Reduction in incidents during COVID-19 in a Secure Children’s Home: an opportunity for learning

Abstract

Purpose The COVID-19 pandemic is unprecedented for young people within the UK. The pandemic has presented particular challenges for vulnerable children and young people. For example, a recent study in the UK indicated that 83% of young people with existing mental health conditions said the pandemic had made their condition worse (Young Minds, 2020). To date, the impact upon populations such as young people in Secure Children’s Homes (SCHs) is unknown. This study aims to elucidate this area. Design/methodology/approach SCHs provide a safe, supportive environment for vulnerable young people who frequently present with multiple and complex needs. Young people residing within a SCH may be residing at the setting because of a Secure Accommodation Order under a Section 25 Order of the Children’s Act (1989) or for criminal justice reasons, i.e. serving a Remand period or custodial sentence. Preliminary research compared a baseline period to a follow-up period after the commencement of COVID-19 national lockdown measures within a SCH in the North of England to develop understanding of the impact for young people. Findings A significant decrease in overall incidents (t (5) = −6.88, p < 0.001), restraints (t (5) = −9.07, p < 0.001) and other incidents including assaults occurred during follow-up. The SECURE STAIRS framework supports trauma-informed care and enhances support within the setting. Consistent with the framework, provision of formulation meetings was significantly increased within the follow-up period (Welsh’s t (74) = −2.74, p < 0.001). Reflections and future recommendations are outlined. Originality/value The unanticipated results highlight the value of examining incident data within secure environments and could lead to effective practice changes for practitioners working within this domain. This research also demonstrates how frameworks such as SECURE STAIRS can be beneficial for vulnerable young people during periods of change and stress in mitigating some of the potential negative effects. The implementation of such frameworks within SCHs is still novel and thus evaluative research is valuable.

The SECURE STAIRS framework: preliminary evaluation of the impact on therapeutic climate in a secure children’s home (SCH)

“…Within the SCH of the current study, findings of a significant decrease in restraints and other incidents including assaults and self-harm were identified six months after the implementation of lockdown measures (McKeown et al , 2022). This is despite increasing incidents such as assaults and self-harm increasing within secure establishments over recent years (HM Government, 2020).…”

“…Post COVID-19 lockdown, research within the setting indicated that the number of case formulations for the young people increased, as well as formulation attendees (McKeown et al , 2022). Previous research has indicated that the formulation-led approach promoted by the SECURE STAIRS framework can enhance staff confidence and knowledge regarding the young people that they are working with, particularly when the young person is present.…”

“…The framework promotes an open culture and the development of meaningful, trusting relationships between young people and staff, factors that could influence the therapeutic climate of a setting (Long et al , 2011). Preliminary evidence suggests that the SECURE STAIRS model can support to reduce incidents such as assaults and restraints within a SCH environment, despite the negative impact of the pandemic (McKeown et al , 2022). Trauma-informed approaches within secure settings for children have also been evidenced to reduce a variety of psychiatric symptoms such as post-traumatic stress disorder (PTSD)-related symptoms (Hodgdon et al , 2013; Marrow et al , 2012), restrictive practice (Brown et al , 2013; Caldwell et al , 2014) and staff confidence (McKeown et al , 2020).…”