Early identification of need and risk
- assessing wellbeing on arrival
- people with physical or mental illness, learning disability, or other healthcare needs
The vast majority of children will arrive with family members who are able to safeguard and meet their needs with minimal support and signposting.
Adults with additional support needs, including adults at risk of harm, may be travelling with carers (relatives or others) who are able to safeguard and meet their needs with minimal support. Additional consideration should be given during the matching process for people with multiple complex needs who require care and support, in addition to accommodation, with a host family.
Inevitably there will also be children and adults whose needs were previously met within their communities. They may require formal support and safeguarding within Scotland, depending on their circumstances on arrival, including proximity of accommodation to their informal support networks. Identifying needs and concern will require a level of immediate assessment and follow up support, in keeping with existing statutory responsibilities wherever necessary. Thereafter there is likely to be a need for regular ongoing assessment and support.
It is likely that an initial assessment of need and early identification of immediate support needs will be undertaken within a Welcome Hub. However, the person or family arriving from Ukraine may then go on to reside in another local authority area. In such cases, clear lines of communication between the hub and the receiving authority should be in place to pass on relevant information, with the consent of the person arriving from Ukraine. It is noted that consent is not required in cases where there are child protection concerns, or in cases where it is known or believed that an adult is at risk of harm, as per the Adult Support and Protection (Scotland) Act 2007.
With this guide is a welcome checklist for people arriving from Ukraine (under supporting documents) designed to guide those welcoming a person or family from Ukraine in immediate health, welfare and protection considerations can be adapted for local use. It is likely that those arriving will be unable or unwilling to share a complete overview of their needs. As such what can be captured in the early stages should be passed, with consent, to local areas who can complete the capturing of the information and undertake any follow up support and assessment required.
Any child or adult at risk of harm regardless of their journey point should be referred immediately to the local social work department and / or Police Scotland.
Regardless of age, arrivals from Ukraine may require aids, adaptations or equipment due to mobility or accessibility needs. As part of the initial wellbeing assessment, consideration should be given to whether the individual – of any age - has any mobility or accessibility needs that may require further assessment. This should form a part of the welcome assessment and will contribute to accommodation considerations in both the immediate and longer term (e.g. if accommodation without stairs is required, if additional aids or adaptations are required).
Consideration should be given to whether assessment or intervention is required because the individual:
- is deaf or hearing impaired
- is blind or visually impaired
- has dual sensory impairment
- has additional communication support needs
- has additional needs due to disability, mental or physical infirmity, mental disorder, or cognitive impairment
- is pregnant
- requires immediate mental health intervention
- requires consideration for admission to hospital or residential social care environment
Some additional support needs may be difficult to identify on arrival, particularly if there is a language barrier. If it is suspected that the individual may be at greater risk of harm (including self-harm, neglect, or self-neglect) due to:
- learning disability
- mental illness
- or other cognitive impairment
Information should be passed to the local authority where the person is at the time the support needs are identified. Attention should be given to anyone who may require immediate attention due to a physical or mental health concern.
Evidence shows us that people with a learning disability and other types of disabilities have overall poorer health outcomes and a shorter lifespan than others. Some of the challenges of working with people arriving from Ukraine is to identify if they have any additional support needs, including due to learning disabilities other special educational needs and disabilities, and other ‘hidden’ disabilities. Some examples of this include:
- diagnosis and support for individuals with disabilities varies between countries, and health professionals in the UK may be the first to identify people who have specialist health and care needs. Health needs can be misattributed as being part of the person’s learning disabilities, and hence not addressed.
- immigration status issues, short-term or unstable accommodation, language barriers and cultural differences may further complicate people’s access to mainstream disability services
- vulnerable people who have disabilities face further social exclusion and discrimination. Stigma (cultural or otherwise) around certain illnesses and disabilities may also make it difficult for individuals and their families to disclose or discuss this topic. Reluctance to discuss health conditions with professionals may impact on social isolation and social exclusion
People arriving from Ukraine will be entitled to the same access to health and social care provision as Scottish citizens. Health, social work and social care professionals should therefore:
- identify specific support needs of those individuals
- following an assessment of need, make referrals for those children or adults to the appropriate departments who can offer support. This may include paediatric services for disabled children and those with developmental needs
- recognise that there will be a requirement for rapid access to Community Mental Health and Psychology teams for a small number of individuals with pre-existing conditions or acute onset of symptoms, particularly if the journey and/or absence from previous treatments (including medicines) may have exacerbated (or be likely to exacerbate) the conditions
- consider the particular needs of children and young people with pre-existing mental health needs who may require access to therapeutic support and/or mental health services
- consider the needs of perinatal women, who may require timely access to mental health services
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