The SECURE STAIRS Framework for Integrated Care was developed by NHS England as a way to promote a trauma-informed, evidence-based and whole system approach to children and young people accommodated in the Secure Estate. A pilot ‘Attachment and Developmental Trauma’ training module was developed by the Atkinson Secure Children’s Home in conjunction with members of the SECURE STAIRS Professional Collaboration Network (PCN). Fifty-six staff members working within a Secure Children’s Home in the North East of England completed the 2 day training. A pre and post evaluation method was utilised to analyse the results.The data indicated increased staff knowledge, understanding and confidence in attachment theory, developmental trauma, brain development and working with guilt and shame. The data also demonstrated the importance of safety and containment in the training environment in fostering opportunities to learn and grow. The need for ongoing training, supervision and reflective practice within the SECURE STAIRS Framework for Integrated Care is considered in order to consolidate knowledge and implement learning into practice.

The SECURE STAIRS Framework for Integrated Care (NHS England, 2016; Anna Freud National Centre for Children and Families, 2022) was developed by NHS England to promote a trauma-informed, evidence-based and whole system approach to children and young people accommodated in the Secure Estate. These settings accommodate children and young people presenting with high risk, high harm and high vulnerability presentations that cannot be kept safe in the community. Reflective practice sessions were facilitated over a twelve-month period for residential staff, physical health staff and management working within a Secure Children’s Home in the North of England. A pre and post questionnaire evaluation method was utilised to analyse the results. The evaluation indicated significant improvements in participant’s confidence in their practice and communication with colleagues and children and young people; ability to be reflective with others both during and after an interaction; levels of stress when interacting with children and young people; and uncertainty within their practice. However, decreases were observed in participants ability to appraise their practice and desire for improvement within their practice. The authors critically review the results of the evaluation and highlight the ongoing need for reflective spaces for staff caring for children and young people with complex needs within the Secure Estate.

Purpose The purpose of this paper is to evaluate pre- and post-formulation findings with multi-disciplinary staff within two secure children’s homes (SCHs) in the North East of England. Design/methodology/approach Multi-disciplinary staff teams involved in formulation across two SCHs were administered pre- and post-formulation questionnaires. The pre- and post-formulation questionnaires focused on five domains: knowledge; confidence; motivation; understanding; and satisfaction with treatment plan. Findings A total of 338 pre- and post-formulation questionnaires were administered across 43 formulation meetings. The highest proportion of formulation attendees were: residential staff (44%); mental health staff (17%); case managers (12%); and education staff (9%). Paired samples t-tests showed significant post-formulation improvements across all domains including: knowledge [t(337) = 22.65, p < 0.001]; confidence [t(337) = 15.12, p < 0.001]; motivation [t(337) = 8.27, p < 0.001]; understanding [t(337) = 19.13, p < 0.001]; and satisfaction [t(337) = 18.81, p < 0.001]. Research limitations/implications The SECURE STAIRS framework has supported formulation developments across the Children and Young People’s Secure Estate. Preliminary findings within two SCHs suggest multi-disciplinary staff teams find psychologically informed formulation beneficial. Future directions are considered including future evaluation of young person involvement in formulation meetings. Originality/value There is a notable lack of existing research within the child and young people secure estate evaluating the impact of SECURE STAIRS trauma-informed care developments including the impact of team formulation. This paper adds to the evidence base.