Children in Care Staying Temporarily in Hospital

SCOPE OF THIS CHAPTER

This policy applies to all children in care:

  • Children subject to S20 accommodation (including abandoned children, unaccompanied asylum-seeking children);
  • Children subject to Emergency Protection Orders;
  • Children subject to Interim Care Orders, Care Orders or Placement Orders;
  • Children made subject to Police Protection.

A child is considered to be accommodated if they are cared for over more than 24 hours.

See also: Pan Sussex Child Protection & Safeguarding Procedures, Children in hospital.

This chapter was added to the manual in November 2019.

1. Overview

  • Hospital staff are not an alternative to carers. If a child in hospital is/becomes looked after, an adult carer should be identified who can spend time daily with the child;
  • Close liaison with the designated safeguarding lead in the hospital;
  • Clarity for hospital regarding child's legal status, and who can consent to treatment;
  • Relinquished babies should not be named by hospital staff.

2. Introduction

Children looked after as inpatients in hospital require arrangements to be made for a full-time carer to spend time with them, caring for them on a daily basis, in the same way that foster carers would outside hospital. Children looked after in hospital need a person who takes up the parental care role, overseeing consistency of care, flagging and chasing up issues as they arise, advocating on behalf of the child and feeding back to the social work team.

3. Definitions

Some of the circumstances in which children in care come into hospital are shown below:

  • A newborn baby, subject to an order, in hospital/ICU, prior to discharge to a foster placement;
  • Parent abandons/relinquishes baby;
  • Parent agrees to S20 accommodation prior to care proceedings being issued;
  • A child is admitted to hospital under police protection, or is already in hospital and police protection is taken;
  • A child is admitted to hospital from an established foster placement.

4. Practice Issues

An identified carer is essential for children in terms of attachment and building a safe and consistent relationship with a caring adult. It is also essential in terms of medical care and consistency, in that the carer will notice and pick up on nuanced changes in presentation of the child over time, and learn the care routine, where these might not be picked up through changes of staff.

It is not acceptable for newborn babies to be cared for solely by ward staff.

The expectation to identify a placement for a child in hospital should be the same as the expectation to identify a placement for a child who comes into Local Authority care that day.

All children in hospital should have a consistent adult carer/carers with them for a minimum of 8 hours a day.

There will be instances where it will not be possible for matched carers to visit the child at this frequency. This may be due to:

  • Hospital placement out of area;
  • Newly identified foster carer having other caring responsibilities that are incompatible;
  • Established foster carer having other caring responsibilities that are incompatible.

In this case, a temporary alternative carer should be sought, in the first instance from the carer's own network. If this is not possible, an alternative in-house or agency carer should be sought.

Where a new mother/parents are caring for their newborn baby in hospital, and it is the intention of the Local Authority to issue care proceedings to seek an ICO, it is good practice to match the child with a foster care placement, and seek consent for visits to take place, in order that the foster carer can visit the child daily and begin building a relationship prior to the child moving into the foster carers home. It is also an opportunity for the foster carer to build a relationship with the parent/s.

5. Role of the Social Worker

The social worker should visit the child at least at the minimum frequency for children in care. The social worker should make contact with the designated lead for safeguarding in the hospital and maintain this channel of communication.

The child's legal status should be made clear to hospital staff, with a specific and clear understanding around consent to medical treatment, and who can give this.

7. Contact

Contact arrangements between birth family and the child should be made clear to hospital staff. Contact arrangements should also consider children's brothers and sisters.

8. Relinquished Babies and their Names

When babies are relinquished in hospital, ward staff, foster carers and social workers must not give a name to baby within the first six weeks, where the mother/parent has not named the child. Baby can be referred to by generic endearing terms. Parents have up to six weeks to register the name of their baby; time should be given for work to be undertaken by the Fostering, Placements and Permanence Team with the birth mother/parents, and part of this work should consider their child's name.

For a relinquished child, their name may be one of very few threads that come directly from a birth parent and is likely to be highly significant to their identity.

If by the end of the six week period the parent still has not given the child a name, foster carer, in consultation with allocated social worker, and other significant adults in the network (including parents other family members where possible) to agree a name for child – this process to be agreed by The Head of Service with practice lead for children in care and recorded for child's life story.

9. Advice for Parents with Children

Children can find going to hospital a daunting experience. This is partly to do with their treatment but also because the hospital is a new and strange environment, full of new sights, smells, noises and people. If possible, talk to your child before leaving for hospital and explain what they should expect.

Stay with your child as much as you can

Children often adapt better to a hospital if their parents stay with them for as long as possible. Reassure your child that you will be staying by their side and let them know the hospital is a safe place to be.

However, if you have to leave the hospital at any time, inform your child how long you will be gone for and make sure you're back on time.

If you're able to stay with your child overnight, the hospital may arrange for an extra bed in your child's room or ward.

Stick to a routine

Keeping a routine can help your child feel more at home – it may help if, for example, you stick to your child's usual bedtime routine, or bring in their favourite toy or comforter.

Take time for yourself

While it's important to reassure children about their stay in hospital, it's just as important to look after yourself. You will be better able to care for your child and give support if you're coping well yourself.

Remember, it's fine to take breaks. Go for a walk, or get a cup of tea or coffee. Talk things through with your partner, friends or family; they will be able to give support, and talking can be a great stress reliever.

For information about neonatal care, see Special care for ill or premature babies.

10. References

Below is the NHS guidance for parents whose children are inpatients in hospital: