Safeguarding online: How Young Somerset digitised their 1-to-1 therapy service in just one week

With haste and care, while keeping their vulnerable young people engaged and satisfying NHS information security considerations. 

Three weeks ago Young Somerset were supporting 350 young people a week through face-to-face youth work and interventions. Their digital infrastructure could best be described as ‘fledgling’.

Three weeks ago teenagers in Somerset were looking ahead to the next day of school, hanging out with their friends, Mother’s Day, Easter, exams and school proms. 

Then, like it did for so many of us, everything changed with the implementation of the UK government’s COVID-19 movement restrictions. On Friday, 20th March Nik Harwood, the charity's CEO suspended all face-to-face services. Suddenly 72 of the most vulnerable young people, those receiving weekly therapeutic CBT sessions from the charity's Wellbeing Service were isolated at home. Already part of the loneliest segment of society home wouldn’t be a pleasant or safe place for some of them. 

The Challenge

Nik and his team faced two challenges:

1. How to keep young people engaged and supported in the immediate short-term - so they know support is still there, that the tap won’t be turned off, while...

2. Finding a method of online delivery that was safe for staff, safe and accessible for young people, and met their NHS commssioner’s information governance and security requirements 

By Sunday, 29th March they had agreed and signed off a new service delivery protocol with commissioners. The following day services resumed, now online.

Here’s how they managed it.  

Slowing down

Knowing from experience that speeding up led to panic and bad decisions Nik deliberately slowed his 45-strong organisation down. He decided to avoid quick fixes and instead took a long view… seeing that this was the chance to put in place the digital infrastructure to reach young people in a rural setting that the charity had been wanting to.

“I looked at the sudden need as an opportunity. This is what gave me the energy to approach digital head on. Knowing that the organisation could come out of this stronger.”

Nik Harwood - CEO, Young Somerset

Researching to understand

At the same time Nik and his senior management team began researching what they’d need to do to get the Wellbeing Service online. This involved:

• Internal meeting (Monday AM)
• External meeting with local Child & Adolescent Mental Health Service Manager - their services were in the same position
• Sharing peer support - joining WhatsApp groups set up by peer youth organisations
• Playing the scenario forward - mapping safeguarding risks, mitigations and likely success indicators 

Through this process a likely solution emerged, but there would still be security hurdles to jump and a safeguarding protocol to develop. And meanwhile their young people still needed supporting...

Keeping 72 young people engaged with the service

Immediately Young Somerset’s senior management team issued clear and precise communications to the, now remote-working, team:

• Call each of your young people. Reassure them that sessions will continue. Let them know it may be by video.
• Keep your comms channels open and be ready to engage with any of your current or previous caseload if they message you by email, phone, whatsapp or the service’s facebook page
• Don’t implement other solutions - we are working on one.

As the team followed through on this Nik made contact with the service’s CCG commissioner to discuss information governance and security.

Four elements of information governance and security

Nik had already read NHSX’s COVID-19 Information Governance advice. It was reassuring. 

The commissioner anticipated the need to move the service online, and the likelihood of increased demand. Once Nik had outlined his proposal he referred it to his Head of Information Security and Governance. 

Together Nik and the Head discussed the solution, its issues from both a security and implementation perspective, and how these might be mitigated. The Head documented these and took time to review, while Nik and his team pulled together all their learning and began writing a protocol. 

Then Nik heard back from the Head and commissioner. They were happy with:

1. The process undertaken - researching what users needed and considering safeguarding and information security requirements
2. The decision - to use Zoom
3. The rationale - their reasons for choosing Zoom
4. The exit strategy - a plan to review the solution weekly and two alternative solutions (Microsoft Teams and Discord).

A new protocol for delivering online support

Young Somerset began delivering therapeutic services online on March 30th. They now have a working protocol that covers:

• Evidence for delivering online support
• Developing therapeutic relationships online
• Risk and safeguarding
• Session set-up Do’s and Don’ts
• Guide to using Zoom
• Guide to helping clients set-up the software

They’ve also taken their consent forms online, developed a protocol for phone support and are developing a protocol for digital open access youth work.

Someret’s CAMHS service also chose Zoom to deliver their therapeutic services. 

“I don’t think we will go back to the world we were in. I expect online delivery to be part of how we deliver therapeutic work in the long-term future”

Nik Harwood

For more information on using Zoom, see the latest blog from our Cyber Resilience co-ordinator, Alison Stone.