CYP would benefit from input, the Service Manager (children), or Senior Rehabilitation Officer (Adults) discusses the nature/level of provision.             

Ceredigion

NatSIP.

On assessment according to need of eligibility criteria.

Conwy

-

-

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

NatSIP standards.

Score on eligibility criteria, assessment and discussion with QTVI, parent and school.

Merthyr Tydfil

NatSIP framework.

ALN manager in consultation with VI co-ordinator.

NPT

We use the NatSIP Eligibility Criteria to determine if children receive support from our service. Any children who have been assessed by a QTVI and are kept on our case load are then assessed by our Mobility Specialist who determines whether mobility/everyday living skills are required.

We use the NatSIP eligibility criteria to determine if children receive support from our service. Any children who have been assessed by a QTVI and are kept on our case load are then assessed by our Mobility Specialist who determines whether mobility/everyday living skills are required.

Pembrokeshire

The child/young person has to have a permanent and substantial visual impairment that affects their daily living skills, communication skills and or mobility skills.

Senior Sensory Officer (Qualified Rehabilitation Officer).             

Powys

Non-correctable visual impairment for direct referrals. For the Children with Disabilities team moderate to profound sensory impairment.

Follows visual impairment assessment by habilitation officer. Children with Disabilities team decides on assessment secondary to VI for specialist assessment and support.

RCT

NatSIP eligibility criteria.

Sensory panel decides using EC and any additional information relevant to the pupil.

Swansea

The habilitation specialists have developed their own eligibility criteria based on NatSIP.

The habilitation specialists.

Vale of Glamorgan

Needs led assessment by Visual Impairment Teacher. If child is known to the Child Health and Disability Team an initial assessment will be completed.

Either the Visual Impairment Teacher or if it is as a result of an initial assessment. the Team Manager of the Child Health and Disability Team will authorise.

Wrexham, Denbighshire and Flintshire

Local Authority eligibility criteria based on NatSIP.

Local authorities within regional provision.

 

 

 

 

 

 

 

 

 

 

 

 

Appendix H – Settings for habilitation services

 

Local Authorities

Within the home environment

Educational settings (nursery/school/college/

university)

 

Public environments (local streets/shops/

towns/

using public transport)

Anglesey/Gwynedd

yes

yes

yes

Bridgend

yes

yes

yes

Cardiff

yes

yes

yes

Carmarthenshire

yes

yes (university – adult service only)

yes

 

Ceredigion

no

yes

no

Conwy

yes

yes

yes

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

yes

yes

yes

Merthyr Tydfil

yes

yes

yes

NPT

yes

yes

yes

Pembrokeshire

yes

yes

yes

Powys

yes

yes

yes

RCT

yes

yes

yes

Swansea

yes

yes

yes

Vale of Glamorgan

yes

yes

yes

Wrexham, Denbighshire and Flintshire

yes

yes

yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix I - When habilitation services are available for children and young people

 

 

Local Authorities

Term Time

School/college/University holidays

 

Both

Anglesey/Gwynedd

yes

yes

yes

Bridgend

yes

yes

yes

Cardiff

yes

yes

yes

Carmarthenshire

yes

yes (university – adult service only)

no

 

Ceredigion

yes

no

no

Conwy

yes

yes

yes

Gwent (Caerphilly, Monmouthshire, Newport, Blaenau Gwent and Torfaen)

yes

yes (limited service)

yes

Merthyr Tydfil

yes

no

no

NPT

yes

no

no

Pembrokeshire

yes

yes

yes

Powys

yes

yes

yes

RCT

yes

no

yes

Swansea

yes

no

no

Vale of Glamorgan

yes (via education)

Yes (via social services)

yes

Wrexham, Denbighshire and Flintshire

yes

no

no

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix J - Overview of Blind Children UK Cymru’s Movement Matters Service

Blind Children UK Cymru’s Movement Matters service provides training to help blind children and young people in Wales move around safely and independently. Movement Matters also teaches important life skills such as handling money and preparing food. For children with complex and additional needs, Movement Matters can provide a tailored programme including body awareness, wheelchair mobility, use of remaining vision and more.

Sighted children learn by watching others; children with vision impairment often need to be specifically taught skills and concepts they would not otherwise pick up. Movement Matters provides personalised training and support in mobility, orientation and independence skills from babyhood to adulthood. These are the skills that will help a blind child to do things like reach for a toy, make a snack, and develop their listening skills.

Movement Matters training unlocks possibilities – helping children and their families to understand that sight loss does not have to be a barrier to reaching their potential.

The Movement Matters’ services include:

·        assessments to establish a child’s or young person's needs

·        mobility and independence skills training

·        advice and support workshops for parents and carers

·        practical work with friends, family and professionals to support children and young people with vision impairment.

These vital services are delivered by our qualified Habilitation Specialists, who work shoulder-to-shoulder with other professionals for example: Speech and Language Therapists, Physiotherapists and Occupational Therapists and other organisations including local authorities.

 

This report was updated on 13th May 2016, this version should be read as final. Registered Charity in England & Wales 1051607 and Scotland SC042089. Registered in England & Wales No 3133018. VAT No. 879717554 0234 05/16.