Cabinet Member decisions

Proposed Decision:

To give delegated authority to the Director for Growth and Communities, to take any necessary actions to enter into a contract for the provision of temporary emergency facilities, including mortuary facilities, in the event of a mass fatality incident

Reason for the decision

KCC currently has a contingency contract for the provision of temporary emergency facilities in the event of a mass fatality incident. That contract expires on 31^st May 2024, having been previously extended.

Whilst the retainer element of the contract represents relatively small expenditure of approximately £4100 per year, in the event that it is required to be called upon the expenditure is likely to be in excess of £1m.

Background

KCC has legal duties to plan and prepare for emergencies which may occur in Kent. The potential for an emergency to occur which results in mass fatalities is recognised. In relatively recent years other local authorities have had to manage such situations including the Grenfell Tower fire, the Shoreham air crash and the Manchester Arena bombing.

A mass fatality incident is defined as being an incident where one or more of the following key elements are present:

·     there are multiple deceased (actual or potential);

·     the nature of the incident is likely to make identification of the deceased difficult;

·     some or many of the deceased are lying in difficult to access locations;

·     there are fragmented human remains;

·     the incident was as a result of terrorist or criminal activity;

·     hazards are present at the scene, for example, asbestos, chemicals, radiological debris, that need to be considered before recovering the deceased, property and evidence;

·     mortuary capacity is, or may become, exceeded or overwhelmed.

There are existing arrangements in place to designate one or more hospital mortuaries in the event of such an incident. If the incident were to be of large scale or occur at a time which corresponded with peak mortuary occupation, for example during winter pressures, then local facilities might be unable to cope and emergency, temporary facilities would be required to allow for the management and identification of the deceased whilst maintaining appropriate dignity and respect.

KCC holds the existing contract on behalf of the Kent Resilience Forum (KRF) partners. The contract allows for KRF partners to call down elements of it to support their roles and responsibilities. Each partner organisation is responsible for meeting the costs of the elements that they call down. It is proposed that the new contract will be on the same basis.

Options (other options considered but discarded)

-      Do nothing. This would leave KCC exposed to not meeting its duties to provide the facilities necessary to accommodate the coroners in carrying out their work and also to significant reputational risk in the event that there is nowhere to accommodate the deceased with dignity and respect out of public view.

-      Rely on national government, local mutual aid agreements or military support. National government no longer maintains capability in this area. Mutual aid agreements are already part of the emergency plan for this type of event, but they are limited in scope and are unlikely to be able to provide the physical accommodation for the deceased which would be required. Military Aid to the Civil Authorities (MACA) may be sought in such an incident but it cannot be guaranteed and, again, is unlikely to be able to provide appropriate physical accommodation. MACA requires that all civil options have been exhausted before it can be undertaken.

How the proposed decision supports Framing Kent’s Future 2022-2026: (https://www.kent.gov.uk/about-the-council/strategies-and-policies/corporate-policies/our-council-strategy)

The decision concerns the provision of infrastructure for the community in the event of an emergency and forms part of KCC’s role in making Kent’s communities safe.

How the proposed decision supports: Securing Kent’s Future:democracy.kent.gov.uk/documents/s121235/Securing Kents Future - Budget Recovery Strategy.pdf

The decision results from a review of an existing contract. The new contract will be of a ‘call off’ nature, allowing KCC to only call off the elements it needs to support its duties. It will also provide the framework to allow partners to call off elements for their own purposes but will provide the means and clarity to ensure that KCC only pays for those elements which it calls off itself.

As Cabinet Member for Community & Regulatory Services, I agree to delegate authority to the Director of Growth & Communities to take any necessary actions to enter into a contract for the provision of emergency facilities, including mortuary facilities, in the event of a mass fatality incident.

Proposed Decision:

The Cabinet Member for Integrated Children’s Services is expected to be asked to:

1.          APPROVE the proposed changes to the rates payable and charges levied for Children’s Services in 2024-25.

2.          NOTE both the changes to the rates that are set by the Government/external agencies: Inter-agency charges and Essential Living Allowance and; any charges to other Local Authorities for use of in-house respite residential beds are to be calculated on a full cost recovery basis.

3.          DELEGATE authority to the Corporate Director of Children, Young People and Education, or other nominated officer, to undertake the necessary actions to implement the decision.

Further Information:

This decision revises the rates payable and charges levied by this Council for Children’s Social Care Services from 1 April 2024

The recommendation report will distinguish between those rates and charges over which Members can exercise their discretion, and those which are laid down by Parliament.

The rates payable and charges levied for Children’s Services are reviewed annually, with any revisions normally introduced from the start of the new financial year.

Some of the increases are directly linked to the published Department for Education fostering rates, which are reviewed by the Department annually.

The proposed decision supports both the key priority of “Levelling up Kent” and “New Models of Care & Support” within the ‘Framing Kent’s Future (2022-26)’. Along with “Securing Kent’s Future – budget recovery strategy”.  Recruitment and retention of our in-house foster and support offer and providing appropriate financial support to our permanency arrangements is crucial in developing and sustaining cost effective placements options for our vulnerable children. Along with supporting families to support children through the use of Direct Payments to be as independent of greater state support. Funds are included as part of the Medium Term Financial Plan 2024-27.

Decision:

As Cabinet Member for Integrated Children’s Services, I agree to:

a)     

i.      The weekly Foster Care Maintenance allowance is increased to:

ii.     The weekly Foster Care Reward element is increased to:

iii.    The weekly Foster Care Disability Enhancement is increased to:

iv.   The weekly Foster Care Skills Based Payment is increased to:

v.     The weekly Emergency Foster Carer Retainer payment is increased to:

vi.   The hourly Sessional & Day Care payments increase to:

vii.  The Foster Carer Mileage Rate will remain at 45p per mile in line with KCC staff.

viii. The additional rates for the Step Across to Fostering Scheme to be set at:

ix.   The Kent Supported Homes (Supporting Lodging payments to hosts) is increased to:

*LHA – Local Housing Authority

**Various – the rate will depend on circumstances and agreed in line with the Staying Put policy.

b)    NOTE:

x.     The rates which are dictated by external agencies i.e. Inter-agency charges and Essential Living Allowance

c)    DELEGATE:

Authority to the Corporate Director of Children, Young People and Education, or other nominated officers, to undertake the necessary actions to implement the decision.

Proposed Decision:

1.    Provide five months’ notice on 1 April 2024 to the Kent and Medway Integrated Care Board (ICB) of the withdrawal of investment for fast-tracked assessments for Looked After Children and Harmful Sexual Abuse from 1 September 2024.

2.    To continue to contribute the £150,000 annual funding for services to the Pupil Referral Units and Post Sexual Abuse; and

3.    Delegate decisions and necessary actions to the Corporate Director for Children, Young People and Education, or other Officer as instructed by the Corporate Director for Children, Young People and Education, in consultation with the Cabinet Member to implement the decision.

Background

Kent County Council (KCC) has a long-established partnership with the ICB, schools, and other agencies, to enable a “whole system approach” to improve children and young people’s mental health. The Children and Young People Mental Health Service (CYPMHS) is provided by the North-East London Foundation Trust (NELFT) and forms one part of this system providing specialist support. The service was procured by the ICB in 2017 with KCC making a financial contribution to fast-track assessments for Looked After Children (LAC) and for support to the Pupil Referral Units (PRU).

Strategic oversight of the contract has been in place through the Kent and Medway Children and Young People Programme Board and managerial oversight for our financial contribution has been through a Section 76 Agreement (S76) between KCC and the ICB, as lead commissioners.  The cost of the KCC investment into CYPMHS per annum is £1,267,000.  This is broken down into two elements:

·         £1,117,000 is the contribution to the ICB/NELFT contract for fast-tracked assessments for Looked After Children.

o    £1,000,000 LAC Priority Assessment

o    £117,000 Harmful Sexual Abuse

·         £150,000 is Services from Local Authorities

o    £50,000 Pupil Referral Unit

o    £100,000 Post Sexual Abuse

The current contract is due to end on 31 August 2024 (two-year contract extension currently operating) with the ICB looking to directly award for a further 12 months before recommissioning a like for like service with an up-to 13-year contract, commencing from September 2025, with transformational change embedded through the term.

Throughout the contract period, NELFT have consistently met and exceeded the performance target of the contract, and this has been demonstrated through the monthly data reporting. However, it has not been determined since 2017 whether Kent LAC, having received their initial assessment, are waiting the standard time for the start of intervention or not. It has not been demonstrated that a Kent LAC has a priority service over other non-LAC referrals. The funding is for a fast-track assessment, not fast-track intervention.

Work has been undertaken by KCC and the ICB to improve the data collection that is provided by NELFT and to understand how the KCC investment is utilised within the contract.  A workshop was held in September 2020 which looked at ways NELFT could provide additional data in relation to the number of LAC referrals that were Kent children.  As a result of this, the KCC Management Information and Intelligence Unit were able to match child level data with NELFT on several occasions.

In 2021, a deep dive was completed to identify any trends with cases that are declined by NELFT at the point of initial assessment. Although the deep dive did not conclude sufficient evidence to show whether LAC children are being treated more disproportionately than other vulnerable children accessing the CYPMHS, it did show that further consideration should be given as to whether to continue with the investment or to reinvest the £1m into an independent assessment service.

Associated with the LAC Priority Assessments is an additional funding of £117k to support meeting the needs of children and young people who present with Harmful Sexual Abuse.  The CYPMHS provides evidence-based interventions for children and young people who have been sexually abused or who exhibit harmful sexual behaviour.  KCC has historically contributed financially to support this however, there is no statutory mandated requirement to do so and as such no reporting mechanism.  These interventions are already part of NELFT’s complex/behaviour pathway; therefore, children and young people would continue to access services through that route.

If KCC does not continue investing into the CYPMHS, there is no evidence to suggest that this would result in a reduced service, however the initial assessment time for Kent LAC would increase from two to four weeks. Once assessment has taken place all children and young people access the service based on a clinical need. It has always been acknowledged that children and young people access the service based on risk and clinical need.

In addition to the LAC element, KCC contributes £150k per annum for the Pupil Referral Unit (PRU) which incorporates support for Post Harmful Abuse as part of NELFT’s complex pathway work.  The PRUs aim is to provide continuity of education for pupils who are unable to attend school due to health needs.  This includes:

·         An education support service to schools for young people with physical medical conditions; and

·         An education outreach service for young people with mental health needs.

There are six PRUs in Kent.  There are approximately 20 children in each.  The units operate in term time only.

Options

Option 1     Continue with the current level of investment £1.117m/year.

Option 2     Negotiate a reduced contribution.

Option 3     Give notice to the ICB of withdrawal of £1.117m investment and reinvest in an independent assessment service.

Option 4     Enter into a new arrangement with the ICB to support a new LAC Network for Kent and Medway.

Option 5     Give notice to ICB of withdrawal of £1.117m investment.

Option 6     Agree to continue funding for a further 12 months.

The recommended option (Option 5) is to give notice to the ICB of the withdrawal of the £1.117m contribution for KCC.

Securing Kent’s Future

This meets Objective 2 in Securing Kent’s Future: Delivering savings from identified opportunity areas to set a sustainable 2024/25 budget and MTFP

Decision:

As Cabinet Member for Integrated Children’s Services, I agree to:

i)           Provide five months’ notice on 1 April 2024 to the Kent and Medway Integrated Care Board (ICB) of the withdrawal of investment for fast-tracked assessments for Looked After Children and Harmful Sexual Abuse from 1 September 2024.

ii)          Continue to contribute £150,000 annual funding for services to the Pupil Referral Units and Post Sexual Abuse.

Delegate decisions and necessary actions to the Corporate Director for Children, Young People and Education, or other Officer as instructed by the Corporate Director for Children, Young People and Education, in consultation with the Cabinet Member to implement the decision.