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3.16.3 Salford CAMHS for Looked after Children: Operational Policy

RELATED CHAPTER

Mental health Crisis Concordat: Improving outcomes for people experiencing mental health crisis.

AMENDMENT

This chapter was updated in April 2014 by adding a link to HM Government, ‘Mental health Crisis Concordat: Improving outcomes for people experiencing mental health crisis’.

Contents

  1. Purpose
  2. Services Provided
  3. Location
  4. Hours of Service
  5. Referrals
  6. Consent and involvement of Birth Parents
  7. Management, Supervision & Partnership Working
  8. Relationship to wider CAMHS
  9. Relationship to Salford Children’s Directorate
  10. Clinical Governance
  11. Participation
  12. Record Keeping
  13. Confidentiality Information sharing
  14. Service Monitoring


1. Purpose

It is recognised that Looked After Children have a high rate of behavioural and emotional difficulties and find it hard to use the services of mainstream CAMHS. The CAMHS LAAC Services are funded jointly by Salford Children’s Directorate & Salford CCG. They are provided by Central Manchester University Hospitals NHS Foundation Trust and by Salford Children’s Directorate.

The Salford CAMHS for LAAC has developed to provide:

  1. Direct assessment and intervention service for LAAC and young people
  2. Consultation and training to carers to enable them to provide quality parenting and care in order to promote the emotional wellbeing of children and young people
  3. To provide consultation and training to social workers to assist care planning
  4. To provide both direct input to placement provision and input to service planning and development to promote services ability to meet the needs of LAAC.


2. Services Provided

  1. STARLAC - accepts direct referrals for CAMHS intervention and provides consultation and training around the needs of children looked after
  2. SAFSS - Salford Adoptive Families Support Service provides an early CAMHS intervention service to children whose plan is adoption, and to adopters, from planning stages pre-placement, through to 3 years post order. The service will also provide support, consultation and training to generic CAMHS around adoption issues
  3. Specialist fostering - Provides CAMHS input via the clinical posts in 3D and Focus Fostering Teams which are managed within Salford Children’s Directorate. Their operational arrangements are described fully elsewhere.


3. Location

The services are located at Turnpike house with the Salford Looked After Children’s Service. Children, families and carers are seen within this facility, in community settings and in their own homes.


4. Hours of Service

The service provides a 9-5 service Mondays to Fridays.

Emergency risk assessment is available through the Salford CAMHS on call rota.

Specialist Fostering operates a 24 hour telephone on call service to which health staff contribute.


5. Referrals

Criteria

0-17 years

Starlac: All children and young people Looked After by Salford Children’s Directorate, their carers’ and families. For children transitioning into and out of care, there will be input from Starlac or generic Salford CAMHS as appropriate.

Salford children and young people who are resident outside of Salford but within reach of the service (approx 50 miles) will be able to access a service. For those placed further away, telephone consultation will be offered.

SAFSS: Children adopted, placed for adoption or with an adoption plan, and their carers, up to three years post adoption order. The prime focus will be children who may be difficult to place, such as older children, sibling groups and those with additional needs.

Specialist Fostering: Children, young people and their foster carers within the two specialist schemes receive CAMH input via the four clinical health posts.

Guardianship Orders: For children on Special Guardianship Orders who have been in the care of the local authority, each case will be considered individually and a service arranged via Safss, Starlac, or generic CAMHS depending which is most appropriate.

Source

Referrals are primarily from Social Workers, but are accepted from all Child Health & Social Care professionals. Where the referrer is not the Social Worker/ Pathway Advisor, the Social Worker will be informed and their agreement to the referral will be sought. Where a young person is 16-17 years and not referred by the Social Worker, consent of the young person will be sought to inform/include the Social Worker/carers as appropriate. Refusal to give consent for this will not prevent the young person accessing the service.


6. Consent & Involvement of Birth Families

Consent to referral will usually be sought from the Social Worker. Where birth families remain involved, it is good practice for the referral to be discussed with them. Some referrals are for consultation to Social Worker or placement services about their practice, and so there may be times when it is not appropriate to involve the birth family. However, for direct work with the child, consideration should be given as to whether or not it is appropriate to gain consent of the birth family, whilst recognising the need for a timely service for the young person.

For a young person aged 16 and 17 their consent to discuss their case with the Social Worker or the birth family (if they remain involved) will be sought from them.

Referrals Pathways - Starlac

Click here to view flowchart


7. Management, Supervision & Partnership Working

The CAMHS for LAAC services are multi-disciplinary, multi-agency services. Line management and clinical supervision arrangements are specified in the table below. However the effective functioning of the services depends on a commitment to partnership working. The Head of STARLAC will attend the Children’s Directorate LAC Managers Meeting and work with the Head of Service Looked After Children to clarify overall objectives and priorities for the service.

STARLAC and SAFSS are lead by CMFT CAMHS Directorate.

Specialist Fostering (3D and Focus) are lead by Salford Children’s Directorate.

 
Employed & Line Management by
Clinical Supervision
Head of Service CMFT CAMHS Directorate CMFT CAMHS Directorate
Clinical Psychologist lead for SAFSS CMFT CAMHS Directorate CMFT CAMHS Directorate
Child & Adolescent Psychotherapists CMFT CAMHS Directorate CMFT CAMHS Directorate
Clinical Psychologists STARLAC CMFT CAMHS Directorate CMFT CAMHS Directorate
Therapeutic Social Workers SAFSS & STARLAC Salford Children’s Directorate CMFT CAMHS Directorate
Consultant Psychiatrist CMFT CAMHS Directorate CMFT CAMHS Directorate
   
Clinical Supervision
Service Management
3D Programme Supervisor CMFT CAMHS Directorate CMFT CAMHS Directorate Salford Children’s Directorate
CMHP 3D( x2) CMFT CAMHS Directorate CMFT CAMHS Directorate Salford Children’s Directorate
Clinical Psychologist Focus CMFT CAMHS Directorate CMFT CAMHS Directorate Salford Children’s Directorate


8. Relationship to wider CAMHS

Starlac, Safss, 3D and Focus Fostering clinicians are part of the wider Salford Psychology Service in Salford CAMHS. The teams will work closely to ensure a seamless service for children who move in and out of care, and to ensure looked after children access specialist services provided by CAMHS as appropriate. It should be noted that Child Psychiatry sessions are purchased specifically to provide a consultation service to Starlac, Safss and Specialist Fostering, and to outside placements. This is in addition to the existing Psychiatry service provided by Salford CAMHS.

Emergency Self Harm Assessment: This will continue to be provided by Salford CAMHS via the PANDA unit and the Royal Manchester Children’s Hospital. Where there is existing Starlac involvement, there will be close liaison to ensure effective monitoring of risk and care planning.


9. Relationship to Salford Children’s Directorate

Starlac and Safss function as autonomous teams working closely with the other teams within the integrated, multidisciplinary Looked After Children’s Service. The Head of CAMHS for Looked After Children attends the LAC Managers meetings. Objectives are agreed with the Head of Looked after Children’s Service annually.


10. Clinical Governance

The Services follow the CMFT Trust guidelines and policies for quality standards and participates in Trust audit processes. It will promote evaluation and monitoring of services in CAMHS for LAAC and the wider LAC service.


11. Participation

The services aim to involve stakeholders, and young people and their families in a collaborative approach to developing their care plan and making informed choices about their treatment. User Feedback is regularly sought.

The services aim to make participation a central part of the service. Initially, the aim is to scope potential for involvement of young people and foster carers in the recruitment process for staff, and to make use of the Children in Care Council.


12. Record Keeping

The Specialist Fostering services operate as an integral part of the multidisciplinary Looked After Children’s Service and are subject to Salford policies about record keeping.

Starlac and Safss maintain Health records and are subject to CMFT policies about record keeping.


13. Confidentiality/Information Sharing

Confidentiality is a complex issue for children looked after, and practice may vary depending on the individual case. The guiding principles for decision making are:

  1. That the Local Authority and Health Services hold Corporate Parenting responsibilities for most of the children with whom the services are involved.
  2. Starlac may encounter issues of safeguarding and quality child care practice that require information sharing
  3. That young people who are seen individually have rights to confidentiality where there are no safeguarding issues.
  4. That the boundaries and limits to confidentiality will be explained to families, young people, and also to Foster carers and Child Care workers in line with CMFT policies.


14. Service Monitoring

Activity data are provided to Salford CCG. An annual report is provided to describe the activities of the service each year. Interventions such as parenting groups & training are routinely evaluated. At least one participation project will be carried out each year.

End