Underpinning knowledge
Transition social workers need to understand the theories and techniques any social worker would use, child and adult social care legislation, and that adolescence is a distinct phase of development.
Challenges we face
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Understanding adults’ and children’s social workOpen
An inescapable challenge for any service supporting young people who are preparing for adulthood is that it involves practitioners knowing about laws and policies relating to both children’s social care and adults’ social care. The two different branches of social work have separate knowledge and skills statements, and social work training typically encourages a degree of specialisation between children’s and adults’ services, meaning practitioners can quickly lose familiarity, and therefore confidence, with the laws and policies of the ‘other’ part of social work.
A good example of this is the Mental Capacity Act. It straddles the transition age bracket, as it kicks in when people turn 16. Nonetheless, children’s social workers supporting young people with disabilities report a lack of confidence in using it, not least because many are not trained to do so, on the assumption that it is for adults’ services to engage with. This lack of exposure to particular laws feeds into to attitudinal differences between children’s and adults’ services as well, which we shall look at more in Right values, skills and attributes.
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Understanding educationOpen
Social workers need therefore to understand the legislation which shapes social care throughout the lifespan, but will also need to engage with the structures and policies of the education system, which can feel entirely unfamiliar. As we explore more in Supporting the person through the system, the transition social work role can also involve engaging with the switch from paediatric to adult healthcare, which brings in another area to grapple with. Even if we limit the knowledge a social worker needs just to laws, policies and local systems, there is a lot to absorb.
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Children one day, adults the nextOpen
Social workers, employed by local authorities that divide services into children’s and adults’ departments, often view people through the same binary, child/adult lens. This is natural – our laws and systems reinforce it all the time. But the group of people who are preparing for adulthood are adolescents, and that is a distinct developmental phase. Clearly, social workers who support people with learning disabilities will be working with people whose development sometimes follows an atypical course, but it remains important that social workers understand that the people they are serving are not (except in law) simply children one day and adults the next, but are progressing through a period of change.
Making it better
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Legal frameworkOpen
Social workers need to understand the laws which shape the support that they offer to both children and young adults with learning disabilities. Four main laws operate here: for children, the Children Act 1989 and the Children and Families Act 2014; for adults (and for those approaching adulthood), the Care Act 2014 and the Mental Capacity Act 2005. Underpinning all of these is the Human Rights Act 1998, and a key message of the NSW work was that good social workers – supporting people of whatever age – have an understanding of the Human Rights Act, and the ability to use it to promote the rights and wellbeing of the people they serve.
To develop an in-depth understanding of these laws, there is of course no substitute for decent training and – more importantly – lived experience of putting the laws into practice. As a starting point, we set out here the main aspects of the laws, in particular those aspects which relate to people who are nearly or newly adults.
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Children Act 1989/2004Open
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Children and Families Act 2014Open
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Care Act 2014 Open
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Care Act and Children & Families Act – how they overlap Open
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Mental Capacity Act 2005Open
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Human Rights Act 1998 Open
This practice framework and guidance is focused on supporting young people with learning disabilities as they prepare for adulthood. Clearly, some of those young people will also experience mental ill-health to the extent that they become subject to the Mental Health Act, but because the Act is, at the time of writing (June 2019) undergoing a major review, and because the transition from Child and Adolescent Mental Health Services (CAMHS) to adult mental health (AMH) services is a different pathway to the one addressed here, we are not looking further at the Act. Useful links are however included in the Resources section below.
DiagnosesAs well as the laws that frame what they do, social workers need to know about the issues and challenges facing the young people they are supporting. To a great extent, clearly, these will depend on the individual young person, and we look in more detail at really getting to know the individual in Focus on the person. But sometimes social workers – rightly wary of generalising, and perhaps anxious about medical terminologies – pay insufficient attention to the likely implications of a diagnosis of, for example, autism, Down’s syndrome, or Rett syndrome.
In particular, social workers in transition services should be prepared to learn about conditions which limit the life expectancy of many children, and which therefore may not often be supported in adults’ services; and about degenerative childhood conditions, where young people may not have had care and support needs in childhood, but have developed them as they enter young adulthood.
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Understanding adolescenceOpen
In many places, the services supporting people with learning disabilities bluntly divide them into children or adults. This is unsurprising; the law itself categorises everyone as a child or an adult, with the switch from one state to the other occurring on one’s eighteenth birthday. Social workers should understand, however, that this binary focus is often unhelpful. Adolescence is a distinct developmental phase. A 17-year-old is very different from a 7-year-old, whatever their condition or disability, and similarly an 18-year-old is not the mature adult that someone 30 years their senior may be.
Adolescence often brings with it certain behaviours, such as risk-taking. This, as Research in Practice for Adults (RiPfA) has recently demonstrated in its ‘Transitional safeguarding – adolescence to adulthood’ briefing, has implications for safeguarding which call for a more nuanced response than is allowed for by a child-one-minute, adult-the-next approach. Even where structures mitigate against it, social workers need to understand that preparing for adulthood is a process, not an event, and support people accordingly.
The changes to SEND provision have prompted many areas to move towards 0–25 teams for social workers, or for multidisciplinary professionals. As we comment elsewhere, there is no clear indication which team model works best for young people, but the 0–25 model would at least seem to mitigate against the stark child/adult changeover. Similarly, teams that include people with experience of children’s social work, and those with experience of working with adults, have the potential for useful sharing of knowledge and skills, and have been commented on favourably when we have spoken with social workers about how they best operate in this territory.
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TheoriesOpen
Of course, any social worker should be familiar with, and able to use, key theories and concepts associated with their work. Expounding on them here is beyond the scope of this resource, but approaches such as person-centred and strengths-based working; systems theories; ecological approaches; and task-focused work all have a role to play in supporting young people as they prepare for adulthood. Social workers should be aware of them.
Top tips
- Promote social work understanding of key legislation: the Children Act 1989 (and 2004); the Children and Families Act 2014; the Mental Capacity Act 2005; the Human Rights Act 1998; and the Care Act 2014.
- Understand the overlaps between the Care Act and the Children and Families Act.
- Look beyond traditional training: consider shadowing, team discussions and mentoring as ways of building legal knowledge across and between services.
- Services must create time and opportunities for social workers to understand adolescence.
- Services must create time and opportunities for social workers to understand the different conditions experienced by the adolescents they support.
- Services should support a culture in which key social work theories and concepts are actively considered, debated and used.
- Team structures and systems should be considered which support a range of knowledge and experience, covering children’s and adults’ social work.
Legislation, statutory guidance, resources and tools
Legislation and statutory guidance
- Care Act 2014 (HM Government, 2014)
- Care and support statutory guidance (Department of Health and Social Care, 2018)
- Care and support statutory guidance: Chapter 16. Transition to adult care and support (Department of Health & Social Care 2018)
- Children Act 1989 (HM Government, 1989)
- Children Act 2004 (HM Government, 2004)
- Children and Families Act 2014 (HM Government, 2014)
- Guide to the Care Act 2014 and the implications for providers (Local Government Association, 2015)
- Human Rights Act 1998 (HM Government, 1998)
- Mental Capacity Act 2005 (Department of Health, 1998)
- Mental Health Act 1983: code of practice (Department of Health, 2015)
- Special educational needs and disability code of practice: 0 to 25 years: statutory guidance for organisations which work with and support children and young people who have special educational needs or disabilities (Department for Education and Department of Health, 2015)
- Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children (HM Government, 2018)
Resources
- A quality- and rights-based framework for professionals involved in education, health and care plans (EHCPs) for disabled children and young people (RIP STARS, 2018)
- BASW human rights policy (BASW, 2015)
- Building independence through planning for transition (NICE and SCIE 2017)
- Care and support statutory guidance’: Chapter 16. Transition to adult care and support (Department of Health and Social Care, 2018)
- Extending personal adviser support to all care leavers to age 25: statutory guidance for local authorities (Department for Education, 2018)
- Knowledge and skills statement for approved child and family practitioners (Department for Education, 2014)
- Knowledge and skills statement for social workers in adult services (Department of Health, 2015)
- Mental health service transitions for young people (SCIE, 2011)
- The role of social care in implementing the Children and Families Act 2014: A two part guide for strategic leaders, frontline managers, social workers and staff working with children and young people with SEN/Disability age 0–25 (Council for Disabled Children, 2014)
- The young person's guide to the Children and Families Act 2014 (Department for Education, 2014)
- Transition from children's to adults' services: QS140 (NICE, 2016)
- Transitional safeguarding: adolescence to adulthood: strategic briefing (RiPfA, 2018)
- Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children (HM Government, 2018)
Tools
- Care Act 2014 learning materials (Skills for Care, 2014).
- Guidance on changing organisations (British Institute of Human Rights)
- Human rights in health and social care (Equality and Human Rights Commission, 2018)
- Mental Health Act (NHS England)
- PfA factsheet: The Mental Capacity Act 2005 and supported decision making (Preparing for Adulthood, 2014)
- Safeguarding during adolescence: the relationship between contextual safeguarding, complex safeguarding and transitional safeguarding (RIP, 2019)
- Transitions in mental health care: a guide for health and social care professionals on the legal framework for the care, treatment and support of young people with emotional and psychological problems during their transition years (Young Minds, 2011)
- Using the Mental Capacity Act
Preparing for adulthood: The role of social workers
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