Secure Care Group minutes: March 2020

Attendees and apologies

• Carole Dearie (CD), St Mary’s, Kenmure
• Alison Gough (AG), The Good Shepherd
• Beth-Anne Logan (BAL), STARR / CHS
• Eddie Follan (EF), COSLA
• Mary Geaney (MG), Rossie
• Janine McCullough (JM), Education Scotland
• Natalie Chalmers (NC), FCAMHS
• Rod Finan (RF), Scottish Government
• Andy Sloan (AS), Care Inspectorate
• Tom McNamara (TM), Scottish Government (joint chair)
• David Cotterell (DC), Secretariat
• Rod Finan (RF), OCSWA
• Gill Robinson (GR), Scottish Prison Service
• Debbie Nolan (DN), Secure care Practice Development Advisor
• Sinclair Soutar (SS), Kibble
• Ellen Wilkinson (EW), Scotland Excel
• Helen Smith (HS), NHS
• Ben Farrugia (BF), SWS
• Peter McCloskey (PM), Edinburgh Secure Services

Apologies

• Aileen Blower, NHS 
• Cath Agnew, Care Inspectorate 
• Alan Mulholland, Police Scotland
• Stephen McLeod, Scottish Government

Items and actions

Welcome and apologies 

TM invited round the table introductions and welcomed the group to the meeting noting this was the first meeting for JM, EW and NC. EF from CoSLA would co-chair. 

The group asked TM to note their thanks to Nicola Dickie for all the work, energy and knowledge she had brought to the group, wishing her all the best in her new role as Chief Officer of Health and Social Care. 

The group also asked EW to pass on congratulations to Nicola Burleigh on the recent birth of her daughter.

TM provided a brief update from Stephen McLeod which include:

• standards of Health Care were agreed back in 2014
• health boards have a duty of care to provide a service to Secure Services in their area
• CAMHS should provide seed funding to support this

HS highlighted the Glasgow model is not sustainable as they have been unable to recover funds from the YP’s home health board. TM said the problem could maybe be resolved with some work alongside all health boards, beginning with those who have secure care services within their boundaries. 

The group asked TM to discuss these issues with SMc with a view to confirming the position in writing.

BF suggested a meeting with Scottish Government MH colleagues, Health Boards (with secure services in their area) and representatives from this group would be helpful to move this on.

Action point 1: TM to ask SMc to provide a written update to group. It was also requested we approach Dr Aileen Blower for an update on the planned mental health facility in North Ayrshire. 

The note of the 3 September meeting was accepted with no amendments. DC confirmed all the action points from that meeting have been cleared.

Pathways and standards

DN had circulated the following papers to the group prior to today's meeting.

• project management plan 
• communication and engagement plan 
• evaluation and monitoring plan 

DN said now that the standards had been signed off by COSLA leaders, STARR and Ministers, we could really press on with plans for communicating and progressing towards implementing the standards. The plan is still to publish the standards on the Scottish Government web-site on 1 April with the standalone web-site launched the same day or soon after. 

DN thanked group members and all those involved in getting the work to this stage - recognising the time, effort and hard work they had all put in. 

DN asked the group to contact her direct if they had any changes or comments on the Project Plan, an updated version of which will be circulated. 

DN advised the group there were gaps in the Comms and Engagement plan and asked group members to help fill them. DN asked if the group were willing to provide a blog she could share to highlight the work of implementing or spreading the word of the standards. 

Action 2: group members to get in touch with DN direct to help fill the gaps in the plan. 

Action 3: group members to get in touch with DN if interested in producing a blog on the Standards. 

AG was concerned that a great deal of work was still to be done before they are implemented. The delay between publication and fully-resourced implementation could provide challenges with expectations from young people and their families.

CD said providers had been working on implementing the standards for nearly two years and was disappointed that more progress had not been made on the ‘before’ and ‘after’ standards. 

TM said there were reasons for this apparent position – related to cost analysis, ICR publication and budgetary timings - all beyond the immediate control of officials. This led to broader discussion on implementation costs and funding. TM observed that much of the standards represented codification of what should be in place already in good practice terms, but there were some new expectations that should be acknowledged. With regards to funding it was agreed it is essential SWS, SG and COSLA carry out an assessment to identify additional costs.

Action point 4: BF said he may be able to provide contact details for three areas that may be able to help with this work.
5 SWS, SG and COSLA to identify any resource implications, cultural and/or practice changes required to implement the standards

The group agreed their ongoing commitment to this work, recognising that effective and disciplined Comms would be vital. There would be clear phased periods of installation and implementation. The group further acknowledged there will be a strong focus on partners to implement the ICR recommendations there is not going to be a quiet time coming any time soon and we will be pushed to deliver.

DN provided an update on the standalone web-site that is being developed with IRISS. The group were able to see the developing web-site - still a work in progress. DN advised the group there would be a video made with STARR to introduce the standards, which the group felt should not be recorded at/in the grounds of a secure care centre. Each standard will show how they are linked to the HSCS and HGIOS. There will be images and audio linked to some of the standards. The website will continue to be reviewed and added to. 

Action point 6: DN to share the link to the web-site and any feedback on this to be provided ASAP.

DN advised how she thought the standards could be reviewed and monitored through the use of LA and education plans along with self-evaluation.

BF said self-evaluation was often difficult to enforce even when the request was in statute. He suggested there was a need for further conversation around potential monitoring tools.

The group felt that self-evaluation should focus on learning, improving outcomes, and better approaches leading to greater transparency. It was agreed that the evaluation and monitoring plan will be revised to reflect this, adopting a more phased approach and opportunity for further discussion with external agencies, and shared for the group for comment. 

Action 7: revised evaluation and monitoring plan to be shared and any feedback to DN.

The Standards will be discussed at a variety of planned events. The Scottish Government will be running 3 national engagement events in April/May where the Standards will feature and workshop submissions have been made for SIRCC, SWS and Youth Justice Conference. Based on the implementation resource contained within the evaluation and monitoring plan, DN has developed a ½ day workshop for those with roles and responsibilities to support both development of local baseline self-assessment and plans for implementation, but also to support gathering of information of the opportunities and challenges for implementation to help inform what support may be required. 

DN asked the group if they thought there should be a launch event. Following a discussion it was clear the group thought there should be. 
The standards are part of a key national agenda strongly linked to the ICR, potentially providing part of the integrated roadmap of change. Ministers have been aware of and committed to the standards for some-time now dating back before the Strategic Board. The group thought a Minister, COSLA leaders and STARR should be invited to speak at any planned launch event. It is important this event connects with other developments and current activities. 

TM agreed to invite a Minister, but could give no guarantee they would be able to attend. 

Action point 8: DN to agree a date for the event with DC and invitations to be sent to the Minister, COSLA leaders and STARR. 

DN informed the group an Irish delegation had visited Scotland over two days to find out more about Scotland’s secure care and visit a secure service. The visit was successful with very positive feedback received from everyone involved. 

Government officials from across the UK and partners have taken part in a tele conference to discuss secure care. This was a very positive meeting and the group agreed to have a quarterly tele call to share good practice and reports people would be interested in. It is hoped this will potentially lead to a face to face meeting with representation from all four jurisdictions. DN will keep the group informed of progress.

STARR

BL provided a brief update.
The group has meet on 3 occasions since September the focus has been on discussing future priorities

• STARR involvement in post ICR implementation 
• the need to increase membership, although this is difficult when the offer/ask is unclear at present-one this is clearer the group will be in a better position to recruit and link in with the centres more 

The group thanked STARR for their vital work highlighting how important they are to the implementation of the standards and ICR recommendations.

Scotland excel 

EW informed the group she was covering for Nicola Burleigh whilst she was on materinity leave and will attend future meetings.
EW explained she was not able to provide any information on the on-going procurement exercise other than to say the work remained on schedule. 

Research group

HS introduced NC to the group she will be working as a research assistant and she has already identified a mountain of papers she is working through as part of the systemic review (phase 1), which will support the feasibility study which finding has been sought for (phase 2) and bid for a longitudinal study of YP in Scotland’s secure care (phase 3).

HS informed the group of some of the work she is taking forward:

• hopes to receive funding to follow Scottish YP for 12 months through their secure care journey
• create a focus group that will ask young people what is important to them in terms of outcomes and to explore opportunities and challenges for longitudinal study
• have a Masters student exploring the ability to consider the economic model for secure care in Scotland
• this will be phase 2 of the study and inform phase 3 application for MRC bid for 4 year study

HS went to seek the group’s views on phase 3 of the study including a randomised control trial for comparing outcomes for YP who were placed in secure care opposed to those that received intensive community supports. HS did say she had some concerns with this and theses were echoed by a number of people in the group. 

Following a discussion TM asked if HS could provide written details that would allow people to fully think this through and reflect on possible challenges.

Action point: 9 HS to provide written details to the group.

Justice committee and independent care review

DC provided PP slides with some of the recommendations from the Justice Committee and the ICR. The group noted there where several gaps. TM said this was not supposed to be a complete record it was simply to generate conversation and prompt initial thoughts on some of the main points from both papers.

 

Some group members thought the Justice Committee had asked that SG and COSLA to review the commissioning process prior to 31 March. 

The recommendation was - The Committee welcomes the evidence provided by Scotland Excel, COSLA and the current secure care providers on the current contractual model (localised commissioning) for the provision of secure care. The Committee notes that this model has some advantages, such as the relative ease of administration and procurement for Scotland's local authorities. Nevertheless, the Committee remains unconvinced that this is a viable model beyond the current contractual period (which ends in March 2020). The Committee calls on the Scottish Government and COSLA to look at alternative models, such as national commissioning or the use of block funding of places. It should never be the case that a child or young person is sent to HMP YOI Polmont when a secure care unit would more appropriate to their needs.

TM explained whilst we are in the middle of an ongoing procurement exercise and whilst waiting on the ICR to report in February 2020, it was unrealistic to have taken this work forward with the timescale suggested. TM said there had been some great work done around funding during the time of the Strategic Board under the 3 horizons and we still had that work to hand. Scottish Government, COSLA and Scotland Excel had already held initial conversations and this work would be picked up again following the award of the contract. 

The group asked that all partners are involved in discussions regarding future funding models for secure care. 

TM advised the ICR recommendations had to be considered and responded to by November 2020. However the FM has already made it clear she does not intend to wait until November and work is underway across government to respond. 

There was a good discussion around the recommendations and how both reports mirrored each other on several points. TM noted the ICR’s stark challenge ‘Scotland should not monetise the needs of its YP’. 

TM advised the group he was encouraged the response to the Justice Committee report had been a joint response from three Ministers and this provided some reassurance the work to deliver change would be joined up. There will be a parliamentary debate on the Justice Committee report on 31 March and work is underway by SG to join up the recommendations from the various reports, which it may be useful for the group to have a focused workshop type session on, similar to that recently undertaken by CHIP in respect of the ICR. 

The future of the group was discussed and how this might change following the launch of the standards and the award of the contract. 
AG said any future group should include representation from all 5 secure units. 

TM said we would consider the future role of the group later in the year and discuss with EF on the attendance of all 5 providers at future meetings.

AOB 

DC advised the group Nicola Dickie had requested we invite along Kim Hartley Kean from the RCSLT. Kim has offered to generate a briefing / presentation for the meeting to “tell the story” covering the following. 

• the issue 
• evidence of need and impact
• SLT role and service model
• SLT impact including links with Secure Care Standards, recruitment, outcomes and other provisions such as CAMHS
• description of the next best steps for provision in Scotland 

The group agreed Kim should be invited to the next meeting. 

TM raised the challenges we all face in dealing with the possible impact of the Coronavirus. TM acknowledged the work secure services did in 2018 to plan for the Flu Pandemic. He advised that they would have to revisit those contingency plans in light of the information the Coronavirus has the potential to impact even more pervasively on workforce availability.

TM said Scottish Government may have to come to providers at very short notice to ask what plans they have in place. 

GR would look into SPS contingency plans for the Coronavirus. 
Action point 10: GR to contact DC and TM.

AS suggested the information in the evacuation plan may assist services to plan for the potential impact of Coronavirus regarding the possible need for movement of YP. MG highlighted the potential financial impact on services should YP have to be transferred to other secure centres. 

BF said COSLA hold contact details for each LA’s resilience lead and they should be copied in to all issues. 

Action point 11: EF to provide resilience leads contact details to secure services and Scottish Government.

TM thanked the group and acknowledged there was no easy solution and where possible Scottish Government would do all it can to support them and keep them up to date with developing and changing guidance.

Date of next meeting 

6 April 2020.