Is The Workforce Fit For Purpose?

SLaM Presentation to Croydon Safeguarding Children Board

Paul Calaminus – Service Director

Child & Adolescent Mental Health Services

Matt Beavis – Assistant Director of Nursing

Trust Named Nurse Safeguarding Children

29th November 2011 – Croydon Town Hall

Lines of AccountabilityBoard ofDirectors

Patient Safety and Service

ImprovementCommittee

AuditCommittee

GovernanceExecutive

ComplaintsMonitoringCommittee

SUIMonitoringCommittee

Clinical Audit &Effectiveness

Committee

Essenceof Care

PromotingSafe/Therapeutic

Services

PsychologicalTherapies

Effectiveness

Research&

Development

SLaM NICE Implementation

Group

PhysicalHealthcare

RiskManagementCommittee

Safeguarding

Children

Safeguarding

Adults

Education& Training

Health, Safety& Fire

IT Security,Caldicott, FOI,

Clinical Records

ClinicalRisk

Committee

NutritionInfectionControl

PhysicalHealthcareECT Mental

Health Act

MedicinesManagement

Drugs &Therapeutics

MedicalDevices

DirectorateClinical

GovernanceCommittees

DirectorateRisk Management

Committees

May 2009

Diagram of Integrated Trust, Borough and CAG Safeguarding Children Lead Infrastructure:

ADDICTIONS:CAG SC LEAD N

Rosie Mundt-Leach

CAG SC LEAD DSally Porter

PSYCHOSIS:CAG SC LEAD

Anne Donohue

MHOA & D:CAG SC LEAD

Andy Shanks

CROYDON:- CLNSC: Linda Galvin- CLDSC: Anna Graham- AMHLSC: Stephen Priestley

LAMBETH:- CLNSC: Charity Nyamukondiwa- CLDSC: Nadia Barratt- AMHLSC: David Grafton

TELSC: Hilary McCallionDoC: Paul CalaminusTNNSC: Matt BeavisTNDSC: Malcolm Wiseman

LEWSH:- CLNSC: Emma Addison- CLDSC: Malcolm Wiseman- AMHLSC: Stephenie Edwards

STHWK: - CLNSC: Nicola Jenkin- CLDSC: Tara Weermanthri- AMHLSC: Chris McCree

KENT CAMHS:- CLNSC: Kathryn Trethowan- CLDSC: John Watts

N&S CAMHS:- CLSC: Sarah Cannell- CLDSC: Vacant

MAP:CAG SC LEAD

Sue Smith

B & D:CAG SC & A LEAD

Christine Hemmings

PSYCH MED:CAG SC LEAD

Debbie Garlick

Staffing Establishment Numbers

20CROYDON CAMHS

352CROYDON

4925TRUST

Staffing Establishment Numbers

Number dependent on clinical need across Trust

trained by Agency / NHSProfessionals

inducted by service area

Bank / Agency

Site-based trainingtrained by Trust

Aramark (Contract Hotel Services)

328

(Kings, LSBU & Greenwich) trained by Universities

inducted by Trust

Students

Safer Organisations

CRB’s (Three-Yearly Updates + HR monthly monitoring process)

Researchers / Honorary Contracts (CRB’s / Training)

Safeguarding Children Statement in all Job Descriptions (Stating Safeguarding Children Responsibilities)

Representation at CSCB Safer Organisations Subgroup

Training

All staff receive Safeguarding Children Training on Trust Induction

Trust Safeguarding Children Training reviewed annually (Design & Delivery – Evaluations & SCR Recommendations)

Trust Safeguarding Children Training mapped against the Intercollegiate Document (2010)

Safeguarding Children Training performance managed (CEO Performance Management, CAG Training Logs, Individual Appraisal)

Training

91%N/A94%LEVEL 3

93%86%75%LEVEL 2

100%94%92%LEVEL 1

CROYDON CAMHS

CROYDONTRUST

It’s Not All About Training…But It Was a Good Starting Point…

Significant Increase in Numbers of Staff Trained (Over 200% Increase in 2010-2011)

Redesign & Increased Performance Management of Training Content, Design & Delivery

Staff Receive Messages re:National & Local Guidance & PolicyWhat They Are Looking For Who to Contact, Information Sharing, Collaboration & Referral ProceduresEscalationImpact of Parental Mental Illness on ChildrenImpact of Their Own Beliefs, Values & Experiences on Their PracticeLearning Lessons to Positively Influence Practice

BUT TRAINING ALONE NEVER CHANGED PRACTICE IN A SUSTAINABLE & CONSISTENT FASHION

Safeguarding Supervision & Management Oversight

Safeguarding children supervision integrated & cascaded within clinical & managerial supervision

Trust Safeguarding Children Advice Line

Trust Safeguarding Children Leads receive monthly individual & group supervision with Trust Named Nurse and Doctor

Trust supervision rates performance managed & regularly audited

Safeguarding Children Impact Assessment on all Trust policies (recent recommendations strengthening safeguarding focus of Trust Supervision Policy)

Quality Assuring Services

Trust Safeguarding Children Policy & Trust Safeguarding ChildrenCommittee

Trust Safeguarding Children Assurance Framework

Performance Management via CEO & CAG PMR’s

Annual Trust Safeguarding Children Reports/Declarations to Trust Board & Risk Management Committee

Trust Incident Reporting (via DATIX) and Complaints Process

Internal / External Audits & Inspections- S11 - CQC - CSCB - Ofsted - Annual Trust Practice Audits (Specific Safeguarding Section)- Post Serious Case Review Audits

87%89%89%TOTAL

84%85%87%MHLD

86%89%91%MHOA

88%97%99%Addictions

88%88%88%Adult Mental Health

SeptAugJul % Child Need & Risk Screen

Croydon Child Need & Risk ScreenCompletions (%) - Quarter 2 - 2011

Further Embedding in Practice

Significant Amounts of Risk Assessment

Staff Completion of Child Need & Risk Screen

Genuine Staff Consultation re Review / Redesign of Child Need & Risk Screen

Post Risk Assessment Evidence of Information Sharing & PotentialReferral to CSC

Regular Systematic MDT CSC Referral Monitoring & Follow-Up

Reviewed & Increased Expectations of Trust Staff Representation & Contribution to Child Protection Conferences & Plans

Regular Threshold Conversations with CSC

Enhanced Focus on Supervision

Further Embedding in Practice

Internal Auditors (South Coast Audit) Audit of Past Recommendations from SCRs

Planned Trust Research into Staff Perceptions re Whether Recommendations from SCRs Have Positively Effected Practice

Trust & Local Presentation of Recommendations & Learning

Trustwide Roadshow Events re Sharing Learning from SCRs

Redesign of Trust Safeguarding Children Intranet Site (now on front page of Trust Intranet – increased access)

“Lessons Learned” Section on Trust Safeguarding Children Intranet Site

Immediate Action Flowchart if concerned about welfare of child

Allegations, User Feedback and Complaints

Allegations Against Staff Policy

Use of LADO (Consultation & Referral)

Complaints Response Procedure

Service User & Care Satisfaction Questionnaires / Surveys / Events

Continued Challenges

Supervision

Disinvestment

National Changes

Competing Priorities

Continued Embedding in Practice