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Insight is a publication of the research group within Information and Analytical Services Division, which is responsible for providing analytical services within the Scottish Executive Education Department ( SEED). Their work is part of a multidisciplinary unit (consisting of researchers, economists and statistics staff) and the staff undertakes and funds economic analysis and social research in the fields of: school education; children, young people and social work: architecture; and tourism, culture and sport.

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Insight aims to present the essence of research projects in a format that will be useful and informative for practitioners, policy makers, parents, academics, and anyone else who has an interest in economic and social research in these areas.

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Secure Accommodation in Scotland: Its Role and Relationship with 'Alternative' Services

Moira Walker, Aileen Barclay, Margaret Malloch, Gillian McIvor
Social Work Research Centre, University of Stirling
Andrew Kendrick, Lynne Hunter
Scottish Institute for Residential Child Care, University of Strathclyde
Malcolm Hill
Glasgow Centre for the Child and Society, University of Glasgow

What is the background to the study?

This research was carried out between November 2002 - 2005 to increase understanding of the use and effectiveness of secure accommodation in relation to young people placed on the authority of a children's hearing. It also examined the circumstances in which open residential or community-based services might provide an 'alternative' to secure placement.

The study was completed almost ten years from the publication of A Secure Remedy, ¹ a joint inspection report which advocated the development of community-based alternatives and the more targeted use of secure provision. Since then a range of 'alternative' services had come on stream, including intensive community-based support, specialist fostering and close support residential provision. Plans to increase secure provision were approved and building began on three new sites. There have also been changes in practice within existing units, with an increased focus on mental and physical health assessments and the use of standard cognitive behavioural programmes. Intensive Support and Monitoring Services ( ISMS), a community-based alternative to secure accommodation involving the use of electronic tagging, were introduced shortly before the research ended.

What were the aims of the study?

The aims of the research were to provide:

1. clearer understanding of the purpose and effectiveness of both secure accommodation and open 'alternative' services in meeting the needs of young people, their families and

2. a framework to assist the decision-making process on the use of secure accommodation by children's hearings and social work departments.

What were the methods used?

Semi-structured interviews with social work and secure unit managers, panel chairs, reporters and key professionals working in secure units.

Tracking a sample of 53 young people who experienced secure accommodation for approximately two years from admission. Information was collated on the young people's characteristics, reasons for admission and how they fared during the secure placement. Similar information was obtained retrospectively on 23 young people considered for secure accommodation, but subsequently sustained in an open residential or community setting for at least six months. Interviews were held with a small number of young people from both samples.

A review was conducted of subsequent placements for all young people made subject to secure authorisation by a children's hearing between 1st July and 31st December 2003.

A limited assessment of cost implications and benefits was also carried out.

Key Findings

Can we compare secure accommodation with 'alternative' services?

The original expectation had been to compare outcomes for young people admitted to secure accommodation with those for similar young people considered for secure accommodation but sustained in an open setting. As the research progressed it became clear that secure accommodation and 'alternatives' were typically offered as complementary services at different points in a young person's care career, so it was more valuable to try to understand how pathways through services were shaped rather than make comparisons between two distinct samples. It also became evident that the use of secure accommodation and 'alternatives' differed across local authorities, reflecting local circumstances and practice. Thus the role and effectiveness of secure accommodation and 'alternatives' had to be understood in context.

What are the key roles of secure accommodation?

Among the professionals interviewed there was broad agreement that the main functions of secure accommodation were to:

• protect the young person and the public;
• assess needs and allow young people to take stock of their situation;
• engage with young people and effect change;
• equip young people to move back into the community.

How well does secure accommodation fulfil these roles?

Secure placements were generally viewed as effective in keeping young people safe, though some concerns were expressed about potential intimidation by other residents. Another worry was the implicit message to the young person that he or she could only be controlled and/or kept safe in a locked setting.

Secure placements were viewed as providing a valuable opportunity for young people to take stock, engage with professionals and effect change, but inbuilt limitations were also recognised. Assessments could provide an opportunity to identify and begin to address educational, health or psychological needs. However many young people had longstanding difficulties, for example in relation to attachment or unresolved trauma and loss, which could not be fully addressed in a short-term placement. In some units a range of evidence-based approaches, such as pro-social modelling and dialectic behaviour therapy, were being introduced to help young people better understand their feelings and behaviour.

However many also needed longer term counselling or therapy, a stable home base and the experience of reliable relationships over time if benefits from these inputs were to be sustained. Some respondents drew attention to the ways in which institutional care itself undermined therapeutic work, partly because young people became preoccupied with adapting to the new environment, but also because learning which took place in a closed setting would not necessarily be sustained when the young person returned to the community.

There was a widespread view that any benefits from being in secure accommodation were more likely to be sustained if the young person was able to move on to a care and education/work placement which corresponded with his or her identified needs. Lack of appropriate provision, particularly in relation to specialist schooling and residential units offering close support, was thought to undermine the secure units' capacity to equip young people to cope when they moved on.

Can there be open 'alternatives' to secure accommodation?

A number of those interviewed questioned whether there could ever be direct 'alternatives' since, if young people required physical security, nothing else should be offered. Others took the view that the point at which secure accommodation became necessary depended to some extent on the capacity of other services to provide enough supervision and support to keep the young person and community safe. This second perspective was associated with a willingness amongst social workers to develop packages in response to the specific needs and behaviour of individual young people, while continuing to monitor whether these allowed risks to be adequately managed. This varied across local authorities and was related to accessing secure placements when required.

What should open 'alternatives' offer?

Expectations of open 'alternatives' to by placing professionals were high. The most common expectation was that the level of contact with the young person should be at least daily and preferably with a 24 hour stand-by service. This intensity of service, coupled with developing a productive relationship with the young person and his or her family was viewed as central to facilitating change. The capacity to work with families and within the young person's community was expected to increase the likelihood that changes in behaviour would be sustained. Thus alternatives were expected to reduce some of the drawbacks of a secure placement. In addition alternatives were expected to provide some of the perceived advantages of secure accommodation, for example keeping young people safe, through frequent contact and on-going risk assessment, and helping them to engage with education and other appropriate resources.

Who decides whether a young person requires secure accommodation?

Decision-making in relation to secure accommodation took place in three key sites: within social work services, at children's hearings and within secure units. The decisions centred around two key dimensions: determining the needs and best interests of young people and deciding who had priority to the secure placements available. Underpinning both aspects were questions about what types and levels of risk could safely be managed in an open setting.

Across local authorities the decision that a young person merited secure authorisation was reached when it was decided that the current level of risk could not be safely managed within the open resources available. Thereafter this decision was considered by a children's hearing. In most instances panel chairs and social work staff were in agreement about when secure authorisation was required. However both panel chairs and social work managers acknowledged that at times panel members' tolerance of risk was lower. In particular, panel chairs could be less convinced that support 'packages' designed around individual young people were likely to be effective, preferring to use services or schemes which were specifically designated as 'alternatives'.

Either shortly before or soon after an authorisation had been made, a secure place had to be found. One of the main issues for social work managers and panel members was that they had little or no control over the process through which placements were allocated. Unit managers said that when prioritising requests for places, their main considerations were the perceived level of risk to self or others and how any individual would fit with the current resident group. This made it difficult for social workers seeking a placement to know what priority their application would be accorded as there was often no ongoing dialogue with the unit in question. Though no local authority was entirely self-sufficient in terms of secure provision, in the three authorities which managed a unit, social work managers had considerably more control over access to secure places. This made the prioritisation process more transparent, so that periods in a secure setting could be more effectively planned.

What influences decision-making in relation to secure placements?

Decision-making was a dynamic process in which the response to each young person was shaped by four characteristics of the local context. These were:

1. ease of access to secure placements;
2. availability of 'alternative' resources which offer intensive support;
3. views about the role of secure accommodation;
4. practice in and attitudes towards risk management.

Together these inter-related considerations shaped each local authority's use of secure provision. Though each authority said they used secure accommodation as a 'last resort', thresholds across authorities were different because of local variation in resources and perceptions of secure placements' potential benefits or harm.

Are there enough secure places?

There was widespread agreement that secure places were in great demand, but stakeholders' opinions differed. Some thought that more were needed whereas others felt that those already available should be used differently. The most common view was that more local provision was required; either secure or highly resourced residential units which could sustain and work with young people in crisis. There was also widespread support for a national system which would allocate places according to transparent criteria.

Information from SCRA² and local authorities formed the basis of a survey for this research and indicated that:

• Of 104 young people (59 boys and 45 girls) made subject to or seriously considered for secure authorisation, most (79/76%) had been placed in secure accommodation by the time the survey was completed.
• Based on information available on 69 of these young people, it emerged that almost three quarters ³ had been admitted on the same day as the authorisation was made, a further nine had been admitted within a week and four within three weeks.
• The remaining five ⁴ (7%) had to wait between 3 weeks and 3 months before a placement became available.

Information was available on 22 of the 25 young people who had been considered for but not been admitted to secure accommodation:

• Most had been accommodated in a form of residential care, either a residential unit (11), residential school (6), or close support unit (2), but two had remained at home and one in foster care. In most instances there had been no change of placement.
• For half of the young people the placement had not gone ahead because the situation had improved or the risk reduced by the time a placement became available.
• Reasons given for the remaining 11 staying in an open setting were: no placement available (4); secure placement was not considered in the young person's best interests (4); young person did not meet secure criteria (3). ⁵
• For nine young people the warrant was not renewed, while for two it was renewed once. This indicated that within 3-6 weeks most situations had settled sufficiently for a children's hearing to have confidence that the young person could remain in an open setting.

The findings of this survey indicated that most young people who required a secure place had been placed within a week, but also that lack of immediate availability had given some young people a chance to settle and so avoid admission. This supports the view that ready access to secure accommodation may result in some young people being admitted who could have been supported in an open, usually residential, setting.

Who were the young people in the secure sample?

The 53 young people who formed the secure sample, 28 girls and 25 boys, ranged in age from 12-16 at the time of their admission. Most had known significant disruption in their family life, over half having been known to social work services before reaching the age of ten. Ten young people, eight of them boys, had experienced the death of a parent, one young man having lost both his mother and father. All young people had been accommodated at some point prior to admission, but for a quarter this had been for less than six months. Half of the sample had been accommodated less than two years and only two young people for five years or more.

How did they reach a secure placement? ⁶

There were three main pathways into secure accommodation:

from a residential unit (31);
from a residential school (13);
from a family home, either with relatives or foster carers (9).

In the year prior to admission, most young people had experienced more than one care placement, with over half having had an admission from their family home. In a number of cases difficulties had continued to escalate after admission to residential care. Only three young people had been offered residential close support prior to admission to a secure placement.

In the preceding year, a range of support services had been offered to these young people, but records indicated that over half of the young people had been reluctant to engage (n=30). Most changes of placement or services had been offered on a reactive basis, because young people were in crisis. Unsurprisingly, most young people's education had been seriously disrupted in the year prior to admission.

• Most young people (89%) had been admitted to secure accommodation because of concerns that they were putting themselves at risk, with all young women but one considered a risk to themselves.
• Just under three quarters (73%) were considered likely to abscond and just over a third to present a danger to others (52% of boys and 18% of girls).
• Typically young people were staying away from their placement and spending time with people and in circumstances which were considered dangerous.
• Excessive drug and/or alcohol use, risk of sexual exploitation and deliberate self-harming behaviours added to the concerns.
• Though 75% of the young people had committed at least one offence, in very few instances had this in itself prompted the placement.

How did young people admitted to secure accommodation fare at the point of exit?

The key expectation for most placements was that they would keep young people safe and start to address the difficulties which underpinned their current circumstances. In some instances, re-establishing better relationships with parents and other family members was considered important, especially if the young person was to return home. Social workers also hoped to introduce young people to other relevant services. The expectation was that the crisis-driven responses of the previous year would be replaced by more co-ordinated, needs-led and individually relevant service provision.

At the point when the placement ended , social workers considered that all young people had benefited from the secure placement in that all were considered to have been kept safe and, with good personal care, to be healthier than they had been when admitted. All except one young woman who refused to attend school were also thought to have derived benefits from the education provided. On other dimensions, signs of benefit were more ambiguous and one of the disadvantages of secure placements was often the distance from home, which disrupted young people's contacts with family and relevant professionals.

Improvements in the behaviour which had prompted the secure placement were noted in relation to 58% of the young people. For the remainder, either the problematic behaviour was continuing or apparent changes were thought unlikely to be sustained. Placements were considered particularly ineffectual in addressing drug misuse. Social workers attributed lack of change in behaviour to a range of factors including: poor fit between young people's specific needs and the programmes offered; issues being tackled outwith the young person's usual environment; and young people's difficulties being too entrenched to be addressed in a relatively short placement.

Taking this range of considerations into account, at the point when the secure placement ended, its impact on the young person was assessed by social workers as follows:

Young person clearly benefited: 33

Some benefits acknowledged alongside some drawbacks: 20

Clear benefits were identified for a higher proportion of girls than boys and for more of those who entered secure from a residential unit than either of the other pathways. ⁷

What about longer term outcomes?

There was a second assessment of young people's progress approximately two years after admission to the secure placement . Outcomes were rated as good, medium or poor, based on the following variables:

• whether the young person was in a safe and stable placement at the point when their progress was last updated
• whether the young person was in work or education at the point when their progress was last updated
• whether the behaviour which resulted in their admission had been modified
• social worker's rating of their general well-being compared with when they were admitted to secure accommodation.

Young people whose circumstances or rating were positive on all four dimensions were considered to have had a good outcome. Where at least one was negative the rating was medium and where no aspects were positive, the outcome was considered to be poor. This meant that the outcome would be considered medium if a young person was living at home i.e. avoiding prison or homelessness, even if they continued some offending or other problematic behaviour. On this basis, outcomes were assessed as follows:

Good:14 (26%); Medium: 24 (45%); Poor: 15 (28%)

The spread of ratings was similar across age, gender, placing local authorities, units where young people were held and placement prior to the secure admission. Good or poor outcomes could not be attributed to single factors, but rather emerged from how several elements of the situation came together.

Where young people were living two years after admission to secure accommodation

Throughout the period, the number of places young people had lived in ranged from one to fifteen, but 32 (60%) had no more than 2 moves and 43 (80%) no more than three. Social workers considered that only four of those living at home were in a 'stable' family situation. Some young people had returned to a family home where there was no bed for them.

At the end of the two-year period, 27 young people ⁹ were in education or work. Almost three quarters of the sample were still in contact with at least one community-based support, primarily projects offering support to independent living, intensive community support, youth justice interventions, drugs or addiction support, mental health services. No particular form of support was associated with a better or worse outcome.

Were changes in behaviour and well-being sustained after two years from admission?

Not surprisingly there was a close correspondence between ratings of change in behaviour and change in well-being. Those whose problematic behaviour had increased were typically involved in drug use, often with associated offending.

Social workers often attributed good or poor outcomes to service provision following rather than during the secure placement. One of the transition practices associated with good outcomes was to gradually reduce the level of structure and supervision to which young people had become accustomed. This so called 'step-down' approach was thought to have applied to a total of 17 young people, none of whom had a poor outcome.

Who were the young people considered for secure accommodation but not admitted?

Twenty-three young people, 16 boys and 7 girls, formed the alternative sample. At the point when they had been considered for admission, they ranged in age from 10-15, with eight aged 10-13 and fifteen aged 14-15. Unlike the secure sample, this group included fewer young women who were vulnerable to drug use, running away or dangerous sexual activity.

In terms of their family composition and life experience, the young people in the alternative sample were similar to those who formed the secure sample. Three young people had begun to show difficult behaviour at age ten or younger, but more usually difficulties had surfaced at age 12-13. All but three of the young people had been accommodated at some point in their lives.

At the time when they were considered for secure placement, nine young people were living in a residential unit, five were in a residential school and nine were living at home. A total of ten young people were enrolled at mainstream school at the point when secure was considered, with five attending reasonably regularly. Others were in specialist education. A key difference between this group and those admitted to secure accommodation was that, in the year prior to being considered for secure accommodation, most (18) had remained engaged with at least one specialist project offering intensive community support and/or offending related interventions. In a number of instances this support had helped sustain school placements and there had often been close work with families.

The young people had been considered for secure placement for reasons similar to those which had resulted in an admission for those in the secure sample. However offending was more of an issue for young people in the alternative sample and fewer of them (7) were absconding.

How did these young people fare?

For approximately half of the young people (12), the reason they were not admitted was that no bed had been available. In these instances, most remained in their current placement, either in residential accommodation or at home. Two young people were not considered to meet secure criteria, either by social work managers or a sheriff on appeal. For the remaining nine an alternative package was developed and agreed by the children's hearing. Six of the nine moved to a new placement, either a residential school, close support or a residential unit. The remaining three stayed at home.

Placements at home and in an open residential setting were often supported by specialist projects, usually intensive community support or projects which focussed on offending. Some of these offered daily contact and 24-hour emergency support. Establishing an authoritative but open relationship with the young person and key members of his or her family was central to being able to effectively monitor risk, avoid crises when difficulties arose and move towards changing harmful ways of behaving or relating to others. The aim was to enable young people to cope well enough in difficult circumstances, rather than trying to effect change by removing them from their home community. The former was sometimes viewed by key workers as a more realistic approach to difficulties which were routed in longstanding stress and deprivation within the family and community. Because the problems were entrenched, the support sometimes had to be provided over several years.

In the year following being considered for secure accommodation most young people's lives were reasonably stable, with approximately half staying where they were and most of the others moving placement once. Only one young person was admitted to secure accommodation and one to a Young Offenders Institution. Most of the young people were in specialist education, though three attended a mainstream school, with additional support, and three were in the process of moving to college at the point when the data was gathered.

What were the cost differences between secure and non-secure options?

Non-secure options are usually expected to be cheaper, but a summary of indicative costs indicated that there was a degree of overlap, depending on what the alternative package entailed. Costs were linked to placement types and to other aspects of care packages and were calculated for a range of placement types: local authority residential unit; residential school; close support unit; secure accommodation; foster care and community support. Information on costs was collated from a number of different sources and it is acknowledged that there are major limitations in that the wide variation in the way in which services are provided to young people is masked in the calculations.

Over the year prior to and following the secure placement, estimated costs for young people admitted to secure accommodation ranged from £66,800 - £354,400. Corresponding costs for those considered for secure accommodation, but not admitted were £20,800-£217,100. Estimated costs broken down to reflect the route through which young people were considered for secure accommodation showed that while there is a tendency for the non-secure sample to be less expensive than the secure, there is wide variation in cost within the two samples and overlap across them.

What are the key implications of this research?

• A key study finding was that the use and effectiveness of secure accommodation was highly context specific.
• The study found that secure provision and 'alternatives' were complementary services rather than directly alternative options.
• This recognition of the interconnections between secure and other services and the extent of local variation has implications for strategic planning at a national and local level.
• Several research findings lent support to the view that three key resources would reduce the need for secure accommodation and produce better outcomes for young people after leaving: residential provision which could manage young people in crisis; intensive community-based support and social work and project staff who were able to effectively gauge and manage risk.
• This study indicated that panel members were willing to tolerate a lower level of risk than social work professionals and could be sceptical about the protection offered by individual packages built round an individual child.
• It is important that social workers have a high enough level of training, experience and contact with young people and their families to be able to safely assess and manage risk.
• Findings in relation to current capacity highlighted that there can never be a straightforward answer to how many secure beds are required. The study indicated that the need for secure placements is related to capacity to manage risk within open residential provision and community support services. Questions of capacity need to consider the type as well as the number of places.
• The importance of continuity and having someone to rely on is clear from this study. It was the on-going relationship with families which enabled some intensive support projects to avert admissions when crises arose, whilst the same principle was key to a step-down approach helping young people retain some of the benefits when they left a secure placement.
• This research confirmed that many young people who are admitted to secure accommodation have been identified as having difficulties from a young age, for others problems first surface in their teenage years, though these often relate to earlier trauma or loss.
• The importance of early intervention is clear, as is the need for developing effective ways of engaging with parents whose children are most in need .

Conclusion

In the short term, secure accommodation had certainly kept some young people safe, and for most there were clear educational and health benefits. Two years after admission, about a quarter were rated as having had a good outcome, but for a similar number the outcome had been poor. Given the seriousness and complexity of some young people's difficulties, these results may be viewed as satisfactory.

However, the alternative sample also included young people with serious longstanding difficulties and some of them were also managing to cope, without the disruption and potential stigmatisation of a secure placement.

Open and community- based alternatives thus also merit further development.

TheInsightSeries

1. Classroom Assistants: Key Issues from the National Evaluation
2. The Impact of ICT Initiatives in Scottish Schools
3. Moving On to Primary 1: An Exploratory Study of the Experience of Transition from Pre-School to Primary
4. Accelerating Reading and Spelling with Synthetic Phonics: A Five Year Follow Up
5. Assessment of Benefits and Costs of Out of School Care
6. Meeting the Needs of Children from Birth to Three: Research Evidence and Implications for Out-of-Home Provision
7. Key Findings from the National Evaluation of the New Community Schools Pilot Programme in Scotland
8. Scottish Qualification for Headship: Key Issues from the Evaluation
9. The Sitter Service in Scotland: A Study of the Costs and Benefits
10. Awards in Early Education, Childcare and Playwork: A Qualifications Framework for the Future
11. An Evaluation of the Higher Still Reforms
12. The Management of Supply Cover in the Teaching Profession
13. Parents' Demand for and Access to Childcare in Scotland
14. Evaluation of Personalised Laptop Provision in Schools
15. Teachers' Perceptions of Discipline in Scottish Schools
16. Minority Ethnic Pupils' Experiences of School in Scotland ( MEPESS)
17. A Seven Year Study of the Effects of Synthetic Phonics Teaching on Reading and Spelling Attainment
18. An Assessment of the Support and Information for Victims of Youth Crime ( SIVYC) Pilot Scheme
19. Child Death and Significant Case Reviews: International Approaches
20. The Impact of Information and Communication Technology in Scottish Schools: Phase 3
21. Investigating the Extent of Commercial Activity in Schools
22. Study Support and Out of School Hours Learning in Scottish Schools
23. Motivations for Undertaking the New Social Work Degree
24. Gender Balance of the Teaching Workforce in Publicly Funded Schools in Scotland
25. The Role Of The Social Worker In The 21st Century - A Literature Review (web only)
26. Evaluation of Free Fruit in Schools Initiative (web only)
27. Mainstreaming pupils with special educational needs
28. Early Years Education: Perspectives from a Review of the International Literature (web only)
30. Safe and Secure Homes for Our Most Vulnerable Children - Analysis of the Consultation on the Adoption Bill
31. Review of Strategies to Address Gender Inequalities in Scottish Schools
32. The Future Delivery of Advice and Information Services for Additional Support Needs in Scotland.

If you have views on Insight or wish to find out more about SEED's research and economics programme, please contact Information and Analytical Services Division, Scottish Executive Education Department, Victoria Quay, Edinburgh EH6 6QQ or by e-mail on recs.admin@scotland.gsi.gov.uk

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