Improving the quality of residential care

If residential care is to survive these problems, it will need to reduce the incidence of problems in the home and increase its influence after residents have left.

In terms of immediate impact, residential homes and schools vary widely in the morale of the staff, the incidence of delinquent behaviour and running away, the proportion of residents who avoid going to school, the relationships between staff and residents, and the degree to which the residents report that they are bullied, offered drugs, or feel part of a friendly establishment to which they are committed. These characteristics are far from fully accounted for by intake, and establishments which do 'well' in terms of one of them tend to do 'well' in terms of the others. fyl6.,1.9

These studies suggest the following conditions required for running homes that are successful in the short term.

• The residential units are either small in size or consist of a large unit broken down into small subunits. Such small establishments seem better able to combat the influence of delinquent residents.

• The units have clear aims, with which the head of the home is in agreement.

• The head of the home has a clear philosophy on how the young people can be helped, and the staff are in agreement with this outlook.

• The residential unit is not based close to the residents' homes. An emphasis on local placement makes it harder to combat the influence of local delinquent cultures or to maintain a clear focus.

Two points are particularly important. Good care depends on the leadership exercised by the head of home and the fit between her or him and the staff. Without this bedrock, the systems, procedures, and management targets advocated in reports on the residential system will fail. The basic principle is to establish a set of shared expectations about what is and is not acceptable, and this is more easily done in a small well-led establishment with a cohesive staff group.

Unfortunately, the ability of homes to affect the behaviour of residents in the short-term implies that the environments to which residents go next are equally powerful. This has been shown to be the case and creates problems for homes in achieving long-term change. Overcoming these problems requires the following.

• Reduction of delinquent and difficult behaviour in the home—as noted above these are influenced by the residential environment, and there is evidence that they lead to future delinquency.

• Encouraging educational achievement and those skills required for 'success' in subsequent life and that are relevant to the resident's subsequent environment—and are seen by the residents as being so. Packages of skills (e.g. in budgeting, making employment applications, looking after health) are required for success in several areas of life, although particular skills are effective in particular areas (e.g. in budgeting).

• Working to improve family relationships so that the resident either goes back to an improved family situation or can turn for support to his or her family even though he or she is not living with them.

• Providing continuing back-up from the residential home or an after-care scheme and practical support (e.g. over accommodation).

Success is probably more likely where the home operates on a number of fronts simultaneously: seeking to improve skills, educational achievement, and the way the residents see themselves and also the environment to which the residents return. (Evidence on the short- and long-term impact of residential care is discussed in more detail elsewhereA!,! ,20))

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