Actions speak louder: A second review of healthcare in ... - HMCPSI

ACTIONS SPEAK LOUDER
Conclusions
One of the fundamental issues for health and youth offending services to consider
is the nature and quality of assessments, both for those who have offended and for
those who might do. If these are not carried out promptly and accurately, important
factors that can be linked to crime can be missed, minimised or ignored. If an initial
Asset assessment is not thoroughly completed, and lacks the necessary specialist
supplementary health assessments, this can impact on the nature both of
sentencing and intervention. The section about court work in this report
demonstrates, for example, that a third of the reports presented to court did not
have an accurate representation of health needs, which could be relevant during
sentencing. Where health needs are not being assessed, this also limits the ability
of the youth offending team (YOT) case manager to offer packages of support for
people on bail, which include health.
Substantial numbers of children and young people who are likely to offend or who
have offended, did not have their generic health needs well assessed and therefore
cannot be referred on to receive appropriate interventions. This situation can be
made worse where young people place themselves at risk and this has often not
been taken into account.
We found too many situations where health needs, including diversity issues, were
clearly present in case file information, but which had not been adequately assessed
and considered in relation to interventions. This was particularly true for those with
physical health needs, where often these needs are simply ignored. Sometimes the
lack of a thorough initial health assessment was due to case managers being poorly
trained in primary health screening; otherwise it was simply because a YOT was not
using recognised assessment tools. Where all children and young people attending
a YOT are subject to accurate and consistent universal screening for health issues
(by a specialist), which includes checks for physical health, emotional and mental
health and substance misuse, they are much more likely to receive appropriate
advice and assistance.
Inspectors found effective audits and performance reviews within YOTs, for example,
in Asset completion, where findings were used to inform future practice – but these
were exceptions.
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