Emergency Placements and Emergency Reviews

1. Emergency Placement Definition

An Emergency Placement is the placement of a Looked After Child made without the usual planning and/or complete assessment process having taken place because of the need to ensure the safety and the welfare of the child immediately; this may be due to:

• A risk of immediate Significant Harm;
• A need to urgently terminate an existing placement (If a placement move occurs in an emergency, the responsible authority must be informed within one working day);
• Where a court has directed that a young person be Remanded to Local Authority Accommodation.

The following placements are deemed to be Emergency Placements:

• The placement of a child outside normal working hours;
• Any placement where the ordinarily required and necessary plans are not in place, i.e. where a child is abandoned, has suffered/is at risk of Significant Harm, or where there is an exceptional and immediate need to end an existing placement (it may be possible for the Placement Co-ordinator/registered manager to have completed Referral and Information Record and/or A Placement Risk Assessment with the placing authority over the telephone);
• A placement in Secure Accommodation without a Court Order but authorised by a Designated Manager (Secure Accommodation) for a maximum of 72 hours.

Receiving Emergency Admissions (in line with the Statement of Purpose)

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.

Emergency Placement Procedure

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.)

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.

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.

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.

2. Criteria and Timing of Emergency Reviews

An emergency review must be initiated no more than 72 hours after any emergency admission, this is a maximum timescale and the urgency of the situation may dictate that the timescales should be shorter.

The criteria of the review will be to ascertain whether the child should remain at the Home, or if it is in that child's interests to move to a different placement.

Discussion around suitability of the placement should take place and if it is found that this is not an appropriate placement, an alternative placement should be discussed and any actions to follow up decided upon.

3. Arranging and Conducting Emergency Reviews

Emergency Reviews will normally be arranged by the manager of the Home, who should act as the chairperson (unless the LA provides an Independent Reviewing Officer (IRO)). This responsibility may be delegated to a member of staff.

See Section 5.1, Chairperson Responsibilities During the Review.

Additional guidance for arranging Looked After Reviews and the role of the IRO is provided in Looked After Reviews and Disruption Meetings Procedure.

4. Who Should Attend or Contribute to Emergency Reviews

The people listed below should contribute to the Emergency Review.

See Section 5.1, Chairperson Responsibilities During the Review.

The people who should contribute are:

1. The child's social worker;
2. The Independent Reviewing Officer (IRO) for the child;
3. The child;
4. The child's parents;
5. If previously placed in a foster home, the foster carer(s) and a family placement worker/social worker;
6. The child's Key Worker, if known, or a member of staff.

5. Preparation and Chairing of Emergency Reviews

Additional detailed guidance on preparation and chairing of reviews is contained in Looked After Reviews and Disruption Meetings Procedure.

Before the review, the chairperson should attempt to collate relevant documentation, such as Risk Assessment/Referral records, Placement Plans/Placement Information Records, Essential Information Records/Chronologies, a Care Plan, Pathway Plan, and other relevant background information about the child.

5.1 Chairperson Responsibilities during the Review

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 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.

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.