Psychology Associates

Psychology Associates Inspection report for an adoption support agency

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Unique reference number SC462558 Inspection date 20 May 2016 Inspector Heather Chaplin Type of inspection Full

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Setting address Psychology Associates Ltd, 41-43 Lower Fore Street, Saltash, Cornwall PL12 6JQ Telephone number 0845 026 7260 Email enquiry@psychologyassociates.org.uk Registered person Psychology Associates Limited Registered manager Sarah Mundy Responsible individual Susan Candy Date of last inspection 17 December 2014 Website: www.gov.uk/ofsted

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This document may be reproduced in whole or in part for non-commercial educational purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Brief description of the service

Psychology Associates Ltd. provides specialised psychological interventions for children, young people, families and adults who have been affected by adoption. The agency provides adoption support as part of a wide range of therapeutic, consultation and training services. This includes:

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Brief description of the service

 Forensic psychology and expert witness work  Consultancy and training for schools and local authorities  Consultancy and training for a wide range of independent children’s services, including children’s homes, fostering and adoption agencies  Bespoke research on behalf of voluntary organisations.

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Brief description of the service

These aspects of the service have not been assessed as part of this inspection, because they fall outside of Ofsted’s regulatory remit. The expertise gleaned from undertaking this wide range of tasks does, however, inform the service’s adoption support work.

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Brief description of the service

The agency is staffed by qualified and experienced psychologists, who offer a diverse range of therapeutic approaches to service users of all ages from the agency’s offices in east Cornwall. The service also employs a number of assistant psychologists, an occupational therapist, an educational psychologist and a specialist therapeutic social worker. There are 100 self-employed associate psychologists across the country who accept work from this agency.

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Brief description of the service

Thirty families receive an adoption support service direct from Psychology Associates. The agency's extensive consultation and training provision means that the service has an additional impact on the lives of traumatised children and their families by disseminating the knowledge and expertise of its staff to other professionals.

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The inspection judgements and what they mean

Outstanding : a service of exceptional quality that significantly exceeds minimum Requirements Good : a service of high quality that exceeds minimum requirements Requires improvement : a service that only meets minimum requirements Inadequate : a service that does not meet minimum requirements

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Overall effectiveness

The overall effectiveness is judged to be outstanding

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Overall effectiveness

This service is outstanding because it provides exceptionally high-quality therapeutic intervention for children and adults who have been affected by adoption. Service users, including those who have experienced traumatic personal circumstances, say that the service is ‘absolutely brilliant’ and that they have made incredible progress. In some instances, they have turned their lives around. Children and young people confirm that they are very well supported to manage past trauma and their resulting difficulties in school and at home. One child told his family that after receiving therapy, ‘I haven’t any worries in my bag anymore.’ Some children have been able to rediscover childhood. They can now giggle and be cheeky, which their parents welcome as a sign that they are beginning to respond to the help that they receive. Adoptive parents receive focused and highly effective support to enable them to care for their traumatised children and to reduce the

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Overall effectiveness

impact of previous abuse on their family lives. At the previous inspection, outcomes for service users and quality of care were outstanding. Since that time, the registered manager and leadership team have ensured that the agency has further developed an impressive skill base in order to offer a wide range of therapeutic interventions. The work is highly focused on the individual service users’ needs, and is flexible and responsive. The weaknesses found at the previous inspection in staff recruitment and service management have now been resolved. Robust auditing, supervision and appraisal systems are now in place to monitor service delivery. There are no breaches of regulation and one recommendation has been made with regard to recording. This is thorough and detailed but the clinical tradition of writing case records by hand means that in the event of a service user requesting access to records they may struggle to read them in some instances.

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation:

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Recommendations

Ensure that records are clear and contribute to an understanding of the child’s life. In particular, ensure that case recording is legible so that it is accessible to service users and relevant professionals (National minimum standards 27.0 and 27.4).

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users

Children and adults benefit from an exceptionally flexible, adaptable adoption support service, which is precisely tailored to their needs, irrespective of their gender, sexual preferences or other individual differences. For example, children who have been severely traumatised by many years of abuse are helped to find strategies to survive their experiences. Children and young people, whose experiences have led them to harm others, receive the support that they need to acknowledge their actions in a climate of warmth and acceptance of them as people. This helps them to build trust with therapists and is an important step on the journey to understanding their behaviour. Adult service users, who have experienced severe health problems and consequently, have lost children to adoption, say that their lives have changed. They report progress way beyond the level that they had expected and they have acquired

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users

valuable insights into their personal circumstances. Children and young people may receive sensitive, carefully managed life story work to help them to understand their histories. The inspector saw examples of very good- quality work which incorporates the child’s own contributions and provides an honest and valuable insight into their family background. When service users’ needs change and different priorities emerge, therapists are highly responsive and flexible. This often involves re-negotiating the terms of their intervention with the child, the family and the funding authority. The agency is highly effective at obtaining negotiated agreements when the duration or intensity of the work has to change.

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Quality of service provision

The quality of service provision is outstanding because highly trained and exceptionally well-supported therapists provide thorough assessments and carefully tailored services to help severely traumatised children, young people and adults. In some cases, this intervention helps to avoid the individual developing serious mental health problems.

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Quality of service provision

There are reliable and efficient administrative systems in place to respond promptly to enquiries from members of the public and other agencies. Service users universally praised the clinical administration and reception staff for their warm, friendly and welcoming approach. This helps to reduce the anxiety for children and their parents who wish to contact the service or to attend the premises for therapy.

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Quality of service provision

Services are targeted but highly flexible to accommodate service users’ wishes and changing needs. Children and families are involved in their own detailed assessments and their views are incorporated in a meaningful way.

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Quality of service provision

Communication with families and other agencies is exceptionally good. Service users say that telephone messages are always responded to on the same day and that their therapist will go over and above all realistic expectations if they are in crisis. The agency has an educational psychologist who can advise on educational matters. Therapists frequently work with children’s schools to help the learning support and teaching staff to understand challenging behaviour, or why a child appears distressed in certain situations. Parents say that this is a really valuable part of the service.

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Quality of service provision

External professionals described the agency as ‘impressive’ and commented on the progress that children have made. One said that the registered manager is ‘highly professional, producing exceptionally helpful, clear reports and formulations, with recommendations that are clearly linked to her evaluation of the clients’ needs.’

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Quality of service provision

Staff and associates are extremely passionate about their work. They actively seek out further training to promote professional development and to improve the quality of their service continually. They ensure that therapeutic intervention is informed by research, and have recently worked with a voluntary organisation to evaluate the effectiveness of different psychological interventions for children who may have been abused. Some staff have also undertaken research projects in local schools.

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Quality of service provision

The agency’s training provision ensures that the staff are able to disseminate the principles of their practice to other health and social care professionals. This then benefits a much wider group of children and young people. For example, children’s homes and fostering service providers receive consultancy services to help support their most vulnerable children, some of whom will have experienced a breakdown in their adoptive families. Providers hold the service in extremely high regard and spoke about the positive impact that psychological consultation from this agency has had on their service.

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families

The agency is outstanding at safeguarding children, young people, adults and families because the managers and staff demonstrate exceptionally clear professional boundaries, combined with a clear understanding of safeguarding guidance and locally agreed protocols. Some therapists work with highly complex child protection matters, which require an exceptional understanding of the impact of abuse. They maintain a calm, highly professional approach and have the knowledge and confidence to advocate for children and birth parents. They also challenge other agencies, when appropriate. The service has undertaken extensive research and development work to help other organisations to inform their own service delivery. Every aspect of the agency’s work is supported by reference to research and is subject to rigorous professional scrutiny through the clinical supervision process. The agency’s managers and staff have received good quality training in safeguarding

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families

and demonstrate the knowledge to put this into practice. They are well aware that they may receive disclosures of current and historical abuse at any time. The registered manager is the agency’s designated person for safeguarding and she is well aware of the responsibilities of this role. She has consulted with the local authority’s designated person regarding the agency’s safeguarding procedures to provide an opportunity for them to comment. Children, young people and adult service users have access to a formal complaints procedure. No complaints have been received since the previous inspection. The service has a robust procedure for recruiting and checking prospective employees. This has considerably improved since the previous inspection and now includes detailed information, containing all the elements required by regulation. References are fully verified and the process is monitored through a formal audit.

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families

The person responsible for maintaining the recruitment files has attended training in safer recruitment to help to ensure that she is aware of all the possible pitfalls and areas that might make the service vulnerable.

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Leadership and management

Leadership and management are strong, highly motivated and ambitious for the agency. They have responded enthusiastically to government initiatives in adoption support. Leaders and managers, supported by the company’s board of directors, have made significant strides in the past year to develop and improve the service.

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Leadership and management

For example, since the previous inspection, the service has strengthened management monitoring. A major financial review has helped managers to ensure that the agency’s previous difficulties in costing work effectively have now been rectified. This means that effective costing and robust accounting systems are now in place to ensure that the service is able to withstand the effects of changes in government policy on funding adoption support and that it remains viable into the future. Staff and managers commented on the positive benefits of greater financial security, which forms the foundation of sustainable growth in the business.

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Leadership and management

The service has included children’s and young people’s views in some of its consultation exercises. Their views are valued and used to inform service delivery; for example, to comment on a presentation intended for schools. The service’s leaders and managers are pleased with this progress, but acknowledge that there is further scope to identify additional areas to which the children and young people could contribute in future.

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Leadership and management

Leaders and managers have been courageous, open and transparent by inviting 360- degree feedback on themselves. They conducted a strengths, weaknesses, opportunities and threats exercise with their staff, and issued a questionnaire. This exercise was completed a month before the inspection. The directors have fed back to staff what they learned from the exercise, and how they propose to take this learning forward.

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Leadership and management

The service has recently appointed a strategic lead for fostering and adoption to join the agency’s leadership team. This person is not yet in post, but their appointment demonstrates the value that the service places on strategic development, and the understanding that as the service grows, the leadership and administration teams will need to expand to provide the required support.

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Leadership and management

The service has very strong and effective relationships with an expanding number of voluntary, private and local authority organisations. There are service level agreements to provide bespoke training and consultation to these organisations, including an independent fostering agency that also provides adoption services. There are plans to extend the group work currently offered to foster carers, to adopters. This will further enhance service provision.

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Leadership and management

The agency has a detailed and clear statement of purpose, which accurately describes the services on offer. This document is available on the website, which is accessible and easy to follow for prospective service users. The registered manager is a qualified clinical psychologist who is registered with the Health and Care Professions Council and the Institute of Dyadic Developmental Psychotherapy (DDP). She has 12 years’ experience of working in health and social care, and 10 years’ experience in management. She is currently undertaking her level 4 management qualification, but has not yet completed this award. The registered manager receives professional supervision both from her line manager and from a specialist DDP practitioner. She ensures that her own professional development is maintained through receiving, and delivering, training. Staff who are employed directly by the agency receive high-quality, monthly

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Leadership and management

supervision from their line manager, in addition to clinical supervision from external or internal therapists to meet any specialised consultation needs. Staff report feeling very well supported and have annual appraisals to support their professional development. The service continues to grow and develop, with a large number of associates who work around the country. Leading and managing such a diverse group of professionals is managed well. After a rapid period of growth, there is some scope for further consolidation to help to ensure that the service’s ethos is disseminated to everyone. Some associates commented favourably on a conference that they had attended and said that more of these events would be welcome in the future. At the previous inspection, one requirement and five recommendations were made, all of which are now met. The requirement concerned the quality and robustness of staff recruitment checks. The service has made considerable improvements in this

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Leadership and management

respect. For example, there is now an effective auditing system in place. Staff files are complete and contain all the information required by regulation. Key staff have now completed training in safer recruitment to help them to understand how to manage the process effectively. To respond to the recommendations, the service has begun to develop formal systems for consultation with children and young people. The children’s guide has been updated with contact information for Ofsted. This was further amended during the inspection to include the Children’s Commissioner. The agency was asked to produce a written development plan. The registered manager has now produced a strategic plan for fostering and adoption services, March 2016 to March 2017. This is a detailed but very accessible document, which describes the service’s progress since the previous inspection, and outlines areas for development. The agency now produces six-monthly written reports on the

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Leadership and management

management, outcomes and financial state of the service. The agency’s case records are hand written. The therapist reviews notes frequently for the purposes of writing emails, reports and letters to other agencies. These documents are always typed so that there is always summarised information available in readable form, but the original case notes are not always easy to read. This could potentially make it more difficult for a service user to gain access to information about themselves. A recommendation has been made.

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About this inspection

The purpose of this inspection is to assure children and young people, parents, the public, local authorities and government of the quality and standard of the service provided. The inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service and to consider how well it complies with the relevant regulations and meets the national minimum standards.

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About this inspection

The report details the main strengths, any areas for improvement, including any breaches of regulation, and any failure to meet national minimum standards. The judgements included in the report are made against the inspection framework and the evaluation schedule for the inspection of adoption support agencies.

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