4.7.5 Health Care Assessments and Health Care Plans

AMENDMENTS

This chapter was slightly amended in September 2011 to take account of the changes in the Care Planning, Placement and Case Review (England) Regulation 2010, see Section 1, Health Care Assessments.

SCOPE OF THIS CHAPTER

This procedure applies to every Child in Care.

It summarises the arrangements that should be made for the promotion, assessment and planning of health care for a Child in Care.

See also Sexual Health Procedure in relation to the provision of advice to Looked After children on sexual health, sexual relationships and contraception.

Health Care Assessments
Health Care Plans

1. Health Care Assessments

The purpose of Health Care Assessments is to promote children’s physical and mental health and to inform the child’s Health Care Plan.

The first assessment must be 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.

The medical practitioner or Specialist Nurses for Looked After Children who carry out the assessments, should complete and send the child’s social worker a Health Assessment Form. The social worker will then arrange for a copy of the Health Assessment to be sent to the child (depending on age), the parents and the staff/carers.

The first Health Assessment must be conducted before or within 14 days of the child’s placement so that a Health Care Plan can be drawn up in time for the first Looked After Review (20 working days of date from which child became Looked After), and any necessary follow up assessment must be arranged by the social worker.
For children aged under two years, further Health Assessments should occur at least every three months.
For children aged between two and five years, further Health Assessments should occur at least every six months.
For children aged over five years, further Health Assessments should occur at least annually

In order to ensure the first Health Care Assessment takes place within the required timescale, the administrative staff in the relevant social work team will inform the Looked After Children's Health Team by completing form HQP1.

The Health Team Administrator will issue reminders to the relevant social work teams as and when further Health Assessments become due under the above time-scales. It is then for the child’s social worker to ensure that appropriate arrangements are made.

Where a child is placed outside Luton, and it is not practicable because of the distance involved for the Health Assessment to take place in Luton, the social worker must contact the relevant local heath trust or GP to make the necessary arrangements for Health Assessments.

In order for the Assessment to be conducted, the social worker must ensure that the Consents section of the child’s Placement Plan/Placement Information Record has been completed and signed by the Parent.

The social worker will inform the child, parents and staff/carer of the purpose of and arrangements for the health assessment, and accompany the child and parents (or arrange for staff/carers to accompany the child, as appropriate).

As part of the explanation, the social worker will ensure that the child, parent and carer receive an appropriate leaflet and questionnaire (to be provided by the Health Team) and that the contents are read and/or appropriately explained.

The Health Team will collect information already available on the child’s health by sending a form to the relevant health visitor or school nurse and obtaining information from the Child Health record system.

2. Health Care Plans

The child’s social worker is responsible for drawing up Health Care Plans for Looked After Children based on the information in the Health Assessment, and will do this in conjunction with the Specialist Nurse for Looked After Children who completed the Health Assessment.

Each Looked After Child’s Placement Plan/Placement Information Record must incorporate a Health Care Plan in time for the first Looked After Review. This Plan must be reviewed after each subsequent Health Care Assessment or as circumstances change.

The Placement Plan/Placement Information Record for each Looked After Child must incorporate how the health care needs of the child will be addressed.

As necessary the Placement Plan/Placement Information Record should address the following matters:

Whether there are any specific health care needs – and how they will be met.
Whether it is agreed that Paracetamol or other painkillers can be used to provide relief for headaches, menstrual or other pain; also whether there are any restrictions on the use of non-prescribed medicines, Household Remedies or use of first aid.
The involvement of the child’s parents or significant others in health issues during the placement.
Any specific medical or other health interventions which may be required, including whether it is necessary for any Intimate Procedures and how they will be undertaken.
The extent to which the child is able to retain or administer medication, or requires support to do so.
Whether it is necessary for any immunisations to be carried out.
Any specific treatment, strategies or remedial programme's required.
Any necessary preventive measures to be adopted.
Whether the child is allowed to smoke and any measures agreed to reduce the behaviour.
Whether there are any illegal or other activities including self harming which it is known or suspected the child is engaged in which may be harmful to the child’s health, and the interventions/strategies to be adopted in reducing or preventing the behaviour.
Whether the placement will contribute to any other health-related assessments.
Whether the placement will contribute to any health monitoring.