We rated this service as good because:

• The service had been set up following evidence-based national guidance for the treatment and support of the patient group and had successfully demonstrated positive outcomes for families over time. The staff team were highly motivated and dedicated to working with the parents and children.

• The team was made up of qualified and experienced clinical staff who delivered therapeutic interventions, but also a group of qualified and experienced staff to support and care for the children.

• Patients said staff were skilled at delivering the treatment and supporting patients to engage in therapy. The service had a welcoming and comfortable environment, for both parents and children. Staff supported patients to overcome barriers of access to services and made sure they were involved in goals for treatment. Staff regularly discussed treatment and goals with parents and shared written copies of paperwork relating to their care.

• Staff understood the specific risks to parents and children accessing the service and managed these appropriately. Staff kept in close contact with, and provided clear and meaningful feedback to, social workers in the local authority who were involved in families’ care. The service provided local authorities with clear information about what the service offered and who would be most appropriate to refer.

• Governance systems ensured the environment was safe, staff could access training and had appropriate employment checks in place. Staff collected and monitored treatment outcomes on a regular basis and this was led by a research officer.

• The service addressed the recommendations made in the last inspection. This included embedding a system for reporting and learning from incidents, ensuring mandatory training covered all necessary areas and that all staff had up to date criminal records checks. The service was open to feedback and made changes where necessary.

• Staff said the team worked well together and were supported well by the clinical services manager. Staff received regular supervision where they were supported with their own professional development and reflective practice.

• Staff kept up-to-date and accurate records about care whilst maintaining patient confidentiality.

We rated this service as good because:

• Staff accessed regular supervision, reflective practice and team meetings. Staff felt supported and were very positive about working at the unit. The staff team were stable with no vacancies and very low sickness rates.

• Staff recorded weekly care notes about patients’ progress that were personalised, inclusive of a wide range of needs and recovery focused. Staff involved parents in their children’s’ care.

• The service used outcome measures and other approaches to measure outcomes for families and the service.

• There was no waiting list for assessments. The service worked well with external agencies such as social services.

• There were clear systems in place for staff to follow if parents did not attend the programme.

However:

• Learning and discussion about incidents and complaints did not take place regularly. Some parents did not feel confident to make a complaint.

• Mandatory training did not address all the essential information that staff needed to know in order to keep families and staff safe in the service.

• Staff did not regularly complete environmental risk assessments to identify where improvements were needed.

We spoke to six people who used the service on the day of our visit and reviewed the files of three people. We also talked to staff and volunteers about the service.

The programme was delivered from bright, attractive and well maintained premises which provided space for creative outdoor and indoor play for small children as well as group therapy rooms and individual counselling facilities.

The people used the service under agreements made between themselves, the provider and social services. People were able to provide input into the way some aspects of the service provide although other aspects were non-negotiable parts of the therapeutic programme on offer and the nature of the agreement with social services.

We saw that treatment and care was tailored to people's individual need and action was taken to ensure people and their children were safe.

The provider had undertaken the necessary checks on staff employed to provide the service although they felt it was not necessary to carry out some checks on volunteers who worked there.

There were good systems in place for monitoring the quality of the treatment provided as well as evaluating outcomes as a measure of effectiveness although data collected in the course of this research about how people using the service viewed the programme was not used to inform the delivery of the service.

We had conversations with four parents attending the service with their children, and they spoke highly of the support provided to them. Their comments included: ”They are excellent,” “They are really good here,” “They listen to you,” and “I’m learning lots.”

People were satisfied that their privacy was respected and that they were treated with respect. They said that they were offered choices about the support they received, and their concerns were taken seriously by staff. They spoke highly of the support provided by their individual therapists and said that they were provided with information about other relevant services available to them.

Appropriate safeguarding procedures were in place to protect people from harm, and staff were appropriately skilled, trained and supervised, with effective team working in place to meet the needs of people using the service. Appropriate quality assurance procedures were in place to look at ways of continuing to improve the service provided.