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Introduction
In accordance with the C hildren and Families Act 2014, the following statutory
Education, Health and Care Plan is made by Swindon Borough Council (‘the education
authority’ ) and the Swindon NHS Clinical Commissioning Group (‘the health authority’)
in respect of Anthony Davis  whose particulars are set out below
Date of Final EHC Plan
Date of Draft  EHC Plan
My Details
Full Name  Sarah Price
I like to be known
as SP
Home Address
Date of Bir th: Religion:
Telephone no:  Gender:  Female
Mobile no:
Home Language:
Email:  None given.  .
Parent/Carer Details
Surname
Other Names
Address if different from above
As above
Relationship to child/young person
Is the child subject to a care order?
Education Health and Care Plan
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Section A
The views, interes ts and aspirations of the child or young person and their parents
SP’s aspirations
SP’s views have been gathered through observation over time by those who know her
well. These have been reported by Educational Psychologist, Dr Susan Pollock, in her
report dated January 2020. Dr Pollock reports that the following things have been
identified as being important to SP :
• Getting her point across, for example, her immediate wants and desires .
• Nurturing relationships with adults .
• Gaining positive adult feedback , for example, opportunities for adults to sign and
say thank you after SP  responded appropriately.
• Her family .
• Physical and outdoor play, in particular getti ng proprioceptive feedback, for
example, by sliding, jumping or running.
• Spending time with her ‘special friend’ at nursery .
• Making noises, for example, hitting or banging items that make different sounds .
• Having a clear routine and preparation for changes in routine.
• Being able to have down time and time not wearing her hearing aid.
SP’s history
SP lives at home in Swindon with her parents, Mr and Mrs Davis , and her older sister .
She was born with C ytomegalovirus  (CMV) , which caused a mild/moderate hearing loss
at birth . This subsequently  deteriorated to a profound loss in both ears, and she was
fitted with  bilateral cochlear implants at the Southampton Implant Centre in May 2019.
Scans at Southampton show that SP  has type 2 incomplete partition Mondini. Final
tuning of the implants took place in September 2019. SP ’s family have started to use a
mini-mic with SP . This will help when there is background noise and SP  is not able to
see the person speaking or is at a distance from the person speaking.
SP has a ‘lazy eye’, for which she is under the Ophthalmologist . In addition, she  can find it
difficult  to sleep through the night. Since July 2019, SP  has been having Melatonin to
help with her sleep.
SP was referred to the Speech and Language Therapy Service in September 2018 due
to a significant delay with the development of her communication, listening, attention and
vocalisation skills. She has  been seen regularly by the Speech and Language Therapy
Service since the referral and she currently receives fortnightly support from both the
Teacher of the Deaf and the Speech and Language Therapist. SP  and her family have
also received support and advice through weekly sessions at Little Steps, which is a
weekly pre- school for deaf children in Swindon. SP  started to atte nd Lawn Nursery in
January 2020.
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How to communicate with SP
SP’s use and understanding o f language are delayed as a result of her hearing
impairment. She is only consistently understanding language at a single key word level
and is just beginning to use 2 words together expressively. Her speech intelligibility is
low, meaning that it can be difficult for an unfamiliar listener to understand her meaning.
Adults need to  use Signalong signs to support SP ’s use and understanding of language
as well as her social interaction with peers.
Views  of SP’s parents
Mrs Davis  shared with the Educational P sychologist that she believed that SP would
benefit from an Education, Health and Care Plan.  She would like SP  to be as
independent as possible and  to be able to do and enjoy  the types of activities of a
hearing child.
In particular, Mrs Davis  would li ke SP to be able to interact socially with hier peers using
spoken language. She feels that developing spoken language will increase SP ’s
capacity to communicate with those in her  wider community .
SP’s parents hope that SP will be learning to read and comm unicating on a similar lev el
to her peers by the end of her reception year in school.
Section B
SP’s areas of strength and special educational need
Summary
Primary Need:         Sensory / Physical / Medical: Hearing Impairment
Secondary Need:    Comm unication & Interaction: Speech, Language & Communication
Additional Needs:   Cognition & Learning;  Social, Emotional & Mental Health
Assessment Information Summary  (Background and general information )
SP’s primary areas of need relate to her hearing im pairment and subseq uent speech
and language delay. She has made good steps of progress in the short time since her
cochlear implants  have become fully functional. However, her speech and language
skills remain  significantly behind those of her peers .
These difficulties impact on SP’s attentional skills  as well as on her emotional wellbeing.
Her delay in language development means that  she is currently unable to put words or
signs to her emotions or to communicate what may be exciting or distressing her.  When
distressed or frustrated she requires an adult to reassure her, help narrate her emotional
experiences and provide options as to what may be causing them.
SP has a number of relative strengths which include the following:
• SP is generally a happy little girl who is described as having a ‘twinkle’ in her
eye.
• She is confident, curious and keen to explore her environment. She particularly
enjoys outdoor and physical learning experiences.
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• SP enjoys interacting with other children.
• When motivated, SP is able to pick up new skills quickly. She is described by
nursery staff as often being  ‘willing to have a go’.
• SP is able to seek reassurance from adults in the setting.
SP’s special educational needs relate to the areas listed below:
• Attention and concentration.
• Speech, language and communication.
• Emotional regulation.
• Hearing impairment.
Current Attainment
SP’s play and other physical development has been monitored using the Early Support
Monitoring protocol for deaf babies and children and is largely age appropriate , except
where a significant language delay has impacted.
Cognition and Learning
Strengths
• SP is curious about the world around her.
• She has shown understanding of the purpose of a number of items in her current educational setting (including books ), and of a number of situational cues, such
as a book being finished when it is closed by an adult. She has also shown some
social problem solving skills, such as by working with other children to move
some furniture around as part of a game.
• She picks up new skills quickly when she is  motivated to do so. The Educational
Psychologist reports that early indicators suggest that SP  has a ‘reasonable’ set
of cognitive skills.
• SP is able to sustain her attention to a m otivating task for 10 minutes.
• She is willing to accept adult support for learning activities.
Special Educational Needs
• SP’s hearing impairment means that she has not had the same opportunities to
develop attention and listening skills as her hearing peers . At this time, SP ’s
attention towards an activity is highly impacted by distractions in the environment.
She finds it very difficult to attend to activities for any length of time and often moves
quickly  from one activity to another. Her  high levels of distractibility mean that her
play is not always cognitively challenging and she struggles to focus on an adult -
directed task.  She attends best when a task is intrinsically motivating for her, is
supported and scaffolded by an adult and involves favoured peers.
• SP’s hearing impairment means that she has not had the same opportunities to
develop early language and communication skills as her hearing peers . This has had
an impact on the development of her early literacy skills. Although SP  has an
understanding of the purpose of books, she  currently struggles to sustain  her
attention on this activity. It is felt that she is unlikely to fully understand that the marks
on the page have meaning, and therefore to begin to develop an understanding of
the relationship between letters and sounds.
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Communication  and Interaction
Strengths
• SP is able to turn to her name, and follow some spoken words when she is in a
good listening environment  and she consistent ly understands language (spoken or
signed – using Signalong) at 1 key word level . The Speech and Language
Therapist reports that it is likely that SP can also understand  signed or spoken
language at a 2 key word level, however,  due to her attention levels, it has not
been possible to reliably assess this skill .
• Since her cochlea implants reached full functionality (in September 2019), SP  has
made good steps of progress with her speech and language development.
• She has been steadily increasing the number of words that she has been saying or
signing over the last few months  and has now started to join these words/s igns
together to form 2 word phrases , such as ‘mummy car ’. She has also started to
ask questions, for example, ‘W hat doing? ’ and ‘What that?’
• She will say ‘please’, ‘thank you’ and ‘sorry’ when encouraged to do so.
• SP has lots of vowels in place. She uses an appropriate pitch and voice quality for
her age and uses a range of intonation patterns. She is beginning to use the
correct number of syllables in a word.
• SP will chat to herself as she plays and has started to sing along to some
television theme tunes.
• SP has been seen to play  alongside her peers  in her educational setting, showi ng
early stages of sharing toys  and using eye contact and vocalisations (including
some clear words) to communicate with both adults and children.
• SP appears to enjoy  interacting w ith other children and has developed a
friendship with another little girl in her setting.  Their play is generally physical and
based on non- verbal communication.
Special Educational Needs
• As mentioned above, SP’s hearing impairment means that she has not  had the same
opportunities to develop early language and communication skills as her hearing
peers.
• SP’s understanding of language is impacted by her level of attention and is delayed
in relation to that of her hearing peers, meaning that she is not yet a ble to access all
of the language of the Early Years curriculum.
• SP’s use of language is also delayed in relation to that of her  hearing peers,
meaning that she is not yet able to communicate with same range of vocabul ary,
sentence structures, and thoughts  and feelings as others. She is  therefore likely to
become frustrated at times and to be unable to fully demonstrate her learning.
• SP usually uses a small range of consonants in her talking, such as  ‘g’, ‘b’, ‘m’ and
‘w’. Consequently, out of context, and t o unfamiliar listeners, it is currently difficult to
underst and most of her words. The Speech and Language Therapist reports that SP
would be rated as 2 on the Nottingham Speech Intelligibility Rating (where the
highest is 5).
• SP’s receptive and expressiv e language skills were monitored by the Advisory
Teacher for the Deaf, using the Early Support Monitoring protocol for deaf babies
and children. At an age of 35 months, SP ’s communication of listening, attention
and vocalisation was found to be within the B5 level, representing an age equivalent
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of approximately 9 -12 months. This shows a very significant delay.
• SP’s speech and language delay also impact s significantly  on her social
communication and interaction with other children at an age appropriate lev el. She
experiences difficulties with sharing and turn taking.
Social, emotional, mental health and wellbeing
Strengths
• In familiar settings, SP  is generally a happy, curious and settled little girl.
• She has been able to settle reasonably quickly at her current educational setting.
• Setting staff have reported that they feel a sense that SP  is aware of some of the
reasons why she might be asked to say or sign ‘sorry ’. (This is typically around
sharing or overly physical behaviour with other children. )
• SP is able to share her enjoyment of an activity through her facial expressions,
vocalisations and bodily movement, for example, jumping when excited.  She
shares distress through facial expressions, vocalisations and bodily movement,
for example, by throwing som ething.
• SP will seek out a member of staff if she is feeling distressed ( for example, if she
has hurt herself or is unsure about the behaviour of another child) and she is able
to be comforted by key staff.
• SP is generally keen to please adults and compliant  with adult’s requests  that she
has understood.
Special Educational Needs
• SP’s difficulties with attention mean that her behaviour can be rather impulsive at
times. For example, if she sees something that she wants, her impulsiveness means
that she is likel y to reach for it straight away, before there is an opportunity for her to
sign or say that she wants it.
• SP’s delay in language development means that  she is currently unable to put words
or signs to her emotions or to communicate what may be exc iting or di stressing her.
She can become frustrated when she is not able to accurately communicate her
message.
• SP’s social and emotional developmental level, as assessed at a chronological age of
35 months by the Advisory Teacher of the Deaf using the Early Support Monitoring
protocol for deaf babies and children, is  about B8 , which is an age equivalent of
approximately 18 -21 months .
• Due to her significant language delay, SP  can be less sure in new situations or with
unfamiliar adults.
Sensory and/or physical
Strengths
• SP enjoys being outside and engaging in physical and proprioceptive (body
awareness) play opportunities.
• SP is independent in regard to her self -care skills.
• SP has made some good progress since receiving her  cochlear implants in May
2019. She  will indicate if the coil falls o ff and she can put it back on by  herself.
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Special Educational Needs
• At times, SP  can appear overwhelmed by the sensory information that she is now
able to access whilst  wearing her cochlea implants.  She will sometimes remove her
hearing device but she is not yet able to put this back on independently.
• SP is descr ibed as liking ‘her own space’.  She can become a little unsettled by
other children standing close behind her. This is likely to be because of her
cochlea implants.
• SP’s hearing impairment can mean that she does not always hear, understand or
respond to instructions from adults immediately. This can sometimes have
implications for her safety in the classroom or playground.
• SP takes can have trouble sleeping and takes Melatonin to support her with this.
This is likely to impact on her ability to focus her attention for learning.
Section C
SP’s strengths and health needs
Strengths
• SP is described as being a generally fit and healthy girl.
• There are no concerns in rega rd to SP’s mobility or motor skills.
Health needs
• SP had a cytomegalovirus  (CMV)  infection before she was born which has left her
with a profound sensory neural deafness. This has been treated with cochlear
implants  which were inserted at the Southampton Implant Centre in May 2019 and
switched on in June 2019. The tuning of the implants was completed in September
2019. SP wears bilateral processing equipment on either side of her head, full time.
These devices generate electrical signals which enable SP  to perceive the
sensations in her cochlear implants as sound.
• SP’s socialisation and behaviour were profoundly affected for about 12 months when
her hearing loss was not compensated for. This appears to have produced a slight
delay in her acquisition of social skills such that she is slightly behind her peers .
•  SP’s condition is known to be linked with a range of features, some of which do not
present until later in life. It is imperative that in her teenage  years, any difficulties ,
particularly in terms of learning or behavioural issues , should be reviewed in the light
of a possible connection with SP ’s early infection with CMV.
• SP is reported by the Paediatrician to have a possible intermittent squint, for which she
is under the Opthalmology Team at the Great  Western Hospital in Swindon.
• SP also experiences some difficulties with sleep.
Health diagnosis
Any diagnosed condition  Diagnosed by  Date of diagnosis
Congenital cytomegalovirus
infection  (CMV)  Unknown
Unknown
Profound congen ital
sensory neural heari ng loss  Unknown  Approximately one year of
age.
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Section D
SP’s strengths and social care needs
At the time of the EHC needs assessment, no Social Care needs have been identified
for SP. If subsequent needs are identified, this section will be amended accordingly .
Section E
Agreed Outcomes
Outcome  1: Cognition and Learning  By when
SP will sit with her peers for the majority  (approximately up
to 70%)  of carpet time in her educational setting and will
engage in those carpet time activities.
End of  Foundation Stage
Within the next 12 months:
• SP will engage in a motivating adult led activity for approximately 3- 5 minutes at
least twice a day.
Outcome  2: Cognition and Learning  By when
SP will demonstrate knowledge that letters represent
sounds and will correctly identify the sound for the majority
of letters , in order to begin to access more literacy based
activities i n the classroom.
End of Foundation Stage
Within the next 12 months:
• SP will listen to and engage with stories in a small group or individually.
• SP will show  a consistent interest in the print and illustrations in books.
Outcome  3: Communication and Interaction  By when
SP will follow simple classroom instructions (with or without
sign support) that include 3 key words and at l east 10
different concepts (for example, colours, sizes and
prepositions).
End of Foundation Stage
Within the next 12 months:
• In an adult directed task using toys that she is motivated by, SP  will accurately
follow 2 key word sentences (which include vocabulary that she is familiar with) on
4 out of 5 occasions . (For example, when using Paw Patrol toys, she will follow
sentences such as, ‘Put Marshall on the chair’,  or ‘Rubble wants the banana’.
Outcome  4: Communication and Interaction  By when
SP will use short sentences that include 3 key words and/or
subject -verb-object , to talk about pictures or activities.
End of Foundation Stage
Within the next 12 months:
• SP will use 2 word phrases which  include a noun (person, place or object) and a
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verb (action word), for example, ‘ Daddy jumping ’ or ‘plane flying ’, in at least  10
different combinations.
Outcome  5: Social, Emotional, Mental Health and
Wellbeing  By when
SP will say, sign or identify a picture that represents her
emotional state (for example, happy, sad, tired or angry)  on
most occasions when she is  prompted by an adult to do so.
End of Foundation Stage
Within the next 12 months:
• When prompted by an adult, SP  will say, sign, or identify a picture to share that
she is happy, on over 50% of occasions.
Outcome  6: Sensory / Physical / Medical  By when
SP will have continued to develop her listening skills so that
she can follow simple instructions (for example, ‘get your
coat’ or ‘sit down’) without requiring accompanying
gestures.
End of Foundation Stage
Within the next 12 months:
• SP will use her listening skills alongside accompanying gestures to follow simple
instructions, such as ‘feed teddy.’
Section F
Special Education Provision , monitoring and annual review a rrangements
Special educational provision
By whom
COGNITION AND LEARNING
SP will need additional adult support at key points during the day, for
example:
• during short adult led activities .
• during transitions from one activity to another, for example , at the
beginning and end of the day, transitioning into and out of lunch time, transitioning into a group or one to one activity .
• during carpet time and other small group activities.
Adults who support SP  will need to be trained in supporting learners w ho
experience hearing difficulties/wear hearing devices/ h ave speech and
language delay. They will need to use, and encourage other school staff
and learners to use, additional visual/signing communication tools which
have been recommended by the Speech and language therapist/Advisory
Teacher .
Adults need to ensure that they gain SP ’s atten tion first before
communicating with her and e nsure that the person speaking to SP is
Members of
setting such
as teachers
or teaching assistants.
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within 1 -2 metres  of her.
Adults to make sure that SP can see their face when they  are
communicating with her.
Staff need to m ake use of visuals to support SP ’s learning at all times.
Adults to use a visual timetable and now and next board so that  SP can
see what is happening.
SP will need regular individual and small group learning experiences in a
quiet place away fr om the main playroom/classroom.
Adults will use a visual system, such as Visual Phonics by hand, to support
any phonics learning.
COMMUNICATION AND INTE RACTION
SP’s understanding and use of language and speech sound clarity are
significantly delayed for her age, and therefore she w ill need support to
access the Early Y ears curriculum so that she can fo llow instructions,
understand teaching, and communicate her thoughts and feelings to adults
and her peers. Consequently, she needs staff who have skills in
understanding and using Signalong signs, who demonstrate deaf
awareness in their communication with SP , and who are able to adapt the
classroom language to her level of understanding.
SP will need staff to be available to play alongside her so that they can
model the language that she could be using, support her attention and
listening skills, show her how to interact and use her communication skills with h is peers, and monitor her audiological equipment, being mindful of her
current targets and outcomes.
SP will also need visits from a Speech and Language Therapist who is a
specialist in deafness, at least once each half -term (i.e. 6 times a year) to
revie w her outcomes and the strategies in place, through observation,
liaison, assessment and play. The Speech and Language Therapist and
Teacher of the Deaf will need to also liaise closely. Staff will need to be
available to work 1:1 with SP  for 10 -15 minutes  in a quiet environment, at
least 3 times a week , to help her work towards her communication and
interaction targets and outcomes.
SP needs adults to show excellent deaf awareness in the setting, for
example, by ensuring that she can see a person’s face w hen they talk,
minimizing background noise, and using signs to support spoken language
when required. There may also be times, although hopefully minimal, when
she is not wearing her implants. On such occasions, it will be essential that
SP has the use of S ignalong to rely on for communication.
SP needs adults to provide her with alternative ways to communicate her
Members of
setting such
as teachers
or teaching
assistants.
Speech &
Language
Therapist / Teacher of
the Deaf, as
appropriate.
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ideas on occasions.
SP will need additional adult support t o play alongside her  and other
children to model language used in social interactions and turn taking.
She needs adults to be vigilant at all times so that they are ready to step in
to support her to understand what her peers are saying or to show her
how to communicate her thoughts and feelings more successfully to them.
(This might in clude, teaching some of her peers the signs that she uses.)
SOCIAL, EMOTIONAL, MENTAL HEALTH AND WELLBEING
SP will need addi tional adult support to:
• Sign, say and provide visuals to support her  development of emotional
literacy skills ‘in the moment’. This will support her to show them how
she is feeling and why and to develop her emotional vocabulary.
• Narrate  SP’s experiences, provide reassurance and support her to
share what may be exciting, upsetting or distressing her.
Members of
setting such
as teachers
or teaching
assistants.
SENSORY / PHYSICAL
As detailed above, SP needs adults to show excellent deaf awareness in
the setting, for example, by ensuring that she can see a person’s face when
they talk, minimizing background noise, and using signs to support spoken
language when required. There may also be times, although hopefully
minimal, when she is not wearing her implants. On such occasions, it will be
essential that SP  has the use of Signalong to rely on for communication.
She needs an educational environment which supports multisensory
teaching methods and ongoing review and improvement of the listening
environment .
Identified staff will need to be available at all times to help with SP ’s
cochlear implants if they fall off or need batteries replacing,  and to fault find
if they are not working correctly .
SP will need at least fortnightly support from a Teacher of t she Deaf.
She will need daily sessions ( of 5-10 minute s) to support her progress in
attention and listening.
SP requires u se of additional assistive listening technology (radio
aid/soundfield systems etc) .
Staff will need to check with the Southampton Cochlear Implant Team/local
Swindon Team and Teachers of the Deaf to clarify whether  there are any
particular features that need to be in place to optimise SP ’s hearing.
Members of
setting such
as teachers
or teaching
assistants.
Teacher of
the Deaf, as
appropriate.
Monitoring of special educational needs and provision
[The arrangements for monitoring of progress and review of the EHC Plan.]
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SP’s progress will be closely recorded and monitored by the school in conjunction with
home and all the professiona ls involved. SP ’s progress will be monitored, recorded and
reviewed at least every 6 months until SP ’s 5th birthday and at least annually  thereafter .
These reviews wi ll be co -ordinated by the setting.
SP’s EHC Plan will be maintained whilst her needs remain. Should she make significant
progress this will be discussed with her parents at the Annual Review. If she has made
such progress that all of her special needs can be met in future and it is no longer
necessary for the local authority to maintain her EHC Plan, consideration may be given
to ceasing the plan
Section G
Health Provision
Health Provision  By Whom
SP will continue  to receive  ongoing medical care and review
from appropriate health professionals as required.
Appropriate health
professionals, for
example, the Acute Paediatric Team,
Opthalmology,
Audiology, ENT and
the Cochlear Implant
Centre in
Southampton.
Section H1
Any social care provision which must be made for a child or young person under
18 resulting from section 2 of the Chronically Sick and Disabled Persons Act 1970
(CSDPA)
Social Care Provision  By Whom
At time of the EHC needs assessment, no Social C are needs
have been identified  for SP. Therefore no provision is required.
If subsequent needs are identified, this section will be amended
accordingly .
Section H2
Any other social care provision reasonably required by the learning difficulties or
disabilities which result in the child or young person having SEN. This will include
any adult social care provision being provided to meet a young person’s eligible
needs (through a statutory care and support plan) under the Care Act 2014.
Social Care Provision  By Whom
At time of the EHC needs assessment, no Social C are needs
have been identified  for SP. Therefore no provision is requir ed.
If subsequent needs are identified, this section will be amended accordingly .
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Section I
Education Placement
This section will remain blank until the Final E ducation, Health and C are Plan is issued.
Section J
Personal Budget
Where there is a Personal Budget, the details of how the personal budget will support
particular outcomes, the provision it will be used for including any flexibility in its usage
and the arrangements for any direct payments for education, health and social care.
Sect ion K
People who have contributed to this EHC plan are:
Name  Title How did they
contribute  Report attached
including date
SP Davis
Child
Observation by
Educational
Psychologist (EP) at
nursery on 20.01.20.
See EP report
dated January
2020
Parents
Not applicable.
Bryony Coulson
Manager / SENCO
Advisory Teacher of the Deaf
Lawn Nursery
Written report
At the time of the statutory
assessment, SP has
not attended at the
nursery for long
enough for a report to
be produced.
Received 24.01.20
Not applicable
Dr Jess Fisher
Katherine Greene
Community Paediatrician
Speech &
language Therapist
Written report
Written report
03.02.20
January 2020
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Dr Kelly Kline  Educational
Psychologist
Written report  29.01.20
Social Care
SP is not currently open to Social Care.
Signatures
Signed on behalf of the DCS