How the views of disabled children are informing short breaks provision in Enfield

Council for Disabled Children case study about commissioning short breaks. Written by Clare Redrupp, Centre Worker Manager, Joint Service for Disabled Children.

Many of the children we work with at Cheviots, a specialist Children's Centre, have complex disabilities and use non-verbal communication. We wanted to ensure that the services that we provide are the services they want and that our commissioning decisions are the decisions they would want us to make. This means making sure that we purchase the equipment they want to have, plan outings that they would choose for themselves and that we organise and train our staff to meet their needs and wishes.

To ensure children and young people with complex communication needs are supported to inform and influence commissioning and service development we needed to come up with a new way of understanding their views.

My colleague Lucy Canton (who is a centre worker) and I designed a new consultation tool, in the form of an observational questionnaire. The questionnaire includes seven questions and is designed to be completed with each individual child by a member of staff who works with the child and knows them really well. Each questionnaire was completed with the child as part of the activities in their usual after-school session or play scheme. 

Undertaking the observational questionnaire  involves  understanding the child's subtle body language, using pictures as a way to support the children to communicate their preferences and observing them in their activities. It also relies on the individual staff member to use their knowledge of the child and the communication skills they have developed to get valuable feedback. The member of staff answered the questions in detail, giving reasons for their answers based on their observations and prior knowledge of the child.

In practice, the observational questionnaire took a lot longer to complete than we had planned. Staff wanted to ensure that they had quality information which meant that they spent a lot of 1:1 time with each child to get as much feedback from them as possible. Staff enjoyed having this 1:1 time and it was clear from the children's responses that they were having a positive experience.

When we brought all of the data together (from 80 questionnaires) we learned a huge amount about the makeup of the group of children we are working with and what their wants and needs are. We had a strong sense that we were really empowering the children by supporting them to share their views. 

The findings from the questionnaire have led us to change the way we structure our groups as the children we work with have extremely different types of needs. We found that some children really benefit from being in a larger group of children with different types of needs whereas some children with multi-sensory needs prefer to have more focused time together in a smaller group.

It was also clear that the children benefited from 1:1 time with staff. We have decided to invest in further developing our staff skills by commissioning training on intensive interactions to support enhanced communication, interaction and engagement with all of the children we work with. We are also thinking more creatively about how to structure sessions so that children have both 1:1 and group time.

The views of our children have now informed how we will use our resources. For example, we had planned to invest our resources to buy more equipment for the children to use at the centre. However it was overwhelmingly clear that the children would choose to have outings such as swimming, cinema and trips to the seaside which we currently only do occasionally due to the cost. We will need to find a more cost effective way to include these activities in our regular offer for our children.

Pauline says:

"U was engaged and smiling for most of his session. U enjoyed playing with cars, trains, noisy toys, outside in the music garden with the water feature and in soft play. I know he enjoyed these things because he concentrated on them and chose to do them. He would also smile whilst doing them. U was laughing when I played peek-a-boo with him."

Reflections and next steps

This was a powerful piece of work which we will definitely repeat in the future to inform how we use our resources within the service.

We are currently planning how we will implement the findings from the observational questionnaires and are considering how we might replicate the process to inform commissioning and decision making for other settings.

We have always worked hard to get feedback from children and young people, but this project has ensured that we are getting the views of all children.

The findings of this consultation have been presented to Enfield's Children with Disabilities Partnership Board, chaired by the Director of Children's Services and attended by the Lead Member for young people with disabilities. Information gathered will be used to inform our future commissioning strategy.

Our learning will be shared at both parent, and young people's forums. It has been published in our local short breaks magazine, and will be shared in Enfield's Local Offer as feedback and an example of continuous improvement.

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