Children Looked After
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.
Children who are looked after fall into five main groups:
- children who are accommodated under a voluntary agreement with their parents (Section 20, Children Act 1989 status)
- children who are subject to a care order, interim care order or supervision order staying with birth family or other legal orders, (Section 31, Children Act 1989),
- children who are the subject of emergency orders for the protection of the child
- children who are compulsorily accommodated. This includes children remanded to the Local Authority or subject to a Youth Rehabilitation Order with a residence requirement
- children in respite/short breaks who are subject to the same statutory reviews as looked after children.
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. Children who have been looked after by a Local Authority for at least 13 weeks since the age of 14 and have left care on or after their 16th birthday are known as Care Leavers up to their 25th birthday and are entitled to additional services and prioritised support.
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, although trends vary between the four nations. The numbers of children looked after in England, Wales and Northern Ireland has continued to increase:
- in England this was up by 4% to 78,150 at March 2019
- in Wales this was up by 7% to 6,846 at March 2019
- in Northern Ireland at 31 March 2019, 3,281 children were in care. This was the highest number recorded since the introduction of the Children (Northern Ireland) Order 1995
- in Scotland, the number of looked after children peaked at 16,248 in 2012 and was down to 14,897 by 2017
This is partly due to differences between the nations around when children are counted as being ‘in care’, and what this means in practice. Because of these differences, rates cannot be directly compared between nations.
NHS Somerset is required, under Section 10 of the Children Act 2004 to ensure the timely and effective delivery of health services to Children Looked After and Care Leavers. To support the ICB in this role a Designated Doctor and Designated Nurse are employed as strategic leads to assist and advise ICB health commissioners and Somerset Local Authority in fulfilling their responsibilities to improve the health of Children Looked After and Care Leavers.
The Health and Social Care Act 2012 places a legal duty on ICBs to work with Local Authorities to promote the integration of health and social care services.
The mandate to NHS England, Statutory Guidance on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies, (2013), and The NHS Constitution for England, (2015), make clear the responsibilities of ICBs and NHS England to looked after children (and, by extension, to care leavers). In fulfilling those responsibilities, the NHS contributes to meeting the health needs of looked after children in three ways:
- commissioning effective services,
- delivering through provider organisations,
- and through individual practitioners providing coordinated care for each child
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 Sub Group
NHS Somerset commissions services for looked after children through Somerset NHS Foundation Trust and Yeovil District Hospital 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.
Yeovil District Hospital NHS Foundation Trust provides medical services to deliver Statutory Initial Health Assessments and Statutory Adoption Medical Reviews.
Information for ICBs and Local Authorities placing children in Somerset
When moving a child or young person into a Somerset placement please email firstname.lastname@example.org 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 and will be charged at the current NHS national tariff rates. Please send all such requests with appropriate paperwork by secure email to CLANursesandDoctors@SomersetFT.nhs.uk
Please direct any questions in respect of looked after children or care leavers originating from or resident in Somerset to:
Sarah Ashe Sarah.email@example.com
Designated Nurse Children Looked After and Care Leavers
Designated Doctor Children Looked After and Care Leavers
NHS Somerset, Wynford House, Lufton Way, Yeovil, Somerset, BA22 8HR