Looked After Children

Last updated: 2018-04-26 14:38:42
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1. Introduction

Looked After Children (LAC) are one of the most vulnerable groups in society. The majority of children and young people who become looked after do so as they have experienced abuse, neglect or a family breakdown. It is acknowledged that children who are looked after are at greater risk of poor life chances and outcomes.

 The term ‘ looked after’ was introduced by the Children Act in 1989 and refers to children who are;

  • Children accommodated under voluntary agreement with their parent(s) written consent (section 20)
  • Children who receive respite care which exceeds over 75 day per year
  • Children who are the subject of a care order (section 31) or an interim care order (section 38)
  • Children who are the subject of emergency orders for their protection (section 44 and 46); and
  • Children who are compulsorily accommodated. This includes children remanded to the local authority or subject to a criminal justice supervision order with a residence requirement (section 21)
  • Children who are detained under the mental health act in a hospital environment 16+

The Children Act 1989 Guidance and Regulations: Volume 2: Care planning, placement and case review sets out the functions and responsibilities of the local authority and partner agencies.

Many of these children come into care from very deprived social backgrounds, many have experienced different forms of abuse or neglect, potentially causing issues in respect to their cognitive and emotional development. This has the potential to impact on their outcomes in the longer term.

Looked After children and young people share many of the same health risks and problems as their peers, but often to a greater degree. They often enter care with a poorer level of health than their peers in part due to the impact of poverty, abuse and neglect. The duty to meet the health needs of Looked After Children for both the NHS and Local Authorities is clearly laid out in ‘Statutory Guidance on Promoting the Health and Wellbeing of Looked After Children’ (DFE, DH 2015).

When a child becomes looked after, local authorities are responsible for making sure an assessment of the child’s physical, emotional and mental health needs is carried out. It is the responsibility of the local authority to arrange a health assessment for a looked after child in partnership with health professionals.

Clinical commissioning groups (CCGS)and NHS England have a duty to cooperate with requests from the local authorities to undertake the health assessments and all agencies including local authorities, CCGs, NHS England and Public Health England need to cooperate to commission health services for all children in their area (DFE, DH 2015).

The NHS has a significant role in ensuring health assessments are timely and that the delivery of health services is effective.

It is acknowledged that almost half of children in care have a diagnosable mental health disorder and two thirds will have special educational needs with a proportion of these children needing a special education, health and care plan (EHCP). All organisations needs to reflect this high level of need in strategic planning for child and adolescent mental health services (CAMHS) for looked after children.

Last updated: 26/04/18

2. Key Issues

We currently have a higher number of looked after children per 10,000 than our regional and statistical neighbours.  In 2016 the rate per 10,000 looked after children in Hartlepool was 105 compared to 84 for regional neighbours and 95 for statistical neighbours.

At times there are limited placement choices to match the needs of the child/young person especially in relation to sibling groups, teenage placements and those with complex needs.

Changes in provision for supported accommodation require a comprehensive review of the service provision.

There are gaps in educational outcomes for LAC compared with other children and young people at each key stage, although the cohort is small.

There is a limited choice available for further education, employment and training opportunities based on GCSE outcomes within Hartlepool.

At the time of reporting 50% of care leavers are Not in Education, Employment or Training (NEET). It is worth noting that the data relates to a small cohort of young people, and that a difference of one young person in the cohort makes a large percentage change.

The percentage of all children and young people with an Education Health Care (EHC) plan across the town is 2.2% compared to 12.8 % of children looked after.

Data from social care assessments which attempt to categorise the key factors for a child being looked after (from a nationally determined set of factors) suggests that the four most frequent factors are the same both locally and nationally, i.e. domestic violence; mental health issues, substance misuse and neglect.

Evidence collated and presented to the Hartlepool Education Commission suggests that neglect has a detrimental impact on brain development of children in their early years.

 

Last updated: 26/04/18

3. Recommendations

1. Creation of integrated teams with Health as part of the Better Childhood in Hartlepool, specifically trained in mental health, domestic abuse, substance misuse as part of an early intervention approach.

2. Improve recruitment drive of local carers with a particular focus on sibling groups and teenage placements

3. Review supported accommodation and staying put options for care leavers.

4. Undertake a comprehensive review of the Post 16 educational offer for children looked after.

5. Review the From Care2Work plan.

6. Undertake a review of the SEND LAC cohort to understand specific needs.

7. Ensure that all children in care have timely and high quality, holistic assessments and reviews of their physical, emotional and mental health needs informed by SMART health plans which reflect the child’s voice.

8. Develop and support an early intervention programme for 0-2 year olds that stimulates early child development via the Hartlepool Education Commission work.

 

Last updated: 26/04/18

4. Who is at Risk and Why?

Gender

Boys are more likely than girls to be looked after. They represent 49% of the overall population aged under 18 but 55% of the looked after children.

Ethnicity

The ethnic breakdown for Children Looked After in Hartlepool has remained static over the years with a high proportion of white British children being admitted into care. However, Hartlepool’s ethnic population is increasing slightly and this may have an impact in the future, this is partly due to an increase in unaccompanied asylum seekers as the Council is part of the national transfer scheme.

Education

Children Looked After are significantly more likely than their peers to leave school with fewer or no qualifications.

Care Leavers are more likely to become NEET (Not in Education and Employment) than their peers and the likelihood of this increases the earlier they leave care.

Emotional Health and Wellbeing

Poor mental health, self esteem and attachment issues place Looked After Children at greater risk of participation in risk taking behaviours particularly early sexual activity, sexual exploitation, smoking and alcohol & drug use.

Families

Although children from all demographic groups become looked after, many Looked After Children typically come from families on low incomes, living in poor housing, with limited support networks, victims of domestic violence, misusing alcohol and drugs, and families where there are issues regarding mental health and learning disability. 

Teenage parents

Children of teenage parents are more likely to become looked after and looked after children are more likely to become teenage parents.  Looked after teenage girls are 2.5 times more likely to become pregnant than teenage girls in the general population.

Criminal Justice System

Children in care and  young care leavers are more likely to be involved in the criminal justice system than their peers.

Last updated: 26/04/18

5. What is the Level of Need in the Population?

The numbers of looked after children in England have increased steadily year on year since 2009. In March 2016, there were 70,440 looked after children – an increase of 1 per cent compared to March 2015 and an increase of 16 per cent compared to March 2009. In Hartlepool, the rate of increase has been more marked, with a 35% rise from 155 in March 2009 to 210 in March 2016.

The following summary of the profile of LAC in Hartlepool draws from analysis of a range of benchmarked data (DfE published statistical releases).

There has been a significant increase in the number of children in care with the rate per 10,000 population increasing from 82.0 in 2015 to 104.9 in 2016.                     

There has been a significant increase in the number of looked after children since 2015.  The majority of wards in Hartlepool have seen an increase in the number of children taken into care.  The number of children taken in to care in the Victoria Ward has seen the largest increase (52%).

Securing sufficient accommodation to meet the needs of looked after childrenand young people is a vital step in delivering improved outcomes for this vulnerable group.  The link below will take you to the LA Sufficiency Assessment, which sets out in detail the Local Authority’s plan in delivering appropriate accommodation for all our looked after children and care leavers.

LA Sufficiency Assessment

Children who return home from care are the largest single group of children who cease to be looked after in any one year.  Research shows that careful assessment of needs, evidence of improvements in parenting capacity, slow and well managed return home and the provision of services to support children and their families after the return home were associated with a positive experience of reunification which lasted.

The graph below identifies those care leavers who were not in education, training or employment who were aged 19 – 21 years old. It is worth noting that the data relates to a small cohort of young people, and that a difference of one young person in the cohort makes a large percentage change.  It is acknowledged that part of the issue in this area is the limited choice in educational options in Hartlepool for our young people.

The graph below identifies those care leavers who were in education, training or employment who were aged 19 – 21 years old..  It is worth noting that the data relates to a small cohort of young people, and that a difference of one young person in the cohort makes a large percentage change. 

In Hartlepool, the percentage overall absence for school children who have been looked after for at least 12 months has decreased year on year to 1.9% in 2015.  In comparison, whilst the figures have also decreased year on year for regional neighbours, statistical neighbours and for the whole of England, the absence rate is still above Hartlepool in 2015 at 3.2% for statistical neighbours, 3.4% for regional neighbours and 4% for England.

2016 Attainment Results

Foundation Stage: of those children that were looked after for at least 12 months, 20% achieved  ‘Good Level of Development’ by the end of the foundation stage compared to 68.4% of pupils in Hartlepool and 69.3% of all pupils nationally. This highlights that by the end of the Foundation Stage the attainment gap between children looked after and their peers is 48.4% and children looked after are required to make greater than average progress in order to narrow the gap.

Phonics Screening Year 1: of those children that were looked after for at least 12 months, 40% met the expected standard compared to 85% for all Hartlepool pupils and 81% for all pupils nationally.

Key Stage 1: of those children that were looked after for at least 12 months, 100% achieved the expected standard in Reading compared to 73% for all Hartlepool pupils and 49.8% for looked after pupils nationally; 50% in Writing compared to 65.3% for all Hartlepool pupils and 37% for looked after pupils nationally;  and 50% in Maths compared to 71.4% for all Hartlepool pupils and 45.6% for looked after children nationally.

Key Stage 2: those children that were looked after for at least 12 months 60% achieved the expected standard in Writing compared to 76.1% for all pupils in Hartlepool schools and 45.7% of looked after children nationally; 60% in Maths compared to 71.6% for all pupils in Hartlepool schools and 41% of looked after children nationally; 40% in Spelling, Punctuation and Grammar compared to 74% for all pupils in Hartlepool schools and 43.7% of looked after children nationally.  There were no looked after children that achieved the expected standard in Reading compared to 65.6% for all pupils in Hartlepool schools and 41% of looked after children nationally.

Key Stage 4: of those children that were looked after for at least 12 months, 16.7% achieved 5+ A*-C including English and Maths compared to 47.6% for all Hartlepool pupils and 13.6% for looked after pupils nationally.  The attainment 8 score for children looked after for at least 12 months in Hartlepool was 23.0 compared to 46.9 for all pupils in Hartlepool schools and 22.8 for looked after children nationally.  The progress 8 score for children looked after for at least 12 months in Hartlepool was -1.69 compared to -0.34 for all pupils in Hartlepool schools and -1.14 for looked after children nationally.

The above figures represent small cohorts which have a significant impact on the figures.

 

Last updated: 03/05/18

6. What Services are Currently Provided?

Last updated: 03/05/18

7. What is the Projected Level of Need?

There are currently no projected levels of need.

 

Last updated: 26/04/18

8. What Needs Might Be Unmet?

 

  • Development of an integrated multi agency delivery model to support prevention and early intervention in relation to domestic abuse, substance misuse and emotional wellbeing
  • Limited number of foster carers to provide care for large sibling groups, teenage placements and those young people with more complex needs
  • Current supported accommodation offer to be reviewed to ensure it fully meets needs of our most vulnerable young people
  • Undertake research across the Tees Valley schools to identify and share best practice to ensure improved education outcomes for our looked after children
  • Limited choice in Post 16 educational options for our young people
  •  Improve information sharing between agencies in relation to those children and young people who are LAC with Special Educational Needs and/or Disabilities (SEND)
  • Timely and high quality, holistic assessments and reviews of physical, emotional and mental needs of LAC which reflect the child’s voice;
  • Children in their earliest years are not making sufficient progress in their cognitive and linguistic development.
Last updated: 26/04/18

9. What Evidence is There For Effective Intervention?

There is a wealth of published research on this subject – one example is the research undertaken by Professors Mike Stein at York and Bob Broad at Loughborough Universities which shows that, although many children in care start from poor starting points:

  • the majority of children and young people will successfully move on from a stable care experience when they have consistent and relatively low level support
  • many more will do well in adult life if they receive skilled and intensive support while in care
  • only a vulnerable minority will continue to need targeted support well into adulthood.

It is useful to bear in mind these groups when commissioning, delivering, measuring and monitoring services to children and young people in care and care leavers.

Mike Stein, ‘We should not stigmatise care’

 

Promoting the educational achievement of looked after children

Promoting the education of lookedafter children and previously lookedafter children

The Educational Progress of Looked After Children in England: Linking Care and Educational Data

 

Promoting the health and wellbeing of looked after children: statutory guidance for local authorities, clinical commissioning groups and NHS England (2015) Department of Education and Department of Health https://www.gov.uk/government/publications/promoting-the-health-and-wellbeing-of-looked-after-children--2

 

NICE Guidance

Quality Standards (QS)

Looked after children and young people QS31 (2013) https://www.nice.org.uk/guidance/qs31

Public Health (PH)

Looked after children and young people PH28 (2010, updated 2015) https://www.nice.org.uk/guidance/ph28

 

 

Last updated: 26/04/18

10. What Do People Say?

The summary report in the link below, Children in Care Council – Education Report 2014, is written by the Children in Care Council and details a piece of consultative work they undertook focussing on the educational attainment gap between looked after children and non looked after children, why there is this gap and what can be put in place to reduce it.

Supporting Documents

The summary report in the link below, Children in Care Council Looked After Childrens’ Reviews Report, is written by the Children in Care Council and details a piece of consultative work they undertook focussing on the views and opinions of children and young people in care or leaving care about the looked after review process.

Supporting Documents

 

Review of health services for children looked after and safeguarding (CLAS) in Hartlepool

The CQC CLAS (2016) review of health services for looked after children and safeguarding in Hartlepool describes foster carers experiences of the looked after children’s nurse and health visiting services.  In addition foster carers talked about the positive involvement in the health plans for the looked after children in their care.

A looked after young person described her experiences of the health visiting service after the birth of her baby had given her confidence in the service and felt that she could trust the health visitor.

Positive experiences of primary care services were also documented in the report with a young person highlighting that they never have a problem accessing their GP.  Foster carers also stated that access to GP’s was very good.

Access to the full report can be found at: https://www.cqc.org.uk/sites/default/files/20160317_clas_hartlepool_final_report.pdf

 

 

Last updated: 26/04/18

11. What Additional Needs Assessment is Required?

  • Undertake a review of the SEND LAC cohort to understand specific needs
  • Undertake and implement a review across Tees Valley schools
  • to summarise plainly outcomes for looked after children across the Tees Valley
  • to identify and share best practice in Tees Valley schools
  • to identify potential barriers to implementing best practice
  • to carry out action research, in partnership with a HEI, to improve practice further
  • to improve teaching practice and hence outcomes for looked after children across the Tees Valley

 

Last updated: 26/04/18

Key contact: Karen Douglas-Weir

Job title: Head of Service, Looked After Children and Care Leavers

e-mail: karen.douglas-weir@hartlepool.gov.uk

Phone number: 01429 405584