This content has been automatically generated from the original PDF and some formatting may have been lost. Let us know if you find any major problems.
Text in this format is not official and should not be relied upon to extract citations or propose amendments. Please see the PDF for the official version of the document.
Children, Education and Home Affairs Scrutiny
Panel
Government Plan Review
Witness: The Minister for Children and Housing
Friday, 30th October 2020
Panel:
Deputy R.J. Ward of St. Helier (Chair) Deputy T. Pointon of St. John
Deputy M.R. Higgins of St. Helier
Witnesses:
Senator S.Y. Mézec , The Minister for Children and Housing
Mr. M. Rogers, Director General, Children, Young People, Education and Skills
Mr. M. Owers, Director, Safeguarding and Care
Ms. S. Devlin, Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills
Ms. A Stamper, Treasury
[10:01]
Deputy R.J. Ward of St. Helier (Chair):
Okay, good morning, everybody and welcome to the hearing with the Minister for Children and Housing and this hearing is regarding the Government Plan, so we will be focusing on the points from the Government Plan. We have got an hour and a half and we will start with some introductions. I am Deputy Robert Ward , and I am the chair of the Children, Education and Home Affairs Scrutiny Panel.
Deputy T. Pointon of St. John :
Trevor Pointon, Deputy of St. John . I am a member of the panel.
Deputy M.R. Higgins of St. Helier : Deputy Mike Higgins, member of the panel.
The Minister for Children and Housing:
Senator Sam Mézec , Minister for Children and Housing.
Director General, Children, Young People, Education and Skills:
Mark Rogers, director general for Children, Young People, Education and Skills.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Susan Devlin, group director for Integrated Services and Commissioning within the Children, Young People, Education and Skills Department.
Deputy R.J. Ward :
Okay. Is there anyone else who may be speaking today?
Ms. A. Stamper:
Anna Stamper. I am in Treasury, supporting C.Y.P.E.S. (Children, Young People, Education and Skills).
Deputy M.R. Higgins:
The other Mark looks like he is frozen. Mark Owers who is the director of Safeguarding and Care is attempting to join us, Chair.
Deputy R.J. Ward :
Okay. Hopefully we will get him in presently. Okay, if we start off with some general questions. Minister, can you confirm the amount of departmental-based budgets from C.Y.P.E.S. that you hold responsibility for?
The Minister for Children and Housing:
So that is next year due to be £29.469 million.
Deputy R.J. Ward :
In the Government Plan on page 131 it does seem to suggest the ministerial allocation for Children and Housing in 2020 is £31.169 million?
The Minister for Children and Housing:
Yes, so that includes some of my Housing portfolio, I think. So your question asked for what is the C.Y.P.E.S. allocation.
Deputy R.J. Ward :
That is good. That is exactly the clarity that we want. How is that budget for 2021 broken down between the various services that fall under your remit?
The Minister for Children and Housing:
I can give you a long list if you would like and that would be more helpful I think on paper, but I can give you some headlines from that anyway. The largest part of that, which is just over £9 million, goes for looked after children. Following that children's management and admin is £4.5 million. Beneath that children's health and well-being is just under £4 million and things like safeguarding just under £2 million. I can give you every single penny for that if you would like, but that might be more helpful on paper.
Deputy R.J. Ward :
Yes, I think it would. That is great, thank you. How does that compare with the remit in 2020, the amount that was available to you?
The Minister for Children and Housing:
I think it is slightly more, so in the course of the Government Plan that was approved last year, so 2020-2023, my budget was due to go up a little bit each year, so I think I ended on something like £33 million per year starting from around £28 million or £29 million, so on that plan it was due to gradually increase.
Deputy R.J. Ward :
Okay, so the ministerial allocation in the Government Plan for 2022, 2023 and 2024 is £52.14 million so is that an increase in the Housing budget? I know this is not a Housing Scrutiny hearing but because of the 2 roles, or is that an increase in the C.Y.P.E.S. proportion of budget?
The Minister for Children and Housing:
There were increases in both, so under the last Government Plan I secured extra funding for some bits and pieces we were looking at, like the care leavers' offer, for example, that there was new money in that sort of thing, but there was also new money for some things on the Housing side as well. In this round of the Government Plan the most drastic reprioritisation, I will call it that, is on the
Housing side, so the numbers when it comes to how we have changed things are smaller on the Children side than the Housing side.
Deputy R.J. Ward :
Without giving anything away to other Ministers who may face this panel, I will be asking them probably similar things: are you confident that any extra monies will be able to be spent in the year allocated? I ask that because there are a number of allocations of budget in the Government Plan, which I could be cynical and say it is a rather dark art in terms of the allocations of unallocated monies, and I just have concerns that we could allocate money early on in a really changing situation regarding COVID, for example, and it not be spent and then just be lost back in government coffers.
The Minister for Children and Housing:
I am trying to think of the most helpful way to answer that question. It is the case that money that was allocated for this year, 2020, we were just simply not able to spend and that is with the best will in the world. It is just how it is. If we could have spent it, that would have been a much better place for the world to have been in, but things like we are just probably not going to be able to recruit the intensive foster carers based on the timetable we plotted out at the start, for totally obvious reasons, because people's lives have been turned upside down in many instances because of the pandemic. In this year there was money that no matter how hard we tried we just could not spend. If you are asking whether I anticipate that to be the same next year, I certainly hope we are able to spend everything that we are intending to, but I have the worry that many other people do, that we are not out of the woods yet with the pandemic and if we did have to have a second lockdown or things got substantially worse here in the way that they are in the U.K. (United Kingdom) that would inevitably mean that our ways of working would be changed and that would not be ideal. It would hopefully be better than last time because we have already been through it once so we know how to adjust some working patterns, and also a lot of the dedicated time and resource that went on to emergency legislation this time round would not necessarily need to be repeated, so I would hope it would not be as bad next time, but that is a risk that I presume every Minister would say there is in terms of our ability to do what we want next year. I would say it is better to have too big a budget and not be able to spend it than not enough budget and needing more.
Deputy R.J. Ward :
The other question I suppose that leads from that - there are 2 points - are there points during the year, such as March, June, et cetera, where you review the spend that has happened and make plans for what may not be spent, and therefore have the opportunity as Minister to perhaps reallocate that in some of the projects that were delayed or, I forget what the phrasing now is used in the Government Plan for delaying them, rebalancing, who knows. Some of those projects, which others would see as priorities and urgent, if the opportunity arises: "We cannot recruit these people. We have this allocation of money. We could be getting on with this instead", is that within a remit of a Minister to be able to do that?
The Minister for Children and Housing:
It is, and that happened to a degree this year anyway, where business cases were put together for extra funding and that went through a process, a process we were not necessarily anticipating we would have to go through, but when it became clear that some extra funding was needed for X, Y and Z they did put together a method by which that money could go, and that would have gone through Treasury, so that was not purely an internal thing in C.Y.P.E.S. I do not know if that is the angle you are asking from in your question, if you can do that purely internally.
Deputy R.J. Ward :
I think it is a question of what control you have over your budget. It is allocated to you in the Government Plan, but if it has to go through Treasury each time - I do not want to go on too long because I know we have got a lot of questions - but I worry that we lose this effectiveness of the oversight that you should have of a department and what you want to be getting done in those terms.
The Minister for Children and Housing:
Yes. I think there is an important point in that, though, that the money is allocated to me and my department through the Government Plan, but it is done through the Government Plan to achieve the purposes of the Government Plan. So if the purposes are going to change for whatever reason, whether it is pandemic-related or a need is identified elsewhere that has to be addressed, then there will be a process for going through that. It would not be right to give Ministers complete freedom once a Government Plan has been signed off to just unilaterally rewrite it because they fancy it. There does have to be some accountability in there to make sure that if they are reallocating money that they are doing it because it is needed and it is appropriate.
Deputy R.J. Ward :
In terms of the funding pressures this service faces, are they being addressed by the Government Plan and can you give some examples of how that is the case?
The Minister for Children and Housing:
We were lucky in that we are a growth area. I say "luck", it is not luck, it is deliberate because children needed to be a growth area. There have been further bids made to get extra growth in that. In the process of working out what goes into this part of the Government Plan I sat with my officers and said: "Right, what are our options for how we do this?" and where most attention was needed I would have suggested that that is where the attention goes, and when it has come to rebalancing or re-profiling, or whatever it is at the early stage of this when everything was on the table the first
thing I did was say: "Right, well, any of these that are going to be problematic for services that are our priorities take them off the table now." That was a discussion had relatively early on in the process to make sure that where there are areas of pressure or areas where there is agreement there needs to be greater funding or greater support. Those were just taken off the table to not be considered any further and that the considerations would purely be on the areas where we could make changes that would be okay.
Deputy R.J. Ward :
Are there other sources of income that the department has and are there any envisaged during the Government Plan period, i.e., additional income?
The Minister for Children and Housing:
There is income that comes to us, and I describe it as peanuts in the grand scheme of things. There is a small amount of money in rent that there is from Thomas House and I think that comes either from Income Support or as residents there paying a rent amount. £6,000 is a pretty low amount and so it should be for that sort of facility. There is also budgeted for £23,000 of income, which again when you compare to any other government department is pretty much nothing. I do not know if any of the officers want to outline exactly where that comes from but you can see it is a relatively small amount. We are not reliant on what some might term customer services to get income to fund our operations.
[10:15]
Deputy R.J. Ward :
I think we have taken our 15 minutes on this for general ones. Deputy Pointon, do you want to ask some questions on the C.A.M.H.S. (Child and Adolescent Mental Health Service) redesign?
The Deputy of St. John :
That is the plan, Chair. I will move to C.A.M.H.S. now. Minister, why has no funding been identified for the C.A.M.H.S. project in 2021?
The Minister for Children and Housing:
The C.A.M.H.S. redesign is not a new idea. It is something that has been on the table for a bit now, so it is not a unique, new idea post-COVID and there are substantial amounts of extra funding due to go in from 2022 onwards. Hopefully you have got access to the figures from that, just below £2 million next year and then rising to £2 million and a bit after that. There is still work that has to be done on the behind-the-scenes arrangement for that service redesign. It is not the case that we can simply turn it on now and have it fully operational, but there is work that goes on to achieve that, not just on my side of things but with wider Department for Health and Community Services and Minister as well.
The Deputy of St. John :
Is what you are saying, that existing budgets are managing this development work?
The Minister for Children and Housing:
We have added to existing budgets to get to the point of being able to do that work. It is previous Government Plan stuff as well that is contributing to that. It was not what was operational budgets before then.
The Deputy of St. John :
So we are saying that there has been an allocation of funds to proceed with this development but it is not being declared for 2021?
The Minister for Children and Housing:
I do not know if Susan wants to provide a clearer answer than I can to that.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Thank you. For clarity, Chair, the panel and Deputy Pointon, there was £500,000 in last year's Government Plan for C.A.M.H.S. so we have been using some of that money for the development and that will be the additional fund that goes forward into 2021. We are also trying to work hard with colleagues in H.C.S. (Health and Community Services) to look at some addition to that possibly. We are looking at that to see where else we can get anything from, then the bigger pot of money for the redesign will come in in 2022. The £500,000 will allow us to get started on that, so I had a couple of sessions with team members and the commissioning officer, who has been involved in the big scale redesign work that this panel knows about, so we were looking at prioritising how we spend that £500,000 in 2021 to try to push us forward towards the outcome we are looking for.
The Deputy of St. John :
So what was not spent in 2020 that enables you to move £500,000 into 2021 but not show any account for it?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
It is shown. It has been shown in last year's Government Plan and that is rolling forward. It is under C.S.P. (Common Strategic Policy) 2, Deputy , and was sitting with H.C.S. under health and well- being. You will see under that section in the Government Plan for mental health there was £500,000 for C.A.M.H.S.
The Deputy of St. John :
Okay, thanks for that. Moving on to the practical stuff, how many new roles are anticipated to be created as a result of this additional expenditure in 2022 and 2024?
The Minister for Children and Housing:
I am trying to find that in my notes but someone jump in ahead of me.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Certainly I can help, Minister, if you would like. At the moment we are still working on precise numbers. We have worked up the budget on a range of posts. That was ahead of the final outcomes of the redesign, so what we know is we are going to put posts into early intervention, some into what I would describe, and this is one of the areas you may want to cover, specialist C.A.M.H.S.; so the existing C.A.M.H.S. team and then into intensive support. We have not settled on a final figure because I want to do some work with the clinical staff to see exactly what number of nurses is best, what number of different practitioners. What I do know is I want to add an additional 2 team managers because we need to get team manager capacity in there. We also need to add support workers but we are just finalising and working through the exact full-time equivalents of that. What I would say is it will be fairly significant. We have a relatively small C.A.M.H.S. service at the moment if you compare it with C.A.M.H.S. services in other jurisdictions. I could probably see us almost doubling in size in terms of the full-time equivalents.
Deputy M.R. Higgins:
Can I just jump in there and say it is still a work in progress and you do not know exactly how many staff you have? Do you have the budget that will cover that?
The Minister for Children and Housing:
We put in for a substantial amount of extra budget. It is millions of pounds recurring year-on-year and so that means we have got an extremely good starting point. If it turns out we get halfway through next year and decide we would like to push for a little bit more we have got the flexibility to do that because we will be going through this whole process again the same time next year. We have got something that if the Assembly agrees is an extremely good amount of money to meet those aspirations, but the fact that it does not kick in until 2022 means that if it turns out we want or need more we can go to the next part of the Government Plan next year and bid for even more without risking losing what we have already got. That is just one of the advantages of this way of doing government finances now.
Deputy R.J. Ward :
Can I just ask a quick question there? When will service users see an improvement? When do you think that somebody who needs to use C.A.M.H.S., a young person, will be able to walk in and say it is better than it was?
The Minister for Children and Housing:
I hope that is happening all the time. At this point the jumps will not be as good or as far as they will be when we are in the position to flick the switch and turn the new system on, based on that redesign, based on those new people coming into post. The system itself when it realises that there are things within our grasp to improve on is not going to stand still for the sake of that. We know that there is something more fundamental underpinning that change that is necessary and it just takes a while to get to that point.
The Deputy of St. John :
It is noted, Minister, that the redesign would improve and refocus the C.A.M.H.S. service as a specialist service. What are you intending to do to ensure that general services are available for people who may have low level needs in the community? I am thinking about the Adult Mental Health Services now have facilities like the Listening Lounge and so on. What are the plans for this lower level of need among children and adolescents?
The Minister for Children and Housing:
I think that is part of the whole rationale behind this piece of work in that the specialist focus on people entering the C.A.M.H.S. service as it is with a gap of what ought to come before it, that if you can focus on that early intervention and support before it would otherwise be necessary to go to C.A.M.H.S. then that is the ideal way of doing it and that is the point of this piece of work. In terms of physically what that will look like, there is still some more thinking to do on that, but there are things they can include, like extra support in schools. When I speak to head teachers that is one of their big concerns, not having facilities within the school where those children are spending most of their day that they could benefit from there. It could mean expanding certain things to a 7-day service instead of a 5-day service. It is those sorts of things.
The Deputy of St. John :
You surprise me that you say there is not a great deal of support in schools.
The Minister for Children and Housing:
That is not quite what I said.
The Deputy of St. John :
There is a well-established school counselling service that is referred to as being the lynchpin for children in schools. Why is that not providing what you are discussing now?
The Minister for Children and Housing:
You started off not quite saying exactly what I said, but what I said is I have conversations with head teachers every now and then when I visit schools and I have some good conversations about broader things that they are concerned about. When I have most recently spoken to a head teacher it was not necessarily that part of the model that they were concerned about; it was simply about the workload and the fact that there is an increasing demand for that. You can have a good model and that is fine but if the number of people needing to access it is greater than what you are capable of meeting, or capable of meeting in a timely manner, then you have got to look at it anyway. I think that the concern was more about just the sheer number of young people needing that support and making sure that if they get it as early on as possible it means that things are less likely to escalate to a higher level or end up with some of the C.A.M.H.S. specialist services. Ideally what we want is for people to never get to that point so that the focus can be as effective as possible at all levels.
The Deputy of St. John :
Given there is obviously a need for an alignment between school counselling service and C.A.M.H.S., are there any plans to integrate the 2 to ensure that there is a seamless service delivered?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
The point about early help being expanded is a really important one. You will see from the Government Plan paperwork that by the end of this Government Plan we will have £750,000 a year going into early intervention. The panel will also well know that our early help offer has been fragmented and insufficient for mainstream issues and for emerging mental health and well-being issues. That is absolutely one thing that we want to tackle. We are not planning to integrate the service into one with C.A.M.H.S. and some of those more psychological or school counselling services. I think our departmental target operating model has us working very closely together and for children and families the point of them being best able to access the right kind of help at the right time is through the new front door, which as the panel knows we accelerated and brought in, in March. That offers a new triage point. We have been able to put a member of C.A.M.H.S. staff just in the last couple of weeks into that hub, that front-door hub, who can offer consultation for colleagues and staff across a range of agencies and services, but also to children, young people
and their families. What we want to do is make those links of the new burgeoning family and community support service sit alongside a C.A.M.H.S. early help service, that early intervention service, which can have a bit more specialist focus on the mental health issues that are emerging and let the more specialist team at C.A.M.H.S. deal with those much more where children are unwell or at crisis point. It is about boosting those upstream services and managers and staff working well together. You have heard me talk at this meeting before about the practice model of Jersey children first, where we have people working in a team around the child with a lead worker, and hopefully that gets people really clear about roles and responsibilities and meeting need. We are pushing hard on that now and we have just gone back with updated training on the virtual college for staff. Hopefully that helps plan those things.
[10:30]
The Deputy of St. John :
Where is that front door that you are talking about?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Do you mean physically where it is based?
The Deputy of St. John : Yes.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
At the moment it is based in Liberty House, and that has been a pragmatic decision during lockdown. Sorry, Minister, I should have asked if you were happy for me to answer that.
The Minister for Children and Housing:
I was going to say exactly what you just said, so that is fine.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
It is based in Liberty House. It is alongside the existing M.A.S.H. (Multi-Agency Safeguarding Hub) facilities and resource and we have been able to do that through lockdown. People are also working at the end of a phone where appropriate, but of course the front door now takes place at an earlier stage than M.A.S.H. M.A.S.H. is behind that and is a process dealing with safeguarding, so the front door is in Liberty House. It is open to staff, it is open to members of the public to make contact by e-mail or phone and the triage happens at an earlier stage, so we are able to get many more people through early help.
Deputy R.J. Ward :
So if somebody has a mental health issue with their child they go to the same place where there could be a M.A.S.H. meeting about the family?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
They go through the same process for referral or seeking assistance. It does not go through the same process as M.A.S.H. M.A.S.H. is a much more ...
Deputy R.J. Ward :
I know it is not the same process but it is the same place. Do you have concerns that the 2 could be associated and that families may not go for mental health help because they may feel "threatened", and I am sure there is a better word than that, by the process? That is an issue that we have raised before. I know we are getting a little bit off Government Plan, but if the redesign amplifies those connections I think it is very important that is considered.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Absolutely, Chair. That is absolutely one of our considerations and the front door being based in M.A.S.H. has been pragmatic as we have been through the COVID process. It would be our intention that that front door is seen to be separate, and indeed is separate. For the moment it is how we are making best use of our resources but yes, you are right, we know that people have talked about the stigma of being M.A.S.H.ed and we are working hard to get away from that. We want people to understand that the only things, to use the terminology, being M.A.S.H.ed is a very small number where there is concern about protection or safeguarding issues. We have been trying to work quite hard at the message around that, but that is something I think that will take a bit of time to permeate and also it will be people's experience.
Deputy R.J. Ward :
As you go through the redesign, would that be one of the things that you could consult with relevant organisations, young people and families about?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Yes. We have involved 100-plus stakeholders in the C.A.M.H.S. redesign work, which has included all the relevant governmental services, first sector organisations, and children and families. They are quite keen that this takes off and works well.
The Deputy of St. John :
Okay, I will move on, Chair. Having found your way through the front door, and being referred to C.A.M.H.S., how long does it take firstly to get an assessment appointment and what is the caseload for C.A.M.H.S. mental health nurses, specialists?
The Minister for Children and Housing:
I am just looking to get those numbers in front of me to make sure I get them right. At the end of September there were 74 individuals aged 17 on the C.A.M.H.S. caseload and 36 aged 18. You asked about waiting?
The Deputy of St. John :
Yes. What is the wait time for the initial assessment and then the wait time for a link with a person who is able to offer treatment support?
The Minister for Children and Housing:
I did have this in front of me. Sorry about this.
Deputy M.R. Higgins:
Can anybody help you while you are looking?
The Minister for Children and Housing: Yes, if that is possible.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
What I can say to you is that currently we have got the waiting lists down. I think we had something like 100 at the beginning of September. The longest person on the waiting list was referred in June and we are now down to 29 people on the waiting list. That is because we have had some additional resource responding to COVID monies. C.A.M.H.S. received some COVID monies in relation to trying to get through backlogs. The caseload has been increasing for the whole of the service over the last 3 years or so and the caseload has sat most of this year at around the 800 mark. That has, give or take a bit, gone up and down. There has been some quite robust managing of caseloads. If you just excuse me while I get that figure.
Deputy Pointon will be very aware of the concept of triage, but is that an initial triage process of just seeing somebody, you can then tick a box to say: "We have seen somebody in C.A.M.H.S. and they are in the process" but the second, third, fourth or fifth follow-up appointment could be much longer, or does that include those? One of the issues is not simply saying: "Well, we have seen somebody." It is the quality of the care and it is getting them through a process with C.A.M.H.S. and being absolutely transparent about what that means. I think that needs to be asked as well in terms of waiting times.
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
There is quite a variance in the amount of time between referral and treatment, so getting triaged is relatively quick. Some people will then get a service quite quickly because of their need and if it is urgent they will get something within a day or 2 and then they will start treatment. In 2020 the largest gap that we had between being referred and receiving C.A.M.H.S. services was 108 days. Now I must stress that that is the largest and there are not many people sitting at that, and that is why we are using the resources that we have been given through the COVID monies to try and get into that. We do understand that being triaged is one thing, but the main thing is about getting treatment and we are doing a lot of work on our pathways in that respect. What we are also trying to do, and we have been doing that as recently as this week, is saying that if we triage people on the waiting list but they are going to have a little bit of a wait for treatment can we use some of our partner agencies to at least offer some support, whether that is family support, some practical assistance, some counselling, that we will do that and we are looking to do that with some of our partner organisations, whether that is Mind or the Y.E.S. (Youth Enquiry Service) Project.
Deputy R.J. Ward :
Sorry to interrupt. The figures that you will give us on waiting is for the initial triage appointment?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
It is the people who are now waiting for treatment. There are 29 waiting for treatment.
Deputy R.J. Ward :
I wanted to be clear with numbers because there a lot of variables within those numbers. Thanks.
The Deputy of St. John :
Yes, and I am presuming for the numbers to decrease in terms of wait times you will need to increase the practitioners available to become involved with these children?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Yes. We have brought a number of practitioners in as part of that COVID money. That has been quite challenging because clearly some of those practitioners have had to be recruited from the U.K. and before they can get started they have had to follow the COVID measures in terms of self- isolation, et cetera. We need more people to provide more opportunities for treatment.
The Deputy of St. John :
Are these people that you have recruited permanent staff or are they agency staff?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
No, the COVID money is temporary, so we can only recruit them on that basis. That is then what we are going to do for the future, redesign getting to that larger, permanent establishment within C.A.M.H.S. because we know that we need to offer a bigger and broader range of services.
The Deputy of St. John :
I am avoiding breaking down the specialities. What do you think the rise in numbers of personnel is going to be, given £1.75 million and £2.25 million up to 2024?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
I think there will be a mix. We will need some nurses, we will need some psychologists. We are going to probably set up a number of the posts as mental health practitioners that will require or at least the specification will allow for different professional or clinical disciplines. It could be a social worker, it could be a therapist of some kind or it could be a nurse, because, pardon the expression, we want to fish from different pools rather than setting our store just on nurses, just on social workers. What we do know is that family therapy has been a burgeoning area for us and we know we absolutely want to increase that capacity. We are looking to put a couple of family therapists into our early help service in an effort to try to do some of that work with families to help them build their own skills and knowledge and help facilitate them to work through some of their own issues. There will be a mix, Deputy .
The Deputy of St. John :
You have already spoken about needing 2 managers. Will those managers be clinically qualified people? Will they make a contribution to supervision, therapeutic supervision, not just managerial supervision?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
Yes. C.A.M.H.S. staff require clinical supervision from somebody who is qualified to do that. Our psychologists are clinically supervised by the appropriate person, likewise nurses and we have lead nurses in place. It certainly is our intention that the team managers will be professionally and clinically-qualified people and they will of course be expected to do the operational management and the day-to-day running of the service but we need that addition.
The Deputy of St. John :
Is it possible to outline your thinking in relation to improving the quality and performance management of the service in the future?
Group Director, Integrated Services and Commissioning, Children, Young People, Education and Skills:
The additional team managers will be part of that improving the quality. We also intend to have somebody with a lead responsibility for quality assurance and performance within the C.A.M.H.S. team.
[10:45]
That has been an area that we have absolutely identified for improvement and we will have some analytical capacity added to the service so that we can ensure that we use that kind of business intelligence to assist with running the service, to highlight gaps, to flag need, all those kinds of things. We will have that there. We will also have a head of service, a third-tier level, head of health and well-being, that is a new post, who will have senior responsibility for the C.A.M.H.S. service and who will report to me as the group director. We are really enhancing and making robust those management arrangements and really having a focus on quality assurance and as part of that we will want to hear and act on the children and families' voice within the service.
The Deputy of St. John :
Thank you for that. I have a final question which has been tabled by Jersey Cares and that question is: in order for children, young people, their families and relevant organisations to comment on the service redesign and contribute to it, can information about it please be made available in languages and a format which is accessible to those people who require use of the service in future?
The Minister for Children and Housing:
In principle certainly, and if Jersey Cares have specific concerns about that or want to engage with us about what is the most effective way of getting that sort of message out there then obviously we are more than happy to do that.
The Deputy of St. John :
Thank you, Minister. I am going to hand you over to Deputy Higgins now, who has some questions on the Public Services Ombudsman.
Deputy M.R. Higgins:
I know this is not your area of responsibility but I am sure you have an opinion on it, seeing as the Public Services Ombudsman was part of the Care Inquiry recommendations. Can you tell me what your view is on the delay in bringing this service into being?
The Minister for Children and Housing:
The short answer to that is I am not very happy about it. It is absolutely right that a Public Services Ombudsman is set up in Jersey. We have had it pointed out to us more times than we ought to have that the current system for people pursuing complaints about the delivery of public services to them or their engagement with the service is not good enough and that the States of Jersey complaints panel system is not robust enough for people to have, firstly, the confidence that it is worth engaging with a system like that and confidence that whatever results from those complaints processes will be dealt with seriously and appropriately. To be in a situation now where something that is really important for the public of the Island and people who are let down by services from time to time be delayed is something that I am not pleased about. I would much prefer that we were getting on with this sooner rather than later and having it implemented and open and receiving complaints and doing the work that we would want it to.
Deputy M.R. Higgins:
Can you tell us, if you can, what discussions have taken place in the Council of Ministers on this? At the present time it is proposed that the operations will be delayed until 2022 and further on in the report it explains that there are further gross savings to be applied over the course of the proposed Government Plan, which could delay the start until 2025. Do you think that is acceptable?
The Minister for Children and Housing:
No, but you have asked what discussions the Council of Ministers had. The Council of Ministers had lots of very difficult and sometimes quite unpleasant discussions about how things were going to be reframed, reprioritised, cut or all sorts of things in putting this Government Plan together. In the early days things were on the table that people would shriek at if they knew were being, I say "considered" but they were not considered; they were just put on the table as discussion items and
I do not think you will find any Minister that is happy that something like this has happened. I do not think that there are people who actively wanted to volunteer and this is something to be delayed. As you said, it is not my portfolio so I did not have the authority to unilaterally take it off the table or anything like that; it falls to others to do that and it just happens to be where in the grand scheme this has fallen and it will be down to others to judge whether this is part of our having to refocus things in a post-COVID world and having to accept that our workstreams have been disrupted very severely by COVID. Even with the best will in the world there has been work that we want to do that we cannot do, that has had to be delayed purely because the people have not been able to be on the ground doing that work. It will be up to others to decide whether this was inevitable or whether it could have been done differently. I think everybody will agree that it is not a good thing.
Deputy M.R. Higgins:
I am going to leave it at that because we are running out of time. Thank you.
Deputy R.J. Ward :
The next one is about the redesign of the therapeutic support model for children with complex needs. Minister, can you elaborate on the rationale behind the decision to move to a pop-up assessment unit? This is a change from the last Government Plan, which had a specific unit being developed for these complex needs. Perhaps you could also give some picture for those who might be listening about what is meant by complex needs in these circumstances.
The Minister for Children and Housing:
We knew that there needed to be an improvement in therapeutic pathways for looked-after children and work was done to consider how that might be delivered and how there could be some sort of therapeutic residential care unit for the small number of children that might need that. Time has gone on, more thinking has been done on that to assess what could be the most appropriate way of delivering that. There are different ways of thinking on this, about whether you would want people essentially to be moved from one place to another specifically for this, rather than to be where they otherwise were and where they might have been comfortable and where they might have had other things in their life and the stability that is incredibly important for young people going through the care system like that. Another think has been done on it to work out what would be most appropriate there. I see Mark Owers is there. I do not know if he wants to add anything to that.
Deputy M.R. Higgins:
Before he does, can I just ask the question: what about those who have not got the stability where they are at the present time and would benefit by being in a permanent unit?
The Minister for Children and Housing:
We want them to get stability but it is not just stability for this part of their life; it is stability for everything else that goes with that as well. Where you are based, where you are living and who is looking after you, whether it is foster carers or whether it is in residential care, the whole package has got to be what is best for those young people and it is possible that a further disruption could be counterproductive.
Deputy M.R. Higgins:
Hope House, which is being operated by Silkworth as part of an addiction centre, also was reported as having facilities for children who have got various mental issues, and I am assuming some of these complex needs may fall within that. Is that being funded by you, is this totally separate or why are they doing it and not you?
The Minister for Children and Housing:
The short answer is I do not know the answer to that exactly. I would have to have a think before answering that. I do not know if any of the other officers have any views on that.
Director, Safeguarding and Care:
Minister, I can answer that in part for you. Good morning all. The third sector in the Island are obviously free to deliver the services they see fit. That is being entirely funded outside of Government and at this stage it will not be provision that we will use for children in the care of the Minister.
Deputy M.R. Higgins:
Can I just say that in that case if they have identified this use is that suggesting there is a failure on your part to deliver this service?
The Minister for Children and Housing:
I do not know because I am not involved in the discussions that took place for them to set that up. I do not know why they felt as a charity that that ought to be their focus. Perhaps I should go and have that discussion with them to understand that better. We have got our programme of work, of things that we know we want to deliver as a service. That is what our focus is on and that is how things fit into our plan. I am happy to have a discussion with others outside who might have a different perspective on that but it is not a discussion I have had so far.
Director, Safeguarding and Care:
In respect of being able to provide the right number of places in residential settings, we do not at this time have young people sitting waiting for provision that we are not providing. We have capacity in our own homes and of course when we cannot meet particular needs we have the option which
we use reluctantly of placing off-Island when we need to. The Silkworth provision is not replacing need that we would not be meeting in respect of social care provision.
Deputy R.J. Ward :
I recognise that some other people have raised their hands but I have just got a couple of other things and perhaps you can answer them. One of the key points about this change is that a needs assessment was undertaken to identify the manner in which the service would be delivered. We commented in a report on the Government Plan last year that certainty was required as to the shape of the proposed service. Who was consulted during this needs analysis in order to determine this proposed change?
The Minister for Children and Housing: Mark, do you want to take that?
Director, Safeguarding and Care:
Thank you, Minister. Deputy , it is a bit more fluid in that what we want to be able to do is provide the right therapeutic support at the right time in the right setting based on need. At the moment across the children's homes that we deliver as a government we are not able to provide the right level of therapeutic support. What we want to be able to do is use this investment money to both use a said building to provide the therapeutic support, i.e., a therapeutic children's home, but at the same time if we have 2 people there and a third person needs to come in, but it is inappropriate for them to be placed alongside the other 2 because of their complex needs, we would want to be able to place them in another of our children's homes and to provide them with the same level of high therapeutic support. The suggestion is that while we would, out of all of our children's homes, have one that took the highest end of need we also need to be flexible and agile enough in a small jurisdiction, which is defined by the sea, to be able to identify and present need to all of those that need high-end therapeutic support rather than having to look off-Island. It is a blend of both a building that is able to meet the need but also to be able to meet the need of children in other buildings.
Deputy R.J. Ward :
Okay, so the phrase "pop-up assessment unit" refers to putting increased resources for a specific individual with complex needs into already existing children's homes or accommodation? Is that what you are referring to?
Director, Safeguarding and Care:
It is. That is what we are talking to. In the Government Plan the paragraph is not particularly long, so it does not explain it in that full detail but it is the ability to have a standing resource and to be
able to provide therapeutic wraparound support where a child needs that. That is not just critically in a residential children's home. It is also when we step that child back down and when they are reunited with their birth family. It is also on the edge of care, as well as within fostering and adoption placements. It is a much more specialist resource than that which we were able to define in the Government Plan in the first instance, but we still need to have therapeutic children's homes.
Deputy R.J. Ward :
At the same time there is a £200,000 saving. That relates to rent, accommodation, staffing costs or ...?
[11:00]
Director, Safeguarding and Care:
Yes it is in that we already have provision and with the bringing on line of the intensive fostering service, which of course is also in the Government Plan, which is not seeing any reductions, we are projecting that we will need fewer residential placements but we still are already paying out of our base budget for those residential spaces for the buildings. The reduction is in respect of how much it costs to run a building as opposed to the therapeutic support that we will be providing children and their families.
Deputy R.J. Ward :
You are absolutely certain that this change will give a better service that better meets the needs of people on the Island for a lower cost simply because you do not need to run a specific separate unit?
Director, Safeguarding and Care:
I am saying we will be running specific separate units as well as the pop-up wraparound support where children and young people need it based on their care setting. I am also saying that that £200,000 reduction will not impact on the service quality and in fact because of the broader review of children's homes and our therapeutic support, which also incidentally does link in with the work that Susan has already been talking about, I am absolutely confident that we will be providing a better service that is more therapeutic in intent for children and families in the Island.
Deputy R.J. Ward :
What is the timescale for reviewing the appropriateness of those changes?
Director, Safeguarding and Care:
There is no doubt that slipped because of COVID. You are aware as a panel that we have had an independent review of our children's homes that is just about to report to us. We are also looking at the support we provide within family intervention support services, which is being done up until the end of this year. We hope to have the full specification ready by March at the latest.
The Deputy of St. John :
Can I ask, Chair, that the repeated reference to therapeutic services, I am wondering what training your existing staff are going to receive. Will that be trauma-informed training and will you need to recruit people with specialist skills into the roles that will be needed with these children with special needs?
Director, Safeguarding and Care: Minister, do you want me to take this?
The Minister for Children and Housing: Yes.
Director, Safeguarding and Care:
It is important to say that, within the overall approach that C.Y.P.E.S. is taking as one department, we are looking at the way in which we provide clinically-governed support. So i.e. through C.A.M.H.S. by psychiatry and psychology colleagues that sit within the C.A.M.H.S. framework and as they relate to the governance provided by H.C.S. Then, within that, we are developing what is called therapeutic-informed social work. We will have social workers, some of whom already have qualifications in D.D.P. (Dyadic Developmental Practice), which is well known within the care system world, developed by Dan Hughes. So there is the element of being accredited as a supervisor and then level 1 and level 2, and we have some of that accreditation already and we have booked training with one of the U.K. leaders in that early next year. We are looking at the enhanced case management system by the T.R.M. (Trauma Recovery Model) Academy, which is essentially an arm of the Welsh Government who have developed trauma-informed working within a youth justice setting. That is so that we are able to consider children's needs through a developmental trauma lens. So i.e. the way in which their brain has not developed in the same way because of child abuse and what that then means to the way in which sometimes they are presenting in an antisocial behaviour on the street, which then leads them to get into trouble with the police. What we want as an Island is to have trauma-informed services, primarily of course within children's social care and within education, but also across the partnership. Deborah McMillan has funded some training, which is about to take place, with social care staff, others in C.Y.P.E.S. and with the police. That is being delivered by the trainers that delivered the trauma-informed model to the Metropolitan Police. That has been evaluated and the outcome of that evaluation is very positive in changing behaviour.
Also, Mark Rogers has recently, on behalf of C.Y.P.E.S., asked me to lead on developing a trauma- informed approach for the whole of C.Y.P.E.S. so that we can start to ensure that all of our services are trauma-informed and understand developmental trauma and the importance of therapeutic parenting. By way of an example, we do a lot of work already, and have done for quite some time, with adoptive families, and we help them to not use a naughty step. We help them not to use time out because we know that impacts and can be considered a secondary trauma for some children who have been abused in their past. The research very clearly shows that we can train laypeople to become therapeutic parents, and they do very good jobs. Unfortunately, their children then step out of their front door and they get on the bus and the bus driver is not therapeutic-informed or trauma-informed. They pass a postman. They go into a school and they might be a bit late because they have been picked on, on the way in, and a teacher shouts at them, which again is like secondary trauma. So, as well as it being high end, Deputy , in relation to C.A.M.H.S., and then the therapeutic- informed social work provision, it is also incumbent on us as a government to ensure all staff that have contact with children and young people have a good understanding of trauma and the way in which they should present to children.
The Deputy of St. John :
That is very interesting because some of the secondary schools deal with their disturbed children by sending them to a naughty corner, an hour in isolation without anything to do.
Director, Safeguarding and Care:
Mark, if you want to come in, in respect of the education ambitions?
Deputy R.J. Ward :
Can I just point out the fact that we have 25 minutes left and we are going down an area of discussion, which really is not related to our question around the Government Plan?
The Deputy of St. John :
I was going to end that, Chair, by asking: when do you expect to have a developed service and when do you expect to fund some of this money? Will it be in 2022?
Director, Safeguarding and Care:
No, we would expect this service to be up and running next year with a technical specification in place by the end of March. Some of that work will already be starting in parallel. But certainly in terms of what it looks like and how it connects across C.Y.P.E.S., particularly with the C.A.M.H.S. redesign work as well as the way in which early help is developing, and what we expect from our universal services, we would have a developed plan by the end of March.
Can I ask a quick question regards the needs assessment that determines the nature of the therapeutic service that we are talking about? Can that needs assessment be made public or be put in the public domain?
Director, Safeguarding and Care:
Yes, Deputy , it can. Although it does need further work as part of that specification design.
Deputy R.J. Ward :
So that will be put into the public domain?
Director, Safeguarding and Care:
Yes. I am very happy for that. In terms of the way in which we are adopting a commissioning model within the department, it is very important that the starting point for any spend is based on demand and need and a good understanding of that in the past, the future and the present. We should be able to present that, yes, in my view.
Deputy R.J. Ward :
The conclusions reached, seeing as the Government are putting children first, were children, young people and their families, consulted in reaching the conclusions from that needs assessment?
Director, Safeguarding and Care:
We have taken account of the work of our independent review of children's homes. Those sorts of questions were asked of children and young people who were currently in the care of the Minister through that lens. As part of our own commissioning of this piece of work and what this looks like, that specification has not been designed yet and we will be consulting with children and young people moving forward.
Deputy R.J. Ward :
We have asked the other question there. Deputy Pointon, we have some questions on antenatal services but also on the rebalancing programme, which I am very keen to get to. Plus some other questions as well. Do you want to move on to antenatal services, Deputy Pointon?
The Deputy of St. John :
Yes, fine. The N.S.P.C.C. (National Society for the Prevention of Cruelty to Children) gave the Family Nursing and Homecare the Baby Steps project to look after, which of course has been funded by Government since. The report in the Government Plan suggests that the current demand for service did not outstrip current funding. Can the service be delivered from within existing budgets?
Will it need additional funding during the course of the coming year, given of course that seemingly we have a fairly constant birth rate?
The Minister for Children and Housing:
That is what it looks like. This is an opportunity to look at what funding was allocated and find funding that, all things considered and looking at where we are, just will not be necessary and is not going to have an impact on delivery of a service. I hope that makes this relatively easy. If this had been something that, on current projections, was likely to have an impact on delivery then I would not have been keen to have it on the table. But it looks like it is all right.
The Deputy of St. John :
Thanks for that, Minister. Chair, I move you on to 26.
Deputy R.J. Ward :
Can you explain how this programme can still be delivered from within existing budgets? That is the question we are very interested in. In particular, I would also say that, with COVID, it may have put extra pressures on the antenatal services because of the concerns around birth early on and pregnant women and the services that are available from the hospital that may not have been available due to COVID. So we are just concerned that it can be delivered from within existing budgets.
The Minister for Children and Housing:
Yes. That is the right question to ask obviously. But it has been looked at and it is just not the conclusion that has been reached. I do not know if Susan has anything to add just on the logic that was behind that. But it was something that we looked at early on and it just seems to be okay without affecting services. I am sure my officers can vouch for me in that, if there was a genuine worry about services being affected by this, then I would have asked for it to be taken off the table. Because I did that with other items as well.
Deputy R.J. Ward :
That assurance is enough. That is what we want. Sorry to push you along, but there are some things we really do want to cover. Just one more following on from that. Is there certainty that there will not be an increase in demand in 2021 and that contingencies are in place to meet any unforeseen increases in demand during that time? I suppose that is the key thing for us.
The Minister for Children and Housing:
Yes. As Deputy Pointon said, that sort of thing you would hope would be reasonably predictable or you could look at what has been happening with this up until now. So I do not know what else to say. It just seems to be all right.
Deputy R.J. Ward :
So we have certainty that is going to work. One of the areas that we do want to ask questions on, in the remaining time, is the review and realigning of the budget for care leavers. There is no reduction to the service, is what we have said. There is a new programme that has existed for just 8 months. Can you detail the manner in which this programme has been actively promoted? We do have concerns from individuals or from people that it has not been actively promoted enough.
The Minister for Children and Housing:
Yes. There have always been things on offer for people leaving care, extra bits and pieces of support. Some of that delivered from other departments than the Children's Service. But there was not any sort of coherent promotion of that or any clear way that those young people could realise they could access things that they were already entitled to. So we decided that, as well as attempting to make accessing those existing things easier, we also wanted on top of that to be able to provide some other bits and pieces extra to that. Also to have staff within Children's Services, personal advisers, who would work with those young people and help them in their early adulthood to get those things that they needed, get advice. Essentially to act as a friend and that sort of figure in their life to help them like that.
[11:15]
So, earlier this year, we launched the care leavers offer. I was pleased that there was a really good take up in terms of the coverage of that and in terms of people from other agencies who came to that and observed it. So that was a good moment to help spread that awareness. From feedback that I have had, it is still the case that there are some difficulties remaining in accessing bits and pieces of what those young people are entitled to. Some of that is not within Children's Services, it is outside of it. So the director for Children's Safeguarding and Care has set up a board for this offer. He can remind me what the exact name of the board is. But that includes people within the service, people from Jersey Cares, et cetera, and getting the voice of those young people who have interacted with that offer about how it can constantly be improved. Some good examples have been raised to us where there have been some issues that have just caused a bit more aggravation than they should have done for those young people. So we are still very much on that learning curve but there is a clear structure in place that will help facilitate that improvement as it carries on.
Deputy R.J. Ward :
One of the concerns that has been raised with us, and it is a general concern and I think it could be applied here, that care leavers are bureaucratised, is the word that was used. Because, unlike families who can just go and pay something out, and I am a parent and negotiations seem to be very one way in what I am paying out, which is fair enough. But in terms of care leavers there seem to be so many hoops to jump through and yet another board will look at this. How do we know that is not happening to people's lives? That is the issue that has come up again and again from care leavers, that there are so many different people involved in the basic needs that they have that it simply is not worth the effort from them.
The Minister for Children and Housing:
I understand that and I have had conversations with young people about that very issue. We will hold our hands up and say I can point to examples where young people absolutely would have been right to have felt bureaucratised, and that is not good enough. But with having these personal adviser roles, having somebody that a young person can hopefully build up a positive relationship with and trust, that person can try to be the driving force that gets around some of it. There is always going to be bureaucracy when you are engaging with a government department. Because it is public money and the public money has to be spent in accordance with the law and in accordance with rules. In a way that if you are asking your parent to pay for something, whatever, they just pay for it, and trying to apply that philosophy in a government context is not easy. Getting authorisation to pay for something simple can be difficult. But it is the case that we are recognising that as we go along finding these things. The director for the service and those who are working on this are working to try to break down those barriers and get this stuff so eventually it will be as seamless as it can possibly be. But launching it was the right thing to do and it is better than it was before. The focus on it is really important as well. It is a new thing and so we are going to find things along the way that we are going to have to work to try to overcome.
Deputy R.J. Ward :
Is this not an area though of Government where that bureaucracy and that process that you talk about, it is sometimes difficult to get hold of money, just needs to be lost? Because these are people's lives and these are people who have faced this in the past and simply do not have perhaps the family to fall back on for that support, because the government is their family. We have talked about this so often, the Care Inquiry talked about it, about the neglect and indifference with those who have been left singularly ill-equipped to cope. They are not going to be helped if you have to go through a number of forms and processes for the basics that are necessary. Particularly when people are really helping themselves through education, through training. So what can you do to stop that? A direct question.
The Minister for Children and Housing:
That is a really good point. I accept wholeheartedly the premise behind the question that we need to get to a point where these people just make things happen and the young person does not have to interact or worry with some of the awkward things behind the scenes. But it is going to be the case in a government that when it comes to spending public money on things like that, there is going to be a cultural thing within the organisation where people will get nervous about it. It is going to be normal that a civil servant might feel nervous about spending money on a credit card that does not belong to them or that sort of thing. This is slightly petty of me to raise this, but there was an incident a couple of years ago where a politician got into big trouble because he whacked out a government credit card and paid for a private jet on the spot. He got in very big trouble for that and it was a very big issue. That is a vast amount of money and very different in this circumstance. But people within the organisation will want to know that, when they are spending money, they are spending it appropriately. We just have to help them in understanding that this is okay in this context. If you need to help someone buy their carpets when they are moving, you can just get on with it. Mark has just stuck his hand up.
Director, Safeguarding and Care:
Thank you, Minister. Deputy , in many respects, looking at the functioning of government through the lens of a care leaver is a very good way of asking some very important questions of whether government is functioning as well as it could. The interesting thing about the care leavers offer is the personal advisers that are employed within the Children's Social Care Service are directly responsible for helping care leavers who have not had the best start in life to navigate bureaucracy. It is one of their core functions. Essentially, most of which we are trying to do to help them sits outside of C.Y.P.E.S. in many respects, apart from, for example, accessing funding to university, which of course sits with us. But gaining a housing position, accessing benefits, being able to get back to work or to start work, all of these things are functions of government. But all of these things have a gatekeeping access process. What we are doing on a day-by-day basis is we are, through the lens of real people that we are supposed to love as much as we love our own children, we are seeing all of the hoops that our government currently expects them to jump through because of legislation, because of procedures, because of financial rules. I would love nothing more, Deputy , than to wake up and come back to work on Monday and for all of those bureaucratic loopholes to have been dismissed. But the fact of the matter is many of those are in legislation and many of those are enshrined in the granite. It is really quite difficult but we are tracking every single example. I will happily share those with Scrutiny to be able to show you just how difficult it is for a care leaver to navigate that which they are entitled to as easily as possible.
Deputy R.J. Ward :
We would agree. That would be a very useful thing to do and we should be acting to absolutely end those things, otherwise we cannot really be seen to be putting those children first. Was there consultation directly with care leavers in relation to the savings identified?
The Minister for Children and Housing:
I do not know if there was any behind the scenes. Mark can clarify if that was the case or if the board were engaged on this. But the point I would make is that, when you look at the Government Plan numbers of this, it looks like quite a drastic change. But it is not in the grand scheme of things because this is not the entirety of the support that care leavers will get. It was just extra bits that we were looking at in the last Government Plan. It does not include a lot of the things that they were entitled to anyway beforehand that were already funded through other mechanisms. It is not affecting the number of personal advisers that are being hired or anything like that. So, on the face of it, as a headline for what was in the last Government Plan, it looks like a significant reduction. But it is not in the grand scheme of things because there is a whole load of other money sitting underneath this that we cannot even quantify because people may or may not choose to claim bits of it and they sit in other budgets anyway.
Deputy R.J. Ward :
Can I go back briefly to something I asked before regards the flexibility for yourself as a Minister? We had a submission from Brightly that said perhaps efficiency savings identified for this project would be better used to provide private mental health appointments for care leavers and looked- after children. Is that the sort of flexibility that could be taken on board rather than simple savings and give a more effective service for care leavers and looked-after children?
The Minister for Children and Housing: Mark, I do not know if you want to take that?
Director, Safeguarding and Care: Susan, do you want to come in?
Group Director, Children, Young People, Education and Skills:
I was just going to say that part of the plans that we have been involved in, Mark and I working together, is to try to enhance the mental health support for looked-after children. So there is a separate amount of money elsewhere for therapeutic support. There is some therapeutic support for looked-after children built into the intensive fostering service specification. It has been on our mind as we redesign the C.A.M.H.S. service. But just on that particular aspect about could they have private mental health support, we would like to get to a point where that was something that we were providing. Because we know that has been something that has not always been as much of a priority as we know it should be.
Deputy R.J. Ward :
But the question is that we are not at that point yet but there is this money that has been saved that could have been redirected to provide that now while those services are being developed. Is that not an issue that could have been addressed?
Director General for Children and Young People:
It is probably for me to jump in at this point if we are talking about efficiencies. That would have been one outcome, Chair, but we have an outstanding efficiency target to meet from 2020, which, as you know, we have not met by delivering those efficiencies in full and therefore have had to find other ways of doing that. Going into 2021, we now have the challenge of making those efficiencies recurrent and therefore the approach that has been taken by the Council of Ministers, and therefore with civil servants, is that we need to meet our efficiency savings in order to balance the Government's books, rather than recycle those efficiencies into further investment.
Deputy M.R. Higgins:
So, in other words, you are not being able to provide the services that need to be provided to meet efficiency targets?
Director General for Children and Young People:
That is not the way I see it at all. We were asked to deliver a set of efficiencies in 2020. We were not able to do so. We need to do that into 2021. The investment that is going into services in the future is a different matter. So efficiencies are about delivering a more economic, efficient and effective, set of services. The investment going forward is about tackling the priorities that the department and, in this particular Scrutiny, the Minister for Children and Housing's portfolio is responsible for.
Deputy M.R. Higgins:
But already this morning we have heard of all sorts of things that are not being fully dealt with at the moment. Surely some of the money could be used for that.
Director General for Children and Young People: That is a political discussion for you to have.
The Minister for Children and Housing:
But sometimes it is not just about the money though, sometimes it is about having people on the ground who are ready and capable to do some of that work. One of the difficulties we had in COVID is that access to those human beings who sit and do the work can be difficult and strained. Even when you have the money, it is no good to you if it is just practically impossible for people to do that work.
Director, Safeguarding and Care:
Just within that, Minister, a good example is, while we have seen lower take up in the numbers this year of the offer, although we have seen that rising, and we do know of young people we are approaching directly to raise the awareness of the offer, we have still appointed all 5 P.A.s (personal advisers). We did not need to appoint all 5 P.A.s based on the numbers. So we have invested in the team and the people and we now, as of this week, have all 5 P.A.s in the service.
[11:30]
That is 5 P.A.s currently working with 56 care leavers. So that is circa 12 care leavers each, per person. In England, for example, you can see a P.A. having care leavers in the number of 30, 40, 50, 60, by way of a caseload. But in terms of our caseloads you can see that we have invested in staff. The money we are talking about here is only a small proportion of that, which we have available, to support our care leavers.
Deputy R.J. Ward :
Is that the significant contingency that you talk about in respect of this efficiency? Is it an efficiency now or is it rebalancing?
Director, Safeguarding and Care:
Within this bit, there has been a contribution to the efficiency and we know what the investment is. But in respect of the headcount for P.A.s that is part of the core budget for which I am responsible. We have been able to appoint to those posts and to continue to invest in our overall services for care leavers. The fact of the matter is, while there is a reduction in this budget line, our overall investment for care leavers is growing. That is not the question we have been asked today. It is probably a question Scrutiny might want to ask us in the future. In terms of the overall budget that we have available, how much of it is spent on care leavers? That is a really good question for us to answer in the future because the way in which we are able to support our care leavers is improving.
Deputy R.J. Ward :
I am sure we will bring that up at a quarterly hearing but this is about the Government Plan so we try to be specific in that. That is very important that is understood. I am conscious that we have used the allocated time that is available. However, I did want to ask if there are any members of the panel who wanted to ask any questions that we may have missed. So, Deputy Pointon? No. Deputy Higgins?
Deputy M.R. Higgins:
I was just going to say that I am concerned about the efficiencies and we are going to have to come back to this because there are areas within the service that need funding now. There is a demonstrated demand and I do not believe the department should be making these efficiencies.
Deputy R.J. Ward : Okay.
The Deputy of St. John :
I do not have anything either, Chair.
Deputy R.J. Ward :
I suppose we are out of time. I would just like to thank everybody for their time today. If there are any questions we have missed we will follow them up in writing. Any other information we can receive would be great. Are there any questions from the other side of the ether, so to speak, that you may have for the panel?
The Minister for Children and Housing:
I was just waiting for your usual surprise question you often get me with at the end. I am relieved there does not seem to be one.
Deputy R.J. Ward :
I have run out of time; you should not have asked. Given the commitment that you made in the press today regards the need for free school meals for children, is that something that you think some of the rebalancing and some of the unallocated funds could be directed to, given that we are putting children first? I am sure that everybody in Children's Service will recognise that feeding our children adequately would be one of the best things that can happen?
The Minister for Children and Housing:
My position in the media was made clear today. It is a noble aspiration to try to make sure that children are fed properly. I like the idea of school meals. It is a good thing to aspire to. The question is, how do you fund it and how do you practically go about doing it? So I will be asking questions behind the scenes about how we can do that. But the principle is a noble aspiration.
Thank you. I am conscious of time. I thank everybody for their time this morning and I will call the meeting to a close.
[11:34]