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Minutes of NSCB Full Board Meeting Held on Monday 22 June 2015 Final v1.1 Nottinghamshire Safeguarding Children Board Children, Families and Cultural Services County Hall West Bridgford Nottingham NG2 7QP Tel No: 0115 97 73935 1

Nottinghamshire Safeguarding Children Board Monday 22 June 2015 Attendance List NAME ORGANISATION PRESENT APOLOGIES ABSENT Chris Few Independent NSCB Chair Julie Gardner Vice Chair Derek Higton Steve Edwards John Slater Laurence Jones Pam Rosseter Paul McKay Cathy Burke Val Simnett Dr Fiona Straw Moira Hardy Elaine Moss Nichola Bramhall Gary Eves Irene Kakoullis Denise Nightingale Dr Stephen Fowlie Wendy Hazard Bushra Ismaiel Andrew Haynes Carole Lavelle Ben Wild Associate Director for Safeguarding & Social Care Nottinghamshire Healthcare NHS Trust Acting Corporate Director, Children Families and Cultural Services, Nottinghamshire County Council (NCC) Service Director, Children s Social Care, NCC Service Director, Education Standards and Inclusion, NCC Temporary Service Director, Youth, Families and Culture, NCC Group Manager, Safeguarding & Independent Review, NCC Service Director, Access and Public Protection, NCC Nurse Consultant Safeguarding, NHS Bassetlaw Clinical Commissioning Group (CCG) Designated Nurse Safeguarding Children, NHS Nottinghamshire County CCG Designated Doctor for Safeguarding, NHS Nottinghamshire County Deputy Director of Nursing, Midwifery & Quality Doncaster & Bassetlaw Hospitals (DBH) Foundation Trust Chief Nurse & Director of Quality, NHS Newark and Sherwood CCG Director of Nursing and Quality, Nottingham South, North, East & Rushcliffe CCG Senior Public Health and Commissioning Manager Group Manager, Early Years and Early Intervention, CFCS, NCC Executive Lead: Quality & Patient Safety; Chief Nurse Medical Director, Nottingham University Hospital NHS Trust Locality Quality Manager, East Midlands Ambulance Service Designated Doctor for Safeguarding, DBH Foundation Trust (FT) Interim Medical Director, Sherwood Forest Hospitals (SFH) FT Assistant Director of Nursing NHS England, South Yorkshire & Bassetlaw Assistant Chief Executive, Derbyshire, Leicestershire, Nottinghamshire & Rutland Community Rehabilitation Company Ltd Deputy Deputy Deputy Deputy Deputy Nigel Hill Head of National Probation Service- Nottinghamshire Superintendent Head of Public Protection, 2

Helen Nottinghamshire Police Chamberlain Clare Taylor Service Manager, Early Intervention Team, Cafcass Tracey Sipson Recovery Practice Quality Assurance Lead, Ashfield Recovery Centre, Leanne Monger Newark & Sherwood District Council Sue Fenton (NAVO Rep) Manager, Home Start Nottingham Deputy Participant Observer Cllr Kate Foale Lead responsibility for Children s Social Care Lay Members Victoria Morley Peter Wright Advisors to the Board Steve Baumber NSCB Business Manager Hilary Turner NSCB Business Manager Bob Ross NSCB Development Manager Trish Jordan NSCB Training Coordinator Michelle Elliott NSCB Administrator (minutes) Carol Fowler (minutes) NSCB Child Death Administrator Visitors/Deputies/Participant Observers Claire Balmer Area Manager Michelle Bateman, Named Nurse Safeguarding Children NSH Trust For Ben Wild. Assistant Chief Exec. Derbyshire, Leics. Notts. & Rutland CCR Ltd For Julie Gardner. Associate Director of Nursing Quality and Patient Experience Alyson Packham, Named Nurse Safeguarding Children Pip Fannine, Home-Start Nottingham Co- Ordinator Ian Cross, Locality Quality Manager, Nottingham Division EMAS Tracey Slater, Senior Nurse Manager For Dr Stephen Fowlie. Medical Director, NUH For Sue Fenton. Manager, Home Start Nottingham For Wendy Hazard. Locality Quality Manager, Nottinghamshire Division, East Midlands Ambulance Service For Carole Lavelle. Senior Nurse Manager Deborah Oughtbridge, Deputy Director of Nursing & Quality Doncaster & For Moira Hardy, Director of Nursing and Quality, Doncaster and Bassetlaw Hospitals NHS Foundation Trust. 3

Bassetlaw Hospital Dr Sarah Hull New Medical Director at CNCS (Observer) Medical Director - CNCS J. Brady (Observer with Sarah Hull) Terri Johnson, Safeguarding Children Manager Strategic Bev Mundle, Children s Service Manager Service Manager, Safeguarding Children (Strategic), NCC (for Presentation) Children s Service Manager, CSC, NCC (for Presentation) 4

Minutes of NSCB Meeting Monday 22 nd June 2015 Agenda Item Discussion Action Welcome & The Chair Chris Few (CF) welcomed everyone to the meeting, Apologies introductions were made and apologies were noted. Minutes & Matters Arising from 16th March 2015 Minutes of the meeting 16 March 2015 were reviewed for accuracy and for matters arising: Outstanding actions:- Page 4 Action for S Baumber (SB) to follow up the You re Welcome criteria with the Young People s Board. (SB) informed the board that there has been a change of Chair: this action remains outstanding. Page 4 Action for CF to chase response to his letter to Norman Lamb MP: this has been completed but still no response due to Norman Lamb no longer working in the same position. CF to make enquiries: this action still remains outstanding. Page 4 Action for H Turner (HT) to follow up the lack of a central point of contact regarding ICPC & RCPC invites in Nottinghamshire Police: HT updated ICPC/RCPC invites are now forwarded to the Police in the MASH. HT has no assurance as to what is currently happening to them: action to remain. SB CF HT Page 6 N Hill spoke of parallel project within Probation involving individuals with personality disorders; clarification that he has offered to share with KM. Page 7 Paul McKay (PM) has contacted Bev Cameron (BC) around the integration and correlation of IT systems to allow one system this project is currently being worked on. Incorporating Health records may be more difficult to integrate NHS numbers into the CSC System. Clarification from PM that NHS numbers are already integrated into adults records on Frameworki. Page 8 CSESAG Annual Report item - on today s agenda. (Action 04). Page 11 Action Plan from HMIC inspection of child protection. Steve Edwards (SE) informed the board that the action plan is presently still being worked on and once it has been agreed it will be circulated. (Action 05). PM TJ SE The minutes of the previous meeting were agreed as a true and accurate copy with two amendments. 5

Ofsted feedback Presentation SIR Subgroup Annual Report 2014-15 Appendix B CF presented a short powerpoint presentation. CF thanked all board members and shared that the initial feedback from the Ofsted Inspection was good overall. Feedback was received that the board members are interactive, competent, knowledgeable, committed, motivated and aware of what is happening, A copy of the full report will be available on 1 st July 2015 and we will have 8 days to respond on accuracy issues. The report will be published on 20 th July 2015. CF also thanked everyone who had been involved with preparing documents for the Ofsted Inspection. Author Bob Ross, Sponsor John Slater. Bob Ross (BR) commented that the SIR sub group have identified that some themes are recurring in Serious Case Review (SCR) actions, and that he is linking in with Trish Jordan (TJ) the NSCB Training Coordinator. John Slater (JS) agreed that we need to learn from the Ofsted Inspection and look wider at Serious Case Reviews through learning and training. CF noted that 84 out of 92 serious case reviews actions were completed. CDOP Subgroup Report 2014-15 Appendix C Action 01- BR to provide information to HT for NSCB Annual Report regarding how old the outstanding actions are. HT and TJ to link together with training and audits. Completed. Author Bob Ross, Sponsor Cathy Burke. Leanne Monger (LM) noted the number of child deaths in Newark. Cathy Burke (CB) commented the number of child deaths in Newark have been subject of review by our Public Health representative on behalf of CDOP. The review concluded that overall numbers of child deaths are very low and are subject of annual peaks and troughs. Statistics for Newark were not out of line with other areas. Paul McKay (PM) spoke about the issue of bath time safety and the use of the bath seats. BR noted that the review over child deaths can be delayed by inquests, Serious Case Reviews or ongoing police investigation. SB added that there had also been a delay in obtaining inquest verdicts. BR highlighted CDOP had worked hard to catch up on the backlog and had reviewed more child deaths in 2014-15 that in previous years. PM queried if we are being informed by the registrar, BR confirmed that we are being notified. Action 02 - PM has contacted the manufactures and will share the information with BR when the information is available. Completed. BR PM Learning and Development Subgroup Annual Report Appendix D Author Trish Jordan. The increased numbers of attendees from adult services were noted and welcomed. A request was made to continue to encourage staff to complete CSE e learning. It was noted that we have unlimited licences for this. A request was made for more detailed analysis of how many staff were eligible to attend training compared with actual attendees. 6

Private Fostering Annual Report Appendix E Terri Johnson (TJO) & Bev Mundle (BM) joined the meeting. Author Bev Mundle, Private Fostering Lead. Val Simnett (VS) thanked Bev Mundle (BM) for a very helpful and comprehensive report. BM commented that considerable work has been done this year. Awareness training with Education has taken place which was positive and further plans to run this again next year. PR commented that promotions had taken place around Private Fostering through posters, leaflets and websites. Laurence Jones (LJ) commented about the difficult pathways for those not meeting the 28 day private fostering threshold. CF advised the Board that he was expecting Ofsted to recommend that the Board promotes and raises awareness about private fostering and what is required. SB commented on What s new in Safeguarding sessions and if it could be an opportunity to present a presentation on Private Fostering. Notification is on par with other Local Authorities but under reporting is still thought to be an issue. It was queried if school admissions data would assist. This currently asks if a child is looked after but it does not ask if a private fostering arrangement is in place. LJ noted that transient children don t hit the 28 day trigger. Champions in different services suggested. Action 03 Task and Finish Group to be established. Derek Higton (DH). It was clarified that the NSCB office will assist Bev Mundle as the CSC lead for private fostering in drawing together a group of representatives from partner agencies to take this work forward. This will form part of the CSC Ofsted action plan. Hilary Turner will be the NSCB link. This action will be incorporated in the NSCB Business Plan. Ongoing. DH CSECAG Annual Report 2014-15 Appendix F Author: Terri Johnson CF noted that this was a high profile topic and this is a comprehensive report. The Barnardos project worker will continue to work in the County until June 2016 and the work will be re-commissioned after this point. LM said her Chief Executive had asked her to raise the issue that they are aware of increased levels of CSE in two particular Academies in the Newark and Sherwood area. She asked for re-assurance that the right people were working together to address this. TJ commented that they are already working with the District Council in relation to taxis but will welcome closer links. It was agreed that the Notts CSE Coordinator, Hazel McKibbin, would attend the District & Borough Council Safeguarding Group Meetings for relevant agenda items. CF commented that it was positive that 10% of the e learning for parents so far accessed nationwide was in Notts. Peter Wright (PW) commented on the difficulty forming a picture due to the large amount of data. CF agreed and suggested a proforma could be used to capture this data to give an easier to read picture. TJ 7

Action 04 - TJ said she would send a further letter out through schools promoting e learning. Completed. Missing Children Annual Report 2014-15 Appendix G LADO Annual Report 2014-15 Appendix H Multi-Agency Audit Subgroup Appendix I Trilogy of Risk Audit: H Turner (HT) Neglect Case Author: Terri Johnson A request was made by CB for Board members to be alerted if a missing child in their area is to be the subject of media attention. CF confirmed that Abby Jakeman was the media team lead for the NSCB and had provided such alerts but had been succeeded by Robin Smith. CF will establish the links with Robin. PR suggested that a brief note be sent out to all Board Members informing them of any situations that may involve children within CFCS. SE noted that the flow of information cannot always be controlled given the 24 hour culture. Action 05 - CF will establish the links with Robin Smith. Completed. Author: Terri Johnson The contents of the report were noted. There were no subsequent questions. HT noted that this is the first annual report for the MAASG. The need to keep the audit programme under review was confirmed, in order to be able to respond to issues as they are identified. HT provided a short account regarding the Trilogy of Risk Audit. Many thanks were expressed to Lucy Peel and Gemma Gelsthorpe from the Performance and Quality Team for organising and leading the audit which is now completed. 8 cases were audited in detail with a further 50 cases screened for multi-agency involvement. 3 main areas for improvement were identified: A common understanding of family compositions across agencies. Agencies being aware of which other agencies have involvement in a case with a family. A multi-agency approach to assessing any safeguarding risks to children where adults are experiencing DA, MH or SM issues Action 06 - The action plan to be agreed with the audit sponsor. This to be consistent with the Think Family Action Plan. Once agreed the Action Plan and Audit Report will be circulated to all Board members. The Action Plan is to be monitored by the Think Family Task and Finish Group. On going. Nichola Bramhall left the meeting Break/Refreshments The meeting divided into smaller groups to consider case 8 CF HT/SE

Studies and discussion exercise studies. Information was supplied incrementally for each case study. The task was to consider each case study in terms of the thresholds set out in the Pathway to Provision Threshold Guidance (version 4, updated June 2014). Feedback was requested in terms of how easy it is to identify when the thresholds are met. Feedback was received as follows: In general all the groups were able to identify neglect concerns and agree threshold and trigger points. Pathways are being revised and workshop/roadshows will be held following the Family Service restructure. The difficulty inherent in having lack of consent from families to share information with other agencies was noted when a concern noted by a single agency was not sufficient in itself to amount to a safeguarding concern. It was noted that in one of the case studies the Tier 4 threshold was identifiable early, and this was then borne out by further information. In another group the case crossed the Tier 4 threshold when the final information was known. Another group noted that their case study emphasised the importance of supervision, as the case started as a 2/3 and ended up as a tier 4. The fourth group noted that their case study highlighted how different practitioners working with a non-compliant family can have different information. One group noted that if they considered each child in a wider family who may be living in different households individually they would not meet the threshold yet seen as a whole they did. VS suggested it would help for Pathway to Provision to signpost where in the guidance information on each tier was. This was agreed. CB suggested it would be useful to do the exercise with frontline health staff. BI agreed it would be relevant for junior doctors. It was noted that P2P would be revised in light of The Family Service later and the revised version will be promoted via the planned workshops. The need for a common assessment tool for neglect was noted. HT is working on a draft neglect strategy. Some graded care scales for neglect were looked at as part of the consistent approach to assessment working group. HT to liaise with Jon HT 9

The Family Service Appendix J Front line visit: Thorneywood Appendix K Hawketts LJ presented The Family Service paper. The Family Service aims to bring together existing services, removing duplication. The structure will be across three localities: Newark & Sherwood, Ashfield/Mansfield, Broxtowe, Gedling & Rushcliffe and will be below the Children Social Care (CSC) threshold level. More information and workshops around the County expected around September and October for staff to attend with a view to going live in November. CF shared with the board that he had visited the CAMHS facility at Thorneywood, Nottingham on the 8 th April 2015 which included the adolescent in-patient unit and the Community CAMHS Team. CF made the following recommendations: 1. That the NSCB raises the difficulties associated with Tier 4 CAMHS commissioning with NHS England. Action 07: CF to send out a follow up letter written previously to Norman Lamb, MP, to his successor. CF commented any issues around working with CAMHS will go through the Health and Protection Executive and will report back in December with an update. 2. That in March 2016 (following implementation of CAMHS Review recommendations) the NSCB commission an examination of coordination and joint working between the community CAMHS and Children s Social Care/Early Help Services. Action 08: to be placed on NSCB forward planner. Completed. 3. That Nottinghamshire Healthcare NHS Trust, Children s Social Care and the Family Service jointly consider and report to the NSCB on the effectiveness of service coordination and discharge planning arrangements for young people receiving CAMHS in-patient treatment. This Board noted this is a commissioning responsibility and it will be discussed in existing working group. 4. That the existing NSCB work streams in relation to escalation procedures note the observations of this report. In response to the report, M Bateman (MB) noted tier 2 & 3 were not yet merged but there is recognition of pressure points existing along the tier 2 & 3 pathway. She will feed CF s comments into the ongoing work being done in NHCT. SE pointed out that the issue of in-patient beds is a national one, for NHS England. C Burke (CB) clarified that tier 4 comes under NHS England responsibility. BR added that an inquest begins today, 22 nd June 2015 of a young person who died after being an inpatient at Thorneywood some years ago. The inquest, which is scheduled for two weeks, is likely to attract local media attention. 10 LJ CF

Historic Abuse in Nottingham Appendix L PR informed the board that a Strategic Management Group has been established between the Nottinghamshire and Nottingham City Safeguarding Boards. Both boards continue to update and investigate enquires into Children Homes and related matters. D Higton (DH) made reference to previous Local Independent Reviews and articles and asked if we were to evaluate these documents could lessons be learnt. CF shared that financial support for this project is provided by both the Local Authorities and not the Nottinghamshire and Nottingham City Safeguarding Boards. PR Information items CF drew members attention to appendices M to P which were circulated for Board members information. B Ismaiel (BI) enquired about an update on Female Genital Mutilation (FGM). CF confirmed that Lynn McNiven (LMc) is overseeing the steering group which is responsible for FGM. CF to update B Ismaiel (BI) after the meeting. Next Meeting Meeting ended Monday 21 st September 2015, John Fretwell Centre, Mansfield 11