PART II CARE PLANNING, REGULATIONS 3 TO 5
PART II CARE PLANNING, REGULATIONS 3 TO 5
Effective and transparent planning procedures for children who become looked after are central to the provision of a service which is fair to all parties; ensures that the aims and purpose of children becoming looked after are carried through; provides stability for children within which their needs and aspirations can be met; operates within timescales which are consistent with children's developmental progress; and can be clearly explained and evidenced to other bodies who have a role in decision making for the child. The key stages are:-
- gathering information
- forming an assessment
- making a plan for the child
- identifying what must change for/by the child and family
- setting goals and aspirations for child and family in achieving change
- identifying and putting in place services to support change
- implementing the plan
- reviewing and monitoring progress (Please see guidance on )
- adjusting or altering the plan if necessary
- agreeing the point where the child no longer needs to be looked after
Alongside this, the local authority has a responsibility to ensure throughout this process that the child's safety, well being and development are consistently monitored and actively addressed.
Regulations 3 to 5 cover the three stages of:-
(a) collection of information about a child who has become or is about to become a looked after child;
(b) assessment of the child's case; and
(c) the plan for the child.
In addition to these main areas in the regulations and the principles and themes at the beginning of this guidance. There are some key issues to which the regulations direct attention:
- the range and level of services to be provided
- the child's development
- parental involvement
The gathering of information is the first step in assessing the need for a child to be looked after and is the foundation for future action and all subsequent planning and decision making. Assessment aims to identify the needs and problems which face the child and other members of the family and their potential for relief, reduction or change. It should highlight ways in which problems can be addressed, needs can be met and strengths can be built upon.
The information outlined in Schedule 1 of the regulations is the minimum that must be collected for a child who is to be looked after; and further information will be needed depending on the circumstances of the child and his or her family. Local authorities should ensure that all those gathering this information understand its purpose and how it can inform both the assessment and the appropriateness of services provided.
The process of collecting information should minimise as far as possible the disruption to the child's life and should, where possible, be undertaken while the child is still living in the family home. The decision to carry out an assessment away from the child's home will normally depend on:-
- the risk of abuse or harm occurring to the child, or continuing to occur, if he or she remains at home;
- the danger posed by the child either to him or herself, to others at home or in the community, if the child continues to live at home;
- the extent to which other family members are likely to refuse to participate in or hinder the assessment, or unduly influence the child. Where this is a factor, consideration might be given to applying for a child assessment order.
- the extent to which the family situation has broken down.
An assessment carried out when a child is removed from home is bound to reflect the child's reaction to a new situation. This may differ in significant respects from behaviour at home.
The local authority should have a clearly identified framework for the comprehensive assessment of children who are, or may become, looked after. They should provide guidelines about when and how to initiate such a process, and possible tools and materials to support it. The assumption is that the assessment will cover the three dimensions of the child's world, whether the child is very young and there are concerns about the care he or she is receiving, or a young person whose behaviour or lifestyle is troubling and parents are struggling to manage this. The three dimensions are:
1. the child and how he or she is growing and developing physically, cognitively, socially and emotionally;
2. whether the people responsible for the care of the child can meet his or her needs; and
3. the child's place in his or her local network community and wider world.
Key elements to address therefore include -
- initial risk assessment
- the child's development, needs and views
- parents or guardians abilities, understanding, lifestyle and motivation
- parent/child relationship
- other key family relationships - siblings and kinship network
- family environment
- chronology of events in the lifetime of the child and significant information from before the child's birth
- wider community links and supports.
The assessment process should actively involve the parents, or anyone else who has recently had care of the child, and the child him or herself. It may also include partners of a parent who has played an important role in caring for the child, private foster carers or informal kinship carers. Where children and families are known to the social work department, there will be some information in case records, but previous information may need updating to respond to a fresh situation. Special attention should be paid to families who move frequently and where previous information is scattered all of which may make obviously worrying patterns harder to discern. This process will also include identifying any other agencies or support services which have been or may become involved in supporting either the child or the parents or guardians.
A child may already be subject to an educational or health support plan. The social work assessment and the subsequent child's plan needs to be developed within the context of the overall plan for the child, and be based on strong multidisciplinary working, ( GIRFEC). Local authorities should have established protocols with and across all their services, and with health services, to cover all stages and situations where multidisciplinary working is necessary. In particular, there should be links in relation to and for: children 'in need' services under the 1995 Act; child protection provisions; looked after children services; and post adoption support services. These links should form the backdrop within which the comprehensive assessment is carried out.
Regulation 3(3)(b) provides for a written assessment of the health and needs for health care of children who are or may become looked after. This is important for the care planning for children, to ensure their health needs are fully assessed and also to help determine placements, where that is appropriate. If the health service in the local authority area provides a specialist Looked After Children ( LAC) nurse service, this should be involved. However, in every case, with or without a LAC nurse service, it is crucial to ensure a complete overview of the collection of the necessary information about children, to ensure a high quality health service based on sound medical knowledge of the child.
Although regulation 3(4) says that a health assessment is not necessary for a child when this has occurred within the three months prior to the child being looked after, this should be considered anyway where there has been any significant change in the child's health or presentation, as this may reflect a change in the child's circumstances. For example, where very young children are concerned or where children have been living in situations which are generating a high level of concern.
The collection of information is an ongoing feature of any local authority service for vulnerable children and families. The information prescribed in regulation 3 and Schedule 1 and the issues listed in regulation 4 underpin the need for intervention and the initial arrangements to be made for the child. Depending on circumstances, it may or may not at that point be possible to have a completed comprehensive assessment. An assessment based on all available information must be made, however, initially about the child's immediate needs. This should consider:
1. The specific needs or difficulties which gave grounds for concern, or are revealed through the assessment. This should focus on the nature of the needs or difficulties, the possible reasons for them, and the likelihood of improving the child's situation or behaviour either through the child becoming looked after or through any alternative forms of action
2. The availability of care, support, and guidance for the child from the family (including the extended family) which, where applicable, should be considered along with the family's willingness and ability to respond to the proposed intervention. The use of family group conferences is frequently helpful here.
3. The level and extent of the risk involved for the child (and, where offending is a factor, the risk to others) of remaining at home or moving to a different placement.
Regulation 4 distinguishes between the child's immediate needs and his or her long-term needs. Even if a child remains at home, albeit under compulsory supervision, the change of legal status to becoming 'looked after' is a significant event. Normally, when a child becomes looked after it is as a result of either a particular episode that required action or as the culmination of a series of concerns.
In this Part, Care Planning, the regulations recognise a variety of provisions that may be made for looked after children: remaining at home under a supervision requirement, kinship care, foster care or residential establishments.
In relation to every looked after child, regulation 4 indicates a number of areas that an assessment must cover, some of which apply at all stages from the point of intervention and others which relate more to longer term planning. Those that apply at all stages include:-
- the proposals for safeguarding and promoting the child's welfare;
- the nature of services proposed and/or to be provided;
- the matters listed in section 17(4) of the 1995 Act, namely: the child's wishes and views; the views of the child's parents, of anyone holding parental responsibilities in relation to the child and of any other person whose views are considered relevant by the local authority; and the child's religion, ethnicity, cultural and linguistic background;
- alternative courses of action including kinship care;
- the need for any change in the legal status of the child.
In the longer term, regulation 4 also requires the assessment to address the sustainability of the arrangements for the child and look ahead to what arrangements need to be in place when the child will no longer be looked after by the local authority. These are particularly mentioned in regulation 4(1)(b) to (e), (h) and (l). These aspects will recur at later points in a child's looked after progress, if the child is looked after away from home and permanence planning is being considered. If a permanence order is under consideration, the child's welfare throughout childhood must be addressed; and if adoption is contemplated, one of the principles is the child's lifelong welfare.
From the outset in every case, there should be active consideration of the purpose of a child becoming looked after and of the possible outcomes. In its broadest interpretation, 'permanence planning', should cover all options, with the aim of a stable living situation for a child and one which meets his or her needs for consistent, sustainable positive relationships, normally within a family setting. The normal point for the local authority is assumed to be the maintenance of the child within, or the restoration of the child to, the birth parents and failing that to the kinship network, unless it is clear that this is contrary to the best interests of the child. Planning should therefore take account of various possible options, at/or returning home, or away from home. Models of 'twin tracking' should be considered.
The options for the time when a child no longer needs to be looked after or requires long-term care away from home therefore include:
- for a child remaining at home, sufficient improvement in the parents' care of the child or in the child's behaviour that supervision is no longer required and the family functioning has stabilised;
- the child can return to parent(s) from kinship carers or local authority accommodation with evidence that such a move is safe and sustainable
- there is a clear plan that return home is not safe or feasible but the child sees him/herself as a full member of their birth family and will require to remain with kinship carers on a permanent basis;
- there is a clear plan that return home is not safe or feasible but the child sees him or herself as a full member of their birth family and will require to remain looked after by the local authority until he or she is able to be independent and make choices for adult life;
- there is a clear plan that return home is not safe or feasible, the child's relationship with the birth family is non existent, tenuous, damaging or dangerous, and the child has the potential to become a full member of another family.
The aim of the long term planning therefore is to establish the best route for a child who becomes looked after and thereafter consider all subsequent decisions about the child's placement, care needs, contact and legal status in a manner consistent with the best outcomes for the child when he or she is no longer looked after. At the outset, the local authority should be clear with parents, children, family members and other bodies and organisations who have a role, that becoming looked after is not an end in itself but is the start of a new process, part of which is assessing the long-term objectives.
Particular attention needs to be given to planning for infants who require to be accommodated by the local authority immediately after birth and where such planning may start pre-birth. This is most likely to be the case where there is significant history of the need for intervention with previous children. The principles and tools developed in concurrent planning projects in other jurisdictions are useful in separating out the small number of infants where previous concerns indicate that planning alternatives to care by the child's parents should be initiated immediately from those where there is a need for a tightly planned and monitored attempt to establish whether there is any possibility of rehabilitation. The approach needs to demonstrate openness and honesty with parents about the seriousness of concerns, the risk that they may not be able to parent this child, a clear explanation of all the steps the local authority, the Children's Hearing system and the courts may take and how they can express their views. The most successful outcomes for these children depend on timely decision making. Where intervention from birth is indicated but there is limited knowledge of the family and/or this is the parents' first child, the emphasis first should be on ensuring a very active assessment process and careful choice of placement to assist this process.
In relation to possible placement in a residential establishment, in addition to the overall assessment of the child's case, the local authority are also required to assess whether a particular placement is appropriate for the child's needs, taking into account the establishment's statement of functions and objectives. Each local authority should have these available for its own establishments and for others that it uses regularly. It should be clear where these are held and where advice can be obtained on the suitability of particular residential establishments for individual children.
Assessments should be recorded in writing. These should distinguish between information gathered as evidence for the conclusions and the evaluation of that information. This evaluation is the professional core of the assessment and is where the specific information is interpreted, weighed against the best available knowledge from research, 'good practice' models and overall criteria; and the balancing of all factors relating to the child's welfare occurs. The assessment should conclude with an outline of options and clear recommendations. This will be the foundation for the child's plan.
Where the assessment has been prepared in partnership with the parents or carers and child, the content and recommendations should be explained to the family and fully discussed with them and the child. Even when cooperation has been limited, every effort should be made with parents and children to share as much as possible about the basis for intervention in their family life. Information should normally only be withheld wholly or partially when a child is unable to understand the assessment by virtue of his or her age or maturity, or disclosure to the parents, carers or child would breach confidentiality or cause harm. Likelihood of change is increased when the key participants understand and acknowledge the need for that change and have had the opportunity to consider what will be involved in that process. Particular care should be taken when parents or children have additional challenges in understanding the content of an assessment, to ensure that they have time to absorb this. This includes when individuals have difficulty with the written word, have a learning disability, do not have fluent use of English or are extremely stressed. Where key participants do not agree with the proposed outcome of the assessment, it should be noted in writing whether they disagree with the evidence, with the evaluation of that evidence, with the plan proposed as a result or with all of these.
Regulation 5 and Schedule 2, Child's plan
The use of the term 'child's plan' in these regulations is within the context of 'looked after' children as defined in section 17(6) of the 1995 Act. During the time when any legislation and regulations are in force, practice moves forward and strategies are developed. In parts of Scotland, the term 'child's plan' may have wider application than solely in relation to looked after children. Some children who become looked after may already be subject to other planned interventions, for example in relation to health or education. These may be under a different title or be brought together under the heading of a single child's plan. Please see the GIRFEC website for further details Equally, when children are no longer 'looked after', other services may need to continue. Regardless of whether the term the 'child's plan' is used in the specific context of the regulations, in relation to the local authority's responsibilities towards looked after children, or in its more comprehensive application, the same multiagency imperative remains, that of working together to provide a cohesive planned intervention and support to vulnerable children.
The child's plan that the local authority must make for each looked after child, regardless of the particular legal status or where the child is living, should be based on the information found and made by the local authority under regulations 3 and 4.
For every looked after child, including those living at home, the child's plan should and set out the matters and arrangements specified in Part 1 of Schedule 2. The Part I matters must be set out in the child's plan for every looked after child and are:
- The local authority's immediate and longer term plans for the child.
- Details of the services required to meet the care, health and education needs of the child
- The respective responsibilities of the local authority; the child; any person with parental responsibility; any foster carer or kinship carer for the child; where the child is placed in a residential establishment, the designated manager of that establishment; and of any other relevant person.
For children who are being or have been placed away from home, the matters covered in Schedule 2 Part II must also be included in the child's plan. Placement may be with a kinship carer in accordance with regulation 11; with foster carers in accordance with regulation 27; or in a residential establishment. Part II has a list of matters to be covered.
- The type of accommodation to be provided, the address and name of the person at that accommodation responsible on behalf of the local authority.
- The contribution the child's parents or any other person will make to the child's day-to-day care.
- Arrangements for involving the child and those contributing to the child's day-to day care in decision-making.
- Contact arrangements between the child and any of the categories of persons in section 17(3)(b) to (d) of the 1995 Act i.e. parents; any person who is not a parent but has parental responsibilities and rights in relation to the child; and any other person whose views the local authority considers relevant. If appropriate, the reasons why contact with any of these people would not be reasonably practicable or would be inconsistent with the child's welfare
- The expected duration of the arrangements for the child and the steps which should be taken in bringing the arrangement to an end, including arrangements for the return of the child to his or her parents or other suitable person.
As part of the preparation for the child's plan, the local authority must, "so far as is reasonably practicable and consistent with the best interest of the child, consult with" the people listed in regulation 5(2). The child's plan should be made in writing and include the matters listed in regulation 5(3). A copy of the plan should be given to those listed in regulation 5(4), including the child where appropriate. However, regulations 5(5) says that a copy of the plan does not need to be given to parents or others when the local authority considers that would it not be in the child's best interests, taking account of their responsibilities under section 17 of the 1995 Act or in terms of any order, warrant etc.
Through seeking the views of affected people and consulting with them, as much as possible should be agreed with the child, taking account of his or her abilities; those who have parental responsibilities and rights for the child; those who have charge of or control over the child at the time the arrangement commences and anyone else the local authority considers "appropriate". Where a child is looked after because he or she is subject to a supervision requirement or an order, authorisation or warrant made under Chapters 2, or 3 of Part II of the 1995 Act or a permanence order, the parents or carers will have no choice about whether or not their child is looked after. However, this should not preclude trying to reach agreements with parents or carers about the ways in which the plan is put into effect.
Where a young person is sixteen or over, arrangements to accommodate him or her may be made directly with him or her under section 25 of the 1995 Act and parents' agreement is not required to look after the child or young person. However, in practice, except where a young person is completely estranged from his or her parents, it will normally be beneficial to the young person to include his or her parents in the decision-making. In these circumstances, care needs to be taken not to undermine the young person's right to request accommodation or breach his or her confidentiality.
Like the assessment, the plan should, wherever practicable, be drawn up in consultation with the child, the child's parents, the prospective carers (if not the parents) and other important individuals and agencies in the child's life. Whenever practicable, the plan for the immediate arrangements for the child should be drawn up before the placement is made. Otherwise it should be drawn up as soon as practicable after the child is placed. It should be reviewed, and where necessary adjusted, at the first and at subsequent reviews and/or if the child changes placement. As indicated, the child, where appropriate, his or her parents, etc and the child's carers should receive a copy of the plan and any amendments that are made to it. This is subject to not providing a copy to parents etc if that is not in the child's interest, (regulation 5(5)).
Where the child remains at home, or is accommodated and placed elsewhere at the request of parents, or is placed under a supervision requirement, permanence order, warrant etc, achievement of the child's plan is most likely where there is agreement between the local authority and the parents about the main matters in the plan. A signed written agreement will generally be the best way of signifying the parents' understanding and commitment to the plan. Where placement is contrary to the wishes of the parents, every effort should be made to be open and honest in discussing the areas of disagreement. It may be helpful in some situations for the parent to record his or her agreement with some aspects of the plan but not others, rather than not agreeing the plan at all.
Where the child is of sufficient age and understanding the child should also be a signatory of the plan. This is particularly relevant if the plan relates to a young person whose behaviour is the primary matter of concern. This may be more difficult to achieve, and sometimes inappropriate, where a child is required to live away from home on a supervision requirement.
The initial plan will primarily address the immediate arrangements to meet the child's care needs. It may require further assessment within a time limited period, defined in local authority procedures and monitored through reviews, to complete a comprehensive assessment. This may then raise more detailed and specific matters which have to be addressed to meet the child's longer term needs. Agreement to a more substantive plan for change can usefully be accompanied by a contract between the child if appropriate, the parents, and the local authority, including expectations of the concerns to be addressed, the services to be provided and anticipated evidence of progress.
In drawing up the child's plan consideration should be given to the following points:
- what are the objectives of the local authority in looking after the child and is any change needed in legal status to achieve these objectives?
- can the objectives be achieved through the provision of accommodation by voluntary agreement with parents either as a single placement or as a series of short-term respite placements?
- is a supervision requirement or other legal order needed to achieve the objectives?
- if the child is to be looked after under a supervision requirement or other legal order, does the child need to be looked after away from home?
- if so, what type of placement is required?
- how long is it planned that the child will be looked after and what arrangements have to be made for the time when the child is no longer looked after?
- where it is agreed that the child is looked after away from home, what plans are there to restore the child to his or her immediate or extended family or, if this is not appropriate or achievable, to provide permanence in an alternative family or to provide support for the child to live independently?
- where it is agreed that the child is looked after away from home, what arrangements need to be made for contact, health care and/or education?
The child's plan should be a clear and focused document which spells out who will be doing what, and by when, in order to meet the objectives of the placement. It should address both what is necessary to ensure appropriate care for the child and also what needs to be addressed in relation to the child's family and environment to secure in the longer term a safe, sustainable and appropriate base for the child. It should outline the responsibilities of the local authority, the child, anyone with parental responsibilities for the child, and any other person the local authority consider relevant. For a child placed away from home, the responsibilities of his or her carers will be relevant. The objectives should be tangible and achievable. The plan should be written in plain language, avoiding jargon, and each party to it should know exactly what it means and what is expected of him or her. It should be a document that is monitored, reviewed and updated so that it remains relevant. The plan should help to ensure that the child is only looked after for as long as is necessary and beneficial for him or her.
The range and level of services to be provided
Type of placement including providing accommodation
For each child, consideration needs to be given to the type of placement and services which will meet his or her assessed needs. Wherever practicable, prior to making a placement when a child is to be placed away from home, the local authority should find out the views of the child and his or her parents about the type of placement which they feel will meet their needs. The child's extended family and friendship network should normally be the first option considered for a potential placement. This is addressed in PART V KINSHIP CARE. However, it will not always be possible to consider kinship carers in short or even long-term planning, and arrangements for and placement of a child should not be delayed where safe and appropriate kinship carers are not immediately available.
If a choice of placement is available, and appropriate, the local authority should provide information about different placements and arrange introductory visits. Even where a choice is not available, information and an introductory visit should be provided, if possible.
Where the child needs placement away from home and no suitable kinship placement is available, a foster placement will usually be the best option for both short and long-term care for any child under the age of twelve. He or she may occasionally be placed in residential care because it has been assessed that this is the best or only type of placement able to meet his or her needs. Where a residential placement is made because of a lack of foster placements, or of foster homes able to keep a sibling group together, a plan to find or recruit a suitable foster home should be made as a matter or urgency.
For a teenager, either a foster home or a residential establishment may offer the best way to meet his or her needs. Where a young person has experienced several foster placement breakdowns, a further foster placement may not be appropriate. Some young people may express a view that they prefer residential care to foster care. This view should be carefully considered as an enforced placement in foster care is unlikely to work. Some young people need specialist educational or therapeutic services provided in the place where they live. A very small number of young people will need secure residential care because of risk factors. For some young people, however, residential care will be chosen because there are insufficient fostering resources. Local authorities should identify the frequency with which this occurs and consider ways to try to achieve the necessary increase in foster homes.
Before placing a child in a residential establishment the local authority should seek and take account of the views of the child, his or her parents, other people with parental responsibilities and any other person deemed relevant by the local authority. The local authority should also be satisfied that the stated functions and objectives of the establishment, as far as practicable, meet the expressed and assessed needs of the child and his or her family.
For every child, when considering the type of placement to be chosen, regard should be paid to a child's ethnicity, religious, cultural and linguistic background. For older children, in particular, issues of gender and sexuality may also be relevant
Regardless of the type of placement, or if children remain at home on home supervision, consideration should be given as to whether there are additional services which will benefit the children. For instance, some children whose behaviour is particularly challenging may require a respite placement, as well as a main placement, if the main placement is to be sustained. Children may need counselling, psychological, or psychiatric services to help overcome the effects of previous deprivation or abuse. Children may need additional help to maintain their ethnic, religious, cultural and linguistic identity, particularly if it has not been possible to achieve this fully within the placement. Children who are offenders may need to take part in programmes which discourage re-offending.
A particular dimension which is central to the social work service is working with both the child and the family. This is the child's plan and as such emphasis is on services for the child. However, part of the overall plan may about the need for:
- change in parental lifestyle;
- additional support to compensate for parental vulnerabilities;
- development of parenting abilities;
- changes to the home environment for the child's benefit.
Some services may therefore be appropriately focused on adult needs and draw on other statutory, voluntary or independent services. Where such services are involved in the child's plan, it needs to be clear that, while subsequent decisions may take into account progress made by parents to improve their circumstances or functioning, the local authority retain the responsibility to assess whether such changes will be sufficient to affect the plan itself, with the child's wellbeing remaining central.
The child's plan should indicate the expected duration of the period of when supervision and/or placement is needed. After a child ceases to be looked after, he or she may remain 'in need', and, along with the parents or carers, may well still require services, even though the period of being 'looking after' has ended.
The regulations make a number of references to health and educational services. Much of this is about ensuring the appropriate transfer of arrangements for services. Effective intra and inter agency collaboration requires:
- a shared understanding of the tasks, processes, principles, and roles and responsibilities outlined in national guidance and local arrangements for protecting children and meeting their needs;
- improved communication between professionals, including a common understanding of key terms, definitions and thresholds for action;
- effective working relationships, including an ability to work in multi-disciplinary groups or teams; and
- sound decision-making, based on information-sharing, thorough assessment, critical analysis and professional judgement.
- Multi-agency training as an essential component in building common understanding and fostering food working relationships, which are vital to effective child care planning
The underpinning concepts on child development indicate the different domains of development that are crucial for children. The studies of the outcomes for looked after children frequently highlight a complex mix of social, emotional and behavioural concerns where health, education, social work and other therapeutic and psychological and counselling services all play a part. The child's plan therefore needs to be multidisciplinary in the widest sense, in order to be effective in meeting the child's developmental needs, and recognising fully the concept of corporate parenting.
All children need to develop physically, cognitively, psychologically, morally, spiritually and emotionally. For many children who are looked, after this is not an easy process. Some will not have received the safety, security, stimulation or encouragement that they require and they may be developmentally delayed or have unmet developmental needs. Other children's development may be affected by disability, mental illness or learning difficulties. There will be a few who are both affected by disability and have not received care that has been conducive to appropriate development. Liaison and joint working with colleagues in health and education is important and crucial for all these children.
Local authorities should act as good parents would in relation to the health care of children who are looked after by them and placed away from their own homes. Child's plans should fully reflect health care needs and should include health promotion, healthy lifestyles and general surveillance and assessment of developmental progress, as well as treatment for illness and accidents. Where children are on home supervision, health care will often be an important element in their plans and local authorities should aim to work with parents to promote and maintain children's health. It is the responsibility of local authorities, and part of carers' tasks, to educate young people to understand the importance of health care and to take increasing responsibility for their own health.
When drawing up a plan for a child placed full time away from home, local authorities should ensure that the child is provided with adequate health care. In many local authorities, responsibility for overseeing this will be carried out by LAC nurses and procedures need to be in place to facilitate their involvement. Consideration should be given to continuity of care, and where possible, the child should retain the same GP, dentist and optician. Children who are looked after will often have suffered early disadvantage and may be at risk of ill health because they have not previously received adequate care.
Local authorities and child health specialists should make arrangements for professional advice to be available to local authorities and to carers, to interpret health reports and information, assist in preparing and reviewing the arrangements for health care and assist in decisions relating to children's care. Local authorities need to decide, in consultation with local child health services, what is the best way to monitor the health of looked after children. For some children, there may also be a requirement for medical examination or assessment as part of a supervision requirement.
Local authorities should have information and procedures about consent to medical examination and treatment of children who are placed away from home. These should be known to the child health services, parents, children and the children's carers in each case. The arrangements for medical consent should be set out in each child's plan where a child is placed away from home. These will vary according to the legal status of the child, the age and understanding of the child and whether the local authority does or does not have parental responsibilities for the child. Parents, where they have parental responsibilities and the child is placed away from home, should be asked to sign a general medical consent form, giving permission for medical and dental procedures and treatment for the child, without delay or confusion. It is helpful if this includes consent to any specifically recommended immunisations.
However, depending on the age and capacity of each child, it must be remembered that a young person under 16 has the right to consent to his or her own medical procedures and treatment, when the medical or dental practitioner considers him or her to be capable of understanding the nature and consequences of the procedure or treatment. This is in terms of section 2(4) of the Age of Legal Capacity (Scotland) Act 1991. Therefore, for an older looked after child, parental or other consent will only be necessary when the doctor considers that the child is not capable of consenting. It remains good practice to include parents and/or carers in discussions, provided the child agrees to this.
Where a child is placed with foster or kinship carers, it is possible for the foster carer to give consent to a specific surgical, medical or dental treatment or procedure, where the child is not of sufficient age or maturity to give his or her own consent and the carer has no reason to think the parent would refuse to consent. This is a useful power in emergencies, or where the treatment or procedure is minor, or where a parent cannot be found. Foster carers should, however, be discouraged from giving consent where the treatment or procedure is major or where there is no great urgency. Parents, should as far as possible, be consulted prior to such treatment or procedures.
There may be occasions when parents for religious or other reasons refuse consent to a medical treatment and the child is not of sufficient understanding to make the decision. If the local authority is of the opinion that the child would suffer significant harm if examination or treatment does not occur, and if the child is already subject to a supervision requirement, a Children's Hearing may be asked to consider a condition about medical treatment etc, and this would overrule parental non-consent. If the child is not subject to a supervision requirement, the local authority may refer the case to the Principal Reporter or seek a child assessment or child protection order. Another option is for a Health Board, NHS Trust or other organisation, or another person such as a foster or kinship carer, but not the local authority, to apply for a "specific issue order" under section 11 of the 1995 Act, to ensure that necessary medical examinations and treatments are available to the child.
Young people of 16 and over have full adult capacity and should be asked to give their own consent to medical examination or treatment. If a young person of 16 or over is not capable of consenting, this is a matter of adult legislation and will need to be dealt with under the Adults with Incapacity (Scotland) Act 2000. As indicated above, children under 16 may also be able to give or refuse consent, depending on their capacity to understand the nature and consequences of the treatment. It is for the medical or dental practitioners to decide this. And in every case, children should be encouraged to express their views to the doctors, etc concerned. Children who are judged able to give consent cannot be medically examined or treated without their consent and this cannot be overridden by a supervision requirement or a warrant or order ( section 90 of the 1995 Act).
An accurate and up-to-date health record should be maintained as part of the record of every child placed away from home on a full time basis. This should record medical assessments, illnesses or accidents suffered by the child, medical, operative, psychiatric, psychological, dental or ophthalmic treatment and operations received or carried out, and all immunisations. The health record should also include any form(s) indicating parental consent to treatment.
Social work departments and education departments have a shared responsibility to fulfil their statutory duties including those for looked after children and for children with additional support needs.
Children who are looked after should have the same opportunities as all other children for education, including further and higher education, and access to other opportunities for development. They should also receive additional help, encouragement and support to address special educational needs or compensate for previous disadvantage and gaps in educational provision.
Educational and wider developmental needs should normally be addressed in the child's plan. When a child becomes looked after, the first step is to establish whether there are any arrangements or provisions or a co-ordinated support plan in place under the Education (Additional Support for Learning) Scotland Act 2004, as amended by the Education (Additional Support for Learning) Scotland Act 2009.
For further information on Additional Support for Learning please see the Scottish Government website.
These Acts provide a single structure for children who require additional support to make the most of their education. Such support can start from very early on, just after birth if children have a disability, and cover all types of reasons why children may struggle in education, not just specific learning difficulties. Looked after children should be considered as having additional support needs just because they are looked after even if there are no other reasons. Social workers responsible for looked after children should be as familiar as parents with both requesting an assessment and also the various arrangements that can be made through provision of a range of supports, personal learning plans, individualised educational programmes and co-ordinated support plans. Strong links should also be formed and sustained with designated teachers for looked after children in schools, and with others in the authorities' education department responsible for additional support needs services and for looked after children. In planning for the child, local authorities should have regard to continuity of education, take a long-term view of the child's education, provide educational and developmental opportunities and support and promote potential and achievement.
Local authorities should, in most cases, act jointly with parents in relation to the education of children who are looked after on a full time basis away from home. The aim will be to ensure that the child receives the support he or she needs to achieve his or her full educational potential. When a child is subject to supervision at home, education will often be a significant element in the child's plan and the local authority should aim to work with parents to promote the child's education.
Local authorities should notify all placements to their education department or the education department of another local authority where children are placed out of their 'home' local authority area. There should be notification about all placements, except for those which are intended to last for less than twenty-eight days. Information should reach those who need it in good time, especially schools. Special support may be needed where a change of school cannot be avoided.
Local authorities should ensure that the carer's responsibilities towards the child are understood by the school. Carers may exercise the parental role in relation to the school in day-to-day matters such as attending parents' evenings or receiving school reports, but there will be many cases where parents continue to play that role or where the role is shared. It is up to the social worker to clarify such arrangements with the school following discussion with all parties.
Carers have a major contribution to make to a child's educational progress and development. They are in a good position to identify the child's capabilities and any difficulties, fears and developmental needs. With the help of the carer, and through school reports and direct contacts with the school, the child's educational progress must be kept under review along with other aspects of the child's welfare. Difficulties should be addressed and help provided, including, where appropriate, access to specialist services within the local authority's educational provision. If a child is excluded from school, the local authority and/or the parents should pursue all the avenues open to them to try to get the child re-instated. If this proves impossible, and the child is permanently excluded, the local authority should ensure that the child receives appropriate education as soon as possible.
Other aspects of development
Children should be encouraged and given opportunities to develop and pursue leisure interests and any special gifts they may have. They also need opportunities to share in activities with their peers and develop both their social skills and their talents to increase their self esteem. With the child's agreement, supplementary educational opportunities could be arranged if these would help the child overcome past disadvantage, help develop a particular interest or talent or maintain his or her culture and language. Even where a child is looked after or placed for a relatively short period, the aim should be to provide opportunities for development so that the child can benefit as far as possible from the placement, and to identify the help the child may need to sustain new interests on return home.
The local authority has a responsibility to address the child's moral and spiritual needs. Where a child is placed away from home, the social worker and the child's carers should discover whether the child practised any aspect of his or her religion when he or she was at home and provide opportunities and encouragement for this to continue. Sometimes a child, particularly an adolescent, may reject the religious persuasion in which he or she has been brought up or may adopt a different religion. In some circumstances, this decision may affect the relationships with his or her own family. This should be part of a holistic understanding of the child's needs.
Parental Involvement for All Children who are Looked After
There is variation in the extent to which parents and others are involved in and contribute to the care of a looked after child, particularly when the child is placed away from home. As a general rule, parents should be helped to exercise parental responsibilities and rights in close relationship with the local authority, provided this is compatible with the child's welfare. Regulation 2 defines "parent" as "either the mother or father of the child or both". The home situations of many children who become looked after may be complex and issues may emerge about a variety of matters such as:
- the genetic parentage of a child;
- who has parental responsibilities and rights; and
- the day-to-day experience of parenting as perceived by the child.
This is particularly likely to be an issue in relation to the paternity of children. The same child may have one person named as the genetic father (agreed or alleged), a second person who has acquired parental responsibilities and rights, and a third person who has carried out the parenting role and is known to the child as his or her 'father'. At an early point, it is important to establish as much as possible about the parentage of a child as a basis for understanding and deciding:
- practical issues about involvement in planning and access to information;
- important relationships for the child;
- issues around legal status and future plans where parental responsibilities and rights may be relevant; and
- ways of helping the child understand the family circumstances, now and in the future.
Parental responsibilities and rights for fathers and others
A man automatically has parental responsibilities and rights for the child if:
- he was married to the mother at the time of conception of the child or later, even if he is not the genetic father; or
- if the child's birth was registered on or after 4 May 2006 and his name is shown on the birth certificate as the father.
Otherwise, a father does not automatically have parental responsibilities and rights for the child. If he is named on the birth certificate but the birth was registered before 4 May 2006, he does not automatically have parental responsibilities and rights.
However, where a father does not automatically have parental responsibilities and rights, he can acquire them. Many fathers have done this or do it after the child has become looked after. The main ways in which a father can obtain parental responsibilities and rights are:
- marry the mother, provided he is the genetic father;
- enter into an agreement with the mother under section 4 of the 1995 Act (a section 4 agreement), provided he is the genetic father;
- obtain a court order for them under section 11 of the 1995 Act;
- be named in the mother's will as the person who is to have parental responsibilities and rights, and she has died, section 7 of the 1995 Act.
Other people, such as grandparents, may also acquire parental responsibilities and/or rights through an order under section 11 of the 1995 Act, or by will. Sometimes a section 11 order is only about contact and this does not give full responsibilities and rights, but the father or other person should be treated as having at least some of these.
Others with a close relationship with the child, even though they do not have parental responsibilities and rights, may also have a role to play, depending on the child's circumstances. This will entail exploring the nature and origins of the relationship with the child; the extent of the involvement; how the child views the person as expressed either verbally or observed through their behaviour when they meet, and the potential of the person for positive and sustained involvement with the child in the future.
Relevant persons for the Children's Hearing system
Being a "relevant person" for a child in the Children's Hearing system is not the same as having parental responsibilities and rights, although there is an overlap. The definition of "relevant person" is in section 93(2)(b) of the 1995 Act as amended by Schedule 2, para 9(8) of the 2007 Act. They are:
- any parent who has parental responsibilities or rights automatically under the 1995 Act, or through a section 4 agreement, or as a result of a court order made under section 11, or as a result of a will when the mother has died;
- anyone who ordinarily (and other than by reason only of employment) has charge of, or control over, the child;
- anyone, including the local authority, who has parental responsibilities or rights as a result of a permanence order under the 2007 Act.
A father, or someone else such as a grandparent, may be a "relevant person" for hearings if he has been living with the child and/or caring for a child, but not have responsibilities or rights. Being a "relevant person" does not give parental responsibilities or rights.
Local authority's relationship with parents
A positive relationship with parents is not always easy to achieve, and consensus will not be possible in every circumstance since the child's welfare must remain paramount. However, the following will increase the chances of developing a successful relationship with parents, and local authorities should develop guidelines for staff covering areas such as:
- provision of both written and verbal information to parents at every stage of the process;
- the maximum amount of participation by parents in decision making that is consistent with the child's welfare, including advice and support to participate in meetings;
- making meetings accessible and comprehensible to parents;
- managing situations which are potentially acrimonious or where this may be difficult for children. For example, if a parent is not invited to a meeting to which it is usual to invite the parent, the reason for this should be recorded on the child's file.
- providing a regular, consistent, and reliable service to parents which does not just focus on meetings;
- considering ways in which parents may be able to contribute towards the child's care in practical ways.
Parents will often wish to be consulted about certain aspects of their child's care even if they do not intend to be directly involved: for example, hairstyles. It may not always be appropriate to include this level of detail in the child's plan but the social worker should ensure that the parents, carers and child, if old enough, are aware of the decisions and actions where consultation is needed.
Contact between Children and their Families
The statutory framework for contact
When a child is looked after, the local authority have a duty under section 17(1)(c) to take steps "to promote on a regular basis, personal relations and direct contact between the child and any person with parental responsibilities". However, this is not an absolute duty. It is qualified, because a local authority should make arrangements so far as they are practicable and appropriate, and taking account of their duty to safeguard and protect the child's welfare as their paramount concern.
Where the local authority are considering placing a child away from the birth parents, with kinship carers or foster carers or in a residential establishment, regulation 4(3) and (4) says they must assess the child's need for contact with:
- the parents,
- family members;
- anyone else with parental responsibilities or rights; and
- "any other specified person".
Regulation 4(6) says that a "specified person" is someone with whom the child has contact as a result of a court order or a supervision requirement or Children's Hearing warrant.
The local authority's general duty about contact, section 17(1)(c) of the 1995 Act, refers both to direct contact and to maintaining personal relations. This indicates a responsibility not just to enable contact to happen, but also actively to encourage and facilitate it, provided it is practicable and appropriate, taking into account a child's welfare. The responsibility under regulation 4(3) and (4) to assess contact arrangements covers the range of people listed above, including any other "specified person". As part of their overall enquiries, the local authority should check if there are any contact orders already in existence, for example under section 11 of the 1995 Act. They should also find out if anyone in the child's family or wider network is seeking a contact order with a child who is, or may become looked after. This will also include checking whether there is any information in their records about any contra-indication to this contact.
Whenever statutory orders are made to remove children from the care of their parents, the Sheriff or the Children's Hearing may make conditions or orders determining with whom children may have contact, and its frequency. The 1995 Act allows children and/or any " Relevant persons" to ask for a review of conditions or orders, whether they are short or long-term ones. Where there is evidence of serious risk, conditions or orders can also include prohibition of contact or restrictions on its nature.
Orders etc under the 1995 Act where contact may be covered include:
- child assessment orders;
- child protection orders;
- warrants from Children's Hearings;
- supervision requirements with a condition that the child lives away from home; and
- private law orders under section 11.
Permanence orders may also include ancillary provisions about contact. Birth parents and others with an interest may go back to court, to ask to have ancillary provisions varied, although they will need leave from the court to go ahead with a full application.
A parental responsibilities order (" PRO") granted under section 86 of the 1995 Act, became a "deemed permanence order" when the 2007 Act came into force on 28 September 2009. Any PRO granted after that date is automatically also a "deemed permanence order" when it is made. A "deemed permanence order" is described in the transitional provisions, in article 13(2) of the Adoption and Children (Scotland) Act 2007 (Commencement No. 4, Transitional and Savings Provisions) Order 2009, SSI 2009/267. It has ancillary provisions and these will include any contact condition attached to the original PRO. Birth parents and others with an interest may go back to court about a "deemed permanence order", to ask to have ancillary provisions varied, although they will need leave from the court to go ahead with a full application, article 15 of the 2009 Order.
Purpose of contact
From the outset, it is important to discuss the purpose of contact with birth parents, both from the perspective of the child and also as part of the plan to work with the family situation. It is very easy for parents to be drawn into the 'rights' debate without really understanding all the potential opportunities of well managed contact. At all points in planning for a child, the relationship between child and parents is central. Where a relationship is largely positive, contact will be an important part of helping the child through a separation. The circumstances leading to the child being placed may have put strain on that relationship, so contact can be an opportunity to refocus on the good aspects. For other parents, contact may provide a space to work on less positive aspects of their relationship with their child or learn new skills and approaches to this. This requires support to all parties.
Observing some of the contact in the early stages of separation is a valuable part of understanding a child's relationships and therefore part of the assessment. It should highlight the valuable aspects of the relationships which can be built on; and also offer evidence of negative or dangerous factors in contact which must be assessed more fully in order to decide if contact should be suspended or terminated. Observation and support during contact should be differentiated from any need for supervision; and the role of any other person present for all or part of the contact explained to participants. This needs to be balanced with opportunities for personal time together.
The assessment of the child should include full consideration of the value of continuing contact with parents and others, and the purpose and frequency of this contact should be outlined in the child's plan.
The plan should be modified where there are clear signs that restriction or termination of contact is necessary, either to protect the child from physical or emotional harm, or to ensure the long-term welfare of the child. This should be based on careful observation and full consideration of all the factors, including the views of the child. Contact, however occasional, may continue to have a value for a child even when there is no question of returning to the family. Such contact can keep alive a sense of origins for a child; may keep open options for family relationships later in life; and may reassure a child about the well-being of the people concerned.
Contact has a broad meaning which includes face to face meetings, letters, telephone calls, exchange of photographs, and sending gifts and cards. Contact should include not only parental but also sibling contact; and also contact with members of the extended family and friends. Sometimes this may lead in due course to a placement where this had not been identified as possible at the outset. It also indicates a place for contact in some form from short term placements though to adoption.
The first weeks during which a child is looked after by the local authority are likely to be particularly important in establishing the relationship between the parents, the social worker, and the child's carer, and the level of future contact between parents and child. At this time, patterns may be set which are difficult to change, whether the child is looked after by a voluntary arrangement or as a result of a statutory order. Local authorities may need to provide services to enable contact to take place and reduce hurdles to its operation. Emergency admissions require special care if parents and children are to be reassured from the outset that they have a continuing role in each others lives, and to minimise distress for the child. The child's carers, whether kinship carers, foster carers or residential social workers, are a key part of the team ensuring effective use of contact; and this should be reflected in their preparation, approval, training and support. These considerations, subject to whatever safeguards are necessary for the child's protection, are equally important where a child is subject to a child protection order, warrant, etc.
Foster homes may be appropriate venues for contact. Foster carers often play a role in facilitating contact and subsequent reunification. However, the foster carers' home is usually a family home and they, their children, and any other foster children also need time to get on with daily life. Contact arrangements or recommendations for contact conditions or orders should always be subject to consultation with foster carers.
Where contact is not reasonably practicable and/or would be inconsistent with the child's welfare, the reasons for this should be recorded. Any risk to a child from contact with parents must be assessed and a decision may be taken that contact should be supervised. Consideration must be given in these situations to the appropriate arrangements for such contact, including safe venues and sufficient people to ensure that contact can be as relaxed as possible within the necessary confines. The reasons for supervision and any conditions that may affect the continuation of the contact should be explained to the parents and the child.
Local authorities should discover and monitor a child's wishes about continuing contact with his or her parents and other family members. Social workers should, particularly in cases where the child is unsure about contact, try to help the child to clarify his or her views, and to understand what is likely to be of greatest benefit to him or her, both in the immediate and in the long-term. If a child who understands the situation continues to insist that he or she wishes to have no contact, or only limited contact, the local authority should consider taking the necessary steps to restrict or terminate contact. The full responsibility for decision-making should not, however, be laid upon the child.
If a child is placed with another agency, the local authority should ensure that there is a clear agreement with the agency about arrangements for contact. Responsibility for the child's welfare remains with the placing local authority. The other agency will normally have the responsibility for ensuring that agreed contact arrangements are implemented. The local authority should, with the agency's help, keep the child's contact with his or her family under review. Any decision to alter or restrict contact arrangements is for the local authority, in consultation with the agency, subject to any supervision requirement or court order.
Authorities should monitor the implementation of the proposed contact arrangements. Records should be kept to remind social workers of decisions taken earlier and to give a new social worker a full picture of the plan for the child. Social workers should check regularly whether the degree of contact with parents and others envisaged in the plan is happening in practice, and whether it fulfils a purpose consistent with the plan for the child. Any progress or problems should be discussed with the parents and the carers. It may be necessary to discuss with parents the possible implications of an inadequate or unpredictable level of contact for the child's future.
Both in the early stages of placement, when holding on to familiar contacts is reassuring, and for children who spend prolonged periods looked after away from home by a local authority, contact with siblings living elsewhere and with other extended family members and friends needs similar attention as contact with parents.
Restriction or termination of contact
Because of their responsibility to give paramount consideration to the welfare of the child, authorities should not avoid or defer difficult recommendations or decisions when it is clear that it is in the best interest of the child that contact should be restricted for the foreseeable future or terminated altogether. However, in both of these circumstances non face-to-face contact may still be in the child's interest. Authorities should have procedures, involving senior members of staff, for reaching such recommendations or decisions. Looked after reviews should be called to consider such recommendations, except in an emergency. Termination will not always be permanent. As children mature and/or recover from traumatic events in their lives, their views about contact and their ability to benefit from it may change.
If contact appears to be damaging a child who is accommodated by voluntary agreement with parents, and the parents are committed to its continuation, the case may need to be referred to the Principal Reporter for a decision as to whether there are grounds for referral; or to a court if the local authority think a Permanence Order is appropriate.
Siblings/Children in the same family
In terms of regulation 4(5), local authorities should try to ensure that siblings (children in the same family) are placed together, except where this would not be in one or more of the children's best interests. Where this proves impossible, they should, wherever possible, be placed near each other. The views of each child should be ascertained, as far as is possible given their age and understanding. The regulation uses the term "any other child in the same family" rather than sibling. This highlights the need for awareness of the child's view of 'siblings'. Many families have complex structures with full, half and step siblings and research has shown that children's perception of brothers and sisters and who is in their family is rooted as much in their living experience as biological connectedness. In initial planning for children, especially when they face a separation from their parents, the emphasis should be on maintaining as much as possible of familiar and comforting relationships. Longer term planning needs to be based on a fuller assessment of the nature and quality of different sibling relationships.
This provision has implications for agencies' policies on the recruitment, payment and housing of foster carers, and on the maintenance of reasonable vacancy levels in foster and residential care, so that placements able to accommodate sibling groups are not filled up with single children. Agencies' ability to meet the needs of siblings will be enhanced if they review and monitor this and how they provide placements for siblings, and make plans to overcome any shortfalls.
Where it is not in children's best interests for them to be placed together, or this has proved unachievable, then it may be appropriate for frequent contact to be maintained. This should be recognised in its own right and not purely as part of contact with parents. Where siblings are placed separately, reunification should be considered at the first and all subsequent reviews, particularly where separation was dictated by a shortfall of placements. In a small number of situations, the relationship between siblings may be inappropriate or dangerous. This may emerge through the overall assessment of an abusing family where the normal boundaries between family members, particularly in relation to sexual behaviour, are not established. Evidence of this may also emerge when the child is in a different placement and the appropriate steps taken to protect individual children.
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