Problems of residential care

Residential care lacks the moral basis that it formerly had. The values that informed orphanages, kibbutzim, public schools, monasteries, and Russian residential schools were very different. However, in all such establishments children and young people lived in groups and learned the disciplines and virtues required for successful group life. These values are no longer widely held, and with them has gone at least some of the justification for 'treating' individual children so that they adapt better to society's expectations. Over the 1980s there was a drastic reduction in the numbers of children received into care because they were delinquent or failing to attend school. This reduction is confirmed by the provisions in the Children Act 1989, which ensure that, except in rare circumstances, young people cannot be 'looked after' simply on the grounds of delinquency when their own welfare and those of others are not at risk.

This moral retreat has been accompanied by theoretical uncertainty. The best-known texts on residential care are now around 20 years old and are dubiously relevant to the current situation where staff no longer live in, and where there have been major changes in staffing, turnover of residents, clientele, and the size and purpose of homes. In any event, there was never a consensus about which theory should underpin treatment or training. Clear evidence for the efficacy of any approach has been lacking, whereas the evidence for the harmful effects of bad residential care has been clear—and frequently repeated on social work courses. Field social workers who guard the approaches to residential care have traditionally expected little from it and seen it as a placement of last resort. As for the young people, they reach residential care as the culmination of a process that marks, and possibly even exacerbates, their social exclusion. Typically, they are disturbed, poorly supported by their families, and lack educational qualifications, a combination which makes it difficult for them to compete subsequently in the job market. Descriptions of residential care do not suggest that it mounts the determined attack on these problems that might have some chance of success.

There are particular problems for those young people who are discharged from residential care to independent living. Residential homes have difficulty in keeping them until such time as they are 'properly launched'. (To do so would create problems over cost and over creating a regime suitable at the same time for younger and older teenagers.) So, the young people leave care when they are still vulnerable, to cope with lives that are lonely and difficult, at an age much younger than their better qualified and supported contemporaries leave home. Their transitions to the adult roles of getting an income, maintaining a home, and living with a partner are made earlier than those of others and compressed into a shorter period.(14) Unsurprisingly, they have a much higher chance than their contemporaries of becoming lone parents, unemployed, imprisoned, or homeless. (131 16)

In addition to these problems, there are pragmatic difficulties.

• Residential care is very expensive; estimated costs are around £61 000 per place per year, so that the system costs considerably more than foster care or preventive work.(l7) Around 14 per cent of those who enter stay for prolonged periods and take up half the beds. So, there is a sharp discrepancy between the official emphasis on prevention and the heavy concentration of expenditure on a small number of young people.

• Residential homes are prone to scandals involving sexual abuse, outbreaks of disorder, and suicidal behaviour. (7)

• Delinquency and running away are widespread within residential homes. In one study, for example, it was found that 75 per cent of those who had a previous conviction or caution, and who stayed for at least 6 months in the home, were convicted or cautioned for a further offence while there; almost all of them ran away at least once. The comparable figures for those with no previous conviction were 40 per cent and 60 per cent. (4)

• There is widespread bullying, sexual harassment, and personal unhappiness. The same study found that out of 223 residents interviewed 40 per cent reported that someone had tried to bully them since arrival, while roughly 25 per cent of the young women said that someone had tried to take sexual advantage of them. Both events were associated with unhappiness and 40 per cent said that they had considered killing themselves in the previous month. (4)

Official reports(!8) continually emphasize the need to recruit a better trained workforce. However, the proportions of qualified staff remain low, there is no agreement on what training is required, and studies that have looked for a relationship between the proportion of qualified staff and a measure of performance found no association/4,!6)

Contrary to common belief high staff ratios do not in themselves lead to better control in homes or better staff morale, although they do increase costs. (416)

The problems of homes are exacerbated by change. Social services have understandably been running down residential establishments—a process which leads to reorganization and uncertainty for remaining institutions, a more difficult clientele, a greater difficulty in defining roles as establishments strive to fulfil a wider range of functions, and additional costs as the number of residents is reduced more rapidly than the number of staff.

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