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

Preparing for independence

The transition to adulthood for young people in care can be difficult. Evidence indicates that services designed with young people in mind and delivered by friendly, approachable professionals can help young people find the right support and advice at the right time, to help them become independent.

Recommendation 46 Support preparation for the transition to adulthood and moving to independent living

Whose health and wellbeing will benefit?

• Looked-after young people (including care leavers).

Who should take action?

• Directors of children’s services.

• What action should they take? Open

  • Refer to and implement the statutory guidance, ‘Planning transitions to adulthood for looked-after children(24)’.
  • Ensure that preparation for adulthood is part of care planning for children and young people of all ages and abilities who are looked after, in a way that is appropriate to age and supports them to move at their own pace and feel integrated and secure within their local communities.
  • Establish protocols with housing, health and adult social care partners that help identify young people moving to independent living as a priority group for accessing adult services.
  • Ensure that supported housing commissioned for care leavers enables them to remain until they are ready to take the next step towards independence and a secure tenancy, or other suitable arrangement. Supported housing should not be unduly constrained by set periods of time or a predetermined age at which the young person must move on; it should be provided on the best interests and needs of the individual.
  • Give young people the option to remain in a stable foster home or residential home beyond the age of 18 and allow those who experience difficulty moving to independent living to return to the care of the local authority for support, including to the previous placement if available.
  • Provide the same level of support to young people moving to independent living from the care of family or friends as given to those moving on from any other kind of placement. This should include:
    • health and development
    • education, training and employment
    • supporting wider family relationships
    • financial and practical skills
    • access to a range of housing options
    • advice, assistance and pathway planning from the young person’s social worker or personal adviser.
  • Ensure young people moving to independent living are encouraged and helped to maintain contact with past foster or residential carers they value.
  • Ensure that all young people have opportunities to develop the full range of life skills needed to make the transition to independent living and adulthood. In particular, planning for transition should take account of the opportunities for learning skills (such as cooking and shopping) that may not be readily available to young people living in residential care or custodial settings.
  • Ensure pathway planning pays full attention to the emotional needs and developmental capacity of young people preparing to move into independent accommodation.
  • Ensure transition planning takes account of young people with complex needs (including mental health problems), so they can proceed at a pace they can cope with. It is important not to push young people into independence too fast and too far, as some may have crises and breakdowns.

Recommendation 47 Provide leaving-care services

Whose health and wellbeing will benefit?

• Looked-after young people (including care leavers).

Who should take action?

• Directors of children’s services.

• What action should they take? Open

  • Ensure there is an effective and responsive leaving-care service that meets the needs of young people in transition between the ages of 16 and 25.
  • Such a service should be readily accessible to the young person and include:
    • safe and settled accommodation
    • opportunities for continuing education including basic skills such as literacy, numeracy and IT, and further or higher education
    • opportunities for employment, including apprenticeships and employability schemes
    • cultural, leisure and other community activities
    • specialist counselling, advocacy, peer mentoring and mental health services to support emotional needs
    • training in life skills to manage everyday living with confidence, including support with personal relationships and money management
    • sexual health and substance misuse
    • advice support to maintain positive contact with parents, wider family and friends
    • general health advice.
  • Ensure that services available to care leavers are clearly outlined in local plans for children and young people’s health and wellbeing and these are readily available to children and young people in suitable formats.
  • Consider a ’one-stop shop’ approach to the provision of services to enable care leavers to more easily access a range of services in a familiar environment. Consider making use of current one-stop shops to provide a specialist service for looked-after children and young people.
  • Ensure all young people know their entitlements to services and how to access them, including independent advocacy if needed.

Recommendation 48: Conduct a comprehensive health consultation when young people move on to independent living

Whose health and wellbeing will benefit?

• Looked-after young people (including care leavers).

Who should take action?

• Social workers and social work managers.
• Leaving care teams. Designated health professionals.

• What action should they take? Open

  • Ensure that when young people are offered their final statutory health assessment all available details of their medical history can be discussed.
  • Ensure young people are supported to understand their health and medical information.
  • Ensure young people are supported and encouraged to attend their final statutory health assessment.
  • Ensure that if a young person declines to attend their final statutory health assessment they are offered the choice of having a written copy of their basic medical history (such as immunisations and childhood illnesses) and that a health professional, in partnership with the young person’s social worker, ensures that the young person knows how to obtain their social care and detailed health history.
  • Ensure that leaving-care services that support young people when they move on to independent living have a process to contact health professionals when necessary to help the young person understand the information in their health history.

Recommendation 49 Support transfer to adult mental health services

Whose health and wellbeing will benefit?

• Looked-after young people.

Who should take action?

• Managers of mental health services (including CAMHS).
• Social workers and social work managers.

• What action should they take? Open

  • Ensure that case management and treatment of young people receiving mental health services (including CAMHS (25)) continues until a handover with an assessment and completed care plan has been developed with the relevant adult service (26) (see also recommendations 8–11 and 12–14).
  • Ensure the pathway plan identifies support that should be in place when care leavers do not meet thresholds for adult mental health services or social care despite having ongoing mental health needs that have been clearly identified (see also recommendation 8–11 and 12–14).

24.

Department for Education (expected date of revised publication end of 2010) Planning transitions to adulthood for looked-after children. See also Leaving Care.

25.

Child Adolescent Mental Health Services (2008) Children and young people in mind: the final report of the national CAMHS review (PDF).

26.

Department of Health (2007) Transition: getting it right for young people: Improving the transition of young people with long term conditions).