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September 2016: Child E SCR

Child E SCR Final Report and Learning & Improvement Report: Child E SCR

Published September 2016

Introduction from Graham Bartlett, Independent Chair of Brighton & Hove Local Safeguarding Children Board

This is an extremely sad case and I would like to express my deepest condolences to this young person’s family. We very much value the input they have given to this serious case review and would like to thank them for their participation.

The purpose of the review is to establish whether there are lessons that need to be learned in order to help prevent these types of tragedy being repeated and to improve child protection and safeguarding in Brighton & Hove. The Local Safeguarding Children’s Board has accepted each of the Review’s findings.

The coroner’s inquest into the tragic incident that caused this young person’s death found that it was neither predictable nor preventable. The review has found no evidence to contradict this view.

However, as this serious case review has indicated we think it’s clear that there are a number of things that need to be done differently in future.

‘E’ was in the council’s care, but was being looked after by other family members. Whilst we recognise that this was in his best interests, we found that this had led to a blurring of boundaries with regard to decision making.

This is a very complex area, and there is a lack of guidance both nationally and locally on balancing these responsibilities. We are therefore calling on the council to develop clearer guidance for its staff and for their Family and Friends carers.

There are recurring themes in the review around poor record keeping by the agencies involved, the sharing of information among the professionals involved, and communication between the agencies.

We think it is clear that agencies working with children and families should have done more to take into account the views of the non-primary carer, and should have done more to try to maintain good levels of communication with the primary carer. We are calling on our partners to reassess their policies and guidance in this area.

We also think it is clear that Sussex Police could have kept better records of their contacts with ’E’, and should have worked more closely with the council’s children’s services to address the concerns these contacts raised. We have therefore called on the police to review the way they operate in this key area.

The review also highlights a need to create different and more ‘young-people friendly’ mental health and emotional wellbeing services in this area.

We acknowledge that much has been done to rectify the issues highlighted in the review and the LSCB will be evaluating the impact of these changes, and those that follow from our proposals, to enhance the safeguarding of children and young people in the city.

We have produced a briefing for staff working in Brighton & Hove to summarise the Learning from this review Child E: Learning Together From SCRs

The LSCB will be holding two seminars to share the Learning from this review with frontline staff and managers whilst considering how agencies can implement any changes to improve practice. These will take place on:

Tuesday 11 October 2016

Tuesday 18 October 2016