Tavistock Relationships

Tavistock Relationships Inspection report for adoption support agency

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Unique reference number 1166735 Inspection date 13 September 2016 Inspector Christine Kennet Type of inspection Full

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Setting address 70 Warren Street, London W1T 5PB

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Telephone number 0207 380 1957 Email Registered person The Tavistock Institute Of Medical Psychology Registered manager Honor Rhodes Responsible individual Andrew Balfour Date of last inspection N/A 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. 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

Tavistock Relationships is part of the Tavistock Institute of Medical Psychology and is a newly registered adoption support agency. The agency is a voluntary organisation and received funding directly from the Department for Education to undertake an innovative programme of work that includes the development of a new post-adoption service for couples.

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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 good

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Overall effectiveness

The Tavistock clinic has an established and effective service to support and enhance couple relationships. Over the past year, additional funding via the Department for Education has allowed this service to develop to run therapy groups and therapy sessions for adoptive parents.

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Overall effectiveness

Of the 33 adoptive couples who attended adopting together services, 21 couples attended couple therapy and 12 couples attended parents’ groups. Evaluative data indicates improvements in parents’ psychological distress, parents’ relationship quality and significant improvements in parents’ perceptions of their children’s adjustment problems. A sample of parents were spoken to during this inspection, all of whom gave positive feedback, some as follows:

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Overall effectiveness

 the group accessibility was perfect and the crèche was great  we were able to talk so freely without judgement  we were all given an opportunity to talk, it was very comfortable in the group  the group facilitators were warm and engaging, they were smashing  we cannot praise it highly enough, we are both delighted with the service.

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Overall effectiveness

Prior to the service commencing, the agency set up a research review and planning team, guided by experts in adoption. Specialist training for therapists has helped Website: www.gov.uk/ofsted

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Overall effectiveness

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. them to understand the lifelong implications of adoption and some staff involved have many years of experience working in adoption settings.

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Overall effectiveness

The service is in its infancy and shows good capacity to develop. There is a real sense of thought and reflection about service provision, including what the agency wants to achieve.

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Overall effectiveness

Two minor shortfalls were identified, one in relation to the recording of supervision for staff and another in ensuring that all information required about staff is recorded and kept on file. No service users were placed at risk because of these shortfalls.

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Statutory requirements

This section sets out the actions which must be taken so that the registered person(s) meets the Care Standards Act 2000, the Adoption Support Agencies (England) and Adoption Agencies (Miscellaneous Amendments) Regulations 2005 and the national minimum standards. The registered person(s) must comply within the given timescales.

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Requirement Due date

The registered person shall maintain and keep up-to-date records specified in Schedule 3, in relation to staff qualifications. (Regulation 22 (1)) 30/11/2016

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Recommendations

To improve the quality and standards of care further, the service should take account of the following recommendation:  Ensure that a written record is kept by the agency detailing the time and date and length of each supervision held for each member of staff, including the registered person. The record is signed by the supervisor and the member of staff at the end of the supervision. (national minimum standard 24.4) Website: www.gov.uk/ofsted

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Recommendations

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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users

The agency is inclusive within its own remit: service users must be couples. However, the mix is diverse, including both heterosexual and same-sex couples. Couples require a level of English which allows them to engage, understand and benefit from the group service offered. Translation and interpreting services have not been necessary in the groups offered thus far. The service would explore with referring agencies and via the adoption support fund how this need would be met as it arose. There are plans to expand the service to meet the needs of a wider cultural mix.

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users

The provision of a crèche allows good access to services for adoptive parents. The building is easily accessible to main transport hubs and has access via lifts for wheelchair users. Services are available throughout the working week and at the weekend, ensuring good accessibility.

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users

Staff use consistent psychometric screening to good effect. Regular monitoring of progress throughout the programme and interventions encourage service users to participate. The means of intervention are clear, visual and easily understood. Service users are consistently encouraged to reflect on the impact their relationships have on the child/young person. Service users report a positive impact on their relationships and their parenting. For example, one parent says, ‘We are working together now as a team, helping each other.’

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users

Skilled and able staff handle the group and therapy process with a great deal of sensitivity. Questionnaires allow service users to apply their learning to everyday situations for clear and task-centred indicators of progress. As a result, service users are able to process difficult and challenging messages and apply learning to improve their parenting.

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users

Service users report good support from caseworkers, with levels of support given depending on the specific needs they have. For example, some service users said they did not require much support but knew the caseworker was available and others had more contact.

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users

Endings are well planned and clear. Parents write a letter to each other, which is shared at the final session. Therapists seek to signpost service users to appropriate services upon conclusion of the service. Website: www.gov.uk/ofsted

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users

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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Quality of service provision

Service users accessed this provision via placing authorities, adoption support agencies and through self-referral from information posted on various websites. Service users describe receiving plenty of useful information and a prompt and helpful response to queries and applications.

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Quality of service provision

Service users had the offer of couple therapy or group therapy, with initial assessments and questionnaires determining their need and the most appropriate route. Keyworkers, allocated at application, kept service users informed, completed assessments and maintained regular contact until groups started. Access to couple therapy was immediate, with a longer wait for groups, due to coordinating dates and venues for up to 12 couples. Despite a wait of up to one or two months, service users stated that they were told straight away if they had been allocated a space and were subsequently kept well informed.

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Quality of service provision

With early assessment and questionnaires, targets and expectations are set and outcomes later measured. The key worker collates feedback collected at the beginning, middle and end of the sessions. This helps the agency to develop the best service to meet needs. For example, the second group programme has slight adaptations following feedback from the first.

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Quality of service provision

The Tavistock is a centre of excellence for research and training and consequently all staff are well trained and supported with relevant training throughout their employment. They provide a prompt and sensitive service. Their knowledge supports service users in developing insight and coping strategies to manage relationships

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Quality of service provision

Staff report a high level of supervision. Their thoughts and feelings about each session are discussed in debrief meetings after groups or therapy take place. This allows staff to liaise effectively with service users. The welfare element of supervision is not immediately evident on case files, although staff report that this does happen regularly. Some supervision notes were not signed and dated to clarify ownership and agreement to content.

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Quality of service provision

Although children and young people do not directly receive services, the therapists Website: www.gov.uk/ofsted

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Quality of service provision

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. and research team thought carefully about how to hold the ‘unseen child’ in mind throughout the service provision. This mindfulness is present in the reflection of staff and the strategic thinking of the service.

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families

The policy regarding safeguarding young people is accessible by staff. This is multi- faceted and includes most key areas. The policy does not currently include the risks of suicide and/or self-harm in children/young people. There is a culture of staff having an open and informed approach within the service. Despite the therapy sessions being flexible in terms of topics and issues raised, key areas around safeguarding are kept very clear. For example, no violence between couples or towards children and young people is ever accepted. Within the initial assessment phase, staff gain excellent guidance on how to approach any disclosures of domestic abuse. They always see each person in the relationship separately as well as together and give service users opportunities to share any concerns from the outset.

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families

Staff files show appropriate criminal records clearances, verification of identity and references. However, they do not contain confirmation records of qualifications or registrations with professional bodies.

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families

Managers and staff show a deep and effective knowledge of child protection and key indicators to which they must be alert. The roles of respective professionals are known and understood. For example, concerns are shared with commissioning services promptly and staff know how to contact the designated officer where appropriate. Staff were confident about how to report safeguarding issues, where to gain advice and their legal responsibilities within this framework.

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families

In addition, the service benefits from a safeguarding lead with a good oversight of the needs of the service. Research-informed practice contributes to understanding risk areas and improving outcomes. Regular reviews of policies take place and updates reflect changes in the law.

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families

Adult service users are further protected by a safeguarding vulnerable adults policy, which is clear and available to staff.

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families

Information about complaints is included in the statement of purpose and on the website. The agency learns well from feedback and reviews, and evaluates its Website: www.gov.uk/ofsted

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families

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. services accordingly. Staff work with parents to seek consent where concerns raised do not require an immediate or emergency response.

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families

Refresher training is provided to all staff. Staff say they feel skilled, able and confident to handle complex situations. There has been specialist adoption training provided by a leading adoption agency prior to the groups commencing, and this has given staff a unique insight into the challenges faced by adopters and social workers. The agency also directly trains social workers in assessing the couple relationships, which helps to encourage good working relationships between placing professionals and therapists.

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families

Crèche provision is provided for the parents using group therapy. Safeguarding information is available for parents and the service is registered and inspected by Ofsted’s early years department.

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families

Case records show a deep and insightful knowledge of the impact of children’s past experiences and traumas on their behaviour. Case files are stored in a safe and secure area.

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families

Clear theoretical guidance allows parents to think about their own experiences and the impact on children. One of the group therapy sessions looks at three generations of parenting. Feedback from parents indicates how helpful this awareness is and how it helped them to understand their children better.

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families

Although provision is in place to deal with any safeguarding concerns, there have not been any raised thus far.

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Leadership and management

A suitably experienced and qualified registered manager runs this service with the close support of the responsible individual. The registered manager has a wealth of post-qualification experience in adoption settings, which gives her vast knowledge in the field of adoption and adoption support. All of the professional staff hold professional qualifications in their field and are registered with their relevant professional body.

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Leadership and management

Leaders, managers and trustees show a strong commitment to continuing to provide effective adoption support services. The responsible individual has recently retired. Website: www.gov.uk/ofsted

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Leadership and management

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. However, prior to retirement they were successful in securing additional government funding via a grant to continue provision for the next 18 months. The agency appropriately notified the regulator of the change in responsible individual and another suitable person is now in post.

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Leadership and management

The staff team and registered manager describe experiencing effective supervision. For group therapy sessions, such reflection on practice and guidance in running and managing sessions is clear, although these records are not signed and dated, making ownership and participation difficult to determine. The practical elements of supervision, although clearly described by staff and managers, are not yet recorded. It is therefore impossible to state whether practice issues are addressed and positive practice evaluated. Despite this, staff report a clear understanding of the management structure and a high level of management support. Workers feel empowered and valued by managers and describe an extremely high level of supervision and support.

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Leadership and management

There is effective monitoring of the service delivery as set out in the national minimum standards. The registered manager provides regular written updates and an evaluation report on the running of the service and the collated feedback from service users and reports this directly to the trustees. This leads to an overall internal business strategic plan, which sets out the agency’s vision for ongoing services.

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Leadership and management

The agency reviewed its statement of purpose and function to reflect the new responsible individual. It also made some amendments to ensure compliance with national minimum standards and to include the contact details of the regulator. This document is easily accessible on the agency’s website.

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Leadership and management

The agency keeps good contemporary records of services provided, that give a clear picture of how the agency is currently working with service users.

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Leadership and management

Leaders and managers speak about the service with clarity and a specific understanding of each of the service users. The group therapy curriculum has been adjusted following the survey feedback, showing that managers listen to and act to improve services.

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Leadership and management

The premises are appropriately risk-assessed and are able to meet the needs of the service. All fire precautions, health and safety checks and insurances are in place. There is a business continuity plan in place in the event of an unforeseen emergency. Website: www.gov.uk/ofsted

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Leadership and management

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. Managers are insightful and consistently find new means of addressing and evaluating the service. They understand the positives and weaknesses of the service well, and take action to improve it where necessary.

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Leadership and management

The service is financially viable and subject to regular financial audit. Website: www.gov.uk/ofsted

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Leadership and management

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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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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