Designated Safeguarding Children Team Annual Report 2015-2016 · provide an overview of the...
Transcript of Designated Safeguarding Children Team Annual Report 2015-2016 · provide an overview of the...
1 Final
Designated Safeguarding Children Team
Annual Report
2015-2016
July 2016
The Designated Safeguarding Children Team (DSCT) Annual Report provides information and assurance to stakeholders and
partners about the role and functions of DSCT for Norfolk and Waveney. However, the team are unable to report on all aspects of
business and activity due to the sensitive nature of some areas of work/functions of the service.
Designated Safeguarding Children Team Norfolk & Waveney CCGs
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1. Purpose of Report
1.1. The purpose of this report is to:
set the context for safeguarding children in Norfolk and Waveney;
provide an overview of the arrangements in place to safeguard and protect children across health services in Norfolk
and Waveney;
outline quality assurance arrangements;
set out objectives for 2016-2017.
1.2. The report will cover the period from 1st April 2015 to 31st March 2016.
2. Safeguarding Context
2.1. National Context
2.1.1. The following documents provide the statutory framework which sets out safeguarding responsibilities and ensures
effective arrangements are in place to safeguard children:
Working Together to Safeguard Children (March 2015);
Safeguarding Vulnerable People in the NHS - Accountability and Assurance Framework (July 2015);
Section 11 of the Children Act (2004) places duties on a range of organisations and individuals to ensure their
functions, and any services that they contract out to others, are discharged having regard to the need to safeguard
and promote the welfare of children;
The Care Quality Commission (CQC) Essential Standards for Quality and Safety (2010) includes outcome 7 which
focuses on ensuring the safeguarding of people who use services from abuse. Joint inspections are now being
implemented which look at the effectiveness of front-line safeguarding and how well the different agencies work
together.
2.2. Local Context
2.2.1. Norfolk Safeguarding Children Board (NSCB) policies and procedures.
2.2.2. NSCB priorities – Neglect, Child Sexual Exploitation (CSE) and Child Sexual Abuse (CSA).
2.2.3. Norfolk Ofsted Improvement Plan.
2.2.4. Norfolk County Council Looked After Children Strategy.
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2.3. Children subject to a Child Protection Plan (CPP)
2.3.1. The following graphs show a monthly breakdown of children subject to a CPP in Norfolk and Waveney for 2014-15 and
2015-16 (graph 1-2) and the types of abuse (graphs 3-4). Data is supplied by the Local Authority.
Graph 1
0
100
200
300
400
500
600
700
800
900
2014/15
2015/16
Number of children on Child Protection Plan - Norfolk
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There has been a decrease in the number of children on Child Protection Plans for 2015-2016 from the same period in the
previous year. The reason for this is not clear but it may be due to the impact of the roll out of Early Help, the implementation
of Signs of Safety and the Norfolk Ofsted Improvement Plan.
Below is a graph demonstrating the number of children with a Child Protection Plan in Waveney for 2014-2015 and 2015-
2016. It is difficult to make direct comparisons between Norfolk and Waveney data as Waveney’s population is far smaller.
Graph 2
0
50
100
150
200
250
Number of Children with a Child Protection Plan - Waveney
2014/2015:
2015/2016:
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Graph 3 Graph 4
Neglect remains the highest category of abuse in both Norfolk and Waveney. This suggests that greater emphasis is
required on identification and early intervention. The NSCB Neglect Strategy has continued to be implemented in 2015/16.
The ‘Multiple Abuse’ category represents more than one type of abuse.
0
10
20
30
40
50
60
70
80
Emotional Neglect Physical Sexual Multiple
Categories of Abuse - Waveney
2014/2015
2015/2016
0
50
100
150
200
250
300
350
400
450
Emotional Neglect Physical Sexual Multiple
Categories of Abuse - Norfolk
2014/15
2015/16
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2.4. Children In Care
Graph 5
The numbers of children in care in Norfolk are generally unchanged apart from a small drop in the third quarter of the year. This is
despite the Early Help Strategy which aims to identify families in need of early support in order that the appropriate assistance can
be provided with the aim of preventing family breakdown and children being placed in care. Norfolk remains a Local Authority with
higher numbers of children in care than their statistical neighbours. No information is available for Waveney at this time, however
DSCT are planning to present this information in quarterly reports going forward.
0
200
400
600
800
1000
1200
Apr-Jun Jul-Sept Oct-Dec Jan-Mar
2014/15
2015/16
Number of Children in Care - Norfolk
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2.5. Children in Need (CIN)
A Child in Need is defined under the Children Act (1989) as a child who is unlikely to reach or maintain a satisfactory level of health or development, or their health or development will be significantly impaired without the provision of services, or the child is disabled. The data for Waveney was not available at the time of this report. It is planned to be included in future reports.
Graph 6
Overall there has been a small decrease in numbers of Children in Need.
0
50
100
150
200
250
300
350
Apr-Jun Jul-Sept Oct-Dec Jan-Mar
2014
2015
Rate of Children in Need per 10,000 under-18 population - Norfolk
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2.6. LADOs
2.6.1. Twenty seven LADOs relating to health care professionals were reported in Norfolk for the period of this report.
2.6.2. More robust links have been developed between the DSCT and the LADO team and this has led to improvements in joint
working.
2.7. Serious Incidents (SI)
2.7.1. Two health serious incidents were reported to NSCB for the period of this report.
2.7.2. This represents a small increase in the numbers reported which is due to the DSCT raising with health providers the
importance of appropriate reporting of any safeguarding children SI’s to the NSCB.
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2.8. Commissioner/ Provider Framework
Great Yarmouth and
Waveney CCG
GPs
(Jointly
with
NHSE)
NNUH
IC24 JPUH
ECCH
NSFT
South Norfolk CCG
NSFT
NCEDS
Norwich CCG
NCH&C
Marie
Stopes Int
IC24
North Norfolk CCG
Spire NNUH
West Norfolk CCG
999
Service
NSFT
NCH&C
Marie
Stopes
Int
QEH
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Ellingham
Huntercombe
Public Health
Cambridge Community
Services: Children & Young
People’s Services in Norfolk
NHS England
School age
Immunisations
Opticians
CAMS Tier 4 SARC
EEAST
GP’s Dentists Pharmacists
Smoking
cessation
FNP as
part of
HCP
Specialist Commissioning
Neonatal
L4 CAMHS
T4
Renal
Dialysis
Bariatric
surgery
Airey Close
NSFT
ICASH
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3. Designated Safeguarding Children Team (DSCT)
3.1. In 2015 funding was agreed with the CCGs and Public Health, to increase the establishment within the team due to the
significant increase in workload. The team was fully recruited to by March 2016.
ROLE WTE
Designated Doctor for Safeguarding Children/Looked after children 0.6wte (0.4wte/0.2wte)
Designated Nurse for Safeguarding Children 1wte
Designated Nurse for Looked after Children 0.6wte
Deputy Designated Nurse for Safeguarding Children 0.7wte
Named GPs 0.8wte (0.6wte/0.2wte)
Quality Assurance Manager 0.46wte
Senior Administrator 1wte
Administrator 1wte
3.2. The DSCT provides support to named and lead professionals as tabled below:
DESIGNATED SAFEGUARDING CHILDREN TEAM PROVIDER SUPPORT
PROVIDER DESIGNATED LINK
Norfolk and Norwich University Hospital Designated Safeguarding Children Nurse/ Deputy Safeguarding Children Nurse
James Paget University Hospital Designated Safeguarding Children Nurse/Deputy Safeguarding Children Nurse
Norfolk and Suffolk Foundation Trust Designated Safeguarding Children Nurse/Deputy Safeguarding Children Nurse
Queen Elizabeth Hospital Designated Safeguarding Children Nurse/Deputy Safeguarding Children Nurse
East Coast Community Health Designated Safeguarding Nurse (Suffolk)
Norfolk Community Health and Care Deputy Safeguarding Children Nurse/Named GPs
Named Paediatricians Designated Doctor
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General practitioners Named GPs
999 service Designated Doctor/ Named GPs
IC24 Designated Doctor/Named GPs
Integrated Contraception and Sexual Health (ICASH)
Designated Safeguarding Children Nurse/Deputy Safeguarding Children Nurse
Cambridge Community Services Designated Safeguarding Children Nurse/Deputy Safeguarding Children Nurse
Ellingham Designated Doctor/Designated Safeguarding Children Nurse/Designated Nurse for LAC
Huntercombe Designated Doctor/Designated Safeguarding Children Nurse/Designated Nurse for LAC
SARC Designated Doctor/ Named GPs
East Anglian Ambulance Service Designated Doctor/Designated Safeguarding Children Nurse
NCH&C and ECCH LAC Services Designated LAC Nurse
3.3. DSCT has implemented safeguarding children group supervision facilitated by an external facilitator for named
professionals working within Norfolk and Waveney provider organisations which takes place on a 6 weekly basis.
3.4. The Designated Doctor and Designated Nurse have supported the development of a regional training event (Level 4) which
took place in May 2016 covering a range of ‘Hot Topics’ relating to safeguarding children.
3.5. An ‘Away Day’ was held in November 2015 led by the DSCT for named professionals covering topics such as Prevent,
Female Genital Mutilation (FGM) and CSE. This will become an annual event with one planned for November 2016.
4. Norfolk Safeguarding Children Board (NSCB). 4.1. DSCT and health providers provide representation at the NSCB and NSCB sub-groups.
4.2. The NSCB priorities continue to be Neglect, CSE and CSA which provide the strategic direction for the DSCT and health
providers regarding the safeguarding children agenda.
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5. Child Death Overview Panel (CDOP).
5.1. The CDOP process was deemed to be inadequate by Ofsted due to the large backlog of cases. The backlog of cases was
addressed in October 2015. Terms of reference have been reviewed along with the membership and the national process
has been adopted including using National Forms A, B and C to streamline the review of child deaths. Form A is for
notification of a child death and will be completed by the notifier. Form B will be sent to relevant agencies asking the case
responsible individual to complete as much as is known about the circumstances of death and relevant history and return
within 3 weeks. If an Agency has no relevant information or involvement regarding the death, then CDOP is asking that an
email be sent to inform CDOP of this. Once Form B has been completed and returned, this will then become Form C. Form
C will be the information presented to the CDOP for discussion.
5.2. CDOP meetings are now held bi-monthly.
5.3. CDOP meetings are attended by the Designated Doctor or Designated Nurse for Safeguarding Children.
5.4. The Designated Doctor will be working with CDOP to undertake a preliminary review of circumstances around child deaths
in preparation for CDOP meetings to underpin more effective and timely information gathering and inform decision making
at Panel.
5.5. The DSCT are part of a multi-agency task and finish group reviewing the NSCB ‘Management of Child Death Policy’ and
‘When a Child Dies’ booklet which will then be ratified by the NSCB in due course.
5.6. The DSCT is awaiting proposed changes to CDOP arrangements in line with the Wood Report recommendations (May
2016).
5.7. The DSCT has highlighted gaps in the provision of the Rapid Response Team in the Waveney area. The Great Yarmouth
and Waveney Children’s Commissioner is now working with NNUH to address the gap.
6. Norfolk Safeguarding Children Health Advisory Group (NSCHAG).
6.1. The function of the NSCHAG is to define the strategic direction in relation to the planning, commissioning and delivery of
services to vulnerable children. The group provides assurance to the NSCB that commissioners and providers of health
services in Norfolk and Waveney work closely with each other. The group monitors and reviews the effectiveness of
safeguarding arrangements across the health economy, across organisational locality boundaries and across borders. The
group has representation from the Norfolk and Waveney CCGs, Public Health, NSCB and NHS provider organisations
across the county and the group reports to the NSCB.
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6.2. Poor attendance has led to the Terms of Reference and format of the group being revised. There are now two parts to the
group. Part A includes Commissioners and the DSCT meeting to address quality assurance and commissioning issues.
Part B includes Provider Executive Safeguarding Children Leads joining the meeting to agree priorities and actions to
address safeguarding issues. Attendance logs are now being monitored (Appendix 2).
6.3. The Norfolk and Waveney CCG Risk Register (Appendix 1) is monitored through this group. It has recently been
reformatted to meet governance processes within Great Yarmouth and Waveney CCG; it is submitted monthly and
reviewed at Great Yarmouth and Waveney Executive Team meetings (HEX) along with all Directorate Risk Registers. HEX
will approve/challenge the risks and when appropriate oversee migration of the risks onto the CCG Strategic Risk Register;
this mirrors the process in West and Norwich CCGs. Any risk to safeguarding will be shared with CCGs to migrate onto
their Risk Registers.
6.4. The Suffolk Health Executive Group for Safeguarding Children is attended by the Chief Nurse from Great Yarmouth and
Waveney CCG.
7. Safeguarding Monitoring of Providers
7.1. Providers – Queen Elizabeth Hospital Kings Lynn (QEHKL) and Norfolk and Norwich University Hospital (NNUH) have new
safeguarding children team models in place.
7.2. DSCT Quality Dashboard - The Dashboard continues to develop with the inclusion from SARC and Ellingham Hospital
since quarter 3. Cambridge Community Services have also been invited to provide data. Going forward IC24, Huntercombe
and Quidenham will also be invited.
7.3. Provider audits have been carried out. Members of staff within a provider organisation are randomly selected to ascertain
their knowledge of safeguarding children and to determine the effectiveness of safeguarding children training. A report is
produced for the provider to demonstrate the effectiveness of their safeguarding children training or to inform the
organisation’s work plan.
7.4. Goddard Inquiry – An independent inquiry into CSA led by Justice Lowell Goddard is underway and will provide annual
reports, concluding in 2020. Chief Executives have been written to and a checklist provided to enable organisations to be
proactive in preparing to meet the expectations of the inquiry. This will be monitored through NSCHAG.
7.5. CQC Action plan - A Review of Health Services for Children Looked After and Safeguarding Children in Norfolk, was
carried out from 20th-24th October 2014 by the CQC. The report and recommendations were published online on 4th June
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2015. In response an action plan was developed by the DSCT on behalf of the CCGs and has been monitored through
NSCHAG. Good progress has been made and complete sign off on this action plan is anticipated in September 2016.
8. Serious Case Reviews (SCR)
8.1. The DSCT are leading on the health contribution to the SCR process, working with providers to identify health specific
themes and areas for learning.
8.2. Two SCRs have been commissioned for the period covering this report.
8.3. The DSCT have worked with providers to develop action plans for cases M, N, O and P which are being monitored through
the NSCHAG.
9. Child Protection Information System (CPIS).
9.1. The DSCT continue to work with the Local Authority on the implementation of CPIS.
9.2. Concerns around delays in implementation have been escalated by the DSCT to the Assistant Director for Performance
and Challenge within the Local Authority. An update is awaited from the Local Authority IT department.
10. Looked After Children (LAC)
10.1. Following an inadequate Norfolk Ofsted Inspection in September 2015, health organisations have been working with the
Local Authority to improve timeliness and quality of health assessments for children to meet compliance with statutory
guidance.
10.2. A Business Process Re-engineering (BPR) event was held on 3rd February 2016 which included all stakeholders and
mapped the complex process between Norfolk County Council and the health providers. This has enabled some
adjustments and a refocussing to deliver more timely compliance. Since the event, there have been parallel work streams
in progress with collaboration between partner agencies to achieve positive improvement in several areas.
10.3. Initial health assessments – there has been significant improvement in compliance since the 4% compliance reported in
February 2016 by the Local Authority.
10.4. Following on from work undertaken at a workshop in September 2015 to scope a way forward, an inaugural meeting of a
steering group to agree a Project Initiation Document (PID) was held on 19 February 2016, with representation by
stakeholders from Health and Social Care sectors. The project will implement a new model of care agreed at the
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September workshop. A project lead was commissioned by the central CCGs, and a business case has been developed,
and this was presented at a workshop held on 25th May 2016. Following wide agreement from stakeholders, the business
case was ratified by the Joint Commissioning Committee in June 2016. The aim is to implement the new model
immediately and negotiation of a contract variation.
10.5. The ‘Re-imagining Norfolk’ team at the Local Authority has worked with Public Health and the LAC designated health
professionals to undertake an audit of the clinical quality of health assessments. A re-audit will be carried out in July 2016
and the results of this will be available in September 2016`. A joint-agency event will be held on 7th June 2016 to write an
action plan from the results. This example of joint working should provide a catalyst for ongoing collaboration which will
reduce duplication and enable best practice across services and disciplines.
10.6. Health Passports - The Norfolk health passport has been developed and signed-off by a working group including the In-
Care Council, and was launched at an event on 5th July 2016. It is intended that the health passport will be issued to all
school age new entrants to care at their initial health assessment appointment. For children and young people who do not
have a health passport these will be issued one at their next review health assessment.
10.7. 196 children are placed out of Norfolk, of these children 150 have had an up to date health assessment as at June 2016.
For those who have not had an up to date assessment there are various reasons for this which require further investigation.
The co-location of the LAC coordinator in the hub has improved working practice and areas for further improvement can
now be addressed.
10.8. The LAC Quality Dashboard is under development. Work is planned with the Local Authority to produce a joint dashboard.
11. GPs 11.1. The focus of the work in 2015-2016 has been to help equip practitioners and support them in their role to be engaged in all
aspects of safeguarding children work. 11.2. The named GPs have provided safeguarding children training sessions in all 5 CCG areas. These sessions addressed
Level 3 competences (Safeguarding Children and Young People: Roles and Competences for Health Care Staff - Intercollegiate Document 2014). In response to feedback from GPs and incidents the named GPs have developed some subject specific shorter sessions. The first of these was delivered on bruises in young children the west in December 2015.
11.3. A network aims to clarify the role of GP safeguarding children leads and provides a six monthly forum for them to share learning and experience. Topics discussed to date include ,role of GP safeguarding lead, training requirements for staff in general practice, practice processes (Section 11 Children Act 2004), Special Educational Need and Disability (SEND), thresholds and referral, Signs of Safety assessment tool, learning from serious case reviews and inspections.
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11.4. Sample safeguarding children policies and procedures and the resource pack for general practice have been revised and updated and audit tools have been developed for processes such as recording who attends consultations with a child and for following up of missed appointments for children.
11.5. The named GPs have worked with IT support from NELCSU to provide in-practice sessions on the use of the SystmOne
East of England safeguarding children template.
11.6. Work has been progressed with health visiting provider organisations to develop standards and a sample contract for
regular planned contact between Health Visitors (HV) and GPs.
11.7. A monthly newsletter ’Spotlight on Safeguarding’ is produced to publicise new policies, processes, publications, training
opportunities and learning from SCRs.
11.8. The named GPs have worked with the safeguarding children Quality Assurance Manager to produce an audit tool for
general practice to monitor compliance with Section 11 of the Children Act (2004).
12. Designated Safeguarding Children Team Priorities for 2016-2017
12.1. Reviewing medical aspects of NSCB policies and leading on the implementation for health:
Female Genital Mutilation
Managing Child Deaths
Medical Examinations
Joint Working Protocol
12.2. Multi Agency Safeguarding Hub (MASH)
The DSCT has led on a multi-agency task and finish group which has produced recommendations for an integrated MASH
model.
A business case is under development for additional health resource within MASH. DSCT provide representation on the Missing Children sub group of NSCB. The DSCT are working with Cambridgeshire Community Services around MASH health practitioner involvement in the review of the Missing Children in accordance with the NHS England policy ‘Safeguarding Alerts Policy and Procedures’.
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12.3. Links with Local Authority
The DSCT continues to build stronger links with the Local Authority to establish more effective joint working at a strategic
level and to support the Local Authority Ofsted Improvement Plan and Looked After Children Strategy.
12.4. NSCB Procedure for undertaking joint visits and assessments by Social Workers, Health Visitors and Midwives,
for Children under 5 (3.11)
DCST has led on the ongoing work to embed joint working between Health and Social Care professionals relating to
vulnerable children (0-5yr old).
The protocol has been ratified by the NSCB and published on the NSCB website.
12.5. Development of CCG training
The DSCT have developed mandatory safeguarding children board training which will be piloted in Great Yarmouth and
Waveney CCG. This will then be rolled out to other CCGs.
DSCT is supporting CCGs in undertaking a safeguarding children training need analysis for all CCG employees.
12.6. NSCB Priorities (CSE/CSA/Neglect) The Designated Doctor is the CSE/CSA lead for the Team. CSE leads have also established within the main provider organisations. The DSCT will support the implementation of CSE lead responsibilities once these have been published by NHS England. The DSCT is continuing to build stronger links with SARC. The DSCT is supporting the roll out of daily MARACS across the county following a positive evaluation of the pilot in the east of the county. The DSCT have supported a health provider to attend a NSPCC presentation on the Graded Care Profile version 2 (GCPv.2 - shorter version). The implementation of the GCPv.2 across Norfolk will be considered by the Neglect Strategy Steering Group. Neglect Raising Awareness Sessions continue to be cascaded to health professionals.
DSCT have supported the roll out of training for neglect champions and will continue to provide support in strengthening the
role of neglect champions.
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12.7. Signs of Safety The Designated Nurse for Safeguarding Children provides representation on the Signs of Safety Steering Group. The DSCT supported the Signs of Safety Conference in February 2016 which was led by the Local Authority. The DSCT continues to support the embedding of the Signs of Safety philosophical framework in practice.
12.8. Threshold Document
The Threshold document has been revised and relaunched by the NSCB and provides a framework for decision making to
ensure children and young people receive the right service at the right time for the right duration.
The DSCT has contributed to the review of this document which is aligned with the Signs of Safety Framework.
12.9. Level 3 Multi-disciplinary Safeguarding Children Training
The DSCT is currently developing bespoke multidisciplinary safeguarding children training in partnership with health
providers.
12.10. Bereavement Support
The DSCT have escalated gaps around bereavement support for a small cohort of parents and the Local Authority is
looking at potential options for addressing the gap.
12.11. Evaluation of GP/HV Communication and Information Sharing
A GP/HV evaluation was undertaken earlier this year to determine the effectiveness of GP/HV communication and
information sharing in light of the findings from the CQC Inspection in 2014 and SCRs.
An executive summary report has been circulated and an action plan will be developed with both commissioners and
providers to implement the recommendations to improve joint working to safeguard children.
12.12. Channel Panel
The DSCT provides representation on the Channel Panel to support multi-agency decision making around young people at
risk of radicalisation.
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Appendices
Appendix 1: Risk Register
Source Top
BAF
Priorit
y /
Corpor
ate
Objecti
ve
Date No. Risk
Type
Risk BAF
/
CRR
/
DRR
Impact Like
liho
od
Initial
Risk
Score
Key Controls &
Assurances
Impact Like
liho
od
Current
Risk
Score
Impact Like
liho
od
Target
Risk
Score
Progress Update
(including confirmation on gaps in assurance &
control /
note to confirm archiving on final HEX update)
Actions
complete
d Y/N
Function Responsible
Senior
Manager
Committee/Pr
ogramme
Board/Project
Steering
Group
Audit Trail
on
reporting
Safeguard
ing
Children
Quality
Oct-
15
Reputa
tional /
Quality
The setting of targets for Health in
the Ofsted Improvement Plan
compiled by Norfolk County Council
(NCC) have not been agreed with
CCG lead (Director of C&Q
GYWCCG) for Safeguarding
Children. The failure to meet targets
is potentially damaging to the Norfolk
CCGs reputation.
DRR 3 3 9 1. Escalated by Designated
Safeguarding Children Nurse
to Director of C&Q
GY&WCCG. 2. DSCT to
promote effective
partnership working across
the economy and
collaboration with NCC. 3.
NSCB Leadership group and
NSCB oversee and monitor
the NCC Action Plan
3 3 9 2 2 4 01/03/16:- 1. Director of C&Q has written to Michael
Rosen. 2. Escalated to NSCB via section 11 self-
assessment process.
y Partnershi
p &
Delivery
Director of
Commissioning
and Quality
GY&W
Norfolk
Safeguarding
Children Health
Advisory
Group.
<15 retain
on
Partnership
and Delivery
Directorate
Risk
Register
Safeguard
ing
Children Quality
/
Improv
ed
experi
ence
Mar-
16
Quality
/
Financi
al
Compliance with Looked After
Children Standards will not improve
unless the LAC service is led and
resourced correctly.
DRR 5 2 10 Multi Agency group in
progress to co-ordinate
planning of improvements.
2. Provider manager of
NCH&C actively pursuing
and implementing new
model of GP recruitment.
Locum paediatricians in
place.
4 2 8 2 2 4 11/04/16 LAC resource and leadership raised at the
System Leadership Group where CEOs for
commissioners and providers are present.
Agreement for new senior officer and project
manager to be appointed. July 16- Quality and
timeliness improvements continue to progress.
y Designated
Doctor LAC /
Designated
Nurse LAC.
Norfolk
Safeguarding
Children Health
Advisory
Group.
Safeguard
ing
Children Quality
/
Sustai
nable
Financ
ing/
Improv
ed
experi
ence
Apr-
13
Quality
/
Financi
al
The Statutory responsibilities for the
provision of Health Assessments for
Looked after Children are not met.
5 4 20 Work streams in progress
from initial project planning
meeting led by
commissioners. CCGs
responsible for negotiating
contract with their providers,
with sufficient resource to
enable quality health care.
4 3 12 2 3 6 01/03/16 1. DSCT leading agreed proposed changes
for delivery of IHA using GP model. 2. Work also in
progress to improve administrative efficiency using
new processes following multiagency BPR work. 3.
DSCT working to replace BAAF paperwork with that
developed by Herts and Cambs. 4. DSCT working
with provider (NCH&C) to maximise number of initial
assessments in short term. 14.6.16: Although GP
model not yet in place there has been a significant
improvement in IHA completed within time frame. In
June 2106 almost 88% were completed in time
frame and 83% of all health assessments for the
1039 looked after children were up to date. The GP
model is due to come into place to ensure that
y Designated Dr
LAC/
Designated
nurse LAC
Norfolk
Safeguarding
Children Health
Advisory
Group.
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improvements maintained.
Safeguard
ing
Children
Quality
/ Make
a
differe
nce for
local
people
/
Improv
ed
experi
ence
Feb-
14
Quality Health needs of care leavers will not
be met due to lack of services.
3 5 15 CCG to commission
adequate service for this
group of young people.
3 4 12 2 3 6 01/03/16. 1. Project plan to include discussions
regarding improvements to service to care leaders.
Designated
Doctor LAC/
Designated
nurse LAC
Norfolk
Safeguarding
Children Health
Advisory Group
Safeguard
ing
Children Quality
/ Make
a
differe
nce for
local
people
/
Improv
ed
Experi
enced
Jul-
13
Quality Lack of effective Pathways and Tier
4 services resulting in inappropriate
admissions to adult / acute facilities
impacting on safe discharge/ transfer
from Tier 4 services.
3 4 12 1. NSFT to open Tier 4 unit
in Carleton Court.
2. Meeting convened to
discuss tripartite
arrangements for high risk
cases requiring secure
accommodation.
3 2 6 2 2 4 01/03/16. 1. Development of protocol for exceptional
placements in progress (PEEP). 14/03/161. The
draft transformation Plan for NSFT CAMHS
incorporating work streams alongside the local
authority and partner agencies looks to address;
early help and support for schools to manage
emotional well-being; intensive and crisis support for
young people; improved access to Eating Disorder
Assessment and Treatment; support for LAC in
partnership with the local authority within specialist
educational services. 2. From the multi-agency tri
partite meeting a working group has been formed
headed by the Designated Doctor to look at a joint
approach to the assessment and placement of young
people in crisis this includes acute Trusts, NSFT,
Police and the local authority
NHS England /
NSFT
Norfolk
Safeguarding
Children Health
Advisory
Group.
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Safeguard
ing
Children Quality
/
Sustai
nable
financi
ng/Effe
ctivene
ss
Apr-
16
Quality
/
Financi
al
Due to limited health practitioner
resource in the Multi Agency
Safeguarding Hub (MASH), there is
a risk around gaps in information
sharing to inform decision making for
safeguarding children referrals, and
no provision of health resource for
the assessment of adult
safeguarding cases.
2 5 10 1. MASH Board have made
proposals for the redesign of
MASH to an integrated
model increasing health
resource. 2. Cambridge
Community Services are
developing a rotational
model whereby safeguarding
supervisors provide
additional sessions.
2 4 8 2 2 4 18/04/16. Pilot of daily MARACS in the east of the
county.
Business Case in development to ensure appropriate
health representation within MASH.
Fast track process for high risk CPIS forms (39D)
Designated
Safeguarding
Children Nurse
Norfolk
Safeguarding
Children Health
Advisory group.
Safeguard
ing
Children
Quality
Due to lack of placements and
Health involvement in planning there
is a risk that CYP are moved to
inappropriate placements as they
transfer from children to adult
services
1. Central and West CCGs in
Norfolk have a monthly
complex case eligibility panel
- managed by CSU - that
includes the reviewing of
CYP with tripartite funding.
2. Robust system within
Suffolk. 3. Transitional Lead
in Norfolk has regular
meetings with children’s
continuing care team to
ensure all CYP with complex
needs are included and
tracked.
May 2016- Norfolk and Suffolk have a Transitional
Lead (LA) have an overview on transition into adult
services. West Norfolk has this identified as a risk on
their RR (CCG). Each child should have a lead
health professional identified. Awaiting information
as to how this is managed in Norwich, North Norfolk
and South Norfolk CCG. All CCGs have been
informed that each child is required to have an
identified Lead health professional. Commissioning
managers to ensure that redrafted reviewed joint
commissioning arrangements with NCC take into
account the need for clinical input and oversight at
key points of transition process/out of county
returning CYP/ tripartite case reviews.
Lead Nurse
SEND
coordinating on
behalf of CCGs
CCGs and
Norfolk
Safeguarding
Children Health
Advisory
Group.
23 Final
Appendix 2: Norfolk Safeguarding Children Health Advisory Group Membership/Attendance 2015-16
Name: Role Membership Organisation 05/03/15 28/05/15 28/09/15 26/11/15 10/03/16
Cath Byford
Director of Commissioning and Quality Chief Nurse/Deputy Chief Executive
Full – Chair Great Yarmouth and Waveney CCG
Y Y Y Y Y
Karen Watts (previously Sheila Glenn)
Acting Director of Quality Norwich CCG Y
N
Chris Turner
N Y Sheila Glen
(part)
Jackie Schneider Governing Body Registered Nurse North Norfolk CCG
N
Marie McDermot
t
N Y N
N
Marie McDermott
(part)
Alison Leather (previously Jo Yellon)
Head of Quality Assurance South Norfolk CCG Y
N
Karen Ward
N
N
Karen Ward
N
Maggie Carter Head of Clinical Quality and Patient Safety
West Norfolk CCG N
N
Sue Hayter
N N N
Sarah Barnes Commissioning Manager for Children and Young People
Public Health N
N
Carolyn Watts
Y Y Y
Mavis Spencer Deputy Director of Nursing NHS England - East N N N N N
Catherine Knox (previously Jane Black)
Designated Named Nurse DSCT N Y Y N Y
Anita Bagge (previously Mark Gower)
Designated Nurse for LAC DSCT Y Y Y N Y
Suzie Fiske/Jane McIntosh
Named GPs DSCT Y Y N Y Y
Bindy Price Quality Assurance Manager DSCT N Y Y Y Y
Sarah Steel Designated Doctor for Safeguarding and LAC
DSCT Not in post
Not in post
Y Y N
Abigail McGarry Board Manager NSCB Y N Y N Y
24 Final
Mandy Renton Chief Nurse CCS N/A N/A N
John Peberdy
Y
John Peberdy
N
John Peberdy & Sian
Larrington
Ali Jennings Named Nurse ECCH N N N Y N
Simon Chase Regional Safeguarding Lead EEAST N N Y N N
Julia Hunt (previously Liz Libiszewski)
Interim Director of Nursing, Quality and Patient Experience
JPUH N N N
Julia Hunt
N
Julia Hunt
N
Julia Hunt
Anna Morgan Director of Service Pathways NCH&C N N N
Richard Allen N N
Emma McKay Director of Nursing NNUH Y Y N
Kim Goodby N N
Jane Sayer Director of Nursing, Quality and Patient Safety
NSFT Y
N
Saranna Burgess
N
N
Saranna Burgess
N
Saranna Burgess
Catherine Morgan Director of Nursing QEH
N
Valerie Newton
N
N
Valerie Newton
Y Y