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CIC and Health. Thresa McCarthy/Jill Sim Children in Care Nurses. Policy Context. Healthy Lives, Brighter Futures: the strategy for children and young people’s health (2009) Statutory Guidance on Promoting the Health & Well-being of Looked After Children (2009)

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CIC and Health

Thresa McCarthy/Jill Sim

Children in Care Nurses


Policy context
Policy Context

  • Healthy Lives, Brighter Futures: the strategy for children and young people’s health (2009)

  • Statutory Guidance on Promoting the Health & Well-being of Looked After Children (2009)

  • The NICE Quality Standard of the Health and wellbeing of looked-after-children and young people (2013)


Effects of trauma and neglect on the child in care
Effects of Trauma and Neglect on the Child in Care

  • These functions may be diminished or lost:

    • language, especially spoken language

    • words for feelings

    • sense of meaning and connection

    • empathy

    • impulse control

    • mood regulation

    • short term memory

    • capacity for joy


Physiological effects
Physiological Effects

  • Perpetual extreme levels of stress arousal

  • may lead to:

    • hyper vigilance and loss of ability to concentrate

    • altered vision and hearing

    • hyperactivity or dissociation

    • avoidance of potential triggers to trauma

    • altered sleep patterns

    • altered eating patterns

    • compulsive self harm

    • attempts to self medicate with substances


What is the impact
What is the impact?

  • Neglect and unmet emotional needs

  • Children may:

    • be slow to learn to walk and talk

    • be very passive and unable to be spontaneous

    • have feeding problems and grow slowly

    • find it hard to develop close relationships

    • be overfriendly with strangers

    • find it difficult to make and sustain relationships

    • be unable to play imaginatively

    • think badly of themselves

    • be easily distracted and find it difficult to learn


Children in care physical health need
Children in Care - ‘Physical Health Need’

  • Two thirds of Children in Care have at least one physical complaint most commonly eye and or sight problems, bedwetting, speech or language problems, difficulty in co-ordination, and asthma. (Meltzer et al 2003)

  • 52% of Children in Care for a year had a physical or health condition that required out- patient treatment. (Skuse et al 2001)

  • Three quarters of children with a mental health disorder also had at least one physical complaint. (ONS 2002)

  • (Quoted in the Guidance on Promoting the Health & Wellbeing of LAC, 2009)


Children in care lifestyle choices
Children in Care -“Lifestyle choices”

  • DRUGS & ALCOHOL:

  • In 2003

  • One in twenty with a mental health disorder drank alcohol daily

  • One in five had used cannabis

  • Next most popular substances were ecstasy and glue (ONS 2003)

  • In 2007

  • 5% identified as having a substance misuse problem of whom two thirds received treatment

  • (formerly DCSF 2008 now Department for Education)

  • In 2008

  • YP in care reported drinking alcohol, smoking and experimenting with sex at an early age but only 11% reported experimentation with drugs ( CAFCASS 2008 )


Children in care lifestyle choices1
Children in Care“Lifestyle choices”

  • Higherlevel of substance misuse , including smoking, among Children in Care than among the non – care population (Meltzer et al 2003)

  • SMOKING:

  • One third 11-17year olds are smokers

  • 69% of those in residential care

  • (DCSF 2008)


Children in care lifestyle choices2
Children in Care“Lifestyle choices”

  • Sexual Health

  • Teenage girls in Care are 2.5 times more likely to become pregnant than other teenagers – Social Care Institute for Excellence 2004

  • - This is more likely if they are placed in residential as opposed to foster care.

  • Children and Young people in Care are at increased risk of sexual exploitation. The Children’s Society 2012.


Role of cic nurse
Role of CIC Nurse

  • Undertake a holistic comprehensive health assessment

  • Inform/support & challenge health professionals and others

  • including CiC Clinical Supervision/advocacy and interpretation of health information

  • Liaise with other CiC Nurses – Countywide/Regionally/Nationally

  • Multi Agency Training - to a multi Agency Audience including Carers

  • Lead and contribute to audits

  • Influence Policy & Strategic Planning, Locally and Nationally

  • Work with Partners

  • Client focused meetings -


Issues of consent
Issues of Consent

  • Parental responsibility.

  • Fraser Guidelines.


  • VSK East and South.

  • Brook House

  • John Wilson Business Park

  • Reeves Way

  • Whitstable

  • CT5 3SS

  • Tel: 01227 284475

  • VSK West and North.

  • Commercial Services

  • Gibson Drive

  • Kings Hill

  • West Malling

  • Kent

  • ME19 4QG

  • Tel: 01732 525355


Service for ola other local authority children
Service for OLA (Other Local Authority) Children

  • 1 Specialist Nurse –Sally Galbraith

  • 2 Part time administrators based at:-

  • Aylesham Health Centre

  • Aylesham

  • Kent

  • CT3 3BB

  • Tel: 01304 843768


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