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6.9 Out of Hours Protocol for Responding to Children and Adolescents who might present Outside Office Hours

AMENDMENTS

This chapter was last updated in March 2011.


Contents

  1. Introduction - General Information and Context
  2. Those Refused a Service
  3. Alerts
  4. Duty Shift
  5. Monitoring Visits Out of Hours
  6. Looked After Children
  7. Children who are the Subject of a Child Protection Plan or at Risk
  8. Children Presenting to the OOH Service
  9. Children in Need
  10. Families with No Recourse
  11. Unaccompanied Minors
  12. Accommodating Children
  13. Parental Mental Illness
  14. Contact with External Professionals
  15. Schools
  16. Hospitals
  17. Police
  18. Feedback to Day Service
  19. Contact Details

    Appendix 1: Alerting Out of Hours


1. Introduction - General Information and Context

The following guideline outlines and details the input Out of Hours Emergency Social Work (OOH) is able to provide to children and adolescents in need of a social care service outside of normal working hours, their expectations of day service colleagues and the limitations and constraints on the service.

The OOH Emergency Social Work Service is not a dedicated Children’s Specialist Service and cannot take on non-urgent tasks on behalf of day service colleagues. The service cannot routinely take on work originating in hours and is not an extension of the Referral & Assessment Duty System

The OOH service is not an alternative source of Section 17 payments. Please do not direct families to contact us for this purpose, as we do not have the resources to make such payments. If a casework decision is made to provide a family with a payment under Section 17 of the Children Act 1989 this should be facilitated within daytime resources.

The OOH Service is not a message service for external agencies needing to notify day services of specific events. Our telephone and fax number should not be given out to external agencies under any circumstances. Agencies should always be given the general council number as a way to contact us.

If partner agencies experience difficulty with the telephone system the OOH team manager can be contacted via relevant senior managers.

The OOH Service provides an emergency statutory response to all vulnerable children and adults within Southwark presenting in a crisis arising outside of normal working hours. The service is ‘live’ for 16 out of 24 hours weekdays and 24 hours weekends and public holidays.

Fundamental to the Emergency Service is that casework management remains with the respective daytime team. It is therefore essential that when alerting the OOH Service to cases that might present to them in an emergency, the judgement and case direction established by the allocated team is communicated as part of a verbal discussion.

The OOH Service expects relevant details of significant contacts within the family and friendship network to be clearly documented and easily accessible either on Mosaic or by email to the OOH inbox. This should also clearly identify any person(s) who can be a protective factor. Relevant details should always include current telephone numbers.

Where a case is likely to need OOH input, the service would expect as a minimum, a summary of recent events, details of the professionals involved and a current risk assessment.


2. Those Refused a Service

Where a service has been refused on the grounds that the person(s) have not satisfied the eligibility criteria, OOH should be told and furnished with the reasons for this decision if there is any likelihood they might be contacted with a further request as a means of circumventing this decision. If such persons present in an emergency, the OOH senior practitioner will make an independent assessment, but information from day services will reduce the possibility of a service being offered in ignorance of the known facts.


3. Alerts

Please also see Appendix 1: Alerting Out of Hours.

Most alerts will be held for up to 28 days unless the referrer requests an extension of this or a longer initial period. The exceptions to this are unborn babies where Alerts will be held until 72 hours or three working days after the child’s birth. It is the responsibility of the referrer to update the OOH Service of any changes in the substance of the alert.

We encourage telephone discussion of ongoing or acute cases that might present out of hours or where colleagues are seeking input on a case in crisis. Telephone contact enables a full exploration of any situation being handed over and ensures that the OOH senior practitioner responsible for that night/weekend shift has the information he/she needs.

The OOH team manager is available between 09:00 and 17:00 for case discussions, exploration of the suitability of the information being forwarded to the OOH inbox on more complex cases and negotiations on cases which has become too acute to carry over from day services to the next working day.

The OOH senior practitioner is available from 16:30 to 17:00 to discuss more complex alerts and negotiate any possible OOH input on urgent cases not already brought to the team manager’s attention. The OOH senior practitioner is also available for consultation and advice to daytime colleagues.


4. Duty Shift

The OOH Shift starts to take referrals for duty response at 17:00.

Referrals before 17:00 remain the responsibility of the relevant day service teams or the daytime duty service and not the OOH Service. In exceptional circumstances the OOH senior practitioner or the team manager can be approached to see whether they can assist with specific urgent work. This is entirely at the discretion of the OOH senior practitioner on duty that day and must be negotiated by a team manager or the duty manager of the day

The OOH senior practitioner prioritises work according to vulnerability and risk. The core roles of the service are safeguarding and risk management. This means that children in high risks situations or believed to be at immediate risk of harm will always take priority over all other referrals. However, Adults in high Risk situations will take priority over all other groups including children in need and child protection referrals where the child is already in a safe place.

The OOH senior practitioner will aim to make initial contact with referrers within 30 minutes of being paged by the EDO (15 minutes where a child may be at risk). They will undertake to give an estimated time frame and will keep referrers updated as to the progress of their referral.


5. Monitoring Visits Out of Hours

The OOH senior practitioner cannot do routine welfare visits and other arrangements needs to be made by daytime colleagues needing to check on children about whom they have concerns. Where a situation is seen as so risky, it needs very high levels of monitoring, it raises the question of whether the child(ren) should be remaining in the household.

The OOH Service will only accept a referral to make welfare visits where this is a situation of genuine emergency such as where a court has refused to grant an order on a high risk case and there was not time to make other monitoring arrangements or a sudden presentation of a high risk situation towards the end of the working day.

Where the possibility exists that the child(ren) may have to be removed in an emergency as a result of the monitoring of a high risk situation, the OOH Service should be informed. This is particularly important at weekends where that possibility needs to be factored into service planning. Additionally a contingency plan should be clearly recorded including alternative kinship carers or foster placement.

The OOH Service will NOT accept referrals to make phone checks on children at risks or in need. If a situation is so risky that it needs additional monitoring it is not appropriate to rely on self-reported information from the family in question


6. Looked After Children

Names and telephone numbers of current foster carers or residential units should be easily accessible on Mosaic and should be added to all alerts concerning looked after children.

Where a placement is in serious difficulty the OOH Service should be alerted and be provided with a current risk assessment and a contingency plan in case the placement breaks down.

Where a child is reported missing from care, the OOH social worker will monitor that a proper missing person’s report is made by the placement and will enter the relevant details onto Mosaic.

Whenever a child is absent from their placement over a prolonged period and reported as a ‘missing person’ there should be a clear plan of action outlined in the alert in case the child is located out of hours. Where the child is the subject of an order requiring possible action the necessary documentation (i.e. a copy of the order and other relevant documents) should be available in Carestore.

If action is sought in respect of a child who has been accommodated by this Department under Section 20 of the Children Act 1989 any relevant agreements with the person(s) who has Parental Responsibility along with contact details should be included in the alert or easily accessible on Mosaic. Case records should include recent events and a current risk assessment.

When the OOH Service cannot access information because the IT system has failed the OOH senior practitioner will seek information from sources such as the police, hospital and the MH database where relevant. While this is no substitute for Southwark’s Children’s database it will allow the OOH senior practitioner some access to information which can assist in the assessment of presenting concerns.


7. Children who are the Subject of a Child Protection Plan or at Risk

An alert should be sent to the OOH Service where a child is subject to a Child Protection Plan and the family situation is so unstable it is likely to present out of hours. The alert should include a summary of recent events, a current risk assessment and contact details for significant persons who might be a protective factor in the family and friendship network. We would expect copies of legal documents and any current agreements to be available in Carestore and it would be helpful if an updated chronology could also be completed in Mosaic.

Where day services are concerned that existing agreements may breakdown and an Emergency Protection Order may be needed, the OOH Service would expect;

  1. To be fully briefed on the circumstances
  2. All documentations to be completed and uploaded into Carestore or brought in person to the OOH team base


8. Children Presenting to the OOH Service

Where a child presents to OOH in a situation of risk, the OOH senior practitioner will endeavour to speak to the child away from adults in their network as part of any investigation. The OOH senior practitioner will seek to locate any other children in the family in order to ensure their safety.

Where a child presents with welfare issues, the OOH senior practitioner will assess and intervene as the situation merits.

If a child subject to a Child Protection Plan presents in a routine situation out of hours the OOH senior practitioner will note the circumstances and ensure that other professionals follow information sharing protocols.


9. Children in Need

The OOH senior practitioner will deal with Children in Need presentations on a case by case basis depending on the context of the presentation.

Where a family under stress presents to OOH in a crisis the OOH senior practitioner will attempt to support the family situation and will notify day service colleagues the next working day.

Where there is a risk of relationship breakdown, which might lead to a child or young person being Accommodated, the OOH senior practitioner will provide immediate advice and support to hold the situation and will alert the relevant day service team. Where a child or young person is between the ages of 11 and 16 years, the Alternatives to Care Team (ACT) will be notified via Mosaic Message. ACT will also be notified where a child or young person of the relevant age has been Accommodated.


10. Families with No Recourse

A family presenting to the OOH Service as having no recourse will not automatically be offered accommodation. In the first instance the OOH senior practitioner will explore whether the family is the responsibility of UK Visas and Immigration (UKVI).

The OOH senior practitioner will look at whether there are risk and welfare issues for the children but clearly a family settled in the UK for several years where the only change in their circumstance is a loss of accommodation, is not likely to be without network or means.

If day services have seen this family it is important that this information and the decision making process is clearly recorded in Mosaic. Where a family has not been previously assessed, the OOH senior practitioner will encourage them to make their own arrangements and present to day services the next working day.

Where a family is accommodated this will only be until the next working day. The family will be directed to present to day services for an assessment of their circumstances.


11. Unaccompanied Minors

The OOH Service cannot provide an age assessment, which is a long and complex process. However, there are times when the police will request accommodation for undocumented persons claiming to be minors with the alternative of releasing them onto the streets. The OOH senior practitioner will make a decision about offering a service based on their best estimate of whether the individual might be a minor. This accommodation will only be until the next working day when they will be referred to day services for assessment.

The OOH Service is not able to provide age estimates in respect of criminal justice or immigration issues and the OOH senior practitioner will refuse these requests.


12. Accommodating Children

The volume of work out of hours means that the OOH senior practitioner will rarely be in a position to complete LAC forms. The emphasis will always be on ensuring the child is settled and safe.

Where there is a request for accommodation on behalf of a child or young person through self presentation or via a third party (i.e. police or other agency), the OOH senior practitioner will investigate the presenting circumstances and will contact the person with whom the young person normally lives to explore the difficulties and try to resolve the situation. Accommodation will not normally be offered in such circumstances though the OOH senior practitioner will offer to mediate and support the family in finding an alternative solution to the crisis.

Where a child/young person has to be accommodated out of hours, the OOH senior practitioner will always endeavour to ascertain the child’s wishes and explain the process and what will happen in the short term. Where the accommodation takes place late in the night this may not be appropriate and the OOH senior practitioner will prioritise getting the child/young person settled in the placement over attempting to interview them. If the accommodation happens over the weekend, the incoming OOH senior practitioner will take on the task of speaking with the child/young person and (where this has not already been done) investigating whether a more suitable alternative to LA accommodation may be available in the family network.

Where a child has been accommodated after being taken into Police Protection, the OOH senior practitioner will endeavour to inform those with Parental Responsibility of the circumstances but not the location of the accommodation and will direct them to make contact with the relevant day service team on the next working day.

If the child is taken into Police Protection at the beginning of the weekend the OOH Service will seek to investigate and try to resolve the situation, but will only return a child to their family, in consultation with the police, once they are satisfied it is safe to do so.

The OOH senior practitioner will inform fostering as well as, the allocated or duty team where an accommodation has taken place out of hours.


13. Parental Mental illness

Where risk of neglect or harm to children arises because of parental mental illness, the OOH Service would expect a contingency to be in place should the children need alternative care. At a minimum, individuals in the network who can support the family situation should be identified and their contact details made available in Mosaic.

Where a parent is suffering a relapse of their mental illness but is not detainable under the MHA, the OOH senior practitioner will assess whether their parenting is adequate to the needs of the children in their care. Where possible the OOH senior practitioner will try to maintain the family situation. In the first instance, the OOH senior practitioner will look at whether additional support and monitoring can come from the family network. If this is not possible, the OOH senior practitioner would look at putting in care and monitoring in co-operation with mental health colleagues. If this is not a viable option, the OOH senior practitioner will try to get parental agreement for Section 20 Accommodation and only as a last resort look at Police Protection or an Emergency Protection Order.

Where a parent has been detained under the MHA the OOH senior practitioner will not assume they lack capacity to make decisions about their children and will work in partnership to try to find kinship care before looking at Section 20 accommodation or an order.

Where an expectant mother presents with mental health issues, the OOH senior practitioner will ensure that Children’s Services have a full report of the risk issues and concerns.


14. Contact with External Professionals

Requests for information from other professionals (i.e. Health or the police) will be considered within current information sharing protocols and the risk and welfare issues of the child or young person being dealt with.

Where external professionals refer concerns regarding the welfare or safety of an expectant mother, the OOH senior practitioner will address the immediate situation and pass the referral to day service colleagues for further assessment.


15. Schools

Where a child remains uncollected at the end of the school day the school should contact the Referral & Assessment Duty Service at the earliest point. It is not appropriate to wait until after 17:00 to make a referral.

Where the OOH Service has been notified of an uncollected child, the OOH senior practitioner will expect the school to make every effort to locate the parent or carer, including a visit to the home address if possible.

Once a referral is made to the OOH Service, the OOH senior practitioner will make further efforts to locate the relevant carers and named contacts. If this is not possible a placement will be identified for the child. The OOH senior practitioner will liaise closely with the referrer to ensure they are fully briefed on the plan to resolve the matter.

The OOH senior practitioner will expect the referrer as a person known to the child to take the child to the placement in order to better reassure and settle him/her and to explain what will happen next.

The OOH senior practitioner will continue to try to make contact with the family network but once that has been achieved will want to make an assessment of the situation and the home circumstances before returning the child home.

Where a child has been uncollected, the OOH senior practitioner will record the details of their involvement and the outcome in Mosaic and will notify the relevant day service team.


16. Hospitals

Where a hospital has Child Protection/Children in Need concerns, the OOH senior practitioner will offer advice and guidance to ensure the child remains safe and where necessary that a referral is made to CAIT. Where a child is admitted, any investigation will not be prioritised above other situations of risks.

The OOH senior practitioner will always attend to investigate the circumstances where there are concerns about non-accidental injuries or serious neglect and discharge is possible but will not always do so where a child has been or is to be admitted.

Where the plan is not to admit a child, the OOH senior practitioner will want to interview the child and investigate the home and environmental circumstances before agreeing to any such discharge.

If the OOH senior practitioner is not satisfied that a child will be safe with the normal carers, he/she will attempt to work with the family to find a safe alternative. If this is not possible the OOH senior practitioner will look at Section 20 Accommodation and only as a last resort to look at a Police Protection or an Emergency Protection Order.

Where there are concerns about a child or young person’s mental health, the OOH senior practitioner will expect a referral to be made to CAMHS. The OOH senior practitioner will endeavour to attend joint assessments with the child psychiatrist on young people who are in-patients but cannot always guarantee to do so.

Where a young person from Southwark presents to KCH or St Thomas’ A&E requiring a MH Assessment the OOH senior practitioner will attend subject to the following conditions:

  1. There is a named person within the hospital to take ongoing responsibility for the patient’s welfare and safety if the OOH senior practitioner has to leave to deal with a more urgent matter.
  2. A&E takes responsibility for arranging transport.
  3. There is a designated person to accept the delegation of responsibility for a patient liable to be detained where a local bed has been identified, should a delay in ambulance attendance mean the OOH senior practitioner has to leave.
  4. There is a designated person to accept the delegation of responsibility to convey where a patient liable to be detained is being admitted to a hospital out of area.

If agreement cannot be reached, the OOH senior practitioner will not attend. The young person then remains in the care of other professionals rather than an OOH senior practitioner who cannot ensure their welfare and safety when other priorities take him/her away from the A&E location.


17. Police

When fully staffed the OOH team previously had a limited capacity to do joint visits on a Saturday and Sunday evening, however most home visits in a crisis will depend on police officers being available to accompany the OOH senior practitioner. While it is preferable for these visits to be made with CAIT, their hours of operation means that OOH visits tend to take place in company with uniformed officers.

Where the OOH Service receives a referral that a child may be at immediate risk in the community the OOH senior practitioner will ask the police to do an urgent welfare visit to the family home or other location where the child is reported be, in order to ascertain the child’s safety. If there are likely to be delays or resource issues, the OOH senior practitioner will negotiate a solution with the duty inspector of the day.

Where concerns are expressed about a child who may be known to another borough but there is uncertainty about the home authority, the OOH senior practitioner will request information from the police and will negotiate access with the duty inspector as necessary.

Where a child is in Police Protection in the community, the OOH senior practitioner will prioritise the child’s immediate welfare above further investigation of the situation and may well go on to prioritise other high risk situations once the child is safe.

Where a child is in Police Protection at a police station, the OOH senior practitioner may want to look into the circumstances and explore accommodation options prior to attending. The OOH senior practitioner will always inform officers of this and provide a timescale, which they will update as needed.

Where a young person has been arrested and there is no one in his/her network to act as the Appropriate Adult, the OOH senior practitioner will facilitate this through the Appropriate Adult Scheme. Where this is not possible and the OOH senior practitioner cannot attend, he/she will make representation for the young person to be bailed where possible.

Where the police requests secure accommodation for minor offences the OOH senior practitioner will not be able to facilitate this and will try to negotiate an alternative such as bail or non secure.

Where the offence is of a serious nature, the OOH senior practitioner will make every effort to try to facilitate this unless this is not feasible or in the young person’s best interest (i.e. a request late at night when the young person is to appear before the court next morning).


18. Feedback to Day Service

  1. The OOH senior practitioner will aim to feedback on work done on shift by 09:30 the next working day. This will normally be in writing but after a particularly busy shift may be by telephone contact in the first instance.
  2. Urgent issues that need immediate follow up action will always be flagged up by phone call to the relevant team or duty senior.
  3. (Where there are mental health issues and CAMHS are involved, a report will be sent to that service. PACE referrals will be fed back to the Youth Offending Service and where welfare or safeguarding issues are also involved the relevant Children’s Services team will be notified.
  4. Where the child or young person is not a Southwark resident the OOH Service will notify the home authority and will fax or post a report to the relevant service in that authority.

Queries or concerns regarding feedback should be addressed to the Admin Officer or team manager in the first instance.


19. Contact Details

Contact Address

Team Manager
Out of Hours Social Work
Dulwich Community Hospital
East Dulwich Grove
E22 8PT

Contact Telephone

020 3299 6012

E-mail

Team E-mail: outofhourssocialwork@southwark.gov.uk


Appendix 1: Alerting Out of Hours

Written Alerts

Unless time pressure prevents it, we would expect ‘Alerts’ to be in writing. This should include a brief case summary, chronology, risk assessment and contingency. These should be by email to ‘out of hours social work’. For colleagues not on the Southwark email it would be outofhourssocialwork@southwark.gov.uk,’ but can also be by Fax if sent before 17:00 - number below.

Urgent change of placement details where a young person is missing should always be emailed to the OOH mailbox.

Any requests for action must be discussed with and agreed by the Senior Practitioner on duty or with the manager during the daytime. The Out of Hours Service cannot take on routine monitoring or visits or be a follow on service for work left uncompleted that originates in normal working hours.

Address:

Out of Hours Social Work Service
East Dulwich Hospital
East Dulwich Grove
London SE22 8PT

Tel: 020 3299 6012 (Internal Only - Not for public or external use)

Fax: 020 3299 6037

General queries can be directed above Monday to Friday 0900 - 1700 and the team managers contact details can also be obtained if she is not at the base when you call.

Please do not give this number to external professionals as the Senior Practitioners are often away from the Dulwich Base for several hours, meaning that any request for urgent contact or action would not be received leading to increased risks for vulnerable service users in immediate need. They need to contact us via the call centre on 020 7525 5000.

Out of Hours

The out of hours senior practitioners are available from 1630 weekday nights for direct discussions with day time duty desks and other day time colleagues.

The senior practitioner checks the out of hours mailbox up to 1700 but cannot guarantee to have the time to do so once the service is open to the public for the night. If you send a late alert after 1700 and it needs to come to the senior practitioner’s attention please ring to alert them and if they are not at base do not leave a message but page them via the Emergency Duty Operator at the Customer Service Centre on 020 7525 5000.

Please note that general public contact is via Customer Service Centre on 020 7525 5000.

End