We need to reform the standard of care in children’s homes

Dr Sarah Parry
Monday, June 28, 2021

There are currently over 9,000 children in care homes in England.

Every single one of them has experienced some form of trauma in their lives, and they are some of the most vulnerable children in our society.

Earlier this month, the independent review of children’s social care recognised that improvements need to be made in children’s care homes. It called for a ‘pragmatic re-think’ of the current system. Although we currently hear a lot of rhetoric around ‘rebuilding’, we need to go much further and radically reform the children’s care home sector. This should centre on developing a comprehensive trauma-informed national framework that can outline and appraise what good quality care should look like for children who have suffered trauma.

Why is this an issue? Currently, there are no nationally recognised guidelines as to how to provide trauma-informed care in residential children’s homes. At its heart, trauma-informed care recognises what has happened to a person, rather than attributing blame or criticism to individuals. Trauma-informed care also recognises that frontline workers need to be emotionally supported in order to undertake their work. This makes it particularly relevant to children’s homes, where frontline staff are expected to adopt an increasingly therapeutic approach but often without suitable support themselves.

If adopted at policy level, trauma-informed care could bring about much needed cultural change across the sector. Without the right support, children who have experienced trauma are less likely to reach their potential at school, will suffer from poor mental and physical health, and are more likely to experience re-victimisation. Without the right support, care providers and organisations will also underperform and underachieve.

The quality of care provided varies enormously across the sector and there are relatively few appraisal systems to verify exactly what level of care children are receiving. The children’s home sector has become largely privatised, with some providers charging as much as £7,000 a week per child on the basis that they are delivering specialist care. However, without a suitable implementation framework and quality appraisal tools, it is difficult to determine whether these providers are living up to their claims.

During the pandemic, our research has shown frontline workers also experience significant stressors. Even though they are expected to deliver therapeutic care, they rarely receive adequate psychologically informed supervision, support and training.

If services claim to offer trauma-informed care, there must also be a clearer commitment to staff wellbeing. Working with traumatised children can have a huge emotional cost for frontline staff, who often work long shifts on low pay in challenging conditions. When staff feel burnt out and unsupported, they will leave. This causes further relational loss for a child who will have already lost their home environment and often lost contact with their family, peers and school.

So, how should we be providing specialist care? To build an effective framework, we need to view care services through the eyes of those experiencing care every day – the children, young people and frontline workforce.

Through the independent review, we have hopefully reached a point when we can look at reform, rather than simply ‘building back’. We need to look forwards, move forwards and develop better standards. There are more and more children coming into residential care, and we need to have a compassionate, robust caring system to ensure the care they receive is good enough. A standardised trauma-informed framework and greater regulation could offer a much-needed solution to an emerging crisis.

Dr Sarah Parry is a clinical psychologist and practice fellow at Manchester Metropolitan University

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