Agenda and minutes

Apologies for absence was received from Councillors Carr, Cooper, Howroft-Scott, Stamp, Tejan. Thorne, and Elizabeth Turpin.

(During this period, the Conservative and Labour and Co-operative political groups had informally agreed, due the Coronavirus pandemic, to run meetings with reduced number of participants. This was to reduce risk, comply with Government guidance and enable more efficient meetings. Therefore the apologies given reflected that informal agreement of reduced participants).

To approve the record of the meeting held on 1 December 2021.

The record of the meeting held on 1 December 2021 was agreed and signed by the Chairman as correct.

There were none.

The Chair welcomed Stephanie Davis, the newest member of the Democratic Services Team who would be taking over clerking of the Committee.

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct. Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

This report details the area covered by the Portfolio Holder for Adults’ Services that falls within the remit of this Committee and updates the Committee on activity in relation to the Children’s Independent Reviewing Office (IRO) for the period April 2020 until March 2021. This team is part of the wider Safeguarding and Quality Assurance Service. This report provides quantitative and qualitative evidence relating to the IRO team in Medway as required by statutory guidance.

Discussion:

Councillor David Brake, Portfolio Holder for Adults Services, with responsibility for the Children’s Independent Safeguarding and Review Service was in attendance and took questions from the Committee.

Members raised several questions and comments which included:

Members praised the positive aspects of the service as reported including the improvements made to timeliness of reviews, gathering of information feedback from young people and dedication of staff to promote the best outcomes for the young people of Medway.

• Workforce – Concerns were raised on the significant staffing issues that had been experienced by the service in 2020/2021. The Portfolio Holder stated that staffing levels had significantly improved, with extensive work completed on recruitment and retention of staff.

In response to a question on what percentage of staff were locum, it was made clear that there were currently no locum or agency staff in the Independent Reviewing Officer (IRO) service which was fully staffed with a permanent workforce. There had been use of agency staff previously to backfill where necessary but there had since been emphasis on conversion to permanent contracts to ensure stability in the service. Significant work had been undertaken to ensure that young people were assigned to an IRO that would continue with them throughout their journey.

• Virtual Meetings- One of the issues identified by IRO’s during the height of the pandemic was the inability to meet in person with young people, and it was asked how the voice of children, which had been identified as a challenge, was captured. The Portfolio Holder acknowledged the difficulties experienced by staff, children and families not being able to meet face to face but praised how well all had adapted to the new ways of working. Whilst the interaction in virtual meetings was not of the same quality as in person meetings, this approach was one of the best tools at disposal in safeguarding all against contracting Covid 19. All cases were individually assessed to determine if a virtual meeting was appropriate and where it had been identified that a face-to-face meeting was the best course of action, this took place in a safe and secure Covid compliant way.

Members were reminded that the duties discharged under the Coronavirus 2020 Act was for a specified period and once restrictions were lifted, full face to face contact resumed.

• Data on Cases – Clarification was sought on the disparity between the number of cases raised during the year which was 150 and the amount resolved which was reported as 159. Officers said that that the figure was higher as it included cases that had been rolled over from previous years and confirmed that there were no new cases.

• Serious Case Reviews – in response to a question on the Portfolio Holder’s awareness of cases and findings as well as recommendations made, the Portfolio Holder said that he was aware of cases, discussions as well as actions taken by the team. He proactively sought feedback and assurance to enable him to make sound judgement on the  ...  view the full minutes text for item 579.

The contract for the Medway Young People Wellbeing Service was awarded to the North East London NHS Foundation Trust (NELFT) and formally commenced on 1 September 2017.  This paper updates Members on the contract and developments through the Local Transformation Plan for CYP Mental Health and Emotional Wellbeing.

Discussion:

The Public Health Principle and the Partnership Commissioning Officer

 introduced the report which provided an update on the contract and developments of the Local Transformation Plan for children and young people (CYP) Mental Health and Emotional Wellbeing.

Members then raised a number of questions and comments, which included:

• Waiting Lists – Concern was raised regarding the longstanding issues with wait times in the service with reference made to the target of 18 weeks which was considered as inappropriately long for young people in need of Mental Health Support. Officers stated that all referrals were received through a single point of access where triage occurred following discussion on the case between clinicians. Decisions on relevant pathway was determined following assessment with cases reviewed on an ongoing basis. At triage, the level of need would be determined, with crisis cases assessed and intervention provided immediately or within short timescales, depending on the level of need.

It was noted that those waiting for a neurodevelopment diagnosis could wait for a period of up to 2.5 years but all young people on waiting lists that had a linked condition (e.g. anxiety) would be seen for those conditions.

Mental Health schools team are a national pilot that went live in some Medway schools in Medway in January. These team provide a whole school approach to mental wellbeing. Commissioners are working with school nursing to expand this support to school not involved with the pilot. Bespoke work around self-harm took place which was underpinned by the self-harm strategy.

In response to a further question on the reasons behind the numbers dropping in Neurological Pathways, officers acknowledged that the wait times were unacceptable, and they were exploring all available options with commissioners to reduce wait time as well as different ways to deliver the service. Throughout the process, parents received support to ensure they understood the service and were kept up to date with timelines. Additionally, support and information was provided on how to manage challenging behaviours.

• Recruitment- It was asked what was being done to address the workforce management issue and to attract potential staff. Officers said that it was difficult to recruit clinicians and they looked into various incentives for the hard to recruit posts. They also learned from other authorities’ methods and recruitments drives and tailored incentives to different areas of recruitment. Aside from financial incentives, a good package of training and ongoing support was offered to all practitioners which was locally accessible.

• Voluntary Sector – in response to a question on what extent the expertise of the voluntary sector was used in assisting with cases, officers said that they welcomed the support provided by voluntary organisations. The broader plan was to equip all professionals with the tools to signpost or provide appropriate support. Work was being undertaken with partners on supporting young people earlier to prevent extreme pressure on core services.

• Budget and Funding- It was challenged that the average Clinical Commissioning Group (CCG) spend on mental health services across the  ...  view the full minutes text for item 580.

The RAA Annual Report attached (Annex A) provides information and an overview of the service, performance set against government targets and service and practice development for the period November 2020 – October 2021.

Discussion:

The Head of Service from the Adoption Partnership South East introduced the Annual report which detailed activities following the launch of the Adoption Partnership in November 2020.

Members then raised several questions and comments, which included:

• RAA Model – it was asked what the likelihood was of the Model being a success and what was being done to manage variations in outcomes between the partnership. The officer responded that information from the National research undertaken to date indicated that the RAA Model was proving to be successful. The DfE had provided time limited funding to support a national strategy team, to ensure practice development and consistency across RAA’s and around the country.

• Difference in the child level data - Regarding the three local authorities in this RAA, Kent was the largest and this would attribute to differences in data. At the point of going live, there was a significant number of Medway children who had an adoption plan, who had now been placed over the last 12 month.

Nationally the number of adoption orders had reduced, partly due to delay in court proceeding due to Covid. This had resulted in a significant number of children in adoption placement awaiting adoption orders, who were waiting longer than they would have done previously.

• Recruitment of adopters- it was asked what was being done to encourage local families to come forward to ensure children could be placed with locally.  The officer responded that 96 children had been placed over the last 12 months and all but four had been placed through the RAA. Most enquirers were from regional adopters, although the RAA still attracts potential adopters from neighbouring local authorities. The aim of the recruitment strategy was to recruit adopters based on the needs of the children. There was good representation across the region of prospective adopters.

• Budget -it was noted that there had been an underspend which had been moved forward to the operational budget for 21/22 and clarification of the underspend was sought. The Committee was informed that there had been several contributing factors to the underspend such as the partnership going live part way through a financial year, inherited vacancies and savings made such as on room hire which could be costly, due to Panel meetings being held virtually. Regular meetings took place with finance leads with reports to the Partnership Board to discuss what to do with the underspend and what proportion could be returned to each LA. Caution was being taken as the partnership went live during the pandemic, there remained some unknowns and there was a balance to be struck going forward.

• Court delays - The Pandemic had resulted in Court backlogs which led to a reduction in Court Orders. As restrictions began to lift, it was anticipated that there may be a surge in demand, and it was asked what mitigation was in place to manage demand. The officer stated that they had been working closely with Child in Care Service Managers and Group  ...  view the full minutes text for item 581.

This report provides an update on the actions being taken to prevent and reduce the likelihood of suicides in Children and Young People in Medway. It sets out the Medway specific interventions being taken forward as part of the Medway Suicide Prevention Action for Children and Young People following the approval of the Kent and Medway Suicide Prevention Strategies for Adults and Children and Young people by Cabinet on the 28 September 2021.

Discussion:

The Public Health Consultant introduced the report explaining that it built on the Suicide Prevention Strategy that was considered by the Committee in August 2021.  The Action Plan was Medway specific, and he reminded the Committee that suicides amongst children and young people were very low (less than five over a three year period) and hospital admissions due to self-harm was below National average and was in the bottom five in the South East region.

Members then raised a number of questions and comments, which included:

• Method of Self Harm and Trends- the prevalence of the use of overdose, as a method of self-harm was referenced in the report and in response to a question on comparable figures, the officer stated that the issues identified in Medway were in line with National data.

In response to a further question on emerging trends as the report identified a higher rate of hospital admissions due to self-harm in Rochester West and Twydall wards and significantly higher incidences of self-harm in girls aged 10-24, the officer said that it was difficult to identify particular factors due to the statistically low numbers. There were several possible explanations such as the same individual presenting at A&E multiple times. Following the introduction of the Emerge project (which provided support to young self-harmers presenting at A&E) and self harm awareness training for partners, there may be a difference in patterns that would be evident in the data available later in January 2022.

• Role of Schools – a concern was raised about the added pressures that may be faced by schools who had been identified as playing a key role in identification and supporting vulnerable young people. The officer acknowledged that schools did face extra pressure which was why the action plan had specific actions regarding mental health promotion within schools with key actions on delivery.  All partners as part of the action plan would be reminded of their responsibilities and duties to provide support to schools and ensure their mental health support and provision complemented the vital work that would be done by schools.

• Diversity – In response to a question on how the action plan would encompass the diversity of Medway to ensure that all the different communities were targeted accordingly and appropriately, the officer welcomed any suggestions and support that could be provided by Ward Members in reaching all areas of the community. The officer welcomed the suggestion to provide a Member briefing session on the strategy and on utilising the Medway Diversity Forum to promote the training and support available.

• Challenges- It was asked what challenges were envisaged that may impact the delivery of the action plan. The officer said that this was a new action plan which had been carefully thought out and although it was starting from a good position, promotion and ensuring good awareness of what was offered may be a challenge. Training was a key element of delivery of the plan, and it was crucial that all  ...  view the full minutes text for item 582.

This item advises Members of the current work programme and allows the Committee to adjust it in the light of latest priorities, issues and circumstances. It gives Members the opportunity to shape and direct the Committee’s activities over the year.

Discussion:

The Democratic Services Officer introduced the report and drew the Committee’s attention to the fact that the four year term of membership for the Parent Governor Representatives would expire on 25 January 2022. Arrangements would be made to recruit to the forthcoming vacancies.

Decision:

The Committee agreed the work programme as set out at Appendix 1 to the report, subject to accepting the proposed changes, outlined in italic text on Appendix 1.

The Committee recommended full Council to make the following appointments to the Committee:

·       That Vicky Aspin be appointed as the teacher position on the Committee for a two year term.

·       That Hannah Roberts be appointed as the named substitute for the teacher position on the Committee for a two year term.

·       That Lenny Williams be appointed as the Church of England Diocese representative (representing the Rochester Diocesan Board of Education).