The second of two episodes to celebrate the Festival of Residential Child Care 2017.
Debbie Nolan, Centre for Youth & Criminal Justice (CYCJ) introduces Alison Gough, secure care national adviser, also of CYCJ. She asks her about the key messages emerging from the Secure Care National Project, which were published in the 2016 CYCJ report: Secure care in Scotland: looking ahead.
Deborah, Lesley and Sharon, who all work in secure care, share their perspectives, experiences, hopes and priorities for the future for young people in, and on the edges of, secure care and the sector.
- Public and professional perceptions of secure care and whether these chime with practice experience
- The implications for secure care practitioners helping young people who have been involved in seriously harming others, alongside those who have been exploited and are very vulnerable to further harm
- Priorities for the planned strategic board for secure care, next steps, and the involvement of practitioners
DN Thanks a lot to everyone for joining us today. Today we're going to be talking about the perceptions and experiences of secure care with myself. My name is Debbie Nolan, I'm Practice Development Advisor at the Centre for Youth & Criminal Justice.
AG Alison Gough, I'm the Secure Care National Advisor and I'm also based at CYCJ.
S Hi, I'm Sharon.
D I'm Deborah.
L And I'm Lesley.
F And everyone here except for myself and Alison work with young people in a secure care centre in Scotland. So, we really appreciate you guys giving up your time and travelling and coming to meet us to have what we think is a really important conversation. So, the focus of today is going to be to explore your experiences and your views about the key messages and calls for action that came from the Secure Care National project which has been based at CYCJ, and these key messages and calls for action were published in the report "Secure Care in Scotland: Looking Ahead" in November 2016, and for anyone who hasn't already seen that report it's available on the CYCJ website at cycj.org.uk. So, to start off the discussion then, Alison, can you tell us about the Secure Care National project and the "Looking Ahead" report and its recommendations?
F Yeah sure. As you say, the Secure Care in Scotland "Looking Ahead" report was really the core output of the Secure Care National project, and that's really been a review of Secure Care in Scotland. It was commissioned by the Scottish Government, and they funded CYCJ to take an independent, strategic, analytical and practice-focussed review - they tried to get as many words as possible into the kind of description of it - and the remit was really to ensure the effective delivery of service to children in secure care, to look at current trends and achievements - which I think is important - and risks, and really make some recommendations to partners about the future purpose of secure care and the shape of the secure care estate. So there's probably three key drivers really behind why the Scottish Government asked our work to be undertaken, and first I think that the government recognised that there was a need to revisit the purpose, function, impact and experience of secure care in the context of the "Getting it Right for Every Child" strategic framework - GIRFEC - because there's been a lot of developments in law and policy and practice since the previous review of secure care which was back in 2009, that was the "Securing our Future Initiative" known as SOFI, and in that time since the SOFI review there's also been real volatility and unpredictability in terms of what people actually want form secure care in Scotland. So, we've seen use of secure care by Scottish local authorities just drop. There have been dips and spikes within that but overall there's been a real significant drop in the use of secure care for children in Scotland. That could be seen as really, really positive obviously if we're responding to very high risks and vulnerabilities in a way that means we don't have to detain young people in care, but that's questionable whether that's always happening, and also as four of the five secure care centres are run by independent charitable organisations it's very, very difficult for them to plan and look ahead in terms of what's needed and how can they plan for the future. So, this question's really around, you know, who is secure care for and who should it be used for, and that really gets us to the third driver which was recognition that strategic direction is required to inform commissioning and planning in terms of what we actually want for our most vulnerable young people who present the highest risk to themselves or others. In the context, really were that although the secure care use has been falling at any one time, really we've got four to five times the number of sixteen to eighteen year olds on sentence or remand in prison settings than they have in secure care.
F So a real range of things that you looked into there, Alison. So how did you go about the project?
F Well we tried to make the approach really one of enquiry, listening to, hearing from and learning from a range of stakeholders, and we tried to be as intensive and inclusive as we could. So, we started really from the heart out, and for us that was meeting first with young people in secure care and with the practitioners and workforce across the five secure care centres. So, we spoke with nearly sixty care-experienced people, most of whom were children in secure care at the time but they talked to us, and we met with nearly two hundred individual practitioners and managers across the five centres. There were lots of other events as well. There were two national events where we brought together kind of sector leads, and one of those involved over a hundred people and there were some significant decision makers there like Directors to Children's Services, CALMS, Senior Clinicians, Chief Social Work Officers and so on.
F So you tried to capture a real range of voices then in the project, but what specifically did you find out?
F Our findings were really wide ranging but I think particularly for today's conversation it's very important to acknowledge that we found a lot of really positive stuff and a lot of progress and changes in how secure care is being delivered in terms of culture and practice within the secure care centres in Scotland, and that's actually quite well documented through internal and external evaluations and awards and particularly through Care Inspectorate and Education Scotland, but I don't know if we really recognise enough when you look across the UK and some of the difficulties that have been happening elsewhere, particularly in England, around outcomes for young people in parts of the kind of secure care and youth justice systems. We perhaps really need to do more to build on the best of what we've got within the secure care at the moment. The (... unclear) network were really dedicated and caring and the kind of compassion with which people approach very, very difficult work and the young people struggling with really serious issues and difficulties, it was really very impressive. Also, the other responsible people I met with, senior social workers, commissioning officers - a whole range of people. Everybody seemed to be really trying to do their best but it's very, very complex issues that we're struggling with here, and certainly the young people that spoke to me shared their reflections on life in secure care were kind of as variable as young people, you know, who I last spoke to really by Who Cares Scotland maybe in 2006, 2007 - the last time there was a piece of consultation done with young people in secure care. So young people shared really powerful accounts. Some of them were saying that secure care saved their life and certainly changed their life for the better, and it being a real turning point for them. Others really, really struggled and still have a sense of secure care perhaps being a punitive or overly restrictive environment for their - and like, they struggled with that. So, I think there's a lot that we still need to look at in terms of how we're approaching secure care and how we do that in a way that means the experience is equitable if you like, across Scotland. The key professional decision makers like chief social work officers, who we did some further research with last year - we've just published that report - they sometimes had really dramatic and different opinions and perceptions of secure care, about the purpose of secure care and the quality of secure care, and they held some fairly strong views on that, and that seemed to be exacerbated by the absence of any kind of national strategy really and standards for secure care that sets out what the purpose is, the values, the principles, the underlying ethos across the secure care experience rather than just each organisation having that in place, and also because secure care seems to be seen by these decision makers as other, and being kind of separate from the wider care system and being very, very out with that. So, the overall focus of the last review and the policy since then - since SOFI - has really been on what can we do to prevent the use of secure care, how can we prevent the young people reaching that point where they need to be secured and of course that's really, really important. I thought we also need to look at what is the experience of young people when they are in secure care and just as importantly, how are they being supported and what's their care journey been about before they've reached that point of secure care, and how are they being supported by their local authorities and all their kind of corporate parents after secure care?
F Okay. So, you've got a real range of views then and quite a mixture - at times conflicting views as well - round about secure care, but what did you find about the future of secure care?
F Well, you know, hundreds of people spoke to us really and a lot of them had a lot to say and had really quite strong opinions, but actually, out of all those people I can rarely count on one hand the number of people who said right, I can rarely see, you know, the Scottish Government's vision is that we have a future where there's no need to detain any child in secure care, and although a lot of people said "yeah, I absolutely agree with that vision", nobody really had a clear sense of how are we going to get to that point, and there seemed to be a real lack of share and understanding between and across agencies about what is the purpose of secure care. Is it purely containment or should it go beyond that, and if it should go beyond that then because it's currently defined as a last resort in legal terms, because obviously you're restricting young people's liberty, how can we expect secure care centres to - as one residential childcare worker said to me, you know, "we're being asked to kind of heal twelve years of hurt and damage and abuse and neglect in a twelve-week placement, it's just not possible." So we know the vast majority of young people in secure care are there for their own protection rather than because of the offences they've committed, but we know at CYCJ - and everyone working in secure care knows - that young people who are involved in offending - and particularly those involved in violence and serious offending - are also young people who've experienced multiple difficulties, hurt, neglect, adverse childhood experiences and so on, and the available information we have also tells us that young people in secure care, the majority of them will have significant mental health and emotional wellbeing needs that have sometimes gone unmet, and sometimes mental health difficulties that have sometimes not been responded to either, and despite this really - although the vast majority of young people are there for their own protection, not because they have offended - young people that spoke to me quite often, even those that said they'd had really good experiences and felt loved and cared for by the staff, teachers, residential childcare workers within secure care, they still used phrases like "I need to just do my time". So they were still equating the experience of being secured with somebody choosing to punish them, the system choosing to punish them, and that was really quite heart-breaking, and one of the women talked about • she was a care leaver • she talked about that she hadn't done anything wrong but she'd been secured alongside a young person who'd set fire to somebody else, and then she talked about well, you know, goodness knows what had happened to that young person when they were growing up, and she said - it's a quote that just really stayed with me - she said were blaming young people and some of the adults who've hurt them and let them down, so I think that kind of tension is right at the heart of things really.
F Okay Alison. So, loads to talk about there and lots of things that we'll come on to in our discussion, but the report is called "Looking Ahead", so what recommendations did it make about solutions to these issues and taking things forward?
F Well, despite raising more questions than we answered - which I think everyone would agree was the main outcome from the project - we did make some strong recommendations, and the Scottish Government are taking some of those forward which is really quite exciting - it's a real opportunity. So we called for a strategic vision, direction and leadership, particularly from local authorities and their representative bodies, and really all the corporate parents who are responsible for making decisions about how we respond to very vulnerable young people, and we felt that that leadership should also include the developmental explicit statement about the purpose, values and principles underlying secure care and that we should move towards a national standards framework and a care pathway that should include things like mental and emotional health and wellbeing for young people who are coming in to secure care. So, we hoped that the secure care national strategic board would be established to take these issues forward and also particularly to look at the remaining questions and tensions in terms of that interface between the Children's Hearings System and the adult justice system, and the use of secure care rather than imprisonment or not. So, the Scottish Government are moving forward with that, and the work that we're involved in currently is, you know, speaking of people and again trying to put together a really clear kind of map if you like for how that strategic board will function, who it will involve and how it will take these issues forward.
F So today's like a real opportunity to start contributing to that planning for the board but you would hope to hear from other residential workers, secure care workers, other agencies that are part of this picture as well who listen to the podcast as well, is that right?
F Absolutely. We want to kind of conclude the project the way we've started it and the way that we've tried to run it throughout, which is to really keep with the voices of young people and secure care practitioners right at the heart of the discussions and the debates, so I'd be absolutely delighted and I've probably said quite a lot, so I'm really looking forward to the next, the kind of meat of the discussion if you like, where I can hear from colleagues who are directly working in secure care about what that means for them and how, what they would like to see the strategic board do in taking things forward for the future.
F Okay, so let's open up that discussion now then. So, it's seems like the National Secure Care project heard a lot and heard that although over eighty percent of young people in secure care are placed through the Children's Hearings System and not through the court process and that regardless of their route in, young people in secure care have almost always had difficult and adverse experiences. Perceptions still remain that secure care is a punitive response and that still seems to be a commonly held belief. From your perspectives, does that chime with your experiences of how people perceive the work that you do in secure care or otherwise?
F I think from doing some research yes it does chime true, which is unfortunate. However, we were getting more people into our organisation i.e. social workers, parents, panel members in to see the organisation then it is perhaps changing, so I think it's the unknown that people are just maybe assuming it's like x, y, and z, it's like maybe like lock up the kids and throw away the key type thing, and it's certainly not like that and I think, well I have certainly a real passion of the people that I work with about the work that we do with the young people and how the environment is for them, how nurturing and therapeutic it is. So hopefully we could change people perspective of how secure is.
F I would agree with that. Definitely. I think there needs to be more opportunity for decision makers to make the effort to come and visit these establishments and actually, rather than putting two and two together and coming up with five, actually see it first-hand, see how the staff do actually work with the young people, see that nurturing side of things, because I would echo what you've said Sharon, that it is, even from friends of mine, you know, or you meet someone for the first time you tell them what you do and where you work and they think "oh", and you're educating them as well. So, it's a public perception as well as people that have a statutory ability to secure young people and I think, you know, it's about certain individuals educating themselves and actually rather than making assumptions, go and find out, you know? Come and visit it and see what it really is because it's not what you think it is, you know?
F Absolutely agree and I think a shared marketing point will be - that will counterblast the perceptions of secure care being a punitive environment - is around what we do as an organisation as everyone's described, inviting people in to actually see what the environment is like, the real therapeutic work that is undertaken with the young people and, you know, we all hold service brochures that we share externally and I think it's about having a real repertoire of the services that we actually do deliver, so it is, it's about getting that information out there for everybody to raise awareness.
F Definitely, and I think that making comments from like the chief social workers it's like none of them have maybe been in secure to see what it's like, so we were lucky enough as an organisation to get a visit from Mr. John Swinney from the government, so I know their vision is not to have secure facilities in the future, but he was taken aback by the quality of work that is obviously produced in secure care. So, I think it is the way forward to get people in, to get them to know what we do and to see the environment and to see how happy the kids are that are there - some obviously aren't happy to be there, but a lot of them do thrive from secure care.
F And I think it's clear that, you know, secure care does have a real critical role in safeguarding and protecting the vulnerable young people that we all look after, and it's really essential they're in the continuum of care rather than being as described Alison, being at the kind of end of the care journey. I think it's crucial.
F I think from families points of view as well. Often I've encountered families are a bit unnerved and they're left feeling quite, they're reeling when they hear that their loved one is going to be secured but again, you know, it says a lot for the staff who are dealing with families directly that they can break down those perceptions and those barriers and we are just normal people who care about the young people that we work with passionately and we do want to help them, however we don't want to just disregard the issues that have brought them in there. We will be honest and we will be open about how we think the best way to manage certain behaviours that are what not, but at the same time, you know, it doesn't end up being as frightening a place as they first view it as initially and they're often turned around in their views. You will always get families who won't necessarily buy in unfortunately, but there are a lot out there that have went full circle, you know, and think "oh do you know what, this is the right place for my child" or whatever, you know?
F I think as well, as it says eighty percent are coming through the Children's Hearings System yet we've got a lot of trainee panel members that come in and they have a visit of the organisation and where the young persons' rooms and where they're going to be sleeping, where they're going to be living, all the kind of things that are on offer for them, and they're kind of taken aback because ultimately it's them that's making the decision for them to be secured. So, it's to give them an insight to what's on offer as well for the young people, so that's been helpful for us as well.
F Yeah that's been crucial in terms of children's panel members and other external agencies being able to come round and have organisational visits and allow us to have that kind of, that forum, in order to really showcase what secure care and the work that we're doing and like you're describing Sharon, actually give panel members the opportunity to see the care environment where young people are being educated, where the intervention work takes place and their bedrooms. I think it's reassuring for panel members as you say, that's making the decision that the young person's going to be placed in our care, so...
F Yeah, so it sounds like a real need for a joined up approach then to make sure that perceptions are being changed on all sorts of levels, so very much on that public perception level, then with young people and their families making sure they're getting good quality information to understand what secure care means, what it can provide and what the parameters of it are I suppose, but then having also that wider professional understanding as well as then ultimately the decision makers as well having that collective understanding and building, I suppose, strategies on each of those levels to make sure that these messages are getting out there. So, you had briefly touched on there about sometimes young people being in secure care for their own protection and possibly their own vulnerability and in terms of being at risk of serious harm, but then likewise in secure care is also a provision for young people who have committed serious harm towards others. You know professionals have really mixed views about in the project that were expressed round about whether secure care could meet at times those different needs and the different challenges that those behaviours could present. What are your views and experiences on this, of that ability to provide the care and support needed for young people who are at risk of harm or present a risk of harm to others?
F I think as secure providers, you know, we've got a real awareness of contagion - I think that's what people are concerned about - but what we pride ourselves on as being secure care providers is that we're providing real pro-adult role modelling, and providing that role modelling provides support to the young people to be able to manage their time when they're around other young people from different, for different reasons, that they've been brought into a secure environment. So yeah, there's a real awareness around that, but there's real factors that almost counteract that as well so, yeah...
F I think although if one young person's presenting risk to themselves, one's presenting risk to others, when you read their backgrounds they've all maybe had some kind of trauma or came from the same kind of backgrounds, so there are similarities. So how to manage it is obviously the high staffing that we've got in place and it's teaching the young people coping strategies, it's allowing them to socialise and as Lesley said, like kind of pro-social modelling with the staff so there's lots of opportunities for them, and we obviously try and keep them as safe as we possibly can when they're in there.
F I think for me at this point in particular it just emphasises the importance of your core team within a unit, and the communication being very clear and transparent and everyone having a full understanding of each young person, their background and their life experiences up until the point that they've came in to you guys, because it's very much not a one size fits all, and everyone needs to be educated to that point who's working directly with the young person. I think as you've touched on, you know, sometimes one to one staffing is definitely advisable - or even more at times - because depending on the risks that are being presented, you know, you've got to be able to manage that and it can throw up some issues in terms of our consistent model of caring, other young people within a unit saying "well why is this person getting this and I'm not getting that," and I think we've all encountered that but, you know, I think again it's about bringing it back to basics and speaking to that young person in particular on a one to one basis and just saying that everyone is individual, you know, we've got to, your circumstances are going to be different from the next person and this is about you and it's about very much focussing on each young person within your unit and making sure that they feel valued and that their care is very, very important to you.
F I think on the flipside as well, when you do get a referral in you read their background and you think "oh my goodness, they're going to harm their self or they're going to harm others" and when they come in they're not like that...
F ...because they're in a place that they maybe feel safe at the time and they've got all the kind of different agencies that can kind of work with the young person, so you don't see that person that's out in the community, so it's a time to get the specific work and intervention work done with them.
F I think as well, you know, we kind of spoke about the amount of young people within Scotland that are in Polmont for example, and personally I feel somewhere a secure facility is more focussed along the lines of a rehabilitation route as opposed to, you know, the kind of prison type environment.
F Again we've kind of mentioned about the amount of young people that, most of our young people have had some horrific life experiences and some serious, serious trauma throughout their life and I think within a secure environment we look to nurture that and try and re-educate and try and learn new coping strategies as opposed to "well this is my life right, this is what I'm going to go on and do for the rest of my life". They may have family members that have been in the judicial system for decades and I think a secure environment actually maybe changes that perception that there is another way and people are here to give you the nurture and the care that you need in order to maybe see that.
F Is that something that you would kind of echo with?
F Definitely, yeah.
F I would agree whole-heartedly. Yeah, just ...
F I think it is, it's the caring aspect of it definitely because if they are sixteen going to Polmont then there's not the same staffing levels, there's not the same interventions, there's not the same time to spend with the young people up there, and they are still children at the end of the day and we need to give them that time and invest in them.
F And you'd spoke earlier in about there needing to be sort of a change in different levels of perceptions round about what secure care does. So, when people are talking about either young people are a risk of harm to others or they're a risk of harm to their self and there's not really that recognition of the shared need, so you think there's a need to try and change some perceptions round about that as well? Round about the backgrounds of the young people that you're working with and round about the similarities of experience however those behaviours are communicated.
F Yeah, I think it's important that they know what the backgrounds of the young people - not to obviously divulge, obviously for confidentiality - but to know that we're dealing with the most damaged children in Scotland, so it is a time to stop and give them time and work with them and give them the care that they've not had, because we've got young people who from four years old have not had the parenting, they've just been allowed to do what they like and kind of bring their self up, so it's about being corporate parents and saying "no, this is the way it should be" and hopefully setting them on a path that's right for them to kind of start their life when they leave secure.
F Unfortunately for a lot of our young people they need to be removed from the temptations that being out with a secure environment brings. No one takes it lightly taking someone's liberty away from them, however, you know, when a young person who's exhibiting certain types of behaviours and going in to a huge cycle, a crisis over a period of time, it's not a major decision, you know? It's not without giving it some serious, serious consideration but, you know, in order for them to actually choose not to deflect away from the emotions that the trauma that they've experienced has, how that's impacted them and the behaviours, that then it comes thereafter, because often it's a case of "well I don't want to deal with that so I'll just drink myself into a stupor, I'll just get full of drugs" or, you know "I'll spend time with negative influences." So secure can take that away, and we have worked with young people who have said "I'm actually relieved because I don't have to deal with that anymore", you know, and it's not that you're saying that you no longer have to make any decision for yourself, because we still have to encourage them to take responsibility and it's still very, very difficult to get to the emotional crux of either behaving the way they do, however if they're not under the influence and their perception hasn't skewed and they're not being able to deflect as regularly as they would do, then it can really, really benefit them. It can.
F I think, although that we are the last resort, I think sometimes going back to when you get a referral in for a young person, so think "if they'd only come into secure two years ago then we could have stopped all this happening" but they leave it and they think "we'll try this in the community", x, y, z and they give them so many opportunities but sometimes it is too late. The damage is done but it's, you think just I wish we weren't the last resort sometimes. I wish we were part of the continuing care and there were other ways to obviously come into secure rather than just it being the last resort. I definitely think the work that can be done in secure is second to none with these young people, and it would give them that chance, and if we just done it that bit earlier it may make the difference for their younger years so that they can enjoy them rather than being in and out children's hearings and in and out of court systems.
F I agree Sharon, implementing therapeutic care really shouldn't be the last resort or the last option, you know, but an intervention of choice, and I think that's what our experiences are, you know, through thorough assessment of need and risk secure care is probably one of the best options for that young person at that time and, you know, stronger belief that, you know, the behaviours that lead to young people placing themselves at such risk and they're at heightened vulnerability, that it's exactly what we can offer in terms of a therapeutic, educational and, you know, and a social approach to making a real difference, and sometimes as you've maybe experienced, we have direct referrals to young people who have come directly from home and there's not been the kind of care journey that has maybe been the expectation that they've gone from family home to foster care and then to a residential placement. We have had young people that come directly in because the assessment of need and risk is as such, that that's the level of care and intervention and they need that therapeutic secure setting and we're giving the opportunity to work with them in that, and in more than what I think the view and the perception is of a containment model. It's a whole range of more where we're able to offer a suite of interventions for whatever that particular need for that young person.
F I would echo that for sure and I know there are a number of organisations that, you know, a young person will be identified a programs work or a psychologist and that individual will then continue to work with the young person if they then go a step down or a residential setting within the same organisation, and that continuing of care is really important because a lot of these young people have just had such erratic experiences of whether that be multiple placements or just within the family unit. Nobody's hung around a lot of the time long enough so for us to then be able to provide that is really, really important and I think we're fortunate to be able to do so.
F So we're hearing a lot about the real positive factors that secure care can bring, the real need to move away from this perception of this being about containment. It's much, much more than that. So, in terms of any strategic board, what do you think they key priority should be for the strategic board in terms of taking things forward for young people who are in or are on the edges of secure care?
F I suppose, just following on from what we were saying about the continuing of care so that not to be the last resort, to look at like other options for it being - I know they can come in voluntary - but it to be not the very last thing and then get to that crisis point, and maybe a young person trying to do something to harm their self or they've harmed someone severely that it's came to that point if they're able to get in there a lot earlier to offer support and give them the kind of care that they need at that time.
F I think as well there's the need for mental health commissioning for the secure units to have the better access to the specialist mental health services that the young people need, and to use that time when you've got young people in a particular place and when they're in a safe place to receive those services and for us to be able to support the young people as they access that as well, and there needs to be a wider range of, and I guess funding into that, into the mental health services that are offered to young people as we've described and spoke about, it is the degree of trauma that the young people have experienced and to, you know, give them the interventions that they need, it's crucial.
F I think as well we need to focus a lot on getting better in terms of communication as well and keeping families abreast to the situation and making sure that they're aware that, you know, secure is on the horizon, and trying to alleviate their stresses about it and, you know, being an open book so to speak that this may be up ahead and this is why and this is why we feel that this could be of benefit to the young person, and just being upfront and honest about things. I do appreciate, and this is coming from, you know, having a lot of kind of cross-border referrals and we have had young people brought in who have basically been whipped away from their last placement and dropped off and in Scotland, you know? They've came from England, they've been dropped off in Scotland and they're kind of "I don't know what's happening here," and maybe families are the same as well and it's very, you kind of start off on the back pedal there because they're already very, very suspicious and they feel like, you know, "well nobody's been honest with me until this point", and I do appreciate that certain young people do present a specific type of risk, whether that be aggressive or whatnot but, you know, I think we need to keep families up to date with what's going on and just try and be, keep the communication so it's clear and transparent as we possibly can.
F I think from all the kind of research and consultation that we did during the project, that's just such a strong point that came over so strongly Deborah. I mean, I was really quite saddened and quite shocked because the young people that spoke to me, most of them were Scottish young people placed in secure care, and sadly quite a high proportion of them had had similar experiences where they really did not feel that they'd been prepared or supported very well through that kind of admission process, and we all recognise the impact of being detained in secure care. It is a very significant life event for a young person.
F I think as Sharon had mentioned earlier, it's the constant, you know, it's a threat, it's a threat, it's a threat, and it's mentioned and it's mentioned and it's mentioned and as you've spoken about, perhaps if it was an earlier intervention then we would see, you know, better outcomes. However, it's like the boy that cried wolf, if your social worker keeps saying the same thing to you and it doesn't happen for as long as maybe a year or whatever, then when it does happen you're thinking "oh well I wasn't expecting this," you know, and it's just, I've came across that quite a number of times where they just feel, I mean it's difficult enough being taken away and having your liberty taken from you, but to then feel as if you just didn't see it coming at all, it's a double whammy I think.
F And I think that's crucial, just you touched on points that you made there Deborah about almost developing a common language, but it's also broader than that in terms of going out and maybe inviting some of the local authority social workers who are working with some of the more high risk young people who are on the cusp of being admitted into secure care, and perhaps inviting them in and spending time with practitioners in the setting and not using that type of kind of fear statements around secure care, that this is where you're going to end up if you continue. There's, you know, we've had experience of residential placements and foster carers using the same language that rather than sort of being more open and transparent about the concerns that they have for a young person's welfare and the risks that there placing themselves in, rather than saying "oh, if you continue you're going to end up in secure care", but if they were, you know, to almost turn it on its head and use a more common language that was going to prepare the young person a little bit more, and that secure care wasn't then going to be viewed in this, because then it comes under the punitive umbrella that...
F Absolutely, that just buys into the first point that we discussed, because it just fuels what the public and beyond's perception is that, you know, that your child or loved one is going to go in here and they're never going to get back out again and you've lost them and, do you know that way, it's untrue but unfortunately I think it's what we come up against quite regularly.
F So sounds like there's a really big role for the strategic board then not just in, but cutting across, everything that's been discussed up until this point today?
F Yeah because, you know, recently you would attend a children's hearing where a panel member, they feel that they're giving good advice to a young person who, almost sympathetic that we've made this decision to take your liberty away but just get your head down and do your time, and they're using that type of language so again, that's reinforcing what we're trying to, you know, move away from quite significantly, and so you're kind of sitting going "don't say that," and I feel that that's absolutely an area that there needs to be greater knowledge and as Sharon said earlier, the invitation of children's panels coming in and really getting an understanding can change the way that the young people in the children's panels are communicated or panels are communicating with the young people, which I feel is crucial as well, you know?
F I think as well for the strategic board to include the young people in the kind of transformation at a secure because how much it's transformed since I started, so there's so much more to kind of go and so much more because we are learning all the time, we don't know everything, so it's about moving forward and including the young people in that that have been involved in secure.
F I think somewhere that they could also improve on would be the transition from secure care, whether that be to a residential setting or back home or, you know, whatever that may be, because within that period it's an intense environment and you do build relationships hopefully that the young person can kind of hang their coat on so to speak. So I think sometimes it's difficult as a staff member because when a young person moves on we would like to have the time to, you know, continue that relationship, but it's often very difficult to do that and I think maybe if there was scope for a key worker going with that young person for a short period of time, whether that be a week or two weeks or whatever or beyond that, I think just to reassure the young person because it is, it's a big, big change you know, and we often find that our young people do struggle with that because it's quite daunting, you know? You've came from an enclosed environment to now having everything again. So, having the reassurance of the person that's been there working closely with you, that's attended all your meetings, do you know? It's just could go to benefit them in the long term I think.
F So really important the board's looking at the before and after, not just the secure care part?
F Yeah, absolutely.
F Also that's not just looking at secure care, it's looking at mental health, it's looking at decision makings and it's taking that broader perspective as well. So, sounds like there's a lot of work for the board there to do, but a lot of really good suggestions and really important that this discussion continues both with practitioners and with young people. So really important. So as Alison had said then, the recommendation for the national standards of secure care has got really widespread support and people kind of really had collective agreement that that was done. I suppose how do you think this should be done then to make a difference in practice and do you have any suggestions for involving secure care staff in developing the standards?
F I think probably what we've said in consultation with social workers, young people, families, just to find out what works and what doesn't work and kind of utilising, I know the English healthcare standards, they've got specific to secure settings, whereas we have this broad...
F A hundred and seventy-seven!
F ...yeah! So, trying to, when we're being inspected, to try and fit it all in, it's just so broad because they're for like care homes, for elderly homes, whereas if we were able to adopt the English kind of care standards then that would be so much more beneficial.
F I think we do use the phrase a lot "not one size fits all" in individual-based care, but then to then have a set of standards that goes across the full board as you say, it just seems contradictory to, you know, the buzz words and a lot of the language that's used, but I would echo that. Yeah, definitely. Take it back to each organisation that everyone is representing today and take it back to your teams and staff meetings and young person's meetings and, you know, get the young people involved because they're the ones that are experiencing this first-hand. It's all well and good having practitioners and whatnot, you know, putting their two bobs worth in so to speak, but it's the young people that's experiencing it. They're living it. We're not. As much as we're trying to prevent as much care and consistency as we can but, you know, it's about enabling them to give their opinion and feel comfortable enough to voice that.
F And it's evolving, it's like what Sharon said, you know, things have changed quite dramatically probably since we began our careers working in secure as well, so generation of the young people are different. So, they're going to give us they most current view of what they need and they'll have far different ideas to what we had or maybe what we thought we had even a few months, a few weeks ago. So yeah, and we would just echo the point as well, you know, the care, the new standards, a hundred and seventy-seven quite prescriptive, you know, but people are going to go all out in terms of trying out evidence and how well they're meeting these standards and do we lose sight of some of the work that we're trying to achieve so, you know, rather than sort of meeting the desired outcomes that we're aspiring to do every day.
F I think the secure care sector put in a response to their consultation on the draft, I'm quite sure...
F ...health and social care standards and it was really about coming back to that, you know, one size doesn't fit all, that there is some commonality and uniqueness about the experience of being in secure care because of the nature of secure care, so back to that kind of the values and principles and ethos and just knowing that that, you know, if there's standards there and in terms of access to services - particularly health services and mental health services. Hopefully that's somewhere that we can really get to grips with.
F That's been a great discussion. That's kind of all the discussion points we intended to have, is there - I'm really conscious though this is about an opportunity to hear from you guys - so is there things that we've not captured or things that you think is important in terms of discussions about the future of secure care or any points that you'd like to raise that you didn't feel you had the opportunity to do so far?
F I just feel definitely there is a future for secure care and it's not being biased, but I think that the work that's done in secure is second to none and it's about changing how people's perspectives and transforming what we've got with our services and just looking towards the future and helping the young people that we've got in.
F Yeah, I would echo that as well and I think we had kind of discussed earlier on about the mental health element that we're seeing, I think we're seeing more and more frequently now and I think, you know, just thinking about experience. We've had young people come in and they've kind of spoke about not really having any real scope or thoughts about their future and how they would quite happily be given a diagnosis as opposed to dealing with the traumatic experiences and the coping strategies that they're putting in place at the moment through a period of crisis, whether that be over a long period of time, rather than that, you know, they're looking to be diagnosed, to be given medication and it's very sad, you know, that they would think "well I would be happy for that to be my future, I just want to be numb to it." However, I think within secure I've had personal experience of working alongside someone who's really, you know, stuck in there, the staff have obviously stuck in there with that person and they've came through the other side, you know? A long term placement but within a secure environment there have been positive outcomes, and young people are able to move on. However, if they had went down the mental health route then you worry about where that would have taken them, you know, and hindered their future. I realise that there is scope for that for certain individuals but, you know, I think within secure you're, because it is an intense set up and there is access to so many different services and programs, workers and interventions then, you know, you can do some really, really excellent work and I would agree that there is a strong future I believe.
F Thank you all so much for your time today. That's gave us a real lot to take away, a lot of things to think about and you've made a number of really, really good points. Clearly, in terms of anyone else who wants to contribute to the discussion, Alison's really keen to hear from you. Either colleagues, people listening to the podcast or people who just have an interest in this area, please feel free to get in touch with Alison via the centre.