HSCB QA Report

Staff perception of Herefordshire’s response to childhood neglect.

Introduction.

A focus group took place on 22nd February 2017, attended by 10 professionals selected by a broad range of partner agencies. The session was 2 hours in length and comprised of 10 questions which were put to the members, having been split into groups of 5.

Questions posed.

•How well do we understand the nature and scale of neglect in Herefordshire?

•How far are children, young people, parents and carers able to seek and receive help?

•How well are the public supported to report concerns about child neglect?

•How well do staff in universal and targeted services recognise and work together to help children at risk of, or currently experiencing, neglect?

•How well do staff in specialist services recognise and work together to help children at risk of, or currently experiencing, neglect?

•How effective are local systems and mechanisms to assess a range of intelligence about concerns for a child and support informed decisions about when, how and who should intervene?

•How well are practitioners equipped to recognise and intervene in cases of neglect; supported by local guidance and evidence based assessment tools; able to access reflective supervision?

•How far do services commission/provide accessible, high quality, evidence based targeted support for children/young people and parents/carers with additional needs?

•How is the neglect strategy and toolkit embedded in agencies that don’t predominantly work with children?

•How effective is the strategic leadership of the local response to neglect?

Thematic outcomes.

•Lack of understanding of tiers 1-4 with reference to CAMHS. Professionals expected CAMHS to accept all referrals to their service when commissioned as a specialist CAMHS service levels 3 and 4 (Mental health)

•Perceived lack of provision of commissioned service for tiers 1 and 2 (emotional support)

•Uncertainty of definition and thresholds, both within individual’s agencies plus a concern from some agencies that colleagues across agency do not understand neglect thresholds

•Perceived variance in applying thresholds in MASH

•Needs of children in families with AMH diagnosis not clearly understood

•Lack of certainty that Neglect strategy will be embedded

•Lack of suitable toolkit at present

•Professionals were not aware of each other’s roles and scope of help available e.g. early help offer.

•Partners unwilling to share early concerns with carers (worry about jeopardising professional / parental relationships)

•Little understanding of resolution of professional disagreement policy (Still referred to by the group as Escalation policy)

•Lack of confidence in the resolution of professional disagreement policy.

•Willingness to share family information without appropriate consent. (This was rigorously challenged by both social workers and facilitators, NHS group member remained very vocal on the subject)

•Request for multi-agency supervision to take place (again without parental knowledge)

General overview.

There are frictions and tensions between LA and other agencies especially paediatrics and education, which would appear to be embedded in the culture

There are unrealistic expectations of what the LA could achieve e.g. removing children without strong multi-agency evidence of significant harm.

It is to be noted that the feedback from the group is as reported; no further interpretation has been made of this by the facilitators.

Learning for the board

•Focus on neglect

Embed strategy

Embed toolkit

•Provide multi-agency training

•Consider how to change cultures

Attendees from

Wye Valley Trust – 1 x Paediatrician, 1 x Health Visitor

Herefordshire Council –CWB – 1 x Family Support Team Manager, 1 x Social Worker, 1 x Senior Practitioner

2gether Foundation Trust–Community Mental Health Worker

Education–Pupil and Family Support Worker

West Midlands Police – 1 x Sargent, 1 x Detective Sargent

West Mercia Womens Aid– Refuge Support Worker

Facilitators

Lynne Renton (CCG)

Anne Bonney (HSCB)

Anne Bonney

15th May 2017 – version 1 (draft)

23rd June 2017 – agreed with changes