to refuse to take responsibility for student with anorexia nervosa?

[Nimbostratus100]

Leading on from discussion on another thread, this situation came up in my teaching career recently. I had a year 10 tutor group in a girls school, and was asked to undertake training on AN, to support one of my tutees.

I did attend the training, but did not complete it. It was "in person" in that I attended a central location where a trainer displayed power points and was available for questioning. It took a couple of hours, and I left before it was completed. The reason I left ( as did others) was because we felt that the whole thing was an exercise in passing The Buck to us, under the pretence that we were somehow prepared, able and competent to give medical support in the absence of any other medical support being available.

The training wasn't just AN, it was also other serious conditions, such as suicidal depression, OCD, body dysmorphia, etc

Some of the content was interesting and potentially helpful, but it was quite shocking, the feeling that we were going to be left in the lurch, not with our little bit of knowledge and understanding just improving feelings of welcome and acceptance for our charges, but somehow responsible for them medically.

I think parents have a very limited idea of what teacher training about medical issues consist of. I have over my career trained in more than 60 medical conditions, but nothing like this, in the past I have learnt danger signs like "if a child with asthma cant complete a sentence without drawing breath, call an ambulance". Or "try painting the wall that a child with ASD is facing blank pale pink, it might help" - or " a child with CP may work better on a vertical surface not a horizontal one" etc

not medical management, and not absolutes, just guidelines for safety and things to try only

I did not complete it, and did not allow my name to be recorded as having attended.

I still stand by that - a run through of a few power points does not make me a safely knowledgeable and qualified person for a child with AN to rely on

AIBU?

If you have an EHCP, your child has a legal right to provide that provision.

If the school cannot provide that provision them "trying" just isnt acceptable.

EHCP provision must be deliverable. If it isnt deliverable it isnt realistic. The EHCP needs changing so it is deliverable.

Yes it is a legal hassle though

I still don't believe that school staff are weighing pupils with AN and certainly not measuring waists.
Did you report this training provision to your safeguarding lead/pastoral lead to flag up concerns about unsafe practice @Nimbostratus100 because if not I think it's a dereliction of your duty of care

No I don't think so either. But I suspect the OP may have got the wrong end of the stick.

If she's right and she hasn't reported her concerns it's a massive failure in her duty of care regarding safeguarding.

If I was the poor kid's parent I would be horrified either way

So what happens whilst the school is trying to recruit (and failing) staff to implement the EHCP, or when the parents are caught up in tribunal trying to get the provision in the EHCP? You can say that schools can’t diagnose (which they can’t), but they are absolutely the provider of last resort at the moment and are left trying to hold all the bits together whilst all the other services crumble around them.

Well trained staff do not materialise the instant the ink is dry on the EHCP.

At least there is an acknowledgement that medical care and the resourcing necessary to implement it should be covered by an EHCP, and teaching stafff shouldn’t just be expected to add it to their never ending list of things to do.

Op I’m fully aware the child was not under an ED team but you have been asked several times what exactly you were asked to do and what the name of the course was.

I will ask again. Were you asked to weigh children, measure waists and restrict water? I don’t believe for one minute that you were because nobody anywhere working with EDs would ask a member of school staff to do that for the reasons I have outlined. So no course would recommend that as one presumes a course would be written in conjunction with ED expertise. If a child was waiting for a referral their GP would be monitoring and would not ask you to do the things you say the course told you to do,again for the reasons I outlined above.

If the course told you to weigh children, measure waists and restrict water you need to say who was running the course as it is hugely worrying.

Ah yes, the OPP (one page profile). The most useless document in the world; supposedly updated once a year but in reality less often.

My dd is recovering from AN, ime the only support anyone at school would give would be low level supervision on whether they have eaten their lunch or not.

In my dds case they wouldn't even do that.

There is nothing else a teacher would be expected to do 🤷‍♀️

If it was general training on eating disorders then good as there is so much ignorance around them any education (as long as it's current) is a good thing.

So no course would recommend that as one presumes a course would be written in conjunction with ED expertise

I think this presumption is wrong. What’s probably happened is someone was told to cobble together some training for staff working with AN people (maybe not even children) and either assumed they’d be qualified clinicians, or just took clinically-relevant training and used that as it never occurred to them that TAs would be using that as a basis for quasi-clinical supervision of children with AN.

The assumption that care of children with complicated health needs is dealt with by a team of suitably qualified staff in good, regular communication and the time to do their job properly, is not correct. And it’s why I fully support teachers and school staff striking.

Thats a very big question with quite complex answers.

Very basic examples drawing from some of my own experiences....

When at tribunal the school i wanted to name in DS' statement (going back now) had no staff with sufficient skills to deliver the statement they were asked by the tribunal judge if it was Realistic to recruit and train a staff member and how long they needed to do it. If they couldn't have done it in this time it would have been considered that I needed to look for a more specialist placement.

In the example I gave in a previous post I would have given applied for a personal budget and called in my own far more expensive specialists had the LEA not sorted out the provision. I would have had the justification to do this as the LEA has a legal responsibility to ensure the provision in the statement. As it was threatening the LEA with judicial action was enough for them to provide the pressure needed to provide a solution to the problem.

Threatening or actually taking the LEA to judicial review can be a remarkably effective way of focusesing everyone's minds on getting the job done.

DS would not have been able to attend school safely without TA support and has a stoppy mum 🙄🙄🙄who would have no hesitation going to tribunal/judicial review if needed. Bluntly I suspect this means he is always top of the list with regard to ensuring he gets the provision in his EHCP. It is unfortunately the case that those who shout loudest get more.

If the school feel it isn't at all realistic recruiting on an ehcp then the provision of the EHCP is also inadequate. The LEA has a responsibility to provide an adequate education. If you are looking at switching to a more specialist/expensive provision this is good evidence that your regular school is unable to meet need. If you can buy in provision, this is also a possibility.

Put simply: threaten the LEA, buy in the provision, change the provision, change the educational setting.

DazzlePaintedBattlePantsM

That’s just ridiculous. Why would qualified clinicians need training?

Training providers don’t just cobble together courses that are inaccurate particularly in areas that involve safeguarding. 😳

It is possible to have it written into the EHCP that you have to meet/have regular (termly) meeting with any TA involved in your child's care "to ensure continuity of approach between home and school". You need to have discussed this with the "experts" who are assessing your child so it is written into their reports and therefore can be included in the EHCP.

In reality often I used this to ensure the school had adequately briefs the one to one's and to build positive and communicative relationships between home and school

But tbf I had a lot of very skilled help with getting DS' statement done and not everyone gets this.

Qualified clinical staff undergo training all the time. A school nurse, for example, will have a basic level of competence, and if there was a child with a particular need (such as poorly controlled diabetes or epilepsy), I would expect them to undergo training to ensure they have more in depth knowledge about how to manage that condition.

I have seen inaccurate materials used in training, but that wasn’t the point I was making, which was that training materials were being used for an inappropriate audience.

Anorexia kills. One would expect the same level of accuracy in training as you would get in epi pen or any other training deemed worthy of educating school staff.Are you really saying schools roll out inaccurate training?

It doesn’t matter who it’s aimed at it needs to be accurate.

Despite being asked several times the op isn’t saying what she was actually asked to do or who did the training.🤔

@Nimbostratus100 the website below explains situation clearly.

medicalconditionsatschool.org.uk/

And this link is the actual statutory government guidance regards to mental health

www.gov.uk/government/publications/mental-health-and-behaviour-in-schools--2

Basically as a TA you have a duty of care. It you have a duty of care you have a legal responsibility towards children with medical needs attending the school. The school have a legal responsibility to provide training. Those responsibilities are statutory, you cannot legally shelve them by failing to attend training.

It's worrying isn't it? It wouldn't surprise me inadequate training is rolled out.

It is shocking that someone with a duty of care won't report a major safeguarding failure

That 2nd link literally says “non-statutory, departmental advice”.

My apologies that was the wrong turn of phrase. I meant guidance. I was literally doing something for DS at the same time

Doing training in treating AN/ED in any capacity such as weighing, fluid intake etc, does not meet statutory requirements or the NICE guidance. It just doesn't. All ED have to be immediately referred and treatment started within one week for urgent and 4 weeks for non-urgent. No-one would be required to do weighing in those four weeks except possibly a GP.
www.england.nhs.uk/mental-health/cyp/eating-disorders/

BEAT the ED charity know exactly what has to be provided legally and what the role of schools is, which is if staff are trained in ED awareness they may spot EDs as young as primary school, inform the parents and encourage them all into medical assessment. Not beyond that:

www.beateatingdisorders.org.uk/training-events/find-training/spot-online-training-for-schools/

I don't know what training you were doing OP but this organization have either failed to transmit to you the responsibilities of staff, or they have set up a programme which breaches statutory and other guidelines.

EDs are the one area of adolescent (and younger) mental health in which action is taken pretty quickly. you may have to wait for CAMHS for full therapy, but medical supervision is provided usually very quickly as these are life-threatening disorders that can suddenly turn very bad. My dd had MH issues which were not properly treated but once an ED appeared, there has been a lot of medical action (as blood tests, ECGs etc have to be performed, even if you are waiting for therapy).

I meant to say School professionals doing training in treating AN/ED in any capacity such as weighing, controlling fluid intake etc, do not meet statutory requirements or the NICE guidance. It just doesn't.

If you look on the BEAT website then only GPs or specialist ED team members are even allowed to do the monitoring training.

I’m sorry there isn’t enough support or any funding for health anymore, it’s shit. It really is.

But as a mum to a newly diabetic primary aged child, them going to school is terrifying. You have no idea. You’ve no idea how hard this is on a small child who just wants to be like their friends, who doesn’t want the attention or be seen as different. Should children with medical needs now be punished by being removed altogether, because their needs can’t be met?

He’s entitled to an education, luckily our school has been brilliant with the care. But I cannot give up work so I can come in once a day to administer insulin or deal with a hypo.

I get that it’s hard and not ideal but it’s only going to increase as more and more children have either mental health issues or medical needs as our population increases and we save more babies earlier. We haven’t caught up and I can’t see how it will with funding being pulled constantly, within schools and the NHS.

Highdaysandholidays1

That was exactly my understanding. I don’t think for one minute this charity told the op to do any of these things. We have been involved with several charities for a variety of reasons on our journey and they have all been so well informed, at some times better than the services themselves. They rely on funding to survive, no way would they screw up something like this.

To the previous poster I agree totally but try not to worry. As diagnosis for conditions improves more and more youngsters will be discovered earlier. That is a good thing. I don’t think staff behave like the op. In my school we wouldn’t have jobs if we had that attitude and walked out of training. EHCPs are taken hugely seriously and we are supported well to deliver what is needed by the SENCO. Medical conditions are treated with the utmost priority, paperwork and procedures are scrupulous and there is a continuous cycle of up to date training with more added in for those that need it working with specific children. Aside from anything I’m pretty sure diabetes would be covered by the disability act. Mental health is and schools can’t just pick and choose who is able to have an education. Reasonable adjustments have to be made.