Under What Circumstances Should Children Be Referred to Res ident ia l Settings?

David Lane Wakefield Community and Social Services Department, U.K.

ABSTRACT: This article surveys legitimate roles that residential care can play in the lives of young people, alternative intervention possibilities, factors affecting place- ment decisions, and the power relationships involved, concluding with lists of positive and negative indicators of the appropriateness of this form of intervention and six propositions to be considered in making such decisions.

In introducing this subject, there are two general issues concerning my viewpoint which I wish to highlight. The first is that we inevita- bly see the subject from our own national viewpoint. We make as- sumptions based on our own knowledge and experience in our work, and in our home communities. Our inputs will inevitably reflect these views which we have internalized over many years.

But we have also become aware of other views through our FICE contacts. People in other countries have other working methods, other systems, other assumptions, and other values and beliefs. In what we have to say, we also take a broader view, therefore, accepting that there are other viewpoints. It remains an open question whether some methods are "better" than others, or "more valid," whether some countries are "more advanced" than others. Can we make such judgements against general criteria which can be universally under- stood and accepted, or does every country have to find the methods and value systems which suit its own circumstances and its stage of development, both economic and social?

Secondly, I am aware that, al though I am a manager of residential child care services, I have not been in practice for eighteen years, and I am therefore a layman, interested, concerned, and with a degree of

Reprinted with permission from FICE International Bulletin, No. 4, Spring 1991, 5-13. Correspondence should be addressed to David Lane, Community and Social Ser- vices Department, Wakefield Metropolitan District Council, 87 Northgate, Wakefield WF1 3DA, United Kingdom.

Child & Youth Care Forum, 22(2), April 1993 103

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knowledge, but looking on the work from outside to some extent and seeing it in a wider context.

I want to be specific, but the detail which I give will be by way of example only, to demonstrate approaches to the subject. None of the detailed charts presented pretends to represent an exhaustive anal- ysis of the subject, but, they can be used as models for people to de- velop their own analyses.

As a background to the detailed exposition, it may help to say a little about the scene in the United Kingdom. Residential child care is largely the responsibility of local authorities, which vary in type and size in the four countries of the United Kingdom. In most author- ities residential child care has been reduced to a minimum, and one authori ty claims to have shut all its homes, relying upon fostering and other forms of intervention. My own authority, the City of Wake- field, is not untypical, with less than 100 children in residential care from a population of 309,000 people. I believe this is about one sixth of the level of residential care in Hungary, to offer a comparison.

Children are mainta ined in their own homes, with extensive sup- port offered to parents, wherever possible. Where children have to be away from home, foster families are used as much as possible, espe- cially for younger children. There are virtually no residential nurs- eries left. About 75% of these children in Wakefield are fostered, for example, with only about 10% of the total in residential care aged 12 or under. Residential care, then, is used for the oldest, most damaged, and most disturbed children, and for those whose foster care has bro- ken down. In a very small number of cases, secure accommodation is used, perhaps as an al ternative to prison. One result of this policy is tha t residential care risks becoming a "dustbin" for all the children others cannot cope with. There is then the danger tha t staff see them- selves as being associated with coping with failures, and they risk seeing themselves as people of low status processing human failures.

A way out of this depressing syndrome is to be positive about the roles that residential care can fulfil, to be specific about the functions of part icular establishments, or to identify the types of children they can help, so tha t their tasks are positively chosen and not negatively dumped upon them. For people who wish to take this approach, Chart I has been drawn up, and it will be seen tha t there is a very wide range of services that can be provided through residential care. Be- cause there is potential for controlling all the external aspects of a child's life 24 hours a day, residential care is a very powerful tool, for good or ill, and is liable to have a major impact on children's lives, for good or ill.

However, this approach does not give a universal answer to the question of which children should or should not be referred for resi-

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Chart I Chi ldren May Be Admitted to Residential Care in Order to:

1. Offer them emergency care if thrown out by parents 2. Offer them emergency care if abused at home 3. Offer them emergency care if family is homeless 4. Offer them emergency care if parents are in prison 5. Offer them emergency care if parents are in hospital 6. Offer them emergency care if parents cannot control child 7. Offer them emergency care if child is delinquent 8. Offer planned short-term care (e.g., respite) 9. Offer a breathing space to rethink plans

10. Undertake "a full assessment of needs" 11. Provide for children's normal upbringing and development 12. Offer good physical care 13. Offer good emotional care 14. Observe child's behavior 15. Provide court reports 16. Provide other reports 17. Contain children needing secure accommodation 18. Provide a family-style setting 19. Provide non-family-style setting 20. Prepare children for adoption 21. Prepare children for fostering 22. Prepare children for return home 23. Offer social training 24. Offer groupwork/group living 25. Offer education/schooling 26. Offer vocational training 27. Offer leisure activities 28. Offer treatment/therapy 29. Offer accommodation 30. Contain disruptive behaviour 31. Provide family rehabilitation programs 32. Provide training in parenting (e.g., unmarried mothers) 33. Hold children awaiting placement 34. Provide holidays

etc., etc., etc.

Note. Not in order of priority.

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dential care. It only says that such children have been, and may be, referred in some countries. Furthermore, every one of the functions in Chart I, can be carried out in some other way, as indicated in Chart II. The alternative may not be as effective and, in terms of provision, it may not be available, but theoretically it could be used. In short, there are no functions which can be provided only through residential care.

The needs of each child have to be considered individually. But in order to weigh up the individual's needs, he or she has to be seen in their social and national context. A wide variety of factors affect the equation of matching solution to needs: A child brings his or her own family situation, schooling history, leisure pursuits, abilities and in- terests, friends, offending pattern, and health, affected by the neigh- borhood, local employment levels, housing, the quality of local educa- tion, and so on. On the other hand, helping agencies can offer a range of types of care, affected by the money available to them, the quality

Chart II Chi ldren Admitted to Residential Care for the Given Reasons

(per Chart I) Could Alternatively Have Their Needs Met as Follows:

1. Fostering 17. Prison 2. Fostering 18. Fostering 3. Emergency housing 19. Boarding school/lodgings 4. Fostering 20. Fostering 5. Fostering 21. Fostering 6. Fostering 22. Fostering 7. Prison 23. Day center 8. Fostering 24. Day center 9. Fostering 25. School

10. Day center child guidance clinic 26. College 11. Fostering 27. Youth club 12. Fostering 28. Adolescent psychiatric unit 13. Fostering 29. Lodgings 14. Day center 30. Prison 15. Fostering 31. Home (i.e., family's own) 16. Day center 32. Family center

33. Fostering 34. Holiday camp

Note. Other examples are possible.

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of staff training, the legislation enabling action to be taken, the coun- try's economy as a whole, and so on. The network of factors influenc- ing the central decision is almost endless, and is interwoven with certain factors (such as public attitudes) affecting the dynamics at several points. Chart III gives a sample of the network.

It may be wrongly concluded from what I have said that children should not be admitted to residential care, or that it is not possible to identify which ones should. Neither of these inferences is true. What is being argued is that each case is individual, with different factors to be taken into account, and different answers may be reached, per- haps because of the child's needs, but also perhaps because of the services available.

In particular, in deciding whether a child should be admitted to

Char t III Some Factors Affecting Placement Decisions.

Note. This is not an exhaust ive list, and the actual in ter l inking of factors is greater t han shown.

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Chart IV Elast ic Band Model: Who Has the P o w e r to Pul l the

Dec i s ion Their Way?

.......... :,'" i', I l " \

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residential care, attention has to be paid to the interplay between the key interested parties. Chart IV shows the "Elastic Band" Model, in- dicating the tensions there can be over the decision, and the different levels of "pull" that interested parties may have. Some views may coincide; some may be opposed. Magistrates may decide on the re- moval of a child who does not wish to leave home; alternatively, a child may leave, supported by a social worker, contrary to parental wishes, etc. Again, this model does not indicate who should be re- ferred for residential care but offers another way of analyzing the issues.

There are, however, indicators which need to be borne in mind in deciding on admission to care. Chart V gives a range of positive and negative indicators. Finally, I offer six propositions in Chart VI. The issues raised by the questions with which we started are perhaps the most fundamental concerning residential care, and it is significant that they cannot be answered simply, with straightforward, immuta- ble, universally acceptable solutions.

Residential care provides a powerful setting for people to relate to each other, and in which to meet their needs. Residential establish- ments are artificial, man-made structures and have been criticized for

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Chart V Indicators for Ca re Decis ions

Positive Indicators Negative Indicators

�9 Need to socialize �9 Need to be dealt with sep- �9 Need to function in (peer) arately/individually

group �9 Need for close family relation- . Need for personal space (i.e., ships

not in family) �9 Need to avoid "contamination" �9 Need to be independent �9 Need for long-term stability �9 Need to be interdependent �9 Cost �9 Need for specific activities in- �9 Inadequate staffing

volving residence �9 Inadequate staff t ra ining �9 Need for al ternative or addi- �9 Inadequate resources

tional culture �9 Need for close supervision or

control

Chart VI Six P r o p o s i t i o n s

1. There are many reasons for admit t ing children to residential care. 2. There is an al ternat ive solution to every type of problem for which

admission to residential care is given as the answer. 3. There are no universally accepted reasons for admit t ing children

to residential care. 4. In some cases residential care is best. 5. The suitabili ty of admission to residential care for a child has to be

weighed and decided on an individual basis, taking account of a wide range of factors, including negotiation between signifi- cant people.

6. The proof of the pudding is in the eating.

not being natural . Yet all social structures, including the family, are artificial and man-made. We need to look at both the family and placements outside the family equally if we are to determine how children are best brought up, and if we are to mold the structures to meet children's needs most effectively.