Looked after children and young people – actions for local multi-agency partnerships

1. Looked after children and young people – actions for local multi-agency partnerships Implementing NICE/SCIE guidance 2010 NICE public health guidance 28

2. What this presentation covers • Background • Scope • Areas for action by local multi-agency partnerships • Costs and savings • Discussion • Find out more

3. Background • More than 60,000 children and young people are looked after in England at any time. The main reasons for becoming looked after are abuse, neglect and family dysfunction • About 60% of looked-after children and young people have mental health and emotional problems • In adulthood, a high proportion experience poorhealth, educational and social outcomes

4. Scope • The guidance covers children and young people from birth to age 25, wherever they are looked after • The recommendations cover strategy and policy, commissioning and delivery of services, and inspection

5. Areas for action • Strategic planning of services • Care planning, case review and placements • Supporting babies and young children, and siblings • Assuring the quality of foster and residential care • Personal preferences, identity and diversity • Health records and information • Improving educational outcomes • Preparing for independence • Training

6. Strategic planning of services • Assess needs during the joint strategic needs assessment and show how these will be met in local plans • Provide dedicated multi-agency services for looked-after children and young people on one site • Publish a directory of local services and resources • Reflect issues raised by the children-in-care council in the yearly ‘pledge’ to looked-after children and young people

7. Care planning and case review • The multi-agency team should have access to a consultancy service to support collaboration on complex casework • Any concerned professional should be able to request a review of the care plan • The looked-after child or young person should also be able to request a review • Develop an information-sharing protocol

8. Planning placements • Develop a placement strategy • Placements with family and friends should be promoted as a positive choice • Ensure there are pooled budgets for specialised care placements

9. Placement changes • Base decisions on changing placements on an assessment of the current needs of the child or young person, and consider their wishes and feelings • Monitor the number of decisions where placement moves are made against the wishes of the child or young person, including the reasons • Monitor the number of emergency placements to understand why they happen and how they can be reduced

10. Supporting babies and young children • Carry out a comprehensive assessment • Specialist services should:– provide support and training to carers and frontline practitioners – work with the child and carer to support secure attachments • Put the impact of loss of attachment at the centre of the decision when deciding on placement change • Use ‘twin tracking’ when appropriate

11. Siblings • Siblings should have the same social worker if possible • Place siblings together unless assessments or the wishes of the child or young person suggest otherwise • When decisions are made to separate siblings:– record the reasons and explain them to the children– plan for ongoing contact if appropriate

12. Assuring the quality of foster and residential care – 1 • Training should cover: • Parenting skills, child development and attachment • Transitions, stability and how to manage change • Meeting needs for physical affection • Educational stability and achievement • Good health and healthy relationships • Joint working with all agencies • Extracurricular activities

13. Assuring the quality of foster and residential care – 2 • Support for foster carers should include: • emotional support and parenting guidance • advice as part of the team ‘around the child’ • child care to help them attend training • additional support until training is complete, and when there are additional challenges • their own children in all support • help with stress and for emergencies • health promotion advice • information about leisure activities

14. Individual preferences and personal identity • Promote continued contact with people important to the child • Ensure access to hobbies and interests • Offer assertiveness training to promote esteem and safety • Promote life-story work

15. Diversity – strategic actions • Produce a local diversity profile, and use this to commission services • Consider setting up a multi-agency panel • Ensure the children-in-care council discuss children and young people with particular needs regularly • Consult looked-after children and young people • Share good practice with similar areas • Appoint a local diversity champion

16. Diversity – actions for service delivery • Consider cultural, religious, ethnic and language issues in core assessments and care plan reviews • Create links with community and peer support • For unaccompanied asylum-seeking children and young people, ensure access to specialist psychological services • Provide support and training to professionals and carers about diversity issues

17. Health records and information • Collect data on the child’s and parents’ health using forms such as those provided by the British Association of Fostering and Adoption • Share health information about the child as appropriate and ensure that the personal health record follows the child up to the age of 18 • Obtain appropriate consent for all healthcare interventions • Obtain appropriate permission to access healthcare information • Put a system in place to monitor, and address failure to obtain, permission or consent for health matters

18. Improving educational outcomes • Appoint a virtual school head to work with schools to maximise the educational potential of looked-after children and young people • Ensure designated teachers are involved in preparing and monitoring PEPs, IEPs and PSPs • Support young people to apply for and attend college and university. In particular provide: – help finding accommodation, including holidays– advice on financial support

19. Preparing for independence • Ensure there is an effective and responsive leaving-care service. Consider a one-stop shop • Establish protocols with housing, health and adult social care to identify care leavers as a priority group • Enable young people to remain in their foster or residential home beyond the age of 18 • Ensure young people are not moved from a secure or custodial placement into independence too soon

20. Training for supervisors • Ensure social workers and managers who supervise carers have training on: • identifying support needs • how to support carers • recognising stress or secondary trauma • when to refer a child for professional assessment or intervention • the additional needs of carers of children with vulnerabilities

21. Independent reviewing officers • Provide independent reviewing officers with training on:– the education system and the importance of a stable education– evaluating health assessments and education plans– holding professionals accountable– how to motivate other professionals – the importance of creative and leisure activities • Monitor the quality of independent reviewing officer service

22. Costs and savings • Likely immediate costs to the NHS, arising from:– delivery of and providing earlier access to services to promote emotional wellbeing and mental health • Possible cost savings in the short and long term, arising from:– avoiding placement breakdown – reduced risk of mental health problems – reduced rates of offending – increased employment opportunities

23. Discussion • How can we ensure access to a consultancy service for complex casework? • How comprehensive is our placement strategy? • How effective are we at managing placement moves? • What support and training do we need to provide for professionals and carers? • How can we improve education services for looked after children?

24. Find out more • Visit www.nice.org.uk/PH28 for: • the guidance • the quick reference guide • costing report • self assessment tool • guide to resources • Visit www.scie.org.uk for Social Care TV films about looked-after children and young people