Looked after children are some of the most vulnerable and let down in society. It is not unusual for some of the children to have experienced many placement changes, therefore making it difficult for them to forge relationships.
Due to the frequent moves they are also more likely to have missed school or even been excluded. This often means they have missed out on routine health screening and immunisations that other children benefit from.
They also lose the chance of gaining valuable social skills by being able to make and keep friends. Important health promotion issues for example, sexual health, pregnancy, drugs etc are often missed or miss-understood.
The reasons why they became looked after can be numerous, but include, abuse of any kind, neglect, poor or inadequate parenting, the child’s difficult temperament, alcohol or drug misuse or even parental mental health issues. Whatever the reason, these children can be understandably very challenging, and require tact and a great deal of kindness.
The Department of Health has produced a statutory guidance for all areas to follow, which includes all the children receiving a health assessment. If a child is under the age of five, the guidance say they need to receive a health assessment twice a year, whereas, children over five receive an assessment annually. The Department of Health also collects annual statistics on dental checks, strength and difficulties questionnaires, immunisations, developmental checks and health assessments. As part of this guidance a designated doctor works within the service alongside a designated nurse. These roles carry out statutory responsibilities required.
When the child receives an appointment to attend for a health assessment at a clinic there are a range of standard procedures and checks which may be undertaken by the clinician. These could include having their height, weight, vision, hearing, urinalysis and blood pressure checked. Currently if they are over the age of eleven they also complete the Strengths and Difficulties questionnaire, which highlights the possibility of them experiencing or beginning to experience mental health problems. The carer is also asked to complete the carer strength and difficulty questionnaire.
The initial assessment at a clinic is always undertaken by one of the many Paediatricians who works for the service. Doctors / Paediatricians are assisted by the three nursing assistants. The nursing assistants also use this opportunity to talk to the children and young people about other health concerns for example smoking cessation.
The team also includes two permanent nurses, who also undertake health assessments but which are offered either at the child’s foster placement or in the children’s homes. The nurses also look at the immunisation status of the children and give some of the injections they may have missed.
It is the nurse’s role to make sure networks are formed and kept with not only Social Care and Health but also education and various voluntary agencies as well as the Children’s Rights department.
There is no structured referral system for our service, as all looked after children should at some time be seen by someone in the team.