Working on behalf of NHS Newark and Sherwood CCG, NHS Mansfield and Ashfield CCG, NHS Rushcliffe CCG, Nottingham North and East CCG, NHS Nottingham West CCG, NHS Bassetlaw CCG GB 16/023c Safeguarding Committee Held on Monday, 21 December 2015 1.00pm at Birch House, Ransomwood Business Park, Mansfield Present: Elaine Moss Val Simnett Dr Vicki Walker Amanda Edmonds Gail Colley- Bontoft Gary Eves Nicola Ryan Mary Corcoran Cathy Burke Kerrie Adams In attendance: Sue Wass Chief Nurse, Newark and Sherwood and Mansfield and Ashfield CCGs (Chair) Designated Nurse Safeguarding Children, Newark & Sherwood CCG Designated Doctor for Children in Care and named doctor for M&A and N&S CCGs (from item 124) Designated Nurse Children in Care Nottinghamshire and Nottingham City (from item 124) Head of Quality and Adult Safeguarding, Nottingham North and East CCG Senior Public Health and Commissioning Manager, Nottinghamshire County Council (from item 124) Deputy Chief Nurse, Bassetlaw CCG Consultant in Public Health, Nottinghamshire County Council (items 1-133) Nurse Consultant Safeguarding, Bassetlaw CCG Senior Public Health & Commissioning Manager, Nottinghamshire County Council (from item 124) Corporate Governance Officer (minutes) ADULT SAFEGUARDING AGENDA WELCOME AND INTRODUCTIONS (SG/15/113) The Chair welcomed members to the meeting. APOLOGIES FOR ABSENCE (SG/15/114) Apologies were received from Nichola Bramhall, Dr Rebecca Stone, Dr Fiona Straw, Dr Emma Fillmore, Dr Amy Taylor, Dr Rebecca Sands, Amanda Jones and Rosa Waddingham. DECLARATIONS OF INTEREST (SG/15/115) No declarations of interest were made in relation to the adult safeguarding agenda. MINUTES OF THE ADULTS SAFEGUARDING COMMITTEE HELD ON 7 SEPTEMBER 2015 (SG/15/116) The minutes were agreed as an accurate record of the meeting. MATTERS ARISING (SG/15/117) The following actions arising from the previous meeting were noted: 1
AS/14/75 FORWARD LOOK: GP member to be requested going forward. Nichola Bramhall will be asked for an update the position for the south at the next meeting. Gail Colley-Bontoft would pursue the action. The Chair emphasised that although there were named GPs from mid Notts, as the Committee was county-wide it would be useful to have a GP representative with a safeguarding role from south Notts or Bassetlaw. Mary Corcoran suggested that the Committee may choose to change the day of the meetings going forward in order to better accommodate GP diaries. ACTION: SW to change the dates of future meetings to a Tuesday. SG/15/90 NSAB UPDATE: SW to add DSAM role to the forward agenda. It was noted that the role was no longer a requirement, however it would be added to the agenda for the development session on 11 th January to assess whether it would be a useful role for the Nottinghamshire CCGs going forward. All other actions were noted as completed. DEPRIVATION OF LIBERTYSAFEGUARDS (SG/15/118) Gail Colley-Bontoft reported to the Committee that with Rosa Waddingham she had undertaken a scoping exercise into the number of patients in the CCG areas in community home care settings that were potentially subject to Deprivation of Liberty Safeguards (DoLS). In total 31 had been identified (5 in Mansfield & Ashfield; 6 in Newark and Sherwood; 8 in Nottingham North & East; 6 in Rushcliffe; and 6 in Nottingham West). They would be risk assessed to ensure that a care plan was in place. There was a discussion concerning the financial implications of seeking legal advice. It was agreed that once the number of potential cases was known, advice from CCG procurement leads should be sought in order to pursue a joint instruction with Browne Jacobson to seek lever a discounted rate. It was agreed that Gail Colley-Bontoft should pursue this route and report back to the March Committee on progress ACTIONS: GCB to report back to the March Committee on progress Other CCGs to formally email Gail to ask her to pursue joint procurement arrangements Gail Colley-Bontoft had drafted guidance on when to inform the Coroner s Office of the death of a patient subject to DoLS. The protocol was intended to help GP practices and care homes decide whether the Coroner s Office should be informed. It had been previously discussed and approved by the Coroner s Office. The Committee agreed that the protocol should be tested with a number of GP practices prior to being circulated more widely. It was agreed that the protocol, once tested, should be adopted and be circulated to GP practices, care homes and the local authority. It would be placed on CCG websites and in newsletters. Bassetlaw agreed to adopt the protocol and it would also be sent to Nottingham City CCG. ACTION: GCB to report back to the March Committee on progress with the testing of the DoLS protocol. 2
LOCAL UPDATES (SG/15/119) NSAB It was noted that there had been an action for CCGs to raise awareness among GPs of the outcome of serious case reviews. An update would be given at the March Committee. JOINT SAFEGUARDING AGENDA Gary Eves, Kerrie Adams, Amanda Edmonds and Dr Victoria Walker joined the meeting DECLARATIONS OF INTEREST (SG/15/124) No declarations of interest were made in relation to the agenda. MINUTES OF JOINT SAFEGUARDING MEETING HELD 17 SEPTEMBER 2015 (SG/15/125) The minutes were agreed as an accurate record of the meeting. MATTERS ARISING (SG/15/126) SG/15/96 IRIS: NB to update the Committee on the implementation of the IRIS project in the south CCGs It was agreed that a paper should be drafted for the March Committee Meeting. ACTION: Update report on IRIS to be drafted for the March Committee GBC/NB SG/15/97 TRANSITION: GE to circulate the transition report to the Committee. Action outstanding. REPORTS (SG/15/127) LESSONS LEARNT FROM THE NHS INVESTIGATIONS INTO MATTERS RELATING TO JIMMY SAVILE ASSURANCE REPORT Val Simnett introduced a report that summarised the assurances received from the CCGs main provider organisations that they had implemented the recommendations of the Kate Lampard Report. It was noted that Sherwood Forest Hospitals Foundation Trust and Doncaster and Bassetlaw Hospitals Foundation Trust had outstanding actions to complete. An update from Elaine Moss and Cathy Burke would be given at the March Committee meeting. ACTION: EM/CB to provide an update at the March Committee Meeting. BASSETLAW GP PRACTICE JSAAF MARKERS OF GOOD PRACTICE VISIT REPORT Cathy Burke reported that all GP practices in the Bassetlaw CCG area had been visited during 2015 to undertake a safeguarding audit. No significant concerns had been identified, although there were a number of recurring themes for safeguarding development. Practices would now be visited to discuss the outcome of the audit and take forward areas for development. 3
There was a discussion on how mid and south Nottinghamshire CCGs, who had a larger cohort of practices, could also seek assurance. Val Simnett had circulated a selfassessment to all practices and it had been agreed to visit practices on a risk-based approach, using CQC data. It was also suggested that links should be made with primary care teams, who could seek assurance on non-specialist areas. It was agreed that a record of responses to the self-assessment and log of visits should be kept and a progress report given at the March Committee Meeting. ACTION: VS/GBC to update on progress at the March Committee Meeting. DISCLOSURE AND BARRING CHECKS FOR MASH STAFF Val Simnett reported that current requirements relating to application of the Disclosure and Barring Scheme meant that for staff who did not have direct access to children or vulnerable adults as part of a regulated activity it was not appropriate to ask for a DBS check. Arden GEM had recommended however that given the nature of work that MASH undertakes, it may be appropriate for a police check for staff at the MASH. It was agreed that MASH staff were dealing with highly sensitive information and DBS checks should be conducted. Police checks were not appropriate as many areas that they checked were not relevant. The Chair had been in discussion with the MASH police, who would formally apply for DBS checks to be undertaken on all MASH staff going forward. PREVENT Gail Colley-Bontoft had drafted a number guidance to support practitioners understanding of the PREVENT agenda and how to ensure signs that someone had been drawn into terrorism were spotted and acted upon in the correct manner. It was agreed that the fact sheets be circulated to GP practices and to PREVENT leads in other CCG provider organisations for dissemination. ACTIONS: SW to circulate the fact sheet as word documents to enable key contacts to be changed for each CCG before wider dissemination. VS/GCB/CB to circulate the fact sheets to GP practices and PREVENT leads in provider organisations In discussion it was agreed that the guidance should be adapted to become the Nottinghamshire CCGs policy for responding to the PREVENT agenda. It was agreed to ask Nichola Bramhall to take the policy to the NSAB and NSCB to inform the Boards of health actions and to share with Nottingham City CCG. It was noted that it was unclear whether there was a health representative on the Nottinghamshire CHANNEL panel, which was seen as a gap; and it would be helpful for Nichola Bramhall as PREVENT lead to sit on the group. ACTION: GCB to feed back Nichola Bramhall on the discussion regarding the Channel Panel and the suggestion that Nichola joins the group. POLICIES / GUIDANCE (SG/15/128) BASSETLAW CCG POLICY AND STRATEGY 4
The Bassetlaw Safeguarding policy and strategy had been brought to the Committee for noting. It was agreed to remove the reference to the DSAM role when the policy was next updated. NOTTINGHAMSHIRE SAFEGUARDING POLICY UPDATED Val Simnett had updated the Nottinghamshire Safeguarding Policy to reflect changes in the Care Act and governance arrangements within the CCG. The revised policy was approved and it was agreed to update the section on PREVENT training following the discussion at item SG/15/127. CCG SAFEGUARDING POLICY: PRACTICAL IMPLEMENTATION Val Simnett had drafted the paper following a request by a CCG governing body to map how CCG responsibilities within the policy were being fulfilled. It was agreed to keep the matrix under review as part of the Committee s workplan 2016/17. Gary Eves asked for clarity around the accountability and monitoring of roles that would shortly transfer to CCGs. It was noted that Nichola Bramhall was convening a meeting to discuss this issue and Cathy Burke asked to be invited to the meeting. ASSURANCE (SG/15/129) COMBINED ADULT/CHILDREN RISK REGISTER SG Combined 1: It was agreed to remove references to home care and for home care to be developed into a separate risk. Having removed the home care element the risk related only to the transfer of continuing healthcare to Citycare, which it was agreed the level of risk should be lowered to 2x4. ACTION: RW and GCB to draft a paper on home care with an associated risk to be added to the Risk Register for discussion at the March Safeguarding Committee. SG Combined 2: It was agreed that the wording should be revised to give clarity to the CCGs role being one of assurance rather than delivery. Reference should also be made to the Committee s PREVENT policy, as agreed at item SG/15/127. ACTION: GCB/NB to update the risk in line with the discussion at the Committee. SG Combined 3: The Chair reported that this issue had been discussed in length by the Quality and Risk Committee and a paper would be shared with the Safeguarding Committee at the March meeting. Gary Eves added that there were separate challenges regarding children s Care and Treatment Reviews, with uncertainty over definitions and resources. It was agreed to leave he risk score as 4x3 until the March Committee when a substantial discussion would be had. New risk: At the last meeting the Committee had discussed a potential risk around delays in information sharing in the MASH. It was agreed that this was not a risk for the risk register. It was agreed that a paper should be brought to the March Committee to examine the level of risk associated with the staffing at MASH and to test other CCGs response to providing contingency cover within the MASH. ACTION: VS to ask Jane Brady to draft a paper on MASH staffing for the March Committee 5
LOCAL / NATIONAL UPDATES (SG/15/130) MASH It was recognised that call handling and waiting times had fallen below standard due to staff sickness and increased call volumes. The situation was now improving. SAFEGUARDING FORUM The update report was noted. ADMINISTRATION (SG/15/100) COMMITTEE DEVELOPMENT DAY It was agreed to examine how the Safeguarding Assurance Group would function in practice at the Committee Development session on 11 January. CHILDREN S SAFEGUARDING AGENDA DECLARATIONS OF INTEREST (SG/15/136) Cathy Burke declared an interest in relation to item SG/15/143 in relation to the LC Sepsis Case as chair of the Child Death Overview Panel. MINUTES OF CHILDRENS SAFEGUARDING MEETING 7 SEPTEMBER (SG/15/137) The minutes were agreed as an accurate record of the meeting. MATTERS ARISING (SG/15/138) It was noted that all actions had been completed or were on this agenda for discussion. REPORTS (SG/15/139) NOTTS & BASSETLAW SAFEGUARDING MONITORING TOOL FOR NHS PROVIDER VISITS The monitoring tool had been updated to reflect the recommendations of the Lampard Review and had been brought to the Committee for approval. The Committee approved the updated Tool. CQC SAFEGUARDING AND LOOKED AFTER CHILDREN REVIEW The report was noted. FGM MANDATORY REPORTING The report was noted. CSE: FEEDBACK FROM CROSS-AUTHORITY WORKING GROUP Val Simnett reported that the Group s Terms of Reference and work plan were being revised to reflect new working arrangements. An update would be given at the March Committee meeting. 6
TRANSFORMATION PLANS FOR CHILDREN AND YOUNG PEOPLES MENTAL HEALTH AND WELLBEING Gary Eves reported that the Plans had been assured and funding had been released to the CCGs. He asked what the preferred reporting mechanism within the CCGs for the Children & Young People s Mental Health and Wellbeing Executive should be. It was agreed this should be the Safeguarding Committee. It was noted that Kate Allen would be the interim replacement for Gary. DESIGNATED NURSE CHILDREN IN CARE: CURRENT SITUATION AND FUTURE PLANS It was noted that Mansfield and Ashfield CCG had agreed to host the Looked After Childrens Nurse position; however concern was raised on a number of issues including finance, TUPE arrangements and resourcing current and future provision. Due to time constraints discussions would be undertaken outside of the meeting and it was agreed that if issues were not resolved by the March Committee meeting it would be added to the risk register. WINGS SCHOOL MEDICAL PROVISION Dr Walker informed the Committee that the school currently did not have a school nurse. It was agreed that details should be passed to Gary Eves, who would contact the local authority s social care team to follow up with the school in order to be assured plans were in place to replace the post and what interim measures had been put in place. ACTION: Dr Walker to pass details of Wings School to Gary Eves ASSURANCE (SG/15/140) CHILDREN RISK REGISTER SG Children 1&2 Combined: It was agreed that Gary Eves should review the risk to ensure the actual and potential risks are articulated. ACTION: GE to update the risk. SG Children 3: It was agreed that as the risk was not within the CCGs remit to influence, the risk should be amended to specify what was in the CCGs sphere of influence. ACTION: Chief Nurses to update the risk to specify what was in the CCGs sphere of influence. SG Children 4: It was noted that national guidance was not yet available and interim processes had been put in place. The situation should be resolved shortly. New Risk: Provider organisations may not fulfil requirements of the 2015/16 standard contract to implement the Child Protection Information Sharing Project (CP-ISP) without additional funding from CCGs to support the IT upgrades and maintenance costs required to implement the system. It was agreed for the risk to be added to the risk register with the addition of wording to incorporate CCG actions if providers failed to implement the CP-ISP. 7
ACTION: risk to be updated to incorporate the CCG actions if providers failed to implement the CP-ISP. LOCAL UPDATES (SG/15/141) NSCB The minutes of the meeting were noted. The next meeting will be held on Monday 11 January, 1pm, Meeting Room 1, Hawthorn House. 8