Working in Partnership to improve outcomes of Children looked after.

1. Working in Partnership to improve outcomes of Children looked after. Laurie Ward Specialist Nurse Children Looked after and Care leavers

2. CLA & Care Leaver Health Service • Works in partnership with HCC children’s services to improve health outcomes for Children Looked After • Signpost and support young people, carers, health & children's services staff.

3. Issues that may impact on health • Children often enter care, with a worse level of health, than their peers • Teenage conceptions & early parenthood • Alcohol & drug misuse and other self harming risk taking activities • School exclusion • Being in young offender institutions & prison • Being within the mental health system • Being homeless • Sexual exploitation

4. Statutory Health Assessments • Process in place to co-ordinate administration of health assessments on behalf of HCC • When a child comes into Care – Initial Health Assessment (IHA) undertaken by a Doctor. • Review Health Assessments (RHA) undertaken by a nurse every 6 months under 5 years and annually up to the age of 18 years.

5. What is a Health assessment • A time for the young person to have a confidential discussion with a health professional • A safe environment for a young person to raise their concerns • An opportunity to establish the young persons Emotional, Physical and Sexual health needs • A summary and action plan developed

6. Why a school nurse? • Local school nurse seeing child locally • Aware of local resources • Relationship with key school staff i.e. Designated teacher • Continuum of care

7. Partnership support • Training • Support and advice • CLA nurse undertake school age RHA if required • The link between health and social care

8. Which of the topics discussed did you find useful?

9. Jess is a 14yr old girl who entered care at 11yrs old. Category: Full Care Order for Neglect. Parental misuse of drugs / Alcohol CLA Nurse Contacted by Social Worker – concerns from carer re. concentration / child talking to herself Initial Health Assessment by GP Referral to School Nurse by Teachers for support around bullying. Regular monitoring in School by School Nurse Referral to CAMHS by School Nurse - Social Worker aware Support /Contact around bullying Review Health Assessment (1) completed by School Nurse in School. Co-Ordination difficulty & Vision problems identified Actions Liaise with School Nurse & Carer Home visit by CLA Nurse. (Young Persons choice of venue & time) School Nurse School Nurse liaised with School: concerns raised by School Matron Liaison with Paediatrician Referral to Orthoptist – Glasses prescribed. Liaison with Carer Review Health Assessment (2) seen in school by School Nurse Liaison from Hospital Paediatric Liaison Nurse Re. A/E admission for fracture Actions Liaison with School Nurse