SCOPE OF THIS CHAPTER
This Protocol clarifies responsibility for Health Assessments for Looked After Children. It guides readers through the whole process, from the point at which a child first becomes Looked After to the completion and recording of Health Assessments within specified timescales. It also explains the process for children who are placed out of area.
Please note, for the purpose of this document the actions within the protocol are also applicable to children / young people who are Looked After and access short break provision i.e. those with complex health needs or disabilities.
This protocol has been updated throughout and was added to the procedures manual in May 2016.
- When a child becomes Looked After, it is the Local Authority's responsibility to notify the LAC Health Team within 3 working days of this occurring. Within the Local Authority this task is undertaken by the administration team on receipt of the C250 from the case holder. Swift notification to the LAC Health Team is essential and this is done by sending the C250 electronically via secure email via Egress at: firstname.lastname@example.org. LAC Health Assessments are only arranged when the initial C250 has been received by the LAC Health Team, and following discussion with the social worker;
- It is the Local Authority's responsibility to ensure that C250s that are sent to the LAC Health Team are completed fully advising if they are new into care, ceased to be LAC, change of main placement, including an accurate address and postcode or change of short break placement. Without a fully completed C250 any required health assessment cannot be arranged. It is also the Local Authority's responsibility to ensure that ICS is updated reflecting the changes in the child's circumstances;
- When the initial C250 has been received by the LAC Health Team the LAC Health Team's Admin team will ensure that the LAC icon is added onto SystmOne within the same working day and that the child is allocated a LAC Nurse;
- The LAC Nurse will contact the child's Social Worker to collate background information as to why the child is now in care or receiving substantial short break package, discuss consent and commence arranging an initial statutory Health Assessment for the child;
- If the child has recently had another medical assessment completed i.e. a neonatal assessment, a Child Protection medical, paediatric review for example the LAC Nurse will review these assessments and ensure that they are available for the initial LAC Health Assessment. Wherever possible a previous medical will be used for the LAC Health Assessment so as not to subject the child / young person to unnecessary assessments / medicals. Please note that Child Protection medicals, however, may not always contain enough detailed information. In other cases, relevant information may simply be unavailable, as in the case of children arriving from overseas. For short breaks if there is a Paediatric Review appointment already arranged this should be referred to by the LAC Nurses. Social Workers need to inform the LAC Nurse if they have arranged a medical themselves or if they are aware that one has been booked;
- Within 20 working days of receiving the C250, the LAC Nurse will offer an initial Health Assessment at one of the LAC clinics held jointly with a Paediatrician. The LAC Nurse will also contact the child's Social Worker and the child's Carer and invite them to attend. Where appropriate the child's birth parent(s) will be invited to attend the Initial Health Assessment appointment by the child's Social Worker. The LAC Health Admin will also send an appointment letter to the child's carer with the details of the appointment. In respect of short breaks the child / young person's parent or respite carer should be invited to attend;
- The child's Social Worker will attend the initial Health Assessment for the child and will assist the LAC Nurse and the Paediatrician in ensuring that the child's history / health needs are fully considered. The LAC Health Team's Admin workers will send a BAAF form to the child's Social Worker. The child's SW should bring the whole BAAF form ensuring that the initial two pages are signed and completed. If there are any extra requirements for the medical, for example if an interpreter is required for the child or parents attending, the social worker should notify the LAC Nurse and arrange for an interpreter to be present;
- Following the completion of the initial Health Assessment the Paediatrician takes responsibility for completing the BAAF paperwork and returning this paperwork to the LAC Health Team office within 5 working days of the assessment. LAC Nurses will ensure that the respective clinic diary is updated accordingly to show which assessments have been completed and which appointments did not take place and for what reason;
- The LAC Nurse will also ensure that the relevant Strengths and Difficulties Questionnaire is completed as well as feedback gathered from both the child / young person and carer using the Friends and Family Test. Both of these will be collected on the day of the health assessment. The SDQ is sent out with the appointment letter and brought to clinic with the child/young person. If not brought to the appointment, nurses can help the child / young person to complete an SDQ during the clinic;
- The LAC Health Team's Admin will scan the completed initial Health Assessment paperwork onto the child's record on SystmOne;
- The LAC Health Team's Admin will email a full copy of the Initial Health Assessment to the child's Social Worker. This is sent securely using Egress. SystmOne and ICS are also updated by LAC Health admin with a note to say that these documents have been emailed to the child's allocated Social Worker by name. On receipt of the health assessment it is then the responsibility of the Social Worker to read the health assessment and upload the health assessment on to the child's file in ICS. Health Assessments that are not read by Social Workers and not uploaded on to the child's file in ICS will not be re-sent to the child's allocated Social Worker;
- The LAC Health Team's Admin will update the dates for immunisations, dental and health assessment on ICS;
- It is the child's Social Workers responsibility to ensure that all health assessments are uploaded into the child's file, that they read the health assessment and complete any necessary actions and also check the dates for immunisations, dental and health assessments on ICS;
- A Youth in Mind report is produced by the LAC Health Team's SDQ coordinator and the Carers SDQ scores are inputted into ICS. An email is sent to the child's Social Worker informing them of this and that they can request a copy of the Youth in Mind Report from the LAC Health Team's SDQ coordinator;
- It is the LAC Nurse's responsibility to offer an appointment for the review health assessment and that this and all subsequent health assessments for the child are completed within the anniversary timescale. Prior to this, however, there will be a consultation with the Social Worker in order to be updated re legal status of the child, change in placement details etc. In the case of short breaks the child's Social Worker should be referred to by the LAC Nurse;
- For children who are aged under 5 years review health assessments are completed 6 monthly. For children who are aged over 5 years review health assessments are completed 12 monthly. LAC Nurses will arrange the necessary subsequent appointments with carers / children / young people;
- LAC Nurses will ensure that the SystmOne template and plan for the health assessment is completed within 5 working days. SystmOne is the electronic health record for each child used by the LAC Nurses and other health colleagues;
- The completed Review Health Assessment paperwork will then be emailed by Egress from the LAC Health Admin to the child's Social Worker.
2. Out of Area Placements
- For Bradford Looked After Children who are placed out of area the LAC Health Team must be informed of this via C250. A full address including postcode is required;
- When the LAC Health Team is aware that a Bradford child is placed out of area then they will assume responsibility for arranging a health assessment to be completed by a health colleague in the area where the child is residing. This will be done following consultation with the child's social worker. The LAC Nurse will need to be provided with written consent for that assessment by the Social Work Team;
- Progressing the health assessment is dependent on the child's Social Worker providing the necessary consent. The LAC Health Team's Admin staff will contact the child's Social Worker requesting the completion and return of relevant consent paperwork to the LAC Health Team. A health assessment will not be arranged without the return of the consent paperwork. Requests for consent from the child's Social Worker are recorded on SystmOne by the LAC Health Admin;
- When the consent paperwork has been completed accurately and returned to the LAC Health Admin Team they will request the completion of the health assessment from the relevant LAC Health Team (or other health colleague) in the area in which the child is residing;
- The LAC Health Team will pursue the completion and return of the statutory health assessment paperwork and will ensure that this is quality assured when it is returned. If there is no response at the first request, then a second request will follow at 6 weeks, and the LAC Health team admin will document this in the Communications and Letters on SystmOne;
- Providing the health assessment is completed appropriately then the LAC Health Admin Team will ensure that the child's social care record is updated accordingly and that the health assessment paperwork is forwarded via Egress to the child's Social Worker;
- It is the child's Social Worker's responsibility to upload the health documentation on to the child's file in ICS. This is sent securely from the LAC Health Team to the Social Worker using Egress. SystmOne and ICS are also updated by LAC Health admin with a note to say that these documents have been emailed to the child's allocated Social Worker by name. On receipt of the health assessment it is then the responsibility of the Social Worker to read the health assessment and upload the health assessment on to the child's file in ICS. Health Assessments that are not read by Social Workers and not uploaded on to the child's file in ICS will not be re-sent to the child's allocated Social Worker.
3. Adoption Medicals
Where it is known at the point of entry into care or at the initial review meeting that the child or Young person is to be triple tracked for adoption, then it is the responsibility of the child/young person's Social Worker to arrange the adoption medical with the appropriate paediatrician. This medical will also serve as the Initial health assessment, helping to avoid unnecessary medical examinations of the child and duplication of work. It is the responsibility of the Social Worker to inform the LAC nurse of the time and date of the adoption medical.