Protecting Specialist Services for Children with Vision Impairment

1.Protecting specialist services for children with vision impairment Advice for local authorities

The purpose of this leaflet is to ensure that local authority officers understand the importance of maintaining specialist education services for children with vision impairment, as well as the legal implications of making any changes. RNIB would be pleased to advise local authorities on the issues raised in this document.

The impact of vision impairment on learning

Vision is our most powerful sense, providing instant access to information and helping us to make sense of the world around us. It plays a vital part in children’s play and their development of language and social interaction. Most teaching approaches take vision for granted, so making sure that children with visual difficulties achieve their full educational potential can present significant challenges. In order to understand and address these challenges, schools need specialist advice from qualified teachers of children and young people with vision impairment (QTVI). There are many different causes of vision impairment and they affect children’s sight in different ways. The functional effects range from moderate partial sight through to complete blindness. Some eye conditions affect central vision, making it hard to detect the fine details which are part of everyday learning and observation. Others may affect a child’s peripheral vision, making it difficult to find their way around confidently. Some children have patchy vision with a mixture of clear and blank areas and others may see everything as a blur. Wearing glasses may help some children but not all, and glasses alone will not remove the effect of a vision impairment. A small number of children are born with no sight, only some of whom will have the cognitive ability to learn to read and write through braille. Understanding the population

Two in every 1,000 (0.2%) children and young people up to the age of 25 in the UK have vision impairment. This is based on the WHO international classification of childhood vision impairment. This amounts to around 25,000 children and young people under the age of 19 in England, making it a low incidence special educational need and disability (LISEND) which is characterised as follows:

 A need which has the potential to have an adverse impact on learning and development unless additional measures are taken to support the child/young person.  The prevalence rate is so low that a mainstream setting is unlikely to have sufficient knowledge and experience to meet these requirements. Settings will need to obtain specialist support and advice on how to ensure equitable access and progression (against national standards).  The prevalence rate is so low that any formula for allocating specialist resources for additional needs, which is based on proxy indicators of need, will not reflect the true distribution of children and young people identified as having low incidence SEND. National Sensory Impairment Partnership (natsip.org.uk)

There is extensive diversity within the population of children with vision impairment and individual children respond to their visual difficulties in different ways. Severity of visual loss does not necessarily equate to the extent of a child’s special educational need and individual assessment is essential. The following broad points can be made:  Severe vision impairment or blindness can delay early childhood development and learning by up to two years, with some children following an atypical developmental pathway. There is considerable individual variation in the way that children with similar levels of vision may function, depending on other factors such as the presence of additional SEND.  At least 50 per cent of children with vision impairment have additional disabilities and/or special educational needs. Around 30 per cent have severe and complex needs. There is a higher than average prevalence of vision impairment in the population of children with learning difficulties and there is evidence to suggest that many children in special schools have undiagnosed visual conditions.  Blind and partially sighted children are capable of achieving the same range of attainment as sighted children. However, they require appropriate teaching and support in order to do so. Support is needed not simply for academic learning but also to teach children to get around independently and to develop appropriate social interaction and everyday living skills.  Children with vision impairment are at risk of poor outcomes across a range of emotional and social wellbeing indicators and the risks are even greater for children with vision impairment and another disability.  In order to reduce lifelong inequalities, it is important that support for children with vision impairment is provided from birth, throughout childhood and the transition into adulthood. If this support is not received, their development and life chances can be severely limited.

The role of specialist support services

QTVIs form part of a specialist team which also includes teaching assistants, mobility officers/registered qualified habilitation specialists (RQHS) and ICT officers. QTVIs hold a specialist mandatory qualification, the importance of which is recognised by the Department for Education:

6.34 Many children and young people with vision impairment (VI), hearing impairment (HI) or a multi- sensory impairment (MSI) will require specialist support and/or equipment to access their learning, or habilitation support. 6.61 Schools should work closely with the local authority and other providers to agree the range of local services and clear arrangements for making appropriate requests. This might include schools commissioning specialist services directly. Such specialist services include, but are not limited to:  specialist teachers or support services, including specialist teachers with a mandatory qualification for children with hearing and vision impairment, including multi-sensory impairment, and for those with a physical disability. (Those teaching classes of children with sensory impairment must hold an appropriate qualification approved by the Secretary of State. Teachers working in an advisory role to support such pupils should also hold the appropriate qualification.) 2015 SEND Code of Practice

QTVIs carry out a central role in the education of children and young people with vision impairment from birth to 25 years, including  managing referrals from health to education  providing direct support to babies and young children with vision impairment and their parents through home-based learning  assessing children’s functional vision and liaising with health professionals  advising in mainstream and specialist settings on curriculum access, independent learning and social inclusion  guiding the work of other professionals such as teaching assistants  teaching specialist skills (for example braille) to children and developing the visual and communication skills of those with additional or complex needs  supporting students through transition into post-16/FE education and independent adulthood.

A Registered Qualified Habilitation Specialist (RQHS) or mobility teacher/ habilitation worker should also be available to teach children and young people how to move around more independently and how to do practical everyday tasks for themselves. All children and young people with vision impairment should receive an initial assessment of their mobility and independence needs carried out by a RQHS.

Habilitation training has two main aims:  Maximising the personal independence of a child/ young person with visual needs (and other needs) ready for their life as a young adult.  Preparing a young person for moving on to college, university, apprenticeships or work, as an independent young adult. Considerations when making decisions that may impact on services There are a range of considerations and legal requirements to take into account when making any decisions that may impact on specialist education services for children with vision impairment. RNIB supports the following key steps identified by NDCS in their publication “Protecting specialist education support services for children with hearing impairment: Advice to local authorities”.

1) Assessing and auditing provision To ensure you are making fully informed decisions, you need comprehensive and up-to-date data on children with vision impairment in your area  The total number of babies, children and young people in your area, their age, and educational settings.  The needs of the children in your area, and their families. This will include information on level of vision impairment, additional disabilities and use of additional languages.  The educational outcomes achieved by children in your area and whether the results are in line with those of other children. The National Sensory Impairment Partnership (NatSIP) has developed a range of tools to help identify outcomes and how services are adding value (natsip.org.uk).  Data on blind and partially sighted children’s destinations and whether these are in line with those of other children  The provision (including resource provisions and special schools) that is available both within and outside your local authority and how this provision matches government quality standards.

Section 22 of the Children and Families Act 2014 requires local authorities to identify all children in its area who may have a special educational need or a disability. Information on the number of children may be available from your local authority’s register of disabled children. Local authorities have a duty to maintain such a register and, in a ruling against Warwickshire local authority, a judge stated that

“Plainly unless this local authority has such a register and knows more or less precisely how many disabled children there are in the county it cannot make a fully informed decision about budgetary allocation or as to the terms of a proposed Local Offer.” (bit.ly/1kgSHli) (2015)

The particular importance of data to plan for the needs of children with sensory impairment is recognised in the SEN and Disability (SEND) Code of Practice.

3.28 Data-sets include but are not restricted to:  use of out-of-area placements for those with low-incidence needs  local data on disabled children from the register of disabled children in their area (including those with impaired hearing and vision) which local authorities are required to keep under Schedule 2 of the Children Act 1989. Local authorities should ensure that registers of disabled children and young people, and particularly details of those with a vision or hearing impairment, are kept accurate and up to date, as such low-incidence needs are particularly difficult to plan for from national data sets. 2015 SEND Code of Practice

The register of children and adults who are blind and partially sighted is an important source of local data on children and young people with severe sight impairment (SSI) or sight impairment (SI). For those who are eligible and their families, registration provides practical and financial benefits. Statutory guidance sets out that registers should be used to help with service planning. However, it is important to note that the duty to plan services also extends to people, including children and young people, who may not be certified or registered.

“22.14. Local authorities should note that there will also be people who have a reduced/low vision but do not meet the criteria for certification who may need to be considered in service planning.” (Care Act 2014)

2) Arranging provision

The Equality Act 2010 places a duty on local authorities to make reasonable adjustments – including through the provision of auxiliary aids – to ensure that disabled children are not placed at a substantial disadvantage. This duty is anticipatory and applies equally to local authorities as it does to education settings. Section 27 of the Children and Families Act also requires local authorities to keep provision for disabled children under review to ensure it is sufficient to meet their education, training and social care needs. Disabled children and their parents must be consulted as part of any such review, as well as in any work to develop your Local Offer. Where a child with vision impairment has been identified as having a special educational need, local authorities are required under the Children and Families Act 2014 to make sure that the child receives the support they need to facilitate their development and achieve “the best possible educational and other outcomes”. Local authorities are also required to assess their needs and, if necessary, determine through an Education, Health and Care Plan (EHCP) what provision is needed to meet those needs. These services cannot be withdrawn without a reassessment of a child’s needs.

9.49 In seeking advice and information, the local authority should consider with professionals what advice they can contribute to ensure the assessment covers all the relevant education, health and care needs of the child or young person. Advice and information must be sought as follows (subject to para 9.47 above):  If the child or young person is either vision or hearing impaired, or both, the educational advice and information must be given after consultation with a person who is qualified to teach pupils or students with these impairments 2015 SEND Code of Practice

Not all children with vision impairment require an EHCP and many can succeed at the level of SEN support, as long as the specialist support they receive reflects their assessed needs. However, there is a risk that financial pressures may encourage local authorities to view children on SEN support as less deserving than those with the statutory protection of an EHCP. Any reduction in specialist support to children or young people with vision impairment should only take place on the basis of a change in their assessed needs, not the SEND category in which they sit. Reducing support to children on SEN support is likely to trigger more requests for statutory EHC needs assessment, which in turn is likely to add to spending in the medium term and thus prove to be a false economy.

3) Ensuring the funding system delivers help where it is needed

Because vision impairment is a low incidence disability, children are unevenly distributed across the population. There is therefore no funding formula using proxy indicators of need which enables funding to ‘follow’ the child with vision impairment. RNIB believes that funding for specialist education support services for children with vision impairment should be held centrally by local authorities. The danger of delegating this funding to schools is well recognised by Ofsted.

“The delegation of funding for support services had a negative effect on the provision for some pupils with SEN. It diminished the capacity of many LEAs to monitor the progress of pupils with SEN and reduced the range and quantity of specialist staff available to provide advice and support.” Ofsted (2005) Inclusion: The impact of LEA support and outreach services.

The Department for Education has recognised the risks that arise from delegation of funding for services for children with low incidence needs. In successive announcements, the Department has acted to ensure that funding for these services would not be recouped from the Local Authority Central Spending Equivalent Grant (LACSEG) as a result of the Academies programme.

4) Considering the impact of proposed changes

Conducting full impact assessments will not only help you identify any risks or unintended consequences that may negatively affect children with vision impairment, but will also allow you to consider in detail any actual savings that are likely to be made. It is important to be aware that, in many cases, other factors may conspire to reduce the original savings expected. Any proposed changes to services must meet the obligations set out under the Equality Act 2010 to promote equality of opportunity between disabled persons and other persons and to take steps to take account of a person’s disability. Local authorities must demonstrate they have had due and specific regard to how any changes will impact on children with vision impairment. This will require the local authority to provide an audit trail or documentation to demonstrate this.

Department for Education guidance on the Act can be found at: bit.ly/1P2rxf1

Though there has never been a specific requirement to produce an equality impact assessment, it is a common way of demonstrating that due regard has been had. RNIB recommends that this assessment is carried out where any changes are being proposed that may impact on services for blind and partially sighted children.

4.19 Local authorities must keep their educational and training provision and social care provision under review and this includes the sufficiency of that provision. When considering any reorganisation of SEN provision decision makers must make clear how they are satisfied that the proposed alternative arrangements are likely to lead to improvements in the standard, quality and/or range of educational provision for children with SEN. 2015 SEND Code of Practice

This restates what is known as the “SEN Test of Improvement” and should be applied to any proposed change to provision. Where provision is not sufficient, this may lead to requests for more out-of-area placements which could increase costs in the medium-term.

5) Co-production and consultation

Regular and ongoing consultation with children and young people with vision impairment, parents and professionals is not just best practice: they may have their own suggestions and ideas for smarter working.

1.12 Effective participation should lead to a better fit between families’ needs and the services provided, higher satisfaction with services, reduced costs (as long-term benefits emerge) and better value for money. 2015 SEND Code of Practice

The involvement of parents and young people is now a requirement under section 19 of the Children and Families Act. This applies to decisions about individual support but also about local provision more generally. Before making any changes to services you should seek the views of children and young people with vision impairment, their parents and the professionals who work with them. The law requires that any consultation allows respondents to make an informed response, ensures adequate time for responses, genuinely takes responses into account and is conducted with an open mind. Section 4.12 of the SEND Code of Practice establishes some principles on how to ensure that young people are able to effectively engage with any consultations.

6) Improving efficiency and effectiveness

Joint commissioning between local authorities This is recognised in the SEND Code of Practice as an effective way of meeting the needs of children and young people with highly specialised and/or low incidence needs, such as vision impairment.

3.68 Partners should consider strategic planning and commissioning of services or placements for children and young people with high levels of need across groups of authorities, or at a regional level. The benefits include:  greater choice for parents and young people, enabling them to access a wider range of services or educational settings  greater continuity of support for children and young people in areas where there is a great deal of movement across local authorities (for example, in London)

2015 SEND Code of Practice

RNIB strongly encourages local authorities to consider regional commissioning as a way of delivering better services whilst achieving valuable economies of scale. Many local authorities attempt to meet the needs of all children and young people with vision impairment with just one or two QTVIs. It is highly unlikely that such a small team will have the range of skills and expertise needed to support the inherently diverse needs of this population. Joint commissioning between education, health and social care Section 26 of the Children and Families Act introduces a requirement for local authorities and health bodies to work together to jointly commission services for children with SEN and disabilities. As the SEND Code of Practice sets out, integration of services across education, health and social care can improve the quality of provision for disabled children. In relation to blind and partially sighted children, consideration might be given to joint commissioning between eye clinic and education services. This could lead to a better quality of support for children with vision impairment, particularly in relation to the low vision devices they use, and a better continuity of support from diagnosis onwards.

Consideration might also be given to joint commissioning between social care and education. Again, this can help ensure that families receive more support to help their child develop appropriate skills, for example in independent mobility and habilitation. Checklist

RNIB maintains that local authorities need clear answers to the following questions before they approve any decisions to make changes to specialist education support services for children and young people with vision impairment.

 Do you have reliable figures on the number of children and young people who are blind or partially sighted in the area, their educational progress, the outcomes they achieve and their post school destinations?  Have you audited existing provision to check compliance with relevant quality standards?  In proposing any changes, can you demonstrate that you have had due and specific regard to the needs of all children and young people with vision impairment and the impact on their educational progress?  Can you demonstrate that the proposed arrangements are likely to lead to improvement in the standard, quality and/or range of educational provision for blind and partially sighted children?  Have you consulted with blind and partially sighted children and young people and their parents on any proposed changes and demonstrated that you have taken due regard of their views?  Have you considered joint working with other local authorities to maximise the benefits from economies of scale while improving the quality of education and range of settings available to children and families?  Have you sought advice from your local authority compliance officer to confirm that your proposals and the way in which they have been developed are not open to legal challenge?