Is family-based care better than group care?

We have the potential to reconsider the idea of family and parenting as possible for residential settings and to look at the full range of provision for all children living away from home in all circumstances and for all needs.

When a publication has misconstrued, misunderstood, misinterpreted Residential Child Care it is important there is a response.

The recent children’s commissioner publication ‘Family and its protective effect. Part One of the Independent Family Review considers Residential Child Care options as ‘institutional’. Page 42 – 43 ‘A significant minority of children live in institutions…’

There are several strongly evidenced responses to critics of residential care:

• The evidence is that it provides a quality of care and parenting

• That many children experience serial and sequential placements is evidence of a system that makes and breaks relationships knowing that relationships and attachments are vital to recovery

• Access to residential provision is hierarchical, the previous environments must have failed the young person for them to cross the threshold

• Using residential care as a last resort is to undermine the efficacy of what is offered, interventions that do not meet need frequently add to the complexity

• Figures show children arrive and leave in mid-teens, too late and too short a time

• Children’s homes act to mitigate the failures of the care system

• We attribute failure to children’s homes when the outcomes are a correlation of previous interventions.

• Outcomes are recorded by last placement but not necessarily attributable to it

• Assessing outcomes when placed in a secure emotional base the development made in residential settings can be at least as good as fostering and often as good as all other settings including families

• Positive children’s homes are found in positive children’s systems.

English responses to evaluating residential childcare have rarely been positive. When there is positive evidence or comment it is notable that quickly there is other evidence provided to revert to the underlying negativity. In such circumstances there is a need for a cultural review.

A Cultural Review requires questions such as:

• What do I know about children and families with this particular background or life experience?

• Where does my knowledge come from?

• What prejudices may I hold (positive or negative)?

• What norms and practices do I take with me?

• What do I know/expect about children of this age, their lives and needs?

• What do I know of children with high level needs?

• What experience have of this group?

How might they and their carers perceive me? As someone who cannot recognise their needs?

Is my perspective and action experienced as not being about them?

What impact might this assessment have on the child and carers lives?

How much weight do I give to knowing it can have a great effect if I cannot get the matching of needs to services/placements right?

Many young people like children’s homes, they felt cared for and looked after.  Some children feel that the children’s home that they live in is exactly where they want to be. It is fair to say that some children do not like living in residential care. But it can be seen as a positive choice when:

Providing stability and a stimulating environment

• Widening cultural and educational horizons

• Creating a framework for emotionally secure relationships with adults – may benefit from having a number of carers

• Providing a setting for intensive therapeutic work

• When a young person feels threatened by prospect of living in a family or does not want to be part of substitute family as still very much part of their own family

• When the emotional load of caring for a very disturbed or chaotic young person is best distributed amongst a number of carers

What can we take from this understanding?

We need to think about:

• Group care and individual care.

• Individuation or personalisation?

• Caring or parenting?

In ‘The Residential Solution’, Ann Davis categorises residential settings on the basis of their attitude to family life. She distinguishes between three models of residential care.

Substitute Family Care. Under this model, residential settings seek to create a family like atmosphere, and family group. We might have been doing this all along, but we recognise it less now?

Family Alternative Care. Taking an extended family perspective and incorporating the positive aspects of communal life. Many boarding schools see themselves in this way as residential communities, quite separate from and superseding children’s family life during term time.

Family Supplement Care. This model contains three main concepts: the need to rehabilitate families; the need to rehabilitate individuals to family life; and the need to share care with families. This maybe the model of most congruence with the view of family support. Such community-based short-term residential care allows for care to be shared as opposed to substituting entirely. For instance, a child may spend all week at a children’s’ home, while another is admitted to care at weekends. The arrangement made is dependent on the family situation. In Europe they ae called Living Groups. Instead of being seen as isolated from communities, residential establishments are be seen as part of the neighbourhood in which they are located, as focal points of community-oriented social work. The emphasis is on flexibility. For example, there may be a range of accommodation and support services; day attendance, part-time residence, or full time care; open visiting hours; flexible staff roles; and a willingness to respond appropriately to the specific needs of each individual family. There is also an emphasis on purposeful intervention with the family. For example, there may be clear plans for time limited family work, for rehabilitation, or for the maintenance of family responsibility and close links between the family and the child. It may provide help with factors such as income, housing, or employment, which effect the family’s capacity to care for the child.

We have opportunity to reconsider the role of the ‘bounded organisation’ in children’s lives.

Jonathan Stanley is manager of National Centre for Excellence in Residential Child Care (NCERCC). This blog was first published on NCERCC website.

Download the NCERCC document ‘Is family based care better than group care here.