Post-Adoption Support & Therapy

Inspection report for adoption support agency: Post-Adoption Support & Therapy Post-Adoption Support & Therapy

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Inspected under the social care common inspection framework

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Information about this adoption support agency

The Post-Adoption Support and Therapy agency was registered in October 2016. An individual practitioner, who is a registered child and adolescent psychoanalytic psychotherapist, operates the agency. The service is provided to any children or adolescents and their families who have been affected by adoption.

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Information about this adoption support agency

Inspection dates: 18 to 20 September 2017

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Overall experience and progress of

service users, taking into account: good

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Overall experience and progress of

How well children, young people and adults are helped and protected good

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Overall experience and progress of

The effectiveness of leaders and managers good

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Overall experience and progress of

The adoption support agency provides effective services that meet the requirements for good.

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Overall experience and progress of

Date of last inspection: N/A Overall judgement at last inspection: N/A Inspection report for adoption support agency: Post-Adoption Support & Therapy

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Key findings from this inspection

This adoption support agency is good because:

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Key findings from this inspection

 It offers psychoanalytic psychotherapy delivered by a highly qualified practitioner.

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Key findings from this inspection

 The individual practitioner offers long-term commitment to those who use the service.

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Key findings from this inspection

 Children and families using the service receive clear information and therefore understand what to expect.

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Key findings from this inspection

 An initial assessment period ensures that the provider understands all potential risks and can manage them safely.

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Key findings from this inspection

 At the beginning of therapy, the provider helps children and families to think about their hopes and expectations for future outcomes. This allows the family to talk about what the issues are, what they want to change and how they will know when changes occur.

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Key findings from this inspection

 The provider communicates effectively with others involved with the child and family, particularly when parents have separate parents working alongside the therapy.

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Key findings from this inspection

 The provider understands the process of therapy and advocates for children and families using the service.

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Key findings from this inspection

The adoption support agency's areas for development:

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Key findings from this inspection

 To ensure that the children’s guide is accessible to younger children and those with learning difficulties. Inspection report for adoption support agency: Post-Adoption Support & Therapy

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Recommendations

 Ensure that the Children's Guide to adoption support services is provided to the child by the Adoption support agency who is providing adoption support. The guide is appropriate to the child's age and understanding and includes a summary of what the service sets out to do for children and is given to all children and/or their representatives. The Children's Guide also contains information on how a child can find out their rights, how they can contact their Independent Reviewing Officer, the Children's commissioner, Ofsted if they wish to raise a concern with inspectors, and how to secure access to an independent advocate. (Adoption national minimum standards, July 2014, page 54, paragraph 18.6) Inspection report for adoption support agency: Post-Adoption Support & Therapy

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Overall experiences and progress of service users: good

This agency offers a specialised adoption support service to children who have highly complex needs, regardless of their status or differences. It helps and supports children and families to make positive changes in their circumstances. Psychoanalytic psychotherapy is used in both short and long-term treatment models. However many children whose early life experiences resulted in abuse and neglect are left with complex ‘attachment disorders.’ This type of therapy, working with the unconscious and emotional aspects of the child, often means intense and or long-term work. Children and families receive support to help them understand their circumstances better and cope with behaviours with greater knowledge. Service users said that they felt understood and supported, and benefited from the service provided. All psychotherapy demands an ability and desire to ‘get better’ plus a situation that facilitates change. Not every child or family achieves their treatment goals but they

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Overall experiences and progress of service users: good

should end the work better placed to deal with their lives.

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Overall experiences and progress of service users: good

Service users spoken to during the inspection gave positive responses to the service offered and how this had helped them. For example, one parent of a service user said, ‘It has been a very positive experience; we receive regular updates and the therapist has been really helpful.’

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Overall experiences and progress of service users: good

The registered person communicates well with other professionals involved in the care of children using the service. For example, one parent of a service user said, ‘Feedback from schools is very positive; the therapist has attended meetings at school and helped to increase their understanding of behaviours.’ Commissioning authorities that use the service receive regular reports. These include a summary of the work undertaken, with progress and targets for ongoing work and treatment plans.

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Overall experiences and progress of service users: good

The registered person advocates well for children and families using the service. This helps other professionals to understand the nature of the complex work undertaken, including the time it can take and the need to have organised and planned endings in therapy.

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Overall experiences and progress of service users: good

Prior to services commencing, the registered person undertakes an initial assessment period to determine the suitability of services. The registered person makes very clear agreements with service users prior to starting therapy. This helps to ensure that they understand the purposes of proposed interventions.

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Overall experiences and progress of service users: good

Occasionally, the initial assessment determines that the agency cannot meet a child’s needs or that the risks presented are too high. In this circumstance, the registered person suggests alternative provision or ensures a referral to a more appropriate resource. Inspection report for adoption support agency: Post-Adoption Support & Therapy Children are able to build up trusting, secure relationships with the registered person. They only attend on the basis that they want to be present. This helps to increase their feelings of safety, security and control over the therapy sessions.

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Overall experiences and progress of service users: good

Basic boundaries and expectations help to bring structure and give children clear parameters about therapy sessions. Sensitive work helps them to understand when their immediate wishes cannot be met and to reflect on and learn how to manage feelings.

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Overall experiences and progress of service users: good

Information about complaints is easily accessible for parents, and there is a simplified version for children within the children’s guide. The provider holds discussions with parents about how much information is shared with children. This is dependent on their age, complexity of needs and understanding. In some situations, it is not appropriate to share complaints information directly with children.

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Overall experiences and progress of service users: good

The registered person is highly trained and skilled as a child and adolescent psychotherapist and sufficiently experienced to offer this service to children with high-level, complex needs. The outcomes and benefits of psychotherapy vary from person to person and where there has been real emotional suffering, the benefit may be no more than acceptance and tolerance. For children whose emotional upset usually translates into disturbed behaviour, often the benefits in their shifts transfer to the family as a whole. Psychoanalytic psychotherapy is long and slow work. Sometimes it is helpful to consider what would have been the outcome if specialist help had not been available. Information during this inspection strongly indicates a number of positive outcomes as follows.  Risk of adoption breakdown would have been high without therapy.  Children have a positive experience where they feel someone has listened to

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Overall experiences and progress of service users: good

them.  Children have been able to reflect more on behaviours.  Children have shown more empathy.  Behaviours are up and down but overall improved.  Children feel safe in sessions and therapy helps them to stay calm.  Parents have been helped to understand their children’s behaviour.

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Overall experiences and progress of service users: good

There are no breaches of regulation. One or two minor shortfalls were resolved during the inspection period. One recommendation is made, to provide a simpler version of the children’s guide and to make this available on the company website.

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good

The registered provider ensures that psychotherapy sessions take place in a safe environment. Individual risk assessments of service users identify the need to adapt Inspection report for adoption support agency: Post-Adoption Support & Therapy the environment to ensure that it is safe for both service user and provider. For example, if a child is likely to throw things, then loose objects are removed from the therapy room.

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good

The registered provider makes careful plans in advance of sessions about how to manage potential situations that may arise during therapy, such as knowing what will happen if a session needs to end abruptly, or ensuring that there are no conversations between parents and therapists in children’s presence. This creates trust and feelings of safety and security. It also ensures that children feel that sessions are exclusively for them. Children can make a decision to terminate the session at any time and therefore parents are on call throughout the therapy session.

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good

Verbal feedback received during the inspection suggests that service users feel listened to and supported. Children, their families and other professionals have the opportunity to give their views through feedback forms sent to them for this purpose. The registered provider also sends out the survey responses on behalf of the regulator. One professional contacted said, ‘X has had a positive experience and feels someone has listened to him.’

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good

The registered provider has good knowledge about child protection and is alert to safeguarding issues. The agency has a safeguarding policy, which gives clear processes about what will happen should there be a referral. Although there have not been any historical allegations or safeguarding issues that have required reporting, the manager is aware of the processes and has contact with the Local Safeguarding Children Board (LSCB) and designated officer (DO) in the host authority. Where children live outside the geographical area, the manager has close liaison with the social work team and is aware of his responsibility to disclose any issues or safeguarding concerns.

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good

The individual running this service receives up-to-date and relevant safeguarding training. This enhances his understanding of safeguarding practice, including up-to- date areas of risk factors and concerns, such as risk of radicalisation and exploitation.

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good

A shortfall identified during inspection was that the agency’s safeguarding policy had not yet been shared with the LSCB or the DO for consideration and comment. This has had no impact on children using the service and was rectified during the inspection period.

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The effectiveness of leaders and managers: good

The registered person, who operates as a sole practitioner, runs the post adoption support and therapy agency effectively. He is suitably qualified and experienced to undertake this role. He is registered with the association of child psychotherapists and has a professional responsibility within this role, including a responsibility of confidentiality to his patients and to maintaining his professional knowledge through regular research and training. Inspection report for adoption support agency: Post-Adoption Support & Therapy Commissioning services and parents receive clear information packs identifying the referral information required by the agency. This sets out the parameters of the service and gives clear expectations.

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The effectiveness of leaders and managers: good

The quality of service is monitored in several ways. The registered person seeks independent feedback from social work practitioners, commissioners and service users. In respect of service users’ progress, two main tools are used to determine progress and outcomes. One, which is used less often, is a strength and difficulties questionnaire, while another used more frequently is the hope and expectations for treatment approach known as the HETA. This allows children and their parents to think about things that they would like to change or improve. Further, into the therapy, these goals are reviewed to record and remind them of progress made. Hopes and expectations are set at different tiers, some easily achievable and others which are longer-term goals.

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The effectiveness of leaders and managers: good

The registered provider actively seeks to build positive working relationships with commissioners, schools, parents, co-therapists and social workers to help secure positive outcomes. An example of this is communication with schools to support them to understand children’s behaviours.

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The effectiveness of leaders and managers: good

The registered provider has regular clinical supervision at least once a month and often twice a month. There are records of supervisions held and these sessions help the registered provider to think of all aspects of the work undertaken with children and their families. Supervisions offer time to reflect, discuss and challenge themes brought by children to therapy.

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The effectiveness of leaders and managers: good

The agency has a clear statement of purpose, recently updated, which is soon to be available on the agency website. There is also a children’s guide, which includes all relevant information. The children’s guide should be more accessible to younger children and children with learning difficulties and should be on the website. The agency is achieving its stated aims and objectives as set out within the statement of purpose.

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The effectiveness of leaders and managers: good

The agency has a complaints policy and the statement of purpose summarises how to complain if needed.

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The effectiveness of leaders and managers: good

Comprehensive case records are held and stored confidentially. The registered person is aware of his responsibility for client confidentiality and ensures that electronic files are password-protected and mobile devices are securely stored when not in use.

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Information about this inspection

During this inspection, inspectors looked closely at the experiences and progress of children, young people and adults. Inspectors considered the quality of work and the Inspection report for adoption support agency: Post-Adoption Support & Therapy differences made to the lives of children, young people and adults. They watched how professional staff work with children, young people, adults and each other and discussed the effectiveness of the help provided. Wherever possible, they talked to children, young people, adults and their families. In addition, inspectors have tried to understand what the adoption support agency knows about how well it is performing and what difference it is making for the children, young people and adults whom it is trying to help.

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Information about this inspection

This inspection was carried out under the Care Standards Act 2000, using the 'Social care common inspection framework', to assess the effectiveness of the adoption support agency, how it meets the core functions as set out in legislation, and to consider how well it complies with the Adoption Support Agencies (England) and Adoption Agencies (Miscellaneous Amendments) Regulations 2005 and the national minimum standards. Inspection report for adoption support agency: Post-Adoption Support & Therapy

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Responsible individual:

Email address: john.crowley@child-psychotherapist.com

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Inspector

Christine Kennet, social care inspector Inspection report for adoption support agency: Post-Adoption Support & Therapy to achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children's social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children's services, and inspects services for children looked after, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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