I recently met the parents of a disabled boy who is 12 years old. He is a regular at a residential respite care centre with excellent surroundings, great staff and lots of stimulus to keep going the activities he is learning at school. But his parents nagging doubt was what would happen to him when he reached 18. Where would he live? What would he do? Would he be with his friends? The local council had a transition team to tackle these questions, but the parents are well aware of the services that are available in their area, and they know that nothing new seems to be in the pipeline. The Commission for Social Care Inspection recently published a report on transition planning for young people with complex needs called Growing Up Matters. We found that while some people have good experiences, at least half the councils we studied do not provide the same level of support for adults as they do for children. This means that young people are at risk of losing their independence and opportunities for a fuller life once they reach the age of 18. Many end up in expensive residential care that restricts their independence – often miles away from their own home, which inhibits long-term planning. Councils need to start planning early in a young person's life to tackle this issue. Ensuring that young people experience a successful transition to adults' services requires, as a starting point, an explicit commitment and strong leadership from councillors and senior managers. Young people – and their families – should be fully involved in decisions about their own care, as well as in the planning and development of local services. Effective strategic planning and commissioning is essential. Adult social care services – along with associated further education, employment, health and housing services – should be informed by an accurate analysis of the transition needs of all young people from the age of 14 onwards receiving support from children's services. Commissioning strategies must be underpinned by long-term financial planning, including action to bring together resources from different funding streams. And councils should not shy away from tackling the difficult issue of different eligibility criteria and different levels of funding for adults' and children's services. Councils cannot do all of this on their own. They need to work closely with primary care trusts and other partner agencies to ensure that systems are in place to develop and commission seamless services. The focus of these services should be on supporting young people to live independently, and providing ‘normal' life opportunities. Direct payments are an important means of achieving this, and young people should be able easily to transfer their direct payments from children's to adults' services. We have seen some encouraging examples of good practice, but this needs to be spread more widely. The new arrangements for children's and adults' social care services present an excellent opportunity for councils to make the experience of transition a positive one, rather than a ‘nightmare', for young people and families. Getting it right means effective communication, strategic planning and sharing information between children's and adults' services. It also means involving people who use services at every step. Making sure that councils know what happens to young people with complex needs in their communities, and making sure they have the opportunity to live the lives they choose, will be a focus of CSCI's work to assess the performance of councils in fulfilling their responsibilities for this group of people. w Dame Denise Platt is Chair of the Commission for Social Care Inspection. The Growing Up matters report is available at www.csci.org.uk
