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9.3.5 General Health Care

SCOPE OF THIS CHAPTER

This chapter has been amended to reflect the Children’s Homes (Amendment) Regulations 2011, Associated Guidance (Volume 5) and National Minimum Standards. Changes have been highlighted below.


Contents

  1. Context
  2. Scope
  3. Procedure


1. Context

Research into the health outcomes for Looked After children and young people has shown that for many there is a need for improvement. The Children Act 1989 and the National Minimum Standards for Children's Homes both respond to the research messages and stress the need to provide young people with healthy living environments, where good health is promoted. Promoting the Quality of Life of Looked After Children and Young People has been published by the Social Care Institute for Excellence (SCIE) and the National Institute for Clinical Excellence (NICE). The focus of the guidance is on how organisations, professionals and carers can work together to help looked-after children and young people reach their full potential and enjoy the same opportunities in life as their peers.

Furthermore both pieces of legislation require an assessment of individual health needs and the ways in which these will be met for each young person.


2. Scope

The National Minimum Standards require policy and written guidance that are implemented into practice, in relation to promoting health of young people, on the following specific areas:

  • Immunisation and Screening
  • Nutrition and Diet
  • Exercise and Rest
  • Personal hygiene
  • Sexual Health
  • Therapeutic interventions
  • The effects of alcohol, smoking and other substances
  • HIV and AIDS and other blood borne diseases

Staff are also guided to the Departmental Health and Safety Policy and Procedures. In particular staff should read the policy that deals with HIV and AIDS and other Blood Borne Diseases and the Section on Infection Control.


3. Procedure

1.0

Each young person should have a Health Needs Assessment that identifies their physical, emotional and mental health needs and the ways in which these will be met. These should be formulated into a clearly written Health Plan (within their Placement Plan) which also covers the following Health Needs Assessment:

  • Medical History
  • Any necessary preventative measures
  • Allergies or known adverse reactions to medication
  • Dental health Records
  • Health Monitoring required of staff
  • Involvement of parents or significant others in addressing a young person’s health needs
  • Any hearing needs records
  • Any optical needs records
  • Any Developmental checks that are needed
  • Any Specific treatment therapies that are needed
  • Any remedial programmes that are needed
1.1 A written record should be kept for each child or young person of all significant illnesses, accidents or injuries that occur whilst resident at the Home. This is kept on the young person’s Daily Living File and recorded within a HS3a.
1.2 According to the age and understanding of the child or young person (‘Gillick Competence’) they should be allowed to choose whether or not, they are accompanied by staff, to medical and dental appointments.
1.3 As far as possible young people should be allowed to choose the gender of the medical or dental practitioner.    
1.4 The health needs of young people from minority ethnic, racial and cultural groups are given specific attention. In order to address and support any specialist needs, staff should, whenever necessary, seek specialist help.
1.5

Children and young people with particular health needs or a disability should be provided with appropriate support and help to deal as positively as possible with their difference. The Keyworker for the young person should ensure that they closely liaise with the health professionals and seek both guidance and direction on any specific and particular health needs.   

Staff involved in delivering therapeutic interventions must have appropriate training and expertise and access to regular supervision.

Specific therapies are used only:

  1. where there is a clear and widely accepted theoretical or evidence base underpinning its effectiveness
  2. with the continuing agreement of the child's Placing Authority or a person with Parental Responsibility and of the child concerned where the child is of sufficient understanding.

Details about home's therapeutic models must be in plain English, so that all agencies responsible for the child are able to understand how the preferred therapeutic approach supports the child to achieve the objectives set out in their Care Plan.

The other young people living at the home should also be helped to understand the issues and all staff should be seeking to promote a positive, supportive and non-bullying environment.
2.0 All young people should be helped to understand the particular health risks associated with smoking, alcohol and other substance use. How this information and awareness building is done will be dependent upon the age of the child and the particular residential context within which they live. It is therefore the responsibility of each home to develop, with the help, support, advice and liaison with colleagues from health and health related services, ways of working with young people on these issues.
2.1 As with 2.0 above, young people also need to be provided with the appropriate advice and support in relation to sexual education and sexual health matters. Again, consistent with 2.0, this needs to be developed appropriate to the age and understanding of each young person and in line with the home’s Statement of Purpose and also consistent and supportive of the Sexual Health Procedure.
2.2

Young people should be actively discouraged from smoking and using alcohol and other substances. (See also: Drugs and Substance Misuse (Including Smoking) Procedure.

Help and advice should be gained from the appropriate drug and alcohol agencies.
3.0 Issues of personal hygiene should be addressed in sensitive and proactive ways within an overall atmosphere that helps young people build and develop a positive self-image.

End