Agenda and minutes

RESOLVED:  To note the attendance at this meeting of the following duly appointed Reserve Member:-

No declarations were made.

That the minutes of the meeting held on 15 June 2016 be taken as read and signed as a correct record.

The Panel confirmed that the names and job titles of officers in attendance at the meeting should be included in the minutes at the end of the document.

It was noted that an amendment was required to Minute 110 on Page 64 of the minutes (Health report for Children Looked After in Harrow).  The final sentence in the penultimate bullet point of that minute should be replaced with the following: “The Central and North West London NHS Foundation Trust held a meeting with the Safeguarding GP to discuss immunisations for asylum-seeking children as some GP’s were only giving one booster and not the full course of immunisations.”   The Committee approved this amendment.

RESOLVED:  That the minutes of the meeting held on 15 June 2016, as now amended,  be taken as read and signed as a correct record.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Executive Procedure Rule 47 (Part 4D of the Constitution).

RESOLVED:  To note that no public questions, petitions or deputations were received at this meeting.

Report of the Corporate Director People Services

Mellina Williamson-Taylor, the Head Teacher of the Harrow Virtual School, presented her report, inviting Members to comment and ask questions on the issues raised. 

The Committee noted the information on educational attainment by Children Looked After, particularly the excellent performance at Key Stage 4.  Councillor Jogia enquired about the  lower levels of performance by Asian boys which was at odds with the position nationally and among Harrow’s statistical neighbours.  Ms Williamson-Taylor confirmed that she would be investigating the factors behind this, including detailed examination of the individual backgrounds and experiences of the children themselves. 

Members were informed that the completion rates for Personal Education Plans were improving, though there were still issues about the quality of these plans which Ms Williamson-Taylor would be addressing.  In response to Councillor Robson’s query, she pointed to the fact that while schools were reliable in terms of carrying out the discussions with the students, there were often delays in writing up the sessions and providing an audit trail of performance against the plans.  She underlined that this had an effect on a number of parties, including the foster parents in trying to track children’s progress and support them accordingly.  Councillor Dooley suggested that staff be separately designated to take notes at such sessions and then to write up the findings; Ms Williamson-Taylor explained that school staff were encouraged to enter the relevant information directly via the portal during the sessions themselves. 

The Committee heard that there had been some modest improvement in the level of fixed-term exclusions; it was still the case that these featured more among those pupils educated outside the Borough.  In response to Councillor Robson’s question, it was explained that the distances involved were not significant, eg. one child was at school in Hertfordshire.  Councillor Dooley suggested that the spike in exclusions in May and June could be explained by the stresses on those taking summer exams.  Ms Williamson-Taylor advised that this might be a factor, although there were not that many exclusions among the Key Stage 4 students.    Councillor Brown highlighted the overall context of only 13 children being excluded from the group of 116 Children Looked After attending school. 

In response to the Chair’s query about the engagement of CAMHS in monitoring the health of Children Looked After, Emma Hedley confirmed that there had been organisational changes at CAMHS which had affected this aspect; however, they were committed to regular meetings with partners at monthly or six-weekly intervals. 

In terms of school attendance, the Committee noted that, in the previous year, 26 children had been a cause for concern, with 17 of these educated outside the Borough.  Welfare Call were responsible for monitoring attendance.  Referring to the tables at Paragraphs 10.5 and 10.10 of the report, Ms Williamson-Taylor pointed that there were some attendance issues among early years children and that the increased absence level in 2015 reflected a national trend. 

Ms Williamson-Taylor highlighted the benefits for Key Stage 3 and 4 pupils arising from the Residential Writing  ...  view the full minutes text for item 116.

Report of the Corporate Director People Services

Paul Hewitt introduced the report, highlighting the following points:

a)            A number of panels were investigating the circumstances of individual cases to test the value for money in the relevant placement and to identify opportunities to make appropriate adjustments.  It was important to understand that the needs of children could change over time and there placements had to be kept under review to ensure that best use was made of limited resources in the interests of the children themselves.

b)            Staff awareness of these factors was being improved and they were being encouraged and supported to challenge providers where there appeared to be scope to adjust arrangements to reduce cost without compromising the children’s care. 

c)            Some placement costs were very high and had to be fully justified by reference to the needs of the child or children involved.  There was a increasing number of complex cases; for example, a recent case of a sibling group of 6 with two of the children under 10 years old having to be placed in residential settings. 

d)            The increasing demands had led to significant budget pressures in Period 6, amounting to over £1m.  Close monitoring and challenge would continue in an effort to reduce these pressures.

e)            Colleagues in the health sector were being encouraged to respond positively to requests for funding support; a tri-partite panel was in place to assist in coordination and cost-sharing, and to scrutinise support arrangements for families and children. 

In response to the Chair’s question about the option of the Council acting as a care provider, it was explained that the specialisms involved made this more difficult to implement and to justify in terms of cost-effectiveness.   Paul Harris advised that councils had discussed possible joint working in this area.  Peter Tolley confirmed that while spot purchase costs were high, there were equally high fixed costs in direct provision; use would be made of the modest income stream from partnerships in West London to explore options such as developing the use the facility at the Firs. 

RESOLVED:  That the report be noted.

Report of the Children Looked After Team, CNWL NHS Trust

Emma Hedley, Designated Nurse for Children Looked After, introduced the report, pointing out that CNWL had reached 100% for the review health assessments in each month in the reporting period with the exception of June when 93% level had been obtained; this represented one child, had been  caused by an administrative error and was the only failing against this target in the last year.  She also confirmed that the “GP with Special Interest” had been successfully recruited; the appointee was a local Harrow GP and had now been in post for about six weeks.  The Designated Doctor and Medical Adviser role continued to be covered by a Hillingdon doctor. 

Laurie Ward, Specialist Nurse for CLA, advised that there was now a more structured referral process in relation to emotional health issues, with children being seen by professionals at the Morning Lane facility or being referred to CAMHS and hospital psychological services, if required.  Emma Hedley added that meetings had been held with Future in Mind and with social work teams/managers to improve coordination in this respect. 

Emma Hedley acknowledged that the performance on immunisations needed to be improved and would be subject to monthly monitoring.  She advised that she would present information to a future meeting of the Panel on the client satisfaction survey which had benefited from a good response rate.

The Committee heard that the risk assessment exercise had revealed issues related to the interaction between the “SystmOne” IT system in CNWL and the work of health visitors and school nurses.  While these staff were doing their best to maintain effective communications, discussion were under way with the providers of SystmOne to ty to secure data sharing using the system.  This had been added to the risk register.  David Harrington explained that this was a particular challenge in the health sector given data confidentiality arrangements.  In response to Councillor Robson’s question, it was confirmed that GPs could not access data in SystmOne; they relied on other ways of communicating, but they were effective in using them. 

Arrangements for the introduction of the Health Passport were almost complete.  The Children Looked After (CLAs) had been consulted on what type of passport would be useful and what data to include.  Peter Tolley explained that historically, data on CLAs had been too easily missed as children moved and changed placements, and it was therefore important to have a secure record; the “passport” also gave the child a greater sense of identify, profile and security. 

In terms of innovative practice, Emma Hedley reported that Laurie Ward had designed an “interpreter’s cribsheet” which had been recognised nationally by the CoramBAAF health group.  Also, the cribsheet, TB leaflet and Handy Hints leaflet had attracted interest and commendation from Thanet CCG.  

The Panel endorsed Emma Hedley’s suggestion that she bring the recently-competed Annual CLA Health Report to the next meeting of the Panel.

In response to Councillor Robson’s question about teenage pregnancies, it was explained that there had been a couple  ...  view the full minutes text for item 118.

Report of the Corporate Director People Services

Peter Tolley introduced the report, pointing out that the date cited on Page 33 for the data on young people in employment, education and training, should read 30 September 2016, not 3 December 2015; and that there was a small discrepancy in the figures in the columns in that same table.  While he acknowledged that the number of 37 (out of 139) not in employment, education and training (NEET), was too high, there were difficult challenges in improving this rate for this group which included those in prison, those with immigration status issues, young mums and those suffering drug/alcohol addiction or mental health problems.  Plans were in place for all of them, including engagement with Prospects (previously Connexions) to explore options, and efforts would be made to develop new links with businesses and the community. 

The Chair asked about the gender breakdown of figures in the report; Peter Tolley would provide this information to members of the Panel, but it was not expected that there were any significant differences given the overall gender composition of CLAs.   

In response to Councillor Whitehead’s question about comparisons with NEET rates in other boroughs, David Harrington advised that this was moderately in Harrow’s favour, but there was nevertheless a firm commitment to improve the opportunities for local CLAs.  Peter Tolley underlined the outstanding performance in Ealing borough; experience there had underlined the value of staying in touch with CLAs. 

Councillor Whitehead referred to her experience as a volunteer manager in CNWL in securing appropriate placements for vulnerable youngsters, including those with autism, in the NHS and its partner agencies; she felt this would provide a supportive environment for children with these backgrounds and needs. Peter Tolley would explore these options further.  He also explained that the Council ran programmes such as X16 and XCite, as outlined in the report, using mentoring, coaching and other methods to build resilience, skills, knowledge and confidence in these young people. 

Mellina Williamson-Taylor added that Virtual Schools in North West London were in discussions about joint work to develop work experience opportunities for their pupils. 

RESOLVED:  That the report be noted.

Report of the Corporate Director People Services

Peter Tolley introduced the report which the Panel had sought at their last meeting.  He pointed to the fact that although there were 9 young people in remand as at June 2016, in fact only 2 of these had Looked After status at the point of sentencing and custody.  The Youth Offending Team worked closely with staff supporting CLAs and care leavers, and there was dedicated social work support for those remanded and thereby acquiring Looked After status. 

Councillor Jogia asked about the impact of the implementation of the new Youth Offending case management system.  David Harrington advised that there had been some disturbance to processes, but these had not affected outcomes which remained good.  An IT infrastructure upgrade on the Citrix system was taking place at present and this was leading to some slowness.  An action plan was in place to address IT support issues. 

RESOLVED:  That the report be noted.

Report of the Divisional Director, Strategic Commissioning

David Harrington introduced the report and emphasised the continuing and unprecedented pressures on the social care system across the country, affecting child protection and support for CLAs.  In Harrow, the pressures were not quite as high as some comparator boroughs, but it remained a very challenging situation.  Efforts continued to recruit more foster carers and to improve the stability of placements for CLAs.  David Harrington reported that issues related to the recording of cases had now been resolved and improvements had been made to referrals between the Council and CNWL.  There was a concerted effort and commitment at all levels and across all partners, to keep pace with the increasing demands.

In response to Councillor Whitehead’s query, Peter Tolley explained that relatively few children in Harrow experienced instability in their placements, with the emphasis placed on comprehensive assessments to match children to carers appropriately in a planned way.  In some cases, there were limited options; for example, where there were few vacancies available in care providers trying to meet increasingly exacting quality standards set by Ofsted. 

In response to Councillor Whitehead’s question, Peter Tolley confirmed that there were very few specialist carers and even if they could be identified, they were often wary of accepting other children into their care given the possible impact on the established family.  Once an appropriate placement was secured, every effort was made to maintain its stability and support the child and carer in this.  Mellina Williamson-Taylor confirmed that school moves were also avoided wherever possible as this could disrupt care placements. 

The Chair asked about whether foster carers preferred to start with short-term placements and whether there was sufficient capacity for children requiring longer-term support.  Peter Tolley confirmed that efforts were made to develop the skills, knowledge and resilience of existing carers, eg. in the use of therapeutic fostering.  Emma Hedley added that the Morning Lane facility also offered support and training was available in areas such as equality and diversity.  The Chair also underlined the importance of the mutual support between foster carers. 

RESOLVED:  That the report be noted.

RESOLVED:  That the agenda be updated in line with Members’ comments.

Officers present:

Harrow Council Officers:

Health Authority Representatives: