SCIE/NICE recommendations on looked after children: Promoting the quality of life of looked-after children and young people

Introduction

Foreword

The focus of this guidance – promoting the quality of life for looked-after children and young people – depends on how well organisations, professionals and carers work together to ensure looked-after children and young people experience high quality care, stable placements and nurturing relationships that reinforce a sense of belonging.

The relationship between a child or young person, their carer and professionals involved in their lives – and the continuity of that relationship – has been central to the discussions of the Programme Development Group (PDG) throughout the development of this guidance. Much of the evidence that the PDG heard identified the importance of secure attachments and establishing a sense of permanence. The child’s need to be loved and nurtured is fundamental to achieving long-term physical, mental and emotional wellbeing. The PDG heard that stable education built on high aspirations is essential to promoting the quality of life for looked-after children and young people. It also heard that their transition to adulthood can often be traumatic. Without access to services to support this transition young people can end up unemployed, homeless or in custody, experiencing a downward spiral of rejection.

A disproportionate number of children and young people in care are from black and minority ethnic backgrounds and have particular needs. There are also other groups of looked-after children and young people, such as unaccompanied asylum seekers or those who are gay or lesbian, who have particular needs. Services should be sufficiently diverse and sensitive to meet the needs of these groups.

Nationally, the quality of services for looked-after children and young people is uneven. Despite guidance and regulation, compliance is variable and questions about leadership have been raised. The PDG heard evidence that strongly suggests that effective leadership is the ability to create an organisational culture with a strong learning capacity. The ability to acquire, assimilate and apply knowledge and take seriously the need to learn from mistakes is critical.

This NICE/SCIE guidance reinforces statutory guidance and national minimum standards without repeating the detail; it highlights key messages and fills some gaps. The guidance is aimed at a broad, cross-agency professional audience and the recommendations should act as levers for good practice and service improvement.

The PDG took the view that when difficult decisions are made about budgets and resources, looked-after children and young people should be a priority, as one of the most vulnerable and disadvantaged groups in our society. Our aspirations should be high and not be compromised.

Dennis Simpson Programme Development Group Chair

Principles and values

The recommendations in this guidance are supported by the following principles (1)

• Put the voices of children, young people and their families at the heart of service design and delivery.
• Deliver services that are tailored to the individual and diverse needs of children and young people by ensuring effective joint commissioning and integrated professional working.
• Develop services that address health and wellbeing and promote high-quality care.
• Encourage warm and caring relationships between child and carer that nurture attachment and create a sense of belonging so that the child or young person feels safe, valued and protected.
• Help children and young people to develop a strong sense of personal identity and maintain the cultural and religious beliefs they choose.
• Ensure young people are prepared for and supported in their transition to adulthood.
• Support the child or young person to participate in the wider network of peer, school and community activities to help build resilience and a sense of belonging.
• Ensure children and young people have a stable experience of education that encourages high aspiration and supports them in achieving their potential.

1.

These were developed by the Programme Development Group based on the principles in the ‘Statutory guidance on promoting the health and well-being of looked after children’ (Department for Children, Schools and Families and DH 2009), the six entitlements of the National Children’s Bureau ‘National Healthy Care Standard’ (see its website at www.ncb.org.uk/healthycare), and discussion of a quality of care index developed by David Berridge and colleagues. For details of the index, see Stein M (2009) Quality matters in children’s services: messages from research. London: Jessica Kingsley Publishers. Available from www.rip.org.uk/qualitymatters/resources/overview/