Councillor presents health and social care report to council

PORTFOLIO holder, cllr Barbara Rice presented a 2,500 word report to the full council last week.

Cllr Rice said:

Introduction

“This is my first portfolio holder’s report and I am very pleased to advise that in both health and children’s social care the Council is doing very well. I am responsible for leading the Council as we prepare to take on major new responsibilities for health and I am responsible for ensuring that the most vulnerable children in our community, those in care, those in need of protection and those who are disabled, receive the very best service.

I will outline the headlines for children’s social care first and then share with you our progress in response to the government’s health reforms.

We are due a 10 day OFSTED inspection of our child protection and children in care services for before April 2012 and I believe this will fully reflect the progress we have made to build a strong service with a stable workforce and manageable caseloads for our social workers. Safeguarding children in everybody’s responsibility and we have effective partnership across Thurrock that ensure every part of the system works together in the interests of children

Child Protection

Like other authorities and consistent with previous reports, Thurrock’s ambition and challenge is to have greater staff permanency. I am extremely pleased that we have managed to improve our levels of management retention. These managers are key to keeping case numbers to a safe level and are successfully doing so. Securing management stability has positively affected how quickly we are able to carry out assessments of children requiring child protection plans. In 2009/10, 79% of children, on average, we receiving an initial assessment within statutory timescales. Today, 96% of children are receiving an initial assessment within statutory timescales. In 2009/10, 73% of children were receiving a core assessment within statutory timescales. Today, 94% of children are receiving a core assessment within statutory timescales.

Work has been carried out this year to reduce the relatively high numbers of children subject to a child protection plan. This is showing so success with a reduction from 229 children in March 2011, to 195 children in September 2011.

The greatest issue for this service area is the impact of domestic abuse on children in the Borough. In response, we are continuing to work and strengthen our links with the voluntary sector, including commissioning services that build on the support we can offer. This includes services such as support groups for children experiencing
domestic abuse – for example we have one such support group set up at Aveley Children’s Centre.

Our focus is on trying to keep families together. Where this is not possible and has resulted in court action, we have received many compliments from those courts relating to the way in which we have dealt with cases.

Disabled Children

We continue to help more disabled children in Thurrock. A key success is that we are helping more people to take advantage of respite services, a main plank of this being through the Aiming High Programme. There are approximately 420 disabled children in Thurrock who meet the criteria for accessing our respite services. Out of the 420, over 365 (87%) are receiving a service. Prior to the Aiming High Programme commencing in 2008, 185 (44%) were able to access these services. This is an increase of nearly 100%.

We have increased capacity to support children through the soon to open day care provision on the grounds of Treetops School in Grays. The new provision will provide additional respite services through group work after school, at the weekend, and in school holidays.

The 2001 Census identified that there were 400 young carers in Thurrock. Over 200 of these receive a service. We continue to help young carers in the community through the provision available at the Sunshine Centre in Tilbury – with a new group starting for young carers between the ages of 4-8.
Our greatest challenge remains our ability to provide and sustain the capacity required – particularly as the Aiming High ring-fenced funding has been abolished and subsumed within the Early Intervention Grant.

Looked After Children

In step with the rest of the country and a continued challenge for us, the numbers of looked after children in Thurrock are rising – in November 2011 there are 240 looked after children compared to 212 March 31st 2011.

We have been keen to embrace improvement and recently commissioned a review led by LILAC (Leading Improvement for Looked After Children), an organisation featuring looked after children themselves. I am pleased to announce that the review was positive, with three out of seven of the challenging standards being fully achieved and the rest partly achieved. Particularly positive praise was received about our staff and also about the young people’s organisation Open Door and their advocacy service for Looked After Children. Thurrock was the only authority in the country (where this review has taken place) to have 100% of looked after children say that they understood why they were in care. A key part of having the review was to see where improvement was required, and we will now be working on achieving fully the remaining four standards – with a repeat review organised for next year.

Adoption and Fostering

Our Adoption Service continues to work well in partnership with Southend and Havering Councils. Timings for adoptions are good with six out of eight children being placed within Government timescales. Recently published rankings show that we are 8th on the timeliness of adoption when we are compared with all other English local authorities. This is extremely pleasing.

We are keen to do all we can to improve, and with this in mind we have accepted an invitation to join a review of our adoption service by the Coram Family. This review is in progress with the results being used to inform service improvement.

With regards to the Fostering Service, Thurrock has a number of excellent foster carers who give above and beyond – but like other authorities, we still need more. I am extremely proud of what our foster carers have achieved, with many achieving outstanding NVQ results – and those in therapeutic foster care earning success through the University of Essex. We are one of a small number of authorities to harness the benefits of therapeutic foster care. In line with our responsibilities, we continue to monitor private fostering.

Quality Assurance

Quality assurance is fundamental to ensuring that our standards are kept high. With this in mind and wanting to ensure that the service is as robust as it can be, we were recently successful in obtaining an advisor on quality assurance from the organisation C4EO. This is at no cost to the Council. We have also established two new child protection co-ordinator posts and have implemented co-ordinated reviews of all our work.

Our Local Children’s Safeguarding Board continues to fulfil its role in scrutinising our work. It has been dynamic in implementing a new type of case review recommended by the Munro Report.

The offer of early help

The greatest challenge for councils to arise from the Munro Review of Child Protection, is the development of the offer of early help. The Council have established Multi-Agency Group Panels to co-ordinate the ‘offer of early help’ on an interim basis while we completely re-engineer our whole system in partnership with schools, health and the voluntary sector to achieve the best possible outcomes for vulnerable children and their families with redesigned children’s centres at the heart of the early help offer.

Youth Offending

The Council has seen another strong year of good performance in this area with overall reoffending rates below national, regional, and family group averages. Part of the reason for this is earlier intervention through the Triage scheme. This is where the service becomes involved at the point where young people first commit an offence and there is an opportunity to divert them away from court and the criminal justice system. The Triage scheme has been fundamental in reducing the number of young people who go on to commit further offences and the numbers speak for themselves – out of 105 young people to have committed a first offence since January, only 9 committed a further offence.

Wanting to enhance the service further, we have become part of a Government pathfinder to have a health-funded health practitioner work alongside our Youth Offending Service. We are also continuing our successful reparation work with positive feedback being received from the sheltered housing complexes where young people have been carrying out gardening activities. Offenders participating in the reparation initiative have most recently been helping the British Legion by making poppies for Remembrance Day.

The Youth Offending Team successfully bid for funding from the Youth Justice Board to participate in the Summer Arts College. Ten individuals completed the course, and Thurrock did extremely well in performing above average in all of the outcomes measured – this included those focusing on improving literacy and numeracy. I am extremely pleased with what we have achieved – particularly with the positive feedback received from the organisation running the programme. We are looking to bid again for 2012.

Let me turn now to Health and update council on the very good progress we are making in implementing the government’s health reforms

Health Reform

There will be a number of changes brought about as a result of national health reform. This gives local authorities a far stronger role locally in how health services are commissioned and provided, and importantly a lead role in improving the health of our communities. The Council will require a strong leadership role and is developing this through the shadow Health and Well-Being Board which has already met three times and of which I am the Chair.

We will have new statutory responsibilities – mostly from April 2013. These include the transfer of Public Health responsibilities from the PCT (including a ring-fenced grant); the commissioning of a new public and patient organisation ‘HealthWatch’, and responsibilities jointly with new clinical commissioners for refreshing a Joint Strategic Needs Assessment and Health and Well-Being Plan. Key to the reforms is commissioning services jointly with our health partners.

To ensure our HealthWatch arrangements are developing, we held a stakeholder event in September at the Culver Centre. This was attended by a range of organisations with an interest in health and social care, and also members of the public. Joan Sadler, the Department of Health’s national lead for HealthWatch, attended to deliver a key note speech.

I am extremely pleased about the progress we have made so far, but know that there are challenges ahead, for example we want one Clinical Commissioning Group for Thurrock and know this is controversial for some of our GP colleagues. We will continue to build relationships with the clinicians who will be our partners as arrangements develop. We will also continue to work with public health colleagues to establish what our arrangements locally will look like. A key challenge currently is ensuring that we have the right resource to be able to deliver our new responsibilities and to make a difference to the health of our communities. With this in mind, we have submitted a position paper to the Department of Health with a focus on getting the right level of funding for our new public health responsibilities.

Health Provision

In addition to gearing ourselves up for the changes ahead, I have been extremely proactive in meeting with our key health foundation trusts – South Essex Partnership Foundation Trust (SEPT), North East London Foundation Trust (NELFT), and Basildon and Thurrock Hospitals University Foundation Trust (BTUH). These foundation trusts provide crucial health services to Thurrock people and therefore my
focus on their quality is vital.

I am particularly pleased with the progress made by the Hospital. Only recently the Hospital was in the limelight for a series of poor compliance reviews carried out by the healthcare regulator the Care Quality Commission. The improvement needed to be made by the Hospital was the subject of a detailed piece of work by the Health and Well-Being Overview and Scrutiny Committee. I meet regularly with the new Director of Nursing at the Hospital and have found the improvements made by her and her team heartening. Only recently the Hospital published its Nursing and Midwifery Strategy. I attended the launch which was attended by Ruth May, the Chief Nurse for the East of England who stated that ‘two years ago I made a site visit to this hospital and found the nursing care to lack leadership and motivations. My concerns were such that I reported them to CQC. Today I have repeated that visit and have found excellent Nursing Care and Leadership being provided’.

I will continue to keep a focus on the providers, ensuring they offer the best services for our residents.

Drugs and Alcohol

Thurrock’s Adult Drug and Alcohol team continue to be extremely effective. The most significant indicator of success for the Team is the number of Opiate and Crack users in effective treatment, where in May 2011 a total of 234 users were receiving treatment against a target of 216. This is the highest number we have ever achieved.

Thurrock consistently secures around 60% of clients leaving treatment successfully; this is well above the regional and national average.
Recent new initiatives for drug treatment services include a focus on the needs of parents in treatment – partly due to the high numbers of parents in treatment in Thurrock (which are the highest in the region), and partly due to the obvious safeguarding issues this raises. As part of the response to this issue, CORAM will be delivering bespoke parenting courses for clients in the treatment services; and client appointments will be held by CDAS in Aveley Children’s Centre. This is as a pilot, which if successful will be rolled out to other Children Centres in the future. This is a very good example of how we make sure we work as a whole council; joining children’s and adults’ services in the best interest of our community

In terms of alcohol, Thurrock’s DAAT has recently set up specific group work for alcohol clients who are on the waiting list. This is to help individuals maintain motivation. Another new initiative is the introduction of an alcohol-specific Arrest Referral Service in to Grays Custody Suite.

The key challenge for the service continues to be individuals who are coming out of treatment remaining out of treatment.

Conclusion

My first report to Council as portfolio holder for Health and Social care is a very positive one. I recognise that there are and will always be challenges to overcome, but I am confident that if we continue on our current trajectory, these will be minimised and our success will be assured.

I wish to recognise the on-going effort and commitment of the whole council, officers
and members working together with partners to ensure that Thurrock residents – some of them our most vulnerable – are able to access the best services we can offer and are supported to achieve good life outcomes.

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