Therapeutic Residential Care for Children 5-10 years old upon admission
Quality and purpose of care
Windows for Children cares for children aged between five years and ten years upon admission with significant emotional and behavioural difficulties. We provide a safe, nurturing and stable environment to children who have suffered significant harm in their formative years. We recognise the children we care for are individuals, who have their own personalities, experiences, needs and risks.
Windows for Children works with and cares for children who display insecure attachment behaviours, and typically have a Disorganized Attachment style. We commonly support and care for children who have experienced many changes in caregiver, and have become developmentally “frozen” (Fahlberg V “The child who is stuck’, in Adcock M, White R (eds), In Touch with Parents: Training materials for working with natural parents, London: BAAF, 1984.) as a result of their traumatic and harmful early life experiences.
It is well known and founded that Disorganised Attachment behaviour in childhood is correlated with later behavioural and psychosocial difficulties including dissociative behaviour, controlling, externalising or aggressive behaviour, conduct and attention disorders and mental ill-health. Upon arrival at Windows for Children, children typically exhibit many of these behaviours and characteristics, have sensory processing difficulties, and have great difficulty regulating their own emotions and behaviours.
Ethos and outcomes and how we will achieve them
In our experience, a child placed with us lacks the ability to reside within a “family” environment, maintain friendships, engage with the school curriculum, and reach their full developmental potential in all areas and has often been compromised by the trauma and adverse life events they have experienced. Windows for Children provides a ‘secure base’ for children in order to address the child’s attachment pattern and accompanying sensory modulation difficulties.
Windows for Children provides children with individualised care and rigorously strives to provide a safe, secure, nurturing, relaxed and homely restorative milieu; where every child’s care, well-being and sense of safety is of paramount importance.
We work intensively with children to support and facilitate progress in all areas of their development, using meaningful relationships as the conduit to achieving these goals. Windows for Children’s over-arching aim is to help the child achieve, sustain and manage emotional and placement permanency. Windows for Children do not offer short-term or bridging placements. Our therapeutic programme is based on a two year placement with a supported and planned transition.
Our therapeutic programme is an integrative approach to the treatment of children who have suffered significant harm and is comprised of three stages;
1. Addressing Sensory Delays
2. Specific Therapeutic Issues
3. Preparation for Permanence
We recognise that negative experiences in-utero and in early childhood impact on a child's capacity to cope with stress throughout life. There is a tendency to either: flee and fight, freeze and dissociate, or fluctuate between these stress states when there is an unconscious trigger or a conscious reminder of traumatic events. Traumatised children tend to operate in persistent state of hyper-vigilance which impedes their capacity for filtering out "irrelevant" sensory experiences such as background sights and sounds. Upon admission, children are typically sensory defensive, as their sensory systems have become sensitised to the possibility of danger.
Although children have developed behavioural strategies early on, in order to survive their attachment environment, their coping mechanisms have often become maladaptive. Stage one of our therapeutic programme recognises the need to address sensory delays and support children in regulating their emotions and arousal states i.e. to shift from the Autonomic Nervous System’s involuntary and instinctual bias of either flight, fight or freeze. Additionally, within stage one of our therapeutic programme, we focus on facilitating modulation of the body senses through the combination of up-regulating and down-regulating experiences, which in turn enables higher level sensory, emotional and cognitive functioning and co-regulation of a child’s attachment style.
Stage two of our therapeutic programme addresses Specific Therapeutic Issues with a child once greater sensory integration has sufficiently progressed and enabled higher order cognitive and emotional functioning. Stage two of the programme is designed to help a child make sense of their early life experiences and therapeutic Life Story Work is undertaken with the child in addition to their 1:1 therapeutic sessions. The children continue to engage in group therapeutic sensory games to consolidate the sensory attachment integration programme undertaken within stage one of the programme. Windows for Children use the Richard Rose model of Therapeutic Life Story Work and have two qualified practitioners within the team.
The final stage of our programme involves preparing a child for emotional and placement permanency. In over twenty years of experience delivering the programme, we have found that children often find transitioning into a “family” setting anxiety provoking and destabilising, particularly as the children who come to Windows have typically experienced a number of placement break-downs prior to residing with us. Without careful planning and preparation, a child can experience regression, making the final stage of the programme a critical part of the child’s therapeutic journey. We support the child in identifying the type of family they would like to transition into; it is crucial that the child’s feels their wishes and feelings are heard and central to their Care Planning. We work closely with Local Authorities to ensure that the placement match is appropriate to the child’s needs in order to reduce the likelihood of breakdown too. Additionally, we work with all relevant parties to devise an appropriate child-focused transition plan. During the final stages of the programme, we support children to manage their transition, and offer the carers indirect support after the child has their choice of ending on the final day of their transition schedule.
Views, wishes and feelings
Policy and approach to consulting children about the quality of their care
Listening to children and integrating their wishes and feelings into all aspects of their care is central to the Windows ethos. It is a fundamental part of establishing the trusting relationships upon which all of our work with children is built, whilst also supporting the work we do to develop self-esteem. We balance children’s views, wishes and feelings carefully, considering them alongside their care and management plans and what all stakeholders assess as being in the child’s best interests.
Children are frequently asked for their views, wishes and feelings concerning their daily routines but more formal structures include monthly children’s meetings and consultation documents. The children are involved in our recruitment procedures and staff appraisals. The children’s right to advocacy and Independent Visitors is encouraged, promoted and supported. The children are involved in our audits and inspections, including our monthly Regulation 44 visits. Recently one child said, ‘They give you lots of opportunities to be heard and you can always talk to the grown-ups.’
Policy and approach in relation to anti-discriminatory practice in respect of children and their families and children’s rights
Windows is an inclusive, value driven organisation committed to achieving the best possible outcomes for children irrespective of gender identity, age, race, religion/belief structure, sexuality, disability or indeed any other points of difference. To facilitate this culture, we ensure that all staff are knowledgeable, trained and have access to support. We have high expectations and staff know they must promote;
Anti-discriminatory practice- staff are expected to be self-aware and be able to identify discriminatory attitudes, behaviour and language in children and other adults.
A wholly inclusive environment for children where they feel valued and can participate fully in the activities of the home.
Access to various local community resources so the children develop knowledge, understanding and tolerance of ‘difference’ within communities.
Diversity to ensure Windows avoids a “one size fits all’ blanket approach, but instead provides individualised care which allows children to develop their own identities.
Our approach to promoting children’s rights is based on the central theme of Article 3 of the United Nations Convention on the Rights of the Child, ‘In all actions concerning children, whether undertaken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interests of the child shall be a primary consideration.' Our value structure is built upon this notion and it is the arbitrating concern in any question regarding decision making and planning on a strategic, daily, micro and macro level.
Education
Supporting children with special educational needs
Windows for Children recognise the fundamental role played by education in the development of children. We recognise the therapeutic value of the social interactions and relationships developed within a classroom setting.
When children are not in education we provide, suitable structured activities within our Learning Lab to rebuild a child's confidence in learning whilst we gather evidence to support an application for an Education and Health Plan before supporting the child into an appropirate registered provision.
The in-house tutor is responsible for working closely with Virtual Schools and social workers to ensure the provision is tailored to the child’s curricular and care needs. Children’s “sensory diets” are woven into the structure of the school day.
Our activities are designed to re-engage he child with the idea of life long learning and to prepare them to re-enter education.
Once the child has completed the first stage of the programme and is sufficiently equipped with the skills to cope with the rigours of the mainstream educational experience we work closely with relevant agencies to design a reintegration scheme lead by the child’s individual needs.
Children coping successfully in a mainstream provision are supported by being encouraged to participate in school teams, after school activities and clubs and supported homework sessions.
All children accommodated at the home are offered daily enrichment. A group therapeutic game takes place every weekday evening and off-site visits to age appropriate attractions and activities take place at weekends.
Windows for Children is committed to working closely with all agencies involved in the provision of education. We believe that transparency and information sharing is a crucial part of ensuring children are able to successfully engage with the emotional demands of mainstream education, curriculum and perform against its assessment foci.
Our tutor
Enjoyment and achievement
Creative, intellectual, physical and social interests and skills
In addition to the therapeutic games, educational trips and activities, group games in the garden and sports activities; the children have access to a range of community based clubs, sports and activities including, but not limited to; swimming, football, tennis, performing arts, after school club, street dance, Brownies, Cubs, Guides, Ballet, trampoline club and guitar/music lessons.
One of the children attends Street Dance club in the community, and stated ‘When I go to Street Dance I have fun and play games. We dance together and it makes me feel happy.’ Another child attends Guides and describes it as, ‘At Guides we learn how to keep our promises and tell the truth always and we go out on missions and it’s making friends and just having fun.’
For the past 27 years the children have been taken on an annual summer holiday to the New Forest. The holiday focuses on creating happy childhood memories and activities include trips to the beach, local theme/water parks, adventure activities including rock climbing, canoeing, building bivvys, orienteering and assault courses.
Windows also recognises the importance of promoting a child’s awareness of their cultural and geographical locality and this is achieved through weekend visits to local sites of cultural, historic or intellectual value. These trips include visits to castles, heritage towns, farms, museums and attractions. These visits are often followed up with reflective work to crystallise the experience and promote ownership of the experience.
Engagement with local services and agencies is an important feature of our work with children and the home is frequently visited by representatives of the emergency services, health care professionals, outside educators and appropriate local government agencies.
Protection of children
Monitoring and surveillance
Windows approach to supervision and monitoring balances the children’s right to privacy with ensuring that they, and others, are kept safe from harm. Our risk assessments are robust, kept under regular review, and are revised following any significant incident in a timely way. The children we work with are at an age where it is appropriate to provide high levels of supervision. Shift teams are built to ensure that the staff/children ratio is in line with the children’s individualised risk assessments and takes account of the group dynamics.
The most effective method of safeguarding children is through supervision and this is our approach to keeping children safe throughout the night as well as through the day. Windows commissioned a purpose-built Sound and Movement Monitor (SaMM). The upstairs floor of the home is fitted with microphones, speakers and infrared sensors to detect sound and movement without infringing on privacy. The information is relayed to a screen, located in the staffroom, where a member of the night staff monitors. The system allows for normal night-time movement (visiting the toilet) to occur without intervention but any situations that could lead to harmful behaviours being managed before they become a risk. Local Authorities and children are made aware of SaMM upon arrival at Windows and are always asked for written for its use. One young person said about SaMM, ‘It keeps me safe, because SaMM is there I know that somebody is looking after me.’
Outside of the home the children are supervised in accordance with their individual risk assessments and care plans.
Behavioural support
Windows is a values driven organisation. All of our work with children comes from our core belief that each individual must be treated with respect, dignity and consistency. Behaviour management at Windows is a careful balance between incentivising positive behaviours through participation in reward games and activities and de-escalation and discouraging harmful behaviours through sanctions based on missing out on fun activities. All behaviour management is built upon positive relationships between staff and children. Positive behaviour is rewarded and negative behaviour is met with opportunities for reflection, restorative sessions and, ultimately, missed opportunities.
We are committed to keeping children safe and understand that in order to do this it is sometimes necessary to implement physical restraints to prevent harm coming to the individual, the other children, members of staff and damage to property. Windows adhere to the Non Abusive Psychological and Physical Intervention (NAPPI) strategies. All staff are NAPPI level three trained and we maintain one senior member of staff at NAPPI instructor level to ensure the highest possible standards of safety.
A physical intervention is only used as a last resort and for the shortest amount of time necessary. All of the children have personalised Laleman Scales which outline all of the individual child’s strategies and de-escalation techniques, so the need for NAPPI is minimised as far as achievable.
Our staff adhere to NAPPI’s SMART Principles, which enable staff to remain calm, supportive and professional, while utilising highly effective yet non-abusive skills. New staff undergo NAPPI training as part of their induction and existing staff undergo ‘top-up’ training every two years but have access to our on-site NAPPI trainer throughout the year to ensure the highest possible knowledge base is maintained.
