The Health and Well-being Standard
Regulation 10
Children’s Attachment: Attachment in Children and Young People who are Adopted from Care, in Care or at High Risk of Going into Care - NICE Guidelines (NG26) - This guideline covers the identification, assessment and treatment of attachment difficulties in children and young people up to age 18 who are adopted from care, in special guardianship, looked after by local authorities in foster homes (including kinship foster care), residential settings and other accommodation, or on the edge of care. It aims to address the many emotional and psychological needs of children and young people in these situations, including those resulting from maltreatment.
Every Child Looked After should have a Health Care Assessment soon after being placed and then at specified intervals; as set out below.
The purpose of a Health Care Assessments is to carry out an initial assessment of the child’s physical, emotional and mental health. The Health Care Assessment will inform the child’s Health Care Plan, and ensure that the placement meets the child's holistic health needs. As a minimum the child’s main carer will be required to completed the carer’s two-page version of the Strengths and Difficulties Questionnaire (SDQ) for the child in time to inform his or her health assessment.
Health Care Assessments must be conducted by a suitably qualified medical practitioner; who should provide the social worker with a written report.Health Care Assessments should not be seen as an isolated event but rather be seen as part of the continuous cycle of care planning (assessment, planning, intervention and review) and build on information already known from health professionals, parents and previous carers, and the child himself or herself.
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, the social worker should ensure that all the necessary consents and delegated authority permissions have been obtained so that decisions are not delayed. Young people (dependant on their age and understanding) can provide informed consent for the assessment.
Each child's Placement Plan, should identify the child’s health care needs (if any) and set out how these will be met by the home.
The initial Health Care Plan should be produced before the first Child Looked After Review. The Health Care Plan should then be updated after each Health Care Assessment or as circumstances change.
The Health Care Plan should describe how the child’s physical, emotional and mental health needs will be addressed to improve health outcomes.
The Health Care Plan (and the Placement Plan as necessary) should cover the following:
One of the key responsibilities of the child's Key Worker is promoting his/her health and educational achievement, liaising with key professionals, including the Named Nurse for Children Looked After, the child’s GP and dental practitioner.
The Key Worker will also ensure that up to date records are 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 Key Worker must also ensure the child is registered with a GP and other health care professionals as set out in Health Notifications and Access to Services Procedure.Also see Key Worker Guidance.