APPENDIX 1

JAR recommendations - progress summary

1. Ensure that an appropriate way is found to successfully disseminate the findings of this report to children and young people in the area.

Progress - on target

The initial JAR report and summary was sent to schools in June 2007. There has been some delay in disseminating the report more widely due to the reorganisation of services for young people. However, a former young person JAR inspector has been contracted to disseminate the report to young people in a range of settings, including the Youth Council, and district youth forums. The report has been uploaded on the Children's Services Website and is available to be disseminated to the voluntary sector, district councils and other providers of children's services.

2. Develop a partnership action plan for delivering joint commissioning for children's services

Progress - target date revised

The joint public health unit is completing work on a children's needs analysis and priorities have been agreed for joint commissioning, By October 2008 a service development and commissioning strategy will be completed for implementation in 2009/10.

A commissioning co-ordinating unit is being established from 01/04/08. Their initial task will be to establish a systematic method for grant aiding and contracting with all sectors ensuring that the process is compliant with the Hampshire Compact (including the new procurement code), promote the use of longer term contracts and look to identify the wide range of services the voluntary sector and children's services can provide. It is anticipated that it will be completed by 01/09/08.

In order to enhance the commissioning function for CAMHS, improve consistency in service contracts and have a stronger and unified performance management process, HCC Children's Services and Hampshire PCT have moved to the second phase of the CAMHS Trust, in which it will pool the fund for commissioning all the specialist CAMHS teams, in addition to some identified tier 2 and tier 3 CAMH service funds (see appendix 3).

3. Review all social work vacancies and ensure that all area teams are adequately staffed.

Progress - on target

We have reviewed the allocation of social work resources with County Treasurer's Consultancy and obtained agreement for an additional investment of 600K in 2008/09 in social care services. Following the recommendations of the consultancy report, investment in edge of care services, linked to commissioning strategy for looked after children, allocates additional support services to the North and East and South East. There is a risk associated with volatility in care proceedings, workload, and recruitment problems.

In the shorter term we have reallocated some work and/or staff across the county to ensure priority needs and statutory requirements are to be met. Unallocated cases from North Area transferred for immediate allocation in Western Area. An action plan is in place to improve the timeliness of initial child protection conferences.

Recent recruitment drives have been successful and we anticipate that Pay and Benefits arrangements implemented in February 2008 will give advantage to Hampshire County Council in comparative pay scales.

As we restructure social care teams we will need to ensure that change does not hinder improvements made.

We are on target to implement the project plan for the reorganisation of social care teams. Options for the new structure have been developed through extensive consultation with staff and further consultation on the implementation of the selected models is underway. Detail on business processes are being worked on to secure implementation plan. Delays to implementation of HantsDirect could impact on project

4. Ensure that suitable packages of respite care and other support are provided, where possible, for families with children with severe and/or complex needs.

Progress - on target

The joint public health unit is completing work on a children's needs analysis and priorities have been agreed for joint commissioning, which include services to disabled children (see recommendation for immediate action 2 above). A three month period of consultation in the context of the Aiming High for Disabled Children project has commenced and a report is scheduled for the Executive Member in May 2008 which will lead to tendering for services commencing in June 2008.

The 2007 audit of short breaks included a questionnaire for parents, carers and young people. The survey found that 46% respondents receive over 50 nights respite care a year and 18% respondents are not in receipt of respite care. The competed audit report will inform the short breaks strategy.

5. Review the strategy for identifying and supporting young carers across all services, with a collaborative action plan and performance indicators.

Progress - on target

Revision of the strategy is well underway and an eight- week consultation period began in mid March. Work will be commencing within the Children's Services Department to look at developing existing IT systems to provide information relating to young carers.

See appendix two for details of progress towards improving the identification of young carers and support.

6. Improve the accessibility of mainstream leisure opportunities for children and young people with learning difficulties and/or disabilities

Progress - on target

Funding has been identified by the Recreation and Heritage Department to deliver a three-way partnership agreement with Children's Services and the University of Winchester to research leisure provision and MA student projects will focus on widening opportunities in mainstream settings across the county. A mapping exercise is also underway within some district councils to build on models of good practice. A toolkit has been developed in partnership with KIDS, on participation, using the model developed within Applemore Sports Centre.

Progress in implementing this recommendation is being monitored through the Disabled Children and Young People's Strategy group. A CAT Mark assessment will be commissioned from the Performance and Resources Branch Participation Team to identify young people's views on the suitability of leisure and recreation services.

APPENDIX 2

Identification and support for young carers

Financial management

The majority of funding to support young carers is from the Carers Grant monies from central government. Children's Services receive £340k per annum of which 43% is spent on young carers services. Children's Services agreed funding to each of the young carer projects between April 2006 and March 2009. This is £7,857 per annum, which enables the projects to

_ Offer a strategic countywide project approach to providing for the needs of young carers in Hampshire;

_ Enhance the quality of service delivery to young carers and their families.

The work associated with this is monitored by the multi-agency Advisory Group - Young Carers.

The Children's Society receive £75,635 per annum from April 2006 - March 2009 to employ two fte development workers to undertake work across Hampshire. The agenda is set by the Advisory Group and the work currently being undertaken includes linking with schools; providing training for GP surgeries to awareness raise; undertaking work with YOT and YISP; working with Adult Services.

Another piece of work is being undertaken by The Children's Society, funded via Children's Fund monies to develop and provide training to designated teachers.

Identifying and sharing information about young carers

The work being undertaken by The Children's Society in respect of designated teachers is to:

· raise awareness and inform practice so that young carers will have the same access to education and career choices as their peers.

· promote train, and support designated teacher leads for young carers in all schools in Hampshire

· ensure inclusion of needs young carers and their families within all school policies across Hampshire.

· enable Hampshire schools to identify external partners when needed, to support pupils with caring responsibilities.

The Information Pack for GP surgeries has been piloted in 10 Surgeries across Hampshire. The pack had been used in the surgeries and feedback was positive. The poster for the waiting room has been seen in a number of surgeries, including those who received it via the district nurses, and also in Winchester Hospital.

A request has been received from the trainer for GP Registrars in Winchester for a training session, following the session that was held in Southampton.

The Children's Society also engaged with the YOT, Police and other agencies working to prevent youth crime to undertake a workshop day to identify the issues and consider how these can be addressed.

Two new support schemes for young carers are being developed - one in Basingstoke where the youth team, social care, voluntary agencies and the District Council are working together to identify young carers, and consider how support can be offered universally and in specialist projects.

The other scheme is in the New Forest where social care is linking with a variety of agencies in the area to identify young carers and provide universal and specialist support.

These two support schemes will receive one-off funding in the current financial year via Extended Services.

Work will be commencing within CSD to look at existing IT systems, the information they provide and how this may be improved to include numbers and other information relating to young carers.

APPENDIX 3

Child and Adolescent Mental Health Services (CAMHS)

1. Progress with arrangements for shared funding of services to children and young people with complex needs

An individual commissioning process has been agreed between HCC Children's Services and  Hampshire PCT (HPCT). The process to consider jointly commissioning services for those with complex needs is based upon the principle of support to joint working at a local level, with reference to an interagency group in those exceptional circumstances where local agreement cannot be reached.

Joint working across agencies to share assessment, agree priorities, to make commitments to provide services and provide support to universal services provided by partners underpins the objective of partners to ensure better outcomes for all children and young people.

The process for partners to consider shared funding of services is based on the following 4 steps with an emphasis on reaching agreement at the point closest to the consumer and always with their appropriate participation and any necessary assessments. The emphasis at all stages in to seek to provide care locally to prevent the need for specialist or purchased care. These 4 steps are summarised below.

Step one - Joint working arrangements between practitioners including the lead professional on a case by case basis, including the role of lead professional within social care teams, community health services and Young People's Drug Treatment Services.

Step two - Multi agency case planning meetings involving local managers to commit to the necessary resources, including the use of the CAF and Team around the Child discussions supported by Locality Teams. At this level local managers may need to refer to PCT commissioners and senior managers within Education and inclusion or Children and Families if additional resources are required.

Step three - A local group to consider those situations where suitable care can not be provided locally even with additional packages in place. This local group may only develop as the County Council and the HPCT is able to allocate additional funds to support local services in the same way JENI joint funds operate. In the interim it is likely that all situations where existing services are unable to meet assessed needs will be referred to the next step in the process - a county panel.

Step four - A county wide panel to consider any cases where agreement can not be reached at a local level and for consideration of funding for residential care and purchased education placements. This panel will include a PCT commissioner, a Social Care manager and the appropriate Education Manager, including the County SEN team as necessary.

Agreement has been reached on what constitutes a health, social care and education need and each commissioner will fund the intervention that meets the assessed need for each child and young person

In considering each application the panel must be satisfied that the level of care intervention required for each case falls outside the service specification of existing providers commissioned by the HPCT or HCC.

The panel will notify commissioners of any emerging trends which could suggest a gap in service provision that may require a strategic response.

2. Progress with pooling existing staff resources to facilitate joint commissioning work

The phase 2 of the Comprehensive CAMHS Commissioning Trust has been approved by chief executives of HCC and Hampshire PCT and commenced on April 1st 2008. The new pooled budget now embraces commissioning funds for more CAMHS tier 2 and 3 services based on service budgets agreed to date, as set out in the table below:

During the course of 2008/9 further service commissioning funds will be contributed to the pooled budget as detailed analysis of service figures

is completed. Service commissioning funds to be contributed are as follows:

· Specialist CAMHS New Forest and Southern Parishes of Eastleigh

· NH specialist CAMHS

· SE specialist CAMHS

· Winchester, Andover and Eastleigh specialist CAMHS

Consideration will be made as to whether to commission the behaviour support team from the pooled budget after the planned service review.

3. Steps being taken to address variable waiting times for initial assessments across the county.

Baseline waiting times figures for all specialist CAMHS teams are being collected. Teams where there have been difficulties with waiting times, where this has been unrelated to high vacancy rates, are trialling the choice and partnership approach. This is a model of service delivery where all clients are offered an initial appointment within 2 weeks of requesting it to clarify needs and consider possible service options in partnership with the service user. Early indications are positive about the impact this has on experience of services being responsive to client needs. This is being evaluated through the course of the year.

The area with the most significant challenges in relation to waiting times due to staff vacancies is north and north east, where the disaggregation of the specialist CAMHS teams from Surrey provision has lead to reduction of staffing to serve the Hampshire population. This is being worked upon by the provider, and should be resolved by the autumn.

4. Steps being taken to facilitate transition to adult health services at 18

In January 2007 a new set of principles for good practice regarding service involvement and transition for 16 to 18 year olds in Hampshire was agreed. The existing 5 transition protocols were too variable and not in line with current guidelines and information from service users about how services needed to support them. These were all planned for review in the light of the new good practice principles. The reorganisations and changes in staffing within Hampshire PCT, Hampshire Partnership Trust, HCC Children's and Adult Services affected the planned protocol reviews, such that this task remains to be addressed. The joint mental health commissioning board will be considering the position regarding CAMHS to adult services transition in June, whereupon a process will be agreed for enhancing the consistency and suitability of transition practices across the county.