1.6.3 Health Care Assessments and Health Care Plans

OUTCOME STATEMENT

Children’s health needs are met and their welfare is safeguarded by the home’s policies and procedures for administering medicines and providing treatment.

AMENDMENTS

This chapter has been amended to include the updates required emanating from the Care Planning Regulations regarding timings of Health Care Assessments.

Health Care Assessments
Health Care Plans
Designated Link Worker

1. Health Care Assessments

Amended Section March 2009: This section was amended in March 2009 stating that the first healthcare assessment must be conducted within 14 days of placement.

Each child should have a Health Care Assessment soon after being placed and then at specified intervals; as set out below.

The purpose of Health Care Assessments is to promote children's physical and mental health and to inform the child's Health Care Plan and ensure that the placement meets the child's holistic health needs.

Health Care Assessments must be conducted by a suitably qualified medical practitioner or local Designated Looked After Nurse; who should provide the social worker with a written report.

In England the first assessment must be conducted before the child’s first placement, or if not reasonably practicable, before the child’s first Looked After Review - unless one has been conducted in the previous 3 months. In Wales, the first assessment must be conducted within 14 days of the placement.
For children aged between two and five years, further assessments should occur at least every six months.
For children aged over five years, further assessments should be at least annually
Health Care Assessments must be conducted more frequently where the child’s health needs dictate.

The Social Worker is normally responsible for ensuring that Health Care Assessments are undertaken, but this responsibility may be undertaken by the home.

In order for the assessment to be conducted, it will be necessary to ensure the Consents section of the child's Placement Plan has been completed and signed by the parent or a person with Parental Responsibility.

If no Health Care Plan exists, the Manager should obtain as much information as possible regarding the child’s healthcare needs (e.g. whether the child is on medication) to incorporate into the child’s Care Programme.

In order for the assessment to be conducted, it will be necessary to ensure that a Parental Medical Consent Form has been completed and placed on the child’s file.

2. Health Care Plans

The Health Care Plan should be informed by the Health Care Assessment referred to above. A Health Care Plan should be completed by the Manager of the home and agreed to by the child's social worker. Any needs identified should be incorporated into the child's Care Programme, setting out what to do to promote the child's healthcare needs.

The matters that should be considered in drawing up the Care Programme are as follows (NMS)

The matters that should be considered in drawing up the Care Programme are as follows:

Child's medical history / whether there are any specific health care needs / what strategies are in place.
Identify the health practitioners that are to be involved in direct support (doctors/dentists/ optician)
The involvement of the child’s Parents or significant others in health issues during the placement.
Any specific medical or other health interventions which may be required, including whether it is necessary for any Invasive Procedures and how they will be undertaken. (see Invasive Procedure)
Whether there are any prescribed medicines that the child should have, and the arrangements for administering them. This should include arrangements for administering medicines when the child is away from the home e.g. at school or visiting Parents/relatives. The extent to which the child is able to retain or administer medication, or requires support to do so.
Whether it is necessary for any immunisations to be carried out.
Any specific treatment or Therapeutic Interventions, Strategies or remedial programmes required.
Any necessary preventative measures to be adopted.
Whether the child is allowed to smoke and any measures agreed to reduce the behaviour.
Whether there are any illegal or other activities including Self Harming which it is known or suspected the child is engaged in which may be harmful to the child’s health, and the interventions/strategies to be adopted in reducing or preventing the behaviour. (see Self Harming Procedure)
Whether the placement will contribute to any other health related assessments.
Whether the placement will contribute to any other health related assessments. (Psychologist / Psychiatrist)
Whether the home will contribute to any health monitoring, e.g. sexual health.

3. Designated Link Worker

One of the key responsibilities of the child's Link Worker (Keyworker) will be for promoting his/her health and educational achievement, liaising with key professionals, including the Clinical Nurse Specialist, the child's GP and dental practitioner.

The Keyworker will also ensure that up to date with information is kept on the child in relation to his/her health needs, development, illnesses, operations, immunisations, allergies, medications, administered, dates of appointments with GP's and specialists.

The Keyworker must also ensure the child is registered with a GP and other health care professionals as set out in GPs, Dentists, Opticians, Hospitals Procedure.

Also see Keyworker Guidance.