1. CHILD PROTECTION & SEXUAL HEALTH Looked After Children & young People

2. Definition of ‘LOOKED AFTER’ Looked after children The term "looked after" was introduced by the Children Act 1989 (DOH 1991) and covers all children in the care of the local authority. This includes children in residential units, those placed with foster carers and children living with their parents who are subjects of a care order who will be in receipt of services from the Local Authority. Also those who are provided with accommodation on a voluntary basis for more than 24 hours, that is children who receive respite care, are included in this definition.

3. All children (11 million) vulnerable children (3-4 million) Looked after children Children in need (3-400,000) on child protection register (27,000) Taken from Promoting the Health of Looked After Children (DOH, 2002b) Populations of children

4. Current status - Wales All children looked after on 31 March 2005- 4,380 Number in foster carer placements- 3,194 Number in residential placements- 234 Number in other placements- 952 Number with 3 or more placements during year-620

5. Legal and policy framework United Nations Convention on the rights of the child The Children Act, 1989 The Children Act, 2004 The Children (Leaving Care) Act, 2000 The Adoption and Children Act, 2002 National Service Framework, 2005

6. Inquiries & Reports ‘People Like Us’, 1997 The Waterhouse Report, 2000 Working Together to Safeguard Children, 2000 ‘Too Serious a Thing’, 2002 The Victoria Climbé Inquiry, 2003

7. health needs of care leavers more than 75% of the client group have no academic qualifications more than 50% leaving care after 16 are unemployed 17% of young women are pregnant or already mothers 38% of young prisoners have been in care 30% of young, single, homeless people have been in care this client group are four times more likely to have a psychiatric disorder

8. Identifying abuse “It is important to recognise that a sexual relationship involving a young person under 16 does not per se imply abuse and exploitation. A young person under 16 who discloses a sexual relationship to a social worker will therefore not necessarily trigger child protection procedures.” Brook 1996

9. Fraser guidelines A doctor or other professional can advise or treat without the parents knowledge or consent if: - the girl/boy will understand the advice - she/he can’t be persuaded to inform her parents - she is likely to have sex anyway - her physical or mental health would suffer without the advice or treatment - her best interests require it

10. Sex between teenagers Adolescents commit one third of all sex offences The government cannot assume that sexual relationships between young people will be fully consensual just because they are a similar age. It is not our intention to punish children unnecessarily. We would not expect the Crown Prosecution Service to bring charges against a child unless it was in the public interest. Lord Falconer

11. COMMON SYMPTOMS – DISORDERS OF ATTACHMENT Superficially engaging and charming Lack of eye contact Lack of joy, humour Indiscriminately affectionate with strangers Lack of ability to give and receive affection Intense negative affect – rage, terror, despair Extreme control problems Lack of Empathy Hurts self and others – emotionally and physically Cruelty to animals Chronic lying No impulse controls (stealing etc) Learning lags and disorders Lack of cause and effect thinking Lack of conscience Abnormal eating habits Poor response to discipline or frustration

12. Alison Owen Specialist Nurse Looked After Children & Care Leavers “ it takes a community to save a child” David Pelzer, 2001