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Apologies for absence
Apologies for absence were received from Councillor S Craig, Councillor P Craig, Councillor Patterson, Councillor McMaster and Councillor Hall.
The Committee is asked to approve as a correct record the minutes of the last meeting held on 12 September 2019
RESOLVED - That the minutes of the last meeting held on 12 September
2019 were agreed as a correct record.
Report of Associate Director Central Locality Community Services, CNTW NHS Foundation Trust
Committee received an update report on the delivery of children and young people’s Mental Health services (CYPS) in Gateshead.
The report to Committee in 2018 outlined the proposals including; establishment of a single point of access (SPA), access to KOOTH, development of new service specifications based on the Thrive model, a move towards more intervention and prevention and the introduction of lead provider arrangements from April 2019.
From 1 April 2019 the new lead provider model went live. The aims of this model are to move towards an early intervention model and to monitor activity as a whole system.
Cumbria, Northumberland, Tyne and Wear Foundation Trust (CNTW) are leading the work to transform the CYPS pathway. A number of providers are now coming under the lead provider model, including; Streetwise, Children North East, North East Counselling Services and Kalmer. Kooth and Barnardos will be coming under this model from October 2019.
The “getting help” and “getting more help” services was previously known as Tier 2 and Tier 3 services. Work is ongoing to flow patients more in to getting help service rather than getting more help, this is in line with the thrive model, which the service specification is based on. Monthly pathway meetings are held with all providers and providers are working more closely than ever before to ensure clients are seen by the right service first time. Providers are also working collectively to reduce waiting times across the service. Regular pathway meetings have already led to improvement in the overarching pathway and significant improvements are emerging.
The NHS providers and the third sector providers are now working under NHS Standard Contracts, this is a 12 month contract from 1 April 2019.
It was reported that all services contracts receive their referrals through the single point of access (SPA). SPA provides a fully integrated and direct clinician support for all providers, it is the first point of contact for all requests for advice and referrals. SPA offers a coordinated access to Getting More Help. SPA is led by a clinician, this allows clinical decision making and interaction at the point of access and ensures referral to the right place first time.
Committee was advised that Kooth is an online platform which provides advice and guidance for young people. This is promoted in all schools and information on Kooth is given to children and young people upon referral to the SPA.
It was noted that CNTW have employed 12 trainee mental health workers to provide support to schools across Newcastle and Gateshead. The teams offer early intervention into schools, supervised by experienced mental health clinicians, for young people with mild to moderate mental and emotional health needs.
In terms of performance, data is now captured across all providers in Gateshead. The key focus is to ensure children are seen in the right place first time. Accepted referral rate is now 99%, this is as a result of the triage service within the SPA. There has also been a significant ... view the full minutes text for item F20
Report of Strategic Director, Care Wellbeing and Learning
Committee received a progress update report on the activities and impact of the Early Help Service (Targeted Family Support) in providing advice, practical support intervention to vulnerable Gateshead families.
It was noted that the majority of the case work of early help is at the far end of tier two. Early help is around working with the whole family to offer advice, referrals, telephone advice, group programmes, dependent on the need of the child. Evidence-based interventions and practical support are offered, for example; Team Around the School pilot, which is currently working in Whickham, Heworth Grange and Kingsmeadow. It is being considered whether this can be expanded to more secondary schools and if it could complement the work of the PRU. Through the ADHD Pre Diagnosis Pathway parenting intervention is offered. In addition, Gateshead leads on a national pilot; Reducing Parental Conflict Group programmes, which is intensive group programmes.
Early Help Workers have a caseload of 12 families and meet with these families on a regular basis, at least once a fortnight. They carry out home visits and offer advice and practical support for the families.
It was reported that since October 2017, 4,545 children and young people have been referred. Since April 2019, the last time early help was reported to Committee, 1,102 children have been referred into the service. It was noted that there continues to be a lot of referral sources, education remains the largest source of referrals with 85% of referrals coming from primary schools. At present there are 698 children on the caseload.
Committee was provided with a map of Gateshead showing the number of early help cases opened across the Borough. It was acknowledged that this data is helpful in terms of mapping provision. It was also noted that the Early Help Service received positive recognition from Ofsted during its recent visit.
It was reported that, of those families who have worked with the Early Help Service, 10.8% will come into the Social Care system within 12 months, 3.1% of those declined the Early Help Service. Therefore 93% of families worked with will remain out of the service since the point of closure, nationally this is approximately 85%.
Committee was informed about the Team Around the School work which is underway in Whickham, Kingsmeadow and Heworth Grange. The programme has worked with 130 young people, there is a smaller more intensive caseload in secondary schools. In addition, parenting programmes are now being run on the school campus which the Early Help Service facilitates, for example; Families First offers support to parents with a child being assessed for ADHD, this is ran in a small group format with 57 parents completing this in 2019.
Work is also ongoing with pregnant women through the Growing Healthy Programme. Midwives identify expectant mothers with vulnerabilities and will offer structured visits from 16-20 weeks gestation up until the child is 24 months, the ‘First 1,000 days’.
A number of case studies were provided to the Committee.
Committee ... view the full minutes text for item F21
Report of Strategic Director, Care Health and Wellbeing
A report was presented on the changes to the Referral and Assessment Service. It was noted that previously the service operated a duty room which received a huge number of contacts from the police, the Referral and Assessment team then transferred cases at the end of the assessment to Safeguarding and Care Planning Teams. The Safeguarding and Care Planning teams then held all cases, including; child protection plans, court work, children in need cases and LAC cases up to permanency.
The service felt that there were too many inappropriate police contacts being handled by the duty room, also there were avoidable transfer points between Social Workers and services. In addition, child in need cases requiring intense interventions were not able to be given the necessary priority.
In order to restructure the service the guiding principles were looked at. These principles included; limiting transfer points as far as possible, maintaining caseloads at levels which allow for meaningful interventions to take place.
From June 2018, multi-agency triage meetings are held daily, where there is representation from police, 0-19 service, Early Help and domestic abuse service. Police contacts are filtered out or redirected and signposted to alternative services. From January 2019 the Referral and Assessment Team became the Assessment and Intervention (A&I) service, emphasising the intervention aspect of the work. There are six A&I teams and a dedicated team manager post was created for duty work so that social workers are no longer working on a rota basis in the duty room.
Children in Need cases remain with the Service unless circumstances change and the case needs to escalate to Child Protection or LAC. In terms of the impact of these changes it was noted that staff seem to prefer the new approach, there has been 53% fewer contacts from the police, CiN assessments are completed sooner and there has been a marked reduction in re-referrals. In addition, there are also fewer cases transferring from A&I to Early Help and there has been 11.5% reduction in Child Protection Plans. It was noted that re-referrals are used as a proxy measure, this has reduced to 55.5 per 10,000 which is a huge reduction. Step downs to other services have reduced, therefore this indicates that the correct CiN plans are in place.
It was reported that the Gateshead CAN model is an overarching systematic and strengths-based approach which recognises the interrelationships between Context, Action and Narrative. Some of the methods and models that Social Workers use were provided to the Committee including Genograms, Signs of Safety and Narrative techniques and tools from positive psychology.
It was questioned whether staff are happy with the changes to the service. It was acknowledged that staff were initially worried about not having enough time to do intervention work, however staff are now happy with the new arrangements. Committee was advised that the Council is not attracting as many Social Workers as hoped, despite comparable salary levels.
RESOLVED - (i) That committee continue to champion the work ... view the full minutes text for item F22
Report of Strategic Director, Care Wellbeing and Learning
Committee received a report on the performance of Children’s Centres, Early Years Childcare Service and the Information Advice and Guidance Service.
It was noted that the number of families accessing Children’s Centre staff supported services has decreased by 83 families over the last year, due to activities being delivered into hard to reach areas away from the Children Centre buildings. There is also a greater number of families accessing from the most deprived areas.
In terms of Early Years Childcare Service it was noted that the quality of settings remains high with 83% of providers being judged at least Good by Ofsted. Take up of two year old free entitlement has remained fairly static at 82%.
The Information, Advice and Guidance Service has performed well in comparison to last year, with 8.7% NEET (not in education, employment or training) reported in the DfE scorecard.
RESOLVED - That Committee noted the content of the report and the
progress to date.
Report of Strategic Director, Corporate Services and Governance
Committee received a report which set out the proposed areas for improvement arising from the new guidance on OSC.
It was noted that the Communities and Local Government Select Committee’s inquiry into OSC set out a number of proposals by which to raise the profile of scrutiny. It was noted that some of the proposals are already underway in terms of Gateshead’s scrutiny process.
The guidance suggests a role for scrutiny when agreeing contracts using public funds to deliver goods and services. A workshop has therefore been set up for all Councillors to attend which will be led by Andrea Tickner, Service Director, Corporate Commissioning. The workshop will aim to give a better understanding and look at the role scrutiny could play.
RESOLVED - (i) That Committee noted the information provided.
(ii) That Committee endorsed the proposed areas for
improvements outlined in paragraphs 2:1 to 2:4 of the report.
Joint report of the Chief Executive and the Strategic Director of Corporate Services and Governance
The Committee received the work programme report setting out the provisional work programme for the Committee for the year 2019/20.
It was noted that, as per the earlier report, the 12 month evaluation of Integrated Referral and Assessment Team report would be added to the work programme for April 2020.
RESOLVED - (i) Committee noted the provisional work programme.
(ii) Committee noted that further reports on the work
programme will be brought to the Committee to identify any additional policy issues, which the Committee may be asked to consider.