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Looked after children and young people – actions for local multi-agency partnerships. Implementing NICE/SCIE guidance. 2010. NICE public health guidance 28. What this presentation covers. Background Scope Areas for action by local multi-agency partnerships Costs and savings Discussion

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

Implementing NICE/SCIE guidance


NICE public health guidance 28

what this presentation covers
What this presentation covers
  • Background
  • Scope
  • Areas for action by local multi-agency partnerships
  • Costs and savings
  • Discussion
  • Find out more
  • 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
  • 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
areas for action
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
strategic planning of services
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
care planning and case review
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
planning placements
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
placement changes
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
supporting babies and young children
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
  • 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
assuring the quality of foster and residential care 1
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
assuring the quality of foster and residential care 2
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
individual preferences and personal identity
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
diversity strategic actions
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
diversity actions for service delivery
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
health records and information
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
improving educational outcomes
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
preparing for independence
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
training for supervisors
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
independent reviewing officers
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
costs and savings
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
  • 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?
find out more
Find out more
  • Visit for:
    • the guidance
    • the quick reference guide
    • costing report
    • self assessment tool
    • guide to resources
  • Visit for Social Care TV films about looked-after children and young people