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FOCUS: "Inefficient" Greenfields to be transformed into crisis care centre

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Monday 10 May 2021

FOCUS: "Inefficient" Greenfields to be transformed into crisis care centre


Children’s secure home Greenfields will be changed into a new facility for “children and families in crisis”, after a review slammed the current arrangements as "neither effective nor efficient."

The Government says it agrees with recommendations in a report by the Independent Children’s Homes Association, which concluded that the new facility should be led by specialist carers, with therapeutic support the main priority.

Greenfields was originally a youth detention facility, but later became a secure children's home. During the pandemic, it also hosted children in mental health crisis.

The review - which was conducted in August and September 2020 - described its current use of resources as "chaotic."

Instead, it recommended that Greenfields be redeveloped into a 'Resource Centre' that provides short break services, education, emergency beds, community outreach and family and child therapeutic support.

It states that its service should be led by the island’s ‘Edge of Care Team’, and the residential element staffed by specialist carers, aiming to help families and children through targeted therapeutic interventions. 

The review also recommends that it would house four short break beds and four emergency beds, and work with multiple agencies including CAMHS, the Virtual School, and the Youth Service.

It further recommends an additional bespoke therapeutic home be built, which would work intensively with young people at risk of being secured on welfare grounds. This, the review suggests, could be included as part of Greenfields' redevelopment.

Therapy.jpg

Pictured: The new review suggests that a new Resource Centre should put family and child therapeutic support as its main priority.

Emphasising that one of Jersey’s ambitions should be not to place children in 'secure' care at all, it added that “the Services should be confident in their ability to support and work positively with these young people outside of a secure environment.”

They added that "while some children will possibly require remand facilities in the future, this should be developed along with a Youth Justice system, or off-island."

The new facility could be operational within 12 months, the review said, but noted there may be a need to retain a small remand provision until alternatives are found - the Government, however, has not given a timescale.

The Government says work has already begun to turn Greenfields into a ‘Resource Centre’, using the £7m previously allocated for redevelopment of the site.

However, in its response, officials noted that the 'Resource Centre' would work as both "a secure and non-secure" setting rather than a purely care-based facility as suggested.

They also confirmed work had begun on the dedicated bespoke Therapeutic Unit.

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Pictured: The new 'Resource Centre' will be developed using £7m allocated for the site.

It’s not the first time calls have been made to close Greenfields as it currently operates.

Two years ago, the Care Inquiry Panel recommended its demolition to build “small homely units” on the site, describing the "oppressive" building as not “capable of being transformed into a more appropriate facility.”

Express also recently spoke to a carer of a child with complex needs, who suggested that the island should invest in a "long overdue" centre where children can be educated while receiving in-depth therapy for individual emotional issues such as trauma.

In the first of a series of reports examining the ICHA review's findings this week, Express has broken down some of the current observations on Greenfields, and the key areas that are said to need improving...

The key issues with Greenfields...

A cell-like facility

The most “impactful” environmental change the review recommended was that the “metal and noisy” bedroom doors should be replaced with quieter ones that are more homely. 

Explaining that they "the impression of a cell door", the review added that "children reported being disturbed by the noise of the doors being opened and closed during the night."

Concerns were also expressed that the environment was not ‘risk-free’, with unsecured televisions meaning that power cables and smashed fragments could be used either for self-harm or as a weapon to hurt others.

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Pictured: Concerns about risks such as unsecured televisions being smashed and used as weapons were highlighted.

Although the review noted that improvements had been made since 2019 to make the admissions area less intimidating, it also said that the area could benefit from “simple touches” like different coloured walls, and more pictures.

In their response, the Government said that new doors will be fitted “as soon as possible”, and that a ligature assessment would be carried out "without delay and regularly moving forward and documented."

MENTAL HEALTH 

The review also queried the lack of mental health assessment from trained professionals upon admission, with the children only having their physical health examined by a nurse upon admission.

It also observed that waiting times for mental health services appear “the same for a child in a secure setting as for a child in the community.”

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Pictured: The review said that waiting times for mental health services for children at the facility are the same for those in the community.

The reviewer said they were "told about one individual who had waited four weeks for a psychology assessment and was led to understand that this is not uncommon." The consultation was carried via Zoom as a result of the pandemic as the psychologist was based in Guernsey.

They added they had "been unable to establish with certainty the availability of psychologists and/or psychiatrists in Jersey and if this situation was a symptom of the pandemic alone."

The comments come a week after minutes from the Government’s health experts showed that "local CAMHS caseload, per 100,000 population, was higher than in the United Kingdom (‘UK’) and had grown by 19% during 2020.”

STAFFING AND RESOURCES

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Pictured: The review said that staff being shared across services meant teams from other homes were depleted as a result.

One of the key points the review raised was that due to the small number of children placed in Greenfields across the year, staff “skills may deteriorate as the unit often lies empty for extended periods and staff are redeployed.” 

“Not only did this deplete the staff teams in other homes, this meant that the team were neither specialised nor cohesive, and arguably unlikely to be able to meet the specific needs of the children and young people,” it remarked, adding that "it was apparent that not all of the staff wanted to work in this environment."

It later said of the arrangement that “this is a chaotic use of resources and one that cannot benefit the children and young people who are sent there, nor those who lose their staff for it to open. The service is neither efficient nor effective.”

Highlighting further problems with this system, it noted how when some children moved to Greenfields, “their staff team moved with them, despite their lack of success in engaging and moving the child forwards in their prior home”, instead of having more targeted therapeutic care.

However, it did also note that “the staff team seen are clearly passionate about the children in their care, and the review of records carried out shows some excellent direct work with the children being carried out in the home.”

PURPOSE 

A key theme of the wider review on Children's Care Homes in Jersey was a “lack of clarity” around their individual purposes, and Greenfields was no exception, as it is used to house: children serving sentences for criminal offences, children placed there on secure accommodation orders, and children requiring mental health inpatient care.

Discussing the unit's 'statement of purpose', it remarked that "no mention is made that its fundamental aim is to provide a locked, secure environment for young people who have either committed a crime or have welfare secure needs."

Concerns about the facility's "confused" purpose had previously been raised in a 2019 review and by the Children's Commissioner.

Although the use of the home for inpatient care was said to have only have arisen from the pandemic and looking for extra provision, the review said it highlighted “a lack of understanding about what ‘secure care’ actually means.”

Deborah McMillan @OCCJersey

Pictured: The review brought up concerns previously raised by Children's Commissioner Deborah McMillan around the "confused purpose" of the home. 

Illustrating this point, the review mentioned how some internal doors were not locked by hospital staff seconded to look after hospital patients, due to an apparent lack of understanding around security.

It also noted how, when some children had moved to Greenfields from Robin Ward, access to the communal outdoor spaces became "limited" to children on the secure side.

In response to this, one of the review's recommendations was that if the home is not repurposed and continues to function as a secure children’s home, then “agreement should be reached regarding its purpose and function.” 

The Government has confirmed that a new ‘Statement of Purpose’ has also been submitted to the Jersey Care Commission.

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Posted by Lesley Ricketts on
And on and on it goes. Yet another report about how our government is failing to look after vulnerable children. How many years and how many reports before they do something that actually benefits these children instead of pouring money into a system that at best is broken and at worst never worked in the first place!
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