Children Looked After
Overview
The term “Looked after Child” (LAC) refers to a child who is in the care of the Local Authority. The term has a specific legal meaning based on the Children Act 1989. These children and young people may also be known as a Child in Care, (CIC), although in Somerset, looked after children request is known as Children Looked After to avoid the so-called LAC abbreviation.
Children can become looked after at any age from birth up to their 18th birthday.
Under the Children Act 1989, a child is Looked After by a Local Authority if he or she falls into one of the following:
⦁ is provided with accommodation, for a continuous period of more than 24 hours (Children Act 1989, Sections 20 and 21)
⦁ is subject to a care order (Children Act 1989, Part IV), or is subject to a placement order.
They may have been placed in care voluntarily by parents struggling to cope, or by Children’s Social Care who may have intervened because they were identified as being at significant risk of harm, neglect or exploitation.
A child will cease being Looked After by the Local Authority when they are adopted, return home or reach the age of 18 years.
Care Leavers are those children and young people who have previously been Looked After by the Local Authority and are now being supported to live independently. Following the publication of the Children and Social Care Act, (2017), Local Authority responsibility for Care Leavers changed from 18 to 21 years to an age range of 18 to 25 years, enabling Care Leavers to request support up to the age of 25, regardless of whether they are in education.
Children who are Looked After may be living:
- with foster parents
- at home with their parents under the supervision of Children’s Social Care
- in residential children’s homes
- in other residential settings, for example schools or secure units.
- away from home on a planned basis for short breaks or respite care
- with supported lodging carer’s if aged 16 years or older
- in semi-independent accommodation if aged 16 years or older
- in independent accommodation if aged 16 years or older
The number and rate of children looked after in the UK are increasing overall.
In England this was up by 2% to 83840 in 2022-2023.
33000 children started to be looked after, this is an increase of 6%.
31,680 ceased to be looked after, increase of 5%.
2960 children were adopted. This is a decrease of 2%.
Our Duties
NHS Somerset ICB is the Responsible Commissioner for health services provided to Somerset Children Looked After whether they are resident within Somerset or outside. The ICB endeavours to meet the health needs of Children Looked After and Care Leavers as illustrated in the Statutory Guidance Promoting the health and well-being of looked-after children, (DoH, DfE, 2015).
A vigorous and robust system of quality assurance and performance monitoring has been developed with health and social care partners to ensure that a seamless service is delivered. The ICB maintains its statutory duty to cooperate with Local Authorities to ensure health assessments are undertaken and support and services are provided to CLA without undue delay.
ICBs must ensure that any changes in healthcare provider due to CLA placement move do not disrupt the objective of providing high quality, timely healthcare to the child.
ICBs must ensure that plans are in place to enable children leaving care to continue to obtain the healthcare they need.
NHS Somerset ICB gains assurance that its healthcare services to CLA meet the standards laid down in the Statutory Guidance by ensuring that high quality Statutory Initial and Review Health Assessments and associated Health Care Plans and Health Leaving Care Summaries are delivered to CLA and Care Leavers in a timely way. Similarly robust key performance indicator monitoring of CLA access to dental services and immunisation rates and completed Strengths and Difficulties Questionnaires, (SDQs), provide assurance that CLA health needs are identified and met.
The ICB also has a statutory role and functions for fostering and adoption as defined in the Children.
Function of the Designated Professionals for Children Looked After and Care Leavers
The Designated Doctor and Designated Nurse for Children Looked After and Care Leavers are the strategic health leads for looked after children in Somerset. They have a very important role in promoting the health and wellbeing of looked after children by:
- assisting the ICB and other health service commissioners in service planning and development
- advising the ICB on fulfilling their responsibilities to improve the health of CLA.
- leading and supporting all activities necessary to ensure organisations within the Somerset Health community, (both commissioner and provider), meet their responsibilities for CLA.
- providing expert advice and support, (including case focused support and supervision), to health staff at all levels who are delivering health services to CLA.
- representing the health needs of CLA at a number of single and multi-agency operational and strategic meetings and Boards including the Corporate Parenting Board and Health and Wellbeing Subgroup.
The Designated Professionals can be contacted on 01935 381999 Monday – Friday 9am – 5pm. Non urgent enquiries can be sent to the team generic email somicb.safeguardingandcla@nhs.net
Commissioned Providers
NHS Somerset commissions services for looked after children through Somerset NHS Foundation Trust. Local Authority Public Health Nurses also provide services to looked after children.
Somerset NHS Foundation Trust provides the Children Looked After Health Team which facilitates the provision of relevant health services to all Somerset looked after children and young people and those children and young people who are resident in Somerset from other Local Authority areas in accordance with their Health Care Plan. This team also provides statutory Review Health Assessments and arranges Initial and Review Statutory Health Assessments provided by Public Health Nurses and providers outside of Somerset.
Somerset NHS Foundation Trust also provides medical services to deliver both Statutory Initial Health Assessment and Statutory Adoption Medical Reviews. They also provide the Adoption Medical Advisor to the Statutory Adoption Panel.
Information for ICBs and Local Authorities placing children in Somerset
When moving a child or young person into a Somerset placement please email somicb.safeguardingandcla@nhs.net providing all demographic information, the name and contact details of the child’s Social Worker and any specific health needs including CAMHS treatment and crisis plans and Education and Health Care Plans, (EHCP). Please follow local protocols for notification to the relevant receiving Local Authority.
Initial and Review Health Assessments can be requested. Please send all such requests with appropriate paperwork by secure email to CLANursesandDoctors@SomersetFT.nhs.uk
Contact Details
Please direct any questions in respect of looked after children or care leavers originating from or resident in Somerset to:
Emma Clothier emma.clothier1@nhs.net
Designated Nurse Children Looked After and Care Leavers
Dr Carol Smith casmith@somerset.gov.uk and carol.smith1@somersetft.nhs.uk
Designated Doctor Children Looked After and Care Leavers
NHS Somerset, Wynford House, Lufton Way, Yeovil, Somerset, BA22 8HR
Switchboard: 01935 384000 Direct dial: 01935 381999
