Talking about Alcohol and Other Drugs : A Guide for Looked after Children's Services [1 ed.] 9781907969331, 9781904787785

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A guide for looked after children’s services As the use of alcohol and other drugs is increasingly part of youth culture, it is essential that young people and the professionals working with them understand the risks their misuse can cause to health and well-being. The challenge for corporate parents is to increase the protective factors for the young people in their care, while reducing the risk factors that can increase the chances of problems developing with drugs and alcohol. And it is clear that the young people involved in the Drug Education for Children in Public Care Project, which led to this guide value their carers and look to them to provide the help and support they need with alcohol and drugs. This guide will provide you with practical help to develop or review your drug education policy and practice, and the management of drug incidents and includes: ■ why looked after children need alcohol and drug education ■ a summary of national policies to support drug education ■ a definition of drug education and a summary of the evidence base ■ a process for developing local policies for looked after children’s services on alcohol and drug education and support ■ guidance on positive practice ■ resources and sources of support for work on alcohol and other drugs.

Talking About Alcohol and Other Drugs A guide for looked after children’s services

Talking About Alcohol and Other Drugs

Talking About Alcohol and Other Drugs: A guide for looked after children’s services is essential reading for managers of looked after children’s services, training managers, managers of children and young people’s residential homes and social workers.

tel: + 44 (0)20 7843 6000 fax: + 44 (0)20 7278 9512

Useful numbers Membership and general enquiries: 020 7843 6080 Conferences and Training: 020 7843 6441 Young NCB: 020 7843 6099 Book Sales: 020 7843 6029 Library and Information Service: 020 7843 6008 Visit our website at: www.ncb.org.uk

Mary Ryan and Jo Butcher

National Children’s Bureau 8 Wakley Street London EC1V 7QE

Talking About Alcohol and Other Drugs A guide for looked after children’s services Mary Ryan and Jo Butcher

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Talking About Alcohol and Other Drugs A guide for looked after children’s services Mary Ryan and Jo Butcher

NCB promotes the voices, interests and well-being of all children and young people across every aspect of their lives. As an umbrella body for the children’s sector in England and Northern Ireland, we provide essential information on policy, research and best practice for our members and other partners. NCB aims to: ■ challenge disadvantage in childhood ■ work with children and young people to ensure they are involved in all matters that affect their lives ■ promote multidisciplinary cross-agency partnerships and good practice ■ influence government policy through policy development and advocacy ■ undertake high quality research and work from an evidence-based perspective ■ disseminate information to all those working with children and young people, and to children and young people themselves. NCB has adopted and works within the UN Convention on the Rights of the Child.

Published by the National Children’s Bureau National Children’s Bureau, 8 Wakley Street, London EC1V 7QE Tel: 020 7843 6000 Website: www.ncb.org.uk Registered charity number: 258825 NCB works in partnership with Children in Scotland (www.childreninscotland.org.uk) and Children in Wales (www.childreninwales.org.uk). © National Children’s Bureau 2006 ISBN 1 904787 78 9 Ebook ISBN 978-1-907969-33-1 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any person without the written permission of the publisher The views expressed in this book are those of the authors and not necessarily those of the National Children’s Bureau

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Contents

List of tables List of case studies Acknowledgements Terminology Foreword

v vii ix xi xiii

1 Introduction

1

2 Alcohol and other drugs and looked after children and young people

3

3 National policy, guidance and other initiatives

11

4 Alcohol and drug education

19

5 Developing local policy

27

6 Practice issues, support and training for carers

37

Appendix 1 A framework for a local policy on alcohol and other drug education and support for looked after children’s services Appendix 2 Organisations, websites and helplines providing information Appendix 3 Local sources of information and support

57 63 67

References

71

Index

77

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Tables

1 Risk and protective factors associated with drug misuse

10

2 The National Curriculum and drug education in schools

21

3 Key principles for alcohol and drug education for looked after children and young people

24

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Case studies

1 Nottinghamshire – The Children and Young People Substance Use Policy

30

2 Hounslow

33

3 A leaving care group in Chesterfield

41

4 Torbay Youth Service

45

5 Ealing Safe Cannabis Group

48

6 Matrix Young People’s Service, South Tyneside

51

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Acknowledgements

This guide has been written by Mary Ryan, Independent Consultant, with support from Jo Butcher at the National Children’s Bureau. Particular thanks to Simon Blake and Helen Chambers for their contribution to the development of this guide, and to Tracey Anderson and Hanneke Koekkoek for administrative support. We would like to thank the following people for their contribution to the project and/or the development of this publication. Mary Bound Claire Bowler Jacqui Bush Simone Common Louise Crompton Barbara Curran Natalie Fishwick Gillian Hardacre Di Hart Nicola Madge Paul Matthews Jenny McWhirter Anne Rathbone Ross Sweeney Hayley Tooley Anne Trout Jill Varndell Jane Wright

North Chesterfield Royal Hospital Foundation Trust Newark Sherwood PCT Foster carer Sunderland Social Services Formerly Coordinator of the National Drug Education Forum Foster carer Southwark Social Services Torbay Youth Service National Children’s Bureau National Children’s Bureau Independent consultant DrugScope Independent consultant Ealing Social Services Matrix Young People’s Service, South Tyneside Nottinghamshire County Schools Independent consultant Hounslow Social Services

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x Talking About Alcohol and Other Drugs

And many thanks to the staff, carers and young people who participated in the consultation activities carried out as part of the Drug Education for Children in Public Care Project. The Drug Education for Children in Public Care Project (DEPC) that led to this publication was funded by the Department of Health. The project worked with four local authorities in England: Brighton and Hove, Cornwall, Sunderland and Tower Hamlets, to explore with foster carers and residential care staff, looked after children and young people, and managers of services how best to provide drug education and support that meets the needs of looked after children and young people. In addition, a national consultation seminar was held and a literature review ‘Substance misuse and children in care’ (Howell 2004) undertaken. The ideas and views throughout this guide from young people and carers were collected in consultations carried out as part of the DEPC project.

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Terminology

Throughout this guide the following terms are used as follows. ‘Manager’ is used for senior managers of looked after children’s services, managers of children and young people’s residential homes and those with line-management responsibility for social workers and other carers. ‘Carer’ is used for residential social workers and other carers in children’s and young people’s residential homes, and for foster carers. ‘Alcohol and other drugs’ is used because alcohol use and misuse is increasing among young people and is often linked to other drug use. In our culture we forget that alcohol is a drug and perhaps the most significant one for young people, playing a bigger role in the culture of many young people’s lives. Young people who participated in the Drug Education in Public Care project thought that education about alcohol was important as alcohol is socially acceptable, freely available and something they will have to learn to deal with as they grow up. ‘Other drugs’ includes: ■ tobacco ■ volatile substances (e.g. solvents, including gases, lighter and other

fuel) ■ illegal drugs including cannabis ■ some plants and fungi (e.g. magic mushrooms) ■ over-the-counter and prescribed medicines that are used for recreational purposes rather than medical reasons.

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Foreword

I am delighted to welcome you to Talking about Alcohol and Other Drugs: A guide for looked after children’s services. Most people who are concerned with the health and well-being of children and young people are aware of the many factors which can increase the chances of a young person developing problems with drugs. You will also be only too aware that young people in public care experience many of these risk factors. The challenge for all parents, and especially the corporate parent, is to reduce the impact of these risk factors and increase the protective factors. Greater stability in housing, achieving well at school, clear boundaries and rules for behaviour, and feeling valued by at least one adult in the community all help to protect young people from developing problems with drugs. When thinking about young people and drug use it is important to remember that most young people do not use illegal drugs. Young people who are in public care may be more at risk of developing problems with drugs, but the document includes some key messages from young people for all those concerned with their care. ■ Asking about drugs, using a drug once or admitting you have tried

something doesn’t mean you have a drug problem. ■ Taking drugs is a personal choice for young people whether they are

looked after or not. ■ Treatment and support is really important and even though young

people may not welcome it at the time, they do value the support.

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xiv Talking About Alcohol and Other Drugs

If you are a manager of looked after children’s services, a training manager or a manager of children and young people’s residential homes, this resource will provide you with practical help to develop or review drug education policy and practice and the management of drug incidents. You will also find a wealth of up-to-date and comprehensive references to source material from a wide range of agencies concerned with alcohol and drug use by young people. If you are a carer or someone working with young people in residential settings, you will also find support for your work with young people. Although some carers lack confidence in their ability to help young people with drug issues, the young people involved in this project were clear that they value their carers and look to them to provide the kind of help and support they need with alcohol and drugs. As you read on, you will see that the key to success in promoting the health of young people in public care is in the title of this document. There is growing evidence that being a ‘good parent’ means being able to talk with young people. This applies at least as much if not more to the corporate parent as any other, so my wish is that this document encourages you to keep talking and keep listening! Jenny McWhirter Chair, Drug Education Forum

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1 Introduction

About this guide This guide is for managers of looked after children’s services, training managers, managers of children and young people’s residential homes and social workers. It identifies how services can develop alcohol and drug education and support and seeks to help looked after children’s services meet the needs of children and young people in their care in relation to alcohol and drug education and support. It offers: ■ a summary of why looked after children need alcohol and drug

■ ■ ■ ■ ■

education that covers tobacco, alcohol, volatile substances and other drugs a summary of national policies to support drug education a definition of drug education and a summary of the evidence base a process for developing local policies for looked after children’s services on alcohol and drug education and support guidance on positive practice resources and sources of support for work on alcohol and other drugs.

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2 Talking About Alcohol and Other Drugs

Alcohol and other drugs are important issues Alcohol and other drugs are part of everyday life for all of us in some way – whether it is medicines that have been prescribed for an illness, over-the-counter remedies, advertising about medicines or alcohol, or our views on smoking – and that is without considering illegal drugs and other substances. Children and young people are growing up in a world where alcohol and other drugs are easily available, often glamorised in the media and there are many different messages about their use. The use of alcohol and other drugs is becoming increasingly part of youth culture; some children and young people will use illegal drugs, alcohol or tobacco as they move from puberty through to adolescence and early adulthood but the majority will not. Parents, carers and professionals are often most concerned about the misuse of alcohol and other drugs by young people and how to prevent this. They know that their easy availability is a fact of life for young people and so all young people need to be able to deal with the potential risks to their health and well-being that the misuse of alcohol and other drugs can cause. Providers of care for looked after children have a duty to ensure that the alcohol- and drug-related needs of the children and young people in their care are adequately assessed and met.

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2 Alcohol and other drugs and looked after children and young people

The Department for Education and Skills document Drugs: Guidance for schools (DfES 2004) notes that: ■ Most young people of school age have never used an illegal drug but

many will try tobacco or alcohol. ■ Very few of those who try illegal drugs will go on to become regular

users. ■ All young people are likely to be exposed to the effects and

influences of drugs in the wider community including opportunities to try legal and illegal drugs. All children and young people live in a world where alcohol and other drugs are easily available, and where alcohol and sometimes illegal drugs are acceptable and may be used for many different reasons. Alcohol and other drugs are one issue among many others that young people are dealing with, such as relationships and sexuality, friendships, finding their place in the world and becoming independent, as well as education and work. There is evidence that alcohol and drug use is often linked with other risk-taking behaviour, such as unsafe sex (Lynch and Blake 2004a). Traditionally associated with adulthood, the use of alcohol and other drugs may now be seen as more a marker of youth, as traditional markers of adulthood, such as economic independence, become less obtainable until later in life (Thomas and Holland 1998).

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4 Talking About Alcohol and Other Drugs

SOME FACTS ABOUT YOUNG PEOPLE, ALCOHOL AND OTHER DRUGS

Of young people in the age group 11 to 15, 18 per cent have taken drugs in the last year (Fuller 2005); this is a decrease from 21 per cent the previous year. Cannabis is the most common drug used by young people (Boreham and McManus 2003). Fuller found that 26 per cent of 15-year-olds had taken cannabis in the last year (2005). Among 16- to 24-year-olds, 46 per cent have used one or more illicit drugs and 27 per cent had used one or more illicit drugs in the last year; and cannabis was the drug most likely to be used. (Chivite-Matthews and others 2005). Young people excluded from school are much more likely to use alcohol and other drugs including tobacco (MORI 2004). The proportion of 11- to 15-year-olds who do not drink at all has remained at 40 per cent since 1988 (Alcohol Concern 2004). However, the numbers of those who do drink is increasing: the number of 11- to 15-year-olds that had drunk alcohol in the last week rose from 18 per cent in 2002 (Boreham and McManus 2003) to 23 per cent in 2004 (Fuller 2005). Young people who do drink are drinking larger amounts of alcohol (Boreham and McManus 2003) and binge drinking is becoming more common (Hibell and others 2000). Nine per cent of young people aged 11 to 15 are regular smokers (Fuller 2005); 22 per cent of all 15-year-olds are regular smokers; and smoking is more prevalent among girls (Department of Health 2004). Deliberate inhalation of volatile substances is responsible for more deaths in young people aged 10 to 16 in England and Wales than illegal drugs (Department of Health 2004).

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Alcohol and other drugs and looked after children and young people 5

There is growing concern and research evidence that some looked after children and young people are using alcohol and other drugs more than their peers who are not in care. They are starting at an earlier age and are at greater risk of this continuing into adulthood and affecting their future health and well-being. A small number of looked after young people will go on to have serious substance misuse problems in their adult lives. A summary of research findings on looked after young people and alcohol and other drugs can be found in the Healthy Care Briefing: Substance misuse (NCB 2005a). It can be accessed at: www.ncb.org.uk/healthycare The consultations undertaken as part of the Drug Education for Children in Public Care Project (DEPC) highlighted that carers and looked after children and young people want to address the use of alcohol and other drugs and want help and support from managers to do this. … you don’t realise how easy it is to get hold of any drug. Young woman aged 15 People get so hung up about drugs but smoking and drinking are often much worse and they are so much more acceptable and accessible. Foster carer Drugs and alcohol are bigger problems for fostered children and young people because they are more vulnerable and don’t have as much support as other young people, you need to be very sensitive to issues like bullying and peer pressure. Foster carer

Why some looked after young people use alcohol and drugs Young people thought that sometimes looked after young people were using alcohol or other drugs as a way of coping with the many difficulties in their lives. They thought drug and alcohol use could be a symptom of unhappiness and distress rather than the cause of it. For example, they cited moving into a residential unit or a change in a

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placement as very stressful and so, for some, a time when alcohol or other drugs were more likely to be used. When you are in a residential home you are more anxious and upset, especially if you have just had to go there because of something bad at home or your placement. If you are with a foster carer it’s not so bad. Young person Young people do drugs for other reasons than to be cool, there can be problems at home and in their life and even school. People should help young drug users by finding out what their other problems are. Young woman aged 14 This view of young people using drugs to cope with difficulties in their lives is also supported by analysis of calls to ChildLine about volatile substance misuse, as a significant number of children and young people calling were looked after and were using volatile substances as a way of trying to deal with severe emotional pain and, in some cases, to harm themselves deliberately (Blake 2005). I’ve already been in nine families this year. It hasn’t been easy for them, me sniffing solvents and cutting myself. They get embarrassed that my dad’s in a psychiatric hospital. I want to make my own life but I can’t see how. Young woman aged 15 (call to ChildLine quoted in Blake 2005) In my last children’s home I was taking heavy stuff, pills, speed as well as aerosols. I don’t like it in my new children’s home. I feel so alone, there’s nowhere to go out. I can’t get anything else so I just take gas. When I don’t take it I get headaches. I want to get off the aerosols cos I’m worried about my health. Young woman aged 16 (call to ChildLine quoted in Blake 2005)

Parents and carers who misuse alcohol and other drugs Many children and young people come into care because their parents or carers are misusing alcohol and other drugs and so are unable to care for them. These children and young people may have different

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Alcohol and other drugs and looked after children and young people 7

needs from other looked after children. They may already have significant knowledge about alcohol and drugs: they may be very anti alcohol or drugs because they have seen the damage it has caused; or they may view alcohol and drug misuse as a normal part of life, including using alcohol and drugs themselves. The Advisory Council on the Misuse of Drugs’ inquiry into parental substance misuse, published as Hidden Harm (2003), examined the immediate and long-term implications of parental drug misuse and made policy and practice recommendations for service providers. Research undertaken for the inquiry indicated that parental alcohol or drug misuse featured in about a quarter of cases of children on child protection registers. Other research has suggested that children and young people of substance misusing parents may view their parents’ misuse as ‘normal’ (Ward and others 2003; Newburn and Pearson 2002) and that children and young people of opiate substance-misusing parents may be using cannabis more than their peers but do not regard it as a drug (FRANK 2004). My life was surrounded by drugs and so I got into drugs and at first it was helping with the emotional problems in my life at that time. Also my family is well known for their drug use and them selling drugs to other users was a normal part of life and that would include all types of drugs. Young woman aged 14

Vulnerability, risk and protection It is important to remember that not all looked after children and young people will use alcohol or drugs or develop problems with them. Looked after children and young people repeatedly said that they do not wish to be labelled as having alcohol or drug problems just because they are looked after. However, many looked after children and young people have had traumatic childhoods, experienced neglect and abuse, and may have already been exposed to alcohol and drug misuse. This means some may be especially vulnerable to developing problems with alcohol and other drugs as they grow up and into adulthood.

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Research has identified a range of risks and protective factors associated with drug misuse. It must be noted that exposure to risk factors does not predict a young person’s future drug taking; just as experience of one or more protective factors cannot guarantee there will be no drug misuse in the future. The risk factors can help to identify young people who may be susceptible to using drugs for comfort and escape from distress rather than the recreational use more commonly associated with young people’s drug use. Corporate parents and managers of looked after children’s services will be only too aware of these factors. They will be keen to enhance any possible protective influences and reduce risk factors through stable care placements; effective care planning; and healthy care practices, including appropriate support and training for foster carers and residential staff (see Table 1, page 10).

Emotional health and well-being Recent work by NCB highlights the complexity of children and young people’s lives – and the range of personal, social and emotional experiences and difficulties that they may face which provide a context for risk-taking and other behaviours (Lynch and Blake 2004a and 2004b). NCB’s work with children and young people in a range of settings, including public care and secure units, highlights the significant impact of poor emotional health and well-being on their lives. Emotional health and well-being – ‘the subjective capacity and state of mind that supports us to feel good about who we are and confident to deal with present and future circumstances’ – is influenced by our emotional development and how resilient and resourceful we feel ourselves to be (Bird and Gerlach 2005). The Department for Education and Skills has issued guidance for schools (DfES 2003) on developing children’s social and emotional behavioural skills. Although targeted at schools much of this guidance is transferable to other settings. It identifies a range of social and emotional behavioural skills that contribute towards children’s emotional health and well-being, which are: ■ being an effective and successful learner ■ making and sustaining friendships ■ dealing with and resolving conflict effectively and fairly

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Alcohol and other drugs and looked after children and young people 9

■ ■ ■ ■ ■ ■ ■

being able to solve problems with others and alone managing strong feelings such as frustration, anger and anxiety recovering from setbacks and persisting in the face of difficulties working and playing cooperatively competing fairly and losing with dignity and respect for competitors recognising and standing up for your rights and the rights of others understanding and valuing the differences between people, and respecting the right of others to have beliefs and values different from your own.

Young people in care need opportunities, experiences and relationships to enable them to build and strengthen their emotional health and wellbeing (see NCB 2005b Healthy Care Briefing: Mental health www.ncb.org.uk/healthycare). Education about alcohol and other drugs can help support children and young people’s emotional and social development by providing them with a safe environment in which to explore feelings and relationships and the impact of their choices in relation to drugs, sexual health and other ‘risky’ activities. It also provides opportunities to explore activities that can help them feel good about themselves and others; and helps them to recognise, care about and take responsibility for their own and others’ behaviour. The process of this education is as important as the content. All children and young people need a safe and supportive environment with clear boundaries, where they are able to learn, achieve, have fun and participate at their own level, and be given appropriate encouragement and praise.

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Table 1 Risk and protective factors associated with drug misuse Risk factors ■ chaotic home environment ■ parents who misuse drugs or suffer from mental illness ■ behavioural problems ■ lack of parental nurturing ■ inappropriate and/or aggressive classroom behaviour ■ school failure ■ poor coping skills ■ low commitment to school ■ friendship with peers involved in negative behaviours such as crime, problem alcohol or drug use ■ low socioeconomic status ■ early age of first drug use ■ being labelled a drug user Protective factors strong family bonds ■ experiences of strong parental monitoring with clear family rules ■ family involvement in the lives of children ■ successful school experiences ■ strong bonds with local community activities ■ a caring relationship with a least one adult ■

How to help develop protective factors help young people to develop supportive and safe relationships ■ insist on regular school attendance ■ provide young people with strategies to cope well with the academic and social demands of school ■ encourage strong and supportive social networks ■ promote the development of good social skills ■ ensure young people acquire a good knowledge of legal and illegal drugs, their effects and risks ■ ensure young people acquire a good knowledge of general health and how to maintain their mental health ■ provide access to help and information ■ delay involvement with legal drugs ■

Source: Adapted from: The Right Responses – Managing and making policy for drug-related incidents in schools (DrugScope 1999) and Drug Misuse: Risk and protective factors (Drug Education Forum 2005) and also quoted in Drugs: Guidance for schools (DfES 2004).

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3 National policy, guidance and other initiatives

This section highlights national policy and guidance that is relevant to the provision of drug and alcohol education and support with particular reference to looked after children and young people. National policy requires that children and young people receive education and support about alcohol and other drugs; this must be provided by education, health, social care and children’s services. In addition, national policy and government guidance also identifies looked after children and young people as a group who are particularly vulnerable and therefore should receive targeted education and support on a range of issues.

The Children Act 2004 This requires all professionals to work towards achieving the following five outcomes for children and young people: ■ ■ ■ ■ ■

be healthy stay safe enjoy and achieve make a positive contribution achieve economic well-being.

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Choosing not to take illegal drugs is a key aim of the ‘Be healthy’ outcome, but drug education and support have a part to play in contributing to the achievement of all outcomes and in safeguarding children and young people. The Children Act 2004 is the legislative framework for the delivery of: Every Child Matters (HM Treasury 2003) and Youth Matters (DfES 2005), the volatile substance abuse framework (Department of Health and others 2005) and the Alcohol Harm Reduction Strategy for England (Prime Minister’s Strategy Unit 2004). It sets out a broad agenda for improving the life chances of all children and young people; and sets the context for specific work on alcohol and other drugs as set out in the National Drug Strategy, and Choosing Health (Department of Health 2004). The Department for Education and Skills, the Home Office and the Department of Health have agreed a joint approach to the development of universal, targeted and specialist services to prevent harm from alcohol and other drugs and to ensure all children and young people are able to achieve their potential. The joint approach and the actions required at local level are described in Every Child Matters: Change for children – young people and drugs (HM Government 2005) and can be accessed at: www.everychildmatters.gov.uk/publications The approach has three main objectives: ■ Reforming delivery and strengthening accountability so that there are

closer links between the Updated National Drug Strategy and the Every Child Matters: Change for Children programme locally, regionally and nationally. ■ Ensuring provision is built around the needs of vulnerable children and young people, with more focus on prevention and early intervention for those most at risk; and with drug misuse considered a part of assessments, care planning and intervention by all agencies providing services for children, including schools. ■ Building service and workforce capacity, i.e. developing universal, targeted and specialist provision to meet local needs and ensure delivery of the workforce training required to support it. It specifically refers to targeted interventions for looked after children and young people:

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National policy, guidance and other initiatives 13

It is vital that looked after children with substance misuse problems are identified early through their health assessment, looked after children reviews and care planning processes, and receive support and appropriate interventions as a result. The joint approach is being implemented nationally. All local authorities in England and their partners are expected to make significant progress towards meeting its objectives from April 2005, with more rapid and sustained progress in a number of High Focus Areas. It is hoped that the High Focus Areas will identify effective practice that can be shared across the country.

Every Child Matters also focuses on building the capacity of the workforce and includes a ‘common core of skills and knowledge’ for all those working within the children’s workforce. These skills and knowledge will contribute to providing effective alcohol and other drug education and support to all children and young people. More information about the common core can be found at www.dfes.gov.uk/commoncore and at www.everychildmatters.gov.uk

National drugs strategy The government’s strategy for tackling drug misuse in England was updated in 2002 (Home Office 2002). Drug Action Teams (DATs) are the strategic bodies responsible for coordinating the local drug strategy (they are sometimes called Drug and Alcohol Teams to reflect work around alcohol or Community Safety Teams as some have merged with Crime and Disorder Reduction Partnerships). From 2005/06, DATs and children’s services are expected to work closely together to prevent substance misuse by children and young people as part of a holistic multi-agency approach. This should include jointly agreeing local priorities and targets for the development and operation of responses to children and young people’s drug use. These should be included in the Children and Young People’s Plan due to be produced in April 2006 and in Drug Action Team annual plans. More information about the updated National Drug Strategy can be found at: www.drugs.gov.uk and select ‘Drug strategy’.

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Children, Young People and Volatile Substance Abuse (VSA): A framework for VSA The Department of Health, in partnership with the Home Office and DfES, has developed a framework, published as Out of Sight?…not out of mind (Department of Health and others 2005), for addressing volatile substance abuse (VSA). It outlines key recommendations to be taken forward in partnership with stakeholders at local, regional and national level. These have been informed by the best available evidence about what works in reducing deaths and harm from VSA. Looked after children and young people are identified as a group who are vulnerable to VSA. Action is required to provide effective education on VSA to all children and young people, including the most disadvantaged, and to provide effective targeted interventions for children and young people abusing or at risk of abusing volatile substances.

The National Service Framework for Children, Young People and Maternity Services This NSF aims to improve the lives and health of children and young people by setting standards for the first time for children’s health and social care, which promote high quality, women and child-centred services and personalised care that meets the needs of parents, children and their families. It is a ten-year strategy which is part of the wider Change for Children programme and a delivery strategy has been published to assist implementation. Information and services are offered to prevent risk-taking and to promote healthy lifestyles in children and young people, covering key areas such as … preventing or reducing use of tobacco, alcohol, volatile substances and other drugs. The National Service Framework for Children, Young People and Maternity Services (Department of Health and Department for Education and Skills 2004)

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National policy, guidance and other initiatives 15

Standard 4 states: ‘All young people have access to age-appropriate services which are responsive to their specific needs as they grow into adulthood.’ Standard 4 notes in more detail that: ■ Health promotion for young people is targeted to meet their needs

and, in particular, to reduce teenage pregnancy; smoking, substance misuse, sexually transmitted infections and suicide. Young people are actively involved in planning and implementing health promotion services and initiatives. ■ Additional support is available for looked after children leaving care

and other young people in special circumstances.

Choosing Health: Making healthy choices easier Choosing Health: Making healthy choices easier (Department of Health 2004), the White Paper on public health, outlines a range of measures to improve public health and identifies alcohol and drug misuse and smoking as key issues to be tackled. Children and young people must be supported to develop healthy lifestyles and to understand and manage risks and to build up self-esteem and other coping strategies.

Youth Matters The consultation document Youth Matters (DfES 2005) sets out the government’s proposals for providing opportunities, challenge and support to young people. The proposals focus on four key policy areas, how to: ■ engage more young people in positive activities ■ encourage more young people to volunteer and become active in

their communities ■ provide better information, advice and guidance to young people to

help them make informed choices about their lives

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■ provide better and more personalised intensive support to young

people who have serious problems or get into trouble. One proposal is for national standards about access to, and availability of, a range of activities for young people, and safe places and enjoyable places to spend time. Another proposal would require children’s trusts to take account of young people who may face barriers to participating in activities when planning and commissioning activities – it is likely that looked after young people would be one group who face such barriers. This consultation document will be followed by a White Paper in due course.

Healthy Care Programme The Healthy Care Programme aims to make sure that looked after children and young people are cared for in a healthy environment and that their physical and mental health and well-being is protected and promoted – this includes alcohol and other drug education and support. It provides a multi-agency framework to improve the health of looked after children and young people in England. It was developed to help implement the Department of Health guidance Promoting the Health of Looked After Children (2002b) and other relevant Public Service Agreements and Targets and includes the National Healthy Care Standard. More information about the Healthy Care Programme and how some looked after children’s services have provided alcohol and other drug education and support can be found: ■ in the Healthy Care Briefing: Substance misuse (NCB 2005a) that

can be accessed at www.ncb.org.uk/healthycare ■ in the Healthy Care Programme Handbook (DfES, Department of

Culture, Media and Sport, DH, and NCB 2005a) ■ in the Healthy Care Training Manual for foster carers and residential

social workers (DfES, Department of Culture, Media and Sport, DH, and NCB 2005b).

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National policy, guidance and other initiatives 17

Promoting the Health of Looked After Children Guidance from the Department of Health states that: All children and young people are entitled to drug education and support. Promoting the Health of Looked After Children (Department of Health 2002b) And, in the Children’s Homes National Minimum Standards (Department of Health 2002a): ■ Standard 12.4 states that: ‘Each child is to be provided with

guidance, advice and support in relation to social issues including alcohol and illegal substance abuse, smoking and solvents’ ■ Standard 12.5 states that there should be a policy and written guidance, implemented in practice, on promoting the health of children in the home including the effects of alcohol, smoking and other substances ■ Standard 12.6 states that children should be actively discouraged from smoking, alcohol and illegal substance abuse.

Local Authority Outcome Indicator Returns From October 2005 local authorities should include information related to substance misuse among looked after children and young people in their outcome indicator returns to the Department for Education and Skills. This information is likely to be collected mainly from annual health assessments for looked after children and subsequent health plans. The information to be included on the outcome return is: 1. The number of all children looked after for at least 12 months who were identified as having a substance misuse problem during the year ending 30 September. 2. The number of these children who received an intervention for their substance misuse problem during the year. 3. The number of these children who were offered an intervention but who refused it. Guidance notes on this new outcome indicator and a screening tool that is used by one local authority (Drug Use Screening Tool by Kent Drug

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Action Team) are available at: http://www.dfes.gov.uk/datastats1/ guidelines/children/returns.shtml (scroll down the page to OC2).

Drug Education: Guidance for schools There is a statutory requirement for schools to provide drug education for all children in all primary, secondary, special schools and pupil referral units. The Department for Education and Skills guidance Drugs: Guidance for schools (DfES 2004) identifies what should be taught at each key stage in the curriculum programmes of study for science (summarised in Table 2 on page 21); and covers the development of school drugs policies, managing drugs within the school community and responding to drug incidents. In addition there is an expectation that schools will use the non-statutory framework for personal, social and health education (PSHE) (and Citizenship at key stages 1 and 2) alongside the national curriculum. The Qualifications and Curriculum Authority published guidance for schools on alcohol and other drug education called Drug, Alcohol and Tobacco Education: Curriculum guidance for schools at key stages 1–4 (QCA 2002).

National Healthy Schools Programme The National Healthy Schools Programme is an initiative to support the development of healthy schools through local education and health partnerships, known locally as healthy schools programmes. The standard provides an accreditation process for these local programmes. The National Healthy Schools Programme identifies drug education as one of its eight themes and sets minimum criteria for schools to measure their achievement, including a requirement to address inequalities and inclusion, which is clearly relevant to looked after children. It has also set out some principles for drug education, which are consistent with national policy and recommendations. This is described in the National Healthy School Standard Drug Education (including alcohol and tobacco) (DfES and others 2003) and includes examples of practice from around the country. It builds on and complements the Qualifications and Curriculum Authority guidance for schools on drug and alcohol education (QCA 2002). More information about the National Healthy Schools Programme can be found at www.wiredforhealth.gov.uk

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4 Alcohol and drug education

Feedback from children and young people indicates that they want honest and credible information on drugs, including alcohol, tobacco, solvents and volatile substances, prescribed and non-prescribed medication and illegal drugs. They want opportunities to increase their knowledge and understanding and develop the skills they need to access support and cope with situations that they may face in the future. Promoting the Health of Looked After Children (Department of Health 2002b) This section draws together evidence from research and practice, alongside the views of looked after children and young people, their parents and carers and those who work with them, which were collected through the Drug Education in Public Care project.

Evidence for effective practice Drug and alcohol education may take place in many settings. Often informal settings such as youth clubs, or out-of-school activities, sports and leisure activities, can provide opportunities for children and young people to learn about alcohol and other drugs, how to take responsibility for themselves, and how to keep themselves healthy and safe. Equally, a home environment or residential setting will provide informal opportunities to support children and young people to learn about the world around them – including drugs and alcohol and other risks – as they grow up. Although drug and alcohol education in school is very important, it is not the only place where it should take place.

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WHAT IS DRUG EDUCATION?

Opportunities for children and young people to learn about alcohol and other drugs, and to build emotional resilience and well-being, will include: ■ acquiring information about alcohol and other drugs including their

effects, risks and consequences, why people use them, and sources of help and advice ■ exploring attitudes and values towards alcohol and other drugs and people who use alcohol and drugs ■ developing personal and social skills so they are able to communicate effectively, recognise choices, identify and manage risk, make decisions, resist negative peer influence and access help when needed ■ building awareness, and understanding, of their feelings and emotions and the impact of these on alcohol and other drug use (and vice versa). Source: Adapted from: Drug Education (including alcohol and tobacco) (2003) Department for Education and Skills, Department of Health and Health Development Agency; and Drugs: Guidance for schools (2004) Department for Education and Skills.

Drug and alcohol education at school Drug and alcohol education is provided in primary and secondary schools. The National Curriculum identifies what all children and young people should be taught. The teaching takes place within personal, social and health education (PSHE) and should cover the development of knowledge, attitudes and skills, and make links with other issues that affect young people’s lives. This is summarised in Table 2 on page 21. However many looked after children and young people will not receive this entitlement, often because of gaps in education and/or moves to different schools. This, combined with their increased vulnerability to substance misuse, makes it crucial that these learning opportunities are

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Table 2 The National Curriculum and drug education in schools Drug education in primary schools At Key Stage 1 (ages 5–7): being safe with medicines and household substances, basic skills for making healthy choices and following safety rules. At Key Stage 2 (ages 7–11): the effects and risks of alcohol, tobacco, volatile substances and illegal drugs; basic skills to manage risky situations; how to make informed choices about their health; how to resist pressure to do wrong; and how to take more responsibility for their actions. Drug education in secondary schools At Key Stage 3 (ages 11–14): the effects and risks of drugs and the laws relating to drugs; skills to recognise and manage risk and to resist pressures; skills to make choices for a healthy lifestyle; and knowledge of where to go for help and advice. At Key Stage 4 (ages 14–16): build on knowledge and learn more about the effects of drug misuse on family, friends, community and society; gain greater understanding through clarifying their opinions and attitudes in discussions and debate and considering the consequences of their decisions. Drug education for pupils with special educational needs (SEN) Pupils with SEN within all educational settings should receive their entitlement to drug education. Teachers may need to focus more on developing pupils’ confidence and skills to manage situations that require making decisions about drugs. This may include developing competence to manage medicines responsibly, staying safe and understanding and managing feelings. Source: Drugs: Guidance for schools (2004) Department for Education and Skills.

provided outside of school. The National Curriculum requirements provide a useful guide as to what should be taught and when.

What works in drug and alcohol education? The best available evidence offers positive guidance on different aspects of drug and alcohol education. The Health Development Agency’s summary of findings, entitled Evidence for Effective Drug Prevention in Young People (Millward and others 2004), highlighted some of the key evidence, including the following:

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■ Intensive life-skills programmes may provide at-risk groups, such as

looked after young people, with the resources to avoid or delay substance use, and help to develop protective attitudes (for example, a positive attitude towards school) (Millward and others 2004). ■ Effective school-based programmes tend to be intensive with a lot of

curriculum time (Canning and others 2003). ■ Effective drug-education programmes include booster sessions

(Canning and others 2003). ■ Universal programmes, such as those delivered in schools to young

people, seem to have some effect in delaying the start of drug use for non-users and temporarily reducing use by some current users (Canning and others 2003). ■ Drug education programmes delivered to all young people (for

example in schools) are more effective for lower risk young people and less effective for higher risk young people. Higher risk young people need more targeted interventions (Millward and others 2004). ■ Young people who are involved in several risky behaviours need

interventions that focus on the whole person and not just one or two issues (Millward and others 2004). ■ In peer-led interventions, the child or young person delivering the

programme tends to benefit most from the experience (Parkin and McKeganey 2000). Source: Evidence for effective drug prevention in young people (Millward and others 2004). A five-year government funded study (Blueprint) is underway to examine the effectiveness of a school-based drug education programme, for 11- to 13-year-olds, based on the principles that underpin effective drug education. It is due to report in 2007.

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The views of young people about their alcohol and drug education .

Key messages from looked after young people about alcohol and drugs ■ Not all looked after young people use drugs or have problems with

drugs. ■ Asking about drugs, using a drug once or admitting you have tried

something doesn’t mean you have a drug problem. ■ Taking drugs is a personal choice for young people whether they are

looked after or not. ■ Treatment and support is really important and even though young

people may not welcome it at the time, they do value the support.

What looked after young people think about alcohol and drugs education ■ It should start at an early age (primary school was thought to be

about right) as otherwise children are learning from each other, on the street or from other drug users and consequently may not get the right information. ■ Don’t wait until there is an alcohol- or drug-related problem before

you talk about it. ■ Give clear factual information and be honest about the pros and

cons of using alcohol and other drugs. ■ Education should be about all the important issues a young person

has to face as they grow up. Young people need help and information on other topics like sexual health, making friends, dealing with feelings, moving to new placements/schools, coping with the reasons why they have come into care, and so on.

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Table 3 Key principles for alcohol and drug education for looked after children and young people The following principles, based on national policy and learning from good practice, have proven valuable in developing and delivering work on alcohol and other drugs. This is adapted from National Healthy School Standard Drug Education (including alcohol and tobacco) (Butcher 2003) and Healthy Care Briefing: Substance misuse (National Children’s Bureau 2005a). Policy issues ■ The service, including senior management, is supportive of alcohol and drug education. ■ The service has a policy on alcohol and drug education and support. ■ The service has a planned alcohol and drug education programme. ■ Alcohol and drug education, specific needs and support are noted and monitored appropriately in annual assessment and action plans, health plans, care plans and personal education plans. Practice issues Start early, e.g. at primary school age and ensure it progresses as children and young people grow older. ■ The range of substances covered should include medicines, alcohol, tobacco, solvents and illegal drugs. ■ Build on children and young people’s existing knowledge, experience and perceptions of alcohol and other drugs. ■ Include a focus on developing emotional resilience and well-being. ■ Information and approaches should take account of gender, social and cultural issues, and local trends. ■ Information should be age-appropriate and take account of the child/young person’s stage of development and maturity. ■ Include skills development to help young people communicate effectively, manage risks, resist negative peer pressure and learn how to make choices. ■ Make links with other issues that are important for young people, such as sexual health and other risk-taking behaviours. ■ Make sure children and young people know how to access help and support, including one-to-one confidential advice and support. ■

Partnerships Outside agencies/individuals and looked after children’s services agree on roles and responsibilities and each agency’s input is planned as part of a comprehensive alcohol and drug education programme, with clear learning outcomes.

■

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■

■

■

Parents and carers are involved so that they can support alcohol and drug education at home. Children and young people are involved in the planning and evaluation of alcohol and drug education. Vulnerable children and young people’s drug education workers are linked into looked after children’s services and work in partnership with the service.

Professional development ■ Staff and carers are trained and confident to deliver their input in alcohol and other drug education. ■ Staff and carers are familiar with, and understand the local policy on, alcohol and drug education and support. ■ Staff and carers can make use of effective learning methods, such as role-play and discussion, and are aware of local resources to support drug education.

■ Alcohol and drug education should be linked to other risk-taking

behaviours such as sexual risk taking. ■ Managers must make sure children and young people don’t miss out

on important education about issues such as alcohol and other drugs if there are gaps in their attendance at school [see Mobile Pupils and Drug Education (DrugScope 2005) for further information about this]. ■ Use interesting and interactive ways of teaching about alcohol and

other drugs as not everyone can read leaflets – videos and computer games can help, for example. ■ Talking in groups could be good but do remember that just because

young people are in the same residential home it doesn’t mean they are friends with each other. ■ Invited guests, such as staff from drug projects or people who have

had problems with drugs in the past, could talk with groups of young people. There is a need, however, to be aware of good practice in using visitors so that they complement on-going education rather than replace it or are just asked to ‘tell their story’ and inadvertently glamorise alcohol or drug misuse. It is important there is understanding and agreement about a visitor’s contribution to the

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overall learning outcomes of alcohol and drug education – see key principles on page 24 and Drugs: Guidance for schools (DfES 2004) with particular reference to the section ‘External contributors to drug education’. ■ There must be opportunities for one-to-one support for young

people. ■ Provide opportunities for interesting and exciting leisure activities,

especially in residential homes. Having something else to do was seen by young people as a good reason for not using alcohol and other drugs. I think that young people should be told the facts and the seriousness of drugs. About why drugs are used, how addictive they are and what can happen if it’s a dud tablet, how it can be expensive and affect friends and family. Young man aged 15 I think young people need to be taught in a way that suits the person or group. There is not simply one way of teaching young people because young people are individual. Young man aged 15 If the teaching involves not only the effects, but the ways to deal with the situation, then the person will know more about what to do in a situation involving drugs, sex and alcohol. Young woman aged 14 (quoted in Sex, Alcohol and Other Drugs, Lynch and Blake 2004b)

Resources and sources of help There are many national and local sources of information, educational resources and many local sources of help and advice about alcohol and drug education and support. Appendix 2 lists organisations, websites and helplines providing information and Appendix 3 lists source of support that may be available locally.

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5 Developing local policy

It is essential that every looked after children’s service has a drugs policy. This may not be a newly developed policy, but could bring together and update relevant and related policies and guidance (for example on confidentiality, managing drug-related incidents, health and safety). A review of substance misuse service provision for young people found that children’s services representatives were difficult to engage in partnership arrangements for commissioning and delivering substance misuse services and recommended that they should be more engaged at planning, commissioning and delivery levels (Didlock and Cheshire 2005). Developing a local policy for looked after children’s services is a way of developing such engagement and strengthening local partnerships with relevant agencies and sources of support. Such a policy will ensure looked after children and young people receive the alcohol and drug education and support to which they are entitled, by: ■ explaining the roles and responsibilities within the looked after

children’s service for alcohol and other drug education and support and by describing good practice ■ providing support for carers in giving appropriate, relevant and timely alcohol and drug education and support to children and young people in their care

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■ involving children and young people in its development and

implementation, thus making sure it is relevant and appropriate to their needs ■ setting a clear values framework.

What a drug education and support policy should cover The local Young People’s Substance Misuse Plan (YPSMP), developed by the local Drug Action Team, should cover how the needs of vulnerable groups such as looked after children and young people will be met. It should also cross-refer to any existing children’s services plans, including those for looked after children and young people. The YPSMP will be essential in supporting the development of an alcohol and drug education and support policy for the looked after children’s service. Issues that a local policy should cover include: ■ why looked after children and young people are vulnerable to ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

substance use and misuse a values framework opportunities for children and young people in care to talk and learn about alcohol and other drugs, including education and prevention local drug trends, prevalence and issues identifying the substance use/misuse needs of children and young people referral care planning child placement policies confidentiality information sharing the supply of illegal drugs and management of incidents including when the police need to be involved storage of controlled medication health and safety staff disciplinary procedures training monitoring and reviewing the policy.

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The DrugScope publication Taking Care with Drugs: Responding to substance use among looked after children (Castleton and Britton 2002) provides further information about how to develop and implement a local policy. It is important to produce a children and young people’s version of a local drugs policy so that they: ■ know who they can talk to if they are worried about alcohol and other

drugs ■ can make use of opportunities for learning about alcohol and other drugs ■ know and understand the services’ policy and protocols about alcohol and other drugs, for example what will happen if they are found using alcohol and other drugs, or what can and cannot be kept confidential if they seek help with regard to alcohol and other drugs. Nottinghamshire County Council has developed a substance use policy for all children and young people’s services to enable a consistent approach by professionals and staff. (See Nottinghamshire County Council and Nottinghamshire Drug and Alcohol Action Team entry in the References.) Case study 1 describes the process used in Nottinghamshire to develop the policy. Hounslow Social Services is seeking to bring together and update existing policies and consider how to support children and young people placed out of the borough and how to support foster carers. Case study 2 describes this process.

How to develop a local policy A number of stages are involved in the development of a new policy or review of an existing one. The way the policy is developed or reviewed can make a big difference to what it finally covers, how well it achieves its aims, and how it is implemented. Consulting and involving agencies and key people at an early stage will assist the development of ownership of the policy. Children and young people and their carers must be involved in developing policy, as they know what the most difficult issues are and have a wealth of experience to share.

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Case study 1: Nottinghamshire – The Children and Young People Substance Use Policy The development and implementation of the policy took over two years. The early stages of getting all agencies on board took considerable time – they all had individual policies (some more or less developed than others) and were reluctant to give them up. However, the publication of Every Child Matters was timely and demonstrated that agencies must work together to meet the needs of children and young people. Strategic leads of agencies came together and agreed to thrash out a common policy that would cover all agencies. Locally, this was the first time such a range of agencies working with children and young people have formally agreed to adopt a common framework and set of protocols. All policies and guidance documents from all services were considered and common elements and gaps identified. Consultations were carried out with staff in all agencies to identify what the policy needed to cover. The policy was intended as a generic framework to help staff understand the background to the National Drugs Strategy, issues relating to confidentiality, the law relating to drugs and the practicalities of handling incidents. It was not intended to replace more detailed policies for individual agencies such as those relating to schools or youth centres. A common core of key issues were identified for all services and discussed in depth. These key issues were: ■ ■ ■ ■ ■ ■

roles and responsibilities risk assessment the law and legal issues communicating with parents and carers support/information and advice confidentiality (this the was the major issue for all agencies).

The new draft policy was widely consulted on across the agencies. This included the children and young people using those agencies and as a result a children and young people’s version of the policy was produced.

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The Nottinghamshire County Council, Nottinghamshire Drug and Alcohol Drug Action Team, Newark and Sherwood PCT, Nottinghamshire Area Child Protection Committee, Nottinghamshire Connexions, Nottinghamshire Youth Offending Service and Nottinghamshire Police Authority adopted the final policy. A rolling programme of training was then implemented to train all staff in awareness of the policy. The policy is now over a year old and Nottinghamshire is considering updating it. Those involved consider that the process used to develop it was vital because it ensured the policy was well researched, responded to local needs and, most importantly, it gained the ownership of the policy by all the agencies involved. The Nottinghamshire policy covers: ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■

confidentiality (generally, and roles and responsibilities) disclosure and risk assessment child protection considerations substance use and significant risk of harm – breaching confidentiality contacting parents or carers substance-using parents or carers drugs and the law managing substance-related incidents and situations work within premises drugs and the law – recommended action checklist drugs and the law – outreach work or work away from base workers and personal responsibility training and implementation.

Staff in all children and young people’s services have been trained in the new policy. To date, all foster carers and residential care staff have been trained. In many cases this has resulted in carers going on to do further training, for example on volatile substances and alcohol. Training is now underway for those providing housing accommodation (including privately managed homes) for care leavers and other vulnerable young people. A special course was run for staff in residential units, entitled ‘Train the trainer’, where one member of staff was trained to deliver

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training and support to other staff team members in the residential unit. This method has been used because residential units are likely to have temporary staff and, consequently, new or temporary staff would not necessarily be up to speed on the policy and the approach it advises. The trained person in each unit is a source of expertise and advice for the young people and also the staff – making sure everyone is aware of, and understands, the policy and is able to provide on-site training and mentoring support to other staff members. A support group is offered monthly to the trainers and focuses on developing good practice and managing alcoholor drug-related incidents. Anecdotal evidence is emerging that smoking is not so common in residential homes since the policy was implemented. It is not yet clear why this is so but it may be related to staff no longer going outside to smoke (and often ending up doing it in the company of young people doing the same thing). It is possible that staff are now being more effective role models.

Stage 1: Get started ■ Identify a lead person – who is going to see that it gets done? It will

need to be a senior manager; they can then help to get other senior managers on board, including elected members and corporate parents. ■ Identify who else needs to be involved in contributing to the policy –

include other services, both statutory and voluntary. ■ Identify what resources might be needed – for consultations,

someone to write it, meetings, producing a copy for young people, printing and distributing it, and so on.

Stage 2: Establish or use an existing working group ■ Set up a working group to oversee the policy development or review.

Consider who needs to be part of this.

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Case study 2: Hounslow Hounslow’s Children’s Services has a number of policies and protocols relevant to alcohol and drug education for looked after children and young people but are now seeking to update these and bring them together into one policy. The Young People’s Misuse Service, based in children’s services, is taking the lead for developing the policy. Developments, such as screening and assessment requirements for vulnerable young people and an awareness of a growing culture of acceptability of alcohol and drug use among some young people, have prompted the review of policies and protocols. The service is also considering how it will meet the alcohol and drug education and support needs of children and young people placed out of the borough and how to make the Young People’s Misuse Service accessible to foster carers (the majority of whom will never have received any specific training or support around alcohol and other drugs issues). A multi-agency group of services concerned with looked after children has been invited to come together to consider how to move forward, together, to develop a local policy. It is considered essential to bring on board the other services such as education, health and the police – their contribution to alcohol and drug education and support is critical. The national change agenda for children’s services has made it a very timely development.

■ It could be a sub-group of an existing group, such as a healthy care

partnership or another appropriate multi-agency planning group. ■ Make sure residential staff, foster carers and looked after young

people are involved in and can contribute to the group.

Stage 3: Review ■ Review any existing policies or other related policies, especially those

related to healthy care (for example a healthy care action plan).

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■ Examine national policy to clarify responsibilities and national

research to identify key issues. ■ Examine any local research to find out what is happening in the

area, key local issues and what services and provision are available.

Stage 4: Consult and discuss ■ Carry out consultations to learn what local needs are, what the

policy should cover and if there is local good practice that can be built on. ■ This must include looked after children and young people, their

parents, foster carers, residential care staff, service managers, and other service providers.

Stage 5: Develop and agree the policy ■ Write the policy based on findings of the review and consultation

processes and send it to all concerned for comments and feedback. ■ Include comments and feedback where possible in the final policy. ■ Consider if you need a young people’s version. ■ Who will finally agree the policy? Request that all partners and

services formally adopt the policy. ■ Who will be responsible for making sure it is put into action? Is an

implementation plan needed to help put the policy into practice? ■ Have necessary resources been identified to implement the policy?

Stage 6: Dissemination ■ Make sure everyone knows about the policy. Consider accessible

versions (for example different versions for different groups, such as one for young people and one for foster carers). Make sure it is easy to find and gets included in service documentation. ■ Consider how the implementation plan will be put into practice.

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■ It is likely that training will be needed to help carers put it into

practice and for managers to make sure they can support staff and carers.

Stage 7: Implementation ■ Provide training and other support to enable staff and carers to

understand the policy and put it into practice.

Stage 8 Monitor and review ■ The policy should be monitored regularly – who will do this? Can the

working group maintain a watching brief? This could help to identify emerging good practice and share information about progress and learning. ■ Review the policy annually to update and amend if need be.

Evidence about how the policy is working in practice, and progress and developments resulting from it, may be useful for other monitoring and reporting including inspections.

A model framework A framework of the issues a local policy could cover is included in Appendix 1. This is drawn together from the issues addressed by three polices (from Sunderland, which developed a policy as part of the DEPC project, Nottinghamshire and South Yorkshire Coalfields Health Action Zone). It provides a starting point for a service which is seeking to develop a drug education and support policy, it is not definitive and any policy must address local circumstances and build on existing good practice. It is essential that policies address the needs of foster carers as well as carers in residential units. Managers need to consider how such a policy could support and be used by foster carers.

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6 Practice issues, support and training for carers

The role of carers in providing alcohol and other drug education and support Staff should play an active role in promoting all aspects of a child’s health. Health care should include education about alcohol and other substance abuse The Children Act Guidance and Regulations vol 4 (Department of Health 1991) This section covers a range of issues related to alcohol and drug education that carers often raise about working with looked after young people. Managers will need to provide extra support and guidance to carers who are talking about alcohol and other drugs with children and young people. This section identifies issues raised by carers and managers and includes some examples of practice from around the country. Work on issues relating to alcohol and other drugs is part of the role of all carers working with looked after children and young people. It contributes to creating a healthy care environment and to meeting the entitlements of looked after children identified in the National Healthy Care Standard (see DfES and others 2005a and 2005b). Carers are well placed to address alcohol and other drugs issues and to provide support to looked after children and young people because they:

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■ ■ ■ ■

know their background, needs and what is happening for them now are in everyday contact with the child/young person are likely to have a good relationship with the child/young person can be concerned about the child/young person’s whole life.

Yet carers often lack confidence because they: ■ don’t have enough, or don’t feel they have enough, knowledge about

alcohol and other drugs ■ are not sure how to talk with young people about alcohol or other

drugs ■ think young people will not view them as credible sources of ■ ■ ■ ■ ■

■

information and advice think that discussing alcohol and drugs may encourage young people to use them are unsure about legal issues are not clear about or aware of their service’s drug education and support policy think drug education or support is being provided by another service or professional think it is not necessary for the children they care for because they have disabilities, special needs or come from a culture where alcohol and drugs are not acceptable do not understand the links between emotional health and wellbeing, vulnerability, risk taking, alcohol and other drugs. Anything would be useful. Starting with practical things such as what action to take with young people you suspect are using drugs, what social services policies are, etc. Foster carer The social worker seemed to want to sweep it under the carpet, I began to feel it was my fault for not knowing what to do. Foster carer

Young people value their carer’s support The young people involved in the DEPC project thought that their carers were the best people to provide drug education, whether in foster care or a residential home.

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They also thought that young people were referred to specialist drug agencies too often and too readily – they saw their carers as people they had relationships with and who knew them and thought they should always be the first people to try and help them. If they were referred to specialist services they still wanted their day-to-day carers to give them support. Some young people saw their use of drugs or alcohol as a passing phase and part of growing up and others saw it as a way of dealing with a difficult life – but they all still wanted their regular carers to be the people who dealt with the issue if possible. Carers and social workers should know that if you ask about drugs, have tried something once or admit you have tried something it doesn’t mean you have a drug problem! Young person: age and gender not specified My foster carer talked to me, she told me about other young people she had fostered and how drugs affected them. She gave me better information than at school. Young woman aged 17

Practice issues Managers will need to provide extra support and guidance to carers who are talking about alcohol and other drugs with children and young people. This section identifies issues raised by carers and managers and includes some examples of practice from around the country.

Raising the subject Carers often worry about how to raise the subject (and others, such as sexual health and relationships). They worry that somehow mentioning the subject might encourage children or young people to use alcohol or other drugs, or they may worry they don’t have enough information or are not up to date enough to be taken seriously.

Practice guidance ■ Carers need to know that it is okay to discuss alcohol and

other drugs with children and young people and to actively

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create opportunities for young people to discuss and learn more about them. ■ A local policy with guidance on alcohol and other drug education for

looked after children and young people can support carers to be confident and clear about when and how the subject will be raised and by whom. ■ Training and support can help carers to feel confident,

knowledgeable and skilled. However the most important skills are those of communication – carers who can build relationships with young people will be best placed to discuss a whole range of sensitive issues but the carers might need some extra training and support to have the confidence and knowledge to do this. I deal with drink and drugs the same way I do with things like sex and relationships. If there is an opportunity to talk about something that has happened on a TV programme that I know the young person is interested in then I might watch it with them or say something like ‘What do you think about that then?’ It is best to just make it an everyday thing so they know you will talk about it without it being a big ‘heavy issue’. Foster carer I always have leaflets at home about all sorts of things but including drugs and drink and smoking – I like ones that are honest, that explain what drugs or drink can make you feel like as well as what can go wrong. There is no point saying it is all bad because the young people know that’s not true. I want them to know that I will always give them honest information – then they are more likely to ask you when they need to know something. Foster carer It is also good if leaflets have the street names for different drugs because that seems to change and they use new names – it keeps me up to date too. Foster carer If I had a problem with drugs I would probably phone a helpline or ask my older brother. My foster carer probably knows less than I do about drugs

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but if I thought she knew what she was talking about and wouldn’t go straight to the police I might talk to her first. Young person Case study 3 looks at how one group brings up the subject of alcohol and drugs in a way that is well suited to its members.

Being clear about boundaries Carers are important role models for young people but they need to consider their professional boundaries when talking with young people about alcohol and other drugs. For example, young people may ask about the carers personal experiences and views and then can use the responses as a justification for their own alcohol or drug use, for example: ‘You did it when you were my age and you’re OK.’

Case study 3: A leaving care group in Chesterfield Two looked after children’s nurses made up a TV-style quiz for a group of young care leavers they worked with. ‘We called it a ‘Sex, drugs and rock n’ roll night’ and wrote a quiz that included questions about music and music celebrities (like who is Madonna’s husband?) but also included questions about sexual health, alcohol and other drugs. We gave out jelly beans instead of points for correct answers and at the end the person with the most beans got a gift voucher. We kept it quite light (we got hold of a buzzer!) and did it like a TV quiz with lots of jokes and giving people beans for trying or being funny. We made sure everyone got involved even if they didn’t know the answers. It was interesting what they didn’t know and we were able to give the right answer (most of them didn’t know how much a unit of alcohol was or the recommended limits). At the end of the session we gave everyone a Goody Bag – with a toothbrush, toothpaste, some deodorant and condoms and a few leaflets – which they really liked. It was a non-threatening and fun way of talking about these subjects and we made them aware that we are happy to talk about these things individually too.’

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Practice guidance ■ Generally it is not appropriate for carers to discuss their own

personal experiences and even though a young person asks for information it can make them and the carer feel vulnerable and unsafe. Many looked after children and young people have not experienced a safe place and a safe person to discuss difficult issues with. By listening to the young person, a carer can provide safe boundaries and create a safe place. Carers could discuss what they know about alcohol and other drugs and, if there is something they don’t know, they can offer to find out that information. They could also try making it less personal and, for example, discuss an imaginary situation or a story from a TV soap. ■ The local drug education and support policy for the service should

cover the issue of professional boundaries; and training on drug education and support can also help carers to be clear about boundaries.

Identifying alcohol- and drug-related needs (screening and assessment) Many looked after children and young people’s services now routinely screen all children and young people entering the service, or when it seems relevant for the particular young person (perhaps following a concern about use or an incident involving of alcohol or drugs). A Home Office and DrugScope publication, entitled First Steps in Identifying Young People’s Substance Related Needs (2003), provides a framework for this to happen within existing assessment procedures. The aim is to find out what the young person’s needs are and to provide a response. It usually takes the form of a series of questions and a discussion to try and identify what a young person knows about alcohol and drugs, any education they may have had, if they would like more information and support, what their experiences have been regarding alcohol and drugs and what they think their needs are. Some services have designed a specific questionnaire for this, often in partnership with the local drug and alcohol action team (which is also used for other vulnerable groups of young people) and others make it

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part of the assessment process. A recent review of substance misuse service provision for young people recommended that in-house needs assessment processes should not be undertaken in isolation but should be coordinated with other young people’s service providers such as social services, health education, youth or voluntary sector services (Didlock and Cheshire 2005). Once a young person’s needs have been identified there will be a number of options available to support the young person. These are: ■ take no further action ■ provide alcohol and drug education in a universal setting (such as a

youth club or school) ■ provide targeted information and advice, including harm reduction if appropriate ■ refer for an ongoing specialist service such as counselling ■ refer for treatment from a specialist agency.

Practice guidance ■ Managers need to be clear about the roles and responsibilities within

the service in relation to identifying young people’s alcohol- and drug-related needs (sometimes called screening and assessment). Where carers are undertaking screening they must have training and support to enable them to undertake this role. ■ Managers must ensure that education and support needs regarding

alcohol and other drugs are appropriately noted and monitored in annual assessment and review plans, care plans, health plans, personal education plans and other relevant plans. ■ Managers must ensure that the process of identifying the alcohol-

and drug-related needs of looked after children and young people is undertaken in a consistent and sensitive way; makes use of appropriate screening tools (either developed locally or elsewhere); and that confidentiality issues are clarified with the young person involved. This should be written and included as part of the drug education and support policy for the service. Further guidance on identifying young people’s drug-related needs can be found in First Steps in Identifying Young People’s Substance Related Needs

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(Home Office and DrugScope 2003), available from http://www.drugs.gov.uk/publication-search/young-people ■ In some services identifying and responding to drug-related needs is

undertaken by a vulnerable children’s drug education worker and, in that case, managers must make sure that carers are clear about how to work together with the drug education worker to support the young person. Drug education workers for vulnerable young people and/or looked after children’s nurses (sometimes based in looked after children’s services or possibly in a community drug education project or youth-related service) often provide alcohol and drug education as well as assess the extent of a looked after young person’s needs. Case study 4 describes how a worker, based in a youth service, approaches this.

Confidentiality This is the most important issue for children and young people and the issue many carers find difficult. When Nottinghamshire developed their Substance Use policy for all children’s services they found that confidentiality was the biggest issue for all services. A local Drug and Education Policy that addresses the issue of confidentiality in some detail can provide carers with clear guidance so that: ■ carers and children and young people are clear about what can and

cannot be confidential ■ carers know when and how they should share information ■ children and young people know what happens to information about them and are consulted and informed about this. The policy also needs to be clear about how links should be made to the developing information sharing protocols within children’s services. Many services have a children and young people’s version of their confidentiality policy, which is made available to all children and young people.

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Case study 4: Torbay Youth Service A drugs and alcohol education youth worker based in a youth service explains her role as follows. ‘I take referrals from social workers for looked after young people; often it is a case of carers becoming concerned that a young person may be at risk from drugs or alcohol, or because the carers have become aware the young person has been getting drunk or using drugs. I often meet with the social worker initially to discuss the concerns and assess need. The social worker might then introduce me to the young person and their carers where I can explain my role, which is concerned with early intervention and harm reduction. I aim to educate young people about the facts about alcohol and other substances, their effects, health effects, risks, the law and other issues such as keeping safe. ‘I often meet with young people on their own to look at their educational needs as it is often difficult for young people and parents/carers to talk about drugs without everyone getting upset and sometimes inhibiting a young person from exploring all his/her thoughts or concerns. I also meet with carers where necessary to assess and meet their educational needs and provide them with information and support if they need it. If it seems a young person may need more specialist support I aim to refer them to a more specialised service in the area. Sometimes it may be difficult for a young person to make this transition to another service. Young people need lots of support during this process and I am able to provide them with this and if need be attend with them. ‘It is essential to take a holistic view when working with young people to meet their educational needs around drugs and alcohol. I try to look at the whole picture and see the whole person: What else is happening? Which drugs are being used? Who with? What other support do they have or need? It could be they are having a difficult time just now and need some extra support or they need to break with a peer group that use drugs a lot and need support to move on to make new friends. Alcohol or drugs is often just part of the problem, my job is essentially to intervene early on to try and prevent substances from becoming the bigger problem.’

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Practice guidance ■ Carers, children and young people need to understand the

boundaries of confidentiality at the beginning of discussions – not at the end when the child or young person has discussed something they would rather keep confidential. ■ If information has to be shared it should always be discussed with

the child or young person first – they should know who is going to be told, why and what will be done with the information. ■ Personal information about a child or young person should only be

shared amongst adults if there is a need to do so – it should never be shared automatically and young people need to know what has been shared and with whom. ■ Services, carers and young people should all be clear about when

the police or parents will be informed about issues to do with alcohol or drug use. ■ Carers, children and young people should be clear that there are

some situations where confidentiality cannot be promised: for example where a child or young person has been harmed; another child or person is at risk; or where a child is subject to a court order that must be monitored.

Harm reduction Because looked after children and young people are among the most vulnerable and marginalised it will not always be possible to prevent them from using or misusing alcohol and other drugs. In these circumstances it is established good practice to use approaches that minimise the risk of harm. This includes, for example, advising someone to eat before they drink alcohol or to try to cut down the number of times they smoke cannabis in a day or week. A number of factors will influence the appropriateness and type of a harm-reduction intervention such as: the context/situation; the age and maturity of the young person; and the drug or drugs being used, including frequency, how it is being used, where and with whom.

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This is a very difficult issue for carers who may not be sure about legal issues or worry that they are encouraging alcohol or drug use. They need clear guidance and support from managers of looked after children’s services about the legitimacy of using this approach; and training to enable them to confidently decide when it is appropriate to use it and to use it effectively.

Practice guidance ■ Managers need to be clear that they support this approach and that

it is best practice and state this clearly in the service’s alcohol and drug policy. ■ Managers need to ensure that staff receive training and support that

enables them to build their confidence and skills in using harmreduction approaches appropriately and effectively. ■ Managers must ensure that carers can talk confidently with someone

when they are worried or need clarity and/or reassurance about using this harm-reduction approach. ■ A local policy on alcohol and other drug education and support for

looked after children and young people can identify how, when and who can use harm-reduction approaches and link this to risk assessment. I talk to him about it so that he is aware of the dangers but at the end of the day it‘s his choice. You can’t be everywhere with them. Foster carer They should not imagine that we do not use drugs and just give us the basics. They should give us information on how not to get ripped off or buy bad drugs. Young person Case study 5 is one example of a group set up with the purpose of harm reduction.

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Case study 5: Ealing Safe Cannabis Group A safe cannabis group was set up for looked after young people and those leaving care in the London Borough of Ealing because of concern that cannabis use by young people is increasing and often involves a stronger form of cannabis (‘skunk’). The group provides information and helps young people think about changing their behaviour either by using cannabis more safely or reducing/ending their use. The group is organised by two workers who both have training in drug education and in running groups. ‘The group meets on a Friday evening as we wanted the young people to start the weekend with some knowledge. We meet for just over an hour, share a pizza and basically talk about drugs. We aim to give the young people factual information, we are very nonconfrontational – we are not saying ‘don’t do this’ or ‘do that’ – we try to make sure the young people have accurate information explained in a way they can understand and we focus on making sure the young people know how to keep themselves safe. We are solution focused – so we will talk about how to smoke cannabis safely as well as how to smoke less and about how to support friends who smoke (one young person who attends does not smoke himself but is very worried about his close friends who smoke a lot). We also talk about what you can do instead of smoking – for example one young person who has cut down a lot has started doing physical activity like running and is now requesting help to look for a job. ‘We have some group rules such as: don’t ask people to talk about their current or past drug use (and that includes young people asking the workers), don’t name other people who are not in the group, and don’t talk about what individuals have said in the group to people outside of the group. ‘The group was planned to run for six weeks but the young people wanted to carry on so now we have been meeting for four months. In that time, two members have reduced their cannabis use by 50 per cent; and one young man, who was about to be excluded from school because of issues related to smoking cannabis, is still at

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school and teachers have reported a 100 per cent improvement in his behaviour. ‘Some group members have become interested in being trained as peer educators because they think other looked after young people should also learn about how to keep themselves safe. They have now made a video about the group, which describes some of their stories, to show to other young people in residential units and for staff and carers. ‘The group was offered to any looked after young person or care leaver who was not happy about their substance use and wanted some support to be safe. Most group members were referred by leaving care teams but attendance is voluntary. Only young men have attended so far but we are going to try a girls only group. ‘The group has proved to be a successful approach and we are definitely continuing it.’

Substance-misusing parents/carers Children and young people who have come into care because their parents are misusing drugs and/or alcohol will have had direct experience of the damage such misuse can cause. They may be distressed and angry about it – they may also feel very alone and that they are the only child/young person with this experience. Drug and alcohol education in school is unlikely to be useful to them as they will already have considerable knowledge about drugs and alcohol; they may be much more interested in how people can get treatment than in general awareness raising. Also, children and young people may have had to take on the caring role for their parents and young siblings and so find the transition to being looked after and being cared for very difficult. These children and young people need targeted support to help them cope with the harm drugs and alcohol have already caused in their lives. Adfam – a voluntary organisation for families of drug or alcohol users – has produced a resource for children and young people called Journeys: When parents take drugs (Adfam 2005), as well as

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other publications and more information about support, which is available via their website www.adfam.org.uk

Practice guidance ■ Recognising and meeting the needs of children and young people of

substance-misusing parents needs to be included in the local policy on drug education and support for looked after children; and to be part of annual assessment and review plans, care plans, health plans, behaviour management plans and other relevant plans for the child or young person. ■ Identify where children and young people of substance-misusing

parents/carers can access support including therapeutic support, such as counselling, to enable them to explore their feelings and emotions and develop emotional resilience and well-being. ■ Ensure that children and young people know and understand what

support is available, how they can access it and what they can expect from it; and provide one-to-one support to help them use it. ■ Foster carers may need support to help them manage a child’s

transition from carer to looked after child or young person. ■ Managers need to ensure that children and young people are not at

increased risk from inappropriate placements. See Case study 6 for an insight into the work of one substance misuse specialist in contact with children of substance-misusing parents.

Responding to and managing drug-related incidents This is another difficult issue for carers, as young people may bring drugs or alcohol into their home environment or carers may become aware that a young person is using drugs or alcohol somewhere else. Foster carers particularly reported being very unclear about how to handle this and wanted guidance – preferably before it happened. They also raised the issue of other children or young people in their home and the need to consider a safe environment for all the children and young people they look after. Although most authorities have such a

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Case study 6: Matrix Young People’s Service, South Tyneside A substance misuse specialist for looked after young people described the work she does with the children of substance misusing parents, as follows. ‘I see young people who are living at home with substancemisusing parents and those who have come into care because of their parent’s alcohol and drug problems. ‘Often these young people are very anti drugs and alcohol themselves, for example some believe that alcohol is not acceptable in society, others however may use alcohol or drugs as a coping mechanism. Some of them think they are in some way to blame for their parent’s behaviour and often think they are the only young person who has experienced this – they can feel very isolated. ‘In the beginning we get to know each other, I want to find out about the young person and who they can use for support – is there someone they trust that they can talk to about what is or has happened at home? I provide education about how substances can affect people and we compare this with their experience of people’s behaviour. We look at the difference between normal behaviour and substance misuse. ‘We also work on coping strategies, for example what makes a young person happy or sad and what they can do to keep themselves safe when a parent is misusing. I try to help them understand that they are not alone and, for example, use a tape recording of other young people talking about their experiences. We also talk about the parent’s role within the home and how parents act as parents and children/young people have needs. If it is possible, I support and encourage communication between family members so that parents are aware of how their behaviour is affecting their child. This may also include a referral to another service such as family group conferencing or an adult treatment service.’

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When I go home from school, I peep in the living room window to see what’s going on and see if my dad’s been drinking. Boy aged 10 (with a substance-abusing parent) My dad showed me drugs and I felt so scared and worried about him. Now I know I am not alone and I can talk about things on my mind. Talking about it has helped me to understand more and worry less. Girl aged 14 (with a substance-abusing parent)

policy, a common response was ‘It is rather old’ and it tended to have been written for residential units and not cover foster care. The local policy on drug and alcohol education and support for the service should cover this as one of many issues. In some authorities, the policy on dealing with drug-related incidents was the main policy that carers were aware of in relation to drugs and alcohol. This runs the risk of making the focus of the work ‘managing incidents’ rather than identification of need, education, prevention and promoting safety.

Practice guidance ■ Precise guidance on how to respond to and manage drug-related

incidents (including intoxication of a young person, legal issues, searching bedrooms, liaising with the police, confidentiality and informing others, recording incidents, and following up with education and other interventions if necessary) should be covered in the local policy on alcohol and other drug education and support for looked after children. Further guidance on this can be found in First Steps in Identifying Young People’s Substance Related Needs (Home Office and DrugScope 2003, it can also be downloaded from: http://www.drugs.gov.uk/publication-search/young-people/). ■ The policy should also cover how to recognise and respond to

volatile substance abuse, as this is often difficult for carers to be aware of without some prior training and awareness-raising.

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How managers can support carers Managers of looked after children’s services can support carers to undertake alcohol and other drug education and support as part of their role by carrying out the following. ■ Develop and implement a drug education and support policy for the

service, which clearly identifies roles and responsibilities, describes good practice and signposts carers to support in the local area (see Developing local policy on page 27). ■ Ensure that carers are aware of the local screening and assessment

process to identify alcohol and drug-related needs, and are clear about their roles and responsibilities within this. ■ Involve carers and children and young people in the development of

a healthy care environment as described in the National Healthy Care Standard (see www.ncb.org.uk/healthycare). ■ Ensure that all job descriptions specifically include promoting and

protecting the health and well-being of children and young people as a key task. ■ Provide training for managers and supervise social workers to

ensure they have knowledge and skills about alcohol and drug education and support; and can support the carers they manage or supervise to do this work. ■ Provide training for carers on how to promote the health and

well-being of children and young people, including training about alcohol and other drugs and emotional resilience and well-being. Offer this at flexible times, including evenings and weekends, as carers of teenagers often have another job. Training in how to promote healthy care would be a good starting point (see www.ncb.org.uk/healthycare). ■ Make sure all training and support for carers is culturally sensitive –

carers as well as children and young people come from different ethnic groups with different cultural experiences of alcohol and drug use. Alcohol Concern and DrugScope have produced a briefing

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Developing Culturally Sensitive Alcohol Education Resources (2005) – this can be accessed via the DrugScope website: www.drugscope.org.uk. In addition, DrugScope produce drug information resources in different languages. ■ Develop partnerships with other organisations and services to meet the

needs of looked after children and young people (for example, youth and Connexions services, the Drug Action Team, drug and alcohol community education projects, public health services, and the police).

Developing skills Current research consistently indicates a need to develop the skills of the looked after children’s workforce – residential staff and foster carers as well as social workers. For example, the National Evaluation of Pump-priming Drug Prevention Projects for Vulnerable Young People (Bauld and Corless 2004) identified that the majority of staff in residential units thought they should be providing information on drugs to young people. Staff who had received additional training were more comfortable with taking harm-reduction approaches (as opposed to ‘just say no’ approaches) and were more likely to address a young person’s cannabis use themselves than involve the police. The study concluded that structured drug prevention training can have a measurable impact on how staff in residential units address drug-related issues. However, the challenges of training this workforce were also identified as, three years after such training, a significant proportion were no longer working for looked after children’s services in that area. This would suggest that, as there is a high turnover of staff in some looked after children’s services, training needs to be repeated and updated at regular intervals to ensure that new staff benefit from training. There is also a need to focus on building the transferable skills of carers and staff – the ability to develop relationships with children and young people and to communicate – essential when promoting overall health and well-being as well as in dealing with difficult or sensitive issues. Staff and carers are requesting training on effective communication skills, thus indicating that they are concerned not just with the facts of alcohol and drug education but also how to communicate with young people on these and other issues (Edmonds and others 2005).

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The Every Child Matters: Change for Children programme (www.everychildmatters.gov.uk) has published a common core of skills and knowledge for all of those working in the children’s workforce. These comprise: ■ effective communication and engagement with children, young ■ ■ ■ ■ ■

people and their families and carers child and young person development safeguarding children and promoting the welfare of the child supporting transitions multi-agency working sharing information.

The importance of developing skills and knowledge around drug and alcohol education is underlined in Every Child Matters: Change for children – young people and drugs (HM Government 2005): All people working with children have a key role to play addressing substance misuse among children and young people. All need to have basic substance misuse knowledge and understanding within their core competences. Substance misuse training should be made available in every area. Basic substance misuse training should be incorporated into core professional training across the workforce. Young people, carers, residential staff and managers considered that such training and support is essential and needed now.

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Appendix 1 A framework for a local policy on alcohol and other drug education and support for looked after children’s services This framework has been drawn from three policies developed in Sunderland and South Yorkshire Coalfields Health Action Zone (these were specifically for looked after children’s services) and Nottinghamshire (a policy for all children’s services). These policies were all developed following consultation and discussion with key partners, such as health services and the police; also involved in their development were carers, children and young people. Sunderland and Nottinghamshire both developed young people’s versions of the policy. This framework lists the areas a policy would need to address, and what each should broadly cover. Note that, in addition, it should reflect local circumstances and arrangements. 1.

2.

Aims and objectives ■ What the policy aims to do. ■ Who the policy is for. ■ Who has signed up to the policy (for example social services, health services, youth services, education, the police and other local services). Values and beliefs ■ The underlying principles of the policy (for example that the

overall welfare of the individual child or young person is most important, the views of children and young people are of central importance).

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3.

Children’s rights ■ Children and young people’s rights to drug education and

other rights such as protection from harm. This may be the appropriate place to identify local children’s advocacy services. 4.

The law and legal issues ■ Legal issues, such as the law on tobacco, alcohol, volatile substances and other drugs. ■ Child protection issues. ■ Information on young people accessing confidential advice and treatment (for example, referring to the Fraser Guidelines and Caldicott principles).

5.

Local trends ■ Any available information about local drug and alcohol use and local issues.

6.

Roles and responsibilities ■ Who is responsible for providing alcohol and drug education and

support, and what the role involves. ■ Possibly carers’ own use of alcohol and other drugs and their personal responsibility. 7.

Professional boundaries ■ Advice and guidance for carers on how to manage this and

what is considered good practice. 8.

Confidentiality, consent and information sharing ■ A detailed description of how confidentiality issues will be managed, when information should be shared, and how and with whom; how young people will be involved and informed about confidentiality issues. ■ When confidentiality may need to be broken, for example in the case of significant potential harm to a child or person.

9.

Drug and alcohol screening and assessment ■ How, when and by whom this is done. ■ Any tools that may be used locally (such as a screening form). ■ How information will be recorded, the position on confidentiality and sharing information, and how and when referrals are made

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to other agencies (and identify, where possible, the local agencies to which referrals may be made). This section needs to be considered with section 13 (Providing alcohol and other drug support and treatment). 10. Providing alcohol and other drug education ■ What drug education is and how this will be provided, when and who will provide it. ■ How to make sure children and young people have not missed important education at school and how to fill in gaps for those who have. 11. Links to care planning ■ How alcohol and other drug education and support will be noted and monitored in annual assessments and review plans for children and young people and other relevant plans such as the care plan, health plan, personal education plan, and behaviour management plan. 12. Care placement policies ■ How to assess the suitability of accommodation before a placement is made: including consideration of the age, maturity and vulnerability of the child/young person to alcohol and other drug use/misuse; and the competence of staff and carers to work with and support a young person who may be taking alcohol or other drugs. ■ The process to follow if a young person is involved in a drugrelated incident or their alcohol or drug taking is discovered. This should include issues such as the impact there would be on the young person if they are moved, for example could it increase their vulnerability or aggravate current problems? ■ The assessment and matching of young people’s needs to placements. 13. Providing alcohol and other drug support and treatment ■ How to refer a child or young person for support and treatment, where to refer to (a list of local agencies should be included) and who should be involved in the referral. ■ How to involve the child or young person in this process and how to support a child or young person who is receiving specialist support and treatment.

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14. Dealing with drug- or alcohol-related incidents ■ What carers should do if they find drugs or alcohol in the home environment or suspect it is being used elsewhere. This should include detailed advice about: disposing of drugs or alcohol; legal issues about removing substances (e.g. carers will not be prosecuted for handling a substance they are removing); searching rooms; if and when the police should be involved; who else needs to be informed; safety and risk assessment (with regard to the young person themselves and others in the home environment); and what needs to recorded about the incident. ■ How children and young people are informed at the beginning of the placement about the policy on these types of incident. ■ This advice on dealing with incidents should cover residential children’s homes, foster carers’ homes and leaving care supported accommodation units. 15. Dealing with intoxication ■ What carers should do if a young person is under the influence of drugs or alcohol including what to do in an emergency. 16. Harm reduction ■ A clear explanation of the service’s policy on harm-reduction approaches – when and how they should be used. 17. Working with young people with disabilities on alcohol and drug issues ■ How the service will make sure young people with disabilities receive education and support about alcohol and other drugs. 18. Working with birth parents and families ■ Could cover an explanation of the importance of gaining parents’ and families’ support for drug education and treatment; including what to do if parents and families do not support it. ■ How parents and families will be made aware of the policy. ■ Could cover issues to do with birth parents who are misusing alcohol and/or drugs. 19. Religion, culture and substances ■ How to make sure information and education is culturally appropriate and takes account of religious views on alcohol and

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other drugs. This may include signposting to relevant resources and local sources of advice and support on this issue. 20. Keeping medicines on the property ■ How to manage prescribed drugs such as methadone. 21. Safe disposal of alcohol or drugs ■ How drugs and alcohol should be disposed of, including drug equipment such as needles, syringes, bongs, etc. 22. Risk assessment ■ How and when to do this – for example following a drug-related incident – and what to do next. 23. Record keeping ■ What information should be recorded about alcohol and other drugs, when and where it should be recorded, how children and young people’s views are included and how to deal with confidentiality issues. 24. Support, supervision and training ■ How carers who are responsible for alcohol and other drug education and support will be trained and supervised to undertake this work. ■ How training about the policy will be delivered. 25. Implementing and monitoring the policy ■ How the policy will be implemented and monitored. ■ When it will be reviewed and who is responsible for this. 26. Specialist contacts for advice and resources ■ Information about local sources of advice, services and resources and national resources (such as websites, helplines and leaflets). 27. Glossary of terminology used in the policy ■ Simple, jargon-free explanations of terms used in the policy.

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Appendix 2 Organisations, websites and helplines providing information

Most of these organisations produce resources for drug and alcohol education and many can be accessed directly from their websites. Some of these websites are for young people but provide good information and ideas for staff, parents and carers too.

Action on Smoking and Health (ASH) www.ash.org.uk Telephone: 020 7739 5902 Information and resources about smoking and its effects on health. Adfam www.adfam.org.uk Information for families of drug and alcohol users. Alcohol Concern www.alcoholconcern.org.uk Telephone: 020 7928 7377 Information, training and resources on alcohol misuse. ChildLine www.childline.org.uk Telephone helpline: 0800 1111 Telephone office: 020 7650 3200 The UK’s free helpline for children and young people.

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Drug Education and Prevention Information Service (DEPIS) www.info.doh.gov.uk/doh/depisusers.nsf/Main?readForm Information and resources on drug education and prevention in school and community settings. Includes a database of local drug education projects and evaluations of projects. Drug Education Forum www.drugeducation.org.uk Brings together national organisations from health, education, police and voluntary sectors that deliver or support the delivery of drug education. Offers a range of resources that tackle key questions plus news and events. www.drugs.gov.uk The cross-government drug strategy website for drug professionals and others interested in the strategy. DrugScope www.drugscope.org.uk Information and resources on drugs, education and support service. Includes a library and information service and provides guidance for professionals. D-World www.drugscope.org.uk/dworld A drug information website for 11- to 14-year-olds produced by DrugScope. Includes information, games, quizzes, projects and advice on how to talk to parents. Educari/SNADE (Special needs and drug education) www.educari.com/SNADE Resources and training on drug education for young people with special needs. FRANK www.talktofrank.com Telephone helpline: 0800 776600 (24 hours) An independent government-funded website for young people and their parents/carers providing: information on drugs, a local service finder, email answers, and answers to frequently asked questions. Also offers

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a free, confidential telephone helpline providing advice, counselling and referral to specialist services. Giving up smoking www.givingupsmoking.co.uk NHS Smoking helpline: 0800 169 0 169 Advice from the NHS on how to give up, and local services. It includes a section for young people plus resources and information. Know the score www.knowthescore.info Information and advice on drugs in Scotland, including leaflets to download. Lifebytes www.lifebytes.gov.uk Website for young people aged 11–14 with facts about health given in a fun and interesting way, including those about drugs and alcohol. Mind, body and soul www.mindbodysoul.gov.uk For 14- to 16-year-olds and part of the Wired for Health series of health and well-being websites for schools. Includes quizzes and games on alcohol and drugs. National Children’s Bureau www.ncb.org.uk Promotes the voices, interests and well-being of children and young people; provides information on policy, research and best practice. Also includes information on the Healthy Care Programme, including a handbook, briefings on key topics and a training manual for carers (visit www.ncb.org.uk/healthycare). Parents using drugs www.parentsusingdrugs.org.uk For children and young people affected by adults using alcohol or drugs in England. Provides advice and information. Also a section for adults and professionals.

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Release www.release.org.uk Information, advocacy and advice to drug users, their families, friends, and statutory and voluntary agencies. Re-Solv www.Re-Solv.org (for parents, carers and professionals) www.sniffing.org.uk (for young people) Telephone helpline: 0808 800 2345 (24 hours) Information, resources and training about solvent and volatile substance misuse. Solveitonline www.solveitonline.co.uk Information, support, advice and advocacy for young people, adults and professionals about volatile substance abuse. Telephone helpline: 01536 420 604 Tacade www.tacade.com Produces publications and materials for drug education for young people, including an education activities pack for those who have problems with reading. Teenage Health Freak www.teenagehealthfreak.org Information and advice on health issues for young people including alcohol and other drugs, plus answers to common questions. The Who Cares? Trust www.rhrn.thewhocarestrust.org.uk/ Produces resources for looked after children and young people including a series on drugs and a website for looked after children and young people. Wrecked www.wrecked.co.uk An alcohol education website for young people provided by the NHS.

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Appendix 3 Local sources of information and support

There are many local sources of information and support about alcohol and other drug education for children and young people. This list is a starting point.

Advisory teacher for personal and social health education (PSHE) – one of these is based in every primary and secondary school and can tell you about PSHE in their school. There will also be a lead advisory teacher for PSHE for the local authority. Community drug education projects can be found in most areas. They provide education, information, training and support and often have a young people’s worker. They can also advise you about resources, such as leaflets and posters for drug and alcohol education, and may offer support such as counselling and drop-in sessions. Connexions – see Youth services and Connexions. The designated doctor and designated nurse for looked after children will be concerned to promote healthy lifestyles, including providing education on alcohol and other drugs, and they can link with local health services. Designated teachers for looked after children are based in schools and they will be concerned with looked after children and young people’s education including PSHE.

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Drug Action Team coordinators can advise on the local young people’s substance misuse plan and local services, as well as where to get information and support. Drug treatment agencies offer treatment for people with alcohol and drug problems. The local Drug Action Team coordinator or community drug education project will be able to provide information about local services. Health visitors and special needs health visitors are concerned with babies and children under 5 and can advise and support parents (including teenage parents) and carers about a range of health issues (such as the effects of passive smoking, stopping smoking, links between alcohol/drug use and domestic violence). Healthy care partnerships focus on how to promote the health of looked after children and young people and will be interested in education on alcohol and other drugs. Healthy schools programme coordinators can advise on what is happening in local schools about alcohol and drug education. You can find details of local coordinators at www.wiredforhealth.gov.uk Police locally will have an officer responsible for issues such as drug and alcohol liaison and young people. It is very likely that the local Drug Action Team will be in contact with an officer who can provide information and advice especially on legal issues and on local trends. Public health specialists are usually based in public health or health development departments of Primary Care Trusts and can advise on information and resources for alcohol and drug education, and may provide training and other support. Vulnerable young people’s drug education workers may be based in a drug education project or youth service or in a social services team. They will be able to provide targeted education for a young person; may be able to provide support to carers; and may work with residential staff to provide education for groups of young people.

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Youth services and Connexions are experienced in working with young people on issues such as alcohol and drug education. They can advise on leisure, sport and other activities available locally for young people and support them to get involved.

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References

Adfam (2005) Journeys: When parents take drugs. London: Adfam. Advisory Council on the Misuse of Drugs (2003) Hidden Harm: Responding to the needs of children of problem drug users. http:// www.drugs.gov.uk/drugs-laws/acmd/102234/ (accessed 10 Feb 2006). Alcohol Concern (2004) Young People’s Drinking Fact sheet 1. London: Alcohol Concern. Alcohol Concern and DrugScope (2005) Developing Culturally Sensitive Alcohol and Education Resources. London: Alcohol Concern and Drugscope. http://www.alcoholconcern.org.uk/files/20050728_091141_ Culturally%20Sensitive%20briefing%20final%2028%20jul%2005.pdf (accessed 6 March 2006). Bauld, L and Corless, A (2004) Drug Prevention Training for Staff Working with Children in Care: National Evaluation of Pump-priming Drug Prevention Projects for Vulnerable Young People, Fact sheet 4. London: Department of Health and University of Glasgow. Bird, J and Gerlach, L (2005) Improving the Emotional Health and Wellbeing of Young People in Secure Care: Training for staff in local authority secure children’s homes, National Children’s Bureau and Sowelu Associates. Blake, S (2005) Dangerous Highs: Children and young people calling

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ChildLine about volatile substance misuse. London: National Children’s Bureau. Boreham, R and McManus, S (eds) (2003) Smoking, Drinking and Drug Use Among Young People in England in 2002. Office of National Statistics. London: The Stationery Office. Butcher, J (2003) Drug Education (including alcohol and tobacco). London: Health Development Agency. http://www.wiredforhealth.gov.uk/ PDF/nhss_drug_education_2004.pdf (accessed 6 March 2006). Canning, U and others (2003) Drug Use Prevention: A review of reviews. Evidence briefing summary. London: Health Development Agency. Castleton, J and Britton, J (2002) Taking Care with Drugs: Responding to substance use among looked after children. London: DrugScope. Chivite-Matthews, N and others (2005) Drug Misuse Declared: Findings from the 2003–4 British Crime Survey. Home Office Statistical Bulletin 04/05. London: Home Office. http://www.homeoffice.gov.uk/rds/pdfs05/ hosb0405.pdf (accessed 10 Feb 2006). Department for Education and Skills (2003) Developing Children’s Social, Emotional and Behavioural Skills: Guidance. London: DfES. Department for Education and Skills (2004) Drugs: Guidance for schools. London: DfES. Department for Education and Skills (2005) Youth Matters. London: DfES. Department for Education and Skills, Department of Culture, Media and Sport, Department of Health, and National Children’s Bureau (2005a) Healthy Care Programme Handbook. London: National Children’s Bureau. Department for Education and Skills, Department of Culture, Media and Sport, Department of Health, and National Children’s Bureau (2005b) Healthy Care Training Manual. London: National Children’s Bureau.

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Department of Health (1991) The Children Act (1989) Guidance and Regulations, Volume 4 Residential Care. London: HMSO. Department of Health (2002a) Children’s Homes National Minimum Standards. London: Department of Health. Department of Health (2002b) Promoting the Health of Looked After Children. London: Department of Health. Department of Health (2004) Choosing Health: Making healthy choices easier. London: The Stationery Office. Department of Health and Department for Education and Skills (2004) The National Service Framework for Children, Young People and Maternity Services. London: Department of Health. Department of Health, Home Office and Department for Education and Skills (2005) Out of sight?…not out of mind. Children, young people and volatile substance abuse (VSA). A framework for VSA. London: Department of Health. Didlock, N and Cheshire, R (2005) Developing the Evidence Base: Young people with substance misuse problems. London: Turning Point/ Addaction. Drug Education Forum (2005) Drug Misuse: Risk and protective factors. London: Drug Education Forum. DrugScope (1999) The Right Responses: Managing and making policy for drug-related incidents in schools. London: DrugScope. DrugScope (2005) Mobile Pupils and Drug Education. A briefing paper for drug education practitioners. London: DrugScope. Edmonds, K and others (2005) Drug Prevention among Vulnerable Young People. Liverpool: Liverpool John Moores University/National Collaborating Centre for Drug Prevention. FRANK (2004 unpublished) Resources Needed to Support Children of Substance Misusers: Qualitative research with young people and support workers.

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Fuller, E (ed) (2005) Smoking, Drinking and Drug Use among Young People in England in 2004. London: The Stationery Office. Hibell, B and others (2000) The 1999 European School Survey Project on Alcohol and Other Drugs. Swedish Council for information and other drugs, CAN Council of Europe, Cooperation group to combat drug abuse and illicit trafficking in drugs. HM Government (2005) Every Child Matters: Change for children – young people and drugs. www.everychildmatters.gov.uk/publications (accessed 10 Feb 2006). HM Treasury (2003) Every Child Matters. London: The Stationery Office. Home Office (2002) Updated National Drugs Strategy. www.drugs.gov.uk and select ‘Drug strategy’ (accessed 10 Feb 2006). Home Office and DrugScope (2003) First Steps in Identifying Young People’s Substance Related Needs. London: DrugScope. http://www.drugs.gov.uk/publication-search/young-people/ (accessed 10 Feb 2006). Howell, S (2004) ‘Substance misuse and children in care’, Highlight, 205. Lynch, J and Blake, S (2004a) ‘Exploring the links between sex, alcohol and other drugs in young people’s lives: A briefing for practitioners.’ Spotlight Briefing, July 2004. London: National Children’s Bureau. Lynch, J and Blake, S (2004b) Sex, Alcohol and Other Drugs: Exploring the links in young people’s lives. London: National Children’s Bureau. Millward, L and others (2004) Evidence for Effective Drug Prevention in Young People. London: Health Development Agency. MORI (2004) Youth Survey 2004. London: Youth Justice Board for England and Wales. http://www.youth-justice-board.gov.uk/Publications/ Scripts/prodView.asp?idproduct=187&eP=YJB (accessed 10 Feb 2006). National Children’s Bureau (2005a) Healthy Care Briefing: Substance misuse. London: National Children’s Bureau.

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National Children’s Bureau (2005b) Healthy Care Briefing: Mental health. London: National Children’s Bureau. Newburn, T and Pearson, G (2002) Drug Use Among Young People in Care. Sheffield: Youth Citizenship and Social Change Programme. Nottinghamshire County Council and Nottinghamshire Drug and Alcohol Action Team ‘A Policy for U and S: You and Substance Use’ http://www.nottinghamshire.gov.uk/home/youandyourcommunity/staysafe/ youandsubstanceuse.htm (accessed 10 Feb 2006). Parkin, S and McKeganey, N (2000) ‘The rise and rise of peer education approaches’, Drugs: Education, Prevention and Policy, 7, 293–310. Prime Minister’s Strategy Unit (2004) Alcohol Harm Reduction Strategy for England. http://www.crimereduction.gov.uk/alcohol02.pdf (accessed 10 Feb 2006). Qualifications and Curriculum Authority (QCA) (2002) Drug, Alcohol and Tobacco Education: Curriculum guidance for schools at key stages 1–4. QCA. Thomas, R and Holland, J (1998) Sexual relationships, negotiations and decision making. In Coleman, J and Roker, D (eds) Teenage Sexuality: Health, Risk and Education. Harwood Academic Press. Ward, J Henderson, Z and Pearson, G (2003) One Problem Among Many: Drug use among care leavers in transition to independent living. London: Home Office.

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Index A Action on Smoking and Health (ASH), 63 Adfam, 49–50, 63 advertising, 2 advice, confidential, 24 see also education Advisory Council on the Misuse of Drugs, 7 advocacy services, 58 age of drug education, 23, 24 of first drug use, 9 agencies, specialist drug, 39, 43, 45, 68 see also services alcohol, xi, 3, 5, 17, 46, 52 education about see education and other risk-taking behaviour, 3 unit of, 41 usage statistics, 4 use by carers, 42, 58 Alcohol Concern, 53–4, 63 Alcohol Harm Reduction Strategy for England, 12 asking about drugs, xiii, 23, 39 assessment procedures, 12, 24, 33, 42–3, 53, 58–9 attitudes and values, 7, 20, 49, 51 availability of drugs, 2, 3, 5 B barriers to participation, 16 behavioural skills see skills binge drinking, 4 Blueprint, 22 boundary setting, 10, 41, 42, 58 Brighton and Hove Council, x bullying, 5 C Caldicott principles, 58 cannabis, xi, 4, 7, 46, 48–9, 54 not seen as drug, 7 care see carers; children’s services; looked after children and young people

care plans, 8, 12, 24, 43, 50, 59 carers children as, 49 confidence or lack of in drug issues, xiv, 38 definition, xi foster, 33, 34, 35, 50 support and training for, 8, 27, 31, 35–55 Change for Children programme, 14 Chesterfield, 41 child protection system/issues, 7, 31, 58 ChildLine, 6, 63 Children Act 2004, 11–12 children’s services, 27–35 Hounslow, 33 staff in, 32, 34, 44, 45 (turnover of, 54) see also skills; training, for workforce choice issues, xiii, 12, 15, 20, 23, 24, 47 Choosing Health, 12, 15 communication, xiv, 20, 24, 34, 38, 39 discussing drug issues, 39–42, 54 skills, 54 community activities, 9, 15 drug education projects, 67 Safety Teams, 13 confidentiality, 27, 28, 29, 30, 31, 41, 43, 44, 46, 48, 52, 58, 61 conflict resolution, 8 consultation, 29, 30, 34, 57 coping skills, 9 strategies, 5, 7, 9, 15, 26, 39, 51 Cornwall County Council, x counselling, 43, 50 crime, 9 see also police, involvement of culture cultural issues, 24, 38, 53–4, 58, 60–1 youth and drug-taking, 2, 33

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D dealing in drugs, 7, 28 deaths, 4 Department for Education and Skills (DfES), 3, 12, 14 guidance from, 8, 17, 24 Department of Health, x, 12, 14, 16 DEPC see Drug Education for Children in Public Care Project disabilities, children/young people with, 38, 60 disciplinary procedures, staff, 28 diversity, 10 documentation, 34, 43 see also record keeping Drug Action Teams (DATs), 13, 17–18, 28, 54, 68 Drug and Alcohol Teams, 13, 45 Drug, Alcohol and Tobacco Education, 17 Drug Education for Children in Public Care Project (DEPC), x, xi, 5 drug education see drug education workers; education Drug Education and Prevention Information Service (DEPIS), 64 Drug Education Forum, 64 drug education workers, 44, 45, 68 drug use, 3, 17, 23 attitudes to, 7, 20, 49, 51 by carers, 58 as a coping strategy, 5 dealing with incidents involving, 17, 26, 29, 50–2, 59, 60 effects of, 21 local trends and prevalence, 28 occasional and regular, 3, 23, 39 and other risk-taking behaviour, 3 reasons for, 6, 28 recreational, 8 screening tool, 17–18 statistics, 4 drug users as information resource, 25 drugs disposal of, 60, 61 illegal, xi, 4, 9, 24, 28 legal, use of, 9 names for, 40 see also alcohol; cannabis; volatile substances Drugs: Guidance for schools, 17

DrugScope, 29, 42, 53–4, 64 E Ealing Safe Cannabis Group, 48–9 education about alcohol, xi, 10, 17, 19–26, 45, 59 effect of drug, 22 failure in as risk factor, 9 importance of success in, xiii, 8, 9 key principles for alcohol/drug, 24–5 national policies, 1, 11–18 about other drugs, 1, 10, 18, 19–26, 27–8, 45, 59 personal, social and health (PSHE), 17 planning and evaluation of drug, 25 range of issues for, 23 in schools see schools settings for alcohol and drug, 19–20 on volatile substance abuse, 14 emotional awareness, 20, 24 health, 8, 10, 24, 38, 53 equipment for drug use, 61 Every Child Matters, 12, 13, 30, 55 exclusion from school, 4, 48–9 F family, 9 communication within, 51 group conferencing, 51 working with, 60 see also parents First Steps in Identifying Young People’s Substance Related Needs, 43–4, 52 foster carers, 33, 34, 35, 39, 50 see also carers; training, for workforce FRANK, 64 Fraser Guidelines, 58 friendships, 45, 48 importance of, 8 G gender differences/issues, 4, 24 H harm and confidentiality, 31, 46, 58 reduction strategies, 43, 46–9, 54, 60

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Index 79

health assessments/plans, 17 knowledge about issues, 9 poor physical and emotional, 8 promotion, 15, 16–17, 67 public strategy, 15 and safety, 27, 28 worries about, 6 Health Development Agency, 21 healthy care partnerships, 68 Healthy Care Programme, 16, 33, 53, 68 helplines, 6, 40, 61, 63–6 High Focus Areas, 13 holistic approach, 22, 23, 24, 45 home children’s, 17 (see also looked after children and young people) environment, 9 see also parents Home Office, 12, 14, 42 Hounslow Social Services, 29, 33 housing, xiii I inclusion, 18 information, 9, 15, 20, 23 for drug users, 48 local sources, 67–9 sharing, 28, 44, 46, 58, 60, 61 (see also confidentiality) sources of, 26, 38, 40, 42, 53–4, 61, 63–6, 67–9 see also education intoxication, dealing with, 60 see also drug use K Kent Drug Action Team, 17–18 knowledge about drugs, 7, 24 of carers, 38, 55 core, 13, 55 see also education; training, for workforce L law relating to drugs, 21, 30, 31, 38, 58 leadership, 32 learning methods, 25 leaving care group, 41, 49

leisure activities, 16, 26, 69 Lifebytes, 65 literature review, x local authority, outcome indicator returns, 17–18 looked after children and young people, 13, 17, 25 and barriers to participation, 16 and their carers, 38–9 drug usage of, 5, 17 educational failings of, 20–1 and national policy, 11 vulnerability of, 5, 7, 11, 14 M magic mushrooms, xi managers, 34 definition, xi support of carers by, 53–5 Matrix Young People’s Service, 51–2 media glamorising of drug-taking, 2 medicinal drugs, 2, 21, 24, 28, 61 controlled, 28 misuse of, xi monitoring parental, 9 and review of policy, 28, 31, 33, 35, 50, 61 multi-agency approaches see partnership strategies N National Children’s Bureau (NCB), 8, 65 research and guidance, 5, 8, 10, 16, 24 National Curriculum, 17, 20–1 National Drug Strategy, 12, 13, 30 National Healthy Care Standard, 37, 53 National Healthy Schools Programme, 18, 24–5 National Service Framework for Children, Young People and Maternity Services, 14–15 networks, social, 9 Nottinghamshire County Council, 29, 30–2, 35, 44, 57 O offenders, young, 13 Out of Sight? … not out of mind, 14

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80 Index

outcome indicator returns, 17–18 outcomes learning, 24 local authority indicator returns, 17–18 policy objectives, 57 required by Children Act 2004, 11 outplacement (of the looked after), 33 P parents corporate, 8 as drug (mis)users, 6–7, 9, 49–52, 60, 65 involvement of, 25, 31, 34, 60, 68 monitoring by, 9 partnership strategies, 14, 18, 24–5, 27, 30, 33, 43, 54, 55, 68 peer-led interventions, 22, 49 personal, social and health education (PSHE), 17, 20, 67 placements assessment of suitability, 59 change in, 5–6 inappropriate, 50 plans care, 8, 12, 24, 43, 50, 59 health, 17 other for the looked after, 24, 43, 50 police, involvement of, 46, 52, 54, 60, 68 policy adoption of, 34 children and young people’s version of, 29, 30, 34, 44 for drugs education, 24, 25 on harm-reduction strategies, 47 implementation plan, 34 local, 27–35, 40, 44, 47, 50, 52 model framework, 35, 57–61 national, 11–18, 34 Nottinghamshire, 30–2 on professional boundaries, 42 school drugs, 17 pregnancy, teenage, 15 preventive strategies, 12 principles, key, 24–5, 26 problem-solving, 10 professional development, 12, 25 see also training, for workforce protective factors, xiii, 9–10

Q Qualifications and Curriculum Authority, 17, 18 R record keeping, 61 see also assessment procedures; information; plans recreational drug use, 8 relationships caring, 9, 38–40 and communication, 39–40, 54 Release, 66 religious views, 60–1 Re-Solv, 66 resources, identification of need, 32 see also information reviews see assessment procedures; monitoring rights, children’s, 10, 58 risk factors, 8, 9 identification and management, 20, 21, 24, 30, 31, 61 those most at, 12, 13, 22 risky behaviour, 3, 22, 24, 25, 38 see also alcohol; drugs; sex, unsafe S safety/safe environment, 10, 42, 50 schools, 8, 9, 12 alcohol and drug education in, 19–22 drug policies, 18 gaps in attendance, 25, 59 see also education; exclusion from school screening for drug use, 17–18, 33, 42, 53, 58–9 self-harm, 6 services, 39, 43 age-appropriate, 15 specialist, 39, 43, 51, 58, 59 targeted, 12, 22, 43 universal, 12, 22 see also agencies, specialist drug; children’s services; education; support; training, for workforce sex sexual health, 24 unsafe, 3, 15, 25

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Index 81

skills children’s workforce, 12, 54–5 (see also training, for workforce) communication, 54 core, 13, 55 life skills programmes, 22 personal and social, 8–9, 20, 24 transferable, 54 smoking see cannabis; tobacco social skills, 8–9, 20, 24 social workers, 45, 53 socioeconomic issues, 9 solvents see volatile substances Solveitonline, 66 South Tyneside, 51–2 South Yorkshire Coalfields Health Action Zone, 35, 57 special educational needs, 21, 64 staff see children’s services standards on children’s activities, 16 for children’s homes, 17 healthy care, 53 national service, 14–15 stress, 5–6 Sunderland Council, x, 35, 57 support for staff/carers, 8, 27, 31, 32, 35, 37–55, 68 see also training, for workforce support for young people, xiii, 9, 10, 15–16, 50, 59, 68 intensive, 16 for the looked after, 17, 23 one-to-one, 24, 26, 41, 45, 50 options for, 43 T Tacade, 66 Taking Care with Drugs, 29

targeted interventions, 12, 17, 22 Teenage Health Freak, 66 tobacco, xi, 3, 4, 5, 17, 32, 68 usage statistics, 4 Torbay Youth Service, 45 Tower Hamlets Council, x training, for workforce, 12, 25, 28, 31, 35, 37–55, 61 cascaded, 31–2, 53 at flexible times, 53 see also education treatment, xiii, 17 trusts, children’s, 16 U usage of drugs see drugs V valued, need to feel, xii values framework, 20, 28, 57 volatile substances, xi, 4, 6, 24, 52 abuse framework, 12, 14 volunteering, 15 W websites, 5, 13, 18, 50, 52, 54, 55, 61, 63–6, 68 Who Cares? Trust, 66 withdrawal symptoms, 6 working groups, 32–3, 35 Y Young People’s Substance Misuse Plan, 28–9 youth culture see culture markers of, 3 services, 69 Youth Matters, 12, 15–16

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A guide for looked after children’s services As the use of alcohol and other drugs is increasingly part of youth culture, it is essential that young people and the professionals working with them understand the risks their misuse can cause to health and well-being. The challenge for corporate parents is to increase the protective factors for the young people in their care, while reducing the risk factors that can increase the chances of problems developing with drugs and alcohol. And it is clear that the young people involved in the Drug Education for Children in Public Care Project, which led to this guide value their carers and look to them to provide the help and support they need with alcohol and drugs. This guide will provide you with practical help to develop or review your drug education policy and practice, and the management of drug incidents and includes: ■ why looked after children need alcohol and drug education ■ a summary of national policies to support drug education ■ a definition of drug education and a summary of the evidence base ■ a process for developing local policies for looked after children’s services on alcohol and drug education and support ■ guidance on positive practice ■ resources and sources of support for work on alcohol and other drugs.

Talking About Alcohol and Other Drugs A guide for looked after children’s services

Talking About Alcohol and Other Drugs

Talking About Alcohol and Other Drugs: A guide for looked after children’s services is essential reading for managers of looked after children’s services, training managers, managers of children and young people’s residential homes and social workers.

tel: + 44 (0)20 7843 6000 fax: + 44 (0)20 7278 9512

Useful numbers Membership and general enquiries: 020 7843 6080 Conferences and Training: 020 7843 6441 Young NCB: 020 7843 6099 Book Sales: 020 7843 6029 Library and Information Service: 020 7843 6008 Visit our website at: www.ncb.org.uk

Mary Ryan and Jo Butcher

National Children’s Bureau 8 Wakley Street London EC1V 7QE

Talking About Alcohol and Other Drugs A guide for looked after children’s services Mary Ryan and Jo Butcher