‘I love this place, it has such a homely feel, I wouldn’t be the person I am now if I wasn’t here.’
This quote for me is a reflection of what it is all about. It came from one of our young people who was talking to an Ofsted inspector. The fact she was talking to Ofsted is not the point, but I strongly believe it is a function of the relationships within her home and the relational model at play that have enabled her to thrive, and for us to have the joy of seeing that happen.
The children and young people in our care have the right to feel safe, secure and happy. For this to happen we all understand that it takes commitment, resilience, resources and time. Multiple placements, carers, schools and missed developmental milestones add to the complex needs of children, and erodes their trust in the very people trying to make them feel safe and secure. The loss of key attachments with family and others makes the road to recovery a difficult and sometimes lonely journey. Professionals from all disciplines must come together with the shared goal to meet the needs of the child in the ‘here and now’, whilst planning to help them achieve long-term goals.
As most people involved in the provision of care would attest, the road to recovery is very rarely smooth with many obstacles to navigate which can place progress in jeopardy. For an individual carer working in isolation, whether residential or fostering, willingness and endeavour alone hold little contest against the presenting demands of a traumatised child. So what does?
In the context of working with children who have been traumatised in their early life, the critical factor is the establishment of positive, safe and secure relationships. This is a statement which I’m sure most, if not all, professionals would agree. However, after 24 years working in residential care, fostering and education, I’ve come to the conclusion that too often individuals will recognise the importance of this statement only in so far as it applies to their own relationship with the child in front of them at that particular time.
Foremost is the relationship between the young person and their carer, but also crucial are those between the professionals around that young person. I believe good relationships between all professionals is the key to making sound decisions that positively impact the children in our care.
However, ‘relationships’ is a term that can often be used too loosely. It is defined as “the way in which two or more people or things are connected; a thing's effect on or relevance to another.” We shouldn’t just work alongside each other, we need to understand our connections, our relevance and our effect on each other. We also need to understand the effect of what is happening within our relationships on ourselves, so that we can act most effectively in that context. But what does that mean, in practical terms, to make a difference in the lives of children and young people? It means we need to understand and gain insight into who the young person is: not just their presenting behaviours, but genuine understanding to the point that we can respond not just react. It relies on holistic assessment that enables us to uncover a young person’s potential and strengths.
It also means we need to understand the impact of the relationship on ourselves as professionals, not least to help us be resilient in what can be one of the most rewarding, albeit challenging jobs there is. The importance of the relationships within this team can’t be underestimated and so for us, alongside supervision, staff are supported by weekly consultations with our therapy team as well as case management and mentalisation meetings.
We often hear the phrase of ‘a team around the child’, but only when we truly operate as a team does this have the impact it should. As teams working with young people who have experienced trauma, it will only work if we truly understand our connections and relevance to each other and shared goals. The young person should never have to experience the impact of dysfunction of relationships between professionals.
I would like to share a case of a young person in our care who I will call Sarah. Sarah was originally with us to give her foster family a month of respite. However, when the foster placement broke down her local authority extended her placement with a monthly review. This experience and uncertainty led to an increase in the frequency of Sarah’s self-harming behaviour and she began to express suicidal thoughts. Sarah is now settled in the home and mainstream school, enjoying running, and has decided to repeat Year 10 to allow her more success when she takes her GCSEs. Looking back, the consistent theme in this case is the development of relationships with a shared goal that placed Sarah at the centre. First was the relationship with the local authority, ensuring it went beyond a contractual provider or commissioner and reviewer approach, but a genuine dialogue where we urged them to commit to Sarah’s care and they supported us to undertake an assessment. This was agreed and the subsequent work undertaken, including clinical psychology and education support, and this has really benefitted Sarah. Mentalisation and supervision from our therapy team equipped the staff to respond, not react, to the presenting behaviours, ultimately strengthening their ability to build relationships, and the relationship with her key worker became very important. The Caldecott Foundation’s relational model of care places the child at the centre of everything we do. Embedding this new model has meant scrutinising our processes through the prism of relationships.
Our work starts before anyone from the organisation has met the child. The referral process is a time to gather information, construct a history, and develop an understanding of them as a person. Knowing relatively basic information about a child, such as their likes, dislikes and behavioural triggers, can mean the difference between a smooth and chaotic first few days. An assessment of need at the start of a placement is critical, and conducted correctly, can contribute immeasurably to achieving the best outcomes. Too often we know too little, as the limited assessment work focuses on the containment of risk, and not the real young person that we need to connect with.
For a child’s and young person’s placement to be successful takes a huge investment of time, resources, and energy, given by all professionals. But success is fragile, support is limited by age, and we risk so much through the withdrawal of care and support at 18. The recent policy report from Centrepoint11 highlighted that 40% of care leavers surveyed had either ‘sofa-surfed’ or had slept rough since leaving care. This is just one piece of data amongst many highlighting the inequality of long term outcomes for care leavers. We want to change the narrative and show the potential and opportunity for young people in our care.
However, it is more than housing, financial, and employment challenges. It is clear to me that until we recognise the devastating effect on a young person of severing their key relationships at the same time as their support systems, then long-term outcomes will be effected. We all have a ‘duty’ to actively track the young people’s journeys when they have left our care. It is a critical period in their lives that can result in life-changing decisions being made. Everyone needs someone to fall back on, and go to when things get tough, so we need to ensure that the very people who know these vulnerable young adults are the very people available as a safety net.
I believe that building and developing relationships should be considered as the most important investment that can be made. The potential for positive impact from developing secure human connections with energy, positivity and passion simply can’t be underestimated. It is, in my view, the single most important influencing factor for achieving positive outcomes for our children and young people.
Nick Barnett is managing director of The Caldecott Foundation