3.1.1 Looked After Children Procedure
With effect from 3 December 2012, a child who is dealt with by a court by way of a Remand to Local Authority Accommodation or a Remand to Youth Detention Accommodation will be a Looked After Child. The care planning requirement will be amended in relation to such children– see Remands to Local Authority Accommodation or to Youth Detention Accommodation Procedure.
This chapter was updated July 2013. The section on ‘Agreement to Accommodate a Child’ should be read following the impact of a court matter on parents consenting to this. This is important and needs to be read.
- Key Objectives
- What is a Looked After Child?
- Summary of Looked After Processes within ICS
- Becoming Looked After - Role of the ICS Brief and Complex Child and Family Assessment
- Normal Residency
- Risk and Links with Child Protection Procedures
- Children with Specific Vulnerabilities
- Complex Child and Family Assessment
- Extended Family
- Placement with Family and Friends and Connected Persons (Regulation 24)
- Agreement to Accommodate a Child
- Agreement with Parents and Care Plan
- Children Subject to Care Proceedings
- The Looked After Child in Placement - Social Workers' Responsibilities
- Placement Choice and Preparation
- Information for Carers
- The Child's Educational Needs
- Partnership with Carer
- Contact and Related Issues
- Social Workers' Responsibilities to the Looked After Child
- Issues in Placement
- Planning and Review
- Return Home
- Permanency Planning
- Leaving Care
|The cornerstone duty is that a local authority must safeguard and promote the welfare of each child whom they look after [section 22(3)a] . . . The authority [is] required to make reasonable use (for the benefit of children who are looked after) of the services and facilities which are available to children cared for by their own parents. (Children Act 1989 45, para. 5.9).|
Local Authorities have a responsibility to provide accommodation for - to 'look after' children who cannot, for whatever reason live with their parents. This may be for a few days or for the whole of a child's life: in either instance it is a heavy responsibility which requires due thought and planning if it is to achieve positive outcomes for the child.
Looked after children deserve the best experiences in life, from excellent parenting which promotes good health and educational attainment, to a wide range of opportunities to develop their talents and skills in order to have an enjoyable childhood and successful adult life. Stable placements, good health and support during transitions are all essential elements, but children will only achieve their potential through the ambition and high expectations of all those involved in their lives. (Preface - Care Planning Regulations 2010).
A child is a 'looked after' whenever they are the subject of a Care Order or Interim Care Order which gives Parental Responsibility to the Authority; when they are provided with accommodation by the authority under S20 of the Children Act OR when they have been Remanded to Local Authority or Youth Detention Accommodation.
The distinction is that a child on a Care Order is a looked after child wherever they are living as long as the Order remains in force.
An accommodated child is looked after only while they are in accommodation provided for them by the Local Authority e.g. a registered Children's Home or Foster Home. If they return home - other than for an agreed staying contact - they are no longer looked after.
When a child is on a Care Order the Local Authority has Parental Responsibility and is responsible for deciding where and with whom the child lives. The parent(s) will also have parental responsibility, which they continue to share with the Local Authority and must be consulted or informed as appropriate regarding significant issues and events in the child's life. While the parent of a child on a Care Order is entitled to have their views taken into account they cannot thwart the Local Authority's decisions regarding the child. They are entitled however to return to the court to apply for the order to be discharged.
When a child is in S20 accommodation the Local Authority does not have parental responsibility: any significant decision regarding the child must be taken alongside the parent. A parent can request the child's discharge at any time.
Some common problems may arise regarding whether or not a child is looked after arise from children living, or being placed with relatives or friends.
A child is not looked after when they are staying with relatives or friends under a private arrangement made by the child's parents or by someone with parental responsibility. If the arrangement lasts for more than 28 days AND the carer is not a relative then Private Fostering Regulations apply and an appropriate assessment must be undertaken. (See Private Fostering Procedure)
Please note however that children who are not living with their parents are likely to be particularly vulnerable. They should receive an appropriate level of assessment and support as children in need, which may lead to consideration of the need for them to become looked after.Placements with Relatives Friends and Connected Persons: Confusion can arise when children are placed with relatives and relevant others with the support or facilitation of a social worker, often in an emergency situation when a child cannot live at home. In these situations it is important to be clear as to the legal basis of the arrangement from the outset in order to ensure that the child receives an appropriate level of safeguarding and to avoid future problems.
- When the arrangement is initiated by the parents; when there are no issues of risk to the child or public legal proceedings and where the parents and the carers accept responsibility for the ongoing financial maintenance of the child then the child is not looked after. Please note though that Private Fostering Regulations apply where the carers are not relatives;
- When the arrangement is initiated by or is at the insistence of the social worker; when there are child protection issues or current or likely legal proceedings; or where the carers are unable to care for the child without ongoing financial support then the child should be treated as looked after. The carers must be treated as foster carers and the procedures under Regulation 24 followed. It is essential therefore to carry out adequate background checks at an early stage regarding any placement within the extended family to which the social worker is party. See Placements with Connected Persons Procedure.
|Summary of LAC Processes within ICS/Framework|
|Brief Child and Family Assessment||Must be completed prior to accommodation in emergency situations|
|Complex Child and Family Assessment||Must be completed before planned accommodation as soon as possible following unplanned accommodation. Serves as the basic assessment of need tool for children who are looked after for up to 10 months|
|Chronology||This should be started at the same time as the Complex Child and Family Assessment. Only the Significant Events section need be completed - other sections can be used if required|
|Placement Information Record||Must be completed prior to initial placement and updated before any subsequent placement. Provides essential information to the carer, deals with medical consent and the foster carer's undertaking|
|Review record||Consists of Pt. 1 - SW report - this should contain details of changes or updates since the previous review
Pt. 2 - Chair's report
|Care Plan||Consists of Pt. 1 - Overall direction and objectives
Pt. 2 - Detailed actions and responsibilities to implement Pt. 1
|Adoption Plan||Should be completed for all children for whom adoption is a possibility from the second (4 month) review. Replaces Part 2 of the Care Plan when adoption becomes the exclusive plan|
|Assessment and Progress Records||Age-related tools to assess the needs of all children looked after for longer than 10 months i.e. after the third review|
|Pathway Plan||Planning tool for young people moving towards independence at 16 years+. Includes Part 1 - overall objectives and Part 2 - detailed plan|
|Statutory Visit||Structured Record of SW's visit to a Looked After Child|
As can be seen from the above tables there are a considerable number of documents which could apply to a looked after child. In order to reduce scope for repetition workers should be aware of their specific purposes as follows:
The Complex Child and Family Assessment aims to assess need and needs to be completed or updated following accommodation in order to inform the Care Plan. It should then be updated to inform the Child/Young person's Plan if and when the child returns home. If a child is likely to remain looked after then the Assessment and Progress Record should be used as the main assessment tool.
The Chronology goes alongside the Complex Child and Family Assessment and should record significant events such as placement and school changes, additions to the birth family, legal orders, hospital admissions, cessation of contact etc. NOT visits, calls and other routine events. It is good practice to update this on a quarterly basis and before any change of social worker.
The Care Plan should contain the core information regarding the child's needs and issues and the plans to meet these. It should be updated as necessary following every review meeting. All appropriate parties - child, parents, carer, Guardian should have a copy.
The Social Worker's Review Report Part 1 should contain details of new or changed information since the last review. It is not necessary to repeat information already contained in the Care Plan and Chronology.
The Assessment and Progress Record is a working tool for the social worker to use to establish and detail the child's needs in order to inform the care plan.
This section deals with the assessment and decision making process which leads to a child becoming looked after.
There are a number of routes to becoming Looked After, however the common feature is that provision of accommodation should be based on assessed need and seek clear objectives and outcomes for the child.
There can be a good deal of pressure; from families, from the young people themselves and sometimes from other professional agencies to provide accommodation as a 'solution' to a range of problems, sometimes of very long standing. It is important that this option is taken only when it is appropriate in the light of the child's overall needs, rather than as a response to a specific situation or crisis.
While it is important that no child remains longer than necessary in a situation in which they are facing direct harm, in many instances there will be greater advantage to thoroughly assessing a child's needs and making proper preparation and planning for any looked after placement that may be necessary than to act in haste. A poorly planned emergency placement that then breaks down can compound the child's existing problems as well as severely disrupting their education.
It is therefore essential that there is a process of information gathering and analysis before any child becomes looked after.
Brief Child and Family Assessment
An IA must always be undertaken prior to any decision regarding accommodation, even when an urgent response is required. This should include an outline of the child's needs, parenting capacity and family and environmental factors, based on what is known at the time.
In some circumstances this may be very basic e.g. if an infant is found abandoned this may be as shown in the box below:
Child's Developmental Needs - Requires age appropriate care and nurture, having been found by police.
Parenting Capacity - Not receiving effective parenting at the present time.
Family and Environmental Factors - Not known at present.
Child's Initial Plan - To place in foster care to ensure that basic needs are met while further enquiries are carried out.
The Brief Child and Family Assessment is the 'gateway' to service provision and, equally, provides a clear and structured rationale for offering an alternative course of action when this appears to be in the child's best interests.
Children should only however be accommodated on the basis of a Brief Child and Family Assessment alone when there is imminent risk or other urgent factors OR when the request for accommodation is to meet a clear time-limited contingency such as a parent having to be admitted to hospital.
Where it is necessary to accommodate children before a Complex Child and Family Assessment can be completed the agreement with parents should specify that the Authority has agree to accommodate the child for a limited period only.
An important aspect of the ICS assessment process is to establish clear and firm factual details regarding the child and their family. It is particularly important to clarify and confirm data regarding a child's normal place of residency whenever there is any uncertainty as to whether they are a Lambeth resident. This will apply particularly to children who may be staying with relatives or whose care is shared between 2 parents.
Any uncertainty in this area must be negotiated by the responsible Team Manager at the earliest possible point. Please see the London Children's Safeguarding Board Procedures for guidance regarding attribution of responsibility and cross-boundary issues in general.
Within the Brief Child and Family Assessment it is important to evaluate the risks to which the child is subject in their present environment and the type of harm that is likely to arise from these. This is particularly important when the most appropriate course of action is to support the child in their present situation while undertaking a Complex Child and Family Assessment.
This should therefore cover:
Specific risks arising from known circumstances: e.g. a parent has assaulted the child or a sibling on a previous occasion; they continue living in the same household; and there has been no basic change in attitudes or behaviour, therefore the child is likely to be assaulted again.
General risks arising from the overall family situation: e.g. older siblings have been excluded from school, started offending etc. between the ages of 11-13 years, therefore it is likely that this child will follow the same path.
The child's age, developmental needs and general resilience: A child of secondary school age will be able to survive shortfalls in practical 'hands on' parental care much better than a preschool child.
The extent to which risks can be mitigated: this will relate to both the type of risk manifested and the attitude of parent and child towards receiving help. It is sometimes possible to calm a situation by the very process of taking the child's and family's concerns seriously and beginning systematic process of assessment.
Where there is any indication of the child suffering significant harm the Child Protection Procedures should be triggered, whether or not accommodation is a likely outcome. This ensures that the police and other appropriate agencies have an input into the process and that action can be taken regarding any potential criminal offences. This means in practice that a Strategy Discussion must always be initiated by the responsible manager.
|Type of need||Immediate Action||ICS processes||Comments|
|Child abandoned||Immediate safeguarding: Placement with relatives if known or in S20 accommodation||Urgent IA, followed by Core||Legal action may be needed, based on the child's age an vulnerability|
|Request for accommodation from Parent / Carer||Attempt to hold the situation while a Complex Child and Family Assessment is undertaken||IA to determine urgency and risk: CA if possible prior to a decision on accommodating||Any request based on family relationship issues needs to be carefully assessed. Consider Family Group Conference|
|Request from Child or Young Person||ditto||ditto|
|Child facing immediate harm||Immediate safeguarding including placement in accommodation if needed||Strategy discussion S47 investigation within a Complex Child and Family Assessment (see CP procedures)||Legal Framework likely to be needed: PP, EPO or S20 pending Care Proceedings|
|Child facing chronic harm||Initiate CP procedures if not already in hand||Complex Child and Family Assessment and Child's Plan (CP). Strategy Discussion/S47 if required||Accommodation and/or Care Proceedings may be needed if the CP plan fails to safeguard the child|
|Young Person remanded to care by the Youth Court||Consider whether YP can remain at home if Court conditions permit. If not place in S20 Accommodation.||Complex Child and Family Assessment should be commenced following accommodation||CA should consider services to meet the YP's needs in the community. It may not be possible to complete a CA in all circumstances|
It may be the case that by the time there is an explicit request for accommodation from either parent or child that the family have lost faith in the possibility of improvements. Most children who become looked after have been known to children's social care for at least 12 months. It is important therefore that all Brief Child and Family Assessments consider the stability of the child's family situation and the likelihood of break down. Children in the following situations are particularly vulnerable:
- Children being cared for by relatives;
- Children who have been excluded from school, particularly where this has happened during primary school years;
- Children living with parents who have long-term mental health, drug and/or alcohol abuse problems.
Assessments should therefore consider the long-term viability of a child's situation. There are times when it will be more in the child's best interests for them to be accommodated on a planned basis, rather than for their welfare to deteriorate until a further crisis occurs.
A Complex Child and Family Assessment should normally be undertaken prior to a decision regarding accommodation. This may not be possible in all circumstances, particularly with new referrals; however a Complex Child and Family Assessment should be in process or be completed for all children where there is ongoing involvement.
The point of the Complex Child and Family Assessment is to inform the multi-agency plan for the child in order to best meet their needs, NOT to 'press the right buttons' to achieve any particular outcome. If the Assessment concludes that the child's needs are best met away from home, whether on a short or long-term basis it will inform the Child's Care Plan (the ICS planning document for Looked After Children); if it proves possible to maintain the child at home it will inform the Child / Young Person's Plan.
It is advisable to obtain the fullest possible details of all the child's adult relatives on both maternal and paternal sides as part of the Complex Child and Family Assessment whenever accommodation is being considered, regardless of whether placement with a relative is being considered as an immediate option. This helps to reduce the likelihood of relatives being put forwards as carers unexpectedly when other options may be being considered.
It must however be recognised that outcomes for older children who become looked after are generally poor. Assessment here should focus on the possibility of improving outcomes for the child within their present living situation, while considering the impact that being accommodated would be likely to have: for example, while a young person may be facing difficulties at school or in their family relationships the assessment should consider whether placement outside of the family home would be likely to have a positive or a negative impact in these areas, bearing in mind the inevitable disruption that would occur in the young person's life.
Where a Complex Child and Family Assessment has not been completed prior to accommodation this must be started as soon as possible and completed within the 35 working day timescale. Where the assessment indicates that there should be consideration of either return home or placement with a friend or relative a referral to the Children Looked After Mental Health Service (CLAMHS) should be considered order to inform care planning. Referrals to this service are agreed through the Placements Panel.
It is essential therefore to explore all appropriate avenues to prevent the need for accommodation. Steps which should be considered include:
- Provision of practical services e.g. day care, domiciliary help, advocacy and advice on housing and other issues;
- Therapy - input from CAMHS, provision of a mentoring service, referral to or co-ordination with adult services;
- Co-ordination of input - where children have been subject to a Child Protection Plan there will be an established basis of Review and Core Group meetings; where this is not the case a network meeting, involving the parents and child, school and any other relevant involved agency should be considered in order to plan and co-ordinate services;
- Family Group Conference - this is a model of working with families in which members are facilitated in taking responsibility for their issues and problems. It can be used both to mobilise help and support for the child and their parents from other members, as well as to explore whether the child could be cared for within the family network. Family Group Conferences can be arranged by through the Independent Reviewing Service. See Family Group Conference Procedure.
It is important to remember however that prevention of accommodation is not an end in itself. It is important that the social worker conveys to the child and parent that they are genuinely working to identify the services and outcome that will most meet the child's needs: any sense of 'fobbing off' will almost certainly be counter productive and will be apt to damage future working relationships.
It is important to consider the potential of the family or social network as an option to provide accommodation for the child on either a short or long-term basis. However, within this you should consider:
- Does the identified friend/relative have the practical resources, including sufficient sleeping space; as well as appropriate personal qualities to offer care to a vulnerable young person? National Minimum Standards for Foster Care are that a child must have sufficient privacy; and while as an emergency option it might be acceptable for them to share with a same sex child, sleeping on the couch etc. certainly would not be;
- Has the identified carer, if a close relative of the child's parents been affected by any of the same issues which have contributed towards the child being accommodated: have they themselves experienced adverse parenting or been affected by significant personal or social problems? If so this should be fully assessed prior to placing the child;
- Is the arrangement to be an 'informal' one i.e. one that the parent has made and is taking responsibility for? If so it is important to confirm this in writing to the parent and child at the time of the placement to prevent any future misunderstanding. The child is not looked after under this arrangement - although they may become so i.e. if the arrangement is a short term measure while a potential foster carer is identified;
- If the arrangement is a 'formal' one, with the child accommodated are the carers aware that while they will receive an allowance they will need to undergo extensive background checks and a thorough assessment process? They will also be required to attend training, keep records and allow unannounced supervisory visits. It is also important that they are frank at the outset about any background issues such as criminal offences, child care issues of their own, mental health or substance abuse problems as these could all compromise a placement. Please note that the Authority's responsibilities regarding the supervision of friends and family foster carers are exactly the same as for other carers. These arrangements can be very beneficial in maintaining a child's extended family links and reducing disruption, however it is important to ensure that the arrangements are likely to be viable for the period of the proposed placement.
Please refer to the specific Procedure in relation to the Placement of Children and Young People with Family, Friends and Connected Persons. (See Placements with Connected Persons Procedure)
The circumstances around these placements changed significantly in April 2010 especially in relation to the nature of the assessment and the people with whom a child can be placed.
Obtaining Parental Consent to Look After a Child
Section 20 agreements are not valid unless the parent giving consent has capacity to do so, the consent is properly informed and fairly obtained. Willingness to consent cannot be inferred from silence, submission or acquiescence - it is a positive action.
Detailed guidance on the obtaining of parental consent was given by the High Court in the case of Re CA (A Baby) (2012):
- The social worker must first be satisfied that the parent giving consent does not lack the mental Capacity to do so. Under the Mental Capacity Act 2005, a person is unable to make a decision if s/he is unable:
- To understand the information relevant to the decision;
- To retain that information;
- To use or weigh that information as part of the process of making the decision; or
- To communicate his / her decision.
- If there is doubt about Capacity, no further attempts to obtain consent should be made at that time, and advice should be sought from a manager;
- If satisfied that the parent has Capacity, the social worker must be satisfied that the consent is fully informed:
- Does the parent fully understand the consequences of giving such a consent?
- Does the parent fully appreciate the range of choice available and the consequences of refusal as well as giving consent?
- Is the parent in possession of all the facts and issues material to the giving of consent?
- If not satisfied that the consent if fully informed, no further attempt should be made to obtain consent on that occasion and advice should be sought from a manager and legal advice sought if thought necessary;
- If satisfied that the consent is fully informed, then it is necessary to be satisfied that the giving of such consent and the subsequent removal of the child from the parent is both fair and proportionate:
- What is the current physical and psychological state of the parent?
- If they have a solicitor, have they been encouraged to seek legal advice and/or advice from family or friends?
- Is it necessary for the safety of the child for her to be removed at this time?
- Would it be fairer in this case for this matter to be the subject of a court order rather than an agreement?
The social worker's assessment that a child's best interests would be served by being accommodated must be agreed with the responsible Team Manager and endorsed by the Head of Service. Non-urgent requests should go to the weekly Placement Panel. The child and family should be informed that this assessment is essential and no undertaking to regarding accommodation should be given until it has been obtained.
Children receiving a planned series of short breaks 'Respite Care' can do so under a single agreement with parents and, while they are legally in S20 care while they are actually accommodated with the respite carer, their overall needs are reviewed within the Child / Young Person's Plan.
For proposals to accommodate children under a series of short breaks, this should be referred to the Placement Panel.
For children who are remanded to the care of the authority by the Youth Court, See Remand to Local Authority Accommodation or to Youth Detention Accommodation Procedure, the Local Authority does not have Parental Responsibility for these children. A remand into care should trigger a Complex Child and Family Assessment in order to determine how the child's needs may best be met; and specifically whether they either may need to remain looked after in order to receive appropriate care; or whether a suitable package of bail support may enable them to remain at home.
It is important that all concerned are clear as to the period of accommodation that has been agreed, its objectives, responsibilities during this time e.g. for attending school parents' evenings etc, for dealing with any ongoing medical condition and for maintaining contact. This should all be outlined in a written agreement, which forms part of the ICS Child's Care Plan.
Children who are subject to care proceedings will usually be subject to an Interim Care Order while the proceedings are ongoing. They are therefore looked after and the Authority has parental responsibility; however as the long-term care plan will not yet be established all significant decision are subject to the direction of the court. The Children's Guardian should be closely involved, and be invited to all reviews.
Children may be subject to an Emergency Protection Order at the commencement of proceedings. This gives limited parental responsibility to the Authority and the children are looked after.
In some instances children may be subject to no order or to an Interim Supervision Order while proceedings are ongoing. In this case they are only looked after if they are also in S20 accommodation with the parents' agreement. Otherwise they are not looked after.
If the child is subject to a Child Protection Plan when they become looked after please refer to the 5th Edition of the London Safeguarding Children Board Procedures, Part B3: Safeguarding Children Practice Guidance and Part B4: Safeguarding Children Information.
This section deals with responsibilities which are common to all looked after children and the ICS processes that support these.
Please see Placements Strategy Procedure
The child's social worker, whether allocated or duty is responsible for placing the child in accommodation which is suitable to their needs.
This must be based on an assessment of their specific individual needs through an ICS Core, or in urgent situations Brief Child and Family Assessment. All placements are located through Brokerage Section: the child's needs should be summarised in the Brokerage Referral Form.
The implications of this are that the chosen placement must be able to meet the child's needs based both on their general characteristics: age, gender, ethnicity, language, culture; and also upon their specific individual needs and circumstances: whether they are being placed with siblings, behavioural issues, health needs, schooling, contact with parents, previous experience of separation etc.
While there is inevitably some degree of compromise in placement choice the child should only be placed in a foster home that is approved to take children of the relevant age and gender unless a specific exemption is agreed by the chair of the Fostering Panel for the agency concerned. A child must never be placed in a residential unit that is not registered to take children of their age.
Preparation of the child for placement begins at the moment they become aware that they are to be looked after; this work can contribute greatly to making the placement work positively for the child.
The degree of preparation that it is possible to undertake will depend on the current circumstances, as well as upon the child's age and understanding. Best practice is that the child should have a pre-placement visit to meet their carer and other members of the household. This applies equally to subsequent as to initial placements and must always be done whenever a child is to be placed on a permanent or long-term basis.
Where this is not practicable other means of preparation should be used: a full explanation and description, photographs of the home, telephone contact with future carers etc.
While preparation of the child may appear to be time consuming it is an essential element of the professional social work role: placements made in haste can often end in haste, leading to more work in the long run, not to mention damage to the child. Never more does the adage apply than in this context: 'To fail to prepare is to prepare to fail'.
The ICS Placement Information Record is the essential document that must be completed before the child is placed and has three key functions:
- As an information record: it covers details regarding the placement and the carer, the worker, and the child's needs;
- As a record of parental agreement: It covers the parents' agreement to accommodation and to medical treatment;
- As a record of the foster carers' undertaking to care for the child.
The Placement Information Record covers the minimum information needed to care for a child. You should also consider providing other appropriate assessments and reports. Fully record any additional discussion you have with the carer regarding the child's needs.
Workers are sometimes concerned that information regarding a child may lead to them being prejudged or stereotyped and that they deserve a 'fresh chance', leading them to under-emphasise aspects of the child' s needs. This approach invariably leads to further problems, not least of which is a loss of trust by the carer towards the worker. Any known difficulty, but particularly any area of risk towards the carer or other members of the household must be documented in an appropriately sensitive and non-judgemental way.
e.g. Not 'tends to steal' but 'Needs help to understand the difference between his own and others 'property'.
Failure to provide sufficient information at the beginning of a placement is invariably cited by carers as a reason for breakdown and other problems, so again attention to this area can reduce later difficulties.
Where the child has been a victim of abuse or has abused other children a risk assessment must be carried out as to possible impact on other children placed in the home.
Foster carers must be provided with all the information they need to fulfil their role effectively. This should be provided in a clear and comprehensive form including the sort of support that they will receive.
Children placed in foster homes must be provided with information regarding the fostering service and how they may complain. Children must understand house expectations before the placement is made. Children placed in children's homes must be given written information regarding the children's home.
The first Health Assessment should take place and the written report be completed before the child is first placed. If this is not reasonably practicable then the assessment and a written report should be completed before the first review.
A copy of each health assessment must be given to the child, subject to his/her age and understanding, the parents (unless inappropriate in relation to the child's care plan) and the child's carers and the child's IRO.
While the child / young person remains looked after, health assessments should take place:
- At least once every six months in the case of children aged under five; and
- At least once every 12 months in the case of children aged five and over.
It is essential that the carer is aware of both the need to ensure the child has their health assessment and of any previous medical appointments. They will also need to register the child with a local GP if they are not within their existing GP's catchment area.
Ideally the child's Parent Held Health Record should be obtained from the parent at the time of agreement to accommodate, however it is accepted that in many instances this will not be possible.
Responsibility for accompanying the child to any medical appointments is an important point to establish within the Placement Information Record. This, as well as giving consent to medical treatment is an important means by which parents of looked after children, including those on Care Orders continue to exercise parental responsibility and should be encouraged whenever this is appropriate within the child's Care Plan.
Role of the Designated Nurse: The Designated Nurse for Looked after Children is a senior nurse who, together with the Designated Doctor for looked after children, has strategic responsibility for promoting quality health care for children looked after by the local authority.
The role involves working with partners in the Clinical Commissioning Group, Children and Young People's Service and the voluntary sector to develop and implement a strategy to improve the health and well-being of this group.
Work includes developing and implementing a training strategy, supporting health visitors and school nurses who are undertaking statutory health assessments.
Clinical work is undertaken by providing regular sessions for statutory health assessments. Children and young people may be seen at a health centre, at their placement, school or other setting. Clinical work tends to focus on the most vulnerable and hard to reach young people. Appointments and discussions can be offered where a young person, carer or social worker has health concerns about a looked after child outside of the health assessment.
Child Mental Health Issues. If a child or young person has been receiving ongoing treatment prior to accommodation from the Child and Adolescent Mental Health Service (CAMHS) this should normally continue, with their current clinician retaining responsibility. Where this is not possible for reasons of distance their clinician is responsible for referring them to the appropriate local resource. The Social Worker should liaise with the clinician regarding this, providing an update on the child's circumstances and plans as necessary. This decision would normally be made at a professionals' meeting.
Where a child may indicate a possible need for mental health support after they have been accommodated they will need to be referred to the appropriate local service. For children placed in Lambeth this would be the Children Looked After Mental Health Service. For general advice and assistance on referrals please discuss with a member of the CLAMHS team.
The Personal Education Plan (PEP) should be initiated as part of the Care Plan before the the child becomes looked after (or within 10 working days in the case of an emergency placement), and be available for the first Looked After Review.
Improving outcomes for Looked After Children is a major national and local priority.
This is again an important area to consider at the earliest point in order to anticipate and minimise potential adverse effects upon the child.
Areas to consider include:
Can the child remain at the same school? There are benefits to this in terms of stability and continuity. Against this needs to be balanced whether the child will be able to manage issues arising from the being looked after with their peer group etc; whether there may be specific risks, and whether if a lengthy journey is involved this may outweigh benefits. The child's age, whether they are engaged in GCSE coursework etc, and the point within the school year are all significant. It is important to keep all concerned 'in the loop' in these considerations, particularly when there are court proceedings.
Has the child been excluded from school or have special educational needs? These factors will almost certainly involve a delay in finding a new school place and will therefore need to be considered at the time a placement is being selected in order that the placement is able to offer a constructive day time activity. Some placements are able to offer education on the premises: while this can be a useful emergency measure such educational units seldom offer the full range of the national curriculum and it is important to move the child into mainstream provision wherever possible.
Where it is necessary to find a new school place it is important to be clear as to responsibilities for doing this. While a foster carer may have contacts at local schools and be able to make enquiries and approaches it is the social worker's responsibility to ensure that the child has a school place and to follow this up through official channels as necessary.
Where practically possible the Lambeth Virtual School should be consulted in relation to the educational needs and plans for a looked after child.
The Nominated Officer must approve any change of placement affecting a child in Key Stage 4, except in an emergency / where the placement is terminated because of an immediate risk of serious harm to the child or to protect others from serious injury.
Support for education. An important aspect of placement planning is to establish that there is an appropriate level of support for the child's educational needs to be met. This includes provision of a quiet space to do homework, access to a computer for secondary age children, support and encouragement to study; monitoring of attendance and punctuality and maintenance of liaison with the school. Where appropriate within the care plan it may be beneficial for the parents to continue to play a role, particularly in attending school events and parents' evenings etc. Wherever a carer is not providing appropriate support for a child's education this should discussed with their Supervising Social Worker in order that action in this area can be taken.
Positive placement outcomes for the child depend on both the social worker and carer exercising their respective responsibilities in a spirit of partnership. It is important to establish this at the outset through:
- Providing full information regarding the child, their needs and the outline plan at the outset, as described above. Avoid jargon, waffle or saying 'it's up to the court';
- Showing due respect to the foster carers and their family both in terms of their rights to a family life and their knowledge of the child. Foster Carers, whether registered with Lambeth or with an independent agency are not employees but independent service providers and should never be treated as 'junior partners'. They have the actual care of the child and have to deal with the consequences of this, both positive and negative so their views must always be treated with respect;
- Fulfilling all your duties promptly and reliably: this is particularly important at the beginning of a placement. Be aware that when a social worker cancels a visit to see a child it is the carer who has to deal with the consequences of this. Punctuality is important as lateness can disrupt the carers' arrangements with other children or with their own family;
- Similar considerations apply to children in residential placements. Professional relationships with the unit managers and with the child's key worker go a long way. You should also take the opportunity to read any reports compiled by the unit as these can inform your assessment.
Contact between looked after children and their parents can be stressful for all concerned and it is important to avoid this becoming a point of conflict. Contact should play a purpose within the child's overall care plan and it is the social worker's responsibility both to be clear about this and to ensure that other significant members of the network are so equally. This should be set out in the Placement Information Record, reviewed as part of the Review of Arrangements and updated in writing as necessary.
All contact is ultimately for the child's benefit and should ideally take place in a setting which is familiar to and least disruptive for the child. Usually this will be their placement. Support for contact is a key requirement of foster carers within National Minimum Standards for Fostering Services.
Although contact covers a wide variety of situations it will usually be for one of the following purposes:
- For the child to maintain contact with parents while temporarily looked after in S20 care. This type of contact should be relatively informal and while there may be times that some help or facilitation is required contact under these circumstances should not be referred to as being 'supervised'. The parent has full parental responsibility and can ask for the child to be returned to them at any time: if this is believed to be against the child's best interests then a legal Framework should be considered. It will usually be appropriate for this type of contact to take place in the child's placement;
- To assess attachment or parenting while care proceedings are current, or where return home is being considered. This type of contact is more problematic in that there will usually be some justifiable concerns regarding parenting. The parent(s) may additionally feel a sense of grievance regarding carers who have taken over their role. Nonetheless every effort should be made for the contact to take place in the child's placement. Exceptions to this would be where this is unacceptable to the parents or where there is a risk of violence or other inappropriate behaviour. This type of contact must be supervised in order to inform the assessment. This should always be done by someone with suitable knowledge and experience: some at least by the allocated social worker; where another party, whether a Lambeth employee or an agency worker assists they must be fully briefed and must maintain full written records. Experienced foster carers should have the skills to undertake this type of work in complex situations and they may play a useful role alongside another worker;
- Please refer to the 'Contact for Children Looked After' Guidance in considering the appropriate frequency for contact;
- For a child in a permanent family placement to maintain contact with their family of origin. In these situations the level and type of supervision should be subject to detailed assessment as part of the child's care plan and will vary according to the issues presented by the parents and the child's age and overall needs. It is extremely important that contact needs are dealt with prominently as part of any permanent placement.
The social worker is responsible for visiting the child at the appropriate frequency and for recording this in the Record of Statutory Visit form. During the visit any significant changes in the placement should be noted, the child seen in private unless he / she is unable to do so, considers it inappropriate or the child (being of sufficient age and understanding) refuses and their bedroom seen. This is also an important opportunity for liaison with the carer.
Additionally, the social worker should make sure that the child knows how to make contact with them if they need to - though never supply a personal mobile phone number - and who they should contact if they are unavailable, preferably a named supervisor or colleague rather than a duty worker.
Looked after children should also be informed whenever their allocated worker takes one week or more leave or are unavailable due to sickness or any other reason.
|Statutory Visiting Requirements|
|Foster Placements under Regulation 24 (Family Friends and Connected Persons)||If the child is placed with a Connected Person with temporary approval, visits must take place at least once a week until the first Looked After Review, thereafter at intervals of not more than 4 weeks.|
|Foster Placements of less than one year's duration.||
Once a week until the first review, then six weekly for the first year and thereafter at intervals of no more than 6 weeks.For placements over 12 months that have been presented to panel and the Agency Decision Maker has agreed a long term fostering or permanent fostering match, visits can be completed at intervals of not more than 3 months.
|Residential Placements||Once a week until the first review and then six weekly thereafter.|
|Placement with Parents under an Interim Care Order (ICO)||For the duration that the child / young person is placed with their parents under an ICO, visits must take place weekly until the first review and then at intervals of not more than 2 weeks. Multi-agency professional meetings in relation to such placements should be held at not more than 6 weekly intervals and follow the guidance for Core Group meeting.|
|Placement with Parents under a Full Care Order||Once a week until the first review and then at intervals of not more than 6 weeks thereafter.|
The social worker should ensure that the child/young person is achieving against the 5 Every Child Matters Outcomes and that:
- The child knows how to raise any issue or problem they may be experiencing;
- They have somewhere to store their personal possessions;
- They are receiving pocket money and have their own savings account;
- Their food preferences are met to a reasonable degree (i.e. consistent with a healthy and balanced diet) and they can get drinks and snacks when they wish within reason;
- They are able to invite friends to their house to see them within reason;
- They are receiving age-appropriate support and encouragement to use their talents and abilities and to develop independent life skills;
- Ensuring that all children placed in children’s homes have regular contact with someone who is neither connected with the children’s home or the local authority.
Work with the Child
The social worker's general responsibilities for work with looked after children includes:
- Gaining an understanding of the child's needs and capacities, wishes and feelings in order to inform planning for them - see also use of Assessment and Planning Records below;
- Ensuring they are aware of plans regarding their future and consulting them regarding any changes;
- Helping them to be aware of their origins, past and significant events and people in their lives - all children who become looked after before age 12 and for whom there are not firm plans to return home should have a life-story book;
- Enabling them to raise any concerns regarding day to day issues in the placement, at school or elsewhere- helping to protect them from abuse or inappropriate care;
- Building a positive relationship with an adult;
- Prepare the child for their Looked After Review.
Social workers with regular responsibilities for looked after children will need to ensure that their training plans build skills in age appropriate communication techniques and in direct work.
Problems and Disruption
Children who have had disrupted and rejecting experiences in their home environments are likely to transfer patterns of behaviour and relationships to foster homes and other settings. It is therefore important that plans of work with children in placement encompass the 'whole child' from the outset and that carers have access to appropriate support and consultation to enable them to focus on underlying needs rather than simply problem behaviour.
While disruption of a placement may be indicative of an inappropriate match between child and carer or of a skills gap on the part of the latter; in many instances a pattern of disruption and placement change continues, with increasingly negative consequences for the child.
In order to prevent disruption and promote placement stability the child / young person's IRO should be asked to chair a Placement Stability meeting and all parties need to be committed to the early identification and resolution of issues that could lead to disruption (Please see Placement Stability Toolkit and Guidance including Screening Document).
Any allegation by the child which may be indicative of abuse must prompt a strategy meeting - see Child Protection Procedure London CP.
A requirement of Working Together to Safeguard Children 2010 (5.25-5.31) (Archived) is that all allegations and other information regarding sexual activity involving young people of under 16 years is formally recorded and a decision made as to whether the police should be informed. Where the information is that the young person is 13 years or younger a Strategy Discussion must be held under the Child Protection Procedures (see London Child Protection Procedures, Child Protection s47 Enquires Procedure).
This requirement applies equally to children who are already looked after and who may be particularly vulnerable to precocious sexual activity. All allegations must be recorded using the Record of Sexual Abuse Concerning a Child.
Clearly this is a very sensitive area in which the young person's right to privacy must be balanced with the need for protection from exploitation.
Other Children in Placement
Placement Regulations require that whenever a child moves into placement the workers for children already placed there are consulted. The intention of this is to ensure that the well-being of the existing children is not compromised on account of the new child's issues or needs.
It is important to ensure that this regulation is complied with, particularly for long- term placements. It may at times be overlooked by Independent Providers: if this happens the problem should be notified to the Commissioning Unit.
Complaints and Representations
All children of appropriate age should be given a copy of the complaints and feedback leaflet when they are placed; and while the social worker should endeavour to avoid matters becoming formal complaints when they can be resolved informally children should be aware of their rights and the avenues open to them.
If a child wishes to make a complaint or needs an advocate to assist them with this process this should be discussed initially with the CYPS Complaints Team.
Where children do not have any regular contact with a parent or other relative, or where that relative is significantly impaired e.g. through illness consideration should be given to appointing an Independent Visitor. Contract and procedure are currently being revised. Strategic Commissioning (ext. 65214) is the contact.
Feedback on foster placements. It is important that Supervising Social Workers both in the in-house fostering teams and in independent agencies receive feedback both periodically and at the end of placements in order to inform the foster carer's training development plan. The LBL Form Fostering Review - Social Worker's Contribution can be created from the Framework documents menu and should be completed when requested by the Fostering Team for the carer's annual review and at the end of any in-house placement.For IFA placements social workers should respond to any agency request for feedback, which should normally be on the same pattern as outlined above. If there are serious or unresolved care problems relating to care standards within IFAs this should be discussed with Access to Resources Team.
The Child's Care Plan, Adoption Plan and Pathway plan
The ICS Child's Care Plan is the central planning document for looked after children. Completion of the Care Plan is not a 'one-off event'; rather it continually develops, from the initial analysis of needs within the Complex Child and Family Assessment in the light of the child's emerging needs and the services that are provided in response to these.
Part 1 - sets out the overall objectives of the plan, e.g. to place with an adoptive family, to prepare the young person for independent living etc.
Part 2 - summarises the specific issues and needs which are to be addressed in furtherance of the plan and is informed by the assessment of the child's needs through the Complex Child and Family Assessment (if looked after for less than 10 months), or Assessment and Progress Records.
Where the plan for the child includes adoption, but other options are also being considered the ICS Child's Adoption Plan runs alongside the Care Plan, and should be in place by the second (4 month) review. Where the plan is aiming exclusively at adoption the Child's Adoption Plan replaces Part 2 of the Care Plan.
For a young person of sixteen years the Pathway Plan supersedes Part 2 of the Child's Care Plan.
Links with Court Care Plans
Although the intention of ICS was that the Care Plan should serve also as the court care plan this has not been resolved at the time of writing and they remain separate documents.
The relationship, as indicated in the diagram, is that the court care plans as submitted should be based on the ICS Care Plan. The final care plan, as agreed in the court should then modify the ICS Care Plan, which is then implemented to ensure that the plan as agreed in court is worked towards.
The Review of Arrangements
The ICS Review of Arrangements takes place within 20 days of becoming looked after; then at a further 3 months, then at intervals of 6 months. A Review can also be held out of sequence when there is an urgent need to change the Care Plan.
The ICS Review process consists of:
- The social worker preparing their Review Report Part 1, based on consultation with the child, parent, carer and other involved parties as appropriate;
- The review meeting, (or meetings e.g. where not all parties can be brought together due to risk factors);
- The Independent Reviewing Officer's Review Report Part 2, which effectively summarises the decisions of the review meeting and lays out how the Child's Care Plan should be updated or changed.
The review is the only process, other than decision of the court, by which the fundamental objectives within Part 1 of the Child's Care Plan can be changed e.g. from rehabilitation to alternative family placement. It may be necessary to make changes in the detailed implementation plans within Part 2, e.g. timings of contact visits as long as this does not affect the fundamental plans.
Children who are receiving a planned series of short breaks are reviewed using the Child / Young Person's Plan - See complex children in need procedure.
The Personal Education Plan (PEP)
The Personal Education Plan (PEP) should be initiated as part of the Care Plan before the child becomes looked after (or within 10 working days in the case of an emergency placement), and be available for the first Looked After Review. (Please see Lambeth PEP Procedures).
Local authorities are required to promote educational achievement as an integral part of their duty to safeguard and promote the welfare of the children they look after. This means that the authority must give particular attention to the educational implications of any decision about the welfare of those children. This duty applies to all children looked after by the responsible authority, wherever they are placed. It includes making sure that young children access nursery or other high quality nursery provision and extends to supporting relevant and former relevant children to do as well as they possibly can in education (Please see statutory guidance Promoting the Educational Achievement of Looked After Children).The Lambeth Virtual school promotes the educational attainment of looked after children and should be consulted in relation to educational decision for looked after children wherever this is practically possible and in accordance with the PEP protocol.
Use of Assessment and Progress Records
Assessment and Progress records are for the ongoing assessment of needs of children and young people who are accommodated beyond their third (10 month) review. This follows on from the work done on the Complex Child and Family Assessment. It is a working tool and you will need to consider what aspects are appropriate and in what depth for each individual child.
You should also consider whether some of the work with the child should be undertaken by another member of the network: foster carer or residential worker.
The heading of each section and the far left-hand column of the Assessment Records contain information and advice to guide social workers when completing an assessment. The prompts and reminders include:
It is important to emphasise that the completion and use of the Assessment and Progress Record is not a mechanical task of going through the sections, filling in boxes or making a few comments. The purpose of reviewing the child or young person's needs and their progress is to come to an holistic understanding of what should be done in order to help the young person.
Completing an Assessment and progress Record may involve:
- Discussions with the child or young person, parents, carers, other family members and professionals working with child and family member;
- Observations of child and his or her interactions, for example, with family members / carers;
- A review of existing information, for example, social services files including the existing chronology, correspondence and reports from other agencies;
- The use of tools designed to assist in particular aspects of the assessment, for example Family Pack of Questionnaires and Scales (Archived).
A proportion of children who have been accommodated will return to their parents or previous carers. It is important that this transition receives the same preparation and care as does the process of accommodation.
The child's legal status - if the child has been accommodated under S20 they are discharged from accommodation when they return home; though it may be advisable in some limited circumstances to arrange a trial visit without discharging them or closing the placement.
If the child is subject to a Care Order or Interim Care Order they remain a looked after child unless and until the order is discharged by the court.
A care order cannot be made under the Children Act 1989 unless the court is satisfied that a child is suffering or is likely to suffer significant harm, and that this is attributable to the care given, or likely to be given, to him / her not being what it would be reasonable to expect a parent to give; or the child is beyond parental control. It is therefore important to be especially careful to ascertain how far those factors that were identified as grounds for the current care order have been addressed before deciding whether a child can be placed back with parents.
It is therefore essential to comply with the Placement with Parents Regulations.
The essential aspects of this are that:
- The written agreement of the Divisional Director is obtained;
- A written agreement is made with the parents covering the essential aspects of safeguarding and of ensuring the child's needs are met.
Potential Risk - If the child was subject to a child protection plan prior to being looked after or if they are likely to require an inter-agency child protection plan to maintain their safety in the community there may need to be a Child Protection Conference prior to or immediately following return home. The need for this should be considered at their final looked after review where return to the community is planned or at a strategy meeting when it is unplanned e.g. where an application for renewal of an Interim Care Order is unsuccessful.
Support Plan - All children who return home from a period in accommodation will require a period of support commensurate with the reasons which initially led to accommodation and the robustness of the parental care and other support they will be receiving.
All children who return home from a period of accommodation should therefore have their Complex Child and Family Assessment updated.
For children who have been accommodated under S20 a Child / Young Person's Plan should be developed.
Children who return home while subject to Care Orders should have their Care Plan updated in the light of the move. They remain looked after until the order is discharged by the court. Full responsibilities for statutory visiting and reviewing therefore continue.
Children should only return home under these circumstances when their parents or other carers are able to take full responsibility for the child's well being and care. It is obviously inappropriate that the Authority continues to share parental responsibility for longer than necessary and essential therefore that a timescale for discharge of the order is agreed before the child returns home.
This should be enshrined in the Child's Care Plan and explicitly confirmed to the parents as part of a written agreement.
When a child returns home it is important to continue to provide an appropriate level of input both through contact with the child and family and working within the network of school, health provision and adult services.
A referral for a Family Group Conference should be considered as part of formulating the support plans for a looked after children where there is a plan to return that child / young person to the care of their parent/s or person with parental responsibility.
Please note that while it may be appropriate to provide some 'one-off' financial assistance to facilitate a child's return home ongoing maintenance of the child becomes the parents' responsibility.
Please see Permanency Procedure
The Children (Leaving Care) Act 2000 requires a Pathway Plan for all eligible, relevant and former relevant young people.
Different regulations now apply, depending whether the young person is 'Eligible', 'Relevant' or 'Former Relevant', although the provisions are virtually identical. (The previous regulations (Children (Leaving Care) (England) Regulations 2001) dealt with 'Eligible', 'Relevant' and 'Former Relevant' young people).
'Eligible' young people now come within the Care Planning, Placement and Case Review (England) Regulations 2010; 'Relevant' and 'Former Relevant' young people now come within the Care Leavers (England) Regulations 2010.
The Care Leavers Regulations re-enact the 2001 Regulations with minor changes.The Act defines an eligible young person as one who is aged 16 or 17, who has been looked after by the local authority for a total of 13 weeks since the age of 14, and remains looked after. A relevant young person is defined in the Act as a young person who was previously an eligible young person but who is no longer looked after and is under the age of 18.
The Pathway Plan fulfils the requirements both for assessing the young person's needs and planning services. The Pathway Plan replaces Part Two of the Care Plan and Assessment and Progress Record for all eligible children, and is informed by previous Care Plans, Review Records and Assessment and Progress Records.
- Part One records the assessed needs of the young person. This should be completed by the Leaving Care Team Social Worker on the basis of an up-to-date Assessment and Progress Record provided by the Looked After Children's Team worker during the period between the final review prior to transfer and the case actually being transferred. Both workers should co-operate closely and check the draft record with the young person as part of the transfer process.
The completed Part One then forms the young person's referral to Aim Hi.
- Part Two records the actions and services required to respond to the assessed needs and to provide support during the transition to adulthood and independence. The Aim Hi Pathway Plan format replaces the Part 2 of the ICS pathway Plan at the present time.
The Pathway Plan should also include:
- The plan for the young person's continuing education or training when he/she ceases to be looked after - where the young person is no longer of statutory school age, the Pathway Plan may need to incorporate the goals and actions that were previously included in the PEP;
- How the Responsible Local Authority will assist the young person in obtaining employment or other purposeful activity or occupation, taking into account his / her aspirations, skills and educational potential;
- The financial support to be provided to enable the young person to meet accommodation and maintenance costs; taking into account his/her financial capabilities and money-management capacity, along with strategies to develop skills in this area;
- The nature and level of contact and personal support to be provided, and by whom, to the young person;
- Details of the accommodation the young person is to occupy (including an assessment of its suitability in the light of the young person's needs, and details of the considerations taken into account in assessing that suitability);
- Details of the arrangements made by the Responsible Local Authority to meet the young person's needs in relation to his or her identity, with particular regard to their religious persuasion, racial origin and cultural and linguistic background.
Completing a Pathway Plan
Work on the Needs Assessment (Pathway Plan Part 1) should be completed within 10 working days of the young person's case being transferred to the Leaving Care Team of a young person becoming an eligible or relevant child, whether he or she does soon turning 16 or later. The Pathway Plan for eligible and relevant children must then be completed as soon as possible after the needs assessment. Currently this is undertaken by the Aim Hi on behalf of Lambeth Children's Social Care.
Methods of obtaining information to complete the needs assessment should take full account of the young person's communication skills and mobility requirements. Where a young person requires additional assistance to fully involve them in the assessment process then this should be offered.
The following people should also be consulted unless there is an exceptional reason not to do so:
- Young person's parents, or others with parental responsibility;
- Any person who cares for the young person on a day to day basis;
- A representative of the young person's school or college;
- The young person's GP;
- An Independent Visitor, where appointed;
- Any other person whom the responsible authority or the young person considers relevant;
- The Connexions Personal Adviser;
- The Pathway Plan should also take account of any existing assessments and plans relating to the young person. These may include:
- Assessment and Progress Record;
- Care Plan;
- Placement Information Record;
- Personal Education Plan;
- Health Plan;
- Transition Plan.
Part One: Needs Assessment
The Pathway Plan Needs Assessment uses the same structure as the other assessment records. It considers the young person's needs in relation to the seven developmental needs dimensions. Parenting Capacity is assessed under the heading of Support, as this heading is more relevant and understandable to young people leaving care. The section assessing the impact of Family and Environmental Factors has two subheadings - Accommodation and Finance, as these are two important areas where young people often encounter difficulties.
The structure of the Needs Assessment is similar to other assessments within the Integrated Children's System:
- The left hand side of the page in each domain or dimension contains a number statements which identify key issues that should be considered in the assessment;
- Tick boxes are used to indicate whether the assessment has considered this issue and the practitioner's assessment of the young person's needs;
- The right hand side of the page provides space for practitioners to record their notes and evidence.
The information gathered in the Needs Assessment is pulled together in the Analysis Section and informs Part Two of the Pathway Plan.