Working with a reflective system within the SECURE STAIRS framework for integrated care: An evaluation of reflective practice sessions within the children & young people secure estate

Abstract

The SECURE STAIRS Framework for Integrated Care (NHS England, 2016; Anna Freud National Centre for Children and Families, 2022) was developed by NHS England to promote a trauma-informed, evidence-based and whole system approach to children and young people accommodated in the Secure Estate. These settings accommodate children and young people presenting with high risk, high harm and high vulnerability presentations that cannot be kept safe in the community. Reflective practice sessions were facilitated over a twelve-month period for residential staff, physical health staff and management working within a Secure Children’s Home in the North of England. A pre and post questionnaire evaluation method was utilised to analyse the results. The evaluation indicated significant improvements in participant’s confidence in their practice and communication with colleagues and children and young people; ability to be reflective with others both during and after an interaction; levels of stress when interacting with children and young people; and uncertainty within their practice. However, decreases were observed in participants ability to appraise their practice and desire for improvement within their practice. The authors critically review the results of the evaluation and highlight the ongoing need for reflective spaces for staff caring for children and young people with complex needs within the Secure Estate.