Revised Process for Recording Health Assessments

Revised Process for recording Health Assessments

In Framework i

Version1.3

Status: released

Date: 11/10/18

Table of Contents

Glossary

Note – From September 2013 BSOs will be recruited to teams to support or take over the role previously completed by Team Admin (BSO).

Current Staff (October 13)

Proposed Changes to Health Assessment Process

1.0 Initial Health Assessment - flowchart

2.0 Review Health Assessment Flowchart

3.0 Out of County(Worcestershire child or young person living in another County)

4.0 Out of County (Worcestershire Child or Young Person living in another County) Review Assessments

5.0 Other Authority children living in Worcestershire Flowchart

1.0 Initial Health Assessment – WCC child or young person living in Worcestershire

2.0 Review Health Assessment - WCC child or young person living in Worcestershire

3.0 Out of County (Worcestershire Child or Young Person living in another County) Initial Assessments(following 1.1-1.5)

4.0 Out of County (Worcestershire Child or Young Person living in another County) Review Assessments (following 2.1-2.3)

5.0 Other Authority children or young people living in Worcestershire

Initial & Review health assessment

6.0 Review Health Assessment – 16+ Flowchart

6.0 Review Health Assessment – 16+ (Worcestershire LAC)

BAAF Forms

Addendum

Immunisations

Out of County Notification added by PDT

Amendment History
Version No. / Date / Reason for Amendment
V0.1 / 16/04/13 / Revised HA process following meeting 13/03/13 with Karol Keenan, Wendy Picken, Jo Thompson, Alison Rigler, Lisa Green, Jill Stephenson, Doe Goodwin, Helen Darke, Sally Gray, Deborah Turley, Debra Turner, Mandi Jenkins
V0.2 / 29/04/13 / Updated with 16 + processes as documented by Doe Goodwin 03/04/13 following meeting with Jo Thompson & Debbie Turley.
V0.3 / 02/05/13 / Updated with DoGo after session with JoTh, DeTu, DeTu
V0.4-0.5 / 05/06/13 / Process 1 & 2 updated in meeting with JoTh, JoLe, CaCo, KaKe, StWa, DeTu
V0.6 & 0.7 / 12/06/13 / Process 3 and 4 updated following mtg JoTh and DeTu 05/06/13 and with feedback from JoTh on 12/06/13
V0.8, 0.9 & 0.10 / 23/07/13
25/07/13 / Updated following session with JoTh & JoLe 09/07/13
V1.0 / 17/08/13 / V0.10 signed off by StWa 26/07/13
V1.1 / 18/09/13 / Updated to show 16+ LAC nurse will initiate RHA episodes for 16+ children
V1.2 / 31/10/13 / Updated with comments from Health
V 1.3 / 06/01/14 / Updated with Health Logo, naming convention for uploading Part C
Owner: Helen Darke / Reviewer (s): Karol Keenan, Jo Thompson

Source File Location:

U:\U161 CHS\U097 BSDT\P5 Key systems\BC65-66 FWi\04 LAC\Health Assessments\07 Apr 13 ToBe\2013 Health Assessment Process TOBE V1.3.doc

Glossary

Abbreviation / Description
BAAF / British Association of Adoption and Fostering
BSO / Business Support Officer
Child's SW / Child's Social Worker
CHPDT / Children's Services Performance and Development Team
CHV / Child's Health Visitor
CSA / Customer Services Assistant
DOB / Date of birth
FWi / Framework I
H&C Trust (HCT) / Health and Care Trust
HA / Health assessment
Health & Care / Previously Primary Care Trust
HV / Health Visitor
IHA - YP / Initial Health Assessment – Young Person (for young people aged 10 years and older)
IHA-C / Initial Health Assessment – Child (for children aged birth to 9 years)
ISL / Integrated Services for Looked After Children
ISL GM / Group Manager: Specialist Support Services
LA / Local Authority
LAC / Looked After Child(ren)
NCRS / NHS Care Records System
OALAC / Other authority looked after children
OOC / Out of County
PDT / Performance and Development Team
PR / Parental Responsibility
RHA - C / Review Health Assessment – Child (for children aged birth to 9 years)
RHA - YP / Review Health Assessment – Young Person (for young people aged 10 years and older)
SLA / Service level agreement
SN TL / School Nurse Team Leader
SW / Social Worker
TA / Team Administrator (BSO)
TM / Team manager
WCC / Worcestershire County Council

Note –From September 2013 BSOs will be recruited to teams to support or take over the role previously completed by Team Admin (BSO).

Current Staff (October 13)

Role / Name
16+ Nurse / Deborah Turley
Health & Care Trust Area LAC Admin
Health & Care Trust LAC Co-ordinator / Jodie Lewis
ISL Health administrator / Debra Turner
Named LAC Nurse for WCC / Jo Thompson

2013 Health Assessment Process TOBE V1.3 Page 1 of 35

Proposed Changes to Health Assessment Process

Access to Fwi for Health & Care Trust LAC Co-ordinator
Direct access to the system to save time posting information through to Health and then back to WCC LAC Nurse and Social Care for circulation.
Record full Immunisations
All immunisations will be recorded on Fwi so that records will be up to date and clearly state whether or not Immunisations are up to date.
Record Other Authority Children Living in Worcestershire on Fwi
Clearly show on the system children living in Worcestershire and status of their Health Assessments, preventing duplicate entry on a spreadsheet.
Change wording of task to clarify that all documents need uploading before sending to HA Team
One of the main reason for rejecting requests for IHA and RHA is that documents are not uploaded to be shared with Health colleagues, task has been re-worded to clearly state this – completed June 2013.
Report to show where Health Assessment has been requested but no Part C date entered
Report requested and due for development September 2013, this will enable proactive monitoring of outstanding Health Assessments.
Report to show rejected tasks to enable follow up of documents
Report requested and due for development September 2013, this will enable proactive monitoring of outstanding documentation that is preventing the commencement of Health Assessment. .
Publication of all BAAF forms in same place
Ensure that staff are completing the correct forms and there is no delay in sourcing forms.
Development of summary sheet for BAAF forms to capture Social Worker issues and concerns regarding Health needs of young person
Ensure that any concerns or issues are shared with Health colleagues prior to the assessment to support a more comprehensive review.
Training for Health Assessment Team, Health & Care Trust LAC Co-ordinator and Business Support Co-ordinator.
Revised process to be circulated w/c 22nd July and signed off by WCC staff by end of July so that it can be signed off by representative from Health Care Board and training arranged for September 2013.

2013 Health Assessment Process TOBE V1.3 Page 1 of 35

1.0 Initial Health Assessment - flowchart

2013 Health Assessment Process TOBE V1.3 Page 1 of 35

2.0 Review Health Assessment Flowchart

3.0 Out of County(Worcestershire child or young person living in another County)

4.0 Out of County (Worcestershire Child or Young Person living in another County) Review Assessments

5.0 Other Authority children living in Worcestershire Flowchart

2013 Health Assessment Process TOBE V1.3 Page 1 of 35

Ref / Process Name / Resource / Process Description

1.0 Initial Health Assessment – WCC child or young person living in Worcestershire

When a Social Worker decides that a child may need to become Looked After, the Social Workermust request authorisation from their Team Manager.
Team Manager approval for LAC is a FWi Episode that the SW can select throughout workflow, and send to their TM.
1.1 / Select Health Assessment Outcome / TM / The TM selects the Health Assessment Outcome (from the TM Approval for LAC Episode), adds the TA's (BSO)name to the "Pass to Worker" field, then clicks "Finish"
NB – for LAC, other Outcomes must be selected too. See Children's Social Care 4.0 LAC processes on SID for full details:

1.2 / Complete BAAF Consent form, IHA & Addendum word docs, (if 16+ check preference for Dr/nurse) / Team Admin (BSO), SW & TM / The Health Assessment Episode will be in the TA's (BSO)Incoming Work Folder. Before staring this episode the TA populates the following Word documents:

BAAF Consent Form(part A)

And

Part A of either the Initial Health Assessment – Child, or Initial Health Assessment – Young Person

And

Part A Addendum

And then gives the documents to the child's SW.
The child's SW will take them to whoever has PR for signature.
If the young person is 16+ Social Worker will obtain their preference for a doctor or nurse completing the Health Assessment and inform TA. Young People with medical issues should always be encouraged to see a doctor).
NB - if there is a Care Order or Interim Care Order, the SW or TM are able to sign the documents.
1.3 / Upload to FWi episode / Team Admin (BSO) / The Health Assessment Episode will be in the TA's (BSO)Incoming Work Folder.Right click on it, and select Start Work.
The TA scans and uploads the signed documents to theDocuments Page of the Health Assessment Episode:
File As: either –"Part A – IHA – C" or "Part A – IHA – YP", "Part A Addendum"and BAAF Consent Form
Main category: LAC Documents
Sub-category: Health Assessments/Health Records
1.4 / Send Notify Health Assessment Team Task / Team Admin (BSO) / The TA (BSO) goes to the Tasks Page of the Health Assessment Episode, clicks on the Notify Health Assessment Team once documents uploaded to episode Task, and sends it to the Health Assessment Team (via the "Pass to Worker" drop down menu).
If the young person is 16+ their preference for Dr/nurse completing the assessment is added to the notes box of the task.
Click Save & Close (not Finish)
1.5 / Respond to Notify Health Assessment Team Task / Health & Care Trust LAC Co-ordinator/ 16+ Nurse (Acting For generic Health Assessment Worker) / NB - Ageneric worker called "Health Assessments" has been created on FWi. The ISL GM, Named Nurse for LAC, 16+ LAC Nurse,ISL HEALTH ADMIN, Health & Care Trust LAC Co-ordinatorand Area LAC Administrators for Health can Act For the Health Assessment worker. This will enable members of the team to easily check for incoming tasks.
In practice Jodie Lewis (Health & Care Trust LAC Co-ordinator) will be the main person checking these tasks and rejecting if appropriate. Jodie will check Child Health System for immunisations and update on Fwi – stating whether or not this means they are up to date.
The Notify Health Assessment Team task will appear in the Health Assessments workers' Incoming Tasks folder:

Right click on the task, and select View Episode(a summary page will be displayed)
Click on Amend (the Health Assessment Episode will be opened in a new window)
Open and check both the Consent Form and the Initial Health Assessment documents (these should have been uploaded to the Documents Page of the Episode by the TA (BSO))

If the forms are incomplete, go to the Tasks Page of the Episode, and then:

Click on the pencil icon (next to the task at the bottom of the Tasks Page.
Select the Rejected radio button
Add details to the Return Notes space (reasons why the form(s) are incomplete/unsuitable)
Click OK

Go to 1.3 - (the TA (BSO) will receive a rejected task notification, and can then amend and upload the forms again, then re-send the task)
Go to the Tasks page of the Episode, and then:

Click on the pencil icon (next to the task at the bottom of the Tasks Page)
Select the Completed radio button
Click OK
Click Save and Close (to get out of the Episode)

If HA is for a nurse led appointment for 16+ YP go to 1.10
If the HA is for a Worcestershire child or young person placed Out of County go to 3.0 (Out of County process)
Otherwise Go To 1.6
1.6 / Distribute to Trust Area LAC admin & add details to HACWExcel sheet / Health & CareTrust LAC Coordinator / The Health & CareTrust LAC Coordinator distributes IHA requests to Trust Area LAC Administrators:
South Worcestershire – Jodie Lewis
Kidderminster and Wyre Forest – Hayley Wright
Redditch and Bromsgrove – Terry Ryan
The following details are recorded on an HACWExcel spreadsheet so that Health & Care Trust LAC Co-ordinator can monitor any delays with the Doctors:

Date completed request received
Child's surname
Child's forename
Child's date of birth
School
Examiner (Doctor)
Area
Social Worker
Social Worker base
Appointment Date
Date Part C uploaded to Fwi
Any comments

1.7 / Print IHA & copy of immunisations & generate appointment / Health & CareTrust Area LAC Admin / The Health & CareTrust Area LAC Administrator prints the IHA form, a copy of immunisations completed (from child health system) and generates an appointment via the NCRS (NHS Care Records System).
1.8 / Send appointment letters / Health & Care Trust Area LAC Admin / The Health & Care Trust Area LAC Administrator sends an appointment letter to the Foster Carer(s). If the appointment is for a Young Person (age 10 +), a DVD explaining the HA process is included.
A copy of the appointment letter is sent to the SW. The SW is required to attend the IHA meeting, and is responsible for inviting the birth parents if appropriate.
1.9 / Attend Health Assessment Meeting / Child's SW, Carer(s), Doctor & Birth Parent(s) / The Child's SW, Carer(s), Birth Parent(s) (if appropriate), and the Doctor attend the IHA meeting.
1.10 / Complete Health Assessment / Doctor/ 16+ Nurse / The Doctor completes Parts B & C of the IHA – C or IHA – YP and sends it to the Trust Area LAC Administrator. The Health & Care Trust Area LAC Administrator types Part C which the doctor then signs.
If the 16+ nurse completes the assessment they will complete Parts B & C of the IHA-YP and pass to the ISL LAC Health administrator. Some sections will not be appropriate and can be crossed through.
1.11 / Distribute Health Assessment / Health & Care Trust Area LAC Admin/ ISL Health administrator for 16+ Nurse / The Health & CareTrust Area LAC Administrator distributes the IHA if completed by a doctor:
The ISL Health administrator distributes the IHA if completed by the 16+ Nurse:
Part C (summary & plan for action) is sent to the Foster Carer(s), GP and young person if appropriate. A scanned copy is also sent to the Health and Care Trust LAC co-ordinator via email.
Part B and C are kept with the child's health notes. Copies are sent to the Named LAC Nurse, and child's School Nurse or Health Visitor.
These still need to be sent to the Named LAC nurse as part B is not uploaded onto Fwi.
The Excel sheet is updated with the following information:

Date of appointment
Comments e.g. attended, cancelled, new appt.
Date returned

1.12 / Update HACW Excel spreadsheet / Health and Care Trust LAC Co-ordinator / The HACW Excel spreadsheet is updated with the following information:

Date of appointment
Comments e.g. attended, cancelled, new appt.
Date assessment uploaded to FWi

1.13 / Update Health tab on FWi & upload copy of IHA part C / Health & Care Trust LAC Coordinator/ ISL Health administrator for 16+ Nurse / The Health & Care Trust LAC Coordinator or ISL Health administrator for 16+ Nurse updates the Health Tab on FWi with the following details:

Physical examination date. This is the date that the Health Assessment took place.
Name, job title and contact phone number of person undertaking the HA

Upload a copy of the IHA Part C to the Documents Page of the Health Assessment Episode. Pre-fix the title with the date of the Health Assessment.
File As: either –"yyyy/mm/dd Part C – IHA – C" or " yyyy/mm/dd Part C – IHA – YP"
Main category: LAC Documents
Sub-category: Health Assessments/Health Records.
If child/young person refuses Health Assessment, create the additional information document and enter:

The date on which the child/young person refused the Health Assessment (if appropriate).

1.14 / Finish Health Assessment Episode and send case note alert to Allocated Social Worker / Health & Care Trust LAC Coordinator/ ISL Health administrator for 16+ Nurse / The Health & Care Trust LAC Coordinator or ISL Health administrator for 16+ Nurse goes to the Outcomes Page of the Health Assessment Episode, and selects the appropriate Outcome.
A case note, using Casenote type 'Health Assessment' is added to alert SW that HA episode has been completed and Part C has been uploaded to FWi.
The Outcomes available are:

Child ceased to be LAC (terminating outcome)
Health Assessment Refused – method:

Add Team Admin (BSO)to the Pass to Worker Field
Add the date the Health Assessment Review will be due to the Scheduled Date Field.
Then click Finish.
The Health Assessment Review will be sent to the Team Admin (BSO)'s Future Work Folder, and will move to the Incoming Work Folder 5 days before it is due.
NB – this is a standard FWi timescale for Future to Incoming Work and cannot be altered.
Go to 2.0 (Health Assessment Review)

Health Assessment Review (5 yrs -16yrs) – method:

Add Team Admin (BSO) to the Pass to Worker Field
FWi will automatically add a date 9 months in the future to the Scheduled Date Field. Although the next review is due in 12 months time for over 5's, the Episode will move from Future to Incoming Work in 9 months time, and thus allow the Team Admin (BSO) enough time to arrange the next Review.
NB – the Health and Care TrustLAC Health Co-ordinator may need to manually amend the Scheduled Date if there has been a delay between the date of the Health Assessment by the Doctor, and the date that the Episode is finished.
Then click Finish.
The Health Assessment Review will be sent to the Team Admin (BSO), and will move to the Incoming Work Folder before it is due.
Go to 2.0 (Health Assessment Review)

Health Assessment Review (16yrs+) – method:

As above, however outcome is sent to Deb Turley 16+LAC nurse to initiate RHA for 16+.
Go to 6.0 (Health Assessment Review for 16+)

Health Assessment Review (under 5 yrs old) – method:

AddTeam Admin (BSO)to the Pass to Worker Field
FWi will automatically add a date 3 months in the future to the Scheduled Date Field. Although the next review is due in 6 months time for under 5's, the Episode will move from Future to Incoming Work in 3 months time, and thus allow enough time to arrange the next Review.
NB – the Health and Care TrustLAC Health Co-ordinator may need to manually amend the Scheduled Date if there has been a delay between the date of the Health Assessment by the Doctor, and the date that the Episode is finished.
Then click Finish.
The Health Assessment Review will be sent to the Team Admin (BSO)Future Work Folder, and will move to the Incoming Work Folder before it is due.
Go to 2.0 (Health Assessment Review)
Child reached 18 – HA no longer required(terminating Outcome)
1.15 / Add Immunisations to Fwi / The Health & Care Trust LAC Coordinator or ISL Health administrator for 16+ Nurse / The Health & Care Trust LAC Coordinator or ISL Health administrator for 16+ Nurse go to 'people, new episode' to generate the Immunisations episode and click on the green cross to launch the Immunisations form.
Immunisations are added as per information on Child Health System, form is saved and closed, episode is finished.

2013 Health Assessment Process TOBE V1.3 Page 1 of 35