Children in Crisis audit finding - Video and audio transcripts

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Hello and welcome to a short video on the findings and recommendations from a recent audit undertaken by the coventry Safeguarding Children Partnership in relation to children in crisis.

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The purpose of the audit was to explore the pathway available to children and young people in coventry experiencing mental ill health and emotional distress.

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This was in order to understand how lower level support measures for mental health available in the Community are supporting children and young people in managing their mental health and whether

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Services at this level may assist in preventing escalation into higher level support and admissions of children in crisis on to ward 14 at UHCW.

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The audit was carried out in a number of different stages.

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Firstly, we identified a cohort which consisted of 10 randomly selected children in crisis who had been discharged from Ward 14 between January and December 2020.

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We then carried out a multi agency case file audit each agency from across the partnership was asked to review the cohort.

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And examine their agencies involvement with the child and young person and then complete a case file audit using an agreed audit template.

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We then conducted a series of targeted interviews with professionals from within primary care education Ward 14 and CAMHS.

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And the aim of these interviews were to gain an understanding of what practitioners file was already working while in terms of support services for children and young people, what they felt wasn't working well and what they felt there needed to be more of.

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Coventry and Warwickshire mind then facilitated a young people engagement event. This was a virtual event where children and young people from across Coventry and Warwickshire were invited to share their thoughts, feelings and views on mental health and emotional well-being.

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And finally we held a multi agency audit panel.

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Following completion of the case file audit, each agency involved was asked to prepare a summary of their findings using a signs of safety approach, identifying what was working well, what they were worried about and what needed to happen and share this with a multi agency audit panel meeting the panel then considered.

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The results from the case file audit from across the partnership and drew out the findings, key themes and recommendations.

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So what did we find that was working well?

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The 24.

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Hour Crisis Helpline was launched during the pandemic by the rise crisis team and feedback from parents and children was that they had been able to speak to an appropriate professional quickly and received a prompt response.

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The CAMS acute liaison team deliver a fast and appropriate response to children and young people in crisis and this is continued throughout the pandemic.

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The team have consistently met their target, ensuring children are assessed within 48 hours of them receiving a referral.

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It was also encourage and for the power to see the positive impact of social workers Co - located within the acute liaison team.

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This is upskilled camhs practitioners and supported the liaison and partnership working between children services and camhs.

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It was also noted that this is the only crisis service in the West Midlands region to have social workers in place.

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Within the team.

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There was evidence of good case management.

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There was good triage within the mash.

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An assessment showed evidence of collaborative working, communicating with families and focused interventions.

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Primary care were also able to demonstrate evidence of good case management. For example, GP's were offering routine appointments following any attendance to the emergency department with self harm or mental health crisis.

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It was clear that relationships are really important to children and young people.

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Practitioners who are able to build relationships with the child and gain their trust are often able to get to the crux of the issues that are causing the child emotional distress and then offer them the appropriate support.

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It was really positive to see evidence of the child voice in this audit

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Child voice is being heard and helping to inform assessments and decisions made about them.

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The case file audit demonstrated effective multidisciplinary team meetings taking place and it was evident that mental health and emotional well-being was high on the agenda for all professionals involved.

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During the pandemic, there has been a significant increase in the number of children and young people with these disorders, both locally and nationally.

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And the case file audit found that the eating disorder referral interage pathway is currently working well.

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So what are we worried about?

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Although the audit found some good evidence of multi agency work taking place, the panel felt that collaborative and joined up working is an area for development and there needs to be better communication between agencies, particularly with education and schools.

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There were several cases in the audit where children services had received a referral at the point of crisis and the child then went on to receive support by early.

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How, however, it was evident that there had been some missed opportunities by other agencies to intervene earlier.

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The case file audit revealed a common theme.

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Family dynamics such as parental conflict has a detrimental impact on the mental health and emotional well-being of children and young people.

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Family dynamics and the behaviour of their parents was a common feature for all of the children in the cohort, and adopting a holistic, whole family approach to assessments of families is crucial.

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Some of the complex issues for some of the children in the cohort was often a result of attachment difficulties.

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The panel agreed that attachment based work with children to help them understand their journey and experiences is an area for development.

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Although we identified that the eating disorder referral and triage pathway is working well, there are staffing issues within the eating disorder team to meet the increased demand.

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This is both a local and national issue.

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The case file audit and professional interviews both drew attention to the long waiting times for a neuro development assessment and the lack of pre and post diagnosis support for ASD.

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However, the panel were unanimous in their opinion that our diagnosis can sometimes be a barrier to support.

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And the focus needs to be on interventions and reasonable adjustments in order to achieve better outcomes for children and young people.

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Whilst outside the scope of this order, it is important to highlight that during a recent rapid review undertaken by the partnership, it was identified that there is a shortage of Tier 4 placements, again both locally and nationally, for children experiencing an acute mental health crisis.

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Coventry and Warwickshire mind held a live virtual event in March 2021, followed by an online survey. The event and survey were accessed by approximately 71 secondary school aged children and young people, predominantly from coventry and some from Warwickshire.

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This event was an.

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Opportunity for young people to share their views and thoughts about mental health and well-being and feed into and shape the services that support them.

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Some of these key messages from the event were around what most children were worried about, and these were things like what's going to happen in the future, friendships and relationships with family members.

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Some of the things that had helped them over their last year were friends, family, siblings, school.

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Music and art, pets, gaming and social media.

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The most preferred way that children and young people want to access support it's face to face at school, followed by face to face outside of school or a video call.

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The least preferred way to access support is in a group.

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Most children want to access support during the school day, followed by later one in the evening after 5:00 o'clock and the least preferred time to access support was before school.

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So what are our

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Recommendations first, we need to develop a coherent communication strategy, promoting messages and resources around mental health and emotional well-being with children, young people, parents and professionals.

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We need to upskill, demystify and increase knowledge and understanding amongst professionals in schools of emotional dysregulation, coping strategies, interventions and the importance of a key relationship or trusted person for children and young people.

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Practitioners need to consistently ensure they are hearing and recording the views, thoughts and feelings of a child or young person and using this to influence their decision making.

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The CSCP your voice matters will gain the views and ideas of children and young people about what works well for them in terms of support for their emotional well-being.

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Education needs to complete a self-assessment with schools in relation to their response to children and young people with mental health, illness and emotional distress to try and identify areas of good practice that can be shared across the education service.

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We need to strengthen the intelligence and understanding amongst professionals across all agencies of the transforming care pathway and the support that is available to the cohort of children with a diagnosis or suspected ASD or learning disability.

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The CSCP will promote the reducing parental conflict training sessions that are being delivered via the early Health partnership.

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All agencies need to raise awareness of the importance of early identification and intervention with children and young people with mental ill health within their organisations.

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And finally, the findings and recommendations from this audit will be shared as a priority with the mental health and well-being board who oversee and implement the local transformation plan that any common service review or transformation work.

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Next steps the children in crisis audit indicates positive work as being undertaken with children and young people, and support services that are currently available or working well.

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However, the audit has identified some areas that would benefit from further development.

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Therefore, the recommendations from this audit, as previously discussed, have been formulated into a smart action plan, and the implementation and progress of these will be monitored by the Partnership's audit performance subgroup.

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Thank you for listening.

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For more information and access to other safeguarding resources please visit.

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www.coventry.gov.uk/CSCP.