Policy and Resources The Care Review The Promise explained: privileging relationships and tackling unresolved trauma Scotland’s Independent Care Review has published its final conclusions. Five reports have been published and the main report ‘The Promise’ runs to 124 pages. To keep our members informed, we will set out the conclusions in a series of brief summaries. From the outset, The Promise acknowledges that “children want to be loved, and recovery from trauma is often built on a foundation of loving, caring relationships.” Here are just five things you need to know: The workforce must be supported to deliver relationship-based practice The Care Review places a strong emphasis on supporting the workforce to ensure that relationships are privileged within services. ‘The Promise’ calls on all care settings to take a relationship-based approach, and for the workforce to be given the ‘time to focus and reflect on relationships’ as well as the necessary support to be ‘present and emotionally available’. The Promise calls for The Care Inspectorate and SSSC to ‘significantly declutter and streamline professional codes, procedures and processes with a clear focus on enabling relationships’. The review further highlights the importance of workers and young people being able to maintain positive relationships after care, calling for ‘imaginative planning, supportive systems and adequate resource’ to enable this. It is stated that ‘the future approach to care must be re-orientated to protect and promote loving, long lasting relationships. This must be done with the expectation that the approach is safe, upholds rights and is open to scrutiny.’ Prioritising relationships in a residential care setting The Promise recommends specific steps that should be taken to prioritise relationships in residential care, including: Improving continuity of carers Removing blanket policies that prevent relationships continuing after young people leave care Scrapping rules that further stigmatise children Relationship-focussed inspections Recruitment of staff based on their values rather than educational levels Supporting and resourcing residential care settings to keep places open for young people in line with continuing care legislation Secure Care as a site of therapeutic, trauma informed support The Promise states that ‘Scotland must take responsibility for its most distressed and at risk children and fundamentally rethink the purpose, delivery and infrastructure of Secure Care’. Some of the recommendations on how to take a ‘radically different’ approach to providing Secure Care to the small number of children who require it include: The underlying principle of Secure Care must be ‘the provision of therapeutic trauma informed support’ A range of therapeutic interventions should be available, with trauma informed assessments of children and a workforce that is supported to care for children who have experienced trauma Spending time in Secure Care must be as short as possible in order to avoid institutionalisation Breaking down barriers to accessing mental health services The Promise notes that care experienced children and young adults have found it hard to access the right mental health support and have found they have to be in acute crisis before support is available. When available, the Care Review heard that support does not consistently recognise the impact of the trauma and abuse that care experienced children and young adults have often experienced. The Care Review calls for a range of measure to eliminate barriers to accessing support and de-stigmatising services, including: Children and young adults must not require a significant mental health diagnosis before they can access support There must be criteria free, community based access to therapies that do not stigmatise, but help and support children and young adults to work through difficulties they are facing Greater availability of family therapy, for all families (kinship, foster, adoptive, family of origin) so that accessing support is not stigmatised, but seen as something that a range of families may require throughout life Scotland must ensure that timely, trauma informed and thoughtful support therapies act as a cushion to all those that require it, regardless of diagnosis Comprehensive training for all involved in The Children’s Hearing System The Care Review notes that the decisions taken at Children’s Hearings are ‘profound and have lifelong consequences for the children and families involved.’ Often, these children and families have experienced trauma and distress in their lives. As such, The Promise calls for appropriate training for all of those involved in the Children’s Hearing System. ‘Everyone involved in The Children’s Hearing System must be properly trained in the impact of trauma, childhood development, neuro-diversity and children’s rights. That training must be comprehensive and regularly reviewed. Those training requirements must also be required for all the different and various professionals who appear at Hearings, including legal representatives.’ Staf is engaging with The Scottish Government on how we can support the next steps on the Care Review, if you want to get involved in the conversation, join us at one of our Focus Groups or Forums. Find out more here. Find out more: Read the Independent Care Review's reports here. Read Staf's initial response to the Care Review here. Read our blog on what the Care Review means for care leavers here. Read our blog on what the Care Review means for the workforce here. For further information please contact Staf Policy and Communications Manager Liam Furby on 0141 465 7513 or by emailing [email protected].