Section 2. Background 2.9 Challenges around providing adequately safe environments persisted, with high levels of violence a consistent finding across the estate. Efforts to minimise violence though complex and dynamic keep-apart measures had a serious detrimental impact on the services provided to children. This was a particular problem at Feltham and Cookham Wood where it prevented the delivery of a meaningful regime, including access to education. Outcomes for children were not sufficiently good in the key test of safety at Cookham Wood, Feltham and Werrington. 2.10 Conversely, our inspections at Parc and Wetherby found some improving safety-related outcomes for children in custody. At Parc, recorded violence was on a downward trajectory, with few serious incidents. Few children isolated themselves in their cells and use of the segregation unit was rare. The leadership team had established a reward-led culture that encouraged positive behaviour, incorporating an evidence-based instant rewards scheme that we considered to be good practice. At Wetherby, the amount of violence had fallen slightly and was lower than at other YOIs, with some good initiatives in place to encourage further reduction. The Keppel unit continued to provide good levels of care and support for some of the most vulnerable children in the country. 2.11 Outcomes were better in our healthy prison test of care. We found reasonable living conditions at all sites, with the exception of Feltham where they had deteriorated since the last inspection. Relationships between staff and young people were mostly positive. Health care was also good but access at some sites was frustrated by the regime restrictions. We remained concerned about the continued delays in transferring sick children to mental health settings. 2.12 Outcomes in purposeful activity were good at Parc where Estyn judged standards, teaching and learning experiences and care, support and guidance to be excellent. At Wetherby and Keppel we found learning and skills was well led, and priority had been given to maintaining high levels of attendance. However, outcomes were not sufficiently good at Feltham and Cookham Wood. 2.13 In the area of resettlement there was good release-focused work at Wetherby. However, across all YOIs outcomes were undermined by a lack of timely provision of accommodation on release, an issue we highlighted in thematic work carried out in partnership with HMI Probation this year.8 2.14 We remain concerned about outcomes for children who are placed in secure training centres. All three STCs - Medway, Rainsbrook and Oakhill - required improvement. Most children placed in these establishments had experienced use of force and had been physically restrained. Furthermore, there remained a significant amount of work to be done in all three centres to ensure fairness and consistency was applied in behaviour management, as well as ensuring that children’s positive behaviour was well promoted. 2.15 More positively, we found some good work in health care for children at Medway and Oakhill, but it required improvement at Rainsbrook. We also found some improved outcomes in resettlement. 8 HM Inspectorate of Prisons (2019) Youth resettlement - final report into work in the community. A thematic inspection by HM Inspectorate of Probation and HM Inspectorate of Prisons. London: HMI Probation. Children in Custody 2018–19 17