Case Studies

David

(name has been changed)

David came into care at the age of 13 following a conviction for two serious offences and was considered a high risk of reoffending by his youth offending team. David experienced difficulties in care, with a number of placements ending prematurely because of his offending behaviour and the level of risk he posed to himself and others. Eventually David went to a secure unit and from there had a planned move to a BMC single occupancy home.

The staff team at the home worked closely with the allocated clinician to consider David’s day-to-day behaviours, area of difficulty and how these areas could be addressed.

Individual weekly therapy sessions were facilitated for David and the care team ensured that David attended weekly appointments with the youth offending team and encouraged him to work with the local CAMHS.

Multi-agency working between his allocated BMC clinician and his youth offending team permitted an updated risk assessment to be undertaken for David. The close working relationships around David allowed for a deeper level of understanding of his individual needs and how his difficulties might present. This allowed his care team to be responsive and support his development.

David made considerable progress following initial high levels of incidents, with physical interventions required on a near daily basis. Over time his levels of aggression, and interventions reduced considerably and it was evident that David had developed positive attachments with the care team.

After ten months, David’s staffing ratio was reduced to 1:1. He then started to have free time and unsupervised contact with his family progressing to overnight family contact and reduced contact with his youth offending team. Positively, David continued to attend his individual therapy sessions on a weekly basis.

Consistent successful multi-agency working was achieved for David with regular meetings held between social services, registered care manager, allocated clinician, youth offending worker and the local police. Towards the end of his placement, the assessed risk to himself and others had reduced to allow his social worker to plan with his care team for his return home in a safe and supported way.

Elenor

(name has been changed)

Eleanor came to us from a secure unit at the age of 16. Having suffered abuse and neglect for most of her life, she had a history of arson, violence, severe self-harm, and was a persistent young offender who also formed inappropriate attachments to female staff.

Eleanor came with an extensive list of ‘labels’ including severe attachment disorder and personality disorder – we worked with the ‘person’.

Eleanor’s long term therapeutic placement with us involved cognitive behavioural therapy, outdoor activities, consistency, boundaries, routine and role modelling.

Eleanor did not commit any criminal offences whilst she was with us and has now gone on to live independently near her siblings. She is also capable of maintaining appropriate relationships with both men and women.

In the final stages of the placement, we worked closely with Eleanor, her social worker and other agencies from the placing authority area to plan for a transition back to her home area.

This involved a detailed and sensitively handled exit plan which included an outreach support package that we provided during the first few months of independent living.

Peter

(name has been changed)

Perhaps the best person to tell you about Bryn Melyn Care is a young person who we’ve looked after. Peter came to us when he was 12.

His mother was schizophrenic, his father committed suicide and Peter had a history of neglect and severe physical and sexual abuse. As a result his presenting behaviours included violence, inappropriate sexualised behaviour and very poor social skills.

Ellie

(name has been changed)

Ellie and her twin were adopted into the same family aged 2 years.  When they reached the age of 12 years, their adoptive parents contacted Social Services advising that they no longer felt able to cope with either of the children.  They reported that both were ‘out of control’ and aggressive.  Both were frequently absenting themselves from the family home, had seriously assaulted their adoptive parents and in addition to this there was a report from school of concern that the twins were engaged in a sexual relationship with each other.  Both children had also made allegations of physical abuse from their adoptive father.  These allegations had been investigated by the police who found no evidence to support any of them.

Whilst both children were initially placed in foster care this quickly broke down because of the level of their challenging behaviours towards carers.  Ellie had a further 2 foster placements before being returned to the family home.  Her twin moved from the first foster placement straight into residential care due to exhibiting higher levels of aggression and assaults on his foster carer than Ellie had at the time.

For two months Ellie stayed in the family home but following a serious physical assault she made on Dad where she used bricks to injure him, smash windows and his new car it was agreed that Ellie also needed residential care.  She was accepted into a BMC Assessment home for a 12 week assessment to determine future residential needs.

As part of the home’s Ofsted inspection Ellie’s Independent Reviewing Officer (IRO) reported that in all of her experience in social care (over 30 years) she was able to recognise ‘the level of expertise and dedication to Ellie from care staff and management at the home which was at the highest level she had ever observed’.  She commented that she ‘believed that Ellie would have been destined for a secure placement and possibly a future of criminalisation and custody’ had she not been placed at the home.

She commented too upon how lovely it was to hear Ellie speak at her Looked After Child (LAC) review and reflect about her time at the home and how staff had ‘helped her turn her thinking and behaviour around’.

The IRO went on to say in the feedback to Ofsted that communication from BMC had ‘always been excellent and that staff always knew what was happening with Ellie and that they always celebrated any positive behaviour in addition to advising of any behaviours of concern from her’.  She also spoke of the meetings she and the social worker had been invited to attend with the allocated clinician and the manager of the home and went on to say, ‘I can honestly say that this is the best residential service currently used by the local authority I represent’. This authority currently has over 100 young people in residential care and almost 900 children in care in total.

Further feedback from Ellie’s IRO stated that she had observed ‘a completely different girl in February from the one who had been placed at the home in December.  She is calmer, able to reflect and to problem solve. Ellie is able to display victim empathy (with the exception of towards her adoptive Dad which remains an ongoing issue the team are addressing) and is also able to take care of her own presentation. She rarely absconds now and if she does, doesn’t go too far for too long, just needing time to think things through alone.  Ellie has also demonstrated an improved ability to discern which people might be good for her and which might cause her distress.  She is brave in requesting that her parents do not visit her at this time and will only agree to take calls from them when she feels sufficiently strong enough to cope with them’.

She finished her written feedback by adding, ‘that the fantastic improvements in Ellie could only be attributed to the Manager and her team working together within a therapeutic model’ and that she would be more than happy to speak directly with the Ofsted Inspector if any further information was needed whilst adding that she ‘just wished this service model and professionalism was available to more young people facing trauma’.