Tower Hamlets review

The Tower Hamlets CSP to satisfy itself that Child A, B and C (as well as their kinship carers) are offered support in relation to the publication of the DHR.

After publication of this DHR, the Tower Hamlets CSP to ensure that this report is attached to Child A, B and C’s social care records. This is so that, if they wish to read the DHR when they are older, it will be available to them. (In delivering these actions, Tower Hamlets CSP – as the commissioning body for this DHR – should satisfy itself that they have been completed, but it is expected that Tower Hamlets Children Social Care will be responsible for delivery).

The Ministry of Housing, Communities and Local Government (MHCLG) to review the learning from this case and issue appropriate guidance nationally to ensure housing providers can be informed of safeguarding concerns at the tenancy nomination stage.

Clarion Housing to review its new tenancy starter information to include information on domestic violence and abuse.

Clarion Housing to review its internal checklist for compliance against the Pre-Action protocol to explicitly address domestic violence and abuse.

The Ministry of Justice to consider the learning from this case and review and / or issue appropriate guidance nationally to ensure consideration of domestic violence and abuse in the Pre-Action Protocol.

Clarion Housing to work with DAHA to address its concerns around the current accreditation framework in order to assist its decision in relation to accreditation at the conclusion of its restructure during 2020/21.

Health Advocates should be used for all pregnancy appointments, particularly the booking appointment.

Ensure that the current development of the organisational domestic abuse policy and on-going training additionally includes: The need to ask about Domestic Abuse at the initial contact with the Health Visiting Service (antenatal contact, new birth or movement in visit) and providing information about local domestic abuse services irrespective of the response. The need to ask to see women alone should partners/ family members/ friends be present at the initial visit. The need to record on EMIS a plan should the above not be possible of how and when it can be asked at a future contact. The need to look for opportunities to ask about Domestic Abuse at all contacts (especially at key developmental reviews). Where potential predisposing factors to domestic abuse are identified there is an increased requirement to ask at every contact. The need to establish, prior to visits, whether an interpreter is required and if so ensure that one is booked and the inappropriateness of using a family member to interpret.

Ensure that the family health needs assessment includes, but is not limited to: Establishing immigration status; Recording both parents’ religion; Household finances; Housing status; Bonding / attachment and barriers to this; Knowledge of local specialist services as well as the local offer information; Assessment of the impact of the above on parental relationships and parenting.

Ensure that that it is clearly stated in policy or standard operating procedure (SOP) and staff to be reminded of: The need to verify address and contact details at every time the family are seen and EMIS record updated accordingly. The need to establish at initial contact whether an interpreter is required and to ensure that only organisationally approved, interpreters are used at planned contacts. The need to initially offer a universal plus Health Visiting service following premature delivery and consideration of support via the MECSH programme. The expected response to a potential non accidental injury, even if there are no obvious visible injuries.

MDT discussions are recorded routinely in clinical records. the CAMHS clinical team leads to review systems to ensure that the outcome of MDT discussions in cases where the parents are reporting that their child is refusing to attend and has never been seen, are included in and inform the action plan.

Tower Hamlets CAMHS leadership team to remind staff of their duties of documenting clinical supervision case discussions on to RIO.

Tower Hamlets CAMHS to continue to communicate care plans verbally and by letter copied to GP directly following families attendance at assessment clinics

Tower Hamlets CAMHS leadership team to ensure that ELFT Guidelines from risk of violence assessment (appendix 4) are circulated and then made readily available to staff via the intranet.

Tower Hamlets CAMHS clinical leadership to ensure that all staff are aware that in all new assessments, there is a record that past RIO records have been reviewed and relevant action plans taken into account, based on the review of notes.

Tower Hamlets CAMHS to consider routinely checking for past or current involvement with social services at point of referral.

If there is a past history of Social services involvement, for clinical team lead to remind staff on obtaining consent from parents to obtain information relating to Social Services involvement.

Tower Hamlets CAMHS staff to be refreshed on and recirculate NICE guidelines on Conduct Disorders and to consider providing assessment guidance to clinicians for children and adolescents presenting with violence or aggression.

Tower Hamlets CAMHS to consider implementing a pathway for young people presenting with violence or aggression and/or those that are hard to engage, as illustrated by the City and Hackney Conduct and Outreach pathway.

Tower Hamlets CAMHS to review systems to ensure that MDT meetings and clinical supervision discussions are clearly recorded in the clinical records.

Tower Hamlets CAMHS to review systems to ensure that interpreting services are booked routinely for initial assessment if referral states that the clients cannot speak English. Giving the patient the option to refuse if not needed.

Tower Hamlets CAMHS to ensure clinicians are aware of the systems for accessing telephone interpreting services if face to face interpreter is not possible.

There are clear supervision structures for Tower Hamlets CAMHS clinicians involved in the assessment, management and safeguarding of young people presenting with violence and aggression. Clinical team leads to ensure that clinical discussions in supervision are clearly documented.

Tower Hamlets CAMHS clinicians are able to access safeguarding and clinical training relating to domestic abuse from a variety of sources. Clinical supervisors to ensure that CAMHS staff are aware of the range of training available.

Clients that disclose any difficulties within a family setting or with partners are interviewed further in an appropriate way to ascertain if there is a need for sign posting and/or referrals for assistance.

Referrals made to other professionals in the context of domestic violence and/or safeguarding are followed up to establish what, if any, further action is required from the referring agency.