Specialist services at Aycliffe Secure Centre

Health

We have a team of nurses who oversee all of the medical care for our young people. All young people in our care receive a comprehensive health screening and treatment service and receive their initial health assessment within 24 hours of admission to make sure that all their needs are met while they are here and that they have a discharge pathway.

Every young person will:

• be registered with the local GP during their stay at the centre - the GP visits our centre weekly
• be able to see a dentist in our own dental suite - the dentist visits our centre monthly and for emergencies
• have access to sexual health services which they can discuss in confidence with the nursing team

All young people who come into Aycliffe are offered a physical health assessment within 24 hours of their arrival. A health care plan is devised with the young person and shared with the residential staff. On discharge a health summary of the young person's physical health care is given to the young person and shared with appropriate professionals with consent from the young person.

Comprehensive Health Assessment Toolkit (CHAT)

All young people admitted to our centre are offered a Comprehensive Health Assessment Toolkit (CHAT). This is carried out by the physical health nurses, Kolvin nurses, speech and language therapists and drug and alcohol worker. This informs the initial and ongoing care of the young person.

The physical health nursing team continue to be employed by County Durham and Darlington Foundation NHS Trust and continue to work as part of a multi-agency team. The lead nurse is actively involved in the implementation of Secure STAIRS agenda. The nursing team received positive feedback from CQC when they visited the unit in September. They reported the nursing team were visible and responsive to the young people's needs.

Mental health screening

All young people receive a mental health screening on admission.

We have a contract with the Kolvin Service who provide an in-reach service. The mental health provision from the Kolvin Service has expanded to include speech and language therapy input and additional nursing and psychological provision. Our mental health in-reach team consists of a consultant psychiatrist, consultant clinical and forensic psychologist and a community psychiatric nurse who are all located at our centre.

If you feel that the young person who you place with us needs additional services from the mental health team this will be considered on an individual basis and negotiated with the local authority depending on the services required.

Integrated care

The complexity and diversity of our young people is challenging including high levels of emotional dysfunction, self-harming behaviour, aggression and violence, gang related behaviours, trauma responses, the effects of exploitation, alienation from families.

Multi-disciplinary working and integration across our centre has considerably developed. In the last six months, the Secure STAIRS model has made rapid developments in embedding within our centre. A Secure STAIRS Implementation Group has been developed with a multi-disciplinary team involvement including senior/middle management, case workers, education, physical health, substance misuse services and senior clinicians from the Kolvin Service. A Secure STAIRS training strategy has been developed to include a comprehensive training plan including Secure STAIRS awareness, induction, modelling and skills development. Young people have been involved in the co-production of this training plan.

We have continued to make progress with quality assurance systems. There have been a number of significant additions in this respect; including the implementation of our online risk assessment tool (GRIST) which staff have undertaken bespoke training and there are champions throughout the centre. The peer and management auditing of multi agency meetings to ensure fidelity to the terms of reference.  

Interventions

Our Intervention Team aim to provide the young people in our care with the appropriate levels of care and support to meet their individual needs. We work with young people exploring the nature of risk that led them to being secured and help them see what choices they can make in the future. 

All interventions are targeted at the individual needs of the young person and take place on a 1:1 basis with the key worker, these sessions are a valuable tool in tackling complex issues. Interventions take place regularly throughout the week and form part of the daily routine. We have an extensive range of programmes including:

• cognitive behavioural programmes focusing on how thoughts and feelings influence behaviour
• substance misuse (up to Tier 4 by our substance misuse team)
• Offending is Not the Only Choice programme (24 sessions focusing on altering pro-criminal patterns that have been identified in repeat offenders)
• Violence is not the Only Choice programme (16 sessions focusing on attitudes, relationships, problem solving, consequential thinking and socio-moral reasoning)
• Ross Programme (16 sessions with a focus on anti-social behaviour looking at developing skills that will assist in pro-social competence) 
• anger management
• self-harm
• sexual exploitation
• those who sexually harm
• peer relationships
• social skills
• self esteem
• absconding
• emotional resilience
• weapons and gangs
• consequential thinking
• knowing and understanding emotions

Interventions are also underpinned with further specific programmes including arson, robbery, burglary, violence, motivation to change, anti-bullying, risk awareness, anti-social behaviours, expressing feelings, communication skills, homophobic bullying, equality and diversity, victim empathy, domestic violence, teen talk and hate crime.