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Contents

1. Introduction 
2. Allocation 
3. Linking the Assessment Criteria  
4. Joint Reviews 
5. Allocation of Cases where Funding is an Issue 
6. Disputes 

1. Introduction

It is generally accepted that children infected/ affected by HIV are Children in Need.  It was agreed to establish a protocol for joint work between Physical Disability and HIV Team because it is recognised that the needs of children differ from the needs of adults.  A protocol will bring together the expertise of the two divisions in order to provide the best possible service to children and families affected or infected by HIV.

The Physical Disability and HIV Team offers a service to people infected/affected by HIV who live in Kensington and Chelsea area, or who attend the treatment centres at Chelsea and Westminster hospital.  For Borough residents, the team will provide an assessment and care management service, which will include liasing with voluntary organisations, and spot purchasing and monitoring home care services.

Infected/affected children are often allocated to a social worker either in the Physical Disability and HIV Team or the Family Services team on the understanding that their needs will be assessed and reviewed.  This may be by joint work and/or consultation.

2. Allocation

Allocation to Family Services social worker is desirable when:

1. The families have a high level of need
2. There are child protection issues.
3. When parents are unable to meet their child’s needs and the child is at risk of Significant Harm
4. The child’s needs are in direct conflict with those of the adult
5. When parents need to make future plans for children including life story work
6. When there is a need for child be temporarily Accommodated during the period of parental ill health

Allocation to Physical Disability and HIV Team is desirable when:

1. An assessment shows the adult needs a social worker in his/her own right

There will be occasions when there is no Disability and HIV Team social worker involved, and the Family Services social worker should refer their duty social worker for advice on the needs of adults and available services.

3. Linking the Assessment Criteria

We suggest the following criteria should be used when determining which team should carry out which assessment.

Criteria for joint assessment

When the parent or caregiver in a family has an AIDS defining illness, or has symptomatic illness, which is affecting his/her ability to care for his/herself and the children, we propose a joint assessment should be undertaken.  In these circumstances, there is likely to be a need for both personal care for the adult and for extra help towards caring for the children.

Criteria for assessment by Family Service Teams only

Where a parent or caregiver in the family is HIV symptomatic but is fully self-caring, but is expressing difficulty in caring for his/her children, we propose that the assessment should be carried out by the Family Services teams only.  The assessor should ensure the family have information about the Physical Disability and HIV Team and the services they offer.

Criteria for assessment by the Health Team only

Where a parent or carer in the family clearly expressed that he/she has no concerns about his/her ability to care for the children, or clearly expressed that he/she does not want the Family Services team involved we propose that the assessment should be carried out by the Physical Disability and HIV Team only, but the assessor should ensure the families are given information about the Family Services team and the services available to allow them to contact them at a later date.  If the Physical Disability and Health Team members have any concerns about the care of the children by the parent or caregiver, then they should consult their manager and consider a referral to the Family Services team.

4. Joint Reviews

Should either team be involved with family when the need for involvement of the other team becomes apparent, we suggest the other team should be invited to a review meeting with a view to establishing joint working arrangements.

5. Allocation of Cases where Funding is an Issue

We would recommend the cases be held jointly by both teams when there is a joint funded package, and by the team purchasing care when this is done on individual basis.  On a joint funded package it may be appropriate to have one worker acting as lead worker to facilitate communication with the family and to reduce duplication of work by the teams.  Which worker is chosen would depend on the following factors:

• Level of what each worker’s previous involvement with family
• A joint agreement about which team’s issues are to the fore
• Any preference expressed by the family

Criteria for joint funding of the care package packages/support for family

Following a joint assessment there will be inevitably rise questions of who should fund which part of resultant care package.  It would be therefore helpful to have agreed procedure for this.  These criteria will only apply when a joint assessment or review has taken place, as neither team can commit the other to any spending without their involvement in the assessment/review.

Model 1: task by task funding

1. Where the care package contains only personal care for the parent or carer, the care package should be funded by the Physical Disability and HIV Team
2. Whether care package contains only care to support the care of the children, for example: escort to school, homework support, or play scheme, the Family Services team should fund the package.
3. Where a care package contains both personal care for the parent or carer and support to care for the children, care for the parent or carer should be funded by the Physical Disability and HIV Team, and care to support the care of the children should be funded by the Family Services team. The care that benefits both the parent and carer and the children (for example meal preparation and house work) should be funded 50/50 by the two teams.

Model 2: 50/50 funding

1. When the care package contains only personal care for parent or carer, the Physical Disability and HIV Team should fund the care package.
2. Whether care package contains only care to support the care of the children, the package should be funded solely by the Family Services team.
3. Where a care package contains both personal care of the parent or carer and care support care of the children, the whole package of care in the home should be funded 50/50 by the two teams.

6. Disputes

Should be resolved at team manager level and if necessary a professionals meeting should be called.

End