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Health Care

This policy describes the processes to be used in maintaining the health care of young people admitted to the Secure Unit and includes general principles, health care during placement, health promotion and records.

The unit will continue to meet the healthcare needs of young people and promote good health both during placement and in preparation for leaving secure accommodation.

Definition

Young people who are placed in residential accommodation, whether open or secure,  are particularly vulnerable because they may not have received a continuity of health care and may have been subject to a sequence of moves within short timescales.

Young people who have experienced disadvantage and disruption in their lives may have health care needs that have not been detected.To ensure that any deficiencies in past health care are remedied, staff need adopt a vigilant attitude towards the health of young people they look after and pursue a proactive approach to health issues.The health of a young person will be promoted with the same enthusiasm that caring parents would give to a young person living at home.This Policy will be used in conjunction with the Policies on admission to the Secure Unit and the Policies relating to medication.

Health Promotion All aspects of a young person's health will be promoted.  Staff need regular training and information in order to promote health issues.

Health promotion must include education about all health care issues and should not be restricted to the treatment of illness and accidents.

Group and individual advice will be available to young people and staff must always respond to any young person who wishes to discuss any health issue in private. Heal th education will be provided on both a planned and an informal basis.  Regular discussions will be held to offer advice on promoting good health in areas such as diet, contraception, sexual matters, smoking, drugs, solvent abuse, HIV/Aids. Such discussions may form part of the care plan and be discussed individually with key workers or as an advice session within the group of young people. Relevant information from Health Authority resources should be used to enable this process.

Young people will be actively encouraged to participate in the selection of topics for discussion and the involvement of specialists in these areas should be secured when appropriate.

Personal Hygiene/Self Care Personal hygiene/self care will be promoted with all young people.  Advice and guidance must be sought from a healthcare professional if such care becomes a matter for concern.

Encouraging young people to share their personal preference in relation to products such as shampoo, deodorant etc. will facilitate choice, individuality, responsibility for self-care, pride in self-care and hygiene.  Care will be taken when supplying such products and risk assessments referred to.

However, the range of items regarded as personal toiletries will be extended if it is in accordance with the individual young person's needs and/or Personal Care Plan e.g. where specified need is identified i.e. health, allergy, skin complaint, racial, cultural, religious or gender need. Staff will ensure that at all times girls have ample supplies of sanitary protection that they should keep in their rooms (where possible).  It is not acceptable for such items to be handed out singly when needed unless deemed necessary by a risk assessment.  It will be necessary to keep a supply within the home for emergencies.All elements of personal hygiene will be detailed in a young person's Personal Care Plan in the home.

Immunisation and Screening

The Placement Plans Part One and Part Two, will detail the immunisation and screening a young person has received prior to admission. Where it is identified that there has been a gap in immunization and screening relevant appointments will be made in consultation with the young person, their parents and social worker to discuss the potential of receiving these immunisations.

Young people will be encouraged to follow immunisation programmes followed within the education sector and in response to injury needs.

All immunisations received will be recorded in the health records.

Exercise and Rest

Both exercise and rest are essential for appropriate health and development.

Young people will be encouraged to exercise but within appropriate boundaries and limits.  Advice should be sought from relevant professionals before gym/weight lifting activities are entered into unless staff working in the unit and are suitably qualified and trained and the Manager of the Secure Unit has copies of such certificates. All such activities will be recorded as part of a Personal Care Plan. Rest is equally important and will be encouraged through appropriate lifestyle guidance in relation to sleep and social activities.  Any re-occurring issues should be recorded and appropriate medical advice sought.

Sexual Health

Staff will approach the subject of sexual health in a supportive, non-judgmental way.

Leaflets will be available in the unit in relation to sexual health and a list of contact numbers for health professionals should be freely available.

Staff will listen to concerns of young people but advice should be sought from relevant professionals on dealing with issues.All concerns and subsequent actions will be recorded in the young person's file and as part of the Personal Care Plan if appropriate.

Effects of Alcohol, Smoking and Other Substances

Staff will approach any discussions with a young person on these or related matters in a professional, non-judgmental way.  Whilst it is sometimes useful to show empathy to young people in such circumstances, the essential element for staff is to encourage a healthy lifestyle and discourage illegal activity and activities that damage health.

Leaflets and contact numbers will be available in the home and staff will involve outside agencies in the management of concerns around alcohol, smoking, illegal substance or solvent abuse.

All concerns or actions in relation to this will be recorded in the young person's file and care plan where relevant.

HIV and AIDS and Other Blood Borne Diseases

Staff will approach discussions on this matter in a professional, non-judgmental manner.Staff will receive training on HIV and AIDS and other blood borne diseases in order to facilitate appropriate discussions with young people.

Leaflets will be made available to young people along with a list of relevant contacts.

Diet

Young people will be provided with food that is adequate in quality and quantity, properly prepared, wholesome and nutritious.

In order to give young people choice, they will be involved in menu planning and account will be taken of their individual needs and preferences.When a young person has special dietary needs, these will be met whether this is due to their health, religious beliefs, racial origin or cultural background.  In these circumstances, guidance on diet will be gained for the young person, from their parents and any health professional involved with him/her.  The diet will include all the essential nutrients required for normal growth and healthy development. Young people will be encouraged to try a wide variety of foods, including those that are unfamiliar.  However, young people will not be forced to eat foods that they dislike.  They will be encouraged to consider 'healthy eating'.  Leaflets will be available in the home detailing appropriate nutrition. There will be some flexibility to meal times to meet the differing requirements of schools, weekends and holiday periods.  Staff should eat with young people wherever possible.  Meals, the preparation of food and cooking are important parts of a young person's day and their involvement in these areas will provide a beneficial contribution to their overall development in terms of life skills but will be managed within the risk assessment framework.

Menus will be recorded and displayed.Use of vitamins etc. may be considered appropriate for a young person but will only be offered in conjunction with health advice and with consultation with a young person and their parents.

Health Records

All records will be kept in a secure place and confidentiality must be a main priority for staff.

Each young person's file must include a section on health care that will contain the following:

Copies of the following will also be kept in the health care section:

The continuum of healthcare is of primary importance in looking after young people.  This policy has two main objectives: 

Staff will take a positive, practical approach to meeting a young person's health needs and this includes monitoring general health care, development progress and treatment for accident and illness.  Sufficient staff need to be trained in first aid to allow a qualified first aider to be on duty at all times.The young person's health care needs must be clearly identified and stated in their individual Personal Care Plan .  The Personal Care Plan will be drawn up in consultation with the young person's Doctor, school nurse or any other appropriately qualified person.

Young people must receive a high standard of health care throughout their placement and medical advice should be sought promptly whenever cause for concern is identified. Young people will be actively discouraged from smoking, alcohol and illegal substances or solvent abuse and under-age sexual activity.

Written records will be kept of all significant illnesses, accident or injuries to young people whilst in placement. Matters concerning a young person's health are extremely personal and may be of a sensitive nature.  All records will be kept secure and only shared on a need to know basis.  Confidentiality is vital. 

 

During placement  young people will be seen by their own Doctor, wherever possible.  Within four hours of admission to the unit they will receive a medical. Any healthcare needs identified at this time will be detailed on file and supported by the staff.  This includes any mental health needs.  Any medication needs should be addressed at this point.

Dependent upon the length of placement in the unit,  appointments should also be made with the young person's Dentist and Ophthalmologist.  These will be considered if the young person is placed over 4 weeks or has not seen such professionals in the previous six months.  Consideration will be given to making such appointments as part of a discharge plan.