Developing a positive working culture for supporting disabled children and young people with severe complex needs

A quick guide for social workers and social care practitioners

Social care, education and health practitioners should work together to put the views, life goals, ambitions and preferences of the disabled child or young person with severe complex needs at the centre of planning and decision-making. 

This is more likely to be achieved if you are part of a team with a positive culture that
encourages and supports good working relationships.

Having a positive workplace culture is vital to delivering high quality care and support.

Skills for Care

Interagency teams

The key practitioners from social care, education and health who are working together to support the disabled child or young person and their family should form an interagency team.  Everyone in the team may or may not be working at the same physical location.

The team should include practitioners with the skills and experience needed to address all the child or young person’s needs from birth to 25 years. Working relationships between practitioners improve when there is an opportunity to air and resolve disputes. Policies for resolving disagreements within the team and between agencies should be in place. Make sure you are aware of them.

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Positive working culture

Practitioners need to be able to work together for the good of the child or young person. Collaborate with your colleagues in health and education to develop a positive working culture.

Actions that can help this include:

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Taking the time to develop good working relationships with each other.

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Treating everyone involved in supporting the child or young person as equals.

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Encouraging open discussion.

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Being sensitive and constructive when challenging other professionals’ opinions.

You should be given dedicated time for team and relationship building.

Learning together

Training that builds an understanding of the role of the other people and services involved in the care of the disabled child or young person may help develop a positive working culture.

You should:

  • Learn about the responsibilities of other people and services who are supporting the child or young person.
  • Have opportunities to observe practitioners from other sectors working with the child or young person.
  • Use this knowledge to provide more wide-ranging and co-ordinated support and information. This helps reduce the number of different people the family needs to contact.

Short-term observational placements in other sectors may also help you learn more about the needs of children and young people in different contexts, and how other services work to meet those needs.

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Joint training should be available for all social care, education and health practitioners. It should cover:

  • Working with disabled children and young people with severe complex needs.
  • Taking their views into account and supporting them to achieve their life goals.
  • Adapting communication for children and young people who communicate differently.
  • Using communication aids.

Shared workshops where you can learn about the needs present in all settings may also be helpful. These may cover needs such as safe eating and drinking, personal care and language development.

Be aware that if healthcare professionals delegate clinical tasks, training and appropriate arrangements should be in place to ensure the safety of children and young people.

Disabled children and young people, and their parents or carers should be involved in developing awareness training programmes by:

  • deciding what the training will cover
  • deciding how to structure and evaluate it
  • delivering the training.

Your service and manager should make clear and help you understand:

  • how your contributions affect education, health and care (EHC) needs assessments
  • how the contributions of different staff fit together to show what support is needed
  • how your contributions will affect the EHC plan outcomes that will be agreed for the child or young person.

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Key working support

Every disabled child or young person with severe complex needs should have a key worker. The interagency team should work with managers to assign a practitioner to provide key working support. The key worker should:

  • Co-ordinate meetings, timings and records with every person and service involved.
  • Update other practitioners about care changes.
  • Be available for discussions if the child or young person has questions or needs more support.
  • Help the child or young person and their family find and access services.

There should be a contingency plan in place for how consistency of support will be maintained if the key worker leaves.

If you are a key worker, you will be able to fulfil your role more effectively if:

  • The training, time, and resources you need are made available, taking into account your other commitments.
  • Governance and information sharing arrangements are in place to ensure you can work with all the different organisations involved.

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This content has been co-produced by NICE and the Social Care Institute for Excellence (SCIE). It is based on NICE’s guideline on developing a positive working culture for supporting disabled children and young people with severe complex needs.