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Promoting Health and Wellbeing Policy & Procedure

7 min read

(Last updated 03/12/2024)

Relevant Legislation & Guidance

Children Act 1989
Children Act 2004
Care Planning, Placement and Case Review 2010
The Fostering Services (England) Regulations 2011, Regulation 15, 16
National Minimum Standards for Foster Carer Standard; 2, 3, 6 and 8
Every Child Matters Framework
Working Together to Safeguard Children 2018

Introduction

Positive Aspiration Group is committed to promoting the physical, emotional and mental health, and overall wellbeing of children and young people, as well as the foster carers who nurture them. We recognise that many looked-after children have experienced trauma, loss or disrupted attachments that can profoundly affect their health trajectories. Research consistently shows their health outcomes can be poorer than their peers.

Meeting these needs is therefore a shared, trauma-informed responsibility between birth families, foster carers, social workers, specialist health professionals, educators and other services acting in their role as the corporate parent. Foster carers, however, are uniquely placed to build safe, predictable, caring relationships that foster healing and resilience.

With the right training and support, foster carers can:

  • Model healthy coping strategies and self-care;
  • Provide stable, nurturing environments that promote safety, trust, choice, collaboration and empowerment – the core principles of trauma-informed care;
  • Work collaboratively with children and young people, valuing their voice in all decisions that affect them.

Ensuring the health and wellbeing of everyone involved in fostering is therefore integral to achieving positive outcomes and fulfilling Positive Aspiration Group’s duty of care.

Policy Statement

All children and young people in foster care have a right to the highest attainable standard of health. All professionals involved share a duty to promote and protect this right, with foster carers holding the most immediate influence over a child’s daily experiences and environment.

Positive Aspiration Group will:

  1. Ensure statutory health assessments
    • Every child will receive an initial and subsequent annual health assessment (or more frequently as required) in line with statutory guidance.
  2. Facilitate registration with universal health services
    • Foster carers will register children and young people with an appropriate GP (ideally their existing practitioner), dentist and optician. Carers will ensure at least two routine dental check-ups per year (or more if clinically indicated) and facilitate access to any aids, equipment or specialist services required. Carers and supervising social workers will work together to secure any documentation needed for registration.
  3. Promote healthy lifestyles
    • Carers will encourage healthful eating, adequate hydration, regular physical activity, balanced sleep routines and other positive health behaviours in ways that are age-appropriate, culturally sensitive and collaborative. Carers should model these habits themselves.
  4. Prioritise emotional and mental wellbeing
    • Carers and professionals will create nurturing environments that enhance emotional safety, build resilience and recognise the impact of trauma. Foster carers will use relationship-based, trauma-informed approaches and seek specialist support promptly if concerns arise.
  5. Provide comprehensive training and ongoing support
    • Foster carers will receive core and developmental training on child development, attachment, trauma, mental health, neurodiversity, sexual health, substance misuse, and the safe administration of medication. Training will emphasise reflective practice, self-care and secondary-traumatic-stress mitigation.
  6. Respond promptly to emerging needs
    • Where new health needs are identified between scheduled reviews, carers and supervising social workers will act swiftly, advocate tenaciously and escalate concerns when necessary to ensure timely, appropriate interventions from the placing authority or other agencies.
  7. Champion collaboration and shared decision-making
    • The voice of the child or young person will be central in all health-related decisions. Wherever possible, birth families will be engaged respectfully in the planning and review of healthcare. Professionals will communicate transparently and share information in the child’s best interests, in line with confidentiality and GDPR requirements.

Positive Aspiration Group also acknowledges that fostering can significantly influence the health and wellbeing of carers themselves. We therefore commit to:

  • Providing reflective supervision, peer support and accessible wellbeing services for foster carers;
  • Ensuring carers can access timely respite and specialist advice;
  • Embedding a culture that promotes psychological safety, learning and continuous improvement.

Physical Activities and Hobbies

Foster carers are expected to encourage all children in their care to explore hobbies, sports and creative interests that support identity formation, confidence and social connection. A proportion of the fostering allowance should be used to fund purposeful activities that nurture these interests.

Supervising social workers will discuss engagement in activities during supervision. Carers should consult with children, birth families and social workers about pre-existing interests and seek to maintain or re-establish them. Carers should also facilitate opportunities to discover new interests, ensuring activities are inclusive, culturally responsive and aligned with the child’s preferences and sensory or physical needs.

Key Points to Consider

Foster carers play a pivotal role in identifying and responding to unmet health needs. To fulfil this responsibility, Positive Aspiration Group will ensure carers have:

  • Holistic knowledge of child development and age-appropriate milestones;
  • Understanding of national screening and immunisation programmes and how to advocate for children’s participation;
  • Skills to recognise indicators of physical health issues (e.g., dental decay, vision concerns, nutritional deficiencies), mental health or neurodevelopmental needs, and risks related to substance use.

Carers will support young people’s sexual health education within a holistic, trauma-informed framework, encompassing emotional readiness, consent, healthy relationships, and protection from exploitation. (See “Sexual Health Policy”).

Young Person’s Consent

Young people aged 16 and over can generally give or withhold informed consent for their own medical examinations and treatment. Young people under 16 may also give consent if assessed as Gillick or Fraser competent. Safeguarding principles and the child’s best interests will guide all decisions.

Foster carers must therefore:

  • Adopt a vigilant, attuned approach to health concerns, particularly in emergency or short-term placements where histories are incomplete;
  • Seek medical advice promptly and without stigma when concerns arise (e.g., possible substance use, self-harm indications);
  • Discuss and agree safe storage arrangements for medication, balancing security with the young person’s developmental capacity for self-administration;
  • Document consent discussions and decisions clearly within the child’s records.

A lockable cabinet must be used for medications. A small, lockable box may be used for items requiring refrigeration.

Training for Foster Carers

Positive Aspiration Group recognises that confident, well-supported carers are central to children’s recovery, safety and growth. We therefore require that:

  1. Pre-Approval Training
    • All prospective foster carers must complete:
      • Paediatric First Aid
      • Safeguarding & Child Protection
      • Health & Hygiene
    • Completion occurs during assessment to ensure a foundational grasp of safety and wellbeing before children are welcomed into the home.
  2. Post-Approval Development
    • Carers will complete the Training, Support and Development (TSD) Standards within 12 months of approval, supported by their Supervising Social Worker (SSW).
    • TSD Standard 3 (Health) discussions cover:
      • Safe administration of medication
      • Delegated authority and consent pathways
      • Advocacy for mental and physical health needs
    • TSD Standard 5 (Development) addresses:
      • Positive sexual health education, including consent and healthy relationships
      • Promotion of hobbies, leisure and recreation to build identity, confidence and social connection
  3. Specialist Health Training
    • When a child has specific or complex health needs (e.g., gastrostomy care, diabetes management), bespoke instruction from qualified health practitioners will be provided to the primary carer and any substitute carers before they assume caregiving duties.
  4. Continuous Learning Culture
    • The agency offers a broad menu of face-to-face, e-learning and reflective workshops on trauma, attachment, neurodiversity, substance misuse, self-harm, and secondary traumatic stress.
    • Carers are encouraged to co-design their personal development plans with their SSW and to access peer support networks.

Placement Planning & Delegated Authority

  • Prior to—or at the latest within five working days of—placement, a Placement Planning Meeting will:
    • Share all known health information, including outstanding appointments, allergies, immunisation status, and cultural or religious considerations.
    • Record in the Care Plan and Delegated Authority Form:
      • Which routine or emergency medical decisions the foster carer may make independently;
      • Circumstances requiring consent from parents, the local authority or the court;
      • Whether the child or young person may self-administer medication, with agreed safeguards and supervision levels.

Health Checks

  • Initial Health Assessment: completed by a registered medical practitioner as soon as possible after entering care.
  • Review Health Assessments:
    • Every 6 months for children under 5.
    • Annually for children aged 5 and over.
  • Dental Care:
    • Minimum twice-yearly check-ups for all under 18s, unless the dentist recommends a different frequency.
    • Children under 2 should attend the carer’s own appointments to build familiarity; the visit is recorded as their check-up.
  • Vision Care:
    • Optician reviews at least annually or sooner if concerns arise.

Foster carers are ordinarily responsible for transporting and accompanying children to appointments, unless alternative arrangements have been agreed (e.g., with birth parents).

The Personal Child Health Record (Red Book) should accompany every health visit. Professionals record interventions, and carers add relevant observations.

Safe Storage of Medication

  • All medication, including controlled drugs and over-the-counter remedies, must be kept in a lockable cabinet inaccessible to other children.
  • Refrigerated medication is stored in a secure, locked container placed inside the fridge.
  • Expectations and practice are reviewed:
    • During the mandatory Medication Workbook module;
    • On at least one unannounced Health & Safety visit each year.

Foster Carer Recording & Notification Duties

  • Carers maintain up-to-date logs of:
    • All medication administered (dose, date, time, reason, initials);
    • Episodes of illness or injury;
    • Changes in the child’s emotional presentation that may signify emerging health needs.
  • The SSW will audit records regularly and coach carers where gaps are identified.
  • Serious Illness or Hospitalisation:
    • Carer seeks immediate medical help;
    • Notifies the child’s social worker and SSW as soon as safe to do so;
    • Completes an Incident Form within 24 hours;
    • SSW escalates to their line manager and, where necessary, Ofsted.
  • Out-of-Hours: If urgent health issues arise outside office hours, carers contact:
    • The agency’s out-of-hours support line;
    • The local authority Emergency Duty Team (EDT).

Health Passport

To combat fragmented records, each child will have a Health Passport—a living document kept by the foster carer and reviewed during every SSW supervision. The passport:

  1. Consolidates all health information in one place;
  2. Ensures continuity when professionals change;
  3. Supports multi-agency discussions;
  4. Smooths transitions if the child changes placement;
  5. Equips the young person with their own health history on leaving care.

Carers gather information from:

  • Previous placement reports;
  • Birth family contributions;
  • Local authority files (via the social worker).
Promoting Health and Wellbeing Policy
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