Quality statement 5: Support from specialist and dedicated services

Quality statement

Looked-after children and young people receive specialist and dedicated services within agreed timescales.

Rationale

Looked-after children and young people have particular emotional needs, and often behavioural needs relating to their experiences before entering care and during the care process. They share many of the same health risks and problems of their peers, but often to a greater degree. Access to an appropriate level of services when needed is essential to meet their emotional, physical, behavioural and educational needs (including specialist educational needs).

Quality measure

Structure:

a) Evidence of local arrangements to ensure that looked-after children and young people receive specialist and dedicated services to meet their needs. These services should be delivered on a continuing basis within agreed timescales.

b) Evidence of local arrangements for health plans to be monitored and updated by independent reviewing officers, social workers and the lead health professional to ensure that the child or young person's continuing needs are being met.

c) Evidence of local arrangements for case management and treatment to continue for looked-after young people moving from child to adult mental health services, until a handover with an assessment and completed care plan has been developed with the adult service.

Process: Proportion of looked-after young people who are moving from child to adult mental health services, whose case management and treatment continues until a handover is completed with the adult service.

Numerator – the number of people in the denominator who have their case management and treatment continued until handover with the adult service.

Denominator – the number of looked-after young people who are moving from child to adult mental health services.

Outcome:

a) Feedback from looked-after children and young people that they have access to the services they need.

b) Feedback from recognised assessment tools that the child, young person or care leaver's needs are being met through access to specialist and dedicated services when needed.

c) Feedback from carers that they feel the needs of children and young people that they look after are being met through access to specialist and dedicated services when needed.

What the quality statement means for each audience

Looked-after children and young people have access to specialist and dedicated services within agreed timescales.

Local authorities and other commissioning services ensure they commission services that provide looked-after children and young people with access to specialist and dedicated services within agreed timescales, and that health plans are monitored and updated.

Organisations providing care ensure local arrangements are in place to refer looked-after children and young people to specialist and dedicated services within agreed timescales, and to monitor and update health plans to ensure their needs are continuously met.

Social care, education and healthcare staff refer looked-after children and young people to specialist and dedicated services within agreed timescales, and monitor and update health plans to ensure their needs are continuously met.

Source guidance

NICE public health guidance 28/SCIE guide 40 recommendations 2, 5, 8, 9, 10, 11, 16 and 17.

Data source

Structure: a), b) and c) Local data collection.

Process: Local data collection. Data are collected through the Children and young people's health service secondary uses data set on the type of service, specialty or sub-specialty providing the care contact (global number 17101630) and consultation medium used (global number 17104470).

Data are collected through the Child and adolescent mental health services (CAMHS) secondary uses data set on whether a child is a looked-after child (global number 17300540), their accommodation status (global number 17300070), the relationship to the person that the child or young person lives with (global number 17300380), discharge reason (global number 17300880), status of service request (global number 17300780), activity location (global number 17300910), intervention type (global number 17302820), care professional team start and end dates (global numbers 17309180 and 17309190) and other assessment tool types completed (global number 17307060).

Outcome: a) and c) Local data collection.

b) Local data collection. Providers may consider using the Strengths and difficulties questionnaire as part of an evaluation of whether needs are being met.

Definitions

Agreed timescales

Access needs to be determined locally given the range of services. The aspiration is that looked-after children and young people receive services when needed and should not be subject to delays in access.

Carers

Carers include foster carers (including family and friends carers), residential carers and supported lodging providers.

Health plan

The health plan forms part of the care plan and is developed from the assessment of the child's health needs. The Children Act 1989 guidance and regulations volume 2: care planning, placement and case review sets out what the health plan should include. Care leavers have a pathway plan that will include arrangements to meet their health and development needs (pathway plan is defined in quality statement 8).

Needs

Specialist needs may include physical, emotional, behavioural, health or educational needs (including specialist educational needs).

Equality and diversity considerations

Services should be available to meet the diverse needs of looked-after children and young people, including (but not limited to):

  • babies and young children

  • children and young people with special educational needs

  • children and young people with learning or physical disabilities

  • children and young people with speech, language and communication difficulties

  • children and young people with a hearing or visual impairment.

Unaccompanied asylum-seeking children and young people need access to specialist psychological services (including child and adolescent mental health services), with the capacity, skills and expertise to address their particular and exceptional health and wellbeing needs. Professionals working with unaccompanied children and young people who are looked after should have a good understanding of cultural differences in attitudes to and beliefs about physical and mental health or wellbeing.

Context for this quality statement

This section signposts practitioners to regulations, statutory guidance and national minimum standards for looked-after children and young people that are of particular relevance to the NICE quality statement and its associated measures. As the legislative framework in relation to looked-after children and care leavers is complex and cross-cutting, this should not be viewed as an exhaustive list.