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3.7.1 Health Assessments

AMENDMENT

Section 1.4 of this chapter was added in July 2011 to reflect the Care Planning, Placement and Case Review (England) Regulations 2010 and Associated Guidance.

Contents

  1. Key Practice Points
  2. Newly Accommodated Children
  3. Within 28 days of Placement
  4. The First Looked After Review
  5. Timescales for Further Health Assessments for Children Currently Looked After
  6. Responsibilities of Child Care Administrative Teams
  7. Recording

    Appendix A: General Health Assessment Process for Looked After Children

For detailed guidance, please refer to the Statutory Guidance on Promoting the Health and Well-being of Looked After Children published in November 2009 and available on the Department of Health website.

This guidance includes information in relation to 'Strengths and Difficulties Questionnaires which need to be completed annually as part of the health Assessment.


1. Key Practice Points

1.1 Allocated social workers should pay the same attention to the health of Looked After children as would be expected of a good parent. This means that as much as possible should be found out about the family medical history and the child's own history. There should be planning and action to address any health problems and the child should be given information and encouraged to pursue a healthy lifestyle.
1.2 Children of sufficient understanding may refuse Looked After medical examinations and their placement is not conditional upon their completion. It would be appropriate to ensure the refusal for a health assessment is an informed one. Should the child refuse, the reason should be documented.
1.3 For children of 11 and over, the Health Assessment will include a Drugs Screening Questionnaire to be completed.
1.4 The first Health Care Assessments must be conducted by a registered medical practitioner. Subsequent assessments may be carried out by a registered nurse or registered midwife under the supervision of a registered medical practitioner, who should provide the Social Worker with a written report (See Appendix A: General Health Assessment Process for Looked After Children)


2. Newly Accommodated Children

2.1

Within two working days of a child becoming Looked After, the allocated social worker will:

  1. Request a health assessment by completing the Referral Form For LAC Health Assessment and;

    Sending / faxing to -
    LAC Health Team
    Energy Centre,
    Mayday Hospital,
    530 London Road,
    CR7 7YE

    Fax: 020 8401 3989
    Tel: 020 8401 3994/2
  2. Complete the consent for medical assessment (part of the Placement Plan/Placement Information Record);
  3. Send a copy of the written consent with the Referral Form For LAC Health Assessment;
  4. Obtain the Personal Child Health Record (PCHR) from the child's parents;
  5. The PCHR will be given to the carer, to take to the health assessment.


3.  Within 28 days of Placement

3.1 The Social Worker will complete the Placement Information Record and send a copy to the LAC Health Team within 28 days of the child's placement.


4. The First Looked After Review

4.1

At the first Looked After Review, the social worker will:

  1. Receive a copy of the health assessment from the Designated Doctor for Looked After Children prior to the review;
  2. Copy the Review Minutes and the Care Plans to the LAC Health Team.


5.  Timescales for Further Health Assessments for Children Currently Looked After

5.1

Children will require a health assessment;

  1. 6 monthly for children under 5yrs;
  2. Annually for children over 5yrs;
5.2 When a Health Assessment is due, one month prior to the child's Looked After Review the child's allocated social worker will complete a Referral Form For LAC Health Assessment and send/fax it to the LAC Health Team. The social worker will receive a copy of the Health Assessment from the LAC Health Team prior to the Review.


6. Responsibilities of Child Care Administrative Teams

6.1

The Child Care Administrative Teams will:

  1. Inform the LAC Health Team of any change in placement, address, or legal status of the child;
  2. Send copies of Review Minutes and Care Plans for all Looked After Children to the LAC Health Team.


7. Recording

7.1 The child's health history, its effect on her/his development and the child's current health should be summarised on the Placement Plan/Placement Information Record.
7.2 If the child has undergone a medical examination in the past three months, this should be noted on the Placement Plan/Placement Information Record.
7.3 If no such examination has been carried out, the social worker should note this fact in the Placement Plan/Placement Information Record before passing it to the Administrative Team.
7.4 It is important to be able to find information on children's health, easily. All information on children's health must be filed in the Health Section of the file. This includes copies of information held in more general records or conversations with health professionals, which may be recorded in the daily log.


Appendix A: General Health Assessment Process for Looked After Children


HEALTH - LAC Health Team,
Children's Medical Services & other health professionals


A.


Initial Health Assessment

1.


On Receipt of Request for INITIAL Health Assessment

  • LAC Health Team (Designated Nurse) allocates health assessment to appropriate practitioner.
 

EITHER

Children under 5 years, or with complex medical needs, will be seen by a community paediatrician from the Children's Medical Services Team.

Children's Medical Service to:

  1. Track child's medical records, GP records
  2. Obtain information from EPEX regarding other health professionals involved in the child's care
  3. Arrange a Health Assessment appointment with the child's carer

OR

Children over 5 years will be seen by their GP

LAC Health Team to:

  1. Contact the carer and provide information about the Health Assessment
  2. Send a request for Initial LAC Health Assessment to the child's GP with a Croydon LAC Health Assessment Form
  3. Collate information received from Children's Social Care on the child e.g. Placement Information Record

2.


Within 14 Working days

The doctor from Children's Medical Service or the GP will carry out the Health Assessment, complete the Health Action Plan and forward it to the Designated Doctor for LAC for comments.


3.


Within 28 days

The Designated Doctor for Looked After Children will:

  1. Oversee the completed Health Assessment and make comments
  2. Authorise payment of the GP
  3. Ensure any referrals made by health have a confirmed appointment date for the Health Action Plan

The LAC Health Team will send a copy of the Health Assessment to the child's social worker prior to the child's first Looked After Review

4.


First Looked After Review Held

Health professional may attend the review if appropriate.

5.


Following Looked After Review

Children's Medical Service will pass all newly accommodated children's medical files, with all completed forms, to the LAC Health Team.

B.


Subsequent Health Assessments
 

The LAC Health Team allocates Health Assessments for Looked After children to the appropriate practitioner:

Designated Nurse LAC, Health Visitor, School Nurse, Practice Nurse or GP

Designated Nurse LAC to:

  1. Discuss required input for the child including continued monitoring and assessment with the health practitioner
  2. Send copy of the initial Health Assessment and Health Action Plan to the health practitioner
  3. Advise health practitioner of date for review Health Assessment
  4. Monitor implementation of Health Action Plans

Key Health Practitioner to:

  1. Adhere to agreed Croydon LAC Health Standards regarding performing subsequent health assessments and Care pathway for LAC
  2. Send completed subsequent Health Assessments and Health Action Plan to the Designated Doctor for LAC

C.


Croydon Children Placed out of Borough

  1. Dependant on the child's placement, the Initial Health Assessment will be undertaken either by the Designated Doctor LAC or the GP in the area where the child is placed. In certain circumstances the child may be brought back to Croydon for a health assessment to be carried out by a Paediatrician from Croydon's Children's Medical Service Team.
  2. Health Action Plan requirements and subsequent Health Assessments will be negotiated by Designated Nurse LAC, with PCT where child is placed.

D.


Other Borough Children Placed in Croydon

  1. All Looked After Children under 5 years or children with complex medical needs will be seen by a paediatrician from the Children Medical Service Team for Initial Health Assessments.
  2. All LAC over 5 years will be seen by their GP for Initial health assessments, negotiated and paid for by the Local Authority placing the child.
  3. Health Action Plan requirements & subsequent Health Assessments will be negotiated with the Designated Nurse for LAC with the health professional or the social worker from the placing Local Authority.

End