Moving into adult services

There are a number of post 16 education options for young people.

For some this will mean staying at school, for instance moving into 6th form, for others it might mean moving into further or higher education or college, and for others it may mean undertaking work based (vocational) training.

Preparation for leaving school

Moving provision can be daunting but there are some things to keep in mind so that services can help to organise what support is required before the young person moves.

It is important that the new provision is aware of the young person's additional needs. This is so that support can be in place as soon as they start.

Transition days

Schools will arrange for all young people to visit their next placement before the end of the school year. This will help them to understand they are moving to somewhere new and feel more comfortable about the move. Information about the new placment including photographs can be helpful.

Transition with an EHCP

An EHCP will need to be updated before a young person moves  so that planning for the support they may need can start as soon as possible. The SEND team can help you with this this, as can the school or college.

EHCPs – Year 9 Preparing for Adulthood

In year 9 the Annual Review of the EHCP will focus on preparation and planning for the young person to move into adult services and post 16 learning.

This means that there may be extra people attending the Annual Review in Year 9, so that discussions can take place about what the young person wants to do when they leave school.

When the young person finishes year 11 of secondary school (aged 16 years+) they will be

• in a school placement.
• in an apprenticeship/further training.
• in a college placement.

The EHC plan continues if the young person remains in education or training potentially up to the age of 25 years.

EHCPs are only for people who are in education. If the young person chooses to leave education and get a paid job, then their EHCP ceases. Once a young person reaches the age of 25 the EHCP ceases regardless of placement.

Who can help?

For those with SEND, transition can feel quite challenging, but there are people in schools or colleges that can help them plan for this. The SENCO in schools or inclusion leads in colleges can help young people and families prepare to transition.

All schools must provide careers advice and guidance to young people to support them to understand and plan for their post 16 transition.

What if the young person is not in education or training?

If a young person has an EHC plan and is aged under 18 but is not receiving education and training (for whatever reason), the local authority must review the plan “to ensure that the young person continues to receive education or training” (see SEN Reg 29).

Whilst this is not, strictly, an annual review, the local authority must conduct the review in accordance with SEN Regs 18 and 19:

 Annual reviews in Year 9 and beyond | (IPSEA) Independent Provider of Special Education Advice

Annual reviews from year 9.pdf (councilfordisabledchildren.org.uk)

At the point a young person with SEND turns 18, they may become eligible for Adult Social Care Services, regardless of whether they have received support from Children’s Social Care  or have an EHC plan.

To receive support from Adult Social Care, the young person will need to be assessed as having eligible needs.

Preparing to transition to adult care services if you are open to children social care

Adult Social Care will work closely with Children’s Social Care services, and other involved people, to ensure that care continues throughout the transition stage. For those likely to have eligible needs, Adult Social Care and Children’s Social Care will start working together from year 9 (maybe earlier).

Some people open to Children’s Social Care will not necessarily move to Adult Social Care, it will depend on level of need.

Preparing to transition to Adult Social Care if you have an EHCP

Not all young people with an EHCP are open to Children’s Social Care, however  young people may still be eligible for support from Adult Social Care.

For a young person with an EHC plan, the transition to adult care and support should be well planned and integrated within annual reviews. Preparing for adulthood will be discussed in detail from the Year 9 annual review of an EHCP onwards, including a discussion around whether a young person should be referred to Adult Social Care.

Preparing to transition to adult care services if you do not have an EHCP

For young people who have SEN but do not have an EHCP, schools, colleges and other Post 16 providers are able to provide information and advice about preparing for adulthood. Young people may still be eligible for support from Adult Social Care.

What is a needs assessment?

The purpose of a needs assessment is to understand what adult social care support a young person might be eligible for once they reach 18 years old or after. Young people or their parents can request a needs assessment at any time prior to a young person’s eighteenth birthday, whether or not they have an EHC plan.

This assessment will take into consideration the support someone is already having, and what might be needed in the future. The assessment will also consider whether there is a financial contribution required to meet the young person’s needs.

If the young person meets the eligibility criteria and is going to receive support, then the young person will be involved in planning their support to help them to achieve their future goals whether it is further education, employment or living independently.

Who is eligible for Adult Social Care?

The eligibility threshold is based on identifying:

• If a person’s needs are due to a physical or mental impairment or illness
• To what extent a person’s needs affect their ability to achieve two or more specified outcomes 
• Whether and to what extent this impacts on the person’s wellbeing

If a young person’s needs are not eligible for adult services, you will receive an explanation as to how this decision was made and you can ask for further information, advice and signposting to universal services as well as prevention services.  

For further details on the Needs Assessment Needs assessment | Bedford Borough Council

How to make a referral for an assessment?

A young person can make a referral themselves or ask someone to make a referral on their behalf.

For those who have a social worker, then they can make a referral on the young person’s behalf (if the young person consents)

For those with an EHC plan and no social worker or current involvement with Children Services, then this should be discussed at the school annual review as part of the preparation for adulthood as to who should make a referral. 

Details of the referral process can be found here Needs assessment | Bedford Borough Council

What if a Young Person does not  consent to an assessment?

After compulsory school age (the end of the academic year in which they turn 16), the young person has the right to make requests and decisions under the Children and Families Act 2014. In any instance where the young person refuses an assessment for Adult Social Care then the local authority is not required to carry out the assessment.

However, under the Care Act 2014, the assessment for Adult Social Care can proceed without consent of the young person if it is deemed that the young person lacks capacity to refuse the assessment and it would be in their best interest to be assessed. A capacity assessment can be carried out to establish whether a young person has the capacity to make the decision to refuse an assessment. The young person will still be involved as much as possible in the assessment. 

Do You Pay for Adult Social Care?

The assessment itself and any information and advice is free. 

The services a young person receives as a result of the assessment may not be free. Adult Social Care is means tested (with a few exceptions) so depending on the young person’s  financial circumstances, they may have to contribute to the cost of any support provided.

A financial assessment is completed. To find out more about choosing/paying for care Paying for your care, legal and advocacy | Bedford Borough Council

Bedford Borough Adult Social Care 

Adult Social Care includes a range of personal and practical help for people over the age of 18 who need support, to stay as healthy and independent as possible, to stay included in their local community and to maintain contact with their families and friends.

Adult Social Care also provides support to carers, whether or not they live with the person they care for.

Please click here for more information 

Below are some frequently asked questions by parents/carers and young people.

Do my rights and responsibilities change as my child becomes an adult?

When your child becomes 16 they can make decisions for themselves and those working with your family must take into consideration those views. However this does not mean you can no longer play an active role in their ongoing support.

What are the legal differences once my child reaches 18 years?

Once a person reaches 18 they become an adult in their own right and will be assessed independently of their parents in regards to a number of areas, including support needs, housing requirements and benefit entitlement.

If my child will have to make decisions about their future, how can I support them to do this legally?

'Mental capacity' is the legal way of describing someone’s ability to make a decision or act for themselves.  The Mental Capacity Act has been put in place to ensure that those people who are unable to make decisions for themselves are protected.

If my son/daughter and I disagree about which options to choose, who can help them communicate what they want and make sure it happens?

As part of the transition process, the care manager will work with your son/daughter and you to explore the options available.  If you do not agree with the outcome of the assessment and support planning process then you would be able to discuss this with the relevant manager within Adult Social Care.  Independent Advocacy support may also be an option if required for you or your son and daughter.

What are the relevant laws in relation to this?

• Mental Capacity Act 2008
• Care Act 2014
• Children and Families Act 2014

Moving from children's to adult health services

In healthcare, the word transition is used to describe the process of preparing, planning and moving from Children's (paediatric) health services to adult health services. Transition should be a gradual process that gives young people, and everyone involved in the care of the young person, time to get ready to move to adult services and discuss what healthcare needs are required as an adult.

When young people transition to adult health services the aim is to ensure that any assessment of need is completed as early as possible and enable a seamless move to appropriate universal and specialist healthcare. Importantly, this includes identifying services that may no longer be available once someone reaches 18 and putting in place alternative healthcare support for young people, and their families, to achieve identified outcomes. 

Those who may have a greater need within health service transitions could include:

• young people in receipt of children’s continuing care funding that move to adult continuing healthcare services and funding;
• young people accessing child and adolescent mental health services moving to adult mental health services; and
• young people with an Education, Health & Care (EHC) Plan that identifies other health service in order to meet assessed needs and outcomes.

Getting ready to transition to adult health services

A health worker will discuss whether a young person may need care and treatment from adult health services. Discussions will usually start when a young person is between 14 and 16 years old.

Where young people are going to move into adult services, both children's and adults service health workers will work together to plan this transition.

Transitions to Adult Mental Health

Some young people supported by Child and Adolescent Mental Health Services (CAMHS) may need help from mental health services as they move into adulthood. We want to ensure that the transition to adult services is well organised and young people are well supported.

CAMHS has:

• recruited Transition Support Workers to help the process of transition from CAMHS to adult mental health services
• updated the Transition policy and
• worked with young people to prepare a leaflet called ‘All About me’ to ensure young peoples’ needs and wishes are identified as they move into adult services.

NHS - transition to adult mental health services

Resource - a checklist to a good transition

corp_pol_transition_to_adult_services_1_1.docx (live.com)

Help to get the right Support

Get Your Rights explains how to get the most out of the NHS and your rights when making decisions and choices about healthcare.

Young people with complex health needs

Up to age 16 or 18 a paediatrician usually coordinates the health needs of young people with multiple or complex conditions.  After 18 this passes to your GP who will arrange any additional health support.

If you are a teenager with very significant health needs you should ask for an Adult Continuing Health Care Assessment. You should ask for this before you are 18 to allow enough time to complete the assessment and to have any discussions about the care you are entitled to for more information about continuing health care click here