Agenda item

[Fiona Brennan, Designated Nurse for Looked After Children and Dr Stephanie Simon, Designated Doctor for Looked After Children to present report]

Fiona Brennan, Designated Nurse for Looked After Children and Dr Stephanie Simon, Designated Doctor for Looked After Children presented the Health Service for Looked After Children Annual Report and highlighted key points.

Fiona Brennan referred to the core activities that required commissioning for Looked After Children (LAC) relating to statutory duties, including the Initial Health Assessments (IHA), the Review Health Assessments (RHA), Care Leaver Summaries (LCS) and Adoption Reports. 

She confirmed that there were 630 LAC, which was a high number when compared to other local authorities, with almost 60% living outside of the city.  She also referred to the breakdown of ‘Out of Authority’ placements.

She confirmed that up until June 2017, she had been undertaking health assessments for LAC placed in neighbouring boroughs; however, she had stepped down as her role was more strategic and that work was now being undertaken by the Royal Wolverhampton (NHS) Trust.  There were huge challenges in respect of quality and timeliness and if the criteria were not met they were returned.  It was hoped that by February 2018, the Trust would cover all LAC assessments. 

She advised that in respect of initial health assessments, only 18% had been completed out of date, as the remaining outstanding assessments had not been due until a later date.

Dr Stephanie Simon advised that due to staff leaving it had been a challenge to undertake all the health assessments; however, it had been covered by other senior medical staff.

She referred to the many improvements, including the introduction of the Health Passports, the establishment of Care Leaver Summaries and a named nurse engaging closely with LAC, which included attending drop in sessions at The Way.

She confirmed that some assessments had not been undertaken as LAC had left care, or figures had been included in adoption figures.  Some LAC were also hard to reach or refused contact and in those circumstances the named nurse would offer support.

She referred to the Family Nurse Partnership and the current review of commissioning arrangements.  She confirmed that the new service would be called The Partnering Families Team.

Fiona Brennan referred to the Care Quality Commission (CQC) and OFSTED inspections undertaken in July 2016 and January 2017 respectively.  The CQC inspection found the service to be adequate and made several recommendations.  The OFSTED inspection found the service to be good; however, it highlighted the inequality of care for children placed a distance from the city.  She confirmed that all the actions had been addressed and implemented.

She advised that she would now be sitting on the National Expert Group for the West Midlands and she would share and highlight best practice.

In addition to the information contained in the report and in response to questions from Board members, officers stated the following:

• There was no specific data in relation to obesity in respect of LAC; however, if it was an issue it would have already been escalated.
• It would be helpful if more general statistics on health issues for LAC could be included in future reports.
• In respect of a health presence during reviews, a balance had to be struck to ensure that there was not a large adult presence, as it was essential that children felt at ease during the process.
• When a LAC was placed outside of the city it was vital that they received the same support.  Good communication was the key to ensure that delays were kept to a minimum.
• Uptake at The Way was beginning to increase, with a ‘drop in’ session every Friday from 1-4pm.  The named nurse provided a vital link to the most vulnerable and her involvement was part of the package of support.

Resolved:

1. That the Health Service for Looked After Children Annual Report be noted.

That future Annual Reports include general statistics on health issues for LAC.