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1.2.7 Protocol for Referrals to Child Health and Disability Teams (CHAD)


This procedure explains how the Child and Health Disability (CHAD) Teams will support disabled children, young people and their families living in Leeds. This includes the Regional Specialist Team and the CHAD Occupational Therapy Team.

This chapter was re-written and added to the manual in August 2022.


Caption: contents list
1. The Children’s Act 1989; Definition of a Child in Need and Disability
2. The Equality Act 2010; Leeds City Council Definition of a Disability
3. Which Children and Young People does CHAD work with?
  3.1 What is the Regional Specialist Team and what do they do?
  3.2 What is the CHAD Occupational Therapy Team?
4. Referrals to CHAD
5. Assessment

1. The Children’s Act 1989 Definition of a Child in Need and Disability

The Children Act 1989 sets out the duty of every local authority to provide services for children in need, their families and others in order to:

  • Safeguard and promote the welfare of children within their area who are in need: and so far as is consistent with that duty, to promote the upbringing of such children by their families, by providing a range and level of services appropriate to those Children’s needs.

A child is defined as a child in need if:

  • They are unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority;
  • Their health or development is likely to be significantly impaired, or further impaired, without the provision of such services; or
  • They are disabled.

The Children’s Act definition of disability states that:

'A child is disabled if s/he is blind, deaf or dumb or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed. (Development means physical, intellectual, emotional, social or behavioural development; and health means physical or mental health)'.

2. The Equality Act 2010; Leeds City Council definition of a Disability

Leeds City Council applies The Equality Act 2010 definition of a disability:

'A person has a disability if s/he has a physical or mental impairment which has substantial and long-term adverse effect on their ability to perform normal day to day activities'.

3. Which Children and Young People does CHAD work with?

Leeds Social Work Service makes a distinction between general Children in Need services and the needs of children with severe or profound disabilities and provides a specialist service for this group.

To be offered a service by the specialist CHAD teams, the child or young person must have a disability that has been formally diagnosed, and be permanent or long term and meets at least one of the following criteria:

  • Children with Cerebral Palsy, Muscular Dystrophy and other physical disabilities that significantly impact on the child's well-being;
  • Children and young people with severe learning disabilities;
  • Children and young people with a diagnosis of Autism with associated learning disability which has a significant impact on their communication needs, social and behavioural development;
  • Children and young people with multiple or severe disability;
  • Children and young people with severe global development delay;
  • Children and young people with severe sensory impairment; and
  • Children and young people with complex physical disability and health needs.

In situations where it is not clear whether or not a child/young person meets the above eligibility criteria there will be a discussion between a manager of the CHAD Service and a manager of other teams within Children's Social Work Service to establish if any joint or co-working is required.

Children who do not meet the eligibility criteria for a service from the CHAD Service may be entitled to services as Children in Need and may be referred to other teams within Children's Social Work Service.

3.1 What is the Regional Specialist Team and what do they do?

The Regional Specialist Team provides emotional and practical support to children and young people with specific medical conditions, and their families.

The children and young people may be from Leeds but the team also work with those from other local authorities who are receiving specialist treatment at Leeds General Infirmary through specialist hospital departments which include the Renal, Oncology, Haemophilia, and Cystic Fibrosis Care and the Paediatric Intensive Care teams. Referrals are usually through the specialist paediatric consultants at Leeds General Infirmary.

3.2 What is the CHAD Occupational Therapy Team?

The Occupational Therapy (OT) Team cover the whole of the Leeds area and assess the long-term needs of children, young people and their parents and carers. They can recommend equipment and adaptations to the home as well as advising families on safe moving and handling techniques. Referrals for this service are made through the Duty and Advice Team.

4. How to Refer to the CHAD teams

Referrals to CHAD are made by practitioners contacting the Duty and Advice Team at the front door. Duty and Advice discuss potential referrals with whoever is making the contact so that it can be demonstrated that the child's identified needs cannot be met by universal or targeted services. If it is felt that a social work response is appropriate, Duty and Advice may refer the child to a cluster social work team but depending on the level of the child’s disability or complex needs (refer point 2 for eligibility criteria), they may decide that a referral to CHAD social work is more appropriate.

Area based Service Delivery Managers may discuss possible transfer of cases with the CHAD SDM if it is felt that the level of a child’s disability/complex needs requires a specialist service from the CHAD team (see To Transfer a Child and Family to a Different Team Procedure).

5. Assessment

Following a referral to a CHAD social work team, a Child and Family Assessment is carried out which includes speaking to all practitioners involved as well as the child or young person and their family. The Social Worker will discuss with the family the key information that has been provided through the referral. The Social Worker will then arrange to visit the family and begin a Child and Family Assessment. This is an assessment that looks in detail at the needs of the child or young person with a disability and those caring for them. The assessment also takes account of all aspects of family life that may be impacting on the needs of the disabled child, siblings, anyone living in the family home and parents/ carer's ability to care. This will include a Parent Carer Assessment which considers the day-to-day impact of the caring role. It will also consider any caring responsibilities that may be placed on siblings that are children.

In addition to a child and family assessment, the CHAD Team may also need to complete a mental capacity assessment (based on criteria, age and need) to understand those children and young people who require Liberty Protection Safeguards.

The CHAD social work teams work to the same statutory requirements as the other locality social work teams. This includes undertaking Section 47 Enquiries (as defined in the Children Act 1989) where it is determined there is a safeguarding issue to investigate. If safeguarding concerns relate to a sibling group that includes a child /children who require a specialist service from CHAD, the CHAD team will undertake a joint investigation alongside the locality based team. The CHAD social worker will be the lead for the disabled child and the locality social worker will take the lead for the non-disabled children.