Integrate Families

Inspection report for adoption support agency: Integrate Families Integrate Families Renee P Marks Associates Ltd Croft Head Business Park, Dale Lane, Skelmanthorpe, Nr Huddersfield HD8 9BQ Inspected under the social care common inspection framework

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Information about this adoption support agency

Integrate Families is a registered adoption support agency. It provides a specialist assessment and therapy service for children and their families, to help children process previous trauma, and to establish a secure attachment between them and their parents. The agency comprises the manager, six therapists and two administrative staff. At the time of the inspection, it was working with around 70 children and their families.

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outstanding

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

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outstanding

The effectiveness of leaders and managers good

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outstanding

Overall judgement at last inspection: outstanding

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outstanding

Enforcement action since last inspection: none Inspection report for adoption support agency: Integrate Families

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Key findings from this inspection

This adoption support agency is outstanding because:

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Key findings from this inspection

 All of the agency’s practice is highly child focused and individualised  Assessments undertaken by the agency are impressively thorough, insightful and focused on improving outcomes for children and their families.  The therapy provided by the agency transforms the lives of children and their parents, helps children process the early trauma they have experienced and promotes children’s positive attachment to their adoptive families. Consequently, the quality of life of children and their families is significantly improved.  The agency’s practice is based on the very latest theory and understanding of childhood trauma and its effects. It is subject to rigorous clinical review and oversight, and the work done influences international understanding of trauma and dissociation.  There is impressively well-developed clinical oversight and supervision of the therapeutic work undertaken. Practice is subject to high levels of internal

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Key findings from this inspection

challenge and monitoring to ensure its effectiveness.  The agency provides adoptive families with very high levels of support not only through the therapeutic process, but also by additional means, including advice, individualised guidance and training, and helping families to work with schools on behalf of their children.

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Recommendations

 Ensure that the service user knows and receives written information about the service they are to receive, what the service is designed to achieve and what is involved in the particular service provision. Specifically, that written agreements with parents and children set out the agency’s duties to report any concerns that children may be at risk of harm. (NMS 15.3)  Ensure that, where services are commissioned by an adoption agency, a three-way working relationship is developed that effectively meets the needs of the service user. Specifically, that the agency consistently provides referring social workers with information about the effectiveness of the therapy being provided and the progress being made. (NMS 15.1)  The management needs to monitor the processes and outcomes of the Inspection report for adoption support agency: Integrate Families service in order to satisfy themselves that the agency is effective and is

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Recommendations

achieving good outcomes for children and/or service users. Specifically, that the agency’s six-monthly management reports take into account the views of children, parents and referring social workers. (NMS 26.6) Inspection report for adoption support agency: Integrate Families

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Overall experiences and progress of service users: outstanding

This agency’s clinical excellence and the extremely high quality of therapeutic support it provides transform the lives of the children and families that use the service in a dramatic and positive way.

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Overall experiences and progress of service users: outstanding

The agency’s practice is based on the very latest theory and understanding of childhood trauma and its effects. This is constantly updated, tested and reinforced through the agency’s engagement in national and international work on early trauma and dissociation. Its clinical lead is active internationally in academic circles and this enables the agency to consult with and seek advice from leading specialists. This means that practice is soundly evidence based and its effectiveness is considered both on a case-by-case basis and through expert peer review.

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Overall experiences and progress of service users: outstanding

Assessments are impressively thorough and evidence based. They clearly identify the needs to be met and form a strong basis for the therapy that is to be provided. This therapy is highly child focused and individualised. Although there is a clear ‘path’ through the therapeutic process, this is tailored to children’s needs and those of their families. Steps can be repeated and work can be revisited as necessary. A range of techniques are used within the therapy framework, based on individual children’s needs, personalities or situations. Therapists are sensitive to families’ situations and lifestyles, and are flexible about ensuring that therapeutic activity is adjusted to reflect things like holidays or life changes.

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Overall experiences and progress of service users: outstanding

The clinical oversight and supervision of therapists’ work is highly effective and exceedingly robust. Regular team supervision takes place, with all cases being discussed fully, and there is close individual case supervision. Therapists provide each other with robust positive challenge regarding their work. This helps to ensure that therapy continues to be appropriate and effective. Furthermore, this practice extends to the agency’s clinical lead, who ensures that her casework is supervised both by therapists within the agency and an external point of reference. This means that the agency is confident in the effectiveness of the work it does. Parents are included in all therapy sessions and the agency makes it clear that they need to continue to parent their children using the techniques they learn in these sessions.

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Overall experiences and progress of service users: outstanding

Most families approach the agency for support after many other sources of assistance have failed to meet their need. Consequently, the difficulties that children and families face are highly complex and long standing. The trauma that children have suffered prior to their adoption often means that attachments are not secure, and that parents struggle to manage the resultant behaviour of their children. Against this background, the changes that the agency’s work makes in the quality of the lives of children and their families is outstanding. As children are enabled to process their early lives and experiences, they are able to attach to their parents. At the same time, parents are helped to understand their children and how their behaviour is a presenting part of Inspection report for adoption support agency: Integrate Families the emotional harm they suffered. This means that children become more able to

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Overall experiences and progress of service users: outstanding

regulate themselves, parents are able to regain an appropriate level of control over their children, and children consequently become happier and make progress. Pressures within families are reduced considerably and in many cases this means that families stay together when they may have not done so otherwise. For example, one parent said that that her family ‘would not have survived this far as a family without it[the agency]’.

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Overall experiences and progress of service users: outstanding

The agency provides different types of additional support for children and their families outside of the therapy sessions. Families have access to online video training discussions produced by therapists and the clinical lead about a wide range of issues that they might face, including trauma, dissociation and attachment, and how to deal with these in a therapeutic manner. The agency also engages with children’s schools to help school staff to understand children’s needs, support them in the school environment, help them learn and support the parents to care for their children.

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Overall experiences and progress of service users: outstanding

Children are provided with excellent information about the therapy they receive, which helps them understand their feelings and the therapy process. A measure of the effectiveness of the therapy is the commitment that children show to the process because of the benefits they experience. One parent said that her child likened therapy to going to a gym, saying, ‘You don’t necessarily want to go, but it does you good.’

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Overall experiences and progress of service users: outstanding

A local authority adoption social worker, who has referred a number of families to the agency, summed up the outstanding outcomes being achieved for children and their families. She said, ‘Across the referred families I see parents who were traumatised, living in fear and with no quality of family life, changed so that they can function. A reduction in child–parent violence, reduction in being hit, bitten, school problems and so on. Parents beginning to enjoy children, parent them, attachments developing, able to take children out when they didn’t dare before.’

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

The therapy provided and the work done with children and their families place a key focus on children’s safety. Assessments and therapy very thoroughly consider risks to children and how to manage these. The agency’s therapists have an excellent understanding of the emotional harm children have suffered and how to address this through the therapeutic process. This enhances children’s lives considerably.

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

As children’s underlying trauma and attachment difficulties are addressed, their behaviour improves and parents become more able to exercise appropriate levels of control and to parent their children safely. This helps keep children safe, as any risky behaviour at home, at school or in the community is reduced. Therapy also promotes the safety of children’s parents. Children being violent towards their parents is not uncommon and helping children to regulate themselves and manage their own behaviour reduces this significantly. Inspection report for adoption support agency: Integrate Families Safeguarding practices in the agency are well developed. Therapy is closely supervised and monitored, with parents taking part as ‘co-therapists’, which makes sure that the work done is transparent and safe. The excellent clinical supervision provided to therapists helps to identify any risks that may occur and how these may

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

be reduced or presented. Therapists have a good understanding of and expertise in child protection practice. They understand the effects and implications of historic abuse, and are alert to situations in which this may come to light. They are similarly aware of current risks to children and the actions to take should they have concerns or become aware of situations in which children are at risk. Procedures cover the actions to take in such a situation and the agency refers concerns appropriately.

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

Written information about therapy for parents and children and the agreements they sign at the start of the assessment and therapy processes do not set out the agency’s child protection arrangements clearly. This means that parents and children are not informed as well as they should be about the fact that, in some situations, the confidentiality of the therapy sessions may be breached in order to report any child protection concerns.

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

Recruitment processes for staff are thorough in checking the suitability of applicants to work with children. This helps to protect all people using the service.

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The effectiveness of leaders and managers: good

This adoption support agency benefits from leaders and managers who are forward- thinking, have a clear vision for the service and its quality, and show a commitment to improving children’s lives.

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The effectiveness of leaders and managers: good

Strong leadership and efficient management mean that these high expectations are reflected by the agency’s therapists. The agency’s commitment to children is delivered through its excellent clinical practice, which helps children and their families to achieve outstanding outcomes and progress. A social worker said of the agency, ‘The agency understands the needs of adoptive families and their children. They have huge respect amongst professionals and the families they work with. Their work is highly valued.’ A parent said of the agency’s work with her children, ‘No other service has recognised or touched their trauma like this one.’

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The effectiveness of leaders and managers: good

The agency works well with the agencies who refer families to it. Communication with referring bodies is good, having improved over the last two years as the agency has grown and more management time has become available to it. Over this period, the agency has got better at keeping the referring social workers updated on the progress that children and their families are making through therapy. However, although the agency’s therapists have an excellent understanding of the progress children are making, this is not always communicated to referring social workers as well as it could be.Encouragingly, the agency has recognised this issue, and is working to do this more effectively. Inspection report for adoption support agency: Integrate Families The agency’s therapists are highly trained and constantly work to keep abreast of the latest developments in their field. They are helped in this by the input of the agency’s

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The effectiveness of leaders and managers: good

clinical lead and senior therapists, who work with leading professionals both nationally and internationally, and ensure that new learning is shared within the team. Supervision arrangements are excellent, and ensure that the agency’s practice is of the highest quality.

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The effectiveness of leaders and managers: good

Management and administrative arrangements are effective, and ensure that the agency delivers its work in a timely, well-planned and efficient manner. This helps to reduce the impact of any delay that may occur for families while they are seeking the funding to access the agency’s support.

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The effectiveness of leaders and managers: good

The agency has appropriate strategic plans in place that ensure its viability and its ability to continue to provide its services. Monitoring arrangements are effective. Six- monthly reports are produced, reflecting the agency’s work and monitoring its referrals capacity, timeliness and outcomes, as well as its ongoing development. The agency seeks the views of parents, children and referring professionals on an annual basis. However, it does not use these views in a formal way to inform its own monitoring of the service and they are not reflected in the six-monthly reports. As a result, the reports are not as objective or as useful as they could be.

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The effectiveness of leaders and managers: good

The agency has suitable arrangements in place for securely handling and storing the confidential information and records it holds.

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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 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: Integrate Families

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Adoption support agency details

Registered provider: Renee P Marks Associates Ltd

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Adoption support agency details

Registered provider address: Croft Head Business Park, Dale Lane, Skelmanthorpe, Nr Huddersfield HD8 9BQ

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Adoption support agency details

Email address: info@integratefamilies.co.uk

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Inspector:

Stephen Smith, social care inspector Inspection report for adoption support agency: Integrate Families 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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