An integrated framework of care in the secure children’s estate

Please describe a relationship, service intervention, program implementation, policy, or other that you initiated or know about that would be considered trauma-informed:

National project – SECURE STAIRS.  The project aims to develop an integrated framework of care across the children’s secure estate, encompassing all staff from health, education and care.  The framework is led by mental health teams and is focused on developing a psychologically informed environment within the estate, based around formulation and understanding the young person’s story and how this has led to them being where they are.  The children are invited to be involved in the formulation meetings so they are fully engaged in the process.

The programme not only focuses on improving outcomes for children by being more trauma-informed, but also aims to support the resilience of residential care staff by training them in trauma and psychologically informed ways of working, particularly when faced with challenging situations.  This includes things like reflective practice and specific training.

The SECURE STAIRS programme looked at how organisations respond to the people in it, and become ‘trauma-organised’, where people feel more comfortable working in silos and within professional boundaries.  The programme aims to break this to make organisations more resilient and ultimately better and safer for staff and service users.

 

What was the outcome?  

The programme has been running for approximately one year and there are lots of positive narratives about how integration has improved and staff from all disciplines have a better understanding of the trauma and psychological needs of the children they are working with.  There is also a set of national KPIs to measure activity data.

 

What supported the positive outcome? (Systemic supports? Organizational supports? Interpersonal supports?):

There was a national drive to roll this way of working out across the secure estate, with a significant amount of funding linked to CAMHS transformation.  Department for Education has also been involved to fund backfill for staff in the homes to be able to attend training.  There is national project support from the NHS England central team for service redesign.  There has also been recommended staffing structures and the funding to support this.

 

 

Tell us more about what motivated you to bring this example to discuss:

True transformational piece of work that focused on making an entire environment psychologically informed.  History of trauma is prevalent in most of the children who are in secure homes, and it is often central to why they ended up there.  This model focused on changing the way of working in the whole environment and is a universal offer, not just an intervention for those with the most complex needs.

 

Whose needs are met in the example that you outline:

Children, staff, and the organisation.

 

Was there any one person or factor that was central to the success of your example and why:

National structure and funding provided a major driver for this piece of work, supported by evidence.

 

What can you or others do to spread this good practice to colleagues and services:

I think the principles could be shared with other services and the outcomes can support a shift in how services are delivered.  Although this programme has been implemented within a confined estate, other services could learn from its successes.