Improving the Health of Looked After Children in Scotland: 2. The Views of Residential Care Workers on the Promotion of Health and Well-Being of the Children they Care For

A lack of communication between social and health care staff has been recognised as one of the main obstacles in meeting the health needs of this group. The previous study of the introduction of a specialist nursing service in the west of Scotland showed that the rates of documentation and information-sharing between health and social care staff remain low but that a specialist nursing service could improve this. This article explores the reasons for the poor rates of information sharing and documentation by interviewing residential care workers (RCWs) and so may offer an explanation of why a specialist nursing service could help. The first theme to emerge was the conflict RCWs face between their corporate parent and health improvement roles. The need to protect the child from distress and the importance of maintaining a relationship with the child were suggested as important reasons for not promoting health interventions. Others included a lack of financial, training and staffing resources. The second theme was the difficulties involved in using the BAAF health record. There was seen to be a duplication of documentation between residential unit, health and other records and there were numerous examples of a new record being used when a child moves instead of the previous record being re-opened. Stigma experienced by the child using the record and a lack of understanding among health care professionals were also cited as reasons for the record going unused. The last theme concerned the barriers within the health service for children in residential care. This particularly referred to the inflexibility of the appointments systems in both primary and secondary care.