Healthy Care Programme - Handbook

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Healthy Care Programme Handbook

NCB promotes the voices, interests and well-beingof all children and young people across every aspectof their lives. As an umbrella body for the children’ssector in England and Northern Ireland, NCBprovides essential information on policy, researchand best practice for members and other partners.

NCB aims to:

■ challenge disadvantage in childhood■ work with children and young people to ensure

they are involved in all matters that affect theirlives

■ promote multidisciplinary cross-agencypartnerships and good practice

■ influence government policy through policydevelopment and advocacy

■ undertake high quality research and work froman evidence-based perspective

■ disseminate information to all those working withchildren and young people, and to children andyoung people themselves.

NCB has adopted and works within the UNConvention on the Rights of the Child.

Published by the National Children’s Bureau, 8 Wakley Street, London EC1V 7QE

Tel: 020 7843 6000

Website: www.ncb.org.uk

Registered charity number: 258825

© National Children’s Bureau 2005

ISBN 1 904787 41 X

British Library Cataloguing in Publication Data

A catalogue record for this book is available from theBritish Library

All rights reserved. Apart from reprographicreproduction for not-for-profit use by a healthy carepartnership, no part of this publication may bereproduced, stored in a retrieval system ortransmitted in any form by any person without thewritten permission of the publisher.

DH INFORMATION READER BOX

Policy EstatesHR/Workforce PerformanceManagement IM & TPlanning FinanceClinical Partnership Working

Document Purpose Best Practice GuidanceROCR Ref: Gateway Ref: 4450Title Healthy Care Programme

HandbookAuthor DfES/Looked After Children

DivisionPublication Date 15 Mar 2005Target Audience PCT CEs, NHS Trust CEs,

SHA CEs, Directors of PH,Directors of Nursing, GPs

Circulation List Local Authority CEs, Ds ofSocial Services

Description The Healthy CareProgramme aims toimprove the healthoutcomes and life chancesfor children and youngpeople who are lookedafter. The programmeprovides an audit tool forlocal authorities againstwhich to benchmark theirservices. Implementing theprogramme will ensure thatcare settings provide ahealthy, caringenvironment, qualityprovision of healthassessments, health careand treatment.

Cross Ref Promoting the Health ofLooked After Childrenguidance

Superseded Docs n/aAction Required n/aTiming n/aContact Details DfES

Health of Looked After Children Team

4th FloorCaxton HouseSW1H 9NA020 7273 5006ncb.org.uk/healthycare

For Recipient’s Use

Foreword vVoices viAcknowledgements viiTerminology viiiAbout this handbook ix

1. Introduction 12. Why focus on Healthy Care? 33. The National Healthy Care Standard 54. The Healthy Care Partnership 95. Children and young people’s participation and involvement 196. Audit and action planning cycle 217. Examples of Healthy Care Programme Work 318. Support and further resources for Healthy Care Partnerships 37

Appendix 1: The National Healthy Care Standard: entitlements and outcomes 39Appendix 2: Healthy Care Audit Tool 41Appendix 3: Healthy Care Action Planning Tool 65

References 67

Contents

Figure 3.1 The National Healthy Care Standard 7

Figure 4.1 Summary of the stages of developing a Healthy Care Partnership 10

Figure 4.2 Case study from Portsmouth Healthy Care Partnership 12

Figure 4.3 Example of a Healthy Care Partnership and task groups 13

Figure 4.4 Potential partners for Healthy Care Partnerships 16

Figure 4.5 Case study from Telford and Wrekin Healthy Care Partnership 17

Figure 5.1 Case study from Telford and Wrekin Healthy Care Partnership 20

Figure 6.1 The Healthy Care action planning cycle 21

Figure 6.2 Key stages of Healthy Care audit and action planning 22

Figure 6.3 Case study from Portsmouth Healthy Care Partnership 25

Figure 6.4 Case study from Eastmoor, Leeds Healthy Care Partnership 28

Figure 6.5 Case study from North Tyneside Healthy Care Partnership 29

Figure 6.6 Case study from Lincolnshire Healthy Care Partnership 29

Figures

Improving the life chances for looked after children and young people,ensuring their safety and promoting their well-being is an essential strandof delivering the government’s Every Child Matters: Change for ChildrenProgramme. Promoting the mental and emotional well-being as well asthe physical health of this small, but very vulnerable group of childrenand young people is a priority to help them achieve the five outcomeswhich we have set out for all children.

The Government has funded the National Children’s Bureau to developthe Healthy Care Programme over four years. It provides a practical toolto help implement the Promoting Health of Looked After ChildrenGuidance, assist implementation of the National Service Framework forChildren, Young People and Maternity Services, and deliver the agendaset out in Choosing Health: making healthy choices easier – the PublicHealth White Paper.

This Handbook provides a clear framework for developing partnershiparrangements as part of a children’s trust; auditing current practiceincluding the participation of children, young people and their carers; andsetting and evaluating an action plan to ensure a culture of continuousimprovement, based on the needs of children. The Healthy CareProgramme Handbook, Healthy Care Briefings and Carer TrainingProgramme together provide a set of resources for local services,including children’s trusts, to help promote stable placements, improveeducation outcomes, and ensure that children and young people cancare for their health now and enjoy and contribute in their future lives.

In addition the handbook shows how successful multi-agencypartnerships were established in pilot areas to ensure effectivecollaborative working and strategic commissioning of services to supportlooked after children.

The value of the work has been shown by over 40 partnerships currentlyinvolved in Healthy Care. The longer term success of the Healthy CareProgramme will be demonstrated through its contribution to making a realchange in the lives of looked after children and young people.

Lord Filkin

Parliamentary Under Secretary of State for Children and Families

Foreword

They tell me to listenSometimes I understandSometimes I don’t understandI just shut upThey think I’m boringAm I boring?

It doesn’t matterI get used to itMoving aroundThat’s when I make new friendsThen everything changesThen I make new friends again

At schoolThey think I’m differentBut I’m notThey get used to meBut it takes a lot of timeThen they stop telling me I’m differentI just waitWait until they stop

What makes me happy?I like jokesAnd calls on our mobileBut if you laugh all the timeIt gets boring

Some things are hardSometimes I think everything is hardAnd then it isn’t

I don’t think I’m sadOther people can be sadI’ve seen people very sad and angryDo you know what makes people sad?

I don’t like some foodSpaghettiTomatoesLettuceI hate liver

What can I use this for?I am making a pool over thereI don’t think I’ll be here to see it finishedWhen it rainsI like to go outI don’t go out all the times I wantWhen I go outThat’s when I call TomI’d like it to rain lots more

I do dream a bitBut I can’t remember everythingWell bitsMaybe I’m not rightCan you remember anything when you dream?

Then something different happensThen everything changes againI don’t knowI just go onEveryone tries to help

Most of my families have been goodTwo I didn’t likeBut that was meThat was my fault

My favourite things are gamesWhat games have you got on your mobile?I like Eddie StobartI go paint ballingNot as often as I likeJust a few times when we can all go out together

Words I find hardTomorrowDinosaur namesThings like that

When I am doing thisI don’t mind you watchingAnd talking

Is that enough?Did I do alright?I like to be alrightMaybe you’ll be back again

Voices

This poem by three young people aged 12 to 15 years formed the basis of a sound loop for aslideshow of images created by looked after young people. It was part of an exhibition of artwork by looked after young people displayed at the Museum of Lincolnshire Life in 2004.

This document was written by Helen Chambers, Principal Officer, NCB.

The Healthy Care Programme is funded by the Department for Educationand Skills (DfES), and developed by the National Children’s Bureau(NCB). It has been informed by the experiences of Healthy CarePartnerships that took place in 13 local authorities in England fromJanuary 2001 to April 2004. Regional Healthy Care Partnerships werealso developed in the East Midlands, North East, South East and SouthWest, to support local Healthy Care Partnerships and share learning. Theinitial five pilot sites and eight shadow sites tested how to set up andimplement Healthy Care Partnerships. They have shared their successesand learning in order to support others to develop Healthy CarePartnerships. The pilot and shadow sites are:

■ Barnsley Healthy Care Partnership■ Derby Healthy Care Partnership■ East Kent Healthy Care Partnership■ Leeds Healthy Care Partnership■ Leicester Healthy Care Partnership■ Lincolnshire Healthy Care Partnership■ London Borough of Harrow Healthy Care Partnership■ Nottinghamshire Healthy Care Partnership■ Portsmouth Healthy Care Partnership■ Salford Healthy Care Partnership■ Telford and Wrekin Healthy Care Partnership■ Trafford Healthy Care Partnership■ Wandsworth Healthy Care Partnership.

Thanks are given to all the participating partnerships, staff, carers,children and young people, and to all of those who have participatedregionally and nationally.

Particular thanks are given to colleagues in DfES and NCB for theirexpertise, time, determination and creativity, which have enabled thisprogramme to happen.

Special thanks to Sarah Heathcote and Nigel Shipley, Healthy Careconsultants, who worked with local Healthy Care Partnerships, and usedthat experience to advise this document.

A final thanks to the document’s editor Mary Ryan for her patience andforbearance.

Acknowledgements

Throughout this document the term ‘carer’ is used to refer to residentialsocial workers and foster carers.

The term ‘looked after children and young people’ refers to children andyoung people who may be:

■ accommodated under a voluntary agreement with their parent(s)consent, or their own consent if aged 16 or 17

■ in care on a Care Order or Interim Care Order under Section 31 of theChildren Act 1989

■ accommodated under section 21 (2) (C) (i) of the Children Act 1989(remanded to local authority care)

■ on an Emergency Protection Order under Section 44 of the ChildrenAct 1989.

Terminology

The Healthy Care Programme Handbook provides information about:

■ The Healthy Care Programme – an overarching programme topromote the health and well-being of looked after children and youngpeople.

■ The National Healthy Care Standard that describes the entitlements oflooked after children and young people and outcomes that will help tomeasure progress towards providing a healthy care environment.

■ How Healthy Care can help to provide evidence for inspectionprocesses and other reviews.

■ How the pilot Healthy Care Partnerships were set up.■ How to carry out healthy care audits and develop and implement

healthy care action plans. Tools and resources are also available tosupport this (available to download from: www.ncb.org.uk/healthycareand some are included as appendices in this handbook).

This handbook will be useful to all involved in and concerned with thecare of looked after children and young people – from elected membersand strategic managers to carers.

About this handbook

The Healthy Care Programme provides a multi-agency framework toimprove the health of looked after children and young people in England.The framework coordinates the key policies and addresses the issuesthat affect the health and well-being of children and young people.

Better outcomes depend on the integration of universal services toaddress the needs of the child and family. The Healthy Care Programmepromotes local healthy care services across agencies and makes the fiveoutcomes of Every Child Matters (HM Treasury 2003) the driving force forthe development and delivery of services to looked after children.

The Healthy Care Programme has been developed in response to theDepartment of Health guidance Promoting the Health of Looked AfterChildren (Department of Health 2002). A key principle identified in theguidance is the direct involvement of children, young people and carers:

To be successful in improving health outcomes for thisvulnerable population any guidance, structures or plans musthave as its central focus a partnership process which buildson the views and priorities of the children and young peoplethemselves.(Department of Health 2002)

Children’s participation is a cornerstone of the Healthy Care Programme.

What is in the Healthy Care Handbook?The Healthy Care Programme Handbook provides a set of tools andresources to assist partnerships to carry out audits of services, deviseaction plans and evidence their progress. It includes case studies andexamples of healthy care work from 13 pilot local authorities. It isaccompanied by a series of briefing papers on key health topics (seewww.ncb.org.uk/healthycare). Every area will develop its healthy careservices to meet local needs and build on good practice.

The pilot Healthy Care Partnerships, or Multi Agency Looked AfterPartnerships (MALAPs) as they are called in some regions, have beensupported by the Quality Protects Programme regional developmentworkers, regional public health leads for children, and other staff based ingovernment offices in the regions. Healthy Care Partnerships lead aprocess of continuous development to enable real and measurablechanges to the physical and emotional well-being of looked after childrenand young people.

Introduction 1

Who is it for?This handbook is for managers of services and Healthy Care Programmelead officers as well as other relevant staff from partner agencies. It willbe of interest to multi-agency staff who provide services for looked afterchildren and young people. It will also be useful to staff in regionalgovernment offices, strategic health authorities and other regionalorganisations.

Relationship of the National Healthy Care Standard to performance managementThe National Healthy Care Standard forms part of the Healthy CareProgramme which reflects best operational practice as identified by thework of Healthy Care Partnerships based in 13 pilot local authorities.Those involved in the provision of health services for looked after childrenand young people will find it helpful in ensuring that health outcomes forlooked after children and young people are improved and that servicesare responsive to their needs, and in evidencing the achievement of partsof the National Service Framework for Children, Young People andMaternity Services (Department of Health 2004). It is however for localpartners to decide how and whether to use the standard. It does not formpart of the Department of Health’s Standards for Better Healthcare or thecriteria which underpin those standards, and will not, in itself, be arequirement of the Healthcare Commission inspection regime.

Healthy Care Programme Handbook2

Children and young people who are looked after are amongstthe most socially excluded groups in England and Wales.They have profoundly increased health needs in comparisonwith children and young people from comparable socio-economic backgrounds who have not needed to be taken intocare. These greater needs, however, often remain unmet. Asa result, many children and young people who are lookedafter experience significant health inequalities and on leavingcare experience very poor health, educational and socialoutcomes.(Department of Health 2002)

Commitment to improving the health and emotional well-being of lookedafter children and young people is high on central government and localagendas. The focus on health inequalities and the impact of socialexclusion has identified this group of children and young people as highlyvulnerable, and improving their health is a key priority.

The physical and mental health of looked after children and young peopleis often poor when compared with their peers, and this may affect theirability to benefit from education and other life enhancing opportunitiesand have serious implications for their health and well-being in adulthood.

National and international research has indicated:

■ Children may come into care with significant physical and mentalhealth problems (Skuse and others 2001, Skuse and Ward 1999,Dimigen and others 1999).

■ Two-thirds of all looked after children were reported to have at leastone physical complaint. The most commonly reported physicalcomplaints were: eye and/or sight problems (16 per cent), speech orlanguage problems (14 per cent), bed wetting (13 per cent), difficultyin coordination (10 per cent), and asthma (10 per cent) (Meltzer andothers 2003, Williams and others 2001). A longitudinal study showed52 per cent of looked after children had a physical or health conditionthat required outpatient treatment (Skuse and others 2001).

■ Looked after children and young people have a high rate of mentalhealth problems (Richardson and Joughin 2000, Buchanan 1999,Arcelus and others 1999, Broad 1999, McCann and others 1996,Bamford and Wolkind 1988). Of looked after children and youngpeople aged 5 to 17, 45 per cent were assessed as having at leastone psychiatric disorder and two-thirds of those living in residentialcare were assessed as having a mental disorder (Meltzer and others2003).

Why focus on Healthy Care? 2

■ There are high rates of self-harm and high-risk behaviour amonglooked after children and young people, particularly in secureaccommodation (Richardson and Joughin 2000, Shaw 1998).

■ Some studies show that there is a higher level of substance misuse,including smoking tobacco, among looked after children and youngpeople, than among the non-care population (Meltzer and others2003, Williams and others 2001, Department of Health 1997).

■ There is a significantly higher rate of teenage conception amonglooked after young people than among the non-care population, andlooked after young women are more likely to become young mothersthan young women in the general population (Corlyon and McGuire1997, Brodie and others 1997, Biehal and others 1992 and 1995).

■ Fewer looked after children visited a dentist regularly, and they weresignificantly more likely to need treatment in comparison with theirnon-care peers (Williams and others 2001).

■ Educational achievement is lower among looked after children andyoung people than among their non-care peers, with only 56 per centof looked after young people sitting at least one GCSE compared with96 per cent of the general population. Also a higher percentage arepermanently excluded from school and a higher percentage arereported absent from school (DfES 2004). Disrupted education leadsto missing out on health promotion work in schools.

■ Children from minority ethnic backgrounds may suffer discriminationwithin the care system leading to health needs being unmet. Trainingon the particular health needs of minority groups has been describedas ‘woefully inadequate’ (Mather 2000).

■ Children with disabilities who are in care may experience unmet healthand social needs (often due to confusion over funding and provision),services often ignore disabled children’s right to a say in their care,and transition to adult services and/or independence is oftenunsatisfactory (Morris 1995 and 1999).

■ There are significant gaps in health records for looked after childrenand young people (Butler and Payne 1997, Mather and others 1997).

■ Standards and indicators for looked after children tend to focus on‘illness’ rather than ‘health’ (Howell 2001).


The development and implementation of the National HealthyCare Standard is founded on a belief that all children areentitled to excellent, consistent care and health care, and acare environment that will equip them with the knowledge,skills and values for life now and in the future.(Chambers and others 2002)

The National Service Framework for Children, Young People andMaternity Services (Department of Health 2004) reinforces this view thatservices should be designed and delivered around the needs of the child,and sets standards for children’s health and social care:

Services are child-centred and look at the whole child – notjust the illness or the problem, but rather the best way to pickup any problems early, take preventative action and ensurechildren have the best possible chance to realise their fullpotential. And if and when these children grow up to beparents themselves they will be better equipped to bring uptheir own children.(Department of Health 2004)

Looked after children and young people have contributed to thedevelopment of the National Healthy Care Standard and have voicedtheir thoughts and opinions about what healthy care should be and whatis most important to them:

They can support us by getting to know us, really knowing us.The things that we feel strongly about, that we believe in.Children in care just want someone to take an interest in them.

It should be somewhere you feel supported and encouragedboth emotionally and physically. You shouldn’t feel that youare responsible for everything as if you are alone.

I would not have been able to cope if it had not been for theteam. Whether it was helping me find a flat or popping aroundto see if I was OK. I never felt alone. There was alwayssomeone to turn to, they were really supportive. They look atyou as an individual and you decide together what yourneeds are – they don’t decide everything for you.(Looked after young people participating in the NationalHealth Care Standard consultation, 2002)

The National Healthy Care Standard is based on a child’s entitlement to:

■ feel safe, protected and valued in a strong, sustained and committedrelationship with at least one carer

The National Healthy Care Standard 3

■ live in a caring, healthy and learning environment■ feel respected and supported in his/her cultural beliefs and personal

identity■ have access to effective healthcare, assessment, treatment and

support■ have opportunities to develop social skills, talents and abilities and to

spend time in freely chosen play, cultural and leisure activies■ be prepared for leaving care by being supported to care and provide

for him/herself in the future.

The National Healthy Care Standard is summarised in Figure 3.1 onpage 7. The relevant outcomes that provide evidence of meeting theNHCS are listed in Appendix 1 (page 39).

The pilot Healthy Care Partnerships have undertaken a range of workfocusing on key health topics across the four NHCS areas for action. Thisis summarised in Chapter 7.


Figure 3.1

The National Healthy Care Standard The National Healthy Care Standard helps looked after children and young people achieve thefive outcomes described in Every Child Matters (HM Treasury 2003):

■ be healthy;■ stay safe;■ enjoy and achieve;■ make a positive contribution; and■ achieve economic well-being.

Children and young people in a healthy care environment will:■ experience a genuinely caring, consistent, stable and secure relationship with at least one

committed, trained, experienced and supported carer;■ live in an environment that promotes health and well-being within the wider community;■ have opportunities to develop the personal and social skills to care for their health and well-

being now and in the future; and■ receive effective healthcare, assessment, treatment and support.

A child or young person living in a healthy care environment is entitled to:1. feel safe, protected and valued in a strong, sustained and committed relationship with at

least one carer;2. live in a caring, healthy and learning environment;3. feel respected and supported in his/her cultural beliefs and personal identity;4. have access to effective healthcare, assessment, treatment and support;5. have opportunities to develop personal and social skills, talents and abilities and to spend

time in freely chosen play, cultural and leisure activities; and6. be prepared for leaving care by being supported to care and provide for him/herself in the

future.

The National Healthy Care Standard focuses on four key areas for action:

The National Healthy Care Standard 7

Policy

Policies ensure services meet the needs oflooked after children and young people.

Participation

The involvement and participation of lookedafter children, young people and their carerswith respect for their rights andresponsibilities.

Partnership

Effective multi agency planning deliversservices which meet the needs of lookedafter children and young people.

Practice

Carers and staff are committed to the well-being of children and young people, and are well trained and supported.

Good health goes beyond having access to health services.Improved health outcomes for looked after children requirethe focus of health care planning to be on health promotionand attention to environmental factors as well as physical,emotional and mental health needs. Children and youngpeople need to understand their right to good health and tobe able to access services. They need the knowledge andskills to communicate and relate to others and to takeresponsibility for themselves.(Department of Health 2002)

This section provides details of the lessons learnt by the pilot areaswhere Healthy Care Partnerships have been established.

The Healthy Care Partnership supports local children’s services andchildren’s trusts including health, social care, education, leisure, thevoluntary sector and other services to work together to fulfil theirresponsibilities to promote the health and well-being of looked afterchildren and young people. The Healthy Care Partnership can bedeveloped by building on existing local partnerships and sit within the local children’s strategic partnership or children’s trust. It provides aspecific focus on looked after children and young people. It provides aframework to develop a healthy care environment through healthypolicies, promoting good practice and the active participation of thechildren and young people and their carers. A Healthy Care Partnership brings together and enhances a range of activities to improve the health and well-being of children and young people in andleaving care.

The Healthy Care Programme provides:

■ a structure for the development of local Healthy Care Partnerships todrive work on healthy care

■ a framework for implementing a range of local, regional and nationalinitiatives including the National Healthy Care Standard

■ opportunities to raise the profile of health and well-being and healthpromotion in the care setting

■ opportunities to raise children and young people’s issues withinplanning and commissioning structures in health and other services

■ opportunities to raise awareness and gain recognition for current andfuture achievements locally, regionally and nationally

■ opportunities for sharing ideas and good practice ■ access to expertise, resources and support through national, regional

and local networks.

The Healthy Care Partnership 4

Developing a Healthy Care PartnershipA Healthy Care Partnership is the driver for leading and coordinatinglocal work on healthy care. In some areas work on healthy care isdelivered through multi-agency looked after partnerships, sometimesknown as MALAPs. A strong multi-agency partnership is able topromote and effect change for looked after children and youngpeople.

Where a specific Healthy Care Partnership is developed there are fourkey stages to be undertaken before work begins on auditing services and planning action. These are summarised in Figure 4.1.


Figure 4.1

Summary of the stages of developing a Healthy Care PartnershipStage 1: Identify a lead for the multi-agency Healthy Care Partnership (a senior manager fromhealth, social services or children’s services) and a senior-level champion, usually theassistant director for social services or children and families or equivalent within children’strusts.

Stage 2a: Involve and secure formal commitment from strategic leads across all key agenciesthrough a formal agreement with sign-up and endorsement from relevant directors, includingsocial services/children and families, children’s trusts, health, education and leisure/communityservices. Include elected members as corporate parents.

Stage 2b: Identify the formal arrangements for the strategic accountability of the Healthy CarePartnership with the children and young people’s strategic partnership, children’s trust orequivalent.

Stage 3: Appoint a lead officer for Healthy Care. This need not be a full-time post – it could bepart of an existing post. This role undertakes some of the coordination of the partnership –crucial in the early stages. Some administrative support is also needed.

Stage 4: Develop partnership structures, such as a strategic steering group, working groupsand lines of communication. Consider who can be involved in the partnership and how.Operational as well as strategic staff must be included and there may be many different waysof involving staff and services. They will want to be kept informed of progress and tocontribute. Ensure the active involvement of looked after children, young people and theirfamilies and carers.

Stage 1 – A senior champion for Healthy Care

Identify a lead person who can act as a senior-level champion; he or sheneeds to be someone who can ensure the involvement of strategic leadsfrom all key agencies. In the pilot Healthy Care Partnerships this hasusually been the assistant director for social services, social care or forchildren and families.

Stage 2a – Involve strategic leads from key agencies

Involve strategic leads from all the key agencies. Depending on localarrangements this is likely to include:

■ director of children’s services or social services and education■ lead officer for looked after children■ director of the children’s trust■ chief executive of the PCTs or child health lead■ director of public health■ director of leisure services■ a corporate parenting officer.

Secure their commitment to the partnership with a written agreement.This confirms their involvement in the partnership and their commitmentto the involvement of looked after children and young people in theprocess.

It is also important to secure the commitment of elected members ascorporate parents.

Stage 2b – Secure a locally appropriate strategic mandate

The Healthy Care Partnership must secure a locally appropriate strategicmandate. The lead person will negotiate this with the relevant group forchildren and young people’s services within the local strategicpartnership, usually the local children and young people’s strategicpartnership.

Stage 3 – Develop partnership arrangements

The membership and working practice of each Healthy Care Partnershipwill largely depend on the local context but will reflect the key agenciesactive locally. Consideration will be given to diversity and inclusion issuesto ensure that the partnership reflects the local communities, prioritiesand circumstances.

Carers have much to contribute to healthy care, and should be providedwith opportunities to share their views and help shape service


developments. Working with the local group from Fostering Network orcarer’s support groups and residential social workers in children’s homesincluding those provided by the independent sector, ensures there areopportunities for carers to participate in the local Healthy CarePartnership. Similarly the families of looked after children and youngpeople may wish to be involved and contribute.

Training and support for carers is an essential part of providing a healthycare environment and the early involvement of training managers forfostering and residential care services is also important.

The involvement of children and young people in and leaving care is crucial.

The meaningful involvement of children and young people within thepartnership provides the opportunity to check that changes in servicesare impacting favourably on them. Portsmouth Healthy Care Partnershipheld a conference with looked after young people and carers to help toidentify priorities for their Healthy Care action plan. The conferencetackled issues that were very important to looked after children andyoung people and produced tangible results (See Figure 4.2).


Figure 4.2

Case study from Portsmouth Health Care PartnershipA one-day multi-agency conference was held to seek evidence about the current healthy caresituation and to identify priorities for the action plan.

The morning session of the conference was presented by looked after young people andfoster carers giving their views and opinions about what needed to happen.

The afternoon saw the members of the partnership group devising an action plan based onthe issues and priorities presented in the morning session.

This draft action plan was presented to the children, young people and carers for theircomments and approval.

As a result the Portsmouth Healthy Care Action Plan included the development of passportsfor both looked after children and young people, and foster carers. The children and youngpeople’s passports contain information about themselves that they want the carers to know asthey come to live with them. The foster carers’ passports include information about thehousehold. Young people have helped to identify what information is necessary. Together, bothpassports should help communication and help to make moves to new placements lessstressful for children, young people and carers.

Healthy Care Partnerships develop different groups functioning atdifferent levels, for example an over-arching steering group tostrategically drive the partnership and one or more implementation/taskgroups to take forward different elements of the action plan (see Figure4.3). This develops over time as the work of the Healthy CarePartnerships grows.


Figure 4.3

Example of a Healthy Care Partnership and task groups

Healthy Care Workforce Development

Leisure activitiesfor children and young people

Local Children and Young People’s Strategic Partnership or Children’s Trust

Residential care 16 plus and leaving care

Healthy Care PartnershipSteering group

Stage 4 – Identify a Healthy Care lead officer

A Healthy Care lead officer is essential – this role can take forward muchof the organisational development and administration of the Healthy CarePartnership. This can be an allocation of time from within an existingpost. Administrative support for this role is also necessary for efficientworking.

The role of the Healthy Care lead officer usually includes:

■ supporting the development of the Healthy Care Partnership includingconvening stakeholder meetings and ensuring relevant paperwork isavailable

■ collating and analysing evidence for the Healthy Care audit■ coordinating the action plan■ monitoring and reviewing the action plan

■ setting up a communication strategy■ reporting progress to the Healthy Care Partnership■ linking with the national Healthy Care Partnership, attending regional

and national seminars■ ensuring feedback to the children’s strategic partnership■ ensuring evidence is available to support inspection of services■ ensuring the action plan is implemented.

Who to involveHowever a Healthy Care Partnership may be organised, it is essential toengage and secure commitment from both operational and strategic staffacross as wide a range of partner agencies as possible. A list of possiblepartners is provided in Figure 4.4 (page 16).

Making the partnership work■ Local Healthy Care Partnerships must engage and secure

commitment from both operational and strategic staff across as wide arange of partner agencies as possible.

■ The formal sign-up of agencies to the partnership has been identifiedas critical to the success of pilot Healthy Care Partnerships.

■ Keep elected members as corporate parents informed of and involvedin progress.

■ Existing partnerships may be used or built on. The partnership doesnot have to be huge and can start with a small committed group. PilotHealthy Care Partnerships have shown that a small group canproduce good outcomes for children, contribute evidence toinspections and reviews, and gain commitment to and increasedmembership of the partnership.

■ Engaging stakeholders can vary with local circumstances. Meetingswith key individuals or groups may be needed to provide information,clarify roles, agency structures, avoid gaps and duplication andencourage active involvement. Early groundwork will develop trust,common understanding and purpose, and clarify the different roles ofpartners.

■ Local coordinators of Healthy Schools will be useful partners – the twoinitiatives have issues in common, such as multi-agency working,involving children and young people, and addressing inequalities,promoting social inclusion and achievement.



■ Use innovative and different ways to involve different stakeholders, forexample, seminars, fun days, training for foster carers, one-dayevents.

■ Good partnership working, led and monitored by a Healthy Care leadofficer, with tasks allocated to task groups will help to ensure effectiveoutcomes.

■ Celebrate successes.


Figure 4.4

Potential partners for Healthy Care PartnershipsThe pool of potential partners includes:

■ children and young people■ child and adolescent mental health services lead (CAMHS)■ children and families leads within social services■ children’s fund projects■ children’s rights worker/looked after children’s participation officer■ children’s trusts representative■ community paediatrician■ community safety partnership■ Connexions representative■ corporate parenting group representative■ designated doctor for looked after children or GPs■ designated teacher/education strategic lead for looked after children■ drugs action team (DAT) representative■ early years/Sure Start projects lead■ carers and foster carers, including independent providers and local fostering networks■ health visitors/school health nurses■ independent visitor/advocate■ leisure services lead officer■ local authority officers (from housing, health, leisure)■ looked after children’s nurse■ looked after children’s psychologists – clinical and/or educational psychologists■ healthy schools’ coordinator■ parents, family carers■ primary care trusts and acute hospital trusts (children’s lead/commissioner and public

health/health promotion lead)■ respite care service representative■ local authority secure children’s home representative■ social inclusion officer (education)■ social workers (looked after children teams, children with disabilities teams, leaving care

teams, therapeutic teams, family placement)■ teenage pregnancy coordinator■ voluntary sector■ youth offending service■ youth service – youth workers/mentors.


Figure 4.5

Case study from Telford and Wrekin Health Care PartnershipHealthy Care work has been driven from within the local partnership development unit, whichhas secondees from key agencies taking forward work on behalf of the local strategicpartnership. The lead officer for Healthy Care is employed by the primary care trust, which hasbenefits in terms of accessing and making sense of the health system. Initially a great deal oftime and energy was invested in engaging stakeholders to build a strong partnership – thisproved to be very worthwhile. The one-to-one contact made by the lead officer in the veryearly stages helped to ensure the commitment and involvement of managers, practitioners,foster carers and young people for the pilot phase.

A seminar was held at which multi-agency senior management support for the Healthy CarePartnership was reinforced and the National Healthy Care Standard explained.

Sub-groups were formed to take forward specific elements of the local programme, these were:

■ assessment■ consulting with children and young people■ a cooking club.

Four areas of the service were chosen for healthy care audits and groups set up to oversee this:

1. respite care2. independent sector3. residential care4. foster care.

Each audit group examined performance against the National Healthy Care Standard anddeveloped healthy care action plans.

Results included:

■ enthusiasm and energy from children, young people, carers and service managers wasquickly generated – they could all see the benefits

■ creative thinking about how to do things differently■ an agenda for change in respite care and disabled children and young people were less

marginalised■ some ‘quick wins’ – the cooking club was easy to set up and very popular with the young

people who managed it themselves with some support■ identification of where deeper practice developments were required (for example, the quality

of care plans)■ the audit tool helped to analyse practice in detail and identify where work was needed.

The focus on positive health and well-being was important so that we were not justscreening for poor health. The audit has given us pointers rather than solutionswhich we can now take forward together.(Member of the Telford and Wrekin Healthy Care Partnership)

To be successful, health improvement programmes needmore than the reluctant consent of the young people, theyrequire their active participation and empowerment, as theprimary custodians of their own health.(Chambers and others 2002)

The National Healthy Care Standard identifies participation as having twokey outcomes:

■ involvement and participation of looked after children and their carers■ a respect for the rights and responsibilities of looked after children.

Children and young people should participate in the entire healthy careprocess, from initial audit and review through to monitoring andevaluating progress. To fully involve children, young people and carersrequires a culture that builds respect and trust between children andadults, and a commitment from adults to listen.

The process of involving children and young people includes:

■ informing children and young people of the issues■ encouraging them to form an opinion■ giving them opportunities to express their opinions to people who

make decisions■ giving them feedback on how their opinions have shaped service

developments■ making sure that appropriate and different ways are found to listen to

children of different ages, with different abilities, from diverse culturesand backgrounds.

Children and young people taking part in local Healthy Care Partnershipmeetings need to be part of a wider reference group that links to thelarger community of looked after children and young people. There maybe an existing participation structure for looked after children and youngpeople that can be used to consult on healthy care issues. Some areashave a children’s rights worker or equivalent, who will be a valuable linkand be able to support children and young people to participate in andcontribute their views to the Healthy Care Partnership.

The pilot Healthy Care Partnerships have found that consulting with andinvolving children and young people has been critical to the success oftheir action plans and has resulted in changes that have made a hugedifference to children and young people – often changes that adultswould not have thought about. Consultations have also brought greatenergy and enthusiasm to partnerships: as one carer commented ‘This iswhat I came to the job to do’.

Children and young people’sparticipation and involvement 5

A young person in Telford and Wrekin co-chaired the local Healthy Careconference and found the experience worthwhile. She describes it inFigure 5.1.


Figure 5.1

Case study from Telford and Wrekin Healthy Care PartnershipI was very nervous about doing this because I had never really done much speaking in front oflarge groups of people so co-chairing the conference was a little scary and a totally newexperience. There were a few other people sitting at the table with Carol and me, which wasnice because I felt that I had support from them. Looking at all of the people in front of us wasvery nerve-racking.

The one thing that I was worried about was that the conference was going to be boring. Iwould hate to have seen people yawning and falling asleep right in front of me. Also, I havebeen to some very boring meetings and it is not very nice for the people who attend and thepeople who are holding them. Quite often the meetings are very valuable and the informationgiven is important but because of the way that they are run people just don’t listen. Luckily forus though, everyone seemed to be enjoying themselves!

The conference set up some task groups to tackle different areas of the standard. I was part ofthe task group that looked at foster care to see whether the young people were getting a fairdeal according to the standard.

There are many resources available with ideas and tool kits for consultingwith and involving children and young people. Total Respect (Children’sRights Officers and Advocates 2000) is a training pack developed with200 looked after children and young people and aims to get carers,social workers, managers and elected members thinking about howchildren and young people experience being looked after. It includes atraining manual, video and audio cassette of messages from looked afterchildren and young people and other resources. There are also twobriefings about using creative participation and using drama to consultwith children and young people available at www.ncb.org.uk/healthycare(NCB 2004a and 2004b).

The first action of the Healthy Care Partnership is an audit of services inorder to acknowledge current good practice and identify what needs tochange and/or be developed. This leads to the development andimplementation of the Healthy Care action plan followed by monitoringand evaluation of progress and updating the action plan. This cyclecreates a process of continuous improvement focusing on the health andwell-being of looked after children and young people.

Audit and action planning cycle 6

Figure 6.1

The Healthy Care action planning cycle

Recordimprovement and celebrate

success

Audit services

Identifypriorities

Agree action plan

Implementaction plan

Monitor andevaluate

HealthyCare

Partnership


Figure 6.2

Key stages of Healthy Care audit and action planningStage 1a: Gather evidenceUse the Healthy Care Audit Tool (see Appendix 2) to help identify current good practice inHealthy Care as well as areas for development and gaps in provision. Include current nationalpriority targets and those addressing public health inequalities.

Stage 1b: Gather evidenceChildren and young people and carers are consulted about what changes are important tothem, and how they can be included in the local Healthy Care Partnership.

Stage 1c: Gather evidenceReview and include evidence from inspection reports and other relevant local reviews andconsultations.

Stage 2: Summarise the findings and prioritiseIdentify priority areas for action, for example fostering services, local authority securechildren’s home, young people leaving care or children from birth to five years old. One or twoaction areas would be considered good practice. Healthy Care Partnerships must ask ‘Whatdifference will the children see if we carry out this piece of work?’ The Healthy Care: PolicyFramework (see www.ncb.org.uk/healthycare) may be used to help identify priorities.

Stage 3: Action planningUse the Healthy Care Action Planning Tool (see Appendix 3) to review each priority area. Thisinvolves examining the four action areas of policy, partnership, participation and practice foreach priority area and identifying required action.

The Healthy Care Partnership may decide to set up task/action groups to focus on eachpriority area. These groups will report regularly on progress.

Stage 4: Accountability and disseminationOnce the action plan is agreed it is taken forward by the Healthy Care Partnership to thechildren and young people’s local strategic partnership, children’s trust board or otheraccountable body. Healthy Care partners disseminate the action plan within their agencies.

Stage 5: Resource the identified work programmeThis is considered by the partnership. Consideration is given to the sharing and pooling ofresources, connecting up of initiatives, and creative use of targeted budgets to provideresources for the work of the partnership.

Stage 6: Monitoring and evaluationThe work is monitored and evaluated and progress reported to the Healthy Care Partnershipand the accountable body. The action plan is reviewed and updated regularly. New and revisedtargets are set as required, and usually include an annual review.

Stage 7: Record improvement and celebrate successThe Healthy Care action plan and record of improvements and impacts provide evidence forservice inspections and reviews. Success and improvement is acknowledged and celebrated innewsletters, annual celebratory events, etc.

How to get started with audits and action plansThe Healthy Care audit is informed by:

■ the views of children and young people and their families and carers■ evidence from multi-agency partners■ evidence from recent inspection reports and other reviews.

Using the audit tool will:

■ enable the participation of key stakeholders, including children andyoung people, their families and carers

■ ensure services are involved in advising on strategic and operationaldevelopment

■ support inspection processes■ clarify which parts of the National Healthy Care Standard to focus on

first■ produce some immediate results and benefits for children■ give partnerships a ‘way in’ to Healthy Care, and produce some ‘quick

wins’ which will increase motivation to develop the work further.

The Healthy Care Audit ToolThe Healthy Care Audit Tool (see Appendix 2) provides a framework forHealthy Care Partnerships to assess their current position for delivery ofhealthy care outcomes in the context of the national outcomes for allchildren. It provides a framework to audit service provision within eachentitlement and outcome considering policy, partnership, participationand practice. It is recommended that the audit is used on one or twoservice areas for looked after children and young people, for examplechildren in foster or residential care, or specific age bands or groups ofchildren. The audit tool is intended to act as a guide and can beamended to suit local situations where appropriate.

Developing an action planWhen the audit is completed, it is important that the Healthy CarePartnership has the opportunity to discuss and share views on thecurrent position locally and to consider additional evidence, gaps andpriority areas for development in the Healthy Care action plan.

The Healthy Care lead officer will collate and summarise information fromthe local sources and prioritise these in the Healthy Care action plan.


Deciding what is to be included in the action plan will be based onconsideration of the following:

■ Priorities identified by the audit.

■ Children and young people’s priorities for action.

■ What is achievable?

■ What will secure the biggest gains for all, taking into account externaldrivers (for example, achievement of national and local targets)?

■ Are there pieces of work already started which need added impetus?

■ Will senior managers, chief executives and elected members agree toactions signed-up to, particularly taking resource implications,including time, into account?

■ Are there specific inequalities or social inclusion issues within the caresetting that need addressing?

The Healthy Care lead officer also considers links with cross-cuttingagendas and other complementary national/local targets and planssuch as the Teenage Pregnancy Strategy, young people’s substancemisuse plans, youth justice plan, education development plan, behaviour support plan, and child and adolescent mental health development strategy.

The pilot Healthy Care Partnerships have identified key learning duringtheir development and implementation of Healthy Care action plans:

■ Be realistic about resource implications, including time, from theoutset.

■ Include some easily achievable goals for children and young people –this helps to motivate the Healthy Care Partnership.

■ Be as specific as possible in defining objectives and the necessaryactions to achieve these – this helps effective implementation andassists evaluation. Keep objectives SMART (specific, measurable,achievable, realistic, time-related).

■ Be explicit and clear about the intended outcomes, and how you candemonstrate these have been achieved.

■ An activity (the Clouds activity) has been included in the Healthy Carehealth promotion training programme for carers because it proved to



be a useful way of identifying changes needed and focused on theNHCS child/young persons entitlements. This has also been useful forconsulting with children and young people and carers.

■ Ensure a range of people are responsible for moving targetsforward.

The Healthy Care Action Planning Tool (see Appendix 3) is helpful inproviding a template for constructing the local action plan.

The action plan should be agreed by the Healthy Care Partnership,senior champion and the children and young people’s local strategicpartnership or children’s trust board (or equivalent).

Key learning from the pilot Healthy Care Partnerships has been that thefocus of the work must result in outcomes that are important to childrenand young people.

Healthy Care Partnerships should ask: ‘What difference will the childrenand young people see if we carry out this piece of work? How will itimpact on them?’

Figure 6.3

Case study from Portsmouth Healthy Care PartnershipLooked after children and young people were asked as part of the consultation on HealthyCare for practical suggestions that they thought would improve their physical and emotionalwell-being. Along with other issues the children identified two things that they thought wouldreally make a difference:

1. Children and young people were very upset that when they moved to a new placement theirbelongings were usually taken in a black plastic bin bag. They found this very distressingand demeaning – as if they and their belongings were not important. They wanted to havesuitcases or holdalls instead. As the young people said, ‘We are not rubbish, so don’t treatus like rubbish’.

2. They found moves between foster homes very stressful and asked if all foster carers couldhave a booklet about their home and themselves with photographs so that they would knowsomething about their new placement and carers before they went there.

Monitoring and evaluationEvaluation is critical to determining if practice is indeed improvingchildren and young people’s health and well-being. Once the activityidentified in the action plan is under way it is important to monitorprogress and get feedback from those involved. Revisiting the action plancan help to address regular changes in the external environment andlocal circumstances. It identifies progress and flags up problems thathave emerged and require attention.

The Healthy Care Partnership reports annually on progress and identifiesevidence of positive outcomes in the four National Healthy Care Standardaction areas (policy, partnership, practice and participation). This enablesthe partnership to:

■ set new or revised targets■ consider setting new priorities based on identified needs■ build on good practice■ strengthen the Healthy Care Partnership■ respond and contribute to inspections■ identify achievement towards local and national targets■ celebrate success■ listen to how children and young people have experienced healthy

care.

Examples of how to measure Healthy CareSome impacts are immediate and tangible and will increase confidencein the Healthy Care Partnership. Others are longer term, and are hard toevidence as being directly attributable to specific initiatives, such aslowering the rate of teenage pregnancy. It is important to track workundertaken to contribute towards targets wherever possible – this can beused in reporting on targets and as evidence for inspections.

Be as specific as possible in defining objectives and the necessaryactions to achieve these – this helps effective implementation and assistsevaluation.

Be explicit and clear about the intended outcomes, and how todemonstrate they have been achieved.

It is essential that children and young people are included in theevaluation process. The aim of Healthy Care is to improve the health andwell-being of looked after children and young people. Therefore theevaluation will examine the impact of the Healthy Care work on the


children and young people – what difference has it made to them? Theiropinions form an important part of the evaluation of effectiveness.

The following examples describe some of the measurable targets thathave been set by Healthy Care Partnerships:

■ To increase satisfactory completion of annual health assessments forlooked after young people aged 14 to 18 years from the current 60 percent to 80 per cent.

■ Carers to be involved in delivering a health promotion trainingprogramme for foster carers and residential social workers that hasbeen developed and piloted as part of the Healthy Care Programme.

■ A Healthy Care health promotion training course for foster carers onhealthy eating and nutrition for families, to be delivered locally bymulti-agency partners.

■ Public service agreements for placement stability cover education andhealth and form part of the local delivery plan.

■ All looked after children, young people and foster families to be issuedwith local leisure services cards providing access to sports and leisurefacilities at a reduced rate.

■ Sex and relationship training for foster carers of teenagers to beorganised and delivered by health promotion, the youth service andthe designated nurse for looked after children.

■ The leaving care group and Connexions to establish a young parents’support group for care leavers who have children or who are pregnant(this could be separate groups for young mums or young dads).

More examples of work focusing on healthy care can be found in Chapter7. These relate to specific themes including substance misuse, healthyeating and physical activity, play and creativity, mental health and sexualhealth.

The following three case studies describe how Healthy Care Partnershipshave focused on particular services or aspects of them – a local authoritysecure children’s home and training for carers.



Figure 6.4

Case study from Eastmoor, Leeds Healthy Care PartnershipEastmoor in Leeds is a 34-bed local authority secure children’s home for looked after youngpeople from across England. It has approximately 200 admissions per year that include longand short stays.

Despite local input from a general practitioner (GP), youth offending team (YOT), nurses andpaediatricians, the young people’s often complex health needs were not being addressedadequately. Reasons included:

■ health records for young people were not received from the placing authorities■ incomplete and poor health information was recorded on those received■ temporary registration with the GP prevented the transfer of health records■ no procedures for the transfer of health information when the young person was discharged■ little or no opportunity for health promotion■ health information was not shared in care reviews.

The framework of Healthy Care, alongside already established partnership working, hasenabled new work to be taken forward. Funding has been agreed for a nurse to be based on-site at Eastmoor 15 hours per week. The role will include:

■ conducting holistic health needs assessments and producing individual health plans■ responding to identified health needs including immunisations and administering

medications■ sharing health needs with relevant agencies and ensuring that they are met■ facilitating/participating in the provision of health promotion to young people and their carers■ establishing and maintaining strong links with a local GP and, in cooperation with the young

people, using the GP services as appropriate■ developing innovative approaches including the involvement of other agencies to improve

the health experience of the young people■ offering training and support to the staff.


Figure 6.5

Case study from North Tyneside Healthy Care PartnershipNorth Tyneside Primary Care Trust working within their Healthy Care Partnership, fundedHealthy Care Health Promotion Training for all foster carers and residential social workers inNorth Tyneside.

A train-the-trainers course was provided by the National Children’s Bureau’s Healthy CareProgramme. A range of multidisciplinary professionals participated including a paediatrician,looked after children’s nurse, health visitor and health promotion specialist as well as carersand residential social workers. The two-day course focused on the training needs of fostercarers and residential social workers and provided information, attitudes and skills training. Itwas co-facilitated with a foster carer/trainer from another region. Course participantscommented the course was ‘thought provoking and useful’ and ‘interesting and practical’.

Carers who participated on the course are now being supported to take up further educationcollege training for adults without a teaching qualification, so developing their skills as trainers.

The Healthy Care Partnership is now developing the programme to involve other social careand children’s services practitioners.

Figure 6.6

Case study from Lincolnshire Healthy Care PartnershipLincolnshire has reviewed its strategic training policy for foster carers and staff supporting youngpeople in residential and foster care. Healthy Care is now embedded in training provision.

A modular training programme has been developed by two healthcare workers who are part ofthe Healthy Care Partnership. The module covers:

1. Induction2. Looking after children for the local authority3. Health and safety4. Our needs and the needs of children and young people5. Child protection6. Disability7. Adolescent care8. Mental health and well-being.

Foster carers will soon be able to undertake modules using a CD-ROM.

In addition a drama production by looked after young people that describes the life of a lookedafter child and young person through their eyes will be available as a DVD to be used as atraining resource for foster carers and residential social workers.

Resources to help undertake audits and develop action plansThe Healthy Care Audit Tool (see Appendix 2) provides a detailedbreakdown of individual outcomes and potential evidence to support theNational Healthy Care Standard outcomes.

The Healthy Care: Policy Framework document(www.ncb.org.uk/healthycare) provides details of policies, initiatives,performance indicators and targets across a range of sectors. It will beuseful for managers, strategic planners and Healthy Care lead officers. Itidentifies how work on healthy care can contribute to progress across arange of policy areas and places healthy care firmly within local policyframeworks.

The Healthy Care Action Planning Tool (see Appendix 3) is an outlinedocument of how to record and track healthy care action.

Briefing papers on looked after children and young people and mentalhealth and emotional well-being, sexual health, substance misuse,healthy eating and physical activity, and play and creativity are availableon the Healthy Care Programme website (www.ncb.org.uk/healthycare).Examples of healthy care work on these themes can be found in Chapter7 of this handbook.

A forthcoming briefing paper for primary care trusts on how the NationalHealthy Care Standard contributes to the five outcomes of Every ChildMatters (HM Treasury 2003) will be available on the Healthy CareProgramme website.

Also, leaflets about healthy care for children and young people, and aleaflet for carers are available from: www.dfes.gov.uk/qualityprotects(search under Work Programme then Health Issues).


This section provides a summary of how Healthy Care Partnerships haveused the Healthy Care Audit and Action Plan to demonstrate their workon the themes of:

■ mental health and emotional well-being (see page 32);■ sexual health (see page 33);■ substance misuse (see page 34);■ healthy eating and physical activity (see page 35);■ play and creativity (see page 36).

More information on these themes is provided in the Healthy Carebriefings available from www.ncb.org.uk/healthycare.

The following examples show the range of approaches to this workacross National Healthy Care Standard areas for action of:

■ policy■ partnership■ practice■ participation.

7Examples of Healthy CareProgramme Work

Mental health and emotional well-beingThese examples show how Healthy Care Partnerships are promoting looked after children andyoung people’s mental health and emotional well-being across the National Healthy CareStandard action areas.


Policy■ Local polices relating to mental health

specifically include responding to the needsof looked after children and young people.

■ Relevant local policies about looked afterchildren and young people include mentalhealth and well-being.

■ A local policy decision resulted in all fosterfamilies, children and young people beinggiven a card for reduced rate access toleisure, fitness and cultural activities. Thisis based on evidence that involvement inphysical activity and other communityactivities enhances well-being andpromotes social inclusion.

Partnership■ A youth worker for looked after young

people encourages and supports them touse mainstream youth, arts, sports andleisure provision. The project is apartnership between the youth service, thePCT and social services.

■ Preventive mental health teams areworking with carers and professionals totrain and support them in theirunderstanding of looked after children’smental and emotional well-being.

■ An ‘Arts in Health’ project is working withvulnerable young people in partnershipwith local organisations and includes avisual arts project for care leavers.Outcomes for the young people to dateinclude: strengthening resilience, greaterself-esteem, and better ability to make andsustain relationships, and it has stoppedbullying.

Practice■ A community therapist has been appointed

under the CAMHS strategy to work

exclusively with the carers of looked afterchildren. This includes running workshopsaround stress relief and angermanagement.

■ All children who are being placed foradoption can be referred for play therapyto help them understand about being incare and the transition to a new,permanent home.

■ A creative participatory music project forlooked after young people in a residentialhome aims to improve low self-esteem.Feedback from the group has shown thatmembers realised their musical potential,improved their self-confidence and abilityto listen.

■ A training resource for staff to promoteemotional health and well-being in secureunits was developed from good practice infive secure units.

■ Training for foster carers and residentialsocial workers includes mental health andemotional well-being.

Participation■ Foster carers developed a folder about

themselves and their home (includingphotographs) for children and youngpeople to see before they came to theplacement. Young people who took partin a Healthy Care consultation identifiedmoves to new placements as distressing,said that they needed to know wherethey were going and suggested thefolder.

■ Monitoring of a specialist CAMHS hasbeen introduced and includes feedbackfrom looked after children and youngpeople using the service. This is informingthe development and improvement of theservice.

Examples of Healthy Care Programme Work 33

Sexual healthThese examples show how Healthy Care Partnerships are promoting looked after children andyoung people’s sexual health across the National Healthy Care Standard action areas.

Policy■ The development of a local sexual health

policy has included partnership working,consultation with young people, needsassessment, involving parents and carers,practice issues and outcomes.

■ Local polices relating to sexual health andsex and relationships education (SRE)specifically include looked after childrenand young people and acknowledge theirright to SRE (for example the localteenage pregnancy strategy and the localpreventive strategy).

Partnership■ A youth worker for looked after young

people has been trained in condomdistribution.

■ A young mother’s supported housing unitincludes young women leaving care orwho have been looked after and links withleaving care teams and looked afterchildren’s nurses.

■ A joint project has been developedbetween the youth service and link nursesfor looked after children and young peopleto deliver SRE and involve young peopleas peer educators.

Practice■ An outreach sexual health worker for

looked after young people offers groupwork (such as a young women’s group)and individual work on sex andrelationships.

■ Leaving care staff have been trained by alocal sexual health project so that they canoffer sexual health advice directly. Workersfrom the project attend young people’sDrop-ins to provide direct access to adviceand free condoms.

■ Leaving care staff are preparing youngpeople to care for themselves after theyhave left care and for example providesensitive support to young people to usesexual health services independently.

■ Telephone numbers of helplines anddetails of local young people’s sexualhealth clinics are displayed in residentialhomes for young people. Staff explain howhelplines work, and make sure that youngpeople can obtain confidential help.

Participation■ Support services have been developed for

young parents who are looked after andcare leavers. They aim to enable them todevelop parenting skills and encouragethem to return to education.

■ A leaflet on sexual health and localservices for looked after young people wasproduced by a sexual health task group oflooked after young people aged 13 to 18years.


Substance misuseThese examples show how Healthy Care Partnerships are promoting substance misuseeducation for looked after children and young people across the National Healthy CareStandard action areas.

Policy■ A drug education and support policy was

developed for the looked after children’sservice. Carers and children contributed toits development and dissemination. Ayoung people’s version was also producedand distributed.

■ Alcohol and drug education for lookedafter children and young people isspecifically included in the local youngpeople’s substance misuse plans.

■ Local protocols are in place to introducescreening tools to assess looked afteryoung people’s vulnerability andsubstance misuse.

Partnership■ Drug and alcohol action teams are part of

Healthy Care Partnerships.■ Youth workers and care staff work

together to provide alcohol and drugeducation in residential children’s homes.

■ A substance misuse policy for all childrenand young people was produced by apartnership of all agencies deliveringchildren’s services. Training about thepolicy was provided for staff across allservices.

Practice■ Training in alcohol and drug education is

provided for foster carers, residential carestaff, mentors, social workers and lookedafter children’s nurses.

■ A drug education and support worker hasbeen appointed to work with looked afteryoung people with problematic substancemisuse.

■ Health assessments for some youngpeople are carried out by the looked afterchildren’s nurse and include sensitivediscussions of alcohol, smoking and otherdrugs and whether there is a need forinformal education or other support.

Participation■ A survey into volatile substance abuse was

carried out by looked after young peoplethat identified levels of knowledge and ideasabout improving education and support.

■ Looked after young people took part indrama workshops, devised a play aboutwhat can happen to young people leavinghome and included problems with alcoholand substance misuse for young people.

■ A music recording and training project isworking with looked after young people,and produced a CD for young people thatused music to educate about alcohol andsubstance misuse. The young peoplegained professional recording skills andknowledge about drugs.

Examples of Healthy Care Programme Work 35

Healthy eating and physical activityThese examples show how Healthy Care Partnerships are promoting healthy eating andphysical activity for looked after children and young people across the National Healthy CareStandard action areas.

Policy■ Outcomes about healthy diet and

opportunities for physical activity arewritten into the local children and youngpeople’s preventive plan.

■ A policy on healthy eating and drinkinghas been developed for residentialchildren’s homes.

Partnership■ Health assessments are held in local

leisure centres. Young people can drop into see the nurse or doctor as well as takepart in arts and leisure activities includingusing the swimming pool and fitnesscentre.

■ A community dietician works with staff andyoung people in children’s homes. Youngpeople’s involvement has includeddesigning a new kitchen for theirresidential home and learning aboutbudgeting, shopping and cooking.

Practice■ A Healthy Care health promotion training

course for foster carers on healthy eatingand drinking and nutrition for families wasdelivered locally by multi-agency partners.

■ A leisure and fun coordinator wasappointed to ensure looked after childrencould access leisure activities includingphysical activities.

■ Height and weight is discussed sensitivelyat health assessments plus healthy dietand physical activity. Rapid weight loss orgain is followed up.

■ Residential care staff have been trained incommunity sports award leadership tosupport and encourage more involvementin physical activity.

■ Fresh fruit and vegetables, water andhealthy snacks are freely available inresidential children’s homes.

■ Carers and staff ensure that meals reflectthe heritage and cultural preferences ofchildren and young people.

Participation■ Looked after young people have helped to

organise ‘Cook and Eat’ groups designedto develop cooking skills and knowledgeabout healthy eating and drinking.

■ A young mother’s group which includesyoung care leavers, supports andencourages breast-feeding and teacheshow to budget and cook healthy meals.

■ Children and young people are supportedand encouraged to participate in physicalactivities of their choice (for example byensuring play/sports equipment isavailable, making sure they can attendregularly and carers showing pride in thechild/young person’s efforts andachievements).

■ Young people were consulted on thecontents of a draft health guidance file forstaff and carers that included issues suchas healthy eating and physical activity.A care leaver was employed to run theconsultation and developed aquestionnaire and quiz. This resulted in arelevant guidance file as well as youngpeople being more interested in healthtopics.


Play and creativityThese examples show how Healthy Care Partnerships are promoting play and creativity forlooked after children and young people across the National Healthy Care Standard action areas.

Policy■ Ensuring local polices relating to play, arts,

culture and education specifically includelooked after children and young people(for example the local cultural strategy).

■ A regional group has been established tofocus on looked after children and youngpeople and creativity. The group ensuresstrategic development, providesnetworking opportunities and shareslearning across the region.

■ A DfES funded pilot project – Out ofSchool Hours Learning – will identify whatworks in encouraging looked after childrento get involved in out of school activities.

Partnership■ A leisure and fun coordinator has been

appointed to support and encouragelooked after children and young people toengage in leisure activities of their choiceand support foster carers to make thishappen.

■ A youth worker and a Connexions advisorfor looked after young people encourageand support young people to usemainstream leisure and youth provision.

■ A weekly leisure club for looked afterchildren and young people has beenorganised by a partnership of education,social services, leisure and communityservices plus the local museums and artsservices and many others. Looked afteryoung people are supported to joinmainstream provision but also remain incontact with the club.

Practice■ A drama project for looked after young

people is promoting well-being by helpingchildren express themselves. This is leadingto increased confidence and strongercommunication skills. Some young people

have developed their interests further byjoining mainstream activities.

■ Looked after children have access to playtherapy services if required.

■ Permission for looked after children andyoung people to attend outings and visitsis arranged at the beginning of aplacement for all visits so that this doesnot stop children participating in school orother leisure activities.

■ A music project for looked after youngpeople ended with a public performance.The young people developed skills in lyricwriting, rapping, music mixing, video andother production skills, learned to worktogether and gained confidence and pridein their abilities and achievements.

Participation■ Care plans for children include information

about their interests and leisure time pref-erences. The children and young peopleare involved in updating this regularly.

■ ‘Make it happen’ – a range of creativeactivities were organised for looked afterchildren who were considered to be mostvulnerable and needing extra support.Professional assistants worked with artistsand sports workers to help the children getthe most out of it.

■ A ‘Quiz’ is used to audit the leisure and funneeds of all looked after children andyoung people aged 5 to 13. Individual plansare devised from the results. A regularevening activity session is provided for children who want to attend and where theycan meet and play with siblings.

■ Carers Can! (a magazine for carers andstaff) includes play and creative activitiesthat have been tried and tested by carers.The activities are suitable for the wholefamily and for groups of children andyoung people.

The national Healthy Care network offers support and links to otherHealthy Care Partnerships in the regions, sharing good practice, andfacilitating cooperation and joint working between partnerships. Moreinformation about how to access the Healthy Care network can be foundat: www.ncb.org.uk/healthycare

Regional development staff at government offices in the regions haveprovided support to develop Healthy Care Partnerships and regionalsupport structures. This work has been coordinated by the regionaldevelopment worker and regional public health leads for children andyoung people.

Further resources to support the Healthy Care Programme are alsoavailable:

■ www.dfes.gov.uk/qualityprotects (search under Work Programme thenHealth Issues) includes information about the programme and links toleaflets about healthy care for children and young people, and a leafletfor carers.

■ www.ncb.org.uk/healthycare includes briefing papers on key topicssuch as: substance misuse, healthy eating and physical activity,mental health, play and creativity, and sexual health; a briefing onhealthy care for primary care trusts (forthcoming) and Carers Can!, amagazine for carers on play and creativity.

■ Healthy Care Training Manual: a health promotion training programmefor foster carers and residential social workers (NCB 2005) has beendeveloped. It includes background information, trainers notes andresources for a two-day course and is available from the NationalChildren’s Bureau (8 Wakley Street, London EC1V 7QE; telephone020 7843 6000).

■ Improving the emotional health and well-being of young people insecure care: training for staff in local authority secure children’s homesby J. Bird and L. Gerlach (2005) and is available from the NationalChildren’s Bureau (8 Wakley Street, London EC1V 7QE; telephone020 7843 6000).

■ Healthy care leaflets for children and young people (Staying Healthy,Feeling Good: A Young Person’s Guide, ref: DfES/0528/2004), and forfoster carers and residential social workers (Healthy Care,ref:DfES/0850/2004) can be ordered from DfES Publications (PO Box5050,Sherwood Park, Annesley, Nottingham NG15 0DJ; telephone0845 6022260; fax 0845 6033360; email [email protected]).

Support and further resourcesfor Healthy Care Partnerships 8

The National Healthy Care Standard helps looked after children andyoung people achieve the five outcomes described in Every Child Matters(HM Treasury 2003):

■ be healthy;■ stay safe;■ enjoy and achieve;■ make a positive contribution; and■ achieve economic well-being.

The National Healthy Care Standard: entitlements and outcomes 1

APPENDIX

The National Healthy Care StandardChildren and young people in a healthy care environment will:

■ experience a genuinely caring, consistent, stable and secure relationship with at least onecommitted, trained, experienced and supported carer;

■ live in an environment that promotes health and well-being within the wider community;

■ have opportunities to develop the personal and social skills to care for their health and well-being now and in the future; and

■ receive effective healthcare, assessment, treatment and support.

The standard identifies the entitlements and outcomes required for a healthy careenvironment:

1. A child/young person will feel safe, protected and valued in a strong, sustained and committedrelationship with at least one carer.

Outcome 1(a): The child/young person is given an opportunity to make safe, protective,caring and continuing relationship(s) with his/her carer(s) and believes that there is at leastone person who is interested in him/her and cares for and about his/her health and well-being.

Outcome 1(b): The child/young person develops a sense of self-worth and is positive andself-directed in relation to the choices and challenges of everyday life.

2. A child/young person will live in a caring, healthy and learning environment.

Outcome 2(a): The child/young person is provided with a safe, secure, caring and stimulating environment, where he/she can develop and achieve his/her physical, emotional, educational and spiritual potential.


The National Healthy Care Standardcontinued

Outcome 2(b): The child’s carers are supported, trained and adequately resourced toprovide for the healthy development of children/young people who are in their care andprotection.

Outcome 2(c): The child/young person has a range of sustained positive relationships withfamily, friends and the community.

3. A child/young person will feel respected and supported in his/her cultural beliefs and personal identity.

Outcome 3(a): The child/young person has a clear and positive understanding of his/hercultural beliefs and identity; these are respected and there are opportunities to celebrate them.

Outcome 3(b): The child/young person will understand and have skills and confidence todevelop appropriate personal and social boundaries and respect those of others.

4. A child/young person will have access to effective healthcare, assessment, treatment and support.

Outcome 4: The child/young person is able to access effective healthcare to enable his/herhealth to be promoted, maintained and treated.

5. A child/young person will have opportunities to develop personal and social skills, talents andabilities and spend time in freely chosen play, culture and leisure activities.

Outcome 5(a): The child/young person is knowledgeable, emotionally resourceful and isable to use his/her own emotions and thinking skills to guide and manage his/her positivebehaviour using a variety of strategies.

Outcome 5(b): The child/young person achieves his/her potential and is proud of his/herachievements.

6. A child/young person will be prepared for leaving care by being supported to care and provide forhim/herself in the future.

Outcome 6(a): The child/young person will develop understanding of his/her needs andresponsibility for maintaining his/her health and well-being.

Outcome 6(b): The child/young person has the knowledge, skills, values and attitudes tokeep him/herself safe, to prepare for adult life and to play a part in creating a healthy, safecommunity.

Outcome 6(c): The child/young person is supported adequately through childhood intoadulthood.

This audit tool accompanies the National Healthy Care Standard andprovides a detailed breakdown of individual outcomes for each of thenational Healthy Care Standard entitlements and outcomes. It identifiesthe evidence that will demonstrate achievement of these outcomes andthe delivery of healthy care for looked after children and young people.

It focuses on the four action areas of:

■ policy and partnership, which focus on the management, strategicand planning responsibilities of an agency

■ participation and practice, which focus on the work carried out toensure children and young people’s ownership and participation inhealthy care and the direct practice of carers and workers from allagencies involved.

The audit tool assists Healthy Care Partnerships to audit their servicesthus identifying gaps, areas for development and good practice. Itprovides a basic template and Healthy Care Partnerships may add to it inthe course of their audits as they identify progress, build on good practiceand other local developments.

2APPENDIX

Healthy Care Audit Tool


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

1a:

The

chi

ld/y

oung

per

son

is g

iven

an

oppo

rtun

ity t

o m

ake

a sa

fe,

prot

ectiv

e, c

arin

g an

d co

ntin

uing

rel

atio

nshi

p(s)

with

his

/her

car

er(s

)an

d be

lieve

s th

at t

here

is a

t le

ast

one

pers

on w

ho is

inte

rest

ed in

him

/her

and

car

es fo

r an

d ab

out

his/

her

heal

th a

nd w

ell-b

eing

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.P

olic

ies

and

prac

tices

are

in p

lace

to

enco

urag

e st

able

pl

acem

ents

and

car

e pl

anni

ng w

ithin

his

/her

ow

n fa

mily

or

in c

are

plac

emen

t.

Par

tner

ship

1.M

ulti-

agen

cy p

artn

ersh

ips,

the

loca

l str

ateg

ic p

artn

ersh

ip

for

child

ren

and

youn

g pe

ople

, ch

ildre

n’s

trus

ts a

nd o

ther

st

rate

gic

part

ners

hips

sho

uld

ensu

re p

olic

es a

re in

pla

ce t

o de

velo

p im

prov

ed h

ealth

and

wel

l-bei

ng fo

r lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le.

2.M

ulti-

agen

cy p

artn

ersh

ips,

the

loca

l str

ateg

ic p

artn

ersh

ip fo

r ch

ildre

n an

d yo

ung

peop

le,

child

ren’

s tr

usts

and

oth

er s

trat

egic

pa

rtne

rshi

ps s

houl

d en

sure

pol

ices

are

in p

lace

to

enab

le t

he

child

/you

ng p

erso

n an

d hi

s/he

r pa

rent

/car

er t

o ha

ve a

co

nsis

tent

and

car

ing

rela

tions

hip.

Par

tici

pat

ion

1.P

artic

ipat

ion

of p

aren

ts a

nd fa

mily

and

car

er is

pro

mot

ed

thro

ugho

ut a

ll th

e sy

stem

s an

d st

ruct

ures

of

the

corp

orat

e pa

rent

.

2.T

he c

hild

/you

ng p

erso

n is

abl

e to

exp

ress

his

/her

ow

n vi

ews

and

wis

hes

conc

erni

ng fa

mily

rel

atio

nshi

ps a

nd c

onta

ct,

and

thes

e ar

e ta

ken

into

acc

ount

.

cont

inue

d

Appendix 2: Healthy Care Audit Tool 43

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Pra

ctic

e1.

The

chi

ld/y

oung

per

son

has

a co

nsis

tent

, ca

ring

rela

tions

hip

with

a n

amed

car

er(s

)/pa

rent

(s).

2.T

he c

hild

/you

ng p

erso

n’s

care

pla

n re

flect

s th

eir

need

for

stab

ility

, pe

rman

ence

and

pro

tect

ion

and

the

oppo

rtun

ity t

o m

ake

sign

ifica

nt a

ttach

men

ts a

nd r

elat

ions

hips

.

3.M

oves

are

min

imis

ed t

o pr

even

t di

srup

tion

to t

hese

at

tach

men

ts a

nd r

elat

ions

hips

.

4.E

ach

child

/you

ng p

erso

n’s

fam

ily a

nd s

ocia

l rel

atio

nshi

ps

help

to

prom

ote

a se

nse

of s

elf,

atta

chm

ent,

belo

ngin

g an

d id

entit

y.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

1b:

The

chi

ld/y

oung

per

son

deve

lops

a s

ense

of

self-

wor

th a

nd is

pos

itive

and

sel

f-di

rect

ed in

rel

atio

n to

the

cho

ices

and

cha

lleng

es o

fev

eryd

ay li

fe.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.P

olic

ies

ensu

re t

hat

the

child

/you

ng p

erso

n is

invo

lved

an

d em

pow

ered

thr

ough

par

ticip

atio

n in

dec

isio

ns a

bout

hi

s/he

r ca

re.

Par

tner

ship

1.C

orpo

rate

par

ents

mus

t en

sure

tha

t th

eir

polic

ies

and

prac

tice

invo

lves

and

em

pow

ers

child

ren

and

youn

g pe

ople

.

Par

tici

pat

ion

1.Le

arni

ng a

nd d

evel

opm

ent

oppo

rtun

ities

ass

ist

the

child

/you

ng p

erso

n in

dev

elop

ing

resi

lienc

e, s

elf-

effic

acy,

an

d se

lf-es

teem

.

Pra

ctic

e1.

Car

ers

prep

are

the

child

/you

ng p

erso

n fo

r in

crea

sed

resp

onsi

bilit

y an

d he

lp t

hem

to

gain

ski

lls in

dec

isio

n-m

akin

g.

2.C

arer

s sh

ow c

onsi

sten

t ca

re,

love

and

res

pect

for

the

child

/you

ng p

erso

n.

3.T

he c

hild

/you

ng p

erso

n’s

care

, fa

mily

and

soc

ial r

elat

ions

hips

he

lp t

o pr

omot

e a

posi

tive

sens

e of

sel

f, at

tach

men

t, be

long

ing

and

iden

tity.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

2a:

The

chi

ld/y

oung

per

son

is p

rovi

ded

with

a s

afe,

sec

ure,

car

ing

and

stim

ulat

ing

envi

ronm

ent,

whe

re s

he/h

e ca

n de

velo

p an

d ac

hiev

ehi

s/he

r ph

ysic

al,

emot

iona

l, ed

ucat

iona

l and

spi

ritua

l pot

entia

l.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.E

vide

nce

of a

dher

ence

to

natio

nal m

inim

um s

tand

ards

for

child

ren’

s ho

mes

, an

d ot

her

resi

dent

ial s

ervi

ces,

ado

ptio

n an

d fo

ster

ing

serv

ice

regu

latio

ns a

nd s

tand

ards

.

2.E

vide

nce

that

the

chi

ef e

xecu

tives

and

ele

cted

mem

bers

of

loca

l aut

horit

ies,

chi

ldre

n’s

trus

ts s

afeg

uard

ing

boar

ds,

and

prim

ary

care

tru

sts

prom

ote

join

t w

orki

ng a

nd a

ccep

t th

eir

stat

utor

y re

spon

sibi

litie

s as

cor

pora

te p

aren

ts.

Par

tner

ship

1.M

ulti-

agen

cy p

artn

ersh

ips,

loca

l str

ateg

ic p

artn

ersh

ips

(and

con

trib

utor

y pl

ans

and

mec

hani

sms)

and

chi

ldre

n’s

trus

ts

dem

onst

rate

join

t w

orki

ng a

nd jo

int

resp

onsi

bilit

y fo

r th

e sa

fe

care

and

impr

oved

hea

lth a

nd w

ell-b

eing

of

look

ed a

fter

child

ren

and

youn

g pe

ople

.

Par

tici

pat

ion

1.T

he c

are

setti

ng h

as s

uffic

ient

div

erse

res

ourc

es t

hat

enga

ge

the

child

/you

ng p

erso

n in

und

erst

andi

ng t

heir

heal

th n

eeds

an

d to

sup

port

the

m t

o ta

ke a

ppro

pria

te r

espo

nsib

ility

for

thei

r ow

n he

alth

and

wel

l-bei

ng.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Pra

ctic

e1.

The

hea

lth p

lan

iden

tifie

s th

e ne

eds

of t

he in

divi

dual

ch

ild/y

oung

per

son

and

the

serv

ices

to

be p

rovi

ded

to m

eet

thos

e ne

eds.

2.C

arer

/par

ent

prov

ides

a n

urtu

ring

envi

ronm

ent

to e

nabl

e th

e de

velo

pmen

t of

hea

lth a

nd w

ell-b

eing

.

3.C

arer

/par

ent

activ

ely

prom

otes

the

chi

ld/y

oung

per

son’

s ed

ucat

ion

and

deve

lopm

ent.

4.T

he P

erso

nal E

duca

tion

Pla

n re

flect

s th

e ed

ucat

iona

l nee

ds

of t

he in

divi

dual

chi

ld/y

oung

per

son

and

puts

a p

lan

in p

lace

to

mee

t th

ose

need

s.

5.C

arer

/par

ent

prov

ides

a s

timul

atin

g an

d su

ppor

tive

envi

ronm

ent

to e

nabl

e th

e ac

hiev

emen

t of

goo

d ou

tcom

es.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

2b:

The

chi

ld/y

oung

per

son’

s ca

rers

are

sup

port

ed,

trai

ned

and

adeq

uate

ly r

esou

rced

to

prov

ide

for

the

heal

thy

deve

lopm

ent

of c

hild

ren

and

youn

g pe

ople

who

are

in t

heir

care

and

pro

tect

ion.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.T

here

is a

tra

inin

g an

d st

aff

deve

lopm

ent

plan

in p

lace

for

care

rs,

staf

f an

d m

anag

ers,

whi

ch li

nks

to a

rec

ruitm

ent,

rew

ard,

and

ret

entio

n po

licy

and

plan

.

Par

tner

ship

1.C

orpo

rate

par

ents

and

age

ncie

s w

ith r

espo

nsib

ility

for

deliv

erin

g im

prov

ed o

utco

mes

to

ensu

re t

hat

care

rs/v

olun

teer

s an

d pr

ofes

sion

al s

taff

are

prov

ided

with

and

tak

e up

tra

inin

g an

d de

velo

pmen

t op

port

uniti

es t

o un

ders

tand

, id

entif

y an

d pr

omot

e he

alth

and

wel

l-bei

ng.

2.M

ultid

isci

plin

ary

trai

ning

, su

perv

isio

n an

d su

ppor

t ar

e pr

ovid

ed fo

r al

l sta

ff, c

arer

s an

d vo

lunt

eers

pro

mot

ing

the

heal

th a

nd w

ell-b

eing

of

look

ed a

fter

child

ren

and

youn

g pe

ople

.

Par

tici

pat

ion

1.C

arer

s an

d m

ulti-

agen

cy s

taff

are

prov

ided

with

goo

d qu

ality

tr

aini

ng,

supp

ort

and

reso

urce

s to

ena

ble

them

to

unde

rsta

nd

the

deve

lopm

ent

need

s of

chi

ldre

n an

d yo

ung

peop

le a

nd t

he

part

the

y pl

ay in

ens

urin

g th

at t

hese

nee

ds a

re r

ecog

nise

d an

d m

et.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Pra

ctic

e1.

Car

ers

have

an

unde

rsta

ndin

g of

chi

ld p

rote

ctio

n an

d ch

ild/a

dole

scen

t de

velo

pmen

t.

2.A

ll in

volv

ed in

the

chi

ld/y

oung

per

son’

s ca

re u

nder

stan

d th

e di

vers

e ne

eds

of lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le,

and

have

the

ski

lls a

nd r

esou

rces

to

mee

t th

em.

3.C

arer

s ha

ve a

com

preh

ensi

ve u

nder

stan

ding

of

the

emot

iona

l ne

eds

of lo

oked

afte

r ch

ildre

n/yo

ung

peop

le,

and

the

skill

s an

d re

sour

ces

to a

ddre

ss t

hese

.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

2c:

The

chi

ld/y

oung

per

son

has

a ra

nge

of s

usta

ined

pos

itive

rel

atio

nshi

ps w

ith fa

mily

, fr

iend

s an

d co

mm

unity

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.Lo

cal p

lans

con

tain

pos

itive

incl

usio

n st

rate

gies

and

ser

vice

s fo

r lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le.

Par

tner

ship

1.M

ento

ring,

inde

pend

ent

visi

tor,

advo

cacy

sch

emes

are

ava

ilabl

e.

2.C

omm

unity

par

tner

ship

s pr

ovid

e a

safe

env

ironm

ent

and

oppo

rtun

ities

for

the

child

/you

ng p

erso

n to

gro

w a

nd d

evel

op.

Par

tici

pat

ion

1.O

ppor

tuni

ties

exis

t fo

r ch

ildre

n an

d yo

ung

peop

le t

o pa

rtic

ipat

e in

com

mun

ity a

ctiv

ities

.

2.O

ppor

tuni

ties

exis

t fo

r ch

ildre

n an

d yo

ung

peop

le t

o m

eet

othe

r lo

oked

afte

r ch

ildre

n/yo

ung

peop

le a

nd t

heir

sibl

ings

.

3.C

onfid

entia

l ser

vice

s ar

e av

aila

ble

and

acce

ssib

le.

4.T

here

are

tra

inin

g an

d su

ppor

t sc

hem

es t

o en

able

you

ng

peop

le t

o de

velo

p ad

voca

cy s

kills

.

5.T

here

are

fora

in p

lace

tha

t en

able

chi

ldre

n an

d yo

ung

peop

le

to c

ontr

ibut

e an

d pa

rtic

ipat

e, a

nd t

hey

are

supp

orte

d in

thi

s.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Pra

ctic

e1.

Ref

erra

ls a

re m

ade

to in

depe

nden

t vi

sito

r sc

hem

es,

men

torin

g an

d ad

voca

cy s

chem

es.

2.T

he c

are

prov

ided

sup

port

s po

sitiv

e co

ntac

t w

ith s

igni

fican

t fa

mily

mem

bers

, fr

iend

s an

d co

mm

unity

.

3.S

iblin

g re

latio

nshi

ps a

re s

uppo

rted

and

con

tact

enc

oura

ged

whe

n in

the

chi

ld/y

oung

per

son’

s be

st in

tere

sts.

4.C

arer

s w

ork

to h

elp

the

child

/you

ng p

erso

n m

ake

posi

tive

rela

tions

hips

with

in t

he c

are

setti

ng a

nd w

ith p

eers

.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

3a:

The

chi

ld/y

oung

per

son

has

a cl

ear

and

posi

tive

unde

rsta

ndin

g of

his

/her

cul

tura

l bel

iefs

and

iden

tity;

thes

e ar

e re

spec

ted

and

ther

ear

e op

port

uniti

es t

o ce

lebr

ate

them

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.P

olic

ies

prom

ote

and

supp

ort

the

child

/you

ng p

erso

n’s

deve

lopi

ng s

ense

of

iden

tity

and

cele

brat

e di

vers

ity.

2.P

olic

ies

prov

ide

a fr

amew

ork

for

addr

essi

ng a

nd c

halle

ngin

g di

scrim

inat

ion

and

oppr

essi

on.

Par

tner

ship

1.M

ulti-

agen

cy p

artn

ersh

ips,

the

loca

l str

ateg

ic p

artn

ersh

ip fo

r ch

ildre

n an

d yo

ung

peop

le,

child

ren’

s tr

usts

and

oth

er s

trat

egic

pa

rtne

rshi

ps e

nsur

e re

sour

ces

are

iden

tifie

d an

d in

pla

ce t

o m

eet

the

indi

vidu

al n

eeds

of

child

ren

and

youn

g pe

ople

.

Par

tici

pat

ion

1.T

he c

hild

/you

ng p

erso

n fe

els

valu

ed a

nd is

abl

e to

exp

ress

hi

s/he

r id

entit

y an

d th

is is

wel

com

ed a

nd c

eleb

rate

d.

Pra

ctic

e1.

Dire

ct w

ork

with

the

chi

ld/y

oung

per

son

help

s th

em t

o un

ders

tand

the

ir hi

stor

y, id

entit

y (in

clud

ing

gend

er a

nd

sexu

ality

), c

ultu

re a

nd b

elie

fs a

nd p

rom

otes

the

ir se

lf-es

teem

an

d se

lf-ef

ficac

y.

2.T

he c

hild

/you

ng p

erso

n is

hel

ped

to u

nder

stan

d di

ffere

nce

and

dive

rsity

and

is p

rovi

ded

with

str

ateg

ies

for

man

agin

g th

eir

own

and

othe

rs’d

iscr

imin

ator

y be

havi

our.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

3b:

The

chi

ld/y

oung

per

son

will

und

erst

and

and

have

the

ski

lls a

nd c

onfid

ence

to

deve

lop

appr

opria

te p

erso

nal a

nd s

ocia

l bou

ndar

ies

and

resp

ect

thos

e of

oth

ers.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.A

ll ag

enci

es h

ave

deve

lope

d po

licie

s an

d pr

otoc

ols

for

shar

ing

info

rmat

ion

that

pre

serv

e th

e pr

ivac

y an

d co

nfid

entia

lity

of

the

child

/you

ng p

erso

n w

ithin

the

lega

l fra

mew

ork.

Par

tner

ship

1.In

form

atio

n sy

stem

s en

sure

tha

t co

nfid

entia

l rec

ords

are

kep

t, re

tain

ed a

nd fo

llow

the

chi

ld/y

oung

per

son,

and

are

acc

essi

ble

to t

hose

who

nee

d to

see

the

m.

Par

tici

pat

ion

1.T

he c

hild

/you

ng p

erso

n un

ders

tand

s w

hat

info

rmat

ion

will

be

shar

ed in

mee

tings

and

con

fere

nces

and

tha

t hi

s/he

r vi

ews

are

take

n in

to a

ccou

nt.

Pra

ctic

e1.

The

chi

ld/y

oung

per

son

is h

elpe

d to

und

erst

and

wha

t th

ey a

re

able

to

keep

priv

ate

and

conf

iden

tial.

2.T

he c

hild

/you

ng p

erso

n w

ill k

now

abo

ut s

ourc

es o

f he

lp a

nd

supp

ort

and

will

be

able

to

acce

ss t

hem

.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

4:T

he c

hild

/you

ng p

erso

n is

abl

e to

acc

ess

effe

ctiv

e he

alth

care

to

enab

le h

is/h

er h

ealth

to

be p

rom

oted

, m

aint

aine

d an

d tr

eate

d.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.C

orpo

rate

par

ents

ens

ure

that

the

re is

a m

echa

nism

for

mon

itorin

g an

d ag

greg

atin

g th

e in

divi

dual

hea

lth n

eeds

of

child

ren

and

youn

g pe

ople

into

the

str

ateg

ic p

lans

and

re

sour

ce d

evel

opm

ent

of t

he in

divi

dual

age

ncie

s.

2.C

orpo

rate

par

ents

ens

ure,

thr

ough

join

t pl

anni

ng p

roce

sses

, th

at lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le h

ave

acce

ss t

o he

alth

ser

vice

s w

hich

pro

mpt

ly a

nd e

ffect

ivel

y ad

dres

s in

equa

litie

s an

d de

ficits

in t

heir

earli

er li

ves.

Par

tner

ship

1.A

ll ag

enci

es p

artic

ipat

e in

and

dev

elop

hea

lth a

nd h

ealth

pr

omot

ion

polic

ies.

2.T

here

is a

cces

s to

incl

usiv

e he

alth

ser

vice

s in

the

wid

er

com

mun

ity a

nd t

he d

evel

opm

ent

of s

peci

alis

t se

rvic

es

resp

onsi

ve t

o ne

ed.

3.M

ultid

isci

plin

ary

plan

ning

, m

onito

ring

and

eval

uatio

n of

se

rvic

e de

liver

y m

echa

nism

s ar

e in

pla

ce.

4.A

str

ong

link/

advo

cate

for

look

ed a

fter

child

ren

is id

entif

ied

in

the

prim

ary

care

tru

st.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

5.D

esig

nate

d he

alth

pra

ctiti

oner

s an

d a

nam

ed s

ocia

l ser

vice

s pe

rson

ens

urin

g de

liver

y of

hea

lth p

rom

otio

n se

rvic

es.

6.A

ll in

volv

ed in

the

car

e an

d ed

ucat

ion

of t

he c

hild

/you

ng

pers

on a

re a

war

e of

the

hea

lth a

nd c

are

plan

s, a

nd s

uppo

rt

thes

e in

the

ir in

tera

ctio

ns a

nd w

ork

with

the

chi

ld/y

oung

per

son.

Par

tici

pat

ion

1.T

he c

hild

/you

ng p

erso

n-he

ld h

ealth

pas

spor

t in

clud

es

iden

tific

atio

n of

fam

ily h

ealth

his

tory

.

2.T

he c

hild

/you

ng p

erso

n is

hel

ped

to b

e aw

are

of a

nd t

ake

up

univ

ersa

l ser

vice

pro

visi

on in

clud

ing

conf

iden

tial s

ervi

ces.

3.H

ealth

per

sonn

el li

sten

to

and

valu

e th

e ch

ild/y

oung

per

son’

s vi

ews

and

opin

ions

and

ens

ure

his/

her

info

rmed

con

sent

.

4.W

here

a c

hild

/you

ng p

erso

n ha

s sp

ecifi

c tr

eatm

ent

prog

ram

mes

the

y ar

e gi

ven

the

requ

ired

assi

stan

ce t

o le

arn

abou

t th

ese

and

take

res

pons

ibili

ty fo

r th

em.

Pra

ctic

e1.

Car

ers

ensu

re a

ll ch

ildre

n an

d yo

ung

peop

le a

re r

egis

tere

d w

ith a

GP.

2.A

hol

istic

hea

lth a

sses

smen

t an

d pl

an is

pro

vide

d w

hich

is

resp

onsi

ve t

o th

e ch

ild/y

oung

per

son’

s ow

n st

reng

ths,

kn

owle

dge,

wis

hes

and

inte

rest

s, a

nd e

ncou

rage

s th

e ch

ild/y

oung

per

son

to p

artic

ipat

e in

and

mai

ntai

n hi

s/he

r he

alth

and

wel

l-bei

ng.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

3.E

ach

child

/you

ng p

erso

n’s

heal

th p

lan

links

with

the

ir pe

rson

al e

duca

tion

plan

, in

divi

dual

edu

catio

n pl

an a

nd a

ny

othe

r ed

ucat

iona

l pla

ns,

incl

udin

g th

e pl

an fo

r pe

rman

ence

an

d th

e re

view

.

4.T

hese

pla

ns a

re r

evie

wed

reg

ular

ly t

o en

sure

the

y co

mpl

emen

t ea

ch o

ther

and

new

act

ions

are

put

in p

lace

as

appr

opria

te.

5.C

arer

s ar

rang

e fo

r de

ntal

che

cks

and

supp

ort

child

ren/

youn

g pe

ople

to

atte

nd.

6.C

arer

s en

sure

all

child

ren/

youn

g pe

ople

atte

nd s

ight

, he

arin

g an

d de

velo

pmen

t ch

ecks

.

7.C

arer

s en

sure

tha

t im

mun

isat

ions

are

up

to d

ate.

8.C

arer

s, t

hrou

gh g

ood

mod

ellin

g, p

repa

re t

he c

hild

/you

ng

pers

on fo

r in

crea

sed

resp

onsi

bilit

y an

d te

ach

good

hea

lth c

are,

ho

w t

o se

ek in

form

atio

n (t

o in

form

the

ir de

cisi

ons)

and

how

to

mak

e de

cisi

ons.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

5a:

The

chi

ld/y

oung

per

son

is k

now

ledg

eabl

e, e

mot

iona

lly r

esou

rcef

ul a

nd is

abl

e to

use

his

/her

ow

n em

otio

ns a

nd t

hink

ing

skill

s to

guid

e an

d m

anag

e hi

s/he

r po

sitiv

e be

havi

our

usin

g a

varie

ty o

f st

rate

gies

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.M

ulti-

agen

cy C

AM

HS

str

ateg

y is

in p

lace

tha

t m

eets

the

id

entif

ied

need

s of

look

ed a

fter

child

ren

and

youn

g pe

ople

.

2.B

ehav

iour

sup

port

pol

icy

and

plan

s ar

e in

pla

ce t

o su

ppor

t th

e ne

eds

of lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le.

3.C

lear

str

ateg

ic li

nkag

es a

nd d

eliv

ery

plan

s ex

ist

acro

ss t

he

dedi

cate

d lo

oked

afte

r ch

ildre

n se

rvic

es –

suc

h as

CA

MH

S

look

ed a

fter

child

ren

dedi

cate

d se

rvic

e, E

duca

tion

Pro

tect

s te

am a

nd h

ealth

nee

ds a

sses

smen

t te

am.T

his

is c

oord

inat

ed

thro

ugh

a m

ulti-

agen

cy lo

oked

afte

r pa

rtne

rshi

p an

d lin

ked

to

the

child

ren

and

youn

g pe

ople

’s s

trat

egic

par

tner

ship

, ch

ildre

n’s

trus

t or

rel

evan

t m

ulti-

agen

cy lo

oked

afte

r pa

rtne

rshi

p.

Par

tner

ship

1.M

ulti-

agen

cy p

artn

ersh

ips,

the

loca

l str

ateg

ic p

artn

ersh

ip fo

r ch

ildre

n an

d yo

ung

peop

le,

child

ren’

s tr

usts

and

oth

er s

trat

egic

pa

rtne

rshi

ps a

nd C

AM

HS

are

res

pons

ive

to t

he d

evel

opin

g m

enta

l and

em

otio

nal n

eeds

of

look

ed a

fter

child

ren

and

youn

g pe

ople

, an

d as

sist

the

ir ca

rers

, fa

mili

es a

nd o

ther

wor

kers

in

mee

ting

thes

e ne

eds.

2.T

he e

duca

tiona

l set

ting

prom

otes

the

em

otio

nal h

ealth

and

w

ell-b

eing

of

the

child

/you

ng p

erso

n th

roug

h po

sitiv

e in

tera

ctio

ns a

nd s

trat

egie

s.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Par

tici

pat

ion

1.T

he c

hild

/you

ng p

erso

n is

pro

vide

d w

ith o

ppor

tuni

ties

to

unde

rsta

nd h

is/h

er b

ehav

iour

and

em

otio

ns,

and

thos

e of

oth

ers.

2.P

erso

nal a

nd s

ocia

l edu

catio

n in

the

edu

catio

n an

d ca

re

setti

ngs

supp

orts

the

chi

ld/y

oung

per

son

in le

arni

ng h

ow t

o de

velo

p po

sitiv

e pe

er r

elat

ions

hips

.

Pra

ctic

e1.

Car

ers

enco

urag

e an

d pr

ovid

e di

ffere

nt o

ppor

tuni

ties

for

the

safe

exp

ress

ion

of e

mot

ions

, an

d th

e ch

ild/y

oung

per

son

rece

ives

com

fort

.

2.T

he c

hild

/you

ng p

erso

n ex

perie

nces

pos

itive

par

entin

g,

whi

ch in

clud

es p

rais

e an

d re

war

d.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

5b:

The

chi

ld/y

oung

per

son

achi

eves

his

/her

pot

entia

l and

is p

roud

of

his/

her

achi

evem

ents

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.E

duca

tion,

art

s, c

ultu

re a

nd le

isur

e po

licie

s pr

omot

e th

e ne

eds

of lo

oked

afte

r ch

ildre

n an

d yo

ung

peop

le a

nd e

nsur

e ac

cess

to

app

ropr

iate

uni

vers

al a

nd s

peci

alis

t se

rvic

es.

2.A

dmis

sion

and

exc

lusi

on p

olic

ies

prio

ritis

e th

e in

clus

ion

need

s of

look

ed a

fter

child

ren

and

youn

g pe

ople

.

3.C

orpo

rate

par

entin

g po

licy

guid

ance

and

tra

inin

g is

in p

lace

fo

r sc

hool

gov

erno

rs a

nd e

lect

ed m

embe

rs.

4.C

orpo

rate

par

ents

hav

e po

licie

s an

d sy

stem

s in

pla

ce fo

r pr

iorit

isin

g em

ploy

men

t op

port

uniti

es fo

r lo

oked

afte

r ch

ildre

n,

in t

heir

own

orga

nisa

tions

as

wel

l as

othe

r bu

sine

ss s

ecto

rs.

Par

tner

ship

1.R

esou

rces

are

in p

lace

to

ensu

re t

hat

each

chi

ld/y

oung

per

son

cont

inue

s to

ach

ieve

the

ir po

tent

ial a

nd d

evel

op n

ew in

tere

sts

and

skill

s.

2.F

undi

ng a

nd o

ther

res

ourc

es a

re a

vaila

ble

to s

uppo

rt

hobb

ies

and

inte

rest

s of

look

ed a

fter

child

ren

and

youn

g pe

ople

.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

3.C

orpo

rate

par

ents

ens

ure

that

a r

ange

of

play

, ar

ts,

spor

ts,

and

leis

ure

activ

ities

are

mad

e av

aila

ble

for

look

ed a

fter

child

ren

and

youn

g pe

ople

.Cor

pora

te p

aren

ts a

re a

war

e th

at

emot

iona

l wel

l-bei

ng a

nd e

duca

tiona

l ach

ieve

men

t ar

e lin

ked

issu

es,

and

reso

urce

s ar

e av

aila

ble

to s

uppo

rt b

oth.

Par

tici

pat

ion

1.T

he c

hild

/you

ng p

erso

n is

sup

port

ed t

o ac

hiev

e he

r/hi

s po

tent

ial

and

has

a re

cord

of

achi

evem

ents

and

qua

lific

atio

ns.

2.T

he c

hild

/you

ng p

erso

n ha

s ch

oice

s an

d op

port

uniti

es t

o ex

plor

e a

rang

e of

spo

rts

and

leis

ure

activ

ities

and

dev

elop

he

r/hi

s ta

lent

s an

d po

tent

ial.

3.T

he c

hild

/you

ng p

erso

n is

giv

en o

ppor

tuni

ties

to d

evel

op s

kills

to

exp

ress

wis

hes

and

feel

ings

.

Pra

ctic

e1.

The

chi

ld/y

oung

per

son

is p

rovi

ded

with

opp

ortu

nitie

s fo

r cr

eativ

e ac

tiviti

es a

nd p

lay.

2.C

arer

s pr

omot

e an

d ar

e in

volv

ed in

eac

h ch

ild’s

edu

catio

n an

d th

eir

prog

ress

, se

tting

hig

h, b

ut r

ealis

tic,

expe

ctat

ions

for

them

.

3.C

arer

s/pa

rent

s ar

e su

ppor

ted

and

trai

ned

to a

ssis

t ch

ildre

n/yo

ung

peop

le’s

edu

catio

nal d

evel

opm

ent.

4.E

mot

iona

l wel

l-bei

ng a

nd e

duca

tiona

l ach

ieve

men

t ar

e pe

rcei

ved

by c

arer

s/pa

rent

s as

link

ed is

sues

, an

d re

sour

ces

are

avai

labl

e to

sup

port

bot

h.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

5.C

arer

s pr

ovid

e op

port

uniti

es fo

r th

e ch

ild/y

oung

per

son

to

deve

lop

exis

ting

and

new

ski

lls a

nd t

alen

ts in

spo

rt,

cultu

re

and

arts

act

iviti

es.

6.T

he c

arer

kno

ws

abou

t an

d ta

kes

an in

tere

st in

the

chi

ld/y

oung

pe

rson

’s a

ctiv

ities

.

7.C

orpo

rate

par

ents

and

car

ers

prov

ide

oppo

rtun

ities

for

cele

brat

ing

child

ren/

youn

g pe

ople

’s a

chie

vem

ents

.

8.C

arer

s ar

e pr

oact

ive

in p

rovi

ding

stim

ulat

ion

for

the

child

’s

deve

lopm

ent.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

6a:

The

you

ng p

erso

n w

ill d

evel

op u

nder

stan

ding

of

his/

her

need

s an

d re

spon

sibi

lity

for

mai

ntai

ning

his

/her

hea

lth a

nd w

ell-b

eing

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.T

he p

olic

ies

of s

ocia

l ser

vice

s, e

duca

tion,

hea

lth a

nd le

isur

e se

rvic

es a

re c

oord

inat

ed t

o en

able

the

you

ng p

erso

n to

de

velo

p an

d m

aint

ain

good

hea

lth a

nd w

ell-b

eing

incl

udin

g yo

ung

peop

le in

out

of

auth

ority

pla

cem

ents

.

Par

tner

ship

1.C

hild

ren’

s tr

usts

, m

ulti-

agen

cy p

artn

ersh

ips,

the

loca

l str

ateg

ic

part

ners

hip

for

child

ren

and

youn

g pe

ople

, an

d ot

her

stra

tegi

c pa

rtne

rshi

ps d

emon

stra

te e

vide

nce

of jo

int

wor

king

and

jo

int

polic

ies.

Par

tici

pat

ion

1.Yo

ung

peop

le a

re a

ble

to d

emon

stra

te t

hat

they

hav

e th

e kn

owle

dge,

ski

lls,

attit

udes

and

val

ues

to k

eep

them

selv

es

safe

and

to

care

for

thei

r he

alth

and

wel

l-bei

ng.

2.E

vide

nce

of in

volv

emen

t in

pol

icy-

mak

ing

and

prov

isio

n of

re

sour

ces

and

info

rmat

ion.

3.P

erso

nal a

nd s

ocia

l edu

catio

n en

able

s th

e ch

ild/y

oung

per

son

to le

arn

abou

t po

sitiv

e an

d sa

fe r

elat

ions

hips

and

uns

afe,

ab

usiv

e re

latio

nshi

ps.

cont

inue

d


Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Par

tici

pat

ion

1.C

hild

ren

and

youn

g pe

ople

sho

w a

n un

ders

tand

ing

of h

ealth

y lif

esty

les,

and

man

agin

g he

alth

ris

ks a

nd g

ains

.

2.R

elev

ant

mat

eria

ls a

re p

rovi

ded

for

the

heal

th e

duca

tion

of

look

ed a

fter

child

ren/

youn

g pe

ople

.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

6b:

The

chi

ld/y

oung

per

son

has

the

know

ledg

e, s

kills

, va

lues

and

atti

tude

s to

kee

p hi

m/h

erse

lf sa

fe,

to p

repa

re fo

r ad

ult

life

and

to p

lay

apa

rt in

cre

atin

g a

heal

thy,

saf

e co

mm

unity

.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.P

olic

ies

and

reso

urce

s ar

e in

pla

ce t

o m

eet

the

need

s of

car

e le

aver

s in

acc

orda

nce

with

the

ir pa

thw

ay p

lans

.Thi

s in

clud

es

supp

ort

whi

le in

fur

ther

edu

catio

n, t

rain

ing

or e

mpl

oym

ent

or

at u

nive

rsity

.

Par

tner

ship

1.M

ultid

isci

plin

ary

part

ners

hips

are

in p

lace

to

ensu

re a

cces

s to

ho

usin

g re

sour

ces,

ben

efits

and

edu

catio

n an

d tr

aini

ng.

Par

tici

pat

ion

1.P

repa

ratio

n fo

r le

avin

g ca

re is

ava

ilabl

e to

all

care

leav

ers.

2.A

car

e pl

an/p

athw

ay p

lan

is d

raw

n up

whi

ch in

crea

sing

ly p

lace

s re

spon

sibi

lity

on t

he c

hild

/you

ng p

erso

n fo

r m

eetin

g he

r/hi

s ow

n he

alth

nee

ds a

s ap

prop

riate

to

her/

his

deve

lopm

ent.

Pra

ctic

e1.

Car

ers,

pra

ctiti

oner

s an

d co

rpor

ate

pare

nts

prov

ide

oppo

rtun

ities

for

deve

lopi

ng s

kills

for

inde

pend

ent

livin

g th

roug

hout

the

chi

ld/y

oung

per

son’

s lif

e an

d id

entif

y su

itabl

e su

ppor

t du

ring

tran

sitio

n to

inde

pend

ent

livin

g.

2.C

ontin

uing

ass

essm

ent

and

revi

ew o

f th

e yo

ung

pers

on’s

ne

eds

is c

arrie

d ou

t to

ens

ure

the

path

way

pla

n is

met

.


Nat

iona

l Hea

lthy

Care

Sta

ndar

d Au

dit

Tool

Ou

tco

me

6c:

The

chi

ld/y

oung

per

son

is s

uppo

rted

ade

quat

ely

thro

ugh

child

hood

into

adu

lthoo

d.

Evi

denc

eE

vide

nce

to d

ate

Act

ion

Poi

nts

Prio

rity

Po

licy

1.S

trat

egie

s co

verin

g le

avin

g ca

re a

nd t

rans

ition

into

adu

lthoo

d ex

ist,

and

thes

e in

tegr

ate

child

ren

and

adul

t se

rvic

es a

nd

prov

isio

n en

surin

g a

smoo

th p

athw

ay.

2.P

olic

ies

and

reso

urce

s ar

e in

pla

ce t

o su

ppor

t fu

rthe

r ed

ucat

ion

and

trai

ning

, em

ploy

men

t an

d un

iver

sity

adm

issi

ons.

Ong

oing

sup

port

is a

vaila

ble

to t

hose

car

e le

aver

s w

hile

livi

ng

away

at

univ

ersi

ty o

r co

llege

.

3.C

orpo

rate

par

ents

hav

e po

licie

s in

pla

ce t

hat

refle

ct t

heir

even

tual

rol

e as

cor

pora

te g

rand

pare

nts.

Par

tner

ship

1.M

ulti-

agen

cy p

artn

ersh

ips

are

in p

lace

whi

ch e

nabl

e ac

cess

to

sup

port

and

oth

er a

genc

y se

rvic

es fo

r ca

re le

aver

s.

Par

tici

pat

ion

1.A

ll ca

re le

aver

s ha

ve a

pat

hway

pla

n th

at t

hey

have

pa

rtic

ipat

ed in

com

pilin

g an

d w

hich

add

ress

es t

heir

shor

t an

d lo

ng t

erm

nee

ds.

Pra

ctic

e1.

Sup

port

is a

vaila

ble

for

care

leav

ers

who

bec

ome

youn

g pa

rent

s.

2.S

uppo

rt a

nd r

esou

rces

are

in p

lace

to

enab

le y

oung

peo

ple

to

cont

inue

with

edu

catio

n, t

rain

ing

and

empl

oym

ent.

3APPENDIX

Use the template on the next page to identify individual actions to includein the Action Plan.

The template is also available electronically atwww.ncb.org.uk/healthycare

Healthy Care Action Planning Tool

Hea

lthy

Care

Act

ion

Plan

ning

Too

lO

utc

om

e:

Wh

at d

o y

ou

wan

t A

ctio

n n

eed

edB

y w

ho

m?

By

wh

en?

Ho

w w

ill c

hild

ren

kn

ow

wh

en y

ou

hav

e d

on

e it

?to

ch

ang

e?W

hat

will

be

the

dif

fere

nce

fo

r th

em?

Po

licy:

Par

tner

ship

:

Par

tici

pat

ion

:

Pra

ctic

e:


Arcelus, J and others (1999) ‘A mental health service for young people inthe care of the local authority’, Clinical Child Psychology and Psychiatry,4, 4, 233–45.

Bamford, F and Wolkind, S (1988) The Physical and Mental Health ofChildren in Care. Swindon: Economic and Social Research Council.

Biehal, N and others (1992) Prepared for Living? A survey of youngpeople leaving the care of three local authorities. London: NationalChildren’s Bureau.

Biehal, N and others (1995) Moving On: Young people and leaving careschemes. The Stationery Office.

Bird, J and Gerlach, L (2005) Improving the Emotional Health and Well-being of Young People in Secure Care: Training for staff in local authoritysecure children’s homes. London: National Children’s Bureau.

Broad, B (1999) ‘Improving the health of children and young peopleleaving care’, Journal of Adoption and Fostering, 23, 1, 40–48.

Broad, B (2005) Improving the health and well-being of young peopleleaving care. Dorset: Russell House Publishing.

Brodie, I and others (1997) ‘The health of children looked after by localauthorities’, British Journal of Nursing, 6, 7, 386–91.

Buchanan, A (1999) ‘Are care leavers significantly dissatisfied anddepressed in adult life?’, Journal of Adoption and Fostering, 23, 4,35–40.

Butler, I and Payne, H (1997) ‘The health of children looked after by localauthorities’, Journal of Adoption and Fostering, 21, 2, 28–35.

Chambers, H and others (2002) Healthy Care. London: NationalChildren’s Bureau.

Children’s Rights Officers and Advocates (2000) Total Respect: trainingpack. London: Children’s Right’s Officers and Advocates.

Choosing Health: making healthy choices easier (2004) The StationeryOffice.

Corlyon, J and McGuire, C (1997) Young Parents in Public Care:Pregnancy and parenthood among young people looked after by localauthorities. London: National Children’s Bureau.

References

Department for Education and Skills/National Statistics (2004) Statisticsof Education: outcome indicators for looked after children: Twelve monthsto 30 September 2003. England. The Stationery Office.

The Children Act (2004) The Stationery Office.

Department of Health (1997) Substance Misuse and Young People.London: Department of Health.

Department of Health (2002) Promoting the Health of Looked AfterChildren. The Stationery Office.

Department of Health (2004) National Service Framework for Children,Young People and Maternity Services. The Stationery Office.

Dimigen, G and others (1999) ‘Psychiatric disorder among children attime of entering local authority care: Questionnaire survey’, BritishMedical Journal, 319, 675.

HM Treasury (2003) Every Child Matters. The Stationery Office.

Howell, S (2001) ‘The Health of Looked After Children’, Highlight, 184.London: National Children’s Bureau.

Lincolnshire Healthy Care Partnership (2004) Voices. Unpublished.

Mather, M (2000) ‘Health Issues for Black and Minority Ethnic Children’.Journal of Adoption and Fostering, 24, 1, 68-70.

Mather, M and others (1997) ‘The statutory medical and health needs oflooked after children: Time for a radical review?’ Journal of Adoption andFostering, 21, 2 36–40.

McCann, J and others (1996) ‘Prevalence of psychiatric disorders inyoung people in the care system’, British Medical Journal, 313, 7071,1529–30.

Meltzer and others (2003) The Mental Health of Young People LookedAfter by Local Authorities in England. Office of National Statistics. TheStationery Office.

Morris, J (1995) Gone Missing: A research and policy review of disabledchildren living away from their families. London: Who Cares? Trust.

Morris, J (1999) Hurtling into a void: Transition to adulthood for youngdisabled people with ‘complex health and support needs’. Brighton:Pavilion.


National Children’s Bureau (2004a) Learning from the Standard: Usingcreative participation with children and young people.http://www.ncb.org.uk/healthycare/docs.asp (accessed 12 November2004).

National Children’s Bureau (2004b) Learning from the Standard: Usingdrama to consult with children and young people.http://www.ncb.org.uk/healthycare/docs.asp (accessed 12 November2004).

National Children’s Bureau (2005) Healthy Care: a health promotiontraining programme for foster carers and residential social workers.London: National Children’s Bureau.

Richardson, J and Joughin, C (2000) Mental Health Needs of LookedAfter Children. London: Gaskell.

Shaw, C (1998) Remember My Messages. London: Who Cares? Trust.

Skuse, T and Ward, H (1999) Current Research Findings About theHealth of Looked After Children. Paper for Quality Protects seminar:Improving health outcomes for looked after children. Dartington SocialResearch Unit and Loughborough University.

Skuse, T and others (2001) Looking After Children: Transforming datainto management information. Report of a longitudinal study at 30/9/99,third interim report to the Department of Health. Loughborough:Loughborough University.

Williams, J and others (2001) ‘Case-control study of the health of thoselooked after by local authorities’, Archives of Disease in Childhood, 85,280–85.

References 69

Documents

Healthy Care Programme - Handbook