MSCB MEETING MINUTES HELD ON WEDNESDAY 15TH MAY 2019 AT 9:30AM IN THE SPENCER ROOM, MIDDLESBROUGH TOWN HALL: OPEN SESSION Safeguarding Children Board

ACTION PART 1 – INTRODUCTIONS & APOLOGIES Chair gave welcome ALL TO NOTE

PART 3 – BUSINESS ITEMS OPEN SESSION M Minutes & Matters Arising (Wednesday 20th March 2019) ALL TO NOTE

M1 Page 2, Section 4, Multi-Agency Safeguarding Arrangements – it was confirmed that this matter would be subject to further discussion under agenda item 6.

M2 Page 2, Section 6, Missing: National Research Project Report and action point – it was confirmed that this matter would be subject to further discussion under agenda item 8.

M3 Page 2, Section 7, Preventing Methadone Ingestion by Children and action points – it was confirmed that this matter and its respect action points would be subject to further discussion under agenda 11, which is inclusive of the presentation by TLR.

M4 Page 4, Section 11, Voice of the Child and action point – although it had been MB to ensure identified that this matter would be subject to the agenda for this meeting, it has been that Voice of the agreed that it would not be necessary. Confirmation has been provided which notes Child is subject to that a conference has taken place with invites provided for interest for professionals further discussion to become champions. The Mind of My Own (MOMO) being promoted with further under the July discussions between chair and ABn but there is a board awareness of what has been board meeting done and how the work has been progressed with an action for the item to be subject agenda following to the agenda for the July meeting. further discussion with ABn

6 Multi Agency Safeguarding Arrangements ALL TO NOTE

6.1 A meeting between Middlesbrough and Redcar & LSCBs was held on HW and RB to Friday 10th May 2019 and chair noted his apologies for being unable to attend on the provide an day. RB provided a presentation and JW noted her and MB’s concern that there was update to a future no discussion in respect of this subject with RB confirming that the presentation had MSCB meeting in included the agreed structure. There were also concerns noted in respect of the respect of the venue, which did not lend itself to professional discussion. AF noted the presentation discussions to be and the need to look at how the processes will work with a view to what it can undertaken at the achieve. meeting on Wednesday 5th 6.2 EK noted how the processes used to amalgamate the Middlesbrough and Redcar & June 2019 Cleveland Health & Wellbeing Boards with a brief discussion undertaken to identify the positives for both forums, the priorities for the combined board and the time constraints. JG noted the information provided by EK but also identified that the agreed structure has been decided by the three strategic agencies. HS noted that this is appropriate but the how it works needs to be identified and JW confirmed that this was what was missing from the previous presentation to ensure that it is beneficial to the safeguarding agenda for children / young people.

6.3 JG noted her agreement with this and chair identified that he had intentionally kept his distance from the process but did provide encouragement to strategic leads in order to ensure that the process is moving forwards. It was also confirmed that RB had inherited the responsibility for making this structure come together with agreements due to be in place by the end of June 2019, as well as the processes to be in place by the end of September 2019, which is when the LSCB will cease to exist. JW questioned whether there is any need for an independent voice.

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6.4 Chair noted that a variety of structures have been employed across the country and the strategic leads will determine the partnership to identify a lead from one of the agencies, which may also be shared over time. Given the dates identified, it was confirmed that the LSCB board meeting on the 18th September 2019 will be the last under the present structure. Chair noted that he may have a role in the new processes in respect of the management of the serious case reviews that have been commissioned.

6.5 There is a partnership group meeting scheduled for Wednesday 5th June 2019 and HW will be providing an update to a future board meeting in respect this. There will be a conversation with GW in respect of the closing down of the board with a piece of work to be undertaken given the need to have a proper transitional handover. JW asked whether she would be able to attend the meeting on the 5th June 2019 and JG confirmed that there would need to be a request to the Chief Executive and chair agreed that there would need to be a further conversation in respect of this.

7 Ofsted Focused Visit: Child in Need & Child Protection ALL TO NOTE

7.1 It was confirmed that there has been nothing published as yet but areas of good The Ofsted letter practice and areas for improvement have been identified, although there were no in respect of the priority areas identified. A letter will be published on the Ofsted website on Thursday inspection to be 23rd May 2019 and board members will be provided with a copy when it is available. provided to board ABn confirmed that there were no cases identified for further review and that the members inspection was held over two days. Chair noted that publication of the Ofsted letter following may lead to regional press interest. publication on Thursday 23rd Completed – the Ofsted letter was emailed to board members on Wednesday May 2019 22nd May 2019

8 Missing: National Research Project Report ALL TO NOTE

8.1 Chair noted that the report had been circulated with JWt present to provide an JWt and SW to overview of the report. This is noted to be the First Steps report and is being shared provide an in its draft format with permission provided to share it with partner agencies. There update to a future was noted to be an earlier version provided to those areas involved with a view to board meeting in ensuring accuracy. JWt noted that the Children’s Society have offered to complete a respect of how presentation to professionals / agencies. Advice is also to be provided to the the work related Government in respect of guidance, which is noted to be vague in areas. There were to the Research noted to be no specific recommendations for the areas involved, as they did not see Project and the any weaknesses that were of concern and shared any identified areas of good Philomena practice to other areas. protocol

8.2 There was a recommendation that a small dedicated team but put in place to address SW to give the issue of children missing from home / care in spite of seeing what happens in our consideration as area in comparison to another area, it was identified that all areas were equal and is to whether the in respect of how they are managed. Chair identified the local changes made, which Children’s has resulted in the Missing from Home / Care process being put into the Local Society could be Authority and managed by JWt. JWt noted that for those Middlesbrough children involved with the based in another area, the commissioning of services to address the missing from Care Home home will be commissioned by the Team, as no one agency can provide a service. conference

8.3 This issue has been raised within the project and recommendations have been provided to the Government. From the 1st June, it has been agreed that the current team will address any missing from home / care young person who resides in a 50 mile radius. RB noted that the gathering of information is being progressed with a view to identifying and reducing risk with a better quality of information. JWt noted an audit undertaken by Martin Weston and the findings from this, as well as the Philomena process / protocol (inclusive of a risk assessment) which is noted to getting results in County Durham.

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8.4 SW confirmed that he is meeting with the County Durham Lead week commencing Monday 20th May 2019 and it has been addressed with the VPG leads to take this forward with a view to improving the process. The recommendations will be reviewed with two yet to be addressed whilst the remaining seven have already been addressed / actioned. Chair requested that an update to be provided to a future board meeting to ensure that the Philomena process has been implemented, how it is working and SW confirmed that the broader aim is to have a care home launch as well.

8.5 JG noted on the back of previous discussions, that it is positive to see that we have identified a problem, what to do about it and implemented the necessary actions to address this. JWt wished to clarify whether there is a need for the Children’s Society to undertake a presentation and chair requested that we keep the offer open with a possibility of them being involved in the conference identified by SW within the discussion.

9 MACH Update ALL TO NOTE

9.1 It was confirmed that the report has been circulated to the members prior to the GW to ensure meeting with confirmation that the process is to go live on Monday 3rd June 2019. that all actions ABn identified the reason for the change of date which assists both areas requested of the operationally with partners working hard to ensure it goes live. There is a service Tees Procedures manager now in post and chair confirmed that the project manager is Kevin Brown has been who had ensured that work was completed fairly quickly. It was confirmed that there progressed as are drop in sessions scheduled and chair noted his plans to attend one of them. He required also wished to note his congratulations to those involved in the process.

9.2 It was questioned whether there is a communication plan in place and it was confirmed that there will be communication with partners to ensure a smooth transition. There is to be a ‘soft launch’ which will help to ensure that agencies should not notice any difference in service provision. It was confirmed that contact has been made with the Tees Procedures in respect of the necessary changes and this has been confirmed with the website providers. Given the need to ensure that this is in place, chair requested that GW would clarify whether this has been progressed as per the instructions provided.

10 MSCB Sub Group Update ALL TO NOTE

10.1 CDOP – EK noted that the future arrangements are aligned with the safeguarding arrangements with conversations to be undertaken with JG with the timescale to address with GW.

10.2a Performance, Monitoring & Evaluation Sub Group: Audits Update / TPMF Q GW to provide Summary – chair noted that the report includes the CSAFE and Core Group Audit, board members which is for members to note. JG noted from the conclusions, particularly 12 and 13 with the action and in relation to early discussions do we need to note that the identification of plans for the neglect needs to be improved, they appear to be soft and repetitive. Chair noted that audits noted there is a need to ensure staff know what to effect change in their practice or from a within the update managerial level. GW noted that the CSAFE Audit had been subject to independent report scrutiny with feedback provided directly to the audit group. MB and GW to 10.2b JG reference point 6, which could be referred to any other subject and there is a need ensure that the to identify how we can do things differently. Chair noted his challenge as to where PME Update is the work is reported on and whose responsibility is it for the action plan to be subject to the monitored. There was confirmation that this would be through the Performance, July board Monitoring & Evaluation Sub Group and JG noted that the board needs to have meeting agenda oversight of this with agencies enforcing that changes in practitioners practice is of benefit / making a difference to the children / young people that they engage with. ABn noted that it would be appropriate and may answer some of the questions raised if the action plan was provided to the board instead of looking at the detail of the audits.

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10.2c HS noted the recommendations from the Core Group Audit that identifies they are not being held, there is a need to identify why they don’t happen, how to address this and without this, there will be no change made. This could be through the implementation of the action plan and the 7 minute briefing. AF noted that the serious case review process is involves frontline practitioner and JG questioned whether this is in respect of learning or a question of compliance. AF identified that there can be issues in respect of recording and understanding of roles with ABk noting that from her agency there had been no escalation from what had been identified. JG noted this and from serious case reviews we continue to share learning and in in respect of compliance, there is a need for line managers to ensure their professionals are compliant.

10.2d KA noted that there is a knowledge that things are working and knowledge as to why things are not happening, therefore it is about understanding. It was identified that there needs to be a collective system improvement. Chair noted that the audits have been requested, undertaken and shortfalls identified. It was agreed that GW would circulate the action plan to members and it was agreed that the actions plans should have identified individuals driving the actions with evidence provided to the board to provide assurance that actions are being addressed. This item will be subject to the agenda for the July meeting.

10.3 Tees Procedures – it was confirmed that there will be a new website and members will be emailed when this is available.

PART 4 – PERFORMANCE & SERVICE IMPROVEMENT 11 Drug Related Deaths ALL TO NOTE

11.1 Chair noted the background to the presentation and TLR identified the need to clarify the problem with an overview of his presentation provided. It was confirmed that the number of Middlesbrough deaths has placed the area in the Top Ten of National Deaths relating to the misuse of drugs and short report can be provided to the board with more detailed information. The data provided is noted to be historical as the current data is not available and JG noted her recollection of current cases which are of great concern but TLR noted that this data is not currently available. JG noted her understanding of the current difficulties but there is a concern about the population with a mix of children / adults.

11.2 EK noted that TLR’s function is linked into CDOP and how this is undertaken. Chair noted that we are fully aware of the extent of the concern and Middlesbrough’s comparison to other areas but there is a need to focus around the dangers / risks to children and young people where drug misuse is prevalent with the challenge for the MSCB to minimise those risks further. JG noted an action for her to ensure that Information Governance will provide TLR with the most up to date information in accordance with Information Guidance.

11.3 RB asked about the comparison with other areas and whether there was any similarity to Middlesbrough’s position that there are more deaths because more children / young people are using drugs. TLR noted that the use in is higher than in other areas therefore there is more chance of harm. EK noted that there had been a request made of HS North to provide a comparison for overall rates. Chair noted the simplicity of the challenge as we know that there is a problem in Middlesbrough but the biggest concern for the board is the risks posed to babies and infants in particular and how we are raising awareness with parents, as well as professionals. What else can we do to minimise the need to commission a further serious case review.

11.4 AF confirmed there has been a move away from the 1ml Can Kill campaign, which had not provided the message to substance misusing parents originally intended. Work continues with the peer questionnaire with TLR identifying that there is a further meeting between Jonathon Bowden (JB) and Dr John Bye (DrJB) to progress this. JG noted this but questioned what is being done to stop more drugs being available in the area. Chair noted that this is a multi-faceted problem, which is being addressed by many agencies but for the MSCB there is a need to distil the concerns for those relating to babies and children and how we can mitigate the risk to them.

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11.5 ABn noted that we now have more recent information which has to change our attitudes towards methadone for treatment given that it is seen as safer in the adult world but is not safe for babies and children therefore the message to parents needs to be not to give methadone to their children. EK confirmed that there is work being completed by the Task & Finish Group around this as well as moving away from methadone as the only choice. There are other drugs available that can be used for treatment are less harmful to children and there is a task to identify who is best placed to check for safety, as well as addressing the possibility of more supervised consumption.

11.6 The issue referred to by JG in respect of drugs being available is noted to be a broader issue is being addressed with Cleveland Police with links to County Lines with a broader agenda to encompass work with schools. Chair noted that the issues range over a broad spectrum and are inclusive of deliberate administration of methadone to infants to the recent case identified in with a broad base of work to address this and there will not be an ‘easy quick fix’ but there is a need to have feedback in respect of the work being undertaken with substance misusing parents.

11.7 AW confirmed that there is a further element within this, that of Neglect, which is a key issue in the development of babies, infants and children. JG confirmed that neglect has been and continues to be an issue that comes under all headings whether this leads to the administration of methadone or evidences itself in other actions. JW noted a further element to this in those children / young people who are excluded from schools and questioned whether they are an element that are being missed completely. Chair noted that neglect is a wider issue but there is a need to remain focussed to know that we are doing something about the issues raised.

11.8 HS agreed that this matter is multi-faceted and with more interventions but confirmed that no one thing can solve all the problems, as there is a need to address the issues with lots of different approaches to also address the associated problems. Chair noted the recommendations from the Daisy Serious Case Review and RT noted the information raised through this and identified that this is not good enough for all children but there was also information that evidenced other elements identified within the review, which also evidences the complexity of working with a particular group of parents / carers.

11.9 It was agreed that the action plan from the steering group needs to be shared with the JB to provide a MSCB and this will be provided to GW by JB for GW to circulate to board members. copy of the TLR reiterated the complexities involved and identified that when interventions are Steering Group put in place there is the possibility that this could raise a further issues that would Action Plan to need to be responding to. JG agreed that there will be a mix of problems some of GW with a view which will be less risky than others and chair noted that it is crucial that we have and to the document continue to have an understanding of an issue before interventions can be identified. being circulated TLR made reference to the slide within his presentation with additional points. to board members when 11.10 AB noted that the number of referrals from Youth Justice have declined, which has available changed to alternative provisions being provided to ensure that they do not become involved with the process. Chair noted the issues raised and if there would be a need to initiate a further serious case in respect of the subject matter, it would be difficult to defend the need to do so given the number of serious case review already undertaken given that it can be difficult to understand the complexities of what is happening and what actions are in place to address the issues identified.

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11.11 ABn identified that from the work undertaken to address the reduction of young people drinking alcohol, which has precipitated a cultural change and there is a viewpoint that this may be the same for the misuse of drugs in the future but at the present time, it is not possible to completely stop the access of drugs and the acceptance of their use within communities. EK confirmed that there are two areas identified for future discussion with work already going on around babies / young children, there is a need for work to be undertaken with teenagers. He questioned whether there was any data available from the health trusts that identify any presenting trends with the second area noted to be drug related deaths in adults under the age of 45 with children affected as a result. Given the impact on children there may be a need to look at bereavement support.

11.12 JW questioned whether discussions have been undertaken with children / young TLR to provide people who do not misuse substances and EK confirmed that the Risk Reduction the date, time Team have undertaken work in Changing the Norms and noted the validity of JW’s and venue of the point. It may be appropriate to redesign campaigns including talking to those who Teeswide Board don’t do whatever subject is being addressed and what pressures they face. TLR meeting to GW noted that an invitation could be extended to the board for representation at the with a view to the Teewside Board. Chair reiterated the action identified earlier in the discussion and identification of a also asked for the date of the Teeswide Board meeting to be provided with a view to MSCB board identifying a board member who would be able to attend. member who may be able to 11.13 Chair also noted the work that is ongoing and his appreciation of this with a request attend for TLR to feed this back to the groups.

12 MSCB Action Log ALL TO NOTE

12.1 It was confirmed that this item is for board members to note.

PART 5 – ITEMS FOR INFORMATION F Future Meetings ALL TO NOTE

F1 The dates of the future board meetings are as noted below:

 Wednesday 26th June 2019 – Extra Ordinary Meeting re Pippa Serious Case Review  Wednesday 17th July 2019  Wednesday 18th September 2019

A Any Other Business ALL TO NOTE

A1 Andy Preston, Middlesbrough Mayor – chair noted that following the elections, Middlesbrough has a new mayor who will has identified a different approach to his role.

A2 Mike Carr / Councillor Representation – it was confirmed that as we remain in Purdah, we do not have an elected lead member but this will become clearer. Chair also wished to note his thanks to MC for all the work and support he has provided to the MSCB over his period of tenure.

D Documents Sent to Accompany the Agenda or For Information ALL TO NOTE

D1 NACRO Ofsted Letter – it was confirmed that this document had been circulated with the meeting papers for members to note its contents.

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MSCB BOARD MEETINGS ATTENDANCE – APRIL 2019 TO MARCH 2020

NAME JOB TITLE 15.05.19 26.06.19 17.07.19 18.08.19 E/O MSCB Business Unit (including Lay Members) Mark Braithwaite MB Independent Chair √

Mary Booth MBo Lay Member Aps

Juliette Oko JO Lay Member Aps

Gary Watson GW MSCB Business Manager √

Janet Whiteway JW Lay Member √

Ann Marie Fishwick AMF MSCB Administrator √

CAFCASS (Children And Family Court Advisory & Support Services) Margaret Harvey MH Service Manager

Cleveland Police Lisa Theaker LT Detective Superintendent, Head of Specialist Aps Crime

Education (including , Primary; Secondary & Further Education Representation) John Dixon JD Primary Representative / Head Teacher Aps

Michael Laidler ML Secondary School Representative / Principal, Aps Acklam Grange School Jane Steel JS Vice Principal / Lead Safeguarding Officer √

Andrea Williams AW Assistant Director of Learning & Skills √

Emma Wright EW Safeguarding Information & Compliance √ Officer, Middlesbrough Children’s Services

Guest Attendees / Attending on Behalf of….. Tom Le Reuz TLR Tees Preventing Drug Related Deaths Co- ordinator, Public Health South Tees √

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Simon Walker SW Acting Detective Chief Inspector, PVP, Crime & √ Justice Command, Cleveland Police Jeff Watson JWt Risk & Reduction Manager, Prevention & √ Partnerships Team, Middlesbrough Council

Harrogate & District NHS Foundation Trust Ann Brock ABk Named Nurse Middlesbrough & Stockton √

Middlesbrough Council (including Children’s Services; Council Member; Education; Prevention & Partnerships & Public Health) Alison Brown ABn Director of Children’s Care √

Rob Brown RB Director of Prevention & Partnerships √

Michael Hackett MH Head of Service, Resource & Review,

Middlesbrough Children’s Care Suzy Kitching SK Head of Quality Standards & Initial Response /

Principal Social Worker, Children & Families N/A Edward Kunonga EK Director of Public Health & Public Protection √

Helen Watson HW Executive Director of Children’s Services

Aps

National Probation Service Ann Powell AP Head of Cleveland LDU, Her Majesty’s Prison Aps & Probation Service

NHS England Christine Brown CB Deputy Director of Quality & Assurance Aps

South Tees Clinical Commissioning Group Alison Ferguson AF Designated Nurse Safeguarding Children & √ Looked After Children Jean Golightly JG Director of Nursing & Quality √

Rosemary Thwaites RT Designated Doctor √

South Tees Hospitals NHS Foundation Trust Helen Smithies HS Assistant Director of Nursing (Safeguarding) √

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South Tees Youth Offending Service Kay Dargue KD Head of Partnerships Aps

Tees Esk & Wear Valley NHS Foundation Trust Karen Agar KA Associate Director of Nursing √

Thirteen Group (Housing) John Rafferty JR Compliance Business Partner (Safeguarding) Aps

Voluntary Sector

Elizabeth Phillips EP Children’s Services Manager, Barnardo’s Tees

Valley

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