Sample Service Standards Extracted from the 3rd Edition StandardsEditors: Rachel Barrett, Carly Butler, Elizabeth Collins, Anne OHerlihy and Peter Thompson

Contents

03

Contents 03

Introduction 04

Section 1: Referral and Access 08

Section 2: Assessment and Care Planning 09

Section 3: Care and Intervention 10

Section 4: Information, Consent and Confidentiality 11

Section 5: Rights and Safeguarding 12

Section 6: Transfer of Care 13

Section 7: Multi-Agency Working 14

Section 8: Staffing and Training 15

Section 9: Location, Environment and Facilities 16

Section 10: Commissioning 17

UK Regional CAMHS Data 18

Glossary 20

Contents

Introduction

04

IntroductionThis sample edition of the standardsThe Quality Network for Community CAMHS promotes integrated services which enable all youngpeople to access timely and appropriate intervention with regards to the severity of their mental healthdifficulties and any related or additional needs. These standards are for all young people up to the ageof 18, including those with learning disabilities or autistic spectrum disorders, or co-morbid substancemisuse problems.

This edition also includes for the first time a subset of additional standards to provide guidance forcommunity CAMHS providing a crisis response or planned intensive treatment in the community for youngpeople with severe and complex mental health needs. The subset has been developed through a reviewof CAMHS and adult policy literature and guidance, as well as service protocols from eight crisis and/orintensive CAMHS teams, and extensive consultation with an advisory group of stakeholders.

The revisions to this edition of the standards have been developed taking account of current policy,including the Care Quality Commissions Essential Standards of Quality and Safety, Valuing PeopleNow, the revised Mental Health Act 1983 Code of Practice and Refocusing the Care ProgrammeApproach. All members of QNCC were also invited to a workshop to gain expert opinion andconsensus and two consultation sessions were also held with the networks Young Person Advisors. Once amendments had been proposed, a consultation draft was circulated to over 200 members on the QNCC email discussion forum, and the final document incorporates their comments and feedback.

This abridged version of the QNCC standards shows a selection of standards from each chapter. Thiswill help you to get a sense of how the standards are constructed and what we encourage services towork towards. If you are interested in your service becoming part of QNCC and being reviewed againstthese standards, please contact one of the team by email (camhs@cru.rcpsych.ac.uk) or by telephone(020 7977 6693).

How to read these standards

The standards are arranged in sections which follow the care pathway of a young person who accessesCAMHS, with overarching service-related standards in the later sections. The sections are as follows:

01 Referral and access02 Assessment and care planning03 Care and intervention04 Information, consent and confidentiality05 Rights and safeguarding06 Transfer of care07 Multi-agency working08 Staffing and training09 Location, environment and facilities10 Commissioning

At the end of the sections on referral (section 1), assessment (section 2), care (section 3), transfer of care(section 6), staffing (section 8) and environment (section 9) there are additional standards which areapplicable to services providing a crisis and/or intensive response. These should be read as additionalto the main standards.

A wide variety of community CAMHS will use these standards. The Quality Network for CommunityCAMHS has member services which are uni-professional as well as multi-disciplinary. Services may workin a clinic base or through schools, GP practices, other community settings and in clients homes.Services are different depending on the client group they work with, including young people with

Introduction

05

learning disabilities and autistic spectrum disorders. Therefore, while these standards are designed to be as inclusive as possible, it may be that particular standards are not applicable for some services. Due to the variety of service models it is not feasible to give an exhaustive list of possible exceptions. If you have any queries about whether a particular standard applies to your service or not, pleasecontact the Project Team.

TerminologyThroughout this document, young people is used to describe all age groups of service users whoaccess child and adolescent mental health services. We have also used parents/carers to identify andacknowledge those who hold parental responsibility but who may not be the biological parent. For moreguidance on terminology, please see the glossary at the end of the document.

NumberingAs a result of the integration of the generic and learning disability standards, the standards have been re-ordered since the last edition, and are numbered by section. The QNCC team has made a note of thenumber changes so comparisons will still be able to be made year on year.

GradingA grade for each criterion is shown in brackets in the left-hand column. The standards are graded as follows:

1 Essential: These are standards that are critical to care. Failure to meet these standards would result ina significant threat to patient safety, rights or dignity and/or would breach the law.

2 Expected: These are standards that a CAMHS team providing a good service would be expected to meet.

3 Desirable: These are standards that an excellent team should meet or standards that are not the directresponsibility of the team.

Links to existing policy and guidanceThe standards have been mapped so that, wherever a criterion may justifiably be seen as contributingtowards compliance with other guidance, this is clearly highlighted. Meeting a QNCC criterion shouldnot be taken as an automatic indication of compliance with the corresponding mapping source stated.

These mapping references are shown in the right-hand column of the standards. The abbreviations for themapping sources used throughout the standards are as follows: (on the next page)

Introduction

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CQC The Care Quality Commissions Essential Standards of Quality and Safety

YW The Department of Healths Youre Welcome Quality Criteria

eNSF The English National Service Framework for Children, Young People and Maternity Services

wNSF The Welsh National Service Framework for Children, Young People and Maternity Services

NHSLA The NHS Litigation Authoritys Risk Management Standards for Mental Health and LearningDisability Trusts

SAM The National CAMHS Support Services Self Assessment Matrix

HSW The Welsh Assembly Governments Healthcare Standards for Wales

GIRFEC The Scottish Executives Getting it Right for Every Child

BHBC The Scottish Executives Better Health, Better Care

DHF The Scottish Executives Delivering a Healthy Future

DOAS Do Once & Share project: CAMHS Learning Disabilities Developing a National Care Pathway

Important Note

Data collection tools adapted from these standards will be provided with guidance notes to QNCCmembers before reviews take place. This document is provided for reference and not for data collection.

These are best practice statements and consequently we would not expect services to meet everystandard. While there are some statements that are based upon legal requirements, this document is notintended to act as a legal guide in any way. This is not intended to be a guide to any reviewsconducted by regulatory bodies.

The complete Service Standards 3rd Edition is available from www.rcpsych.ac.uk/communitycamhs

If you have any questions about these standards please contact us on:

Telephone: 020 7977 6693Fax: 0207 481 4831Email: camhs@cru.rcpsych.ac.uk

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The 3rd Edition Standards Sample Selection

Referral and Access

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Section 1: Referral and Access

! Crisis and/or intensive response subset:Standards for an unplanned crisis response within CAMHS:

1.5 CAMHS work with all potential referrers and other local CAMHS, to ensure appropriaterequests for a crisis response are received

1.5.1 CAMHS providing a crisis response are resourced to offer advice and 2support to frontline referring servicesGuidance: See the National Mental Health Development Units website (www.nmhdu.org.uk) for guidance

1.5.2 CAMHS disseminate clear referral criteria to all relevant referring 2services (including frontline services) for eliciting a crisis response

Number Standard/Criterion Type Ref.

1.1 CAMHS work with all potential referrers to ensure referrals are appropriate, timely and co-ordinated

1.1.1 CAMHS offer consultation and training to frontline referring services 2 eNSF (9)Guidance: For example, by appointing Primary Mental Health HSW 12dWorkers or other link persons to work with education, social services, GIRFECdrug and alcohol teams, and primary healthcareRef 48: pg 9 recommendation 7Ref 87: pg 57

1.1.2 CAMHS disseminate clear referral criteria to referrers, including 2 wNSFcriteria for varying levels of response 2.20 Guidance: For example, specifying the criteria to elicit a routine or HSW 12d urgent referral YW 1.3 Ref 97: [Wales] pg 12, recommendation 2.20, Service providers publish GIRFECand disseminate referral guidelines and pathways for access to their servicesRef 105: pg 27, recommendation 1, A defined set of referral criteria that state what conditions are eligible for the service

1.2 Young people and their parents/carers (where appropriate) are fully involved and informed during the process of referral so they know what to expect

1.2.1 Staff provide young people and their parents/carers with written 2 CQC 1Hinformation about the service prior to or during their first attendance YW 2.1Guidance: This might include the distribution of leaflets and web HSW 6aaddresses to referrers and linked services GIRFEC

BHBC 3.2

1.4 CAMHS have systems in place to monitor access and referral

1.4.2 Missed appointments (DNAs) are monitored and reviewed in order to 2 HSW 2didentify where access difficulties may exist eNSF (3)Guidance: This should include monitoring of failure to attend the initial BHBCappointment after referral and early disengagement from the service 2.4 3.6Ref 39: pg 97, Failure to attend can be an indicator... that a service is DHF 145 difficult for families to access or considered inappropriate, and requires Action 12reviewing

Assessment and Care Planning

09

Section 2: Assessment and Care Planning

! Crisis and/or intensive response subset:Standards for a crisis response within CAMHS initial assessment:

2.9 Young people in need of a crisis response from CAMHS receive a comprehensive assessment in line with the Care Programme Approach (CPA) and/or other relevantassessment frameworks (e.g. CAF, SEN)

2.9.1 If appropriate, within days of referral, staff providing a crisis response 2can co-ordinate an initial care plan with the young persons local CAMH service and offer a detailed multi-disciplinary assessment in accordance with the Care Programme Approach (CPA) and risk assessmentGuidance: Many services specify a time-frame of within a few days after the initial assessment

2.9.3 At the first assessment, young people and their parents/carers are 3given a brief card or sheet that contains contact details of who to contact if they require support or if a crisis occurs

Number Standard/Criterion Type Ref.

2.1 Young people receive timely mental health assessments

2.1.2 Young people with urgent or emergency mental health needs receive 1 CQC 4Cspecialist mental health assessments promptly and within acceptable HSW 3timescales according to service specification or Trust policy eNSFGuidance: In emergency cases, specialist mental health assessments (9) 4are provided within 24 hours or the next working day wNSF 4.7

2.2 Assessments are effectively co-ordinated with other agencies so that young people and their parents/carers are not repeatedly asked to give the same information

2.2.2 Prior to assessment, the assessing practitioner accesses relevant 2 CQC 4L 6Bprevious information to minimise the number of forms and assessments HSW 12dyoung people and their parents/carers are required to complete English NSFGuidance: The assessment process should be co-ordinated across (3)agencies where necessary, including through CAF or other local systemsRef 28: pg 32, single assessments that underpin continuity of care using the principle of ask oneRef 29: pg 30, Information gained during assessments (including risk assessments) should be shared as appropriate between agencies to avoid reduplication

2.4 Young people and their parents/carers experience assessment as collaborative and are fully informed and involved

2.4.3 During assessment young peoples views, wishes, and feelings are 2 HSW 6cactively sought and recorded by the assessing practitioner, as far as CQC 1A,B,possible with regards to capacity E 4AGuidance: Wherever possible with regards to age and ability, the assessing practitioner ensures that no decision is made about a young person without their full involvementRef 28: pg 32, involvement of family, friends and other carersRef 50: pg 8, recommendation 2.14, Childrens views, wishes and feelings, on all aspects of their care are sought in a manner appropriate to their age and understanding

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Care and Intervention

Section 3: Care and Intervention

Number Standard/Criterion Type Ref.

3.1 The service offers a range of interventions according to individual and family needs

3.1.1 CAMHS work in partnership with primary services and other relevant 2 CQC 4.4Aservices to ensure young people with particular needs (for example sensory impairments or autistic spectrum disorders) receive the co-ordinated care and intervention they needGuidance: Collaboration involves providing advice or education to other agencies on how to manage young people with learning disabilities and/or mental health needs; more formalised collaborative arrangements involve, for example, joint care, CAMHS paediatric liaison

3.3 Staff provide support and guidance to enable young people and their parents/carers to help themselves

3.3.4 Young people and their parents/carers are informed about local 2 CQC 1.1Mvoluntary organisations and self-help groups, including culturally HSW 31d 7specific groups and organisations where relevant GIRFECGuidance: This may include those waiting between assessment and treatment

3.4 Young people and parents/carers experience collaborative and consistent care

3.4.2 Young people and their parents/carers are provided with information 2 CQC 1A,C,about the evidence base, risks, benefits and side effects of intervention E, F, 4E 4I 9Doptions and of non-intervention HSW 6bGuidance: For example, staff provide children, young people and their eNSF (10) 4parents/carers with NICE/Cochrane guidelines about the treatment for NHSLA particular conditions 1.4.2Ref 28: pg 32, good, clear information to inform peoples choices and decision making

3.5 Outcome measurement is routinely undertaken

3.5.1 Resources are available to support the routine evaluation of outcome 2 CQC 16ARef 32: pg 41

3.5.2 Staff monitor clinical outcomes at regular intervals, using validated 2 CQC 16Aoutcome tools where appropriate and relevant HSW 11dGuidance: For example, staff use SDQ, HoNOSCA, CGAS; see the SAM 10 (i)CAMHS Outcomes Research Consortium website for guidance GIRFEC(http://www.corc.uk.net/) BHBC 3.5

! Crisis and/or intensive response subset:For a planned intensive intervention:

3.8 CAMHS providing intensive interventions prioritise a flexible and assertive approach to engaging young people and their parents/carers in treatment

3.8.1 Staff can provide an intensive intervention and support in the young 2persons home or other safe informal locations in the community

3.8.2 Young people receive an intensive intervention and support as frequently 2as required to resolve crisis and support managed handover of care

Information, Consent and Confidentiality

11

Section 4: Information, Consent and Confidentiality

Number Standard/Criterion Type Ref.

4.1 Young people and their parents/carers are provided with information that is accessible and appropriate for their use

NB standard 4.1 is overarching: criteria apply to all information that is provided for young people and parents/carers including service information, intervention information,information on consent, confidentiality and rights

4.1.1 Staff provide young people with information that is clear, 2 HSWdevelopmentally-appropriate and easy to understand in order to 6a 6b 10enable genuine participation eNSF 3 8Guidance: Staff use communication methods that are consistent with YW 2.1 2.3young peoples usual means of communication BHBC 3.2Ref 27: pg 21 4.12, tailored, age- and developmentally- appropriate DHF 183methods are needed to communicate with children and young people so Action 1they can understand their mental health problems and the choices they have about their treatment and careRef 29: pg 4, children and young people need information to be tailored to them, to recognise their process of cognitive development and, for those under 16, the extent of their competence to give consent

4.1.11 CAMHS facilitate initiatives in which young people who wish to are 3able to act as information sources for others with similar conditionsRef 22: pg 146, recommendation 8, Children identify a number of issues to be addressed [including] provision of opportunities for contacts with other disabled children

4.2 Staff follow clear procedures for gaining valid consent to treatment

4.2.1 Assessments of individuals ability to consent to the proposed treatment 1 CQC 2Bor intervention are made in accordance with the relevant legal principles: wNSF 2.26 Under 16s are presumed not to be competent to make decisions

about their treatment unless they are assessed to be Gillick competentGuidance: A Gillick competent child will have sufficient understanding and intelligence to enable him or her to understand fully what is proposed; see the Code of Practice to the Mental Health Act paragraphs 36.38-36.50 and the Legal Guide p. 18 19 People aged 16 and over are presumed to have capacity to make

decisions about their treatment unless it is established that they lack capacity (section 1 MCA 2005)

Guidance: See the Code of Practice to the Mental Health Act paragraphs 36.27-36.34 and the Legal Guide p. 19 23

4.5 Young people and their parents/carers are well-informed about confidentiality and their rights to access information held about them

NB following standard 4.1, this information is given to young people in ways that enabletheir participation as far as possible with regards to age and ability

4.5.1 Young people and their parents/carers are informed of their right to 1 YW 2.1 2.2confidentiality and the limits of this 3.3 3.4Guidance: This should be through verbal explanations, supplemented eNSF (4)by prominently displayed leaflets and posters DHF 199

Action 3

Rights and Safeguarding

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Section 5: Rights and Safeguarding

Number Standard/Criterion Type Ref.

5.3 Young people and parents/carers are well-informed about how to make complaints and how to seek independent advice

5.3.1 Complaints procedures are well-publicised and patient-friendly and staff 1 CQC explain to all young people and their parents/carers how to use them 1H 17A,EGuidance: Complaints procedures should be explained verbally and in HSW 15binformation packs and posters (for clinic-based services) GIRFECRef 107: The young people suggested that the name of the person who BHBC 2.3young people could contact if they were unhappy with a service should DHF 199be clearly displayed/available Action 3

5.5 Young people are protected from abuse through clear safeguarding policies and procedures

5.5.1 Staff act in accordance with current child protection protocols (e.g. the 1 CQC 7A,Eprocedures of the Local Safeguarding Children Board), regardless of HSW 17the young persons level of ability SAM 4 (ii)Ref 22: pg 60, recommendation 5.60, Any childs disclosure of misuse GIRFECor an untoward event must be taken seriously. Neither immaturity nor a DHF 91history of behaviour or psychiatric disorders renders a childs disclosure incredible: each case must be judged singly and carefully on its merits. We are certain that all safeguards and standards that apply to children who are physically sick must apply equally to those with mental health problems and disorders or learning disabilities

5.5.5 The specific safeguarding needs of young people who are looked 2 HSW 17after are responded to through policies, procedures and practice that DHF 91are designed to protect themRef 10: pg 124, recommendation 2.7, Policies, procedures and practicetake full account of, and are appropriate to the specific safeguarding needs of children living away from home including bullying and self-harm...

5.5.8 Staff who may see young people with learning disabilities receive 1regularly updated training in child protection with specific regard to young people with learning disabilities, recognising that young people with learning disabilities are at increased vulnerability to abuseGuidance: Staff should receive training as part of their induction and have access to in-house training and refresher courses on an annual basisRef 22: pg 13, recommendation 3.5, ...some children are more vulnerable than others because they are younger, less able to tell adults of their concerns, physically less able to move away from unwanted contact, more isolated (with fewer visitors) or less likely to be believed because they themselves have learning disabilities or mental health problemsRef 83: pg 12, Child abuse, including neglect, emotional and sexual abuse children with learning disabilities are at greater risk than others of certain kinds of abuse (Chamberlain et al, 1984)

5.6 There are policies and procedures on whistleblowing

5.6.3 There is a forum in which staff are able to express their concerns 1 CQC 14Dabout the management of young people within the service, and such 16Bconcerns are taken seriously wNSF 2.23Guidance: Staff should be made aware that they have a responsibility HSW 23ato critically challenge decisions that they feel may not be in the best GIRFECinterests of young people and their parents/carers

Transfer and Care

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Section 6: Transfer and Care

Number Standard/Criterion Type Ref.

Leaving the service:

6.2 The service makes arrangements to ensure that young people are offered continuity of carewhen they move on from the service

6.2.6 On leaving the service, there are agreements with other agencies for 2young people to re-access the service if needed, without following the initial referral pathwayGuidance: There may be exceptions where young people require a generic assessment and where it may be appropriate to follow the initial referral pathway

Transfer to inpatient care:

6.3 Young people who require inpatient care are referred to units that meet their individual needs with effective continuing care

If inpatient care is required:

6.3.2 Young people are referred to a unit that is as accessible as possible so 2 eNSF (9)that contact with home and family is maintainedRef 41: pg 19

Transfer to adult mental health services:

6.4 CAMHS work closely with adult services to arrange effective handovers of care

6.4.3 Joint reviews of young peoples needs are held with adult services (e.g. 2 CQC 6Musing the CPA) and the young person to ensure that effective handover HSW 12dof care takes place eNSF (9) 10Ref 41: pg 5, recommendation 10, When children and young people GIRFECare discharged ... into the community and when young people are DHF 119;transferred from child to adult services, their continuity of care is ensured 178by use of the care programme approach Action 5Ref 41: pg 43

! Crisis and/or intensive response subset:Transfer of care from a CAMHS crisis response and/or a planned intensive intervention:

6.5 Young people who require inpatient care are referred to units that meet their individual needs with effective continuing care

Continued from standard 6.3

6.5.1 CAMHS providing crisis response and/or planned intensive 1intervention can access a CAMHS bed in an emergency without delay, when required

6.6 Staff work closely with the young persons locality CAMHS team or inpatient service to arrange effective handover and joined-up provision of continuing care after the community-based intensive intervention

6.6.1a During admission to an inpatient setting, the staff providing an 2intensive intervention stay involved to: Attend review meetings

Multi-Agency Working

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Section 7: Multi-Agency Working

Number Standard/Criterion Type Ref.

7.1 The service works closely with, and has good access to, a range of CQC 4Aservices and agencies that are appropriate to the needs of the young HSW 12Dpeople and parents/carers GIRFECThese include: YW 6.1

7.1.1 General practitioners and other members of the primary healthcare team 2Ref 28: pg 32, early intervention and other evidence based interventions, including diversion delivered by high quality services along a stepped pathway of care from primary to secondary services

7.1.3 School health services including community paediatricians and school 2or college nurses

7.1.4 All relevant departments in social services including foster care and 2 DHF 30adoption services

7.1.5 Education and education support services 2 DHF 39

7.1.7 Youth justice service 2 DHF 32

7.1.8 Inpatient and day-patient child and adolescent mental health services 2

7.1.11 Speech and language professionals 2

7.1.12 Young peoples drug and alcohol teams/substance misuse services 2Ref 29: pg 30, more effective partnerships between general mental health and substance misuse services would improve health and reduce risk

7.1.19 Employment support agencies 3Ref 29: pg 23

7.2 The service has clear, up-to-date, documented agreements with a range of local services and agencies

7.2.3 There are arrangements to ensure that there is 24 hour cover for 1 CQC 6Dyoung people in need GIRFECGuidance: Joint protocols should be agreed, for example, with BHBC 3.7commissioners, primary healthcare services, paediatricians, adult psychiatry services, emergency medical departments, social servicesRef 104: pg 40, It is vital that commissioners, CAMHS and adult mental health meet together to explore creative and realistic solutions to providing adequate and appropriate out of hours cover to this vulnerable group of young people

7.2.5 There are joint collaborative arrangements with specialist drug and 2alcohol teams for providing joint care

7.2.8 There are joint protocols on involving or notifying other services or 1 CQC 6B, Eagencies when there is suspected abuse of young people HSW 12DRef 10: pg 123, recommendation 2.2, Child welfare concerns are GIRFECresponded to and assessed by the relevant agencies and professionals DHF 29 working in partnership, with clear identification of intended and actual 91outcomes from any response

Staffing and Training

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Section 8: Staffing and Training

Number Standard/Criterion Type Ref.

8.4 Staff are regularly appraised and supervised and know how to gain additional support when needed

8.4.2 All staff receive regular supervision totalling at least one hour per 1 CQC 14A,Cmonth from a person with appropriate experience HSW 11b

YW 5.3NHSLA 1.2.4GIRFEC

8.5 Staff morale is monitored by the clinical and general manager

8.5.3 There is a clear mechanism for formally recognising good performance 3and innovation within the service Guidance: For example, this may be at events, in newsletters or with achievement awards

8.6 Staff are well-trained for their jobs, and their continuing professional development is facilitated

8.6.4 Staff are provided with opportunities to develop their practice in 2 CQC 14Aparticular areas, such as learning disabilities, autistic spectrum disorders and substance misuseGuidance: For example, this is achieved through joint-working, peer consultation, special interest groups and appropriate supervisionRef 7: pg 8

8.8 Staff work effectively as a team or network

8.8.3 Staff are consulted on relevant management decisions such as 2developing and reviewing operational policy

Crisis and/or intensive response subset:

For CAMHS providing crisis response and/or intensive intervention:

8.12 Staff work effectively as a team or network

Continued from standard 8.8

8.12.2 Staff providing crisis response and/or intensive intervention have 2access to a list of senior professionals who they can call for support or advice if required

8.13 Staff providing crisis response and/or intensive intervention are able to undertake their work safely in the community

8.13.1 Staff have access to a safe visiting policy and procedures which 2outline the necessary steps to plan each visit, assess risks and ensure safety when working alone or out-of-hours

8.13.3 Staff are trained to undertake a dynamic risk assessment and are 2aware of the circumstances under which a visit can be terminated

!

Location, Environment and Facilities

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Section 9: Location, Environment and Facilities

Number Standard/Criterion Type Ref.

9.1 The locations where CAMHS are delivered are well-designed and have the necessaryfacilities to meet service needs

9.1.4 CAMHS centres are age and developmentally appropriate for the 2 CQC 4I,whole age range seen by the service and are young person-friendly 10A, IGuidance: For example, waiting areas in CAMH centres contain age HSW 4aand developmentally appropriate play and reading material YW 4.1 Ref 28: pg 32, age and developmentally appropriate settings and 4.2approaches for children and young people and adults of all ages SAM

4 (iii) (v)DHF 82

9.3 CAMH services are delivered in safe environments 10A

9.3.1 Entrances and exits are visibly monitored and/or access is restricted 1 eNSF (3)Ref 39: pg 109 HSW

4c 4dYW 4.1

9.3.2 CAMHS centres are securely separated from adult services 1 CQC 10A,Guidance: There are separate areas and entrances for adults and Cchildrens services, and access to childrens services is restricted eNSF (3)Ref 39: pg 109, All agencies and organisations review the security HSWarrangements for services they provide to children and young people 4c 4dto ensure that access is limited to those adults who need it YW 4.1

9.3.4 When consultation takes place in a new setting, staff carry out a risk 2 CQC 10Aassessment regarding the safety of the environment and its suitability NHSLA 1.3.1for meeting the needs of the consultation

9.3.6 There is a system in place so that staff can summon help in an 2emergencyGuidance: For example, wall alarms in clinics, personal alarms, mobile phones for lone worker

9.4 Staff have sufficient office facilities and IT systems 10A, D 14D

9.4.1 Staff report they have sufficient space to do administrative work 2 SAMGuidance: Staff can access suitable space to make confidential 8 (iv)phone calls GIRFEC

! Crisis and/or intensive response subset:For CAMHS providing crisis response and/or intensive intervention:

9.5 Staff providing crisis response and/or planned intensive intervention are integrated withinCAMHS and have established links with locality CAMHS teams, and day and inpatientCAMHS used by the Trust

9.5.1 Staff have a central base from which to undertake their activities and 2to support administrative work, team meetings, and links with other CAMHS teams and partner agencies

Commissioning

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Section 10: Commissioning

Number Standard/Criterion Type Ref.

10.1 Commissioner-provider relationships are collaborative and effective

10.1.1 Senior CAMHS managers work collaboratively with the CAMHS 2commissioning lead for each commissioning agency involved

10.1.6 The following groups are involved in and consulted on the 2 CQC 1D 1Jdevelopment of the commissioning strategy: HSW 1 Young people who may access the service SAM 2 (vi) Families of young people who may access the service BHBC 1.2 People from different religious, cultural and minority ethnic groups, 1.4 2.4 3.6

whether or not they are patients of the service DHF 120 CAMHS staff, including frontline staff 196 Local community groups and partner agenciesRef 39: pg 66, recommendation 2.7, Primary Care Trusts and Local Authorities ensure that local parents are involved in planning and delivery of services, with representations from all local communities and groupsRef 50: pg 8, recommendation 8.19

10.4 Adequate resources are available to meet the needs of young people with mental health problems

10.4.1 Commissioners ensure CAMH services are appropriately staffed 2 HSW 24aGuidance: English NSF p 30: a generic specialist multidisciplinary DHF 145 CAMHS at Tier 3 with teaching responsibilities and providing Action 4evidence-based interventions for 0-17 year olds would need a minimumof 20 whole time equivalents (WTEs) per 100,000 total population, and a non-teaching service, a minimum of 15 WTEs; clinicians on the FOCUS discussion group have estimated that services seeing patients up to age 18 require 25% increase in workforce capacityRef 104: pg 30-31

10.4.4 Commissioners ensure that young people are not placed out of area 2as a consequence of inadequate support being provided in the local communityRef 59: pg 102, The right level of support should be made available to schools to help keep children in-borough... The reason for the placement out of borough in 46% of cases was the need for specialist provision... The proportion of these children who also had mental health difficulties, which contributed to the placement, is not known; 46% had received mental health services at some point. Of the 18 children placed out of borough owing to mental health difficulties, only 61% accessed mental health services before out-of-borough placement. Mental health services were not considered early and there was poor inter-agency communication

10.5 There is a clear framework for service review and performance management that is agreedbetween the commissioning and provider agencies

10.5.1 There is a review process involving commissioners and the service that 2 GIRFECtakes place at least annually

10.5.3 Performance criteria are informed by the principles identified in the 2strategic framework

10.5.4 Performance criteria are informed by the opinions of young people 2 HSW1and their parents/carers

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UK Regional CAMHS Data

Scotland:

North East:

North West:

UK Regional CAMHS DataThe data below shows how well teams in your area scored on average against the QNCC Standards.

By participating in QNCC youll be able to find out how well youre performing against the standardsand benchmark yourself against other similar services locally and nationally.

19

UK Regional CAMHS Data

Scotland:

East Midlands:

Wales:

West Midlands:

South:

20

Appendices

GlossaryCAF Common Assessment Framework an assessment tool for use across all

professionals working with children

CAMHS Child and adolescent mental health services; refers to community not inpatientservices for the purposes of these standards

CPA Care Programme Approach systematic assessment of a patients health andsocial care needs, care plan, key worker and regular review of progress

Crisis response When a young person presents with an urgent mental health need that requires animmediate response from CAMHS that is not part of a care plan

DNA Did Not Attend when a young person misses a planned appointment

Intensive intervention When a young person requires an increased level of CAMHS input and contactthat is part of their planned care

Intervention Any therapies or medical procedures that form part of a child or young personsassessment or care, including medical treatments, talking therapies and physicalexamination

Parents/carers Those who hold parental responsibility, not necessarily the biological parent

Young people All age groups of service users who access child and adolescent mental health services

References

Full details of references are available in the complete Quality Network for Community CAMHS 3rdEdition Standards available from www.rcpsych.ac.uk/communitycamhs.

Find out more information

To find out more information about these standards, their development, meaning and how they can beused within your service, please contact the project team:

Telephone: 020 7977 6693Fax: 0207 481 4831Email: camhs@cru.rcpsych.ac.uk

Copyright 2012 Royal College of Psychiatrists, Quality Network for Community CAMHS Sample Standards edited by Ralph Turan.

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