Moving on

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How to support young people with complex needs to transition to adult services

High quality transition is critical for the success of placements for children, young people and their families. As the complexity of a young person’s needs increases, they require significantly more support to transition successfully.

However, it is easy to neglect the young people’s own processing and understanding of this critical transition, which often represents them leaving what they have come to understand as “home” and leaving behind friends, familiarity and security.

Key points for a successful transition:

  • start early; start the process of identifying possible services one to two years prior to the transition
  • practise; use small transitions, such as moving class, to establish a young person’s relationship with change
  • ask your local authority to consider a full assessment by your desired provider as soon as possible; this will save time and prevent panic as the deadline for transition looms
  • transitions should be planned by people who best know the young person; ensure that key people who have established relationships with the young person, such as teaching assistants, social care supporters and key workers, are central to the planning and implementing processes; involving families is critical as young people need to know their family understands they have moved to an adult service; future staff should also be involved to ensure consistency
  • think about how much notice to give a young person
  • help the young person to tell their own story of transition; people make sense of big changes by talking through the process with those around them; if a young person is communication impaired or non-verbal, creative ways to enable this process, such as a photobook, will provide meaning
  • share examples of successful transitions afterwards; this could involve young people helping friends move and visiting them in their new setting
  • be prepared for complications; young people need to feel safe and secure during times of change
  • when you have identified the appropriate placement, share as much information as you can with them about the young person; it can be very useful to create a book to pass on, summarising all the good things a young person has learnt; the book ensures each young person’s story moves with them
  • mark transitions; parties are a great way to do this. Make sure it happens as near to the leaving day of the young person as possible, preferably the day before; goodbyes need to come directly before the leaving, otherwise they start to lose their meaning.

Transitioning in

Whilst every transition will be unique, here are a few ideas that should help make things a little easier in the young person’s new home:

  • make sure that a formal and thorough assessment has taken place and you are satisfied that the placement will meet the needs of the young person; ask the provider questions about specifics, such as how much therapy will be given weekly, what level of specialist support will they guarantee as a minimum, and things like who provides clothing and pocket money if it’s residential
  • be completely open about the young person; the right placement will not be put off by negative behaviours but a placement may be unsuccessful if things are not clear from the outset. Bear in mind that any issues will take a little time to settle
  • if time and distance allows, try to have numerous visits to a new placement, both with and without the young person; the new direct support workers should aim to start building a relationship with the young person during these visits
  • introduce familiarity where you can; for young people with sensory impairment, think about sending the bedding from the previous night ahead to the new placement, so that the young person’s room will smell like them. Also, ensure tablet computers, switches and communication aids are passed on quickly so the young person can communicate as they are used to doing and avoid becoming frustrated.

Asher’s story

Asher presents with vision impairment, a learning disability and autism. He is also non-verbal.

Due to autism impairing social imagination, everyone involved in his transition to adult services knew Asher would have huge problems anticipating what would happen and his key workers needed to find out how long he could hold a future event in his mind.

A few years before moving to adult services, Asher moved to a different bungalow within the same service. This provided an opportunity to learn how Asher coped with a significant transition and therefore how he  might subsequently approach his transition to adult services.

Asher had already coped well with a one-week warning that he was going to visit his mother at home. He was given two weeks’ notice that he was moving to a new bungalow to see if he coped with thinking about the future over a longer period. Initially, he managed well, with a lot of support from his key workers, but towards the end of the fortnight he became eager to move. This reaction informed the time-frame that would need to be implemented to prepare him for transitioning to adult services.

The formal preparations for this transition started many months before he finally made the move. Asher’s mother was helped to identify a service she thought was appropriate for Asher. Key workers also worked with adult social services to get funding for the placement, and with the new provider so that they understood Asher’s needs and experiences.

Asher had his first interaction with his new service four weeks before he was due to move out. A staff member from his new placement visited and talked Asher through the story of his new house and the people living and working there using a photo album. Over the next few weeks, more staff from the placement visited Asher so they could get to know each other. An overnight stay at the placement was also arranged for Asher, with a member of staff from his current placement attending for additional support. While he was there, he met the staff and the people living there, and took lots of photos. He used the photos to tell others about the new house, which was a very natural way for him to communicate about his transition.

It is rare for a transition to a new service to go without any kind of a hitch and Asher’s case was no different. After his first preparatory visit to his new house, the news came that funding for the placement had been withdrawn. It was clear Asher was invested in the transition and had already begun to engage with the idea of his new home. Providers of his existing and his new placement worked hard with adult social services to ensure the funding was successfully secured and ready for his move day. It was important that everyone concerned managed to contain their feelings during this period of financial uncertainty so as not to upset Asher.

In the end, Asher’s transition was successful and he continues to do well in his new placement.

Further information

Beverley Samways is Team Leader and Lynn Donovan Transitions Officer at RNIB Pears Centre for Specialist Learning:
www.rnib.org.uk/pearscentre

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