Referral to Emergency Duty Team

SCOPE OF THIS CHAPTER

This document is the Children and Adults Services' Emergency Duty Team Operational Handbook.

It contains information on the role of the Emergency Duty Team (EDT); the procedures for EDT staff and the arrangements between the EDT and day services in both Children's and Adults Divisions.

LEGISLATION, REGULATIONS AND GUIDANCE

The list below is an example of the legislation that governs the work undertaken by EDT, it is not exhaustive:

  • Children Act 1989;
  • Policing and Crime Act 2017
  • The Children Act 2004;
  • Working Together to Safeguard Children;
  • DH Assessment Framework;
  • National Assistance Act 1948;
  • Chronically Sick and Disabled Persons Act 1970;
  • NHS and Community Care Act, 1990;
  • Direct Payments Act 1996;
  • Delayed Discharges Act 2003;
  • Carers and Disabled Children Act 2004;
  • Mental Health Act 1983;
  • Mental Capacity Act 2005;
  • Mental Health Act 2007;
  • The Care Act 2014;
  • The Children and Families Act 2014.

RELATED DOCUMENTS

Wirral Department of Adult Social Services Procedures

Mental Health Crisis Care Concordat

Cheshire and Wirral Partnership NHS Foundation Trust Mental Health Procedures

1. Introduction

1.1 Statement of Purpose of the Emergency Duty Team (EDT)

The principal responsibility of the EDT is to respond to out of hours referrals where intervention from the local authority is required to safeguard a vulnerable child or adult, and where it would not be safe, appropriate or lawful to delay that intervention to the next working day.

The EDT may also deal with referrals, which are not assessed as emergencies but where delay before intervention by day staff could cause deterioration in the welfare or safety of the subject of the referral.

The EDT is not intended to provide the same level of service that is available during normal office hours. It does not have the resources to do so, either in terms of staff or access to information and support from partner agencies.

1.2 Service Objectives

EDT will:

  1. Respond to out-of-hours referrals where it is judged that intervention is necessary to safeguard a vulnerable child or adult, and where it is judged it would not be safe, appropriate or lawful to delay that intervention until the next working day;
  2. Deal with referrals, which are not assessed as emergencies but where delay before intervention by day staff would be likely to cause deterioration in the welfare or safety of the subject of the referral;
  3. Fulfil statutory requirements and all Wirral Council policies and procedures when responding to referrals;
  4. Deal with referrals in order of priority and with regard to the possible consequences of delay;
  5. Aim to ensure that the "best value" response is made to all referrals;
  6. Ensure that referring agencies and individuals are kept fully informed as to Children and Adults Services responses and advised where there is unavoidable delay in dealing with referrals;
  7. Act in compliance with statutory requirements and all Wirral Council policies and procedures in delivering a timely response to referrals made outside of office hours;
  8. Deploy internal Children and Adults Services resources and acquire resources from other service providers as necessary and appropriate to meet assessed service needs;
  9. Ensure that referring agencies and individuals are kept informed where there is unavoidable delay in dealing with referrals;
  10. Maintain sufficient knowledge of local authority and other services to be able to screen and re-direct referrals which are not appropriate for the EDT to respond to;
  11. Seek to foster good working relationships with all other out-of-hours agencies;
  12. Foster stronger links and communication with children and adult day time services;
  13. Ensure that at all times there are effective working relationships with day services;
  14. Negotiate clear responsibility for cases involving other local authorities, ensuring that Wirral Council responsibilities are always fully discharged, whether by the EDT or another authority;
  15. Provide a service, which positively reflects Wirral Council policies on equality and diversity, ensuring that services take account of issues of ethnicity, race, culture, disability, religion, sexuality and gender;
  16. Ensure that all referrals made and work carried out is clearly and fully recorded in line with Wirral Council requirements, and so as to enable day staff to progress work promptly and effectively;
  17. Ensure that, where appropriate, senior officers are informed of referrals;
  18. Represent Children and Adults Services positively to all other agencies and organisations, using delegated authority appropriately.

1.3 Service Standards

EDT will meet the following service standards in line with guidance issued by the regulatory Authority:

  1. Service users will receive a prompt and effective out of hours response, which is adequate to deal with the need referred and is sufficient to support service users until mainstream services can be provided, if necessary;
  2. The Children and Adults Departments will maintain a clearly written, up-to-date and comprehensive policy for securing emergency out of hours services;
  3. The Children and Adults Departments will work collaboratively with other agencies, and Departments, to ensure a co-ordinated approach to the provision of emergency out of hours services;
  4. All Out of hours work and assessments will be sufficient to determine the nature and extent of the response, which will then be provided promptly to Children and Adults Social Care in there identified social care system, e.g. Liquid Logic (LL);
  5. Emergency out of hour's services will be sensitive to issues of race, religion, language, culture, gender and disability;
  6. EDT staff will be appropriately recruited, trained, deployed and supervised;
  7. The Children and Adults Departments will provide an organisational structure and management support to ensure the delivery of effective emergency out of hour’s services.

2. Relationship with Day Services

2.1 Working Arrangements between EDT and Day Staff

The EDT Team Manager will have a particular responsibility for ensuring that there are good operational links between EDT and day services.

2.2 Responsibility for Referrals

EDT is only responsible for dealing with referrals, which are initially made outside office hours. Day staff should complete all work where the initial referral was made before 17.00hrs.

Where day staff considers that they are unable to complete a piece of work, EDT may exceptionally take this on. However, it is essential for day staff to speak directly to the EDT officer on duty to negotiate this. Day staff must therefore leave a telephone number on which they can be contacted after 17.00hrs.

It is not acceptable for day staff to leave a message asking for the EDT to complete a piece of work. If the day staff cannot speak to the EDT worker then it must be assumed that the work will not be undertaken by the EDT.

It is part of the role of the EDT to help and support day staff that are working outside normal hours. Any colleague working after normal hours can contact EDT for advice, information, resources or assistance.

2.3 Criteria for Referral to EDT

EDT is principally responsible for providing an emergency service in situations where there is real and immediate threat to life, safety, health or liberty. Additionally, EDT will seek to provide a service where delay could cause deterioration in the welfare or safety of the subject of the referral.

It is therefore not appropriate to make referrals to EDT for routine monitoring of service users or carers out of hours. EDT cannot guarantee to be available for this purpose, which must be covered in general care planning for a case.

As outlined above, it will be unusual for day staff to make a referral for action, as the expectation is that day staff will normally complete work in which they are involved.

When day staff do need to make a referral, the worker should ring the EDT contact number, email or page them via Arrowe Park Switchboard requesting a consultation. (There is a referral form, but this alone is insufficient).

2.4 “Alerts” for EDT from Day Staff

There will be occasions when day staff need to alert EDT to referrals which may arise, giving background information and indicating a course of action which they would like EDT staff to take. Contact details for an appropriate officer should normally be included. These “alerts” should be completed online and emailed to: cypdedt@wirral.gov.uk.

The EDT duty officer will check the mailbox at the beginning of each shift.

2.5 Communication of EDT Referrals to Day Staff

At the end of each EDT duty period it is the responsibility of the EDT officers who have dealt with a referral to ensure that safe and accurate transfer to the relevant day service and to forward this by Liquid Logic for the availability of that service.

Sometimes it may be necessary for the incumbent duty officer to use other means such as email or fax as well as Liquid Logic. It is for the duty officer to determine this.

Where urgent follow-up is required of day staff, the EDT officer may in some circumstances ring the appropriate duty team to confirm actions required.

Queries about previous work can be dealt with by the Team Support Officer or the Team Manager who are in the office during day time hours, or by e-mail.

3. EDT Resources and Organisation

3.1 Staffing

The EDT consists of 1 Team Manager and 8 established posts. 1 Team Support Officer does all the administrative duties arising from the operation of the team. They are available from 9:30am till 3:00pm Monday to Friday. There is access to a pool of highly experienced senior workers with suitable experience/qualification.

The Team Manager reports to the Mental Health Service Manager in Adults Social Care and has liaison capacity with the Senior Manager for IFD (CYPD).

Sessional workers may be utilised at various periods due to capacity and demand of work and referrals.  They will be governed by the same procedures as the established posts.

3.2 Rota

The EDT Team Manager is responsible for drawing up the rota of working sessions for EDT staff.

The EDT service is operational between 5pm and 9am Monday to Friday, and at weekends from Friday at 5pm through to 9am on Monday. The service is extended to cover Bank Holidays and other public holidays.

Shifts are organised so that two social workers are on duty all the time. Most of the time both incumbent officers will be experienced in child protection/safeguarding/and have an AMHP qualification. The minimum operational requirement is that each of the two officers will have one of the above requirements.

The shift patterns for the EDT have been reviewed and take account of European Working Time Directives and interests of Health and Safety guidance.

There is an equivalent rota of senior managers in Children and Adult Social Care, who are available for advice and guidance.

3.3 Annual Leave

Annual leave must be agreed by the Team Manager, giving as much notice as possible. However, requests for leave at short notice will be accommodated wherever possible, subject to the demands of the service.

3.4 Sickness

Where a social worker is unable to start or complete a shift because of illness, they must advise the Team Manager by 10am, who is responsible for arranging duty cover.

3.5 Working Arrangements

The EDT service will normally be provided by two social workers on duty together. They work together and answer all calls wherever possible. The answerphone message, when they are not available, advises the caller of the option, in times of urgency, to contact Arrowe Park Hospital who will page the social workers. Each social worker also has a work mobile number which they can also be contacted on.

The social workers receiving the calls are responsible for risk assessing and prioritising calls.

Where there are issues of high expenditure or difficult casework decisions they will consult the relevant senior manager for financial matters and some casework decisions. Some casework decisions will be discussed with the Team Manager.

For the period covered by the EDT service, when both social workers are out and they receive a page they will attempt to advise Arrowe Park Switchboard and the caller of the time period involved in responding. The duty police inspector and Arrowe Park Switchboard also have access to the incumbent duty officer’s mobile phone numbers.

It will be the aim of the EDT officers to speak to the person making a referral within thirty minutes of the referral being received.

Visiting is subject to health and safety procedures. This applies to both the community and various parts of the hospital.

At the start and finish of a working shift, each EDT social worker will act to ensure continuity and good communications. This will sometimes involve direct contact with daytime services or requesting the Team Manager or Team Support Officer to do so on their behalf.

When one EDT shift is followed directly by another, it is the responsibility of the officers being relieved to pass written handover information on pieces of work that require continuance. This will be done on the correct document in the handover period. There will also be verbal exchange.

3.6 Management Cover

A rota of senior managers ensures that advice and assistance is available to EDT officers at all times. The EDT Team Manager is also normally available to the EDT officers on duty.

3.7 Supervision, Appraisals, Performance Management and Training

The EDT Team Manager will be responsible for the individual supervision, appraisals and performance management of EDT officers in line with Wirral standard procedures, requirements and expectations. Training and development plans for each officer will be agreed through these processes, always ensuring as a priority that staff are adequately equipped, qualified and supported to carry out emergency duties across all service user groups.

The EDT Team Manager will monitor/review quality of referrals to locality teams and regularly liaise with day team managers to provide feedback and share necessary information.

3.8 Team Meetings

The EDT Team Manager will be responsible for ensuring that Team Meetings are arranged at least once a month, during normal office hours. EDT officers are required to attend all Team Meetings.

3.9 Quality Assurance

The EDT Team Manager will be responsible for developing and implementing a range of measures which ensure that the quality of the service provided by the EDT is of a high standard, and is routinely monitored. These measures will include the routine collection and analysis of agreed management information, and regular audits of individual cases. There are a number of joint forums attended by the Team Manager which provide feedback about EDT performance.

The EDT will aim to achieve the targets detailed below:

Service Activity Target
Initial response to referral within 30 minutes. 90%
Referrals to be passed to day services @ 09:00hrs. 95%

3.10 Review of Handbook

This document will be reviewed annually by the EDT Team Manager.

4. EDT Service Procedures

4.1 Use of EDT Service Procedures

The EDT will be responsible for all referrals made to Children and Adults Services outside of office hours. EDT staff will follow standard departmental procedures and guidance in determining their response to those referrals as and where they are commensurate with EDT Service Procedures. There may be some variance where prevailing conditions dictate.

tri.x procedures