Healthy Relationships Survey – Summer 2014



Healthy Relationships Survey – summer 20141. IntroductionThis report presents the results of a survey of school staff, conducted by North Somerset Council in summer 2014. The survey was requested by the Child Sex Exploitation subgroup of the North Somerset Safeguarding Board. They wanted to find out how schools in North Somerset contribute to safeguarding children, by addressing ‘healthy relationships’ in the curriculum.Two surveys were produced, one for primary schools and one for secondary schools. (KS3 and 4 only). Special Schools could decide to complete either or both of the surveys. The survey was written by a group that included:Health Improvement Coordinator: Children and Young People-NSCEducation Safeguarding Officer-NSCDomestic Abuse Coordinator-NSCSubstance Advice Service (SAS) Manager/Mental Health Specialist –NSCSpecialist Community Public Health Nurse- NSCP/CIC Deputy SENCo- Nailsea SchoolTrainee Educational Psychologist – NSCBusiness Support Manager (Children)-NSCThe survey covered:The organisation of Personal, Socal and Health Education(PSHE)The content of education related to Healthy RelationshipsDifficult areas and what support would help to deliver themCurrent good practice and useful resources in schoolsAdditional support for pupils with difficulties forming healthy relationships and families experiencing abusive relationshipsThe council designed the survey and provided the questionnaire online. The survey was anonymous. No staff names were asked for and any potentially identifying information has been deleted from the data file.All 74 schools in the district were invited to take part. 35 Primary schools with Primary aged pupils and 10 schools with secondary aged pupils actually took part in the survey, although they didn’t all complete every question. As some Special Schools may have completed both surveys, we can’t assume that 45 different schools in total completed the survey. We can conclude that at least 56.7% of schools have been involved in the survey.This report will be published on the school’s noticeboard.July 2014For more information contact:Shaun CheesmanHealth Improvement CoordinatorNorth Somerset CouncilTel: 01275 818415Shaun.cheesman@n-.uk2. Recommendations1.To facilitate networking, consideration should be given to the establishment of a ‘sharing’ website for PSHE, open to school staff and support agencies. Good practice could be shared and information disseminated, about sources of local support and current and up to date resources, for instance. 2.To support schools with Healthy Relationships, consensus should be reached locally on which Sex and Relationships Education Schemes of Work cover this area well, so they can be recommended to schools consistently.3.Short units of work and support should be provided to Primary and Special schools, to assist them to deliver the aspects of Healthy Relationships which they find the most difficult:What kind of physical contact is acceptable and comfortable or unacceptable and uncomfortable and how to respond (inc. who to tell, how and when)’.To recognise how images in the media do not always reflect reality and can affect how people feel about themselves (eg. magazines, music videos, TV drama).Learning skills or strategies for resisting pressure to do something that makes them uncomfortable, anxious or that they believe to be wrong4.Secondary schools should be supported to deliver the following aspects of Healthy relationships:How to manage unwanted attentionThe influence of the media on body image and attitudes towards relationships and sex (eg. music videos, advertising, pornography)Identifying behaviours in a relationship which are abusive and learning strategies to manage then or get helpHow to support peersConsideration should be given to commissioning resources which will support secondary schools to deliver aspects of the above.5.More work should be done to ensure that schools are clear about procedures for identifying local support services, especially The ‘Single Point of Access’, the Family Information Service and School Nursing Service.6.Schools should be given advice and guidance on how to gather the views of children and young people about the delivery and teaching of Sex and Relationships, including Healthy Relationships. This issue has not been raised by the analysis, but was raised in discussions with the survey development group.3. AnalysisSection 1Question 1Does your school have a dedicated member of staff who is responsible for coordinating PSHE?Primary School responses: OptionCount Yes97% (34) No3% (1) Secondary School responses:OptionCountYes100% (10) No0% (0) With the exception of one school, all of the other respondents had a member of staff who is responsible for coordinating PSHE. What we don’t know, is whether the role is the sole responsibility of the member of staff or whether they also have many other responsibilities. It is also unknown whether the secondary coordinator has any specialist knowledge of PSHE, or whether they have managerial responsibility only.Question 2Does your school have a planned, progressive programme of Personal, Social and Health Education?Primary School responses:OptionCountYes91% (32) No 9% (3) Secondary School responses:OptionCountYes100% (10) No0% (0) 93.3% of the total number of schools who participated, reported that they have planned, progressive programmes of Personal, Social and Health Education. What isn’t clear, is how up to date they are and whether they are being delivered consistently across the school.Question 3In line with the DfE mandatory timeline, is your PSHE curriculum currently displayed on your school website?Primary School responses:OptionCountYes32% (10)No68% (21)Secondary school responses:OptionCountYes70% (7)No30% (3)41.4% of all schools who responded to this question have displayed their Personal, Social and Health Education Curriculum on their school website, in line with the DfE timeline. There is a variation here between primary and secondary schools, with a majority of secondary schools having published their PSHE curricula online and a minority of primary schools having published their PSHE curricula online.The number of schools who haven’t published their PSHE curricula online may reflect a lack of knowledge that this is a requirement. Alternatively, it might simply mean that some schools are slightly behind due to other pressures, as this needed to be done by the end of spring 2014 (no date was specified).Section 2Question 1What do you do in a structured way, to support your pupils with Healthy Relationships?This question listed different aspects of Healthy Relationships education and asked schools if they covered them:1) In a systematic way each year, but not through discrete PSHE lessons (e.g. cross curricular, assemblies events, visitors, visits etc.)2) In a systematic way through discrete PSHE lessonsFor each aspect listed, schools could choose either one of the options, both or neither.Primary and Secondary Schools were each given a different list of aspects to consider. These were based on the PSHE Scheme of Work produced by the PSHE Association in 2013. Schools were asked to say whether each aspect was covered in KS1 and KS2 in Primary Schools and KS3 and KS4 in Secondary Schools. The primary and secondary responses to this question are considered separately below. Primary school responses:1= Covered systematically but not through PSHE lessons2=Covered through discrete PSHE lessonsAspect12botha) To identify their special people (family, friends, carers), what makes them special and how special people should care for one anotherKS121% (6)0% (0)79%(23)KS224%(7)3%(1)72%(21)b) To learn about the skills needed to develop and maintain positive relationshipsKS117%(5)3%(1)79%(23)KS213%(4)10%(3)77%(23)c) To realise the nature and consequences of teasing, bullying and aggressive behaviours in relationships.KS110%(3)7%(2)83%(24)KS27%(2)10%(3)83%(25)d) What kind of physical contact is acceptable and comfortable or unacceptable and uncomfortable and how to respond (inc. who to tell, how and when).KS136%(9)28%(7)36%(9)KS234%(10)28%(8)38%(11)e) Recognise that they share a responsibility for keeping themselves and others safe, when to say, 'yes', 'no', 'I'll ask' and I'll tell'.KS123%(6)12%(3)65%(17)KS221%(6)21%(6)59%(17)f) When it is ok to keep a secret (eg a surprise party) and when we should not agree to keep something secret.KS137%(10)22%(6)41%(11)KS233%(10)27%(8)40%(12)g) Understanding the safe and responsible use of ICT.KS111%(3)11%(3)79%(22)KS210%(3)17%(5)73%(22)h) Learning skills or strategies for resisting pressure to do something that makes them uncomfortable, anxious or that they believe to be wrong.KS217%(5)24%(7)59%(17)i) To recognise how images in the media do not always reflect reality and can affect how people feel about themselves (eg magazines, music videos, TV drama).KS230%(7)30%(7)39%(9)j) Deepening understanding of keeping safe online, including social media, online games and mobile phones.KS210%(3)20%(6)70%(21)k) The importance of protecting personal information, including passwords, addresses and imagesKS27%(2)32%(9)61%(17)Between 28 and 30 people responded to each aspect listed. Most aspects were addressed in both PSHE lessons and in other structured ways, indicating that they are well covered.Fewer than 28 people responded to some aspects, which implies that these areasare not being covered at all in a small number of schools.This is particularly true for KS1, when teaching about ‘acceptable and unacceptablecontact’ and ‘when it’s ok to keep a secret’. (aspects d-f). It is also noticeable, bothin KS1 and KS2, that these 3 aspects are more likely to be taught either in PSHElessons or outside structured PSHE lessons, but not both.There was also a low response rate from KS2 to aspect i) ‘recognizing that images in the media do not always reflect reality and can affect how people feel about themselves’. A significant minority of schools do not appear to be addressing this area. It was also more likely to be taught either in PSHE lessons or outside structured PSHE lessons, but not both.Secondary school responses:1= Covered systematically but not through PSHE lessons2=Covered through discrete PSHE lessonsStatement12botha) The qualities and features of positive relationships and the skills needed to maintain themKS333%(3)33%(3)33%(3)KS456%(5)22%(2)22%(2)b) Identifying behaviours in a relationship which are abusive and learning strategies to manage them or get helpKS338%(3)25%(2)38%(3)KS444%(4)33%(3)22%(2)c) Understanding rights and responsibilities within relationships, including the right not to be intimate until ready and the importance of respecting the right of others to withhold consent during physical relationships (inc. Laws to protect right of consent). KS330%(3)10%(1)60%(6)KS410%(1)40%(4)50%(5)d) Strategies to manage both the need for peer approval and peer pressure.KS350%(5)10%(1)40%(4)KS450%(5)30%(3)20%(2)e) How to manage unwanted attention.KS350%(4)13%(1)38%(3)KS444%(4)33%(3)22%(2)f) The influence of the media on body image and attitudes towards relationships and sex (eg music videos, advertising, pornography).KS356%(5)22%(2)22%(2)KS463%(5)13%(1)25%(2)g) The safe and responsible use of information communication technology, including social media, online games and 'sexting'.KS320%(2)10%(1)70%(7)KS430%(3)20%(2)50%(5)h) The safe management of own and others' personal data, including images.KS322%(2)11%(1)67%(6)KS433%(3)22%(2)44%(4)i) The role and location of local support services for young people, such as 'No Worries!’KS356%(5)0%(0)44%(4)KS440%(4)30%(3)30%(3)j) How to support peers.KS330%(3)10%(1)60%(6)KS456%(5)0%(0)44%(4)k) The possible negative influence of drugs and alcohol on healthy relationships and sexual behaviour.KS322%(2)11%(1)67%(6)KS410%(1)30%(3)60%(6)Responses for each of the aspects above were made by 8-10 people, which implies that 1 or 2 secondary schools may not be covering some of the areas at KS3 or KS4, but there is no obvious aspect which is not being covered by a significant number of schools.There are some aspects which are less likely to be covered both in the PSHE curriculum and outside it. (aspects with 6 or less respondents when KS3 and 4 are combined) They are:The qualities and features of positive relationships and the skills needed to maintain themIdentifying behaviours in a relationship which are abusive and learning strategies to manage them or get helpHow to manage unwanted attentionThe influence of the media on body image and attitudes towards relationships and sex (eg music videos, advertising, pornography).Strategies to manage both the need for peer approval and peer pressure.It is noticeable in the secondary responses, that where an aspect is covered either in PSHE lessons or outside them, it is more likely to be addressed outside PSHE lessons. The only two exceptions, which are more likely to be taught in PSHE lessons are:At KS4 - Understanding rights and responsibilities within relationships, including the right not to be intimate until ready and the importance of respecting the right of others to withhold consent during physical relationships (inc. Laws to protect right of consent).At KS4 - The possible negative influence of drugs and alcohol on healthy relationships and sexual behaviourThis reflects the movement in secondary schools away from delivery through PSHE lessons to drop down days and other forms of provision.Question 2Which of the above aspects do you find the most difficult to cover?Schools were asked to identify up to 3 areas. The responses of primary and secondary staff are examined separately below.Primary school responses:Option Counta) To identify their special people (family, friends, carers), what makes them special and how special people should care for one another0% (0)b) To learn about the skills needed to develop and maintain positive relationships3% (1)c) To realise the nature and consequences of teasing, bullying and aggressive behaviours in relationships6% (2) d) What kind of physical contact is acceptable and comfortable or unacceptable and uncomfortable and how to respond71% (22)e) To recognise that they share a responsibility for keeping themselves and others safe, when to say, 'yes', 'no', 'I'll ask' and I'll tell'26% (8)f) When is it ok to keep a secret (eg a surprise party) and when we should not agree to keep something secret13% (4) g) Understanding the safe and responsible use of ICT10% (3) h) Learning skills or strategies for resisting pressure to do something that makes them uncomfortable, anxious or that they believe to be wrong35% (11) i) To recognise how images in the media do not always reflect reality and can affect how people feel about themselves45% (14) j) Deepening understanding of keeping safe online, including social media, online games and mobile phones23% (7)k) The importance of protecting personal information, including passwords, addresses and images19% (6) It is clear from the response above, that primary schools find teaching about ‘what kind of physical contact is acceptable and comfortable or unacceptable and uncomfortable and how to respond’ to be the most challenging aspect of healthy relationships. Linked to this, about 1 in 4 respondents found it difficult to teach children about ‘when to say ‘yes’, ‘no’ ‘I'll ask’ and I’ll tell’.Other aspects of concern are:Learning skills or strategies for resisting pressure to do something that makes them uncomfortable, anxious or that they believe to be wrongRecognising how images in the media do not always reflect reality and can affect how people feel about themselvesPerhaps unsurprisingly, primary schools are most comfortable addressing the aspects of the curriculum which are related to fostering positive relationships. There were also few concerns about the safe and responsible use of IT and ‘when is it ok to keep a secret (eg a surprise party) and when we should not agree to keep something secret’.Secondary school responses:Option Counta) The qualities and features of positive relationships and the skills needed to maintain them20% (2) b) Identifying behaviours in a relationship which are abusive and learning strategies to manage then or get help40% (4) c) Understanding rights and responsibilities within relationships, including the right not to be intimate until ready and the importance of respecting the right of others to withhold consent during physical relationships (inc. Laws to protect right of consent)20% (2) d) Strategies to manage both the need for peer approval and peer pressure30% (3) e) How to manage unwanted attention50% (5) f) The influence of the media on body image and attitudes towards relationships and sex (eg music videos, advertising, pornography)50% (5) g) The safe and responsible use of information communication technology, including social media, online games and 'sexting'.No Datah) The safe management of own and others' personal data, including images10% (1) i) The role and location of local support services for young people, such as 'No Worries!'20% (2) j) How to support peers40% (4) k) The possible negative influence of drugs and alcohol on healthy relationships and sexual behaviour20% (2)Unfortunately, due to an error, g)‘The safe and responsible use of information communication technology, including social media, online games and 'sexting' was left out of the question above, so it’s not possible to know whether secondary schools find this aspect difficult to deliver.The two largest aspects of concern for secondary schools were: How to manage unwanted attentionThe influence of the media on body image and attitudes towards relationships and sex (eg music videos, advertising, pornography)There were also a significant number of concerns raised about:How to support peersIdentifying behaviours in a relationship which are abusive and learning strategies to manage then or get helpSecondary schools, like Primary schools, had fewer concerns about teaching positive relationships. Section 3Question 1Is there anything that would support you to deliver this area of work more effectively?Primary school responsesThere were 20 responses from Primary Schools and suggestions for support broadly fell into the following areas:Provision of up to date resourcesThis came up the most and individual examples given were materials on how to discuss sexting and updated SRE DVDs. One respondent mentioned the importance of resources being in ‘childspeak’ and another mentioned specific lesson plans. There was a comment about the need for support material at KS1 and about the need for updated SEAL materials, although this is clearly a national issue.PSHE/SRE Scheme of WorkWithin this category, it was suggested that recommendations for good PSHE Schemes of Work could be made. Another respondent mentioned a ‘better SRE syllabus’, perhaps suggesting that one could be provided for guidance locally.It was also mentioned that it would be helpful to have basic Schemes of Work for more difficult topics, which could be adapted by each school. Another school suggested that it would be useful to have suggestions for cross curricular opportunities, so that important areas could be ‘drip fed’ to children throughout their time in school, at an age appropriate level. Sharing of good practice/training2 respondents mentioned training and another referred to general sharing of good practice.Provision of Free servicesOne respondent mentioned ‘services like the Life Education Bus but without the associated charge/fee’.Secondary School responsesThere were 7 responses from secondary schools, which fell broadly into the following categories:Provision of up to date resourcesUnlike Primary schools, secondary schools are more likely to want support with information about outside agencies and speakers, or to want these provided. One respondent specifically identified resources and guidance for delivering programmes to children with special needs. Another comment was made about the importance of enlisting parental support for this area of work.Sharing of good practice/training2 respondents felt that it would be helpful if best practice was disseminated.Knowledge of local services for studentsOne respondent wanted to know more about local services that could support studentsIt is interesting that at secondary level, unlike primary, training and Schemes of Work were not identified. This might mean that they are secure with what they already have in place or might reflect the movement away from trained PSHE teachers delivering PSHE in dedicated lessons.Question 2Are there any resources that you find particularly useful to deliver this area of work?Primary school responsesPrimary school staff who responded, said that the following resources were useful for addressing healthy relationships:Channel 4 Living and Growing DVDLife Education Bus and its staffChildscape Books For KS1SEAL resourcesJig-saw PSHE Scheme of Work‘Different Family same love’ resource pack (particularly for KS2)Seal resources were mentioned by 3 respondents and the Jigsaw PSHE Scheme of Work by 2 respondents. All other resources were mentioned once.Secondary school responsesSecondary school staff who responded to this question, suggested the following as being helpful resources:The PSHE Association websiteChild Exploitation and Online Protection (CEOP) resourcesA Hollyoaks storyline, supported by 'extra scenes' available on You Tube. (‘It helped a lot of Year 10 students get a way in to the topic as they watched the programme and already had opinions’).Educational Action Challenging Homophobia (EACH) (‘particularly good at supporting anti-homophobic bullying work and supporting students who are in homosexual relationships’)No worries! (‘are a beneficial agency that support the school and do a massive amount of work with our vulnerable students’)There was no resource that was mentioned more than once, which may show, along with Primary schools, a lack of consistency across the district.Question 3Is there any good practice in this area that you're pleased with and would be happy to discuss?Unfortunately, only one school identified themselves in this section, which was Worlebury, who are a Lead school for SEAL. For this reason, it isn’t possible to let schools know about where they can go to for information about different resources.There were some interesting responses to this question though, which give a small insight into the delivery of healthy relationships education. They are recorded below:Primary school responses:E safety is well established.Whole school ethos very secure in this area.First primary school in the country to achieve Internet Safety Award.Family SEAL sessions have 95% attendance from families.Effective mentoring on 1:1 basis or small groups where intervention is necessary for identified families.The NSPPC delivered a very good training to Y5 and 6. Would like to see this rolled out to other key stages.We are investing in a new PSHE scheme between other schools in the area.Secondary school responses:Whole days dedicated to PSHE, involving outside speakers, workshops and specifically geared towards certain year groups.The school is keen to attend network meetings to share and receive best practice.General safeguarding procedures and informing and training staff consistently within the schoolIn term 6 we cover SRE across the school - early years to P16. (special school)Each February we have Safer Internet Week, this includes leaflets for parents.Question 4Do you provide any additional support, outside the curriculum, for pupils who have low self-esteem and difficulties forming healthy relationships?Primary school responsesPrimary respondents were almost unanimous in responding ‘yes’ to this question:OptionCountYes97% (31)No3 (1)If the answer was yes, schools were asked to briefly describe the support available. It is clear from the responses, that by far the largest source of support are Learning Mentors (18 mentions) and The Behaviour Improvement Programme. (10 mentions)Other forms of support that were mentioned between 2 and 5 times were:Self esteem groups/individual supportSocial skills groups/socially speaking/social storiesNurture groupsSilver SEAL Family Liaison worker/Family Advisor support for individual pupils and their familiesLego ClubsThe following were mentioned once:Sports coachingCalm club at lunchtimesFriendship groups (Learning Mentor Led)SENCOLunch and Break clubsSharing and cooperation clubs (eg gardening, family cookery)VisitorsForest SchoolsAd hoc counseling‘Thrive’ approachSensory room Vulnerable Learners ServiceA full list of primary responses to this question can be seen in appendix 2Secondary school responsesSecondary respondents were unanimous in responding ‘yes’ to this question.OptionCountYes100% (10) No0% (0) Secondary staff identified the following sources of support between 2 and 4 times:CounselingFamily Support/Parent Support AdvisorNo Worries!CaMHSBehaviour Support Team/Behaviour Improvement ProgrammeSocial Skills groups (eg Lego club, forest skills)/social skills workOther sources of support mentioned once were:1 to 1 sessions with tutors(matched to their needs)‘Grow’ programmeSEALStudent Welfare OfficerAdvice from police/social careBrook VisitsSupported club for vulnerable studentsYOTEducational PsychologistsLearning support staff (run Social and Emotional Aspects of Learning Clubs to develop self esteem and build relationships)Question 5Do you support the whole family, if it is known that abusive relationships are occurring?A large majority of respondents said ‘yes’ to this question:Primary school responses:OptionCountYes90% (27) No10% (3) Secondary School responses:OptionCountYes100% (10) No0% (0) It is unclear why some schools aren’t supporting whole families if it is known that abusive relationships are occurring. It may be that they haven’t encountered the problem yet, or it may be that they don’t feel adequately equipped to address the issue. Alternatively, staff may not have known how to interpret the question or interpreted it differently from other schools. For instance, one school may have responded ‘yes’ because they signpost to services, while another may have taken it to mean working directly with families through a Family Support Advisor. Appendix 1Listed below are school responses to the question ‘is there anything that would support you to deliver this area of work more effectively?’Primary school responses:unsureWe already use the NSPCC to teach about child abuse.We are currently revising our PSHE curriculum to include the PSHE Association Programme of study and The SREServices like the Life Education Bus - without the associated charge/feeA basic scheme of work for these more difficult topics that teachers could adapt to suit the needs of their children. We are in the process of designing something to help with this.Up to date materials that can be used in school - eg how to discuss sexting in upper primary?More time built into the curriculum to allow these topics to be taught as discrete PSHE lessonsCross curricular opportunities in drip-feeding the same messages throughout a pupils time at school at an age appropriate level.Staff CPD training.sharing of best practice and useful resources etc.We have purchased a new resource called 'Jigsaw' for September and are confident that this will support our delivery.Books or computer programme.More up to date Sex Ed DVD materialsRecommendations for good PHSE schemesIn the next academic year we will be reviewing our PHSE delivery and our SRE policy which will feed into our delivery of these areasUp to date Sex and Relationships DVD / resource materialsUp to date SEAL materials. These have been really useful but now need to be improved.Training opportunities and more support materials that age appropriate.Better SRE syllabusGuidance and resources for covering this in KS1.More guidance for Teachers, resources, lesson plans etcSecondary school responses:Dissemination of best practice from other local schools.We do two huge PSHE Days for all of our students; this involves specific workshops for each year group. This is alongside the allocated PSHE lessons. We have absolutely NO support from the LEA with resources, organisations, speakers etc.The use of outside agencies and specific resources designed for use by young people.Knowing local services for studentsLocal groups willing to come in and talk to students/deliver sessionsMore intervention form external agencies used to dealing with and supporting young people. Also, parental support is vital to be able to effectively deal with it.More advice/examples of good practice and resources to deliver all of the above.Resources and guidance for delivering programmes to children with special needs.Appendix 2Listed below are school responses to the question ‘Do you provide any additional support, outside the curriculum, for pupils who have low self-esteem and difficulties forming healthy relationships?’Primary school responses:Support from BIP and our learning mentor, as well as sports coaching.We have 2 learning mentors.Through our SABIP sessionsCalm Club at lunchtimes. Learning Mentor - friendship groups etcLearning mentor support. Support from our local Behaviour and Improvement ProgrammeSENCOLearning Mentor works with children on a variety of projects including Lego Club. Other support staff complete programmes such as Socially Speaking if and when required.Two members of staff are Silver Seal trained and work with targeted groups and individuals.BIP groupsWork with a Learning Mentor, tailored to fit individual childrenNurture groupsLunch and Break ClubsActivities based around sharing and co0operation, eg, Lego Club, Gardening, Family CookeryWe have a learning mentorself esteem groups, nurture groups, BIP, learning mentors, visitorsFamily Adviser support for pupils and their parent/carers, in small groups or 1:1 basis.Silver SEAL groups.Referral to external agencies if necessary.Forest rmal ad hoc counselingNB,We consider everything that takes place in school to be part of our curriculum and so yes this is providedA Learning Mentor works with individuals and group of children.The BIP team run programmes of work with groups of children.Secondary school responses:All of our students have one to one sessions with tutors who have been 'matched' to their needs.Grow programmeSEALStudent Welfare OfficerCounsellingPSANo Worries!Students have the opportunity to refer themselves to the Student Counselling Service. Students with these difficulties work with our Parent Support Advisers.Apart from advise from the Police or Social Care there is a limitation as to where we can direct young people who are vulnerable to exploitation in North Somerset.Student CounsellorNo Worries! ClinicPSA supportSpecific visits by agencies such as Brook. ................
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