Source · Investigations in the NHS

An independent investigation into the care and treatment of Mr X: Published 11 June 2018

North West Published 11 Jun 2018 Subject Mr X

This is the report of the independent investigation into the care and treatment of Mr X .

Acceptance status

Per recommendation
No Response Published
11

Total recommendations
11
About this data

Acceptance status tracks whether the trust accepted or responded to each recommendation.

Independent health investigation reports and reviews commissioned by government or NHS England.

About this investigation

Source & metadata

Independent investigation report. Recommendations and any published response are extracted below.

Recommendations

11 total
1 Relevant Health and Social Care Agencies No Response Published
Recommendation
Training should be offered to Care Coordinators with explicit inputs regarding safeguarding issues.
1 Relevant Health and Social Care Agencies No Response Published
Recommendation
A family protocol to be developed to establish boundaries and statutory agency response when differences of opinion develop between families and health and social care agencies when providing care and treatment to both children and vulnerable adults.
1 All Stakeholders in Health and Social Care No Response Published
Recommendation
Exploration of current services to be conducted by all stakeholders in partnership in order to ascertain how they could be further developed to provide specialist autism services locally.
1 Stakeholders in Health and Social Care No Response Published
Recommendation
Stakeholders to examine current processes and systems using Mr X’s case as a worked example in order to understand how processes can be improved for the future. This to be focused upon safeguarding of children and vulnerable adults.
1 Stakeholders in Health and Social Care No Response Published
Recommendation
Stakeholders to examine investigation processes for complex cases to ensure streamlining and maximum lessons for learning.
2 Relevant Health and Social Care Agencies No Response Published
Recommendation
Safeguarding should be raised in all clinical supervision meetings.
2 Relevant Health and Social Care Agencies No Response Published
Recommendation
Early work with families when children are diagnosed with a learning disability to be re-visited and a protocol developed (in general).
3 Relevant Health and Social Care Agencies No Response Published
Recommendation
Consideration should be given to identifying key senior liaison personnel across the area who could provide independent mediation in difficult cases.
3 Relevant Health and Social Care Agencies No Response Published
Recommendation
Work with Mr X’s family to assess their expectations and Mr X’s needs for the future (in particular).
4 Relevant Health and Social Care Agencies No Response Published
Recommendation
Clarification of safeguarding protocols and a review of training and inter-agency information sharing.
5 Relevant Health and Social Care Agencies No Response Published
Recommendation
Current safegaurding policies should be reviewed in the light of the findings and conclusions of this case with particular regard to professional and interagency communication.