COVID, mental health and complex safeguarding for young people, but no mention of the climate crisis

Mike Franks reports from the Children & Young People Scrutiny Committee for Team Scrutiny. 

September’s Children and Young People Scrutiny Committee received a COVID-19 Update: Amanda Corcoran (Director of Education) began by stating most schools reopened on 6 September, with staggered starts at secondary schools and colleges so that pupils could access lateral flow tests onsite in line with government guidance. Masks are no longer required although recommended for young people on public transport. Other measures include good hygiene and ventilation. It’s important that children displaying symptoms are not sent into schools. Vaccinations are now available for 16 and 17 year olds. Some 3100 vulnerable 12-15s in the city will be offered two doses of the Pfizer vaccine. For other in that age group, we await updates, and discussions with medical officers continue.

Mental Health Services in Schools was discussed. Amanda stated that the focus of the paper is on how the local authority with partners have enabled schools and settings to support the wellbeing and mental health of children and young people. It includes the M Thrive in Education offer and that from Healthy Schools, and also an update on the Anxiety-Based Schools Avoidance pathway developed over the last 18 months. In response to a complaint to the ombudsman, the report includes in the appendices an updated section 19 policy (a local authority’s duty to provide suitable education for children who otherwise may not receive such). An update on elective home education (EHE) is also provided.

In an item on ‘Helping and supporting Our Children to lead a safe, healthy, happy life and have a successful future’, Sean McKendrick (Deputy Director of Children’s Services) skipped through the 21 slides to give a broad overview of the organisation’s commitment to continuous improvement supported by significant investment in quality assurance frameworks, to redesign services where they are not working and to embrace innovation. Increasing family time, an independent review, engagement and participation of children and young people, permanence and placement stability, pathway planning, health indicators, and NEET prevention were amongst topics covered.

For the item on the Complex Safeguarding Hub, Susan Butlin (Interim Head of Locality Children’s Services), Claire McNicholls (Named Nurse Safeguarding Manchester University NHS Foundation Trust – MFT) and Supt Rebecca Boys (GMP) presented the Complex Safeguarding Hub which is a co-located response to young people who are experiencing exploitation, serious street violence, or children missing from home. Based at Greenheys Police Station, the multi-agency team co-ordinate responses to support young people experiencing or at risk of exploitation.

For fuller details of items discussed, questions asked and answers given, please see the longer version of this report (below).

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Children and Young People Scrutiny Committee meeting 08-09-2021

 

Chair Councillor Julie Reid (Gorton and Abbey Hey) checked there was no urgent business, appeals nor interests to declare. Minutes of the previous meeting in July were approved noting two attendees’ names had been omitted.

 

Item 5 COVID-19 Update: Amanda Corcoran (Director of Education) began by stating most schools reopened on 6 September, with staggered starts at secondary schools and colleges so that pupils could access lateral flow tests onsite in line with government guidance. Masks are no longer required although recommended for young people on public transport. Other measures include good hygiene and ventilation. Really important that children displaying symptoms are not sent into schools. Vaccinations now available for 16 and 17 years-old. Some 3100 vulnerable 12-15s in the city will be offered two doses of the Pfizer vaccine, awaiting updates on others in that age group, discussions with medical officers continue.

 

Dr W Omara (co-opted member) asks about support for children returning from abroad, planning for another spike if it happens, and support required from parents and governors. Cllr Tina Hewitson (Ardwick) asks why there is no information about reactions to vaccines.

 

Amanda Corcoran says not all children have returned yet, and for some today is their first day back, so a fuller picture will be available next month. We are in a better position with contingency plans, knowing what works and can quickly put them in place.  Support from parents is absolutely key. A letter has gone to parents giving them an update and thanking them for their support. Information has been sent to Governors as well. To answer the question of reaction to vaccines will require a talk with public health or our clinical team. Cllr Joanna Midgely (Exec Member for Health and Care – Chorlton Park) adds that GPs can offer advice and confirms that there is a 12-point action plan for dealing with COVID in the autumn with support for schools and colleges key.

 

Cllr Linda Foley (Disdbury East) asks whether a firebreak during the October half term is planned. Amanda Corcoran suggests it is just press speculation. Cllr Garry Bridges (Exec Member for Children’s Services – Old Moat) adds that everyone is keen to make this year as normal as possible, and ministerial briefings leading to press speculation are unhelpful.

 

Cllr Rob Nunney (Woodhouse Park) asks whether the third of 16-17-year-olds who have been vaccinated is because of slow roll out or is there reluctance to take the jab? Cllr Reid has heard some schools will keep bubbles, and raises concerns that this means large numbers of children will be sent home, also about attendance, exams and university’s resistance to face to face tuition.

 

Amanda is unsure about schools retaining bubbles but suggests some measures such as staggered lunch breaks have led to a calmer environment. Only those who test positive will self-isolate. Attendance, it is early days so will need to review, but with fewer children required to self-isolate it will improve.  Exams, at the moment the view is that they will go ahead, with topics to be covered identified soon. Universities with increased numbers of students may have opted for virtual rather than onsite tuition.

 

Cllr Reid asks for a written COVID update with some statistics for the October Scrutiny Committee. Cllr Midgely states that work continues to increase take up of vaccines by 16-17-year-olds with regular clinics at 6th form colleges and via comms such as instagram. Cllr Foley asks for clarification on attendance, whether it has to match the national average to be good? Amanda responds that figures nationally for last year have yet to be published. Cllr Foley stresses that school attendance in Manchester and the North West was adversely affected due to lock-downs in the last school year compared to other parts of the country, and this should be made clear in any pending school inspections.

 

Item 6 Mental Health Services in Schools: Amanda states the focus of the paper is on how the local authority with partners have enabled schools and settings to support the wellbeing and mental health of children and young people. It includes the M Thrive in Education offer and that from Healthy Schools, and also an update on the Anxiety-Based Schools Avoidance pathway developed over the last 18 months. In response to a complaint to the ombudsman, the report includes in the appendices an updated section 19 policy (a local authority’s duty to provide suitable education for children who otherwise may not receive such). An update on elective home education (EHE) is also provided.

 

Kimberley Evans (Team Lead for Healthy Schools in Manchester) gave an update on the involvement of Healthy Schools in conjunction with M Thrive in Education. Healthy Schools covers all areas of public health education in Manchester, anything from drugs and alcohol, relationships and sex education, to social, emotional, and mental health. The collaborative and joined-up approach through M Thrive in Education has improved outcomes for schools for example in the work of school nurses where holistic support for schools is identified so averting clinical needs. School Health Checks will be made available in a responsive way to meet requirements. Emphasis will be on physical activity and links to mental health and the obesity issues coming out of lock-down.

 

Sharon Gardner (Senior Schools Quality Assurance Officer) adds since the report was shared the M Thrive hubs commissioned in 2020, the south hub has gone live this week and the central hub will follow shortly. Data from the pilot scheme in the north show 188 children, young people and families have been supported through the north hub since April, whether signposted from schools or CAMHS. It is a welcome and developing resource. EHE has been added to this report as numbers were rising due to family anxiety caused by COVID. These numbers have reduced and are likely to reduce further as children return to school.

 

Dr Omara wished to know out of how many were the 27 Manchester College EHE students and secondly improvement in CAMHS waiting times which have been as much as six months. Mr Liam Duffy (co-opted member) wanted to clarify whether the 5,763 young people in Manchester who contacted Kooth (the online counselling and emotional wellbeing service) in 2020-21 accounted for the 40,151 reported logins.  Cllr Foley asks whether suicide prevention training is included in the critical incident support project.

 

Sharon Gardner responds that Manchester College students receiving home-schooling support for GCSE courses is a smaller cohort than in the previous year. Numbers change year on year. Unable to give data relating to CAMHS waiting times as a colleague from CAMHS who would otherwise have been able to answer is on leave. However, CAMHS have restarted referral training courses for school leaders so support can be sought. The Kooth figures quoted are local statistics supplied by school nurses in Manchester and may relate to students accessing articles and not seeking further support. On the suicide prevention pathway, a social worker in the education team is providing supervision for designated safeguarding leads currently, so an update can be given at the next meeting when safeguarding is on the agenda.

 

Cllr Susan Cooley (Brookland) asks for clarification on children referred to CAMHS compared to those who actually receive services from them. Cllr Midgely points to a pilot scheme for young people on suicide prevention. Discussions are ongoing as to how the service will be distributed. As for CAMHS, different levels of service are provided. Cllr Cooley seeks reassurance that where children referred to CAMHS who do not reach the required threshold to receive services, families are signposted to other sources of help. Cllr Bridges confirms that is the point of the Thrive model.  Sharon refers to a video which explains the pathway of referrals to a Thrive hub, and to CAMHS if needed. A webinar on the CAMHS escalation pathway is publicly available. Cllr Foley flags up that in a ward disproportionately affected by suicides of young people, many had not accessed any mental health services. Cllr Paula Sadler (Higher Blackley) points to pressures on young people through social media and families being unable to afford costly football boots for instance. Cllr Reid comments on the rise in elective home education particularly during COVID and wants to know what actions are being taken to encourage them back to school, would like something to be said about the complaint to the ombudsman and the duty to provide alternative education, and some mention of bespoke offer and what would be regarded as a critical incident. CAMHS waiting list has been an ongoing issue and disappointing that nobody from CAMHS is here. The role of the school nursing service is important. Not mentioned in the report was the early help service and SureStart which helps the whole family. As regards children not wanting to go to school, it is difficult for both schools and parents. Views about transitioning could have been made more explicit in the paper as could those of the BAME community.

 

Amanda picks up the section 19 review. The conclusion of the ombudsman was in favour of the complainant and the local authority should have provided support for home schooling. There was a place for the child and in the school’s view that would be best for the child, but the child’s guardian thought differently supported by the GP. Hence the need to review triggers for alternative education services. Critical incidents over the last year such as the death of a member of staff, or of children, or road traffic accidents, which cause concern within a school community may require access to advice and support. Sharon says we regularly review EHE policy and include parents who elect to home-school. Statutory powers are quite limited but we make it clear we want to engage with the child about their education. The Education Committee made a representation to the Secretary of State around changes to elective home education. Kimberley refers to the school nurses during COVID redeployed to assist with immunisations. However, the CHAT health service was kept running and in conjunction with the Heathy Schools team, school nurses created health education videos. Sharon adds that the LGBT community is referenced in inclusion strategy documents, other guidance about supporting children and young people, in multi-agency partnerships, and plans for equality workshops in the Year of the Child which will also include children from different ethnic backgrounds. Kimberley than describes the additional support available to schools. Cllr Reid endorses the reports’ recommendations.

 

Item 7 Helping and supporting Our Children to lead a safe, healthy, happy life and have a successful future: Sean McKendrick (Deputy Director of Children’s Services) skips through the 21 slides to give a broad overview of the organisation’s commitment to continuous improvement supported by significant investment in quality assurance frameworks, to redesign services where they are not working and to embrace innovation. Increasing family time, an independent review, engagement and participation of children and young people, permanence and placement stability, pathway planning, health indicators, and NEET prevention are amongst topics covered.

 

Cllr Bridges comments as a stock take of the service it contained a lot of information and a lot of positive data there, and COVID has not knocked us off course. Every time Ofsted have been there has been an improvement and it should still be the case. Cllr Cooley asks about health indicators especially dental care, looked after children and missed opportunities to speak with their social workers, and thirdly the number of children placed within families under special guardianship orders (SGOs) who may lose touch with the service.

 

Sean recognises the dental care issue. Cllr Bridges adds: discussions about this had taken place at the last two corporate parenting meetings with rapid improvement seen. Health recovery for looked after children is a priority. Sean continues agreeing that inconsistency of contact will have an adverse effect on any child, but considers it is a rare occurrence. Special guardianship orders, each comes with a support plan overseen by the court initially, so it is about the effectiveness of the support plan. In cases where things don’t work out there may be issues about re-engagement which require further investigation. Cllr Cooley expresses her concern about the uncertain future of children under SGOs and requests a report on the available support. Cllr Zahra Alijah (Fallowfield) is concerned about the court delays and its impacts on the child and prospective parents and asks about reducing the large proportion of our looked after children placed beyond Manchester boundaries. Cllr Muqaddasah Bano (Whalley Range) wonders if young people accidently drawn into crime or who suffer domestic violence or abuse are being missed and whether other agencies should be involved. Cllr Foley asks about progress from the last Ofsted review and would like a report that focuses on those areas which required improvements, can we be confident our services are now good? Cllr Reid points out this will be covered by the Ofsted sub-group. Sean says the figure of 51% of looked after children within Manchester boundaries should be seen in the context of the geography of the city and a much larger percentage within 20 miles. Cases of vulnerable children may be picked up in the next item on safeguarding. As for whether we are now good, there is ample evidence of improvement. Cllr Alijah wonders whether reciprocal arrangements are in place with neighbouring local authorities for former looked after children placed out of borough. Sean says the Greater Manchester Care Leavers Forum are looking at the issue of reciprocity which will need to resourced and financed. Cllr Bridges confirms there is a great deal of commitment by the Greater Manchester Children’s Board to the issue. Cllr Reid would like to know more about family time and voice of the child, points out drift and delay in cases was picked up by Ofsted previously. Sean endorses Cllr Reid’s comments about staff retention, states family time is now aligned to the signs of safety model, and recognises there is still room for service improvement.

 

Item 8 Complex Safeguarding Hub: Susan Butlin (Interim Head of Locality Children’s Services), Claire McNicholls (Named Nurse Safeguarding Manchester University NHS Foundation Trust – MFT) and Supt Rebecca Boys (GMP) present the Complex Safeguarding Hub which is a co-located response to young people who are experiencing exploitation, serious street violence, or children missing from home. Based at Greenheys Police Station, the multi-agency team co-ordinate responses to support young people experiencing or at risk of exploitation. Daily risk meetings with information sharing, expertise, professional challenge, and working more effectively. Advice, training and support offered across the partnership (for social workers and schools for instance). Governance, accountability and assurance arrangements for the joint agency includes a GM peer audit. Response to COVID covers continued contact with young people where possible, constant level of exploitation yet a reduction of missing children compared to the previous year, and proactive joint work with the British Transport Police. The Achieving Change Together model (ACT) has a positive impact. Every child open to the complex safeguarding hub will be supported by a dedicated social worker and police officer.

 

Cllr Reid is pleased to see agencies working together and police involved and here today.  Cllr Alijah wonders whether the hub has enough capacity and could more be done.  Cllr Cooley asks how soon early signs and indicators can be picked up.  Cllr Foley asks for clarification, whether criminal exploitation is ‘county lines’, are 64% of ACT clients young women because they are more likely to engage with the process, and why are over half the cohort from Hulme, Moss Side and Rusholme.

 

Supt Boys says neighbourhood teams should be aware of the complex safeguarding hub, building their ability to respond to exploitation is key. There isn’t capacity to deal with every young person where there is a suggestion of exploitation. Intelligence teams and school engagement officers pick up early signs to do with safeguarding. Susan Butlin mentions training programmes with schools, and a missing from home panel, help to pick up early signs. Claire McNicholls from a health perspective commends the robust training for staff in A&E, gynaecology and sexual health. There is a complex safeguarding sub-group and policy developed this year, with staff understanding of indicators. There is a video briefing for staff, and risk indicator check lists for exploitation and knife crime. Supt Boys says ‘county lines’ is only part of criminal exploitation, which may include violence and robbery offences. Susan Butlin comments that ACT data is from a small cohort of young people and not typical of the overall cohort which has more young men. The model was designed in Rochdale and Wigan and primarily for female victims of sexual exploitation. We adapted and broadened the approach to other forms of exploitation. To be effective young people elect to be part of the process, and the small cohort does not reflect the overall picture where there is more of an even spread of clients in north, south and central parts of the city.

 

Sean McKendrick is keen the work receives a wide audience to help prevent exploitation.  Cllr Bridges adds that ward members and the public can engage with safeguarding of young people. Reporting of suspicious behaviour can lead to concrete outcomes. The model is in its infancy at the moment. Cllr Reid comments that police in schools may be something that can be brought back, FGM not mentioned for a while, forced marriage, cuckooing becoming a huge issue for vulnerable adults, and asks was there a spike following COVID lockdown.

Supt Boys responds that complex safeguarding covers exploitation external to a family (thus FGM and forced marriage excluded but picked up elsewhere) and agrees cuckooing is a huge issue.  Susan Butlin comments there was a slump in referrals at the beginning of the first lockdown, now back up to normal levels. There were a number of referrals from British Transport Police. There has been a reduction overall but it has stayed quite steady. Missing children showed the biggest drop in data, but numbers of those going missing frequently stayed the same and were kept under review.

 

Cllr Reid thanks the team for their presentation.

 

Item 9 Overview Report: Cllr Reid notes the report and closes the meeting.

 

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