Minutes of the Meeting of the Joint Committee on Children and Young People held in the Board Room, Assynt House, Beechwood Park, Inverness on Friday, 14 August 2009 at 10.30 a.m.
Present
Members
Highland Council
Mrs M C Davidson
Mr W Fernie
Ms E McAllister
NHS Highland
Ms P Courcha (in the Chair)
Mrs A Bethune
Mrs G McCreath
Mr I Gibson
Mr C Punler
Mrs J Baird
Ms J Douglas, Chairman of the Highland Drug and Alcohol Action Team
Miss C Burns, Youth Convener
Officers:
Highland Council
Ms J Baines, Development Officer Support for Learners, Education, Culture and Sport Services
Miss J Maclennan, Principal Administrator, Chief Executive’s Office
Highland Council/NHS Highland
Mr B Alexander, Head of Children’s Services
NHS Highland
Ms S Amor, Child Health Commissioner
Ms J Park, Clinical Specialist, Looked After Children
In attendance:
Mrs L Munro, Children’s Champion
Mrs M E Paterson, Children’s Champion
Mr C Munro, Highland Children’s Forum
Ms C MacLean, Children in the Highlands Information Point + (CHIP+)
Mrs A Brady, Care and Learning Alliance
1. Apologies for Absence
Apologies for absence were intimated on behalf of Mr A S Park, Dr M E M Foxley, Mr A M Millar, Mrs L MacDonald, Ms A Darlington, Mrs R Morrison, Mr H Fraser, Mrs H Dempster, Mr A Geddes, Ms J Veasey and Ms R Sime.
2. Minutes of Meeting of the Joint Committee held on 5 June 2009
The Minutes of the meeting of the Joint Committee held on 5 June 2009 were circulated and NOTED.
Arising from the Minutes, also NOTED:-
i. Item 2, New Round of Child Protection Inspections – the Highland Council
area was due to be inspected in January 2010;
ii. Item 3, The Pines Centre – the official opening was scheduled for Monday,
17 August 2009; and
iii. Item 7, Recruitment of Social Work Staff – posts continued to be filled and
there was now very few permanent vacancies.
3. Revenue Budget – Unaudited Outturn 2008/09 and Monitoring
2009/10
Report No CYP-25-09 by Bill Alexander, Head of Integrated Children’s Services had been circulated setting out the unaudited Revenue Budget outturn position for the Joint Committee for the year ended 31 March 2009 together with the monitoring position on the 2009/10 Revenue Budget for the three months to 30 June 2009.
At the end of financial year 2008/09, the budget had shown an underspend of £0.375m due to the recruitment challenges in Early Years, Additional Support Needs, Youth Action Teams and Children’s Services Workers. This was, however, an improvement on what had previously been reported as a result of entering into Service Level Agreements with voluntary organisations to provide specialist services and the expenditure made to support emergency care placements in the independent sector care units based in the Highlands. In relation to the current financial year, it was too early to make any firm predictions but it was currently anticipated that the budget would be on target.
Arising from discussion on various factors surrounding the budget, it was felt more effective monitoring could be achieved if detail could be included in monitoring reports to show variances on a phased budget throughout the financial year. It was also suggested that consideration should be given to commissioning additional emergency services for Looked After Children to supplement the capacity already being used in Highland with the aim of ensuring best use was made of financial resources.
NOTED:-
i. the unaudited 2008/09 Revenue Budget outturn position;
ii. the 2009/10 Revenue Budget position for the 3 month period to 30 June
2009;
and AGREED:-
iii. that future monitoring reports should also include information on variances
on the phased budget; and
iv. to investigate the merits of commissioning additional Looked After Children
services within Highland.
4. Quality Improvement Scotland Asthma Services for Children and Young People
Report No CYP-26-09 by Jan Baird, Director of Community Care had been circulated which informed the Joint Committee that, following the production of clinical standards for Asthma Services for Children and Young People in March 2007, Quality Improvement Scotland (QIS) had embarked on a round of Health Board reviews. Their visit to NHS Highland in January 2008 had focused not only on performance but on how services were delivered within the framework of clinical governance and risk management. A self assessment had been prepared ahead of the review and a Working Group established which, it was agreed, should report through the Children’s Services Network. In particular, an area of improvement which had been identified by the Working Group was the collection of information from families, children and carers in relation to their experiences following diagnosis and a piece of work had been commissioned from Highland Children’s Forum in association with Youth Voice.
Discussion followed on particular points contained within the Action Plan. In particular, although there had been a perception that training was taking place, it transpired that this had related more to adults with asthma than to children and young people but Members were assured this was now being addressed with GP Practices. The collection of electronic data would also allow the number of young people involved to be more accurately determined and this would, in turn, enable improvements and trends to be measured more effectively.
NOTED:-
i. activities progressed against the 2008 QIS Review Asthma Services for
Children and Young People (incorporating clinical governance and risk
management); and
ii. the actions to meet the full range of QIS Standards.
5. Health Outcomes for Looked After Children
Report No CYP-27-09 by Jane Park, Clinical Specialist, Looked After Children had been circulated which set out the work of the specialist health service in Highland and various recent developments regarding the health of Looked After Children (LAC). A DVD showing the experiences of LAC and the issues which could arise was shown to Members which demonstrated the need to keep children at the centre of all the policies and infrastructure in place to support them.
Detail of the developments which had taken place was provided and particular reference was made to the National Action Plan published in 2007 “We Can and Must Do Better” which set out broad objectives for health for LAC and ensuring need was met. However, in April 2009, the Scottish Government had issued a letter to NHS Chief Executives setting out more specific goals in relation to LAC and Members were informed of the detail of how it was proposed that these goals would be achieved and the core principles guiding this work.
Collecting data on the health of LAC was difficult given the numbers entering and leaving the system but the information available showed Highland to be in a good position. In particular, full immunisation in Highland for LAC was 82%, far exceeding the national average, and there had been a 90% increase in health assessments. Although these figures were to be commended, it was pointed out that these achievements were meaningless unless the issues arising from the health assessments were acted upon.
During discussion, Members raised a number of issues, including the following:-
- although many targets were being met, particular challenges were faced in meeting the health needs of LAC who remained at home and how this was reflected in the child’s plan;
- the majority of parents of LAC still had rights and responsibilities and their contribution to the health needs of these children had to be the subject of on-going discussion;
- the Joint Committee had a duty to ensure compliance with the various objectives set out;
- the generic health assessment to be used in Highland exceeded the standard being set by the Scottish Government;
- clarity was needed as to what was involved in a mental health assessment;
- there was a need to provide information, support and access to health services, as appropriate, to young people leaving care but while recognising the need to avoid a dependence on this facility;
- in recognising the resource challenges facing both the Highland Council and NHS Highland, the need to “Spend to Save” and investing in the Early Years of all children, and in particular, LAC, would have enormous benefits in the longer term; and
- GPs had a core role in delivering good quality services to LAC and recent developments in technology had assisted in the sharing of information.
NOTED:-
i. the issues raised in the report;
ii. that Highland’s LAC health service continued to be well advanced in terms
of meeting recommendations to address the various policy drivers;
and AGREED:-
iii. that, in recognising its role in ensuring the specific objectives set out in the
Scottish Government’s letter to NHS Chief Executives were complied, the
Joint Committee should receive reports on progress from the Highland Multi
Agency LAC Strategy Group;
iv. copies of the Chief Executives’ letter be circulated to Members of the Joint
Committee; and
v. a web-link be provided for Members to the Who Cares? Scotland survey “A
Young Person’s View of Health”.
6. The Work of the Integrated Services Moving and Handling Working
Group and the Movement Opportunities Via Education
Implementation Group - Update
Report No CYP-28-09 by Jane Baines, Development Officer, Support for Learners had been circulated setting out the background to the multi-agency group and the progress made in promoting integrated practices around children and young people with moving. The aim was to improve moving and handling to maximise the potential for young people and carers which, it was stressed, had life long benefits. The report highlighted the issues which still needed to be addressed, the new targets which had been identified and sought approval of the group’s on-going action plan. In addition the report presented the integrated policy and guidance on the implementation of the MOVE (Movement Opportunities Via Education) approach across the Highland area.
A DVD presentation featuring young people from Drummond School was shown, including a clip of their school production, highlighting the benefits an integrated approach could generate.
In relation to the provision of a suitable equipment service, Members were informed that a temporary store had now been sourced, separate from the “main” equipment store which largely held equipment for adult service users. However, issues remained surrounding the effective logging and tracking of equipment and the capacity to store all the equipment currently being held in schools throughout the Highlands. It was hoped that this would be addressed with the development of a database to ensure best use was made of what was available and resources maximised.
NOTED the report and AGREED to:
i. endorse the significant progress made by the Integrated Services Moving
and Handling Working Group;
ii. provide a mandate to the group to seek to increase the number of moving
and handling trainers to deliver a joint training strategy;
iii. endorse the joint policy and guidance of the MOVE approach across
Highland; and
iv. the planning of a paediatric equipment service for the efficient and
effective management of equipment.
7. Pupil Support in Badenoch and Strathspey
Report No CYP-29-09 by Bill Alexander, Head of Children’s Services had been circulated seeking approval for the funding of a new service to support pupils in specialist and therapeutic activities in the Badenoch and Strathspey area which would avoid young children having to travel to Inverness to access services. This was similar to a number of other developments supported by the Joint Committee over recent years which had enabled many children to be sustained in their local communities.
Although welcoming the proposal, there was a need to ensure effective monitoring of the service took place. Reference was made to other organisations providing similar services and particular mention was made of the excellent work provided by “Doorways”. There were considerable demands on the services provided by these organisations and, in this connection, it was suggested that further investigation be made as to how support might be provided for similar projects and community groups which, in turn, could allow other sources of funding to be accessed.
AGREED:-
i. funding from the out of authority placements budget of £12,000 for an
initial one year period to initiate this new service;
ii. to consider a framework for how such support work was sourced in
communities to ensure maximum use was made of opportunities and the
funding available;
iii. that Chief Officers should take forward a mechanism as to how the
effectiveness of this venture could be demonstrated;
and NOTED:-
iv. the good work achieved by “Doorways” in effectively intervening in the
lives of a substantial number of young people.
8. For Highland’s Children 3 - Update
Report No CYP-30-09 by Bill Alexander, Head of Children’s Services had been circulated detailing proposals for the final draft of ‘For Highland’s Children 3’ to be published for the Seminar prior to the Joint Committee meeting scheduled for 2 October 2009.
To assist with the consultation process with young people, and to encourage Members of the Joint Committee to attend Youth Voice events, a timetable of their activities was requested. In addition, it was pointed out that there was no target in ‘For Highland’s Children 3’ relating to the number of Looked After Children progressing into tertiary education and, while such a target might be difficult to achieve, it was important it was incorporated into the Plan. Reference was also made to the terminology used regarding teenage pregnancies which it was felt gave an impression that all such pregnancies were either unplanned or that the girls involved were under age.
AGREED:-
i. presentation of a final draft of ‘For Highland Children’s 3’ at the Joint
Committee Seminar scheduled for 2 October 2009;
ii. as it was to be used as a platform to talk to young people about ‘For
Highland’s Children 3’, a timetable of Youth Voice events should be
provided for Members;
iii. consideration should be given to setting a target for the number of Looked
After Children continuing into Further and Higher Education; and
iv. that the wording be revised when reference was made to teenage
pregnancies.
9. Future Business of Joint Committee for Children and Young People
Report No CYP-31-09 by Bill Alexander, Head of Children’s Services, had been circulated setting out a proposed list of reports to be considered at future meetings of the Joint Committee on Children and Young People.
NOTED the proposed list of reports and also AGREED that reports be considered on the following:-
- Child and Adolescent Mental Health Services – Framework Update
- Child Health Review – Actions
- Looked After Children – Progress achieved in relation to the Scottish Government’s Letter to NHS Highland’s Chief Executive
- Review of Nursing in the Community
10. Date of Next Meeting
NOTED that the next meeting would be held in the Council Chamber, Highland Council Headquarters, Inverness on Friday, 2 October 2009 at 2.15 p.m., following the Seminar to be held in the morning on ‘For Highland Children’s 3’.
11. Exclusion of the Public
It was RESOLVED that, under NHS Highland Standing Order 4.1 and Section 50A(4) of the Local Government (Scotland) Act 1973, the public be excluded from the meeting during discussion of the following item on the grounds that it involved the likely disclosure of exempt information as defined in Paragraph 5 of Part 1 of Schedule 7A of the Act.
12. Death of a Child Who had been Looked After – Response from
Social Work Inspection Agency
Report No CYP32/09 by Harriet Dempster, Director of Social Work, had been circulated to Members only and detailed the response from the Social Work Inspection Agency (SWIA) following the submission of a report from the Highland Council on the death of a child in care in April 2005.
AGREED:-
i. to welcome the response; and
ii. that the strategic groups involved in various aspects of the preparation of
‘For Highland’s Children 3’ ensure that each of the recommendations
detailed in the report was being picked up and would be taken account of
in the developing final draft of the plan.
The meeting ended at 1.10 p.m