Secure care
Supports, interventions and reviews

During a child’s stay in secure care, the period of stability this affords should be utilised to provide full support and interventions to children to address their underlying needs and encourage healthy development to promote positive outcomes (CYCJ, 2020). As concluded by the Independent Care Review (2020, p.80) “If Scotland’s decision makers remove the liberty of a child for whatever reason, Scotland must ensure that they are provided with all the support they need to go on to live fulfilling lives in a community”. Every child should be supported and encouraged to attain and achieve the highest standards and to develop their interests, skills, strengths and hopes for the future, being provided with comprehensive, effective, holistic and individualised therapeutic supports and services from a range of agencies (Scottish Government, 2020; 2021; Independent Care Review, 2020). Supports should focus on promoting and supporting the physical and psychological recovery and social reintegration of children, with healing and rehabilitation in an environment which fosters the health, self-respect and dignity of the child (Article 39 UNCRC; Independent Care Review, 2020). The difference this can make has been highlighted by children with experience of secure care:

“At the end of the day some of these staff have genuinely changed my life and changed me for good in different ways, they really have”

“Staff care about me - I haven’t had that anywhere else I have lived. I feel safe and looked after” (Secure Care Pathway and Standards Scotland)

All children throughout their period in secure care will be supported to participate in:

Centre staff

All secure care centres and individual children’s houses are staffed with a wide range of staff, with various roles and responsibilities. All staff have roles and responsibilities including to:

Further information is detailed in the Secure Care Pathway and Standards Scotland and secure care service specification (available from Scotland Excel).

Health and wellbeing

Children in secure care “…must have access to all the support services required to achieve the highest possible standard of health” (Independent Care review, 2020, p. 83). All secure care centres have health facilities and access to nursing staff. Children also have access to dentist, podiatrist, sexual health in reach, opticians, psychologists and therapists, and any necessary more specialised health treatments and supports, including mental health supports and speech and language therapists. It is important that everyone supporting the child understands their physical, mental, emotional and wellbeing needs, including the impact of any trauma and difficulties experienced, and responds sensitively to these needs and can ensure access to any supports or specialist services that may be required (Scottish Government, 2020).

Separation, searching and restraint

Children and/or their room can be searched when they are in secure care but the decision to do so should be based on the child’s circumstances (Scottish Government, 2020). The level and type of search should be proportionate and least intrusive possible - this may include a personal search when a child is asked to remove items of clothing by staff of the same gender (Scottish Government, 2015; 2020). Children should only be searched when this is justifiable, there is a legal basis to do so, and necessary to keep the child and others safe (Scottish Government, 2020). The child’s views should be taken into account and they should be given a choice on how the search might happen (Scottish Government, 2020). Throughout any search the child should be treated with respect, dignity and compassion and supported to understand their rights, the reasons for a search and how it will happen (Scottish Government, 2020). Staff conducting searches are trained to do so (Scottish Government, 2015).

Restraint can generally be described as a physical intervention to restrict a child’s movement and each secure care centre will have their own policies, procedures, methodologies and training for staff on approaches to physical restraint, which should be part of a broader focus on preventing the need for restraint and de-escalation (Davidson et al., 2005; Gough, 2016; Independent Care Review, 2020). A child should be well supported to manage their feelings in secure care and should only ever be restrained when this is absolutely necessary to prevent harm (Scottish Government, 2020). Children should be treated with respect, dignity and compassion, their rights upheld and be held in the least restrictive way for the shortest time possible (Scottish Government, 2020). Being a witness to restraint can be traumatic, frightening and distressing for everyone involved, and all involved should be well supported afterwards and given the opportunity to discuss the restraint (Scottish Government, 2020; Independent Care Review, 2020). The approach adopted to restraint must be approved, the staff member appropriately trained, and each restraint should be recorded and the child’s social worker notified (Davidson et al., 2005).

Children should receive the care, comfort and individual support they need when they are isolated, and only ever isolated from other people when this is absolutely necessary to keep the child or others safe, for the shortest time possible and in very limited and justifiable circumstances (Scottish Government, 2020). Isolation should never be used as a punishment and should be a measure of last resort, during which time the child should be monitored, the use of isolation approved by a senior member of staff, recorded and the child’s social worker informed (Scottish Government, 2015; 2017). Each secure care centre has their own written policy on the use of isolation.

These practices raise significant concerns about the upholding and infringements of children’s rights and the place of such practices in the provision of trauma-informed care (see Lightowler, 2020; Independent Care Review, 2020). Reducing and working towards eliminating the use of restraint is an area of significant attention in Scotland (Independent Care Review, 2020). 

Review meetings

For all children

Regular reviews of the Individual Placement Agreement and Child’s Plan should be attended by the child, their parents/guardians, staff from the secure care centre, Lead Professional and any other relevant professionals and held at least every three months. Reviews should measure progress against GIRFEC wellbeing indicators and outcomes detailed in the Child’s Plan. Following each review the Lead Professional should update the Child’s Plan.

The Lead Professional should maintain a high level of regular contact with the child, their family and secure care centre staff out with review meetings.

Other review meetings should be held, as detailed in the section on Placement review meetings and planning for children who are on remand, sentenced, or subject to CSOs.

Third sector

Any third sector organisations working with the child or their family may be involved in providing support, reviews and updates on progress and future planning.

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