Children leaving care deliver their verdict
Voice developed exit questionnaires in three secure children’s homes. Analysing the results of these revealed the following: young people were generally positive about their care and identified good outcomes, particularly in education aspects of daily living caused the greatest dissatisfaction young people tended to lose contact with their “home” peer groups and 10% had no clear discharge plan. Unit managers and advocates were generally positive about the impact of the process on practice.
1. Secure Children’s Homes
Secure children’s homes in England and Wales are locked facilities that are used to accommodate different groups of young people: those remanded or sentenced by the courts and those detained because of a history of absconding that puts them in serious danger or because of the threat they pose to themselves or other people if placed in any other form of accommodation. Their use is currently declining (Held 2006, Secure Accommodation Network 2007).
2. Voice and the Visiting Advocacy Service
Voice is a national charity, providing independent and advocacy services. The visiting advocacy service in secure children’s homes dates from the mid-1980s and was commended in the Utting Report (1997, p185). The visiting advocate’s role is to provide independent support to young people who wish to raise concerns about their care or make representations. The advocates visit on a regular basis and become familiar and trusted persons to young people.
3. Development of the Exit Questionnaires Service
Clayfields House is a secure children’s home in Nottingham. In 2000 the manager of the home approached Voice’s northern office to request the development of a system of exit questionnaires. A draft questionnaire was developed using a tick-box approach with space for the young people to comment on each question. This was piloted with young people and modified. The questionnaires were extended to two additional secure children’s homes in April 2002, Gladstone House in Liverpool and Sutton Place, in Hull.
The process is the same in all three units. The advocates give a questionnaire to the young person who is leaving, who has the choice of not doing it, completing it on their own or asking the visiting advocate to help them. There are few refusals and most questionnaires are completed with the assistance of the visiting advocate concerned. The completed questionnaires are forwarded to the Voice regional office for collation. The reports which result are then discussed at six-monthly meetings between the advocacy service and the unit manager and action is agreed to address problematic areas
4. The research
88 questionnaires, out of a possible 275 leavers, were completed in the two years of the study (2002-2004), 33 from girls and 55 from boys, an overall return of 32%. The results of these were analysed. The three unit managers were interviewed about the impact of the process in their establishments and the views of the advocates were also sought via questionnaire (Storr 2007).
1. Young people’s individual and overall responses
There were considerable individual differences in what young people valued and found problematic, even in the same unit, over the same period of time. Some young people commented articulately about their experiences but others had significant problems with literacy. Most young people were predominantly positive about their experiences. 25 of the questions asked for a positive or negative judgment to be made. Just over half (46) of the young people recorded at least 15 positive and three or fewer negative responses, with only four young people recording a majority of negative responses.
The young people’s responses reveal gender differences in some areas. As a group, the girls were more negative in their responses to many of the questions, with the differences being most marked in the areas of food, arrangements for telephone calls, the range of activities and how complaints and issues were dealt with. They responded more positively than the boys to only two questions: their relationship with their families and their estimate of their future ability to cope with the pressures of drugs, alcohol and solvents. Girls were in a minority in both mixed units. In Clayfields House they represented a third of the resident group and at Sutton Place they were heavily outnumbered by boys during the period in question.
Education was enjoyed by 78% of the young people with 85% being happy with their progress in this area. Some young people gave evidence of concrete educational achievements and ambition. Enjoyment of education and satisfaction with their progress was strongly associated with young people’s self-esteem. 69% of the young people were happy with their educational plans on discharge, this lower percentage being related in part to uncertainty about where they were going to live. This positive outcome should be set in context. The low academic achievement of looked after children has received much public and political attention in recent years (Berridge 2007) and for most young people in secure accommodation, education has been a highly problematic area (O’Neill 2001, Goldson 2002).
4.Other positive outcomes for young people
There are many examples in both the ratings and the comments of young people identifying other positive outcomes from their placement in secure care. Positive comments were made about the help given in key work sessions. A majority of young people thought that they would not get into trouble again and were better able to cope with the pressures of drugs, alcohol and solvents. In the study sample, 82% of young people said that they had developed a better understanding of their past and its effect on them during their stay at the unit and 70% of young people reported that they felt better about themselves. Examples that they gave about their improved self-esteem included improved health, appearance, attitude, behaviour and anger-management.
5.Areas needing attention
The questions that received the largest numbers of negative ratings lie in the area of daily living: the quality of food provided, the range of activities, the arrangements for telephone calls and privacy. How complaints and issues were dealt with also attracted a relatively large number of negative ratings. These are key areas in residential life and how they are dealt with conveys important messages about respect and valuing. Food is particularly important, giving as it does both physical and psychological sustenance. There were significant differences in responses between the units in the areas of food, arrangements for telephone calls and complaints.
Local authorities have a duty in respect of looked after children to promote contact between them and the people they are connected with, including friends, unless it is not practicable or consistent with their welfare. Almost two thirds of young people thought there had been no change in this area, with nine (10%) commenting that they had had no contact or didn’t know. This raises general questions about what work is undertaken to assess young people’s relationships with their peers and sustain those that may be positive. Relationships with peers have a significant impact on children’s opportunities at all stages of their development and in the mid-teens are important in the formation of gender and ethnic identities (Hudson 2000).
The other area worth highlighting is discharge planning. Nine young people (10%) said that they did not know where they would be living after they left the secure unit and all but one of these and a further eight young people still wanted more information about where they were going. Uncertainty about future placement or a badly managed discharge process puts at risk any progress made in the placement.
6.Listening to young people
Young people were generally positive about staff being easy to talk to and willing to listen, although there were differences between the units. The willingness of staff to listen was positively associated with young people’s happiness at the way issues and complaints are dealt with, and with the system of rewards and sanctions. Similarly, young people’s happiness with the way their complaints are dealt with was strongly or moderately associated with their satisfaction with some of the more contentious areas of daily living. This suggests that listening to young people and taking their issues seriously are key skills that can have a ripple effect on their levels of satisfaction with other aspects of the care they are receiving.
7.Exit questionnaires and change in residential care
Exit questionnaires provide an additional way for young people’s views to influence the care they receive. The question of outcomes is crucial if the process is not to become tokenistic. Although managers said they had had prior knowledge of the issues raised, they thought that the summaries did convey young people’s perspectives clearly and sometimes led to a change in their assessment of a particular issue or in their priorities for action. Managers also gave examples of action taken as a result of the questionnaires and changes in practice and service delivery. The advocates, as a group, agreed on balance that the questionnaires were effective in changing practice within the units.
There were two very clear examples of change occurring. In one unit, after significant and sustained criticism of the system for telephone calls, it was changed and in the subsequent summary of the questionnaires, all the responses from the young people were positive. In another unit where the majority of young people said that staff sometimes listened to them when they wanted to talk, the management team undertook a staff training programme to develop “a listening culture”. The percentage of young people replying that staff listened to them when they wanted to talk went up from 22% in March 2003 to 50% in March 2004 then 66% in March 2005. Over the three units as a whole there has been a small incremental rise in the percentage of positive responses from young people (64% in 2003, 66% in 2004 and 2005, 68% in 2006 and 69% in 2007)
8.Exit questionnaires and advocacy
Under the 1989 Children Act, children have the right to make representations about the services that they receive, under the Act, from the local authority. Exit questionnaires are one way for young people to exercise this right.
All the managers saw exit questionnaires as part of the advocacy role within the unit and valued particularly the fact that someone independent was undertaking the task. The advocates were generally positive about the overall process, particularly the gathering and presentation of information about young people’s perceptions about their care.
The young people generally welcomed the questionnaires. One advocate reported, “virtually everyone I have asked to complete one has been more than happy to do so and it usually creates interest in the group as they come and ask what it is”. This reinforces the advocacy role within the unit and gives the opportunity for a rounding off of the relationship with the young person and the identification of any late issues around discharge.
IMPLICATIONS FOR PRACTICE
• The decline in the use of secure children’s homes occurs against the background of a rising use of custody for young people (Youth Justice Board 2008). The feedback from young people in this study should cause policy makers to reflect on how this trend can be reversed. It is a matter of considerable concern that Gladstone House, one of the secure children’s homes in the study, was closed in March 2008.
• In some areas there were significant differences between units in young people’s ratings and it would be helpful for managers to develop some mechanisms for sharing good practice.
• The number of young people without a clear discharge plan is unacceptably high. This is the responsibility of the social work or youth offending teams, depending on the young person’s grounds for detention. More attention also needs to be paid by these teams to the assessment of young people’s peer relationships and how positive friendships might be sustained.
• Exit questionnaires should be more widely used in institutional care. They provide both a way of empowering young people and an additional safeguarding tool.
Ian Storr qualified as a social worker in 1971 and has worked in field and residential social work with children in England and Canada, both as a practitioner and as a manager. He currently manages the visiting advocacy services to secure and open children’s homes for Voice in the North of England and is an associate lecturer in social work at Sheffield Hallam University.
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