Deciding Whether to Start Transition (Transition to Adult Care and Support)

1. Using this Procedure

This procedure should be used by any practitioner working with a young person under the age of 18 when establishing whether or not to carry out a child's needs assessment under Section 58 of the Care Act.

If you are working with a young adult who is already 18 an adult needs assessment should be carried out, having full regard for all information that has already been gathered in any previous assessment, Education Health and Care Plan or Transition Plan.

If you are working with a carer (adult or young) who is approaching transition, see: Deciding Whether to Start Carers Transition.

2. The Purpose of a Child's Needs Assessment

Under the Care Act the purpose of a child's needs assessment is;

1. To understand what the young person's needs are now;
2. To understand what the young person's needs are likely to be after the age of 18; and
3. To understand the support that the young person will need to enable a smooth transition to adult Care and Support.

A good assessment will also;

1. Support young people and families to understand their strengths and capabilities within the context of their situation;
2. Support young people and families to understand the support that may be available to them within the community or through other networks and services; and
3. Support young people and families to consider some of the different ways that the Local Authority may be able to support them (other than through a formal service).

The information gathered will help the Local Authority to;

1. Make a determination about eligibility for adult Care and Support when the young person becomes 18; and
2. Understand the kind of service provisions that could be explored to meet current and future needs.

3. Likely Need and Significant Benefit

A child's needs assessment should only be carried out when;

1. The young person has an appearance of likely need from the age of 18; and
2. Carrying out the assessment now would be of significant benefit to them.

If the young person does not have an appearance of need from the age of 18 you need to decide whether carrying out a child's needs assessment will still be of significant benefit to them in terms of planning and preparing for adulthood. Often, carrying out the assessment will prevent, reduce or delay any future need for Care and Support by helping the young person and their family to identify assets in their own communities and networks.

Significant benefit relates primarily to the timing of the assessment and whether the young person will be able to engage in the process and get the most out of it in terms of being able to plan and prepare for adulthood. The following are all things that should be considered;

1. Whether there is sufficient information to be reasonably confident about what the young person's needs will be when they become 18;
2. The stage they have reached at school and any upcoming exams;
3. Whether the young person wishes to enter further/higher education or training;
4. Whether the young person wishes to get a job when they become a young adult;
5. Whether the young person is planning to move out of their parental home into their own accommodation;
6. Whether the young person will have care leaver status when they become 18;
7. The time it may take to carry out an assessment;
8. The time it may take to plan and put in place the adult care and support;
9. Any relevant family circumstances; and
10. Any planned medical treatment.

Where the assessment is not of significant benefit to the young person at the current time, you should agree when a suitable time may be to carry out the assessment and make the necessary arrangements to follow this up when the time comes.

In all cases the young person and their parents must be advised of their right to request an assessment again should circumstances change in the future.

4. Consent and Capacity

From the age of 16

Adult Care and Support interventions (including transition assessments) cannot be carried out unless;

1. The young person is making the request; or
2. The young person has given their consent; or
3. The young person lacks mental capacity and a decision has been made that the intervention is in their Best Interests; or
4. The young person is at risk of harm from abuse or neglect.

Under the age of 16

The Gillick competency test should be used to determine whether a young person under the age of 16 is able to consent to the assessment. To be able to consent the young person must be able to understand what they are consenting to and the implications and likely outcome of consenting.

If the young person is able to consent then the same conditions apply as for a young person over the age of 16 (see above).

Where a young person under the age of 16 is not able to provide consent this should be given by a person with parental responsibility for them. Their mother will always have parental responsibility, and normally the father will as well. Depending on the circumstances other people may also have been granted parental responsibility by the courts.

5. Wellbeing, Prevention and Information

The Care Act places certain duties on the Local Authority whenever it is making any decision about a person with Care and Support needs (including young people going through transition). These are things that you absolutely must consider and are;

1. The impact on the young person's individual wellbeing;
2. Whether any prevention services will delay, reduce or prevent the need for Care and Support (although the duty to provide such services directly does not yet apply); and
3. Whether information or advice can be provided to support the young person to find their own solution, or to delay, reduce or prevent the need for Care and Support.

It is vital that you understand your duties in relation to the above. Please use the links below to access further information as required.

See: Promoting Individual Wellbeing for information about the duty to promote individual wellbeing.

See: Preventing Needs for Care and Support for information about the duty to prevent, reduce or delay needs.

See: Providing Information and Advice.

6. Gathering Information and Consulting with Others

Sometimes consulting with others can be beneficial in making a decision about the benefit of carrying out a child's needs assessment at that time.

The purpose of gathering information and consulting with others

The purpose of consultation and information gathering is to ensure that the response of the Local Authority is a proportionate and appropriate one to the young person's situation and level of need. Only information relevant to this purpose should be gathered and shared during consultation.

All information gathering and sharing should be carried out with regard to the Caldicott Principles, Data Protection Legislation and local information sharing policies.

See: Providing Information about a Carer for further information.

Methods of consultation

The method of consultation and information gathering used should reflect the individual circumstances of the case. Depending on the level of urgency, risk and need consultation and information gathering can be formal or informal in nature.

For example;

1. A telephone conversation;
2. An e-mail or letter;
3. A video conference; or
4. A face to face meeting.

Where the method of consultation is not face to face you should be satisfied that the information you share will only be seen by the person to whom it is intended to be seen.

Where the young person has requested the Local Authority Gather Information or Consult

The Care Act is clear: Apart from cases where the level of risk is paramount you must consult with anyone that the young person has asked you to consult with before making any outcome decision.

Examples of paramount risk could include;

1. Where urgent action is required, that if delayed to allow consultation would place the young person at imminent risk of abuse or neglect leading to serious harm;
2. Where the person to be consulted is deemed to be the perpetrator of abuse and neglect and consulting with them at that time would place the person at imminent risk leading to serious harm;
3. Where urgent Care and Support provision is required, that if delayed to allow consultation would place the young person at imminent risk of harm through the non-meeting of essential needs.

The young person should be told why consultation has not occurred, and long term decision making should be avoided until such time when consultation is possible.

Consulting with Parents

You should consult with the young person's parents when they are under 18 before making any decision about carrying out a transition assessment.

The purpose of doing so is;

1. To gather further information about the needs and situation of the young person; and
2. To understand the needs of their parents in relation to their own continuing role as a carer when the child turns 18.

Where a young person is between the ages of 16 and 18 their consent should be sought. However, even if they do not provide it you must still consult with their parents.

Consulting with Others

You should proactively identify anybody else that it may be appropriate to speak with in order to gather comprehensive information upon which to decide whether to carry out the transition assessment. This could be a family member, a teacher, a health professional, another Local Authority or an organisation (such as a Care and Support provider). Under the Care Act anybody contacted by the Local Authority has a duty to co-operate with any requests for information or support.

See: Co-Operation to read more about the duty to co-operate under the Care Act.

If the young person is under the age of 16 and unable to provide consent to consultation a person with parental responsibility can provide such consent.

Consent to Consult and Mental Capacity (young people aged 16 and above)

With the young person's consent, the Care Act permits the Local Authority to consult with anyone it deems relevant to consult with.

If there are concerns that a young person over the age of 16 may lack capacity to consent to you gathering information from or consulting with others then a mental capacity assessment must be carried out to determine whether this is the case. This should be carried out by the Local Authority because it is the Local Authority who wishes to consult.

If the young person has capacity to consent following the mental capacity assessment their consent must be obtained before consulting others.

If the young person lacks capacity to consent following the mental capacity assessment then a Best Interest Decision must be made to confirm that consulting with others will be in their Best Interests. This decision should be made by the Local Authority because it is they who will be consulting.

7. Making the Decision

Clear outcome

If it is clear to you that a transition assessment either is or is not required, and you are authorised and confident to make this decision you should do so to avoid the young person and their family from experiencing any unnecessary delays.

Unclear Outcome

If it is not clear whether a transition assessment is required or you are not authorised or confident to make this decision you should explain to the young person and their family that;

1. It is not clear from the available evidence whether or not a transition assessment should be carried out; and
2. You need to seek advice from a manager or colleague with the appropriate expertise; and/or
3. You may need to gather further information from others (for example a health professional).

In all cases you should;

1. Assure the young person and their family that their views have been heard and will be considered in any decision that is made; and
2. Agree with the young person and their family when they can expect to hear from you again.

Refusing an assessment

If an assessment request has been made by the young person or their parents the only grounds upon which the Local Authority can lawfully refuse it is when:

1. There is no likely appearance of any need from the age of 18; or
2. Carrying out the child's needs assessment at that time would not be of significant benefit.

It is unlikely that the Local Authority would refuse many assessment requests.

If you do feel that an assessment is not appropriate you should discuss this with a manager before refusing it as you must be sure that the decision to refuse is legally sound.

Whenever you refuse to carry out a child's needs assessment on the basis that the timing is not of significant benefit you must indicate when it may be of significant benefit and make appropriate arrangements to make sure that the assessment is carried out at that time.