Children looked after

Children Looked After (CLA) are children and young people who are in the care of a local authority because they cannot live at home with their birth family, or because they may be at risk if they remain in the care of their birth family.

Under the Children Act 1989, a child or young person is considered CLA if they are:

  • provided with accommodation for a continuous period of more than 24 hours (Children Act 1989, Sections 20 and 21)
  • subject to a care order (Children Act 1989, Part IV)
  • subject to a placement order

This can include:

  • children receiving respite care
  • children who are voluntarily accommodated
  • children and young people who are newly arrived in the UK and seeking asylum
  • children detained in youth offending institutions

Note: If a CLA remains in care until their 18th birthday, they stop being CLA and become a care leaver. Support is provided by the local authority to help with a smooth transition into adulthood and independence.

Who are we?

The Cheyne Child Development Service CLA team includes paediatricians, specialist nurses, coordinators and administrative support staff, and a specialist Infectious Diseases team. Within the team, there is a Named Doctor for CLA and a Medical Adviser for CLA and adoption.

What do we do?

We are responsible for the healthcare of CLA aged 0 to 18 (or up to 19 if they have a neurodisability and are still in school).

We aim to address health issues in a timely way, and to provide advocacy and support to improve long-term health outcomes for CLA. We also work to reduce health, emotional and economic inequalities.

We provide mandatory statutory Initial Health Assessments (IHA) and a health care plan for all CLA within 20 working days of entering care. These assessments are carried out by experienced paediatricians.

We then provide Review Health Assessments (RHA):

  • every 6 months for children under 5 (with a paediatrician or specialist CLA nurse)
  • every 12 months for children aged 5 and over (with specialist CLA nurses)

During your appointment

During the IHA, we take a detailed health history from birth to the present, including family history. We also aim to capture the child or young person’s views about their health and care.

During the health assessment, we will:

  • take growth measurements
  • carry out a full physical examination, including ears, eyes and teeth

The child or young person can decide how much examination they are comfortable with.

We also provide health promotion at every assessment. We offer advice, referrals and signposting to relevant services. Depending on age and stage of development, we may discuss:

  • sleep
  • healthy eating and weight management
  • dental and eye health
  • alcohol and drug use
  • sexual health and relationships
  • mental health
  • support to stop smoking or vaping

We liaise with other professionals and services, including social care, schools (including specialist schools and residential homes), school nurses, health visitors, Allied Health Professionals, CAMHS, GPs, sexual health clinics and multidisciplinary teams.

For children going into adoption, we provide a comprehensive report of health status from birth to the present, including an opinion on longer-term outcomes and a support plan for prospective adopters.

For children and young people seeking asylum in the UK, we run a joint specialist clinic with the Infectious Diseases team based at St Mary’s Hospital. General health screening, infectious diseases screening and mental health screening are carried out.

How do we arrange appointments?

We work closely with social care and the CLA’s carer to arrange health assessments. The child or young person’s allocated social worker sends a notification and request for a health assessment to our CLA team coordinators within 4 days of a child entering care.

We then arrange an appointment so the child or young person is seen and a health care plan is provided within 20 working days of entering care. Review assessments are also requested by the allocated social worker through the CLA team coordinators.

If health advice is needed outside of the health assessments, this can be requested via the CLA team coordinators or the specialist CLA nurses. They will make sure the Medical Adviser provides advice or signposts to relevant services.

Contact details

Social Paediatric Officer/Coordinator for the Children Looked After Service
Cheyne Child Development Service
Chelsea and Westminster Hospital NHS Foundation Trust

Telephone: 020 3315 3120
Email: Chelwest.LAC@nhs.net

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How did we do?

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