Agenda and minutes

Apologies for absence were received from Cllr Thompson, Cllr Geddes, Cllr Hall, Cllr Mullen, Cllr Craig, Cllr Davison and co-opted members Sasha Ban and Maveen Pereira.

The Committee is asked to approve as a correct record the minutes of the last meeting held on 7 September 2017

The minutes of the meeting held on 7 September 2017 were agreed as a correct record.

Report of the Consultant Paediatrician and Designated Doctor Safeguarding Children, Gateshead Health NHS Foundation Trust

The Committee received an overview of the report by Dr Carmen Howey – Consultant Paediatrician and Designated Doctor Safeguarding Children, Gateshead Health NHS FT.

Concerns were raised by partner agencies, Local Authority and Public Health, in relation to a potential excess of Foetal Alcohol Spectrum Disorder/Foetal Alcohol Syndrome (FASD/FAS) diagnoses amongst the Gateshead paediatric population, particularly those children who are Looked After (LACYP). It was agreed by Gateshead NHS Foundation Trust (GHNT), in conjunction with Newcastle Gateshead Clinical Commissioning group (CCG), to review the diagnoses of this group to establish if those concerns are valid.

The Committee were advised that a new review tool has been developed to review the diagnosis of children on the FASD database. This has been completed for 60 randomly selected children from a total of 223 on the database which was compiled by the previous Designated Doctor LAC.

The accepted diagnostic criteria for FASD that the review has been working to are:

A.   History of maternal alcohol intake in pregnancy (quantities needed to cause effects of FASD/FAS are uncertain with limited evidence available)

OR

B.   Presence of typical facial features associated with FAS

AND

C.   Microcephaly (head circumference <3rd centile for age) in pre-school children

OR

D.   Clear evidence of significantly impaired function across at least 3 domains of the FASD checklist

An overview of the outcomes of cases reviewed to date was provided from the report and the Committee were advised that the review is a significant piece of work which is ongoing.

It was noted that the results of the review so far support the view that some children were receiving a FASD/FAS diagnosis without the relevant diagnostic criteria being evidenced. The Committee were also advised that in order to determine the validity of a child’s diagnosis further assessments would need to be done.

A comment was made that professionals working with young women and expectant mothers need to get better at discussing the risks of drinking alcohol during pregnancy in a non-judgemental way. It was also noted that improvements need to be made to keep a record of when an expectant mother makes an admission of drinking alcohol – having such a record can assist in making a diagnosis of potential FASD/FAS should a child display symptoms later on.

A comment was made that the information presented at Committee on this occasion was a more neutral and balanced view than what had been previously reported. Information presented to Committee previously suggested an epidemic of FASD/FAS which would have a significant impact on Children’s Services. It was commented that the volumes identified by the previous Designated Doctor LAC were deemed to be large proportion of children however it was much about perception.

It was asked whether enough importance on diagnosing FASD/FAS was being given by the CCG. It was noted that the process has been manageable so far however there may be a need for a more formal approach in the future. The Committee were also advised that a discussion needs to take  ...  view the full minutes text for item F23

Report of the Strategic Director, Care Wellbeing and Learning

The Committee were presented with information from the Edge of Care Review report. The review was established to look at the challenges facing services for adolescents and to consider the key ingredients of successful approaches to effectively support young people and their families on the edge of care.

An overview of the term ‘edge of care’ was provided – this covers the following situations:

·         Before entering care the young person has been identified as being at risk of needing care

·         When a young person is leaving care by going home or to live with a relative or into a range of accommodation

·         Young people 16 and 17 years presenting as homeless

·         Care leavers are particularly vulnerable as are their future children

It was noted that every young person’s situation is different and that it is important not to generalise from specific situations as there are varying circumstances that can lead to a young person to be looked after.

Some of the multiple elements that cause a young person to become looked after were described from the report; these include violence from the young person, anti-social behaviour, mental illness and family dysfunction.

The Committee were advised that a Rapid Response Team (RRT) is being developed to increase the support capacity of the Looked After Children’s Service. It was noted that this team would be made up of multiple partners across varying departments able to provide knowledge and support in areas such as housing, mental health and referral & assessment. Staff members from these services were present at the meeting to screen questions from the Committee. The function of the RRT was outlined as follows:

·         The ethos is predicated on a belief that children should live within the family where safe to do so

·         The team will work intensively with families in order to bring about change to reduce the need for accommodation or rehabilitate the child quickly

·         They do not work with families beyond 12 weeks

·         The team’s terms and conditions include evening and weekend/bank holidays

·         There is a firm commitment to invest in the professional development of the team and equip them with the skills and tools to do the job

·         Staff are recruited with the pre-requisite skill mix

·         The rapid response service will work as part of the CCIN team

·         Clinical supervision is provided by the Manager/Systemic Practice lead

·         It is understood that the Social Worker from CCIN retains responsibility for the case

·         The team works collaboratively will partners

It was repeated that importance is being placed on supporting the young person through their issues whilst they remain at home whenever practical and safe to do so. It was also said that the prevention of homelessness in care leavers is a priority and that collaborative work with Housing Services has helped to develop a taster flat scheme. It was advised that the taster flat scheme has been developed to promote stability and integration for care leavers within the community.

A comment was made that the multi-service approach is welcomed –  ...  view the full minutes text for item F24

Report of the Strategic Director, Care Wellbeing and Learning

An update on the Early Help Strategy was provided to the Committee. It was noted that there are strong links between this report and Edge of Care report.

The Committee were advised that the Early Help Strategy will bring together many strands of work to create a vision for the future where families are resilient and supported within their local community. It was noted that by developing flexible evidence based early interventions, which are delivered in a timely way families would feel empowered and less reliant on Council services.

From the report the Committee were advised the delivery model will:

·         Bring together a range of services which support children and families – a broader range of provision and community activity, including health, emotional wellbeing, behaviour support, family support, advice and support around debt, worklessness and poverty

·         Use CAF and TAF approaches to wrap support around families to meet the multiplicity of their needs

·         Ensure that practitioners identify and intervene with causes rather than with presenting symptoms

·         Harnesses the social capital of communities and use an asset based approach to developing solutions

It was noted that this draft of the Strategy which will be brought before Cabinet in November 2018. The draft has been developed in partnership with internal and external partners and it is hoped that it is used as a working document.

It was said that in practise this Early Help Strategy would be implemented before the need for statutory Council services whilst working in a coherent way with relevant partners. It was also noted that work within children’s centres and other outreach locations would continue.

It was mentioned that the outcomes framework as outlined within the report was helpful and that it was encouraging to see further joined up working across services. Further to this, the Committee were advised that some of the intended outcomes from the report were aspirational and contained a mix of Council priorities as well as outcomes dictated by external partners.

Background on the Families Gateshead was provided. It was noted that unlike some other local authorities Gateshead have taken a proactive approach to working with families to put interventions in place to remove their barriers to employment. The Families Gateshead programme provides support to all family members regardless of age and is run on a payment by results model. Recent audits have shown that there has been an impact due to this service.

RESOLVED

(i)            That the Committee note the contents of the report and the Early Help Outcomes Framework.

Joint Report of the Chief Executive and the Strategic Director, Corporate Services and Governance

The Committee received the work programme for the municipal year 2017/18. It was noted that the work programme would be a standing item on each agenda so that members could see any changes.

RESOLVED -

(i)            That Committee noted the provisional programme.

(ii)          That 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.