The Health and Well-being Standard
Regulation 10
Health and Wellbeing, Health Notifications and Access to Services Procedure
In May 2023, information was added into Section 2, Health Care Plans, in relation to allergies.
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 (which may be a separate plan or may be incorporated in to the Child's 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; who should provide the social worker with a written report:
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.
Young people aged 16 or 17 with mental capacity are presumed to be capable of giving (or withholding) consent to their own medical assessment/treatment, provided the consent is given voluntarily and they are appropriately informed regarding the particular intervention. If the young person is capable of giving valid consent, then it is not legally necessary to obtain consent from a person with Parental Responsibility.
A child of under 16 may be Gillick Competent to give (or withhold) consent to medical assessment and treatment, i.e. they have sufficient understanding to enable them to understand fully what is involved in a proposed medical intervention.
In some cases, for example because of a mental health issue, a child's mental state may fluctuate significantly, so that on some occasions the child appears Gillick Competent in respect of a particular decision and on other occasions does not.
If the child is Gillick Competent and is able to give voluntary consent after receiving appropriate information, that consent will be valid, and additional consent by a person with Parental Responsibility will not be required.
Where a child under the age of 16 lacks capacity to consent (i.e. is not Gillick Competent), consent can be given on their behalf by any one person with Parental Responsibility. Consent given by one person with Parental Responsibility is valid, even if another person with Parental Responsibility withholds consent. (However, legal advice may be necessary in such cases). Where the local authority, as corporate parent, is giving consent, the ability to give that consent may be delegated to a carer (or registered manager of the children's home where the child resides) as a part of 'day-to-day parenting', which will be documented in the child's Placement Plan.
For further information on consent, see Department of Health and Social Care Reference Guide to Consent for Examination or Treatment.
Each child's Placement Plan, drawn up by the Home, must include the health care needs for the child and how they will be promoted by the Home.
Additionally, each Child must have a Health Care Plan (which may be part of the Child's Care Plan or may be a separate Plan) drawn up by the Placing Authority/Social Worker.
The initial Health Care Plan should be drawn up in time for the first Looked After Review, after a Health Care Assessment has been undertaken. The Health Care Plan should then be updated after each Health Care Assessment or as circumstances change.
The matters that should be considered in drawing up the Health Care Plan (and addressed in the Home's Placement Plan as necessary) are as follows:Information should also be given about any allergies. See also First Aid, Home Remedies and Medication Procedure and Provision and Preparation of Meals Procedure.
One of the key responsibilities of the child's 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 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 Health and Wellbeing, Health Notifications and Access to Services Procedure.
Also see Keyworker Guidance.