7.3 Protocol with Health Visitors and School Nurses
|1.||Purpose of Protocol|
|2.||The Role of the Health Visitor|
|3.||The Role of the School Nurse|
|4.2||The Assessment Process|
|4.3||Requests for Assessment/Service (Referrals)|
|4.5||Child and Family Assessment|
The purpose of this Protocol is to identify the framework within which Health Visitors and School Nurses will exchange information with Children’s Services, in order to facilitate delivery to children and their families of the appropriate services available from within the local authority and Primary Care Trust. This will include the exchange of non-personal information in the form of ‘consultation’.
The Health Visiting and School Nursing (Community Nursing Services) have a long history of working with Children’s Services especially in Working Together to Safeguard Children within the London Child Protection Procedures. The Assessment Framework offers an assessment of Children In Need including children at risk of Significant Harm, so it is important to remember that a Child Protection Enquiry will be incorporated into the Assessment process when there are child protection concerns.
- The Health Visitor is a continuing presence in the life of a family with children under 5 years old, especially in cases where there are concerns about a child;
- The Health Visitor is a source of information on all aspects of child welfare through their role in the Community and in the Primary Care Trusts. Their role in the community involves visiting family homes and assessing the health needs of family members. They are usually aware of family relationships and patterns of care;
- The Health Visitor’s assessment will include the child’s developmental progress, the quality and style of parenting available to the child and information concerning the home circumstances.
- The School Nurse is the health professional usually best placed to report on the health of a school child and to monitor his or her progress. The School Nurse does not have a brief to do home visits but will hold a lot of information about a school child and will often be aware of aspects of the child’s school life that will enhance the ‘health’ contribution to the assessment process;
- The School Nurse has an important role in identifying difficulties, monitoring particular children and offering continuity beyond the assessment period. The School Nurse may offer support and counselling to individual children within agreed bounds of confidentiality.
The Assessment and Care Planning Teams provide a range of services to children and families in Enfield including:
- Assessments of Children In Need and their families including children at risk of Significant Harm;
- Support and services to Children in Need and their Families including Disabled Children, Looked After Children and children who are the subject of a Child Protection Plan.
Children’s Services carry out assessments of Children in Need in line with the Framework for the Assessment of Children in Need and their Families.
Requests for assessments of Children in Need, including children at risk of Significant Harm should be made to the Referral and Assessment Team in Children’s Services using the agreed Multi-agency Request Form (available to all agencies on disk).
Guidance and information on the Assessment Framework has been distributed to all agencies and teams along with the London Child Protection Procedures. Managers should ensure that all staff members are familiar with the London Child Protection Procedures and the Assessment Framework Guidance and Procedures.
The Request for Assessment Form is detailed but Health Visitors and School Nurses are asked to complete the form as fully as possible as this will assist the assessment and decision making process. Parents need to agree to the referral to Children’s Services (Data Protection Act 1998) unless there are child protection concerns in which case consent can be overridden. In child protection cases the parent should be informed that Children’s Services are going to be asked to do an assessment, unless by informing the parent this would increase the risk to the child.
The Referral and Assessment Team must make a decision within 24 hours as to what action they will take and inform the professional making the request.
An Assessment will be carried out within 7 working days from the point of the first significant contact with the family. At this point the case will be reviewed by the manager to consider the complexity, what further work is required, if any and direct the social worker accordingly with indicative timescales for the completion of the work. The manager will return the assessment to the social worker within 3 working days of receipt.
Child and family Assessments may be complex assessments and will include a Child Protection Enquiry when necessary. In Enfield the Child and Family Assessment must be concluded within a maximum of 35 days of the referral date. However, it is and should be possible to conclude the Assessment sooner depending on the complexity and the urgency of the case. In all circumstances the assessment should be proportionate to the presenting need of the child and family and in exceptional circumstances the assessment may be concluded in excess of 35 working days and up to a maximum of 45 working days. However the specific timescale will be determined in conjunction with the manager for the case.
If an Assessment is undertaken as a result of a request from a Health Visitor or School Nurse it is likely that they will be involved in the assessment process either by supplying information, possibly by joint visits, and by drawing up a Family Support Plan, Children's Plan or Child Protection Plan as required.
Key points at which the Health Visitors and School Nurses will be involved in the Child and Family Assessment process are:
- In the setting up of the assessment, where decisions are made about its focus and its scope;
- As a contributor to the assessment process, in the form of direct work with the family or the provision of information;
- In making available their professional judgement, during the formulation of the Children’s Plan that will coordinate ongoing work at the end of the assessment stage;
- As a provider or facilitator of services to be offered as part of the final Children’s Plan.