INDEPENDENT COMMITTEE OF INQUIRY INTO THE CARE AND TREATMENT OF NICHOLAS ARNOLD AND LORNA THOMAS
No. Recommendation Response of Milton Keynes Council
4. The Milton Keynes Council and Buckinghamshire County We have now established new eligibility criteria, Council Social Services Departments and the Milton different to those that existed four and a half years Keynes Community NHS Trust should review their ago and which would not exclude people such as referral policies to allow Psychiatrists in Learning Lorna. (This work was not as a result of the Inquiry Disability to refer patients with a mild learning disability and the work pre-dated the publication of the draft and mental health needs, who may benefit from the report). service, to Keystone or any other similar service (Page 43).
7. The Milton Keynes Council and Buckinghamshire County A review has been undertaken, and consultation is Council Social Services Departments should review their taking place on new Appropriate Adult procedures. “appropriate” adult procedures to support people with a Training on the role of the Appropriate Adult has been learning disability who are to be interviewed by the Police provided for duty social workers in mental health and and should provide the necessary continuing support learning disability. afterwards (Page 41).
14. The Milton Keynes Community NHS Trust, Milton Milton Keynes Council is committed to working in Keynes Council and Buckinghamshire County Council partnership with users and carers. We are actively Social Services Departments should ensure that there is encouraging users and carers to contribute their an express recognition of the need to engage service views about the support they need. This is users and carers as far as possible in the planning and highlighted in the recently published “Better Care, delivery of care and after care. Service users and carers Higher Standards”. should be active participants in the assessment of need, Users and carers are involved in the planning of planning, treatment, risk assessment, discharge and mental health services and are members of groups follow-up support. Special consideration should be given which monitor joint policies and services. to home circumstances. The views of service users and ANNEX TO ITEM carers should be sought and recorded (Page 58). 18 JULY 2000 RESOURCES POLICY AND COMMITTEE 16 D:\IServ Files\2000-01\enl_Report_312262_ANNEX_ITEM_16.doc - 1 - INDEPENDENT COMMITTEE OF INQUIRY INTO THE CARE AND TREATMENT OF NICHOLAS ARNOLD AND LORNA THOMAS
No. Recommendation Response of Milton Keynes Council
15. The Milton Keynes Community NHS Trust, Milton Mental Health is a very high priority for the PCG and Keynes Council and Buckinghamshire County Council the Council and a joint partnership approach between Social Services Departments should ensure that every the PCG, MK Community NHS Trust and the Council effort is made to encourage GPs to make an effective is in place. contribution to discharge planning and the CPA, particularly for patients requiring ongoing treatment, including people with learning disabilities. Meetings should be notified in good time to help ensure the attendance of the GP or practice nurse. Failing this attendance, the Community Nurse should make early contact with the GP as well as with the patient (Page 99).
16. The Milton Keynes Community NHS Trust, Milton A review of risk assessment and procedures has Keynes Council and Buckinghamshire County Council taken place between Milton Keynes Council and the Social Services Departments should ensure that risk MK Community NHS Trust. Joint assessment tools assessment is an on-going feature of psychiatric and procedures to replace existing ones are being treatment and that in all cases this entails adesigned by a multi professional group. These will be comprehensive multi-disciplinary summary compiled by used throughout the mental health services and will the keyworker with relevant contributions from medical, be subject to regular audit. nursing, Social Services and Police and Probation staff where appropriate. This should be completed at a multi- disciplinary review meeting where the responsibilities of each agency are agreed and recorded. There should be regular audit of risk assessments (Page 91).
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No. Recommendation Response of Milton Keynes Council
23. The Milton Keynes Community NHS Trust, the Milton Multi agency Section 136 procedures are well Keynes Council and Buckinghamshire County Council established and have been cited by the Mental Health Social Services Departments, working with Thames Act Commission in their Eighth Biennial Report as an Valley Police, should ensure that their staff follow local example of good practice. All agencies including Section 136 procedures. There should be a system or Thames Valley Police and service users review the monitoring and clinical audit of the handling of Section use of S136 at a quarterly monitoring meeting. The 136 episodes, the results of which should be included in monitoring group provides an annual report on the the annual report of each Authority (Page 69). use of S136.
24. Buckinghamshire Health Authority, Milton Keynes In conjunction with PCG and MK Community NHS Community NHS Trust, Buckinghamshire County Council Trust, we now have joint commissioning and Milton Keynes Council Social Services Departments, arrangements. In addition, there is a local multi liaising as necessary with Thames Valley Police, the agency agreed policy for Protecting Vulnerable Probation Service and voluntary agencies, should Adults. A training officer was appointed to ensure improve local arrangements for joint planning, effective implementation of the policy across commissioning and providing services for vulnerable agencies. adult groups including people with learning disabilities and substance dependency (Page 120).
27. Health and social care agencies in Buckinghamshire and Section 115 Crime & Disorder Act gives powers to Milton Keynes should meet with the local criminal justice certain bodies to share information for the purposes agencies to review and reconsider policies and protocols of reducing crime and promoting community safety. on the exchange of information in the light of national This overrides existing legislation. Protocols are guidance and the experience of this homicide (Page being developed through the Crime and Community 123). Safety Partnership with Probation, Thames Valley Police, Bucks Health Authority and the MK Primary Care Group.
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No. Recommendation Response of Milton Keynes Council
29. The Director of Social Services for Buckinghamshire We have a recording policy in place, which is backed County Council and Milton Keynes Council should take up by detailed procedures. These are subject to steps to ensure the accuracy and completeness of Social regular audit. Services record keeping (Page 56).
31. The Health, Education, Social Services, Probation, We have reviewed our record retention and archiving Police and Housing Authorities in Buckinghamshire policy in line with SSI guidelines. Further should review current arrangements for record keeping consideration will be given to a joint record retention to raise standards to those of the best and to harmonise policy with other agencies. retention time spans for records wherever possible (Page 130).
33. The Department of Health and the training bodies should Although this has a national focus, locally, we have a encourage cross-disciplinary training in mental health, comprehensive joint training programme for these substance abuse and learning disability for nurses, social services. This is required training for Approved workers and all those who might be appointed as Social Workers. Through joint discussion, keyworkers to persons who have dual diagnosis (Page consideration will be given to extending that 55). requirement to Learning Disability staff.
37. The Milton Keynes Council should review its housing Since being a Unitary Authority (1997) the Council policies in order that more effective consideration can be has developed integrated housing and social care given to the health and social needs of individuals when structures which promote integration and liaison. The deciding on the merits of a request for rehousing (Page Council has developed a process for establishing 59). priorities and has employed three staff providing real and practical support to residents of Granby Court. (Where Lorna lived although she was a tenant of Jephson Housing Association).
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No. Recommendation Response of Milton Keynes Council
38. The Social Services Departments of Buckinghamshire We now have new arrangements in place. We are County Council and Milton Keynes Council should working on further policies, which will ensure workers ensure that when they “close” a case, this is handled with are aware of their responsibilities and service users sensitivity and openness. The client and their families are clear on the service they are expecting to receive. should be aware that the case has been closed and the reasons notified in writing (Page 41).
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