What Decisions Can I Make?
Standards and Regulations
Training, Support and Development Standards for Foster Care
- Standard 2 - Understand your role as a foster carer.
- Standard 3 - Understand health and safety, and healthy care.
Many foster carers and children who are Looked After face obstacles to everyday activities, like going for haircuts, school trips and sleepovers, which can make children's lives more difficult. Rotherham Metropolitan Borough Council wants to work in partnership with parents or those with Parental Responsibility for a child to make sure that clear arrangements are in place. An important aspect of working together is joint planning and decision-making, which includes the day to day health care for the child, as well as arrangements for activities.
Delegated authority is the term used when the responsibility for making day to day decisions about a child is passed to someone like you. An officer of the local authority such as a Social Worker can pass the delegated authorities onto you if they have an Emergency Protection Order or a Care Order. If they don't have an order the only person that can pass the delegated authorities on is the person with Parental Responsibility which is usually the parent.
It is the Social Worker's responsibility to work with parents sensitively to make sure you are well prepared and clear about what decisions you can make particularly about any recommended immunisations, medical, dental and ophthalmic treatment for a child. The most convenient arrangement is where you have delegated authority for routine treatment and minor procedures
Any work with the child and their families where English is not the first language, should be with a suitably qualified interpreter, and any written material must be translated into their first language.
The child's informed consent to all health care and treatment should be sought and recorded in a way appropriate to the child's age and understanding
The Placement Planning meeting which is held when a child is placed with you should clearly state what decisions you can make about everyday life.
This includes things like when a child wants to stay with a friend; use of social media and decisions around education. You can make a decision as any good parent would about whether this is safe and appropriate. All decisions to delegate authority should be recorded in the Placement Plan.
How this can help:
- Reduces delays in decisions being made;
- Reduces the emotional stress delays can cause to the child/young person;
- Reduces the stress to you;
- Acknowledges you as a professional and part of a team working with the child;
- Normalises the child/young person's experience of being in foster care;
- Better use of resources and people's time.
Delegated authorities should be monitored in case there is a need for change and discussed at the child's review or with the child's Social Worker if the decision needs to be taken quickly.
As a child increases in age, then their competence to take part in the decision making process will also increase, and should be taken into account.
The question of who may consent to examination or treatment of a child will be determined by:
- The age of a child;
- The competence of a child; and/or
- Who holds Parental Responsibility for a child.
Young people aged 16 and 17 are presumed to have the competence to give consent for themselves.
Children under 16 may also give or refuse consent depending on their capacity to understand the nature of the treatment - it is for the Doctor to decide this.
If a child of 16 or 17 is not competent to take a particular decision, then a person with Parental Responsibility can take that decision for them; although the child should be involved as much as possible.
For a child to have the competence to take a particular decision, they must be able to:
- Comprehend and retain information about the decision, especially the consequences of having or not having the intervention; and
- Use and weigh this information in the decision-making process.
It should never be assumed that a child with learning disabilities is not competent to take their own decisions. Many children will be competent if information is presented in an appropriate way and they are supported through the decision making process.
Some children under the age of 16 will be competent to give consent if they have sufficient understanding and intelligence to enable them to understand fully what is proposed (sometimes known as Gillick Competent). There is no specific age when a child becomes competent to consent to treatment: it depends both on the child and on the seriousness and complexity of the treatment being proposed.
If a child under 16 is competent to consent for themselves, it is still good practice to involve their family in decision making where possible.
Once a child reaches the age of 18, no-one else can take decisions on their behalf, because Parental Responsibility has ended.
The law says that the person who has care of the child (e.g. a foster carer) can do what is reasonable in all circumstances for the purpose of safeguarding and promoting the child's welfare. This means in an emergency if no agreement has been made about what to do, you should do what a reasonable parent would.
If a child is requiring urgent treatment, for example, following an incident or serious illness, and is unable or not old enough to give consent in their own right and parents are unable to be located, the Doctor will determine whether immediate treatment is required in the absence of any appropriate adult.
Where a child/young person requires an operation or any major treatment (as defined by medical personnel) then consent must be given immediately prior to the operation/treatment by a person with Parental Responsibility.
Where the Local Authority has Parental Responsibility for a child/young person, only the Head of Service (or Deputy Head of Service or Director) can give consent for an operation/planned major treatment.
Where the Head of Service (or Deputy Head of Service or Director) are required to give consent to an operation/planned major treatment, see the checklist of "Questions to Ask Health Professionals" which can be accessed via the 'Forms & Guidance' button.
The same principles which are used when seeking consent for the treatment of children's physical issues apply when children are suffering from mental health issues.
Wherever possible, a child should receive treatment for their mental health issues with their agreement.
Where the child's agreement cannot be gained, consideration must be given to the most appropriate legal framework to use. You should speak to your Supervising Social Worker and the child's Social Worker for advice.
An activity occurs whenever children leave their usual placement under the direct supervision of Social Care staff. It can also include organised activities which take place within the usual placement, such as foster carers undertaking organised activities with groups of fostered children.
At the point of coming into care, the parent/person with Parental Responsibility, will be asked to complete the "Parental Consent Form for Activities and Visits".
This will give delegated powers to you to consent to activities within the definition of "Low Risk" (see below).
Any activities which are classed as "Moderate Risk" (see below) will require a specific consent form to be signed by the parent/person with Parental Responsibility.
The Parental Consent Form for Activities and Visits for each child will need to be amended if a parent requests this at a later date.
The following definitions can be found in LEA Circular 146 (Code of Practice and Guidelines for Educational Excursions and Outdoor Adventurous Activities).
Low Risk
Where the risk of injury is slight and can be competently controlled by leaders who are used to supervising groups of young people but who may have no specialist outdoor activity skills or equipment. For such activities, leader qualifications are not required, e.g. drama workshop, nature trails, and visits to town, field sports and games.
Moderate Risk
Minor scratches, bruises, and apprehension are regarded as normal in the processes of growing and learning. Where activities require specialised leader competencies for their safe management, they are considered to incur "moderate risk". In general, field sports and games can be stopped at a moment's notice and the generated tension, competition or even risk eliminated. With canoeing, mountain walking or remote camping, the participants cannot be suddenly isolated from risk on the blow of a whistle. For this reason remote field work takes on a "moderate risk" commitment and should be considered as such. For all moderate risk activities, leader qualifications are required, e.g. mountain walking, sailing, abseiling, horse riding.
High Risk
Where a safe outcome is in doubt regardless of the competence of the participants or the leader, "high risk" is incurred. Such activities cannot be condoned or approved by Rotherham Metropolitan Borough Council.
There is no specific guidance regarding when a young person becomes able to consent to activities and trips in their own right.
If a young person is 18 years of age and above, then they are classed as an adult and can give their own consent, unless there is concern that they lack the capacity to do this. In this case, this policy will not apply.
For children aged 16 - 18 years old, a view has been taken that they are of sufficient age and understanding to give consent for "low risk" activities, unless concerns are raised to the contrary. "Medium risk" activities will still require parental consent as detailed above.
Children under the age of 16 years old will require the appropriate consent as detailed above.
There are different circumstances that might lead to a Looked After Child being away from their placement overnight.
This would be the case, for example, where a child is placed for respite. If a child is placed for over 24 hours, then this is classed as a foster placement, and the appropriate checks need to be carried out.
Organised overnight stays away from your home e.g. residential school trip should be classed as "medium risk" activities, and the appropriate parental consent should be sought.
Looked After Children should be supported to take part in a wide range of activities to promote their personal development, but there will be some children whose previous experiences are such that overnight stays would not be advisable. You should speak to the child's Social Worker if you are not sure.
There is no legal requirement for adults to be Police checked when Looked After Children stay overnight (unless this is for over 24 hours). However the Social Worker should:-
- Meet with the parents/carers and assess the suitability of the proposed stay;
- Gain agreement for SWIFT checks to be completed for all adults in the house.
If the proposed stay is to be a regular arrangement, Police checks must be completed for all adults in the house.
N.B. "All adults" refers to any member of the household aged 18 years and over.
Overnight stays away from the foster home, e.g. camping weekend will be covered by the Parental Consent Form for Activities and Trips, to be signed by parents when the child becomes looked after. If this is for longer than 2-3 nights and/or clashes with any contact arrangements, then the child's Social Worker will need to be informed in advance of the trip so that any necessary arrangements can be made.
If you are planning holidays during school term time, you should seek permission from Social Care in advance.
A three-way discussion must be held between you, the child's Social Worker, and class teacher, to assess the impact of missing education.
If it is felt that the impact of the missed education will be detrimental to the child/young person, then permission will not be given for the child/young person to be taken out during term time.
If it is felt that the wider educational value of a family holiday will outweigh the impact of the missed education, then permission will be given for the child/young person to be taken out during term time. The decision will take account of factors such as: the age of the child/young person, the number of days lost, and the timing of the holiday within the school year.
Where the discussion agrees for the child/young person to be taken out during term time, the meeting should also agree a written plan for any missed work to be covered on the child/young person's return from holiday.
Where appropriate, the views of the parent/person with Parental Responsibility should also be considered at the three way discussion.
If parental consent to activities is unreasonably withheld, then this should be discussed with the Service Manager at the point of the young person being accommodated, and a decision made as to whether legal advice needs to be taken.
Last Updated: August 23, 2024
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