• I have subsequently finally discounted the option of the ICO for children. My reasoning is that the developing recognition of the nature and urgency of the governance problem, alongside the changing context of the ICO proposal, led me to the honest conclusion that there is nothing which would persuade me it would be both achievable and good for Torbay’s children. I have written to the trust Chief Executive to explain this. She and her organisation have behaved properly throughout in my view, but the prospect of this seemingly attractive solution has in various ways clouded Torbay’s judgement and planning for some four years now and I am convinced it needs finally to be put to one side. This model may yet work somewhere but if it does it will be from a far more stable and capable base than Torbay currently offers.
expenditures for the groups of children in the top 10% and top 1% of most expensive children, by county among children age >= 1. Tables 17a-b show the variation in inpatient expenditure and utilization by county for each of these groups. There was considerable variation by county for the number of children who were in the most expensive groups, as well as variation in the total per child expenditures and the distribution of inpatient expenditures. Among counties with at least 100 children in the top 10%, Sonoma, Santa Clara, San Francisco and Monterey had the highest total per child expenditures. The percent of inpatient expenditures accounting for total expenditures varied in these counties from 43% to 78% with outpatient pharmacy and outpatient procedures accounting for the remainder of the total expenditures; Santa Clara also had high inpatient expenditures per child. (Table 16a). At least 70% of the children were hospitalized with two hospitalizations per child on average and about 10 bed days per hospitalization in these four counties (Table 16a). Although Los Angeles and San Diego had the largest number of children and accounted for 30% of total expenditures, per child expenditures in these two counties was lower than several other counties; they also had lower inpatient expenditures per child as
continued to be ambiguous. She does not have an operational social work background and inevitably this is likely to have contributed to an initial lack of confidence in taking a very decisive and proactive role in managing her service. It is clear from talking to managers in the service that the she and the current DCS are seen as complimentary, rather than two leaders working closely together, with common objectives though different responsibilities and roles. The distinction between their roles has been too blurred. As an example, the recently issued QA framework has a single paragraph on the responsibilities of the DCS and the Director of Children and Families without distinguishing between them.
7.1 One of the key concerns about Blackpool is that, given the serious failings in its Children’s Services in 2012, lessons do not appear to have been learnt at political and corporate leadership levels and effective systems of monitoring and scrutiny were not in place to notice and respond to deterioration after 2014. The new DCS in 2014 was internally appointed across adult and children’s services. It would appear that she had a strong focus on commissioning and partnership, especially with Health, and successfully attracted programmes like Headstart and Betterstart to Blackpool, however she did not have a strong knowledge of children’s social work and much decision making about policy was left to the children’s social care assistant director and heads of service. By 2017, the Council realised that children’s services was deteriorating and initiated an internal review which resulted in the appointment of the present DCS and the establishment of the improvement board. The current improvement journey in the Council started in mid 2017 from a very low base.
6.1 For children adopted during the year 2013-14, the time between the point the child became looked after, to placement with adopters, and the time from Placement Order to Matching is still below the national average. There are children who have a plan for adoption where this is no longer realistic or achievable. These children have been reviewed by the Permanency Panel and 6 have been returned to Court to change the plan to long term fostering, with a plan for a further 6 to be returned to court by end of August 2014. Progress is now being made to improve the
6.11 At the same time the LA, like most, was facing significant budgetary pressures. It could be suggested that the savings taken in respect of children’s services were done so without the benefit of a clear strategic approach. The budgetary pressure facing the LA was being exacerbated by consistent and significant overspends on placement budgets and some describe frustration and a potential blame climate which created the conditions where simple ‘salami slicing’ and short term delivery was prioritised. The savings challenge became one for hardworking leaders in the service rather than one for the whole organisation. There are examples of projects completed to deliver efficiencies and at the same time seek improvements. These however, with hindsight, were simply projects or initiatives rather than being part of a wider strategic programme of improvement and efficiency. There appears to be little evidence of creativity and innovation in which ‘invest-to-save’ strategies supported longer-term and potentially more desirable outcomes. Neither would it appear was there was any meaningful benchmarking of the spend on children’s services within Wakefield compared to other LAs. The contribution to the LA’s response to the austerity challenge needed to be more evidence based and differentiated. More recent decision making on investments by the LA would appear to be some acknowledgement that such an approach may not have been in place at earlier times.
This recommendation has the support of the Council, who have requested in writing that they create a Council-owned company (through the Teckal exemption to EU procurement legislation) to deliver the full scope of children’s services. For the sake of clarity, this would include their children’s social care, early help and education services. In order to do this they would require support designed to help them with the transformation. I have been clear with the Council that any financial support would be in the nature of a one off grant to help with moving to a new format rather than ongoing revenue funding. They would also explore links with other local authorities to ensure that governance is strong and robust. I would support their proposal and look forward to discussing it with you.
Hunningley Grange is a detached residence with a purpose built extension, registered to provide personal care for 36 residents. All accommodation and services are on the ground floor. The home is located in the centre of Stairfoot, approximately two miles from Barnsley Town centre and situated on a main bus route. The home is within walking distance of a full range of shops e.g. chemist, newsagent, hairdressers,
Children told us about their friends and we saw that children played co operatively and chatted amicably together. We saw younger children approaching staff for cuddles and we observed relaxed relationships between older children and staff, as they chatted in a warm, comfortable manner. Older children in the after-school element of the service managed their behaviour well and played together happily. We observed younger children playing together outside and the children interacted and co-operated well with their peers and adults. We noted that the children were learning to express their needs. Children were polite, used good manners and were well behaved. They were forming positive friendship groups. We saw that there was an emphasis on the importance of working together and helping each other. We heard children saying please and thank you regularly and they were praised for good manners. Children were calm and relaxed throughout our visit and it was clear that children were beginning to develop good relationships with each other.
15.2 - DEFICIENT: There is buckling and warping of the baseboard behind the toilet that appears to be moisture-intrusion related. The most likely cause of this is from a current or past leaking toilet base or leakage from the toilet's shut off water valve. No visible moisture in this area was observed at the time of the inspection.
1. About the Inspection: A visual inspection was conducted in the readily accessible areas of the structure(s) indicated (see Page 1) including attics and crawlspaces which permitted entry during the inspection. The inspection included probing and/or sounding of unobstructed and accessible areas to determine the presence or absence of visual evidence of wood destroying insects. The WDI inspection firm is not responsible to repair any damage or treat any infestation at the structure (s) inspected, except as may be provided by separate contract. Also, wood destroying insect infestation and/or damage may exist in concealed or inaccessible areas. The inspection firm cannot guarantee that any wood destroying insect infestation and/or damage disclosed by this inspection represents all of the wood destroying insect infestation and/or damage which may exist as of the date of the
• Improve: The synthetic stucco is not sealed properly at the west side of the home near the rear of the home. Not only is proper installation technique critical to the performance of this material, but ongoing maintenance is necessary. All openings at connection points, around windows and doors, and areas where the stucco abuts brick veneer should be monitored and kept appropriately sealed. An intrusive moisture inspection is recommended to determine the extent of damage behind stucco finishes, if any. Evaluation of moisture within the wall is beyond the scope of this inspection. • Improve: Wood/soil contact at the steps at the rear of the home should be avoided. • Improve: Prior water damage was noted under the steps on the front of the home. • Monitor: Exterior Insulated Finish Systems (EIFS) look similar to stucco but are
act to collect roof water and drain the water at least five (5) feet fro m the foundation or into a functional storm sewer. Downspouts that are clogged or broken below grade level, or that discharge too close to the foundation are the most common source of basement lea kage. Please refer to the Roofing and Exte rior sections of the report for more informat ion.
Landscaping and lot topography is examined during a residential house inspection as they can have a significant impact on the building structure. It is important that surface runoff water is adequately diverted away from the building. A high water table or excessive ground saturation can also impact septic systems. Even over watering of gardens and shrubbery can have significant effects. A similar impact can result from tree roots growing against the foundation and causing cracking or movement of the structure. It is a standard recommendation that the lot grading slopes away from the building. Grading should fall a minimum of one inch every foot for a distance of six feet around the perimeter of the building. It is also important that tree branches are not permitted to overhang the roof and that all landscaping is kept well pruned and not permitted to grow up against any part of the building. This will help prevent the development of pest and insect problems.
Through the CHIPRA Quality Demonstrations, Grantees will test and evaluate the use of the initial core set of children’s health care quality measures. To address the need for improved core measures and for the development of new measures in health care quality areas not reflected in initial core set, AHRQ, with funding from CMS, will work with seven Centers of Excellence to develop new measures and refine the core measures as necessary. 46 The AHRQ/CMS Centers of Excellence, which comprise the Pediatric Quality Measures Program (PQMP), are a cohort of entities with expertise in health care quality measurement specific to the needs of children and their health care delivery system and include collaborations of academic institutions, children’s hospitals, and measurement experts. The PQMP, required by section 1139A(b)(1) of the Act, is designed to (1) improve and strengthen the initial core set of measures to make them more broadly applicable to Medicaid, CHIP, and other programs; and (2) develop additional quality measures that address dimensions of care where standardized measures do not currently exist. Two of the Quality Demonstration grantees (Illinois and Massachusetts) are developing new measures related to children’s health care quality and participate in the activities of the PQMP.
The dependent variable of interest (postscreening specialty BH services) comprised the 4 categories shown in Table 2. These include the following: a psychopharmacology visit de ﬁ ned as a claim for psychopharmacology oc- curring; a psychiatric visit de ﬁ ned as the presence of any claim/encounter with CPT codes used by psychiatrists, psychologists, and social workers (90801 – 90899); and a health or behavioral as- sessment de ﬁ ned as visits with CPT codes (96100 – 96103, 96105, 96111, 96115 – 96120, 96125, 96150 – 96155) and nonphysician mental health visits de ﬁ ned as other BH professional codes (Healthcare Common Procedural Codes [HCPC H] codes). In addition, the new HCPC codes introduced in Massachusetts to track remedy services for the CBHI (S9484 and S9485, crisis intervention; and T1027, T1017, and T2022, family counseling and case management) were included. We examined visits occurring at any time after the salient visit and within 90 days of the salient visit. Psychopharmacology agents were de- ﬁ ned by using the HMO Research Net- work 15 and the Mental Health Research
Please note if you are allocated a placement within inpatient forensic, children and young people’s services, at Roycroft clinic, Lennox unit or Stephenson House please contact one of the following occupational therapists prior to the placement starting
This report presents a summary of the first year of research on the Children’s School Lives (CSL) study. CSL is a nationally representative mixed methods study of primary schools in Ireland commissioned by the National Council for Curriculum and Assessment (NCCA) and carried out by the University College Dublin (UCD) School of Education . CSL is taking place over six school years in 189 primary schools across Ireland. In CSL, approximately 4,000 children and their class teachers, school principals, parents and a subsample of grandparents are helping the UCD research team to explore primary schooling in Ireland. This activity is ongoing between May 2019 and June 2024. This report is preliminary and is the first of our annual reports that will be added to across time.