Children in Care and Care Leavers (also known as Looked After Children)

Contact details

Designated Doctor for Children in Care and Care Leavers:

Dr Saraswati Hosdurga

Email: s.hosdurga-ICB@nhs.net

Email: bnssg.safeguardingadmin@nhs.net

Tel: 0117 900 2613

Designated Nurse for Children in Care and Care Leavers:

Nicki Ayres

Email: nicki.ayres3@nhs.net

Tel: 07887 625484

Deputy Designated Nurse for Children in Care and Care Leavers:

Gemma Shannon

Email: gemma.shannon2@nhs.net

Named Nurse for Children in Care Bristol, North Somerset & South Gloucestershire:

Elizabeth Dando

Community Children’s Health Partnership

Sirona Care & Health

Eastgate House, Eastgate, Bristol, BS5 6XX

Email: liz.dando@nhs.net

Tel: 07881 586218     Tel: 0300 125 6911

Sirona Children In Care and Health Team:

• Provide Children In Care with an initial health assessment and a review health assessment. They also undertake all aspects of the statutory guidance ‘Promoting the health and wellbeing of Looked After Children’.

If you have a query regarding a Child in Care and need to contact one of the 14 nurses within the Sirona Children In Care Health Team please use the following details:

Admin team email: sirona.cicadminbnssg@nhs.net

Admin telephone number: 0300 125 6911

Children In Care Nurse Email: sirona.cicnursesbnssg@nhs.net

Children In Care Nurse Telephone: 0300 125 6911

 Local Authority Contacts for queries regarding Children in Care and Care Leavers:

Bristol:

If you need to contact someone about a child who has a social worker please contact the social worker at their area social work office. Phone lines for offices are open Monday to Thursday, 8.30am to 5pm and Friday 8.30am to 4.30pm. In an emergency (fire, ambulance, police) call 999.

Disabled Children Service: Telephone: 0117 903 8250

Through Care and Placement Service: Telephone: 0117 353 4100

Through Care Teams 1 to 3: 0117 357 6146

Through Care Teams 4 to 6: 0117 357 6147

Through Care Teams 7 to 9: 0117 357 6148

Group Unit: 0117 353 4108
Placement Team: 0117 357 4679 / 0117 353 4194
Fostering/Adoption: 0117 353 4196
Fostering/Adoption Recruitment: 0117 353 4200

North Somerset: 01934 888 888. For emergencies outside of office hours, 01934 622 669.

South Gloucestershire: 01454 866000. Office Hours 8.45am to 5.00pm Monday – Thursday / 8.45am to 4.30pm on Fridays. At other times your call will be diverted to a service which only deals with emergencies.

Useful Information regarding caring for Children in Care and Care Leavers

A child who has been in the care of their local authority for more than 24 hours is known as a looked after child. Looked after children are also often referred to as children in care, a term which many children and young people prefer.

Reasons children are in care

There are a variety of reasons why children and young people enter care.

• Children's services may have intervened because they felt the child was at significant risk of harm. If this is the case the child is usually the subject of a court-made legal order.
• The child’s parents might have agreed to this – for example, if they are too unwell to look after their child or if their child has a disability and needs respite care.
• The child could have been lost, abandoned or there may be no one with parental responsibility available to care for them, as is the case for unaccompanied asylum-seeking children.
• The child may have been charged with a criminal offence and temporarily placed on remand in the care of the local authority.

(Looked after children | NSPCC Learning)

Every child in care is a unique child with individual strengths and needs. However, the physical, emotional and mental health of some looked-after children and young people will have been compromised by neglect or abuse. The rate of mental health disorders in the general population aged 5 to 15 is 10%. However, for those who are looked after, it is 45%, and 72% for those in residential care. In addition, frequent placement moves can keep looked-after children and young people from receiving the support they need by disrupting treatment plans and access to services. Frequent placement moves are linked to poorer mental health and a lessened sense of belonging. Practitioners and services involved with the child need to work collaboratively to assess and review the child's needs and how these can best be met. (Context | Looked-after children and young people | Guidance | NICE)

Who is a Care Leaver?

The law is divided into different categories according to a young person’s situation. A support offer may vary depending on these categories. A social worker or Personal Advisor (PA) can help to understand which of these categories applies to the young person.

Eligible Care Leaver

• Currently looked after
• Aged 16-17
• Looked after for a period of at least 13 weeks after the age of 14

Relevant Care Leaver

• Not currently looked after by the Local Authority but have previously been “Eligible”
• Aged 16-17
• Have been detained or in hospital but were “Eligible” before that OR have lived for six continuous months with a parent or someone with parental responsibility and that has broken down.

Former Relevant Care Leaver

• Aged 18+ and when under 18 were “Relevant” or “Eligible”
• If between 21 and 25 and in education or training, will remain a Former Relevant Care Leaver until the end of agreed ETE pathway
• If 21 or over and want to pursue or are currently pursuing education or training, can be reinstated as a Former Relevant Care Leaver.

Qualifying Care Leaver

• At least 16 but under 21
• Was looked after prior to the making of a special guardianship order which was in force when reached 18 OR…
• If at any time after 16 but before 18 were looked after by any of the following: a voluntary organisation (or on behalf of them), a registered children’s home, a health authority or have been fostered
• As a Qualifying Care Leaver can access advice and assistance based on a Needs Assessment completed by Social Care. However, won’t be entitled to the full Care Leaver offer.

It can be very complicated to know exactly what support a Care Leaver is entitled to. The following can be useful to signpost a young person to if they are in doubt regarding their status and support:  Am I a care leaver? - Coram Voice

Unaccompanied Asylum-Seeking Children

The UK Home Office defines an Unaccompanied Asylum-Seeking Child (UASC) as a person under 18 years old, who is applying for asylum and is separated from both parents, and not in the care of a guardian. The number of unaccompanied children in the UK has been increasing because of spontaneous arrivals and through processes under the Dubs Amendment and Dublin III arrangements.

Many unaccompanied minors are at increased risk of exploitation and abuse due to their legal status, age and experiences. Support and protection for unaccompanied children and young people needs to recognise their particular needs and vulnerabilities, as well as drawing on their strengths and protective factors.

IRiS, in collaboration with Save the Children, has developed this toolkit with a range of resources to inform and assist local authorities, foster carers and practitioners working with unaccompanied children.

Unaccompanied Asylum-Seeking Children Toolkit - University of Birmingham

Care Orders

When a child is placed under the care of the local authority, the local authority is given parental responsibility and shares it with current parental responsibility holders, such as the child’s parents. However, to protect a child’s welfare, the local authority may exercise parental responsibility beyond that of current parental responsibility holders. For further information regarding Care Orders please access: Care orders - childlawadvice.org.uk

Parental Responsibility (PR)

Who has parental responsibility (flow diagram)

Parental Responsibility and stepparents, same-sex male couples, and surrogacy:

The birth mother holds PR irrespective of who's sperm and egg are used, including surrogacy, unless legal orders/agreements alter this prior to or following delivery.  If the child is born overseas then the laws of the UK country (e.g. E&W) that the child and adult(s) come to reside in usually apply - but this is an area where seeing any legal documentation and taking expert advice is strongly recommended. 

In England and Wales, the following apply.  For Scotland and NI there are differences and it is advised that local guidance is accessed.  See here 

If not already holding PR by a mechanism listed in the main flow diagram, there are four main options to seek to obtain it via parental responsibility agreement, court order, parental order or adoption depending on the scenario. 

There are different categories of PARENTAL RESPONSIBILITY AGREEMENT (PRA): 

PRA1 - agreement that the biological father should be granted PR (not needed if already on birth certificate or other criteria as per flowchart diagram). 

PRA2 - agreement between a child’s parents and a stepparent (who is the spouse or civil partner of a parent) that the stepparent should have parental responsibility for the child. 

PRA3 - acquisition of parental responsibility by second female parent (not needed if PR already in place via civil partnership at time of treatment etc.). 

COURT ORDER can be applied for if no agreement can be reached for PRA1/2/3. 

However, if SURROGACY is used then there is a separate process and a PARENTAL ORDER is applicable and still requires the applicant or at least one of the applicants (if a joint application) to be biologically related to the child (sperm/egg donor) plus other criteria such as having the child living with you in the UK and the application to be made within 6 months of birth. It is a complex area; see the hyperlink for more guidance: surrogacy-guidance-for-intended-parents 

If neither the adult (nor their partner if a joint application) is related to the child, adoption is the only way to become the child’s legal parent. 

Promoting the health and wellbeing of looked-after children - GOV.UK (www.gov.uk) is joint statutory guidance from the Department for Education and the Department of Health. Within this document is the expectation of the statutory contribution from the primary care team. (Promoting the health and wellbeing of looked-after children - GOV.UK (www.gov.uk))

NICE Guidance

Looked-after children and young people (nice.org.uk)

Trauma informed care

It is imperative that Children In Care and Care Leavers receive trauma informed care. There are 6 principles of trauma-informed practice: safety, trust, choice, collaboration, empowerment and cultural consideration. Please see the following link for further information: Working definition of trauma-informed practice - GOV.UK (www.gov.uk)

Free prescriptions for care leavers

BNSSG ICB are soon to be able to offer Care Leavers free prescriptions. Please contact Designated Professionals for information regarding this.

Signposting

Useful Signposting for Children In Care and Care Leavers:

Home Page - Become (becomecharity.org.uk)

Am I a care leaver? - Coram Voice

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.