A Guide for Commissioners - Glebe House

A Guide for

Commissioners

Overview of services We Are: Glebe House is a registered Children’s Home, running as a Therapeutic Community; we are also an independently registered School. It is part of the not-for-profit Quaker Charity, Friends Therapeutic Community Trust.

The Trust specialises in therapeutic work with Young People with a history of harmful sexual behaviours. Our Intake is for young men aged 15-18 at the point of referral.

We are inspected by OFSTED and CQC, as well as through the Royal College of Psychiatry’s ‘Community of Communities’ as an Accredited Therapeutic Community.

The Residential Programme: Glebe House offers a 52 weeks Residential Treatment Programme. The Programme lasts for at least two years, depending on the individual needs of the Young Person in question and their age on arrival.

Community Based Work: Based in the wider community, this work is designed to offer assessment and intervention relating to male and female children and young people, living either at home or in other care settings.

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Training and Consultancy: We work with other agencies and organisations that require support, training, supervision and consultancy, relating to their work with children and young people who have abused or whose behaviour causes significant concern.

Terms and Conditions Fees are fully inclusive and fixed for the duration of each individual’s placement.

Transition Services are free at point of delivery.

Circles of Support & Outreach Work: A Circle of Support and Accountability in the Young Person’s home area is coordinated by Glebe House, or 18 month enhanced Outreach contact for people where a Circle is not a possible option.

This will include: • Regular telephone contact • Face-to-face meetings • Attendance at appropriate professionals’ meetings These services will be available to all Young People who have completed a therapeutic placement at Glebe House and who have a suitable Local Authority leaving care package.

If a Circle of Support is not appropriate, we offer tailor made Outreach Programmes.

This work is delivered in liaison with the referring agency and in partnership with other care providers. These services are free at the point of delivery.

Legal Status Glebe House is a Therapeutic Community registered with Ofsted. We are inspected annually. A company limited by guarantee in England and Wales (Company No. 6525659) and Registered Charity (No. 1124673).

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Glebe House is an Ofsted and CQC registered and inspected Care Provider.

delivers This service are utstanding c o y tl n te is s n co nd h a backgrou it w n re d il h c for lly se and sexua u b a , a m u a of tr rial iour. Manage v a h e b l fu harm effective. ly h ig h is t h oversig

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The children’s home provides highly effective services that ards consistently exceed the stand of good. The actions of the ly home contribute to significant ren improved outcomes for child help, and young people who need protection and care.

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This is a stable safe and h leader ome. A skille sh d priorit ip team ise and sa s the welfa re fe extrem ty of all chil dr e excelle ly well. Ther en e n place t processes are for adm in issions .

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Risks are clearly identified and balanced with meticulous management st rategies.

Safety plans are rigorously and systematically reviewed to ensure that the y are accurate and effective. If any concerns are raised, staff and managers respond imme diately and rigorously, com municating wit h parents and pa rtnership agen cies and following st rict processes in a timely fash ion. The safety of the children is their paramoun t concern.

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Therapeutic a rs e v li e d e ic The serv nd ing therapies a lk ta f o e g a k c a P n. pport for childre su l a ic g lo o h c psy compliments d n a s rt o p p su This ng work with ti n re a p y a -d o day-t ntial team. a skilled reside child’s All aspects of a re considered in a t n e m p lo e v e d nthly reviews, o -m e re th r la u reg h, education, including: healt lanning for p d n a t c ta n o c family purposeful ly h ig h is h T . re the futu ns approach mea d te ra g te in d n a of a child’s that all aspects nsidered and progress are co planned for.

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Children p articipate in this work on an exceptiona l level. They are fully inv olved in daily Co mmunity Meetings a s well as individual programm es.

They are re gularly invo lve in importa nt, cathartic d and challengin g work abo ut their issues and, as a re sult, they feel n urtured an d begin to d evelop a p ositive self-view.

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ly nurturing.

Staff are high er as a team, th e g to rk o w They ng extensively communicati y ry opportunit and using eve sues and to reflect on is speak highly y e h T . ts n e id inc ent team and m e g a n a m e of th rely on one n a c y e th t a feel th pport. another for su

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Transiti on develop al planning ha s been e are pre d extensively, pa so adults. red for their fu that children Childre n are en ture lives as obtain co the hig hest po uraged to qualific ssibl ati skills. Th ons alongside e academic vocatio ey n excellen have opport unities al t direct to and pra ctical e gain xperien ce.

Acc red itat the ion Chi ldre s for n’s H om e

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site to view our latest Please visit the CQC web .cqc.org.uk inspection reports: www

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The Therapeutic Treatment Programme The Glebe House Therapeutic Treatment Programme integrates psychoanalytic, person centred and cognitive-behavioural approaches.

These approaches are embedded in a Therapeutic Community model based on Rapoport’s four cornerstones of: Democracy, Communalism, Tolerance and Reality Confrontation.

Residents who have sexually harmed are offered a specialist intervention programme of both 1:1 and group work.

The integrative approach in this work has an emphasis on understanding how offences took place in the light of developmental experience, deficits and trauma.

This understanding then leads to the development of new skills aimed at helping the Young Person to make more positive choices in the future. Relapse Prevention plans focus on developing both internal and external inhibitors, seeking to build as robust an internal process as possible to manage stress and risk in the long-term.

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Glebe House views the specialist 1:1 and group work as part of the integrative approach; offending being seen in the context of understanding the influence of early years experiences, the process of offending and the links with current and future behaviours.

1:1 work and small group work may integrate a number of theoretical models that relate directly to offending behaviour including: • • • • •

Resilience based intervention drawing on the AIM model Finkelhor’s ‘Four Pre-Conditions to Offending’ model Ryan’s ‘Victim to Victimiser Cycle’ Life Story work Therapeutic Sex Education

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May 2017

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Gardening/Horticulture

Therapeutic Community Ethos

Vehicle Maintenance

Glebe House operates as a Therapeutic Community, using Rapoport’s Four Cornerstones as an adaptive model.

This is a psychodynamic approach emphasising that there is meaning in all behaviour and that meanings are often linked to past experiences. Emphasis is placed on the significance of group living and the management of day-to-day tasks as a reparative therapeutic tool.

Trade Instruction

The experience of living in a Therapeutic Community offers the opportunity for significant learning. Most of the young men who live in our Community have experienced disruption during their early years that may be reflected in the quality of the relationships they form.

Arts and Crafts

At times, this may result in an inability to develop a sense of belonging and maladaptive responses to their environment. As a Therapeutic Community, we enable Residents to take an active part in planning and resourcing their activities. It is within the day-to-day interaction with peers, adults and the wider community that their progress, in terms of relapse prevention, can be monitored and reinforced. These learning opportunities are enhanced by a range of on and off-site activities including:

Work Experience

• • • • •

Gardening/Horticulture Vehicle Maintenance Trade Instruction Arts and Crafts Work Experience November 2020

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In addition there are a wide range of social activities on offer.

The Milieu based activities aim to increase the Young Person’s sense of self-worth through personal and group achievement. Social and academic achievements are recognised as positive factors in building resilience. The Therapeutic Programme offers a number of structured activities to support this process.

Elements of the

Therapeutic Community

Community Meetings At the core of our programme are the daily Community Meetings. Each meeting is chaired by a Chairman who is one of the Residents. The meetings offer an opportunity to reflect on recent events in the Community, enabling Residents to give and receive feedback and to explore the dynamics present within the Milieu at any given time, in the context of their past experiences. Decision making is framed by the Four Cornerstones: Democracy, Communalism, Tolerance and Reality Confrontation, and the group tries to reach a consensus about any action that might be taken.

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Chairman Role All Residents, regardless of ability and status, will have the opportunity to apply to be Resident Chairmen. This role carries a great deal of authority, responsibility and the opportunity to use power appropriately. Chairmen not only facilitate Community Meetings, they also attend Staff interviews, take a lead role in inspections, sit on the Health & Safety Committee and contribute to policy making. The selection and interview process for Chairmen is rigorous and many go on to be Mentors, working to support new Chairmen and the Community.

Projects All Residents are involved in projects designed to enhance a sense of engagement with the Community.

These projects are skills-based and include the development and maintenance of our three acre site.

As our Residents have had input into all levels of the development of our Community, acts of vandalism and delinquency are rare.

Group Activities During the year the Community undertake various group activities, both on and off-site, including a week long holiday and a 5-night narrowboat challenge. These and other events foster an attitude of team work and mutual support that can be felt in the Community throughout the year.

Vocational Training All Residents have access to on-site work experience and vocational training that can include working as a Kitchen Assistant or Groundsman. We offer a range of qualifications to support this work. Where appropriate, this experience is a precursor to off-site work placements. We also hold one or two ‘Work Weeks’ during the year, where all members of the Community join in to carry out projects on the site.

Expressive Arts We have an Art room, where the Young People are supported to create visual arts and art work for themselves and for Community events, particularly relating to scenery and props for our pantomime.

We have a purpose built theatre on-site,

where most of our Community Meetings are held.

For many years we have commissioned a theatre company to run a five day experiential workshop with the young men at Glebe House. The workshops explore issues relating to the area of sexual abuse, culminating in a group performance at the end of the five days. Each year, this has proved to be an incredibly meaningful experience for the young men who create a very powerful final performance.

There is also a wide range of music creation activities. At times this involves external facilitators teaching musical instruments and electronically produced music.

Vehicle Maintenance Workshop We have a fully equipped Motor Vehicle Workshop on-site and our Young People have the opportunity to get involved in servicing and maintaining vehicles and learning to drive them on our car track. We offer a Vehicle Maintenance qualification to support this. Residents are able to take driving lessons and driving tests whilst at Glebe House.

Sport and Leisure We have a very robust programme relating to physical exercise and the pursuit of age-appropriate leisure activities. There are regular visits to the local gym for small groups of Residents.

We have a football coach visiting us on a weekly basis to train our Young People.

We attend regular football matches with local teams and weekly swimming excursions. Other leisure activities include: visits to the coast, fishing, cycling, trips to restaurants, concerts and the cinema.

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Independence Our comprehensive Independence Programme begins at the time that a Young Person first visits us for a Residential Assessment. At this point, a needs analysis is undertaken and each Young Person will receive a tailored Programme designed to enhance and develop their independence skills.

Over time, Residents will take more responsibility for their own care culminating in a move to an independence bedsit, where they will cater for themselves. Many of our Residents will then move into the bungalow. This building is on-site and receives Staff support commensurate with the ability level of those Young People in residence.

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The Glebe House Therapeutic Treatment Programme integrates psychoanalytic, person-centred and cognitive behavioural approaches.

These approaches are embedded in a Therapeutic Community model based on Rapoport’s Four Cornerstones of Democracy, Communalism, Tolerance and Reality Confrontation.

• • • • •

Treatment Milestones diagram Developmental Factors diagram Emotional/Behavioural Factors diagram Identity Factors diagram Sexually Harmful Factors diagram

There are regular forums to ensure that the specialist intervention is integrated into the day-to-day living experience the Young Person has at Glebe House.

Young People are active in the care planning process in order to tailor their individual Programme to their current needs.

The planning process is formalised in quarterly internal reviews of the Young Person’s Individual Treatment Plan (ITP) that will establish appropriate levels of supervision and explore strategies to encourage the Young Person to move towards independence in a safe way.

Social, educational and vocational experiences are reviewed and explored with the Young Person to support the process of ensuring the abuse-specific work remains grounded in real experiences and to help the Young Person to reflect on their future plans.

Treatment and Risk Developmental Factors

Emotional/ Behavioural Factors

Identity Factors

Sexually Harmful Factors

Treatment Milestones

Developmental Milestones

Family History

Illness/ailments

Attachment

Mental health issues

Parenting Styles

Difficulties/ disabilities

Trauma and abuse

Environment Culture Statutory involvement Previous intervention

Developmental Factors

Emotional vocabulary

Resilience

Anti-social behaviour

Empathy Impulsivity Mood disorders

Substance misuse

Psychological mindedness

Aggression Self harm

Emotional/Behavioural Factors

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Sexual identity Notion of self and others Self esteem

Family scripts

Hobbies and interests

Relationship scripts

Strengths

Cultural identity

‘Safe’ identity

Place in society

Future plans

The experience of developmental deficits and relational trauma caused by: neglect, lack of care, physical, emotional or sexual abuse, violence and significant loss, can cause severe problems with emotional regulation and create a child who is insecurely attached and unable to trust adults and can display a range of destructive behaviours.

We understand, and believe, that a supportive environment, combined with specific interventions, which address the most destructive behaviours and the most distorted beliefs, can repair some of the worst effects of early adverse experience.

Identity Factors

Offence profile Victim profile Grooming style

Pathway to offending

Impact of behaviour

Motivation to offend

Victim empathy

Sexual fantasy

Sexually Harmful Factors

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Cognitive distortions

Human beings have a natural drive towards growing up healthily, which includes the potential to recover from traumatic and harmful experiences.

Research indicates that resilience seems to be the development of positive, self-shaping experiences within the context of consistent and healthily pro-social relationships.

At Glebe House, we provide an integrative Therapeutic Programme designed to provide these experiences, with the philosophy that, over time, they can allow the Young Person to unlock their natural drive towards development and recovery that has been severely derailed. We are optimistic and practical in the delivery of our service. We believe that change is possible.

As a Young Person moves through their placement, the emphasis on developing future relapse prevention plans increases.

This process is actualised through the completion of a relapse prevention

folder, known as a ‘Toolkit’ that will summarise the abuse-specific work, making links to early years experiences and outline strategies to manage risk in the future. The Young Person will take the folder that they have created with them to support their transition to a new environment and relapse prevention plan.

Change can often be experienced as highly stressful and can trigger early experiences of separation and abandonment; therefore, there is a risk that the response to increased stress is to revert to the use of past defensive behaviours and coping strategies. Glebe House offers an Outreach Service for 18 months post-placement to support the young men in their leaving process and the maintenance and development of the relapse prevention plan. This service is free at the point of delivery.

Evaluation The Glebe House ‘Outcomes Star’ is an adaptation of Maslow’s ‘Hierarchy of Needs,’ which aims to provide Keyworkers and Residents with a form of measurement for the work achieved in the Milieu. There are five different areas to be considered, which are: 1.

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Giving Something Back Sense of Development Relationships Care Needs Safety

Each area is scored out of a maximum of five points. The star does not measure the severity of a Young Person’s difficulties, or the amount of support they require, but their ability to manage their issues themselves.

Risk Assessment and Relapse Prevention Glebe House embed risk assessment and risk management into all aspects of the Therapeutic Programme. In working with risk therapeutically, the aim is to encourage the Young People to take ownership and develop understanding of their concerning behaviour. This is integrated into their individual treatment plans.

As a Young Person progresses through the Programme, they are encouraged to complete their own risk assessments.

Each Resident undertakes an initial assessment period at Glebe House before being offered a place on the full Residential Programme. During this assessment period a detailed risk assessment is completed. As a Young Person progresses through the Therapeutic Programme their risk and progress is regularly reviewed and updated. Progress through treatment is assessed in a variety of formal and informal processes, including risk assessments. These assessments guide the Young Person’s supervision both within the unit and when off-site, as well as being integrated into the therapeutic work.

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During the leaving transition the elements of the work undertaken throughout the Therapeutic Programme are drawn together, enabling each Young Person managing their risk, as much as they are able to, and developing their relapse prevention ‘Toolkit’ into a working model.

Education Education at Glebe House is delivered through our registered Independent Special School, where Young People are provided with access to an individualised curriculum, which offers opportunities for both academic and vocational qualifications.

Many of our learners will have experienced difficulties or disruption within their educational history prior to their arrival here; they may have faced significant barriers to learning because of gaps in education or a diagnosed condition or specific learning difficulty - all of which can impact on a learner’s level of attainment, confidence and self-esteem.

Our learners have needs that are often multiple and complex, and we have a significant proportion of students with Special Educational Needs or Disabilities (SEND). In order to give our learners the best opportunities for success, our curriculum is tailored towards learners’ individual capabilities and interests. Career direction and proposed transitional progression are all taken into account within the curriculum, which is delivered in small group or one-to-one settings.

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The Staff team are all experienced practitioners and our provision is regularly reviewed in order to ensure that it continues to meet the needs of our students.

We currently offer a range of academic and vocational qualifications accredited through the following exam boards: AQA, OCR, WJEC, Edexcel, City and Guilds, Trinity and IOSH. They cover learning abilities from Entry Level to Level 3 on the National Framework of Qualifications.

Students who play a musical instrument, sing or are interested in musical production are able to do Grade Examinations through the RSL Music examination system.

Science is currently delivered through Science Workshops and within our Science-biased PSHE Programme. We do have an experienced Science Teacher on our Staff team and Science lessons will become a more formal part of our curriculum offer.

Modern Foreign Languages – Conversational French and Spanish tuition is available, with experienced MFL teaching Staff in place, should a learner wish to take this subject further.

Physical Education is delivered both on-site and off-site through links with external resource providers; making use of specified hire times at local community sports facilities for such activities as swimming and badminton.

In order to support our Young People in their preparation for working life, learners are provided with access to a range of Work Experience opportunities both on and off-site, including those involving: administration work, site maintenance, bicycle maintenance, gardening and kitchen experience.

Enrichment Activities are designed to help our learners to develop their personal and social skills in a slightly different way to other learning opportunities. They may include taking part in activities that call on team-work or negotiation skills, planning, problemsolving or even a physical activity.

Enrichment Days also give our learners the opportunity to take part in activities or educational visits that they might not usually choose to experience; helping them to gain a better understanding of the broad range of options available to them.

Please see our website for our latest Ofsted reports: www.ftctrust.org.uk/ glebe_education.php

Not all the learning taking place at Glebe House is qualification focused. All learners take part in PSHE (Personal, Social, Health and Economic) lessons, which cover a range of relevant, focused activities that help to enrich and inform their understanding of current personal and social issues.

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Proof

that what we do works Between 2001 and 2014 an independent research team studied the outcomes from Young People placed at Glebe House. The main body of this research tracked over 40 Young People who had completed the Treatment Programme.

These ‘Programme Completers’ were matched by a ‘Comparison Group’ of similar demographics. These were young men who had been referred to Glebe House but not placed.

This was a substantial research project.

Young People were tracked for up to 10 years. The researchers were able to access conviction/reconviction data for the ‘Comparison Group’.

This showed significantly higher crime – sexual, violent and non-sexual in the ‘Comparison Group’ compared to the ‘Completers Group’. For those successfully completing the Treatment Programme the research identified: • • • •

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A threefold reduction on the number of Young People with convictions A fivefold reduction in the number of crimes committed A fivefold reduction in the number of violent crimes committed A fivefold reduction in the number of sexual crimes committed November 2020

The ‘Comparison Group’ is a good guide to establish a baseline for the risk level of the Young People who we work with.

This tells us more than using general population reconviction data and clearly demonstrates a positive effect in the therapeutic work.

“The longitudinal and complementary qualitative and quantitative data contained in this report have the advantage of demonstrating movement over several years, and can thus claim considerable robustness of method and reliability of findings.

In particular, the study has been able to demonstrate that positive change has followed for the majority of those respondents who have completed the Therapeutic Programme. Not only were most of them not re/convicted, as against a considerably higher-convicted comparison group, the majority also felt their lives had been turned around by the two or more years they had spent at Glebe House and by the commitment of staff who always had time for them.

Thus, it would appear that an investment in placements at Glebe House is well worth making.”

Boswell 2014 The research team were the ‘Boswell Research Fellows’: Gwyneth Boswell Peter Wedge Annie Moseley Jane Dominey Fiona Poland

Staff Staff Team We have a large, well-established and knowledgeable team of Staff.

Our comprehensive programme of staff support, training and supervision, ensures high morale and longevity of service.

We have a team of Clinical and Milieu Practitioners as well as an Education Team, Business Operations team and locums.

Trustees: Our Trustee Board is made up of a group of Quaker Trustees with a wide range of skills and experience. They are on hand to support the Senior Management and Staff Teams.

Again, we benefit from the range of skills and professions each one of them brings to Glebe House.

Our work is underpinned by a robust programme of consultancy, including input from a Consultant Psychotherapist and a Consultant Psychologist.

The team hold a broad range of qualifications and professional skills including a doctorate, social workers, teachers, youth workers, and therapists.

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T: 01799 584359 referrals@glebehouse.org.uk www.glebehouse.org.uk Glebe House Friends Therapeutic Community Trust Church Road Shudy Camps Cambridge CB21 4QH A Company Limited by Guarantee in England and Wales Registered Office as above Company No. 6525659 Registered Charity No. 1124673