Implementation of the National Trauma Framework in North Lanarkshire
North Lanarkshire Council · 5 May 2023
Back to Wellbeing and Tackling Poverty Committee — 5 May 2023 and its agenda
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North Lanarkshire Council Report Wellbeing and Tackling Poverty Committee Does this report require to be approved? ☒ Yes ☐ No Ref AG/AG Date 05/05/23 Implementation of the National Trauma Framework in North Lanarkshire From Alison Gordon, Chief Social Work Officer (Education, Families, Justice and Integrated Practice) E-mail GordonAl@northlan.gov.uk Telephone 01698 332001 Executive Summary The Transforming Psychological Trauma: Knowledge and Skills Framework (The Framework) has been developed by NHS Education Scotland (NES) to support the delivery of Scottish Government and COSLA’s joint policy intention to create a trauma-informed workforce. Being trauma-informed is about long-term culture and system change across the council to create the conditions in which staff feel supported to care for and respond to citizens in ways that recognise the impacts of trauma and create relationships that heal and resist re- traumatisation. It will support the delivery of the ambitious changes within the new Programme of Work. The purpose of this paper is to set out for Committee the actions being taken by the Council to embed the Framework in North Lanarkshire, highlight areas of practice where a trauma informed approach is already making a positive difference for children and individuals and outlining next steps, in ensuring North Lanarkshire becomes a leading trauma-informed council. Recommendations It is recommended that the Wellbeing and Tackling Poverty committee 1. Endorse the approach to the implementation of Trauma Informed Practice across the Council as set out in this report 2. Agree that the whole workforce should be trained at the ‘trauma-informed level’ as part of the suite of mandatory training 3. Appoint an Elected Member Trauma Champion to support the work to promote a vision for North Lanarkshire becoming a leading trauma-informed Council 4. Agree to North Lanarkshire Council signing up to the national Leadership Pledge of Support
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The Plan for North Lanarkshire Priority Support all children and young people to realise their full potential Ambition statement (9) Invest in early interventions, positive transitions, and preventative approaches to improve outcomes for children and young people
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1. Background 1.1 Evidence of the full impact of trauma, particularly adverse childhood experiences (ACES) has been emerging now for some time, establishing beyond doubt that its effects can be wide-ranging, substantial, long-lasting, and costly (NHS Education for Scotland, 2021). In response to this, the Scottish Government established a National Trauma Training Programme, led by NHS Education for Scotland (NES) to support the ambition, agreed with COSLA, to create trauma-informed and trauma-responsive workforce and services across Scotland. 1.2 In 2019 the Scottish Government published the Scottish Psychological Trauma Training Plan (Trauma Training Plan) to support local implementation of the Transforming Psychological Trauma: Knowledge and Skills framework for the Scottish Workforce (The Trauma Framework). Working with COSLA, the commitment to the implementation of The Trauma Framework was reiterated in the Programme for Government 2021-22 along with the initiation of a Leadership Pledge of Support for Trauma Informed Practice to raise the standard of support across public and third sector organisations. COSLA and a number of local authorities and HSCPs have signed this pledge, including North Lanarkshire HSCP. See Leadership Pledge Signatories. 1.3 The Trauma Framework outlines the importance of creating a trauma-informed system and organisation that supports the workforce engage with citizens in a trauma-informed way. This is reflected in 5 key drivers for trauma-informed practice which emphasise the importance of leadership and the wellbeing of the workforce: 1. Leadership and management 2. Workforce wellbeing 3. Workforce knowledge and skills 4. Experts by experience 5. Data and feedback loops 1.4 Being ‘Trauma Informed’, both at the practitioner and organisational level means being able to recognise when someone may be affected by trauma, taking this into account, and responding in a way that supports recovery, does no harm, and recognises and supports people's resilience. To achieve this, a trauma informed approach comprises 5 key principles: Safety, Trust, Choice, Empowerment, and Collaboration (see Appendix A). 1.5 The Trauma Training Plan, developed by NES, tailors training to the type of role and function performed by staff across 4 practice levels: trauma informed; trauma skilled; trauma enhanced, and trauma specialist (see Appendix B). 1.6 Being trauma-informed as an organisation has significant benefits for staff and the people they serve. Services are organised in ways that promote safety and trust to prevent re-traumatisation, and this is effective in preventing concerns and difficulties escalate, which in turn have a human and economic cost. The approach is about addressing inequality by ensuring that those affected by trauma (staff or those they serve) do not experience barriers to life chances and choice as a result of trauma and that trauma is recognised and responded to in order to support recovery. Becoming a trauma-informed organisation is not simply about doing what we already do better. Rather it is transformative in the way services are organised and delivered and
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therefore has the potential to be key driver of success for the delivery of the ambitions of the Programme of Work 2023-2028. 2. Report 2.1 Scottish Government and COSLA asked all local authorities and health boards to appoint trauma champions to ‘oversee, encourage and raise awareness of trauma informed and trauma responsive practice across all services within their area’. The champions have a specific responsibility to influence local leaders to embed the five key drivers of trauma-informed practice (as detailed in 1.3) across their area. 2.2 The Principal Psychologist and Senior Education and Families Manager (Social Work) are the nominated champions for the Council and a Health and Social Work Manager is the champion within the North Lanarkshire Health and Social Care Partnership. As requested by COSLA and Scottish Government, Ministers have been advised of these names, who are working with national leads in Scottish Government and the Improvement Service, as well as local leads in NHS Lanarkshire in relation to implementation. 2.3 Following agreement by Corporate Management Team in July 2022, a steering group of officers from Education and Families, Enterprise and Communities, People Resources and the HSPC has been established with the purpose of providing strategic direction and coordination of support and training to promote the implementation of Trauma-Informed Practice. The Scottish Government has made £100K available to all local authorities over two years to support the implementation of Trauma-Informed Practice. An officer was therefore appointed in January 2023, to lead on the implementation of Trauma Informed Practice and build on, and add pace to, the work started to integrate the Trauma Training Plan with current training plans in place to deliver The Plan for North Lanarkshire. Trauma Informed Practice in North Lanarkshire 2.4 The importance of being trauma-informed in our approach to support children, young people and their families has been recognised by services across the Council. Within the Education and Families, the Roadmap to Recovery, approved by the Education and Families Committee in September 2022, sets out a strategy to develop a trauma skilled work force, building on established work around nurture, resilience and other approaches based of forming strong relationships with children and families. Awareness about the importance of trauma recovery has been integrated into the delivery of nurture and resilience work and critical incidents. 2.5 The importance of being trauma-informed also underpins the Children’s Services Partnership’s longstanding investment in the Solihull approach (early intervention to promote emotional health and wellbeing) and its principles have been incorporated within the multiagency child protection training delivered by TOD and has informed the statement of principles, ‘Our Approach to Family Support’, adopted by the Partnership. Within children and families social work, there has been specific focus on key innovations in the implementation of Trauma Informed Practice. For example, North Lanarkshire is one of the first local authorities in Scotland to adopt the Scottish Child Interview Model (used with children who may have experienced abuse) with staff trained in Trauma Informed Practice at an enhanced level to reduce the re- traumatisation of children and promote recovery. High rates of disclosure have been a key indicator of success in taking this trauma-informed approach. A further example is work to develop a trauma informed approach by social work and CLD staff with young
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people at risk of harm or exploitation in the community – Contextual Safeguarding. An evaluation of this approach, undertaken by the University of Sussex in 2022 found that practitioners demonstrated trauma informed practice by • Prioritising who young people are and what they could be – rather than the risks that they face • Identifying young people’s experiences of trauma and addressing these when developing plans to support them • Challenging each other when service practices/cultures are not trauma-informed or risk re-traumatisation • Identifying services and relationships in community settings that could offer sustainable safety to young people beyond the life of an intervention 2.6 The housing service is working to a embed trauma-informed understanding of working with people through its implementation of the Solihull approach across the service. Other initiatives such as psychologically informed environments, ‘Family Plus’ and ‘Forever Homes’ have been piloted with housing and partners recognising the importance of trauma-informed approaches on improving outcomes. The new Local Housing Strategy (2021-2026) and the Rapid Rehousing Transition Plan also set out how a trauma-informed workforce will improve outcomes for people in need of support with housing. Work is also underway to help identify the barriers and enablers for adopting a trauma-informed approach within housing to inform the actions and support required to embed trauma-informed practice in housing practice. 2.7 An awareness of the impact of trauma is now also embedded into the approach to the design and development of our community hub programme. Working with the Promise Development team and Council equalities officer we applied a ‘trauma lens’ using the Scottish Government toolkit and identified a number of improvement actions e.g. paint colours, signage, seating, layouts and signposting to supports and services. This work will continue as our new community hubs are introduced and through tests of change to address the barriers that those affected by trauma can experience while accessing supports and services. 2.8 The Council’s Equalities Delivery Board also has Trauma Informed Practice firmly sitting within its strategy, delivery framework and five objectives to ‘ensure that local public services are responsive to different needs and treat users with dignity and respect’. Training 2.9 The steering group is developing a strategy to use the national Trauma Training Plan to support implementation in North Lanarkshire. An e-learning module at the ‘informed level’ (see Appendix B) is in development for all staff in the Council and committee is asked to approve its inclusion within the mandatory suite of training for Council employees. Beyond this, an assessment tool is being developed for services to identify at what level groups of staff need training across. A specific training offer for education staff has been developed in collaboration with Education Scotland to enhance understanding of trauma responsive strategies, aligned with the outcomes within the Roadmap to Recovery. 2.10 Dr Claire Stewart, Lanarkshire Trauma Coordinator, has delivered an introduction to The Trauma Framework to the Corporate Management Team and elected members, which is now available to members digitally.
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2.11 The principles of being trauma informed underpin and support all work with children, families, and adults. As such, the steering group has coordinated a review of training delivered to social work practitioners, housing staff, within education and across public protection to identify where the principles of trauma informed practice are embedded in training already. Training packages have been updated to reflect these principles where required. Next Steps 2.12 There has been a lot of activity to raise awareness about trauma-informed practice to lay the foundations for a trauma informed workforce through training. However, the success of such initiatives will be limited without clear and unambiguous strategic and organisational support for the approach, which ensures it ties in with the vision and strategic priorities of The Plan for North Lanarkshire. We are at the beginning of this process as a Council that moves from an organisation that is trauma aware to one that is trauma informed as set out in Appendix C. Particular attention needs to be given to ensuring that we understand the impact and how outcomes for people are being improved through the development of a trauma informed workforce. 2.13 Embedding sustainable trauma-informed ways of working is about long-term culture change. The steering group has identified key priorities below linked to the 5 strategic divers for a Trauma Informed organisation outlined in 1.3: 2.13.1 Leadership: Appoint an elected member as Trauma Champion to support the work of the steering group develop plans for North Lanarkshire becoming a trauma-informed Council to support the fulfilment of the ambitions of the Plan for North Lanarkshire and the new Programme of Work. Re-fresh governance of the steering group to align with the new arrangements for overseeing the Programme of Work 2023-2028. 2.13.2 Workforce Wellbeing: The actions to deliver the Council’s Mental Health Strategy for staff are underpinned by the 5 principles of a trauma-informed organisation. 2.13.3 Workforce knowledge and skills: Each service across the Council assesses at which level staff need training and a base line is established in order to update the training strategy for trauma-informed practice. 2.13.4 Experts by experience: Individuals, families and communities drive our approach to becoming a trauma informed organisation using existing structures for participation and engagement. 2.13.5 Data and Feedback Loops: Base lines and outcome data for trauma informed practice are integrated and aligned with measures of success within the Council’s new Programme of Work. Leadership Pledge 2.14 As set out in the Programme for Government 2021, a Leadership Pledge of Support has been introduced for organisations to demonstrate their commitment to supporting and embedding a trauma informed culture across their workforce and services. Signatories to this pledge agree to: • Work with others to put trauma-informed and responsive practice in place across our workforce and services.
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• Deliver services that wherever possible are actively informed by people with lived experience of trauma. • Recognise the central importance of relationships that offer collaboration, choice, empowerment, safety, and trust as part of a trauma-informed approach. • Respond in ways that prevent further harm, and that reduce barriers so that people affected by trauma have equal access to the services they need, when they need it, to support their own journey of recovery. 2.15 Members are asked to endorse the Council becoming a signatory to the Pledge as a further step in signalling the Council’s commitment to becoming trauma informed as a way of working and approach in everything it does and its importance for the delivery of high-quality services and support to people in North Lanarkshire. 3. Measures of success 3.1 Staff are trained in Trauma Informed Practice at the level commensurate with their role. 3.2 Improvement action on trauma design of spaces are delivered in line with the implementation of town and community hubs with ongoing learning feeding into future design. 3.3 Staff engagement, retention and wellbeing is improved through the implementation of trauma informed work at a systems level. 3.4 Council staff, services, and environments recognise the prevalence and impact of trauma, how they may create barriers to support, the key role they play in people’s recovery, and how they can reduce the possibility of re-traumatisation. 3.5 Outcomes for children, young people and adults are improved through positive relationships with staff and evidenced in feedback from citizens on their experiences. 4. Supporting documentation 4.1 trauma-training-plan-final.pdf (transformingpsychologicaltrauma.scot) 4.2 Appendix A – Trauma Informed System 4.3 Appendix B – Trauma Training Plan 4.4 Appendix C – Trauma Informed Roadmap 2023-25 Alison Gordon Chief Social Work Officer (Education, Families, Justice and Integrated Practice)
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? There is a growing body of evidence that impact of adverse childhood experiences and trauma contribute to increased risk of a wide range of physical and mental health conditions and social problems, including involvement in the justice system (Scottish Government, 2018). A trauma-informed approach to the delivery of services mitigates these risks and is an important component in the strategic work to reduce inequalities and delivering priorities within the Council’s new Programme of Work. If Yes, has an assessment been carried out and published on the Council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☒ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Cost of the Trauma Informed Practice implementation post (NLC 12) at mid-point including on costs is £46,705, 0.8 FTE. This is a temporary post for two years funded from Scottish Government Grant for 2022-23 which is being carried forward into 2023-24. 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☒ No ☐ If Yes, have all relevant HR impacts have been discussed and agreed with People Resources? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Trauma Informed Practice features as a firm commitment within the strategy, delivery framework and objectives of the Equalities Delivery Board. In terms of trauma design of town and community hubs and their spaces, the Council’s Safety and Wellbeing team and Equalities officer are involved in plans and improvement actions. The TOD team are engaged in training roll out proposals contained in this report and as HR policies are reviewed the impacts of trauma will be considered in development of guidance and toolkits to promote the wellbeing of staff. It is important to note that many staff may have experienced trauma themselves, and some research suggests that those in human services have a higher prevalence of adverse experiences, which means that staff support and strategies to mitigate secondary traumatic stress are crucial (Scottish Government, 2021).
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5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☒ If yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☒ No ☐ If yes, please provide a brief summary of the impact? There will be some impact on technology and digital given that supports and services will take a Trauma Design approach. This includes materials and media, policies and procedures and communications digitally. Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☒ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the Council’s communications activities? Yes ☒ No ☐ If yes, please provide a brief summary of the impact? There will be some impact around communication and engagement with communities and with staff if the report is approved. Particular emphasis will need to be given to engagement and communication around the training roll out. In terms of physical design of spaces, environment, and buildings there may be requirements to replace signage and other communications material.
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5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g., Corporate or Service or Project Risk Registers), and how they are managed? There are risks to children and families of re-traumatisation and increased distress if staff are insufficiently trauma-informed in their approach and practice. The roll out of The Training Plan is a national policy priority and the extent to which services have integrated and applied the approach will be subject to external scrutiny, particularly in any joint strategic inspection of children’s or adult services. If our workforce do not recognise trauma as an important factor impacting health throughout a person’s life, there is a risk that we do not enhance the positive impact we are seeking to achieve against our citizens health and wellbeing outcomes. If our physical spaces are not designed and maintained to offer a sense of safety, calmness, dignity, and promoting choice and control it could significantly impact the positive impact and aspiration we have for our town and community hubs. This also extends to an impact on productivity of staff and our ability to provide supports and services that are inclusive and responsive in their delivery. The trauma roadmap applied to our operating model for town and community hubs will address this risk through the improvement action. Attention to the principles of Trauma Informed Practice has now been incorporated into the revised Strategic Policy Framework adopted by the Policy and Strategy Committee on 16 March 2023. Furthermore, Trauma Informed Practice now firmly sits within the objectives of the Council’s Equalities Delivery Board. The steering group is creating a project risk register in line with the development of the implementation plan as outlined in 2.11. 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. • Our approach to participation planning to ensure that all citizens with lived experience are included in co-design/co-creation of services, and we engage with relevant organisations. • Completion of EQIA for operating model for town and community hubs
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Appendix A: Trauma-Informed System
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Appendix B: Trauma Training Plan
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APPENDIX C: Trauma Informed Roadmap 2023-25