Care Quality Commission report
The Assistant Director, Out of Hospital Services, Brent Clinical Commissioning Group will give a presentation summarising the CQC review of Health Services for LAC and Safeguarding in Brent.
Isha Coombes (Assistant Director, Out of Hospital Services, Brent Clinical Commissioning Group) summarised the findings of the Review of Health Services for Children Looked After and Safeguarding in the borough that took place between 9 June and 13 June 2014. There had been two inspectors on site and two days’ notice had been given. The review had been outcomes focussed and looked at the performance of the CCG (Clinical Commissioning Group) and the NHS in particularly in terms of effectiveness, the experience of children, need identification and collaboration between agencies. Of the highlights, Ms Coombes was pleased to report that governance across CCG and safeguarding children was seen to have improved and there were some positive reviews from service users including young people. She then drew attention to the recommendations of the review and members raised questions on the action plan in place to address concerns.
Ms Coombes advised that the agencies concerned would be sent the final actions to implement, that these would be reviewed quarterly and evidence submitted of actions taken and she cited an example of successful contingency planning. Efforts would be made to ensure it was embedded and filtered down. CCG and the local authority were also meeting monthly to review quality and identify gaps. Ms Coombes acknowledged that it was proving challenging to ensure that initial health assessments for children looked after were carried out within the statutory timescales due to a number of factors, usually child refusal but there had been a significant improvement which had been noted by the inspectors. Members’ attention was also drawn to problems in delays in electronic record keeping and Isha Coombes was pleased to report that the CCG had agreed to meet the costs of all records being electronic which was due to be completed within the next two weeks. Isha agreed to give the Looked After Children Council a full opportunity to comment on the final report.
Members, in questioning, commented on the indicator rate for emergency department attendances for children under four which was worse than the England average and also referred to mixed messages about the purpose and effectiveness of MASH (multi-agency safeguarding hub) and lack of clarity over decision making. The Strategic Director of Children and Young People clarified that MASH had different elements and that insofar as this report referred to safeguarding it was accurate. Discussion also took place on the consistency and timeliness of initial health assessments which was acknowledged to be patchy in 2011 however more recent reviews carried out by the children looked after nurses was assessed as being exemplary. Isha Coombes confirmed that the action plan had been produced within the required 20 days for the CQC and would thereafter be monitored and RAG rated and agreed to report back on progress on all recommendations.
Isha Coombes responded to a question on the progress of integration of public health into local authority responsibility and members heard that the CCG was still currently responsible for commissioning but this would mobilise into public health in the future.
that items relating to Brent CCG and Ealing Integrated Care Organisation (recommendations 6.1-6.4 in the review report) be reported to the next meeting and quarterly thereafter, with a clear action plan on how to mitigate concerns.