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The term Children in Care (CiC) is generally used to define, all children under the age of 18 whose care is the responsibility of the local authority under explicit sections of the 1989 Children’s Act. These sections cover emergency police protection, full and interim care orders and voluntary accommodation (NSPCC, 2013; HM Government, 1989).
Every child in care is allocated a Social Worker, and it is their responsibility to ensure effective ‘care planning’ for that child. The plan should be inclusive of the child’s health and developmental needs in all areas of their life to ensure they fully reach developmental milestones and successfully transition into adulthood.
Their care should be overseen by an IRO (Independent Reviewing Officer). This is an independent Social Worker and it is their job is to ensure the Local Authority manages a child's case appropriately and ensure their views are taken into account. Any concerns in relation to care planning for a child in care should be escalated to the IRO first and foremost.
All children in care should have a named health professional this will usually be a Health Visitor, School Nurse or Children in Care Nurse. Any information related to health and wellbeing should be shared with them as they will influence care planning in relation to the child’s health needs.
Any staff from the Trust providing services for Children and Young People in care should be involved in Care Planning and Review meetings.
The Initial Health Assessment (IHA) is a document that is a comprehensive, child focussed review of current and future health issues. A good assessment requires input from SW, carer, birth parents, medical reviewer and child.
The child is usually invited to an appointment with a doctor/nurse/ healthcare assistant where the assessment can be completed. The social worker, parents/carers should also attend.
At the appointment we will need detail about the childs’
- birth history and background health
- current health
- family history
We will need to know GP and Dentist contact details and about any allergies, current medications and immunisations. The childs ‘Red Book’ is useful as well as any other health documents available such as the Mother and Baby Form, Parental Health form.
We will also need to ask about other important aspects of well-being such as mood, education, relationships. A tool may have already been completed to assess mood (The SDQ) or this may be given at the appointment.
This assessment works best when the child is engaged and his/her ideas/concerns and expectations are heard and recorded. It may be appropriate that the child is seen alone during part of the appointment if they are willing. Please let us know if an interpreter is needed prior to the appointment.
Usually a focused examination of the child is carried out with consent. This may include a developmental check on a younger child.
At the end of the appointment an Action Plan is made for optimising any current or on-going health issues and predict any potential health problems in the future.
The Action Plan has a timescale and who documents who is responsible for carrying out each task that is made. Afterwards this is usually shared with any relevant people like Social worker, GP and will be updated at the next health review. The caregiver and the child can request a copy too.
If at any point you find yourself worried about something that’s going on in your life - whether it is relationships, drugs / alcohol or your mental health, the first step is beginning to talk about it. Here are some links to agencies and professionals who can give you some non-judgemental help when you need it.
Liverpool - www.brook.org.uk/?gclid=EAIaIQobChMI2IPNnbL61wIVjr3tCh3sCga6EAAYASAAEgJOufD_BwE
Sefton – www.seftonsexualhealth.co.uk/young-people-under-25/
Knowsley – www.sexualhealthknowsley.nhs.uk/
Alder Hey Children's Charity