Posted on: 6 September 2022
Staff at HMYOI Feltham have introduced SECURE STAIRS– a nationwide framework to support staff to deliver more developmentally-attuned and psychologically-informed care.
Over the past 15 years, the number of children and young people (CYP) in custody in England has plummeted – from 2,800 under 18-years-olds in 2005 to 429 in May 2022.
Those left are characterised as ‘hard to reach’. They often have complex needs that span multiple domains, including high levels of substance misuse and a range of mental health and neurodevelopmental needs.
Of this group, about 40 percent have experienced the care system compared to just 0.5 percent of the general population, most have been excluded from school, and at least 80 percent have a significant history of adversity in childhood.
In a dramatic process shift, Feltham’s Health and Wellbeing Team changed its scope from simply providing individual mental healthcare to young people to delivering a holistic systems-wide approach that involved staff training, the provision of reflective practice and the facilitation of multi-agency formulation meetings.
The team at Feltham recently won a CNWL Improvement Academy Award for their work.
Varinder Panesar, Senior Psychologist, and Katie Stone, Residential Governor, at Feltham collecting the Improvement Award
SECURE STAIRS, in combination with an array of other initiatives, helped to reduce rates of assaults and adjudications across the board. As you can see from the graph below, there was a significant reduction in the number of violent incidents, total use of force and fighting.
The staff at Feltham took the principles of SECURE STAIRS and adapted them to meet the unique demands presented by operating in a young offenders’ institution. Dr Rhiannon Lewis, who worked on the project, said: “Changing an embedded culture is daunting task that requires persistence, innovation and flexibility.”
CNWL and Feltham’s Health and Wellbeing Team were careful to make sure that the staff and young people alike didn’t feel like they were being ‘done to’. Getting input from all sides in community meetings was crucial in the success of the programme and the question that needs to be answered now is whether these principles can be sustained in the long term.
The quotes below are just a small sample of the hugely positive feedback the project received.
“The team at Feltham has set the benchmark for SECURE STAIRS for the whole YOI estate.”
CQC inspector (verbal feedback)
“A great place to start thinking about who we are, how we practice and the impact of the work we do.”
HMYOI Feltham staff member
“The staff are helpful. I always have the option to talk or not.”
Young person
What does SECURE STAIRS mean?
Staff with skill sets appropriate for the interventions needed
Emotionally resilient staff, able to remain child-centred in the face of challenging behaviour
Cared for staff: supervision and support
Understanding across the establishment of child development, attachment, trauma, and other key theories
Reflective systems, able to consider impact of trauma at all levels
Every interaction matters – a whole system approach
Scoping the presenting situation
Targets identified that staff, young people and home agree on
Activators – interventions are based on a multi-factorial formulation that identifies the activators for the CYP
Interventions – specialist and core interventions tailored to each CYP’s needs
Review progress towards agreed targets regularly
Sustainability always in mind