Supporting those in care: A spotlight on our Children Looked After Health Team

It’s not uncommon for their needs to change frequently, given the trauma they have experienced and associated vulnerabilities, especially with their emotional and mental health.

This is one of the major reasons why it’s important to have in-depth documentation of their care that everyone involved in their care can access.

Those in care are sadly more likely to be susceptible to risk taking behaviours and childhood exploitation, which makes safeguarding for this cohort of children more challenging because they tend to be at risk of coercion…this is where our Children Looked After Health team can help.

Kristie King, the operational service manager and named nurse for our Children Looked After (CLA) Health Team, says the service ensures that every child or young person in care is offered and encouraged to have their statutory health assessments.

“We’re a team of paediatricians, nurses and administrators who work with our cohort of children, their carers, allied health professionals, and children’s social care colleagues to ensure a suitable package of care is in place,” she says.

“Every child who comes into care, for whatever reason, will be offered an initial health assessment through our service with a paediatrician, who will look at the potential impact on them of neglect, additional needs, and discrimination – those unmet health needs.

“The number of children in care in Somerset has increased, which also includes our cohort of unaccompanied asylum-seeking children, for who we’re currently developing a bespoke package of care to meet their specific health needs.

“Since 2021, we have led on best practice for those children whose plan is adoption, with our CLA nurse specialist for adoption having led on many improvements, changes, and processes to better adhere to legislation and judicial recommendations.

“We strive to build trusting relationships with our cohort of children and it’s important that we ensure that the same CLA nurse completes their assessment each time for continuity where possible, and that we remain accessible to them in between assessments.

“At every health assessment, amongst other health topics, we assess and discuss with the child or young person their emotional health needs, and if they need support, we can signpost or refer them to various charities or services in emotional health and wellbeing or child and adolescent mental health services.”

Our Children Looked After service is made up of Kristie as service lead, alongside two specialist lead nurses, seven nurses and five administrators. The team was also incredibly proud to receive the trust’s Our People Award for ‘Clinical Team of the Year’ in 2021.

“When I began my role in 2020, we had just four colleagues in the service,” Kristie continues. “Since then, we’ve grown into a team of 15 – a great investment in the service in recognising those unmet needs and packages of care required.

“Each of the colleagues in our team have ‘champion’ roles where we’re responsible for liaising with other services who our cohort are likely to access, such as GPs, dentistry, mental health, social care, immunisation team and others.

“We know that for all children, their unmet health needs need an ongoing review and follow up to ensure their progress and completion.

“Following recruitment, we’re now able to do this by reviewing child health care plans three months after the health assessment. This process requires collaborative working with other health and care professionals, such as independent reviewing officers and social workers.

“As non-Children Looked After, I think we can all sometimes take for granted those little details that we ask our parents, such as how heavy we were at birth and what time we were born, whereas those in care don’t necessarily ever have that opportunity, but our fantastic administrative colleagues are able to source this information and it is documented in health assessments.”

Recently the team has been working with colleagues in our school-aged immunisation nursing team to ensure that children under our care are able to access their immunisations via them, in a timelier manner.

“It’s so important that every child and young person has equal access to immunisations to reduce the risk of illness, particularly with winter bugs circulating at this time of year,” says Kristie.

“Historically when we’ve carried out a health assessment and perhaps established that the child isn’t up to date with their immunisation programme, we’ve signposted them to their GP practice, but now we can access this as a fast track for secondary aged children, through our colleagues in SAINT, who will book them in for an appointment.”

Following feedback from children, young people, and their carer’s, the team has also changed the health assessment templates.

“We’ve historically followed the British Association of Fostering and Adoption forms to complete our health assessments, but we never really felt that they fully encompassed the views, wishes, and voice of the child,” adds Kristie.

“So, we’ve made a change in that all of our health assessments are now written to each child or young person and not about them, it’s more about “you told me that, you shared this with me” – this feels much more child-centred and is likely to be more beneficial for the child now and in the future.

“All health assessments discuss relationships and attachment to ensure that all children and young people feel safe and cared for – a crucial part of emotional wellbeing.

“Other areas covered include general health and development, education, and safety. For our older cohort we discuss sexual health/puberty, budgeting, diet, and empowering them to take responsibility for their own health so they can reach their full potential in adulthood.

“We are seeing some real successes in our team now, especially with the uptake of health assessments within the statutory timeframes.

“In fact, only 6% of the children and young people we offer an assessment to in Somerset have declined, which has been lower compared with the national average.

“We’ve gained much positive feedback from other counties regarding the format and content of our health assessments, some have requested to adopt our best practice."

“Like most services, we too experience challenges, but it’s helpful to celebrate the successes so that we can be innovative and motivated to make changes and improvements to help resolve those challenges."