Starting Well - Adverse Childhood Experiences
Looked After Children
Introduction
Looked After Children (LAC) are one of the most vulnerable groups in society. The majority of children and young people who become looked after do so as they have experienced abuse, neglect or a family breakdown. It is acknowledged that children who are looked after are at greater risk of poor life chances and outcomes.
The term ‘looked after’ was introduced by the Children Act in 1989 and refers to children who are;
• Children accommodated under voluntary agreement with their parent(s) written consent (section 20)
• Children who receive respite care which exceeds over 75 day per year
• Children who are the subject of a care order (section 31) or an interim care order (section 38)
• Children who are the subject of emergency orders for their protection (section 44 and 46);
and
• Children who are compulsorily accommodated. This includes children remanded to the local authority or subject to a criminal justice supervision order with a residence requirement (section 21)
• Children who are detained under the mental health act in a hospital environment 16+
The Children Act 1989 Guidance and Regulations: Volume 2: Care planning, placement and case review sets out the functions and responsibilities of the local authority and partner agencies.
Many of these children come into care from very deprived social backgrounds, many have experienced different forms of abuse or neglect, potentially causing issues in respect to their cognitive and emotional development. This has the potential to impact on their outcomes in the longer term.
Looked After children and young people share many of the same health risks and problems as their peers, but often to a greater degree. They often enter care with a poorer level of health than their peers in part due to the impact of poverty, abuse and neglect. The duty to meet the health needs of Looked After Children for both the NHS and Local Authorities is clearly laid out in ‘Statutory Guidance on Promoting the Health and Wellbeing of Looked After Children’ (DFE, DH 2015).
When a child becomes looked after, local authorities are responsible for making sure an assessment of the child’s physical, emotional and mental health needs is carried out. It is the responsibility of the local authority to arrange a health assessment for a looked after child in partnership with health professionals.
Clinical commissioning groups (CCGS)and NHS England have a duty to cooperate with requests from the local authorities to undertake the health assessments and all agencies including local authorities, CCGs, NHS England and Public Health England need to cooperate to commission health services for all children in their area (DFE, DH 2015).
The NHS has a significant role in ensuring health assessments are timely and that the delivery of health services is effective.
Looked after children
The numbers of looked after children in England have increased steadily year on year since 2010. In March 2018, there were 75,420 looked after children – an increase of 4 per cent compared to March 2017 and an increase of 17 per cent compared to March 2010. In Hartlepool, the rate of increase has been more marked, with a 69% rise from 165 in March 2010 to 278 in March 2018.
The following summary of the profile of LAC in Hartlepool draws from analysis of a range of benchmarked data (DfE published statistical releases).
It is acknowledged that almost half of children in care have a diagnosable mental health disorder and two thirds will have special educational needs with a proportion of these children needing a special education, health and care plan (EHCP). All organisations needs to reflect this high level of need in strategic planning for child and adolescent mental health services (CAMHS) for looked after children.
There has been a significant increase in the number of children in care with the rate per 10,000 population increasing from 128.0 in 2017 to 139.0 in 2018.
There has been a significant increase in the number of looked after children in recent years. The majority of wards in Hartlepool have seen an increase in the number of child in care. The number of children in care in the Victoria Ward is still the highest at 23.4%.
Children who return home from care are the largest single group of children who cease to be looked after in any one year. Research shows that careful assessment of needs, evidence of improvements in parenting capacity, slow and well managed return home and the provision of services to support children and their families after the return home were associated with a positive experience of reunification which lasted. Data is shown for 2018 Hartlepool only as this figure is no longer published nationally.
The graph below identifies those care leavers who were not in education, training or employment who were aged 19 – 21 years old. It is worth noting that the data relates to a small cohort of young people, and that a difference of one young person in the cohort makes a large percentage change. It is acknowledged that part of the issue in this area is the limited choice in educational options in Hartlepool for our young people.
The graph below identifies those care leavers who were in education, training or employment who were aged 19 – 21 years old. It is worth noting that the data relates to a small cohort of young people, and that a difference of one young person in the cohort makes a large percentage change.
In Hartlepool, the percentage overall absence for school children who have been looked after for at least 12 months has decreased year on year to 1.9% in 2015 but has started to rise to 4.0% in 2018. In comparison, whilst the figures for regional neighbours, statistical neighbours and for the whole of England have followed the same pattern, the absence rate is still above Hartlepool in 2018 at 4.38% for statistical neighbours, 4.10% for regional neighbours and 4.50% for England.
2018 Attainment Results
Foundation Stage: of those children that were looked after for at least 12 months, 28.6% achieved ‘Good Level of Development’ by the end of the foundation stage compared to 69.4% of pupils in Hartlepool and 71.5% of all pupils nationally. This highlights that by the end of the Foundation Stage the attainment gap between children looked after and their peers is 40.8% and children looked after are required to make greater than average progress in order to narrow the gap.
Phonics Screening Year 1: of those children that were looked after for at least 12 months, 66.7% met the expected standard compared to 82% for all Hartlepool pupils and 82% for all pupils nationally.
Key Stage 1: of those children that were looked after for at least 12 months, 33.3% achieved the expected standard in Reading compared to 75.5% for all Hartlepool pupils and 51% for looked after pupils nationally; 33.3% in Writing compared to 71.9% for all Hartlepool pupils and 42% for looked after pupils nationally; and 33.3% in Maths compared to 76.9% for all Hartlepool pupils and 49% for looked after children nationally.
Key Stage 2: those children that were looked after for at least 12 months 50% achieved the expected standard in Writing compared to 81.6% for all pupils in Hartlepool schools and 50% of looked after children nationally; 40% in Maths compared to 77.8% for all pupils in Hartlepool schools and 48% of looked after children nationally; 30% in Spelling, Punctuation and Grammar compared to 78.7% for all pupils in Hartlepool schools and 51% of looked after children nationally; 40% in Reading compared to 75.3% for all pupils in Hartlepool schools and 52% of looked after children nationally.
Key Stage 4: of those children that were looked after for at least 12 months, 30.8% achieved grade 4 or above in English & Maths compared to 60.4% for all Hartlepool pupils and 17.8% for looked after pupils nationally. Of those children that were looked after, 15.4% achieved grade 5 or above in English & Maths compared to 37.8% for all Hartlepool pupils and 7.7% for looked after children nationally.
Attainment 8 and Progress 8 are two performance measures introduced in 2006 that look at the achievements of the pupils and the quality of the school. Attainment 8 looks at pupil’s achievement across 8 qualifications, not just English and mathematics, and assigns a score based on each of the 8 grades achieved. Progress 8 looks at how pupils performed in their attainment 8 compared to how they are expected to perform based on their key stage 2 results. Pupils are rated against the average national attainment 8 performance of those in the same key stage 2 attainment group, resulting in a positive or negative score, where each full number is the equivalent of achieving 1 full grade above or below what was expected.
The attainment 8 score for children looked after for at least 12 months in Hartlepool was 18.3 compared to 42.3 for all pupils in Hartlepool schools and 17.5 for looked after children nationally. The progress 8 score for children looked after for at least 12 months in Hartlepool was -0.92 compared to -0.47 for all pupils in Hartlepool schools and -1.47 for looked after children nationally.
The above figures represent small cohorts which have a significant impact on the figures.
Current
Future
- Creation of integrated teams with Health as part of the Better Childhood in Hartlepool, specifically trained in mental health, domestic abuse, substance misuse as part of an early intervention approach.
- Improve recruitment drive of local carers with a particular focus on sibling groups and teenage placements
- Review supported accommodation and staying put options for care leavers.
- Undertake a comprehensive review of the Post 16 educational offer for children looked after.
- Review the From Care2Work plan.
- Undertake a review of the SEND LAC cohort to understand specific needs.
- Ensure that all children in care have timely and high quality, holistic assessments and reviews of their physical, emotional and mental health needs informed by SMART health plans which reflect the child’s voice.
- Develop and support an early intervention programme for 0-2 year olds that stimulates early child development via the Hartlepool Education Commission work.
