Emergency Placements and Emergency Reviews

The registered person of the Home cannot admit children in an emergency unless they are registered to do so, therefore this capacity will be explicitly included as a function and written into the Home's Statement of Purpose. The Home will need to show it is able to care for children admitted at very short notice while continuing to offer high quality care. Homes set up for emergency placements as indicated and detailed in their Statement of Purpose will require sufficient staff trained and skilled in the admission and care of children, where their full background may not be known. When children are admitted in an emergency, staff should do all they can before the move to address any anxieties that children may have about moving to a new home without preparation. A warm welcome and introduction to the Home is an entitlement for all children whether they are admitted in a planned way or in an emergency.

Where it is within the Home's Statement of Purpose the Registered Manager will ensure that procedures are in place for receiving emergency placements. They will have a detailed routine, with which all members of staff are familiar.

The routine will include having:

• A check list for admissions readily available;
• A vacant bedroom with appropriate facilities, in a state of readiness;
• Easy to prepare basic food and drink accessible for staff to prepare day or night;
• A strategy for the redeployment of staff to deal with the emergency admission.

The Registered Manager of the Home should ensure that where an emergency admission takes place a planning meeting also known as an Emergency Review is held within 72 hrs, see Section 2, Criteria and Timing for Emergency Reviews.

The Homes Manager should ensure the Home is adequately staffed to admit a child in an emergency.

Homes staff should be provided with the information needed to safeguard and care for the child. Homes Managers should ensure that an interim care plan, risk assessment and presenting behaviour risk management plans are developed. These should be shared with Homes staff prior to or on placement of the child and reviewed at the Emergency Review that should take place within 72 hours of the child being placed in the Home, or sooner as agree with the placing Social Worker.

The child’s admission should be recorded in the Homes admissions log

When a child moves into the Home in an emergency Homes staff are to provide them with copy of the Children’s Guide. A copy of the guide should also be provided to the placing Social Worker and child’s parents.

Homes staff should ensure there is a welcome pack for the child in their bedroom.

Homes staff should warmly welcome the child and give a tour of the Home and facilities.

The child should be introduced to other children living in the Home.

Homes staff should show the child their bedroom and support the child to unpack their belongings in line with the child’s views, wishes and feelings.

Homes staff should offer the child food and drink.

Homes staff should ensure the child is aware of Homes complaints and fire evacuation procedures as soon as possible, but within 24 hours of arriving at the Home.

Any medication for the child should be logged in the Medication Register, then stored and administered as per schedule. MARS should be put in place to record any administration of medication, and an audit record for medication counts.

A Keyworker should be appointed to the child in the interim until a decision is made at the Emergency Review regarding whether the child is to remain living in the Home.

In the event of a referral for an Emergency Placement, the person receiving/administering the referral should do all that is reasonable to follow the normal admissions procedures. (When an emergency placement is requested out of hours then the on call manager should be consulted prior to accepting the referral).

When a placement is to be made on an emergency basis the on call Manager (if out of hours), Home Manager and placing Social Worker must consult with the Responsible Individual prior to any decision being made.

If the Responsible Individual is not available to make a decision in relation to an emergency placement, the Homes Manager and placing Social Worker must contact the Service Development Manager prior to any decision being made.

If the Service Development Manager is not available to make a decision in relation to an emergency placement, the Homes Manager and placing Social Worker must contact the local authority Safeguarding and Quality Assurance Service, Cared for Children’s Service Manager prior to any decision being made.

Any decision to admit a child in an emergency must be based on an assessment of the available information and, based upon this available information, it must be concluded that the child's needs are likely to be met by the Home.

The Homes Manager should undertake an Impact Risk Assessment to assess any impact on the children living in the Home and what measures will be put in place to manage any identified impact. If the Impact Risk Assessment determines the impact cannot be addressed or managed the placement cannot be made

Given the time constraints, the risk assessments is likely to be carried out from information provided over the phone or via e-mail. Referral forms need to be completed and received before the young person is admitted despite the time pressures with emergency placements.

As a minimum, the following information will be required at the time of the placement:

• The contact arrangements that may be permitted between the child and their parents, siblings, relatives and friends – no contact may be allowed without the approval of the social worker or as set out in the child's Placement Plan;
• A copy of the child's Health Care Plan or, if this is not available, details of any healthcare or medical needs/requirements that the Home should be aware of e.g. Home remedies or medication that the child may require, see Health Care Assessments and Plans Procedure;
• Copies or information relating to any Court Orders that may be required or influence the child's placement e.g. if the child is subject to a Remand;
• Parental Consent Form for Accommodation and Medical Consent (if Section 20);
• Delegated Authority Form;
• Placement Information Record;
• Placement/Care Plan.

The person administering this process must keep a record of the matters that are not undertaken, and pass this to the chair of the Emergency Review (see Section 2, Criteria and Timing for Emergency Reviews), so that they can be followed up.

The Homes Manager should request under regulation 5 of the Children’s Homes (England) Regulations any statutory documents required from the local authority not received on placement of the child.

The overall purpose of the Emergency Review is to consider whether the placement is suitable for the child; having regard for the child and the other children in the Home.

The views of the child, parents and others should be accounted for; but the decision should be made by the social worker and Home manager or chairperson.

The Responsible Individual must be included in any decision made at emergency reviews regarding the placement of a child in the home.

Should the Responsible Individual be unavailable to be included in any decision about the placement of a child in the home the Service Development Manager will support the decision making process.

Should the Service Development Manager be unavailable to be included in any decision about the placement of a child in the home the local authority Safeguarding and Quality Assurance Service, Cared for Children’s Service Manager will support the decision making process.

The matters which should be considered are:

1. The likely appropriateness of the placement in meeting the child's needs, as set out in the Care Plan or Pathway Plan in the context of the Statement of Purpose for the Home;
2. Whether the placement of the child may adversely affect any other children in the Home.

If it is decided that the placement is suitable then the Placement Plan should be updated to reflect this decision.

If there is a view that the placement is appropriate but  that additional support is required to make it entirely suitable, the Placement Plan should be updated to reflect this.

In both the above situations, it is essential that the Home manager obtains relevant consents to emergency medical care/treatment before the meeting is concluded.

See Consents and Delegated Authority Procedure.

If there are concerns that the placement is not suitable, even with additional support, consideration should be given to the following:

1. The child remaining in the placement until a more suitable placement can be found; in which case, the Placement Plan should be updated to reflect this decision;
2. The immediate ending of the placement, in which case no Placement Plan is necessary.

If the Placement Plan cannot be completed sufficient to sustain the child until the first Looked After Review, the chairperson must arrange for a Placement Plan Review to occur within 7 days so that the plan can be completed.

If this is necessary, the chairperson must agree what further information is required in time for the Placement Plan Review.