Recommendation 5

HM Government Acknowledged

15. It is important that children and young people have access to support that aid them in dealing with issues of self-harm and mental health. It is well recognised that children and young people in custody have a range of complex needs and associated vulnerabilities. As such, the approach of the YCS is to work within the Framework for Integrated Care within which the vision of multi-disciplinary and multi-agency working is paramount. Once fully functional, children and young people identified as being particularly vulnerable to the risk of self-harm will be given a provision of support developed by individuals and services involved in their care. Associated activity will be based on a comprehensive formulation of the child or young person’s needs, with an emphasis on the importance of the child or young person being part of this planning. 16. To enable the above activity, we are building processes to ensure staff have the right skills and support to enable them to continue to respond in a child-centred way to challenging circumstances. Relevant training around individual development and trauma forms part of this approach. We will also continue to develop opportunities for support and reflective practice amongst staff. 17. In addition, HMPPS and NHSE&I have developed a package of interventions within the Behaviour Management Strategy that address risks and needs of children and young people through early intervention and an initial multi-agency approach. The intensity and specialisation of interventions then increase based on the individuals need. Our strategy includes rolling out the Custody Support Plan (CuSP), a care planning approach, based on the ‘hierarchy of needs’, namely meeting physical needs (for example warmth, shelter and food), building trust and safety, working on relationships, self-esteem and achievement; and self-actualisation (growth, change and development to plan for positive future). The CuSP forms part of the wider support approach for children and currently operates across the 4 public YOIs. 18. As the overall population has decreased, we have an increased proportion of children and young people in the youth secure estate who present varying complex needs including self-harm. These children are also some of the most vulnerable in society and require bespoke interventions to support their needs. That is why we have been progressing work with a focus on some of the most vulnerable and challenging young people in custody through the Critical Case Pathway (CCP). This joint YCS and NHSE&I pathway provides a level of oversight, assurance and support to professionals working with children who self-harm and those with the most exceptionally complex needs. The multi-disciplinary approach allows staff to take action to ensure effective assessment, planning and co- ordination to make sure every effort is made to meet the needs of this group. The CCP builds on the provision of support and expertise at site level with additional opportunities for support, advice and intervention from central services as identified as necessary. 19. Our priority is to always increase understanding, so in addition to local safety diagnostic tools, central management information gives sites within the youth secure estate the ability to further review self-harm data on a monthly basis. This data provides breakdowns on trends, allowing sites within the youth secure estate to determine location, time and frequency, thus building a better understanding of how to address, and where possible, prevent self-harm in children and young people.