Prioritising Child Health: Practice and Principles

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Ensure this approach applies equally to siblings of multiple heritage. Update to 'The Children Act guidance and regulations volume 2: care planning, placement and case review' Department for Education.

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Provide additional support and resources that help the co-placement of siblings to prevent disruption and possible end of a placement for any child or young person in a sibling family group. Where siblings live or are placed in different local authority areas ensure that arrangements are in place for their independent reviewing officers or social workers to liaise on their needs, ensuring ongoing contact and any possibility of future co-placement are regularly considered from the perspective and wishes of each sibling see recommendation Evidence suggests that frequent moves and parents' physical and mental health problems can adversely affect the ability of babies and very young children to form healthy attachments that lead to healthy emotional and physical development.

To combat this disadvantage, there is a need to plan decisively for permanent placements, based on high-quality assessments carried out by skilled professionals. Comprehensive, flexible service provision can help meet this aim.

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Ensure that comprehensive and sensitive assessment processes are in place to identify the needs of babies and young children as early as possible. Ensure frontline practitioners support the baby or young child and carers and, if necessary, a referral is made to specialist services, following the needs assessment. Ensure that equal priority is given to identifying the needs of children who may not attract attention because they express emotional distress through passive, withdrawn or very compliant behaviour. Ensure that interventions recommended by assessments are included in the healthcare plan.

This is the responsibility of the social worker managing the case see also recommendation 5. Ensure that interventions recommended in the healthcare plan continue to be made through transitional periods if babies or young children move from a placement and when they move to permanence. Ensure that all frontline practitioners have access to specialist services and evidence based interventions including dedicated CAMHS teams to help them meet the emotional and physical wellbeing needs of looked-after babies and young children. These services should have practitioners who:.

Ensure that specialist services can provide support such as consultation and training to carers and frontline practitioners, and can work directly with the child and carer on interventions that focus on supporting secure attachments.

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Ensure that all carers and practitioners who care for and work with babies and young children including foster carers and prospective adopters receive training from specialist training providers including CAMHS. This should be additional to core training see also recommendations 18, 31—38 and 50 and should include information on the:.

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Ensure care planning takes account of the need to minimise the experience of separation and loss for babies and young children see also recommendations 5, 12, 13 and 30 see The Children and Families Act Ensure assessments of emotional welfare and the impact of loss of attachment are primary considerations in a decision to make a placement change, including a move to permanent carers.

Consider returning the child to a previous stable placement if an adoption placement breaks down. Ensure that the history and extent of previous placement instability is taken into account before a change from the current placement is agreed. Give serious consideration to a foster carer's desire to adopt a child and ensure that an adoption assessment fully considers the capacity of foster carers to provide long-term stability and secure attachment. Ensure alternative placements are available 'twin tracking' if assessments of birth parents or carers who are family or friends are unsatisfactory.

This might include approving carers who wish to adopt as both foster carers and prospective adopters.

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  6. 1 Recommendations | Looked-after children and young people | Guidance | NICE.
  7. Evidence indicates that accurate and up-to-date personal health information has significant implications for the immediate and future wellbeing of children and young people during their time in care and afterwards. Understanding their own 'health history' is an essential part of growing up securely.

    Inconsistent record keeping can lead to wrong decisions by professionals and adversely affect the child or young person.

    The Right Way: A Children’s Rights Approach in Wales - Children’s Commissioner for Wales

    Ensure that all looked-after children and young people have their physical, emotional and mental health needs assessed by appropriately trained professionals according to 'Statutory guidance on promoting the health and well-being of looked after children Statutory guidance on promoting the health and well-being of looked after children Department for Children, Schools and Families.

    Local authorities should make notifications about looked-after children and young people who are placed out of the authority's area or across NHS commissioning boundaries in good time and in accordance with the statutory guidance The Children Act guidance and regulations volume 2: care planning, placement and case review Department for Children Schools and Families. Consider introducing a protocol into information-sharing processes that addresses legal and confidentiality issues, to assist information flows between health and social care.

    Ensure that healthcare professionals share health information with social workers and other professionals. Ensure that there is a process for social workers to obtain consent for statutory health assessments, routine screenings and immunisations. Ensure social workers obtain permission to access the child or young person's neonatal and early health information. Ensure social workers obtain permission to access information on parental health, including obstetric health.

    Ensure that parental or delegated consent is given to healthcare professionals when they are scheduled to carry out a medical or surgical procedure on any looked-after child or young person. Ensure that a system is in place to monitor, and address failure to obtain, permission or consent for health matters. Ensure that any health information is collected and shared in a sensitive and professional manner. Ensure health information is incorporated into relevant assessments and shared with healthcare professionals, as appropriate.

    Ensure that physical and emotional health information, and consent for medical procedures, including mental health interventions, follows the child or young person.


    This may include deciding with partner agencies how hand-held paper records can stay with the child or young person. Ensure that early health information is available to enhance life-story work with the child or young person when they are ready see also recommendations 24, 25 and 48 or to help them make informed decisions when they are ready to start their own family.

    follow url Ask social workers to ensure that the personal health record red book follows the child or young person up to the age of Ensure that if the original personal health record is lost or unavailable a new one is provided, and when it is reissued it should include as much information as possible; the issuer will need to look back and incorporate historic information.

    Share all information obtained from parents and other sources to help complete the reissued record, and if birth parents are unwilling to give up the original personal health record, ensure social workers work with them to relinquish it temporarily to enable information to be copied. Ensure that early health information is obtained, including obstetric and neonatal health information, on all children or young people entering care. Ensure there is a clear process to reissue the personal health record to all new carers for children or young people in their care.

    Ensure that a contact person is identified to manage the administration of the personal health record. Ensure that when assessments are commissioned for court processes, permission from the court is obtained to share this information with health professionals who carry out statutory assessments or advise on health needs. Evidence indicates that developing a positive personal identity and a sense of personal history is associated with high self-esteem and emotional wellbeing.

    Life-story work, as an ongoing activity, can help children and young people understand their family history and life outside of care. Children and young people also have needs and preferences for contact with valued people and participation in the wider community as ways to build their self-esteem and assertiveness. Promote continued contact with former carers, siblings or family members personally valued by the child or young person where this is felt to be in their best interests.

    Where this is not possible, acknowledge the significance of losing former attachment figures and relationships. Promote ongoing contact with valued friends, professionals or advocates where this enhances and promotes emotional wellbeing and self-esteem. Ensure access to creative arts, physical activities, and other hobbies and interests to support and encourage overall wellbeing and self-esteem.

    Offer assertiveness training appropriate to age to all children and young people to promote self-esteem and safety, combat bullying and enhance wellbeing see also recommendations 26— Ensure looked-after children and young people participate in policy decisions that affect their life see also recommendations 1 and 2.

    Allow contact with close family members to diminish when it is clearly not in the best interests of the child or young person and contrary to their wishes see also recommendation Ensure that policies and activities are in place to allow each child or young person to explore their personal identity, including their life story.

    For information gathering when a child or young person first becomes looked after, consider using forms such as those provided by the British Association of Fostering and Adoption, which collect data on early infant health and parents' general health. Ensure life-story activities are planned and supported using a sensitive approach that focuses on the needs of a child or young person and that information is delivered by a trusted individual known to them in a respectful, sensitive and supportive manner. To carry out life-story activities:. Ensure that in life-story work looked-after children and young people have access to as much personal information including family history as possible by promoting ongoing conversations between children, young people and their carers and social workers that include discussion about their:.

    Extend existing good practice and policy on life-story work with children and young people during and after the adoption process to all children and young people who are looked after, including those leaving care. Looked-after children and young people from black and minority ethnic backgrounds have particular needs. Other groups of looked-after children and young people also have particular needs, such as those seeking asylum and those who are gay or lesbian.

    Ensuring their needs are adequately met requires special attention and expertise to champion their rights. Strategic plans need to identify how appropriate services will be commissioned to ensure these looked-after children and young people are not marginalised. Recommendation 33 is about unaccompanied asylum seekers with looked-after status, and recommendation 34 is about black and minority ethnic children and young people. Provide all professionals and managers with specialist training, resources and access to expertise to:.

    Consider setting up a multi-agency panel tailored to local needs to discuss particular requirements and placement choices for the looked-after children and young people identified at the beginning of this section. This could be a priority in areas with low numbers of these looked-after children and young people as there may be a need to increase local knowledge. Ensure that children and young people with particular needs are consulted about their experiences of services see also recommendations 24 and Network and share good practice with other local authorities with a similar profile of looked-after children and young people.

    Consider secondments of key staff to local authorities where good practice is recognised, and ensure that there are mentoring and co-working opportunities. Ensure children-in-care councils include discussion of looked-after children with particular needs as a standing item on their agenda. Appoint a local diversity champion with strategic and leadership responsibilities to increase awareness of the needs of looked-after children and young people identified at the beginning of this section and act as an advocate on their behalf. Ensure that the diversity champion reports to and is accountable to the director of children's services.

    Ensure the diversity champion also reports to and engages with the children-in-care council to help define the particular needs of these children and young people. Produce a local diversity profile covering the looked-after children and young people identified at the beginning of this section.