Quality statement 5: Support from specialist and dedicated services | Looked-after children and young people | Quality standards

Quality statement

Looked-after children and young people receive specialist and dedicated services within agreed timescales.

Rationale

Looked-after children and young people have particular emotional needs, and often behavioural needs relating to their experiences before entering care and during the care process. They share many of the same health risks and problems as their peers, but often to a greater degree. Access to an appropriate level of services when needed is essential to meet their emotional, physical, behavioural and educational needs (including specialist educational needs).

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

a) Evidence of local arrangements to ensure that looked-after children and young people receive specialist and dedicated services to meet their needs. These services should be delivered on a continuing basis within agreed timescales.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from patient records.

b) Evidence of local arrangements for health plans to be monitored and updated by independent reviewing officers, social workers and the lead health professional to ensure that the child or young person's continuing needs are being met.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from patient records.

c) Evidence of local arrangements for case management and treatment to continue for looked-after young people moving from child to adult mental health services, until a handover with an assessment and completed care plan has been developed with the adult service.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from patient records.

Process

Proportion of looked-after young people who are moving from child to adult mental health services, whose case management and treatment continues until a handover is completed with the adult service.

Numerator – the number of people in the denominator who have their case management and treatment continued until handover with the adult service.

Denominator – the number of looked-after young people who are moving from child to adult mental health services.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from patient records

Outcome

a) Feedback from looked-after children and young people that they have access to the services they need.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from patient records and surveys.

b) Feedback from recognised assessment tools that the child, young person or care leaver's needs are being met through access to specialist and dedicated services when needed.

Data source: Local data collection. Providers may consider using the Strengths and difficulties questionnaire as part of an evaluation of whether needs are being met.

c) Feedback from carers that they feel the needs of children and young people that they look after are being met through access to specialist and dedicated services when needed.

Data source: No routinely collected national data for this measure has been identified. Data can be collected from information recorded locally by health and social care professionals and provider organisations, for example from carer surveys.

What the quality statement means for different audiences

Service providers (organisations providing care) ensure local arrangements are in place to refer looked-after children and young people to specialist and dedicated services within agreed timescales, and to monitor and update health plans to ensure their needs are continuously met.

Health and social care practitioners and education staff refer looked-after children and young people to specialist and dedicated services within agreed timescales, and monitor and update health plans to ensure their needs are continuously met.

Commissioners (for example, local authorities) ensure they commission services that provide looked-after children and young people with access to specialist and dedicated services within agreed timescales, and that health plans are monitored and updated.

Looked-after children and young people have access to specialist and dedicated services within agreed timescales.

Source guidance

Looked-after children and young people. NICE guideline NG205 (2021), recommendations 1.5.3, 1.5.17, 1.5.18, 1.5.19, 1.5.20 and 1.6.7

Definitions of terms used in this quality statement

Agreed timescales

Access needs to be determined locally given the range of services. The aspiration is that looked-after children and young people receive services when needed and should not be subject to delays in access. [Expert opinion]

Carers

Carers include foster carers (including family and friends carers), residential carers and supported lodging providers. [Adapted from NICE's guideline on looked-after children and young people, and expert opinion]

Health plan

The health plan forms part of the care plan and is developed from the assessment of the child's health needs. It should include health history, current arrangements for healthcare, routine health checks and screening, preventive measures and health promotion. It should specify actions to be taken and services provided to meet the health needs identified in the assessment, the person or agency responsible for undertaking each action/providing each service, the likely timescales and the intended outcomes. Care leavers have a pathway plan that will include arrangements to meet their health and development needs (pathway plan is defined in quality statement 8). [Adapted from Department for Education's Children Act 1989 guidance and regulations volume 2: care planning, placement and case review]

Equality and diversity considerations

Services should be available to meet the diverse needs of looked-after children and young people, including (but not limited to):

babies and young children
children and young people with special educational needs
children and young people with learning or physical disabilities
children and young people with speech, language and communication difficulties
children and young people with a hearing or visual impairment.

Unaccompanied asylum-seeking children and young people need access to specialist psychological services (including child and adolescent mental health services), with the capacity, skills and expertise to address their particular and exceptional health and wellbeing needs. Professionals working with unaccompanied children and young people who are looked after should have a good understanding of cultural differences in attitudes to and beliefs about physical and mental health or wellbeing.