To receive a presentation from Janette Harrison, Designated Nurse, Children and Adult Safeguarding and Chris West, Director of Nursing and Quality, reviewing the issues raised in the Care Quality Commission (CQC) report; “Review of Health Services for Children Looked After and Safeguarding in Rutland.”

A copy of the CQC report is attached

A presentation reviewing the issues raised in the Care Quality Commission (CQC) report; “Review of Health Services for Children Looked After and Safeguarding in Rutland.” was received from Janette Harrison, Designated Nurse, Children and Adult Safeguarding and Chris West, Director of Nursing and Quality.

During discussion the following points were noted:

·         The CQC review took place in July 2019 and looked at the experiences of 50 children including 6 cases which were then further tracked right across the range of health practitioners and partner agencies.

·         Unlike OFSTED, the CQC did not provide a judgement grade but asked for action plans to be submitted. The action plans were collated from RCC and Public Health commissioned services such as drug and alcohol and sexual services, as well as from the CCG.

·         Any reports submitted to the CGG went first to the organisations’ safeguarding committees.

·         The review looked at four main areas; Early Help, Children In Need, Child Protection and Looked After Children (LAC), as well as the management and governance of these areas.

·         All children in care with mental health issues could be fast tracked to a specialist Children and Adolescent Mental Health Services (CAMHS) team; the Young Persons’ Team. A recent audit had shown that there were no Rutland children in care who were currently on the CAMHS waiting list.

·         Every LAC had to have an independent health assessment (IHA) within 20 days.

·         Peterborough and Cambridgeshire hospitals had explained that they had not got the capacity to do any IHAs for LLR so a specialist nurse went out of area to perform them. 

·         The CQC had looked at the management and the leadership of the health services for Children Looked After and Safeguarding in Rutland and could see that the issues were already being worked on.

·         Councillor Begy asked whether the action plan and a further progress report could be given to ensure that the actions were being delivered and were on track.

·         The inspection that the CQC referred to in their report was an inspection in November 2018 but their report was just 6 months later in July 2019. 7/8 months was not a great deal of time to see results but the CQC appreciated that things were on the right trajectory.

·         Midwifery was currently being audited which would enable the CCG to see whether the pre-birth assessments, referred to in 2.6 of the report, were now robust.

·         Councillor Harvey voiced concern, and this was also highlighted in the CQC report at para 4.10, that although there was a fast track to CAMHS for assessment for Children Looked After, the waiting time for actual treatment was still too long.

·         The IHAs were sometimes undertaken by trainees but their work was overseen by the CCG’s designated doctor, Dr Lyn Snow, and were regularly quality checked.

·         Any 18 year olds or younger who presented themselves to the adult emergency department were now asked a set of questions to ensure that safeguarding was considered.

·         Level 3 training in safeguarding was being rolled out across the board so that eventually all nurses in hospital settings would be fully trained.

·         The action plan was in 5 parts and the CCG had to email each of the agencies involved to ask permission to release their plans. This could not be achieved within the timeframe for the meeting but the CCG confirmed that once they had received this permission they would be happy to let the Committee see the complete action plan, as requested by the CQC in their report.

RESOLVED:

·         The Committee REQUESTED that the CCG allow Members to review the complete action plan which addressed the recommendations outlined by the CQC in their report, Review of Health Services for Children Looked After and Safeguarding in Rutland.