Agenda item

To receive a report from the Croydon Safeguarding Children’s Board as recommended at the meeting of 3 November 2020.

(Report to follow)

The Chair expressed thanks to officers for the briefing papers circulated to Members on Neglect as requested at the last meeting of the sub-committee. The detailed content of the paper was commended as it addressed concerns.

A Member questioned why there had been a delay in setting out actions as per the Neglect Practice guide and milestones. The strategy commenced in 2019 and it was asked what the monitoring framework would be and who the Greater Care Profile practitioners were. Officers acknowledged that timeframe had not been outlined in the briefing supplied. There had been delay to proceedings due Covid but there was an upcoming meeting to discuss the next steps. It was envisaged that the action plan would be drawn up in April ready to have everything in place by June with the commencement of training and ongoing monitoring using the Greater Care Profile tool. Monitoring would be through the quality monitoring group. The neglect community champions were current practitioners such as social workers, school health nurses.

The Director of Public Health introduced the item on Antenatal and Developmental Check visits. and shared a Presentation. This was followed up by a Presentation from the Associate Director of Operations, Croydon NHS Trust and Head of Public Health Nursing, Croydon NHS Trust.

Following the presentations, Members had the opportunity to ask questions.

A Member challenged that the presentation stated that there had been 100% new birth visits completed in January 2021, the instruction from NHS was that visits were not to take place face to face and if this was the case how was the target achieved. It also stated that antenatal visits for risk assessments had been completed and it was difficult to understand how risk assessments could adequately be assessed over the telephone. Officers said that in Croydon, face to face visits were being provided. Face to face contact was being done with the use of correct PPE and the figures supplied were correct with all new birth visits that were due completed within the 10-14 day time frame. As part of processes, health visiting service attended the monthly vulnerable women group and women that were identified as being at risk were discussed and targeted for visits. Midwifery and health visiting team leaders meet monthly to identify most vulnerable women who were then targeted for visits. There is duty line and ‘chat help’ for practitioners to refer any concerns and mothers that are discharged from maternity unit received daily telephone call and any identified risks were shared with the health visiting service.

The commitment for improvement of the service was commended but it was highlighted that performance had been an issue for a number of year. This was reflected in public health data and a further question was raised on what was being done to contact the cohort of families that did not have the home visits as they should have. Additionally if there was a recovery plan in place to address issues. Officers said that they had been making contact with all families, there was a bookable service in locality hubs across the borough for families to book visits. There was a recovery plan in place but it was stressed that some families also made the choice not to have a health professional in their homes during the pandemic.

The Member went on to say that if a home visits was not carried out then it would be difficult to assess or identify risks. The Director of Public health said they had all been working together extensively to reassure families that all was being done to mitigate risks  though use of correct PPE in order to encourage parents to allow visits to take place. There was still ongoing work that was being co-produced with service users to ensure that visits could take place as required.

It was pointed out that If people were being invited in to locality hubs, assessments of the whole home and environment were not taking place and would not measure to the purpose of home visits. Officers agreed that visits did need to take place as mandated but there had been challenges and would ask that the sub-committee give them the opportunity to come back to a future meeting to provide further reassurance.

The Cabinet for Children Young People and Learning agreed with the challenged but stated that there was two pieces of work, in that when families had been offered and not taken up the visits, we needed to identify why not and to work closely with midwifes. Additionally families that had not been offered opportunities that we are making changes to ensure that families do not fall though the gap and that we were reviving these cases.

The Chair thanked all officers for their engagement with the sub-committee and stated that there was recognition that the service was not where it needed to be and that this was being addressed. Additionally data would be beneficial in six months’ time to show the trajectory of the service.

Neglect

The Sub-Committee came to the following conclusions

1. The Sub-Committee welcomed the paper and the evidence that improved outcomes would be monitored once the constraints due to the pandemic were relaxed.

Antenatal and development Visits Update

The Sub-Committee came to the following conclusions

1. The presentation given and commitment by the director of public health on this matter was encouraging
2. Issues with visits had been a problem for many years with efforts of improvement stymied by the events of Covid
3. There had been clear interruptions to the service that needed to be recovered quickly and efficiently
4. The Sub-Committee was not reassured by the measures, recovery plan or risk assessment of the cohort of families that had missed or not been provided with a antenatal visits in the first weeks of the child’s birth
5. Croydon is a culturally diverse community and it was important that the composition of staff reflects that in order to appropriately serve the needs of the community.

The Sub-Committee recommended that

1. Officers to attend a meeting in six months to provide an update on their timeline on delivery of antenatal visits
2. Officers to provide a briefing paper in six months of the measures in place to support the cohort of parents that had not received an antenatal visits in the first few weeks of child’s birth in order to provide assurance that these families had not fallen through the gap or had been forgotten about.
3. Data on the composition of diversity of health visiting staff to be included in the briefing