Residential child care:a view from inside the service

I am often asked by adults new to our work who may have just finished a particularly frustrating shift, “ Which children can residential child care really help ?” Let me make a list of those children I think it can help best.

I think it can help young people for whom there has been very little boundary setting in terms of the way they have been parented. I am talking about families where there has not been a great deal of structure and these are often those where there has been drug and alcohol abuse.

I believe that young people who have attachment issues which have resulted in the making of relationships a painful business do better in the first resort in a residential setting.

Young people who are facing family difficulties but who have strong ties to their biological family do well with us.

Young people with addictive behaviours are in my view those we can have the best chance of helping, though don’t think of the immediate stereotype of an addictive person when I make this claim. Finally I feel we can help children and young people who have suffered multiple emotional trauma. This is the set of young people I think we can best help in residential child care.

There may be alternative forms of care for these young people – including adoption and fostering – for I would always make the proviso that every child’s needs should be met after assessing their individual situations. However drawing from my own experience the groups I have listed generally would need more than one or two carers at home at the same time. If this is not the case in such a young person’s placement then I fear they will not be able to last the distance towards the goal of leading a reasonably tolerable adult life. I think the behaviours that the children I have described display – their extreme coping mechanisms – mean that they need a group of adults who are there and trained specifically to hold them emotionally and very occasionally to hold them physically in order to manage their extreme presenting behaviour. Of course for many children and young people foster care is the best of placement but it is my experience in relation to the young people I have described that in foster care, if a carer’s home is for instance trashed twice in a short period of time, it is natural that the carer will not be inclined to see it happen for a third time. In one way it is understandable that a foster carer, who finds that the personal items of their own children are stolen or destroyed, may not have the resilience to deal with this – occasionally some do, but my observations over many years suggest this is the exception rather than the rule.

Children with boundary setting difficulties

In terms of helping young people maintain boundaries, it is asking too much of one person – for instance a foster carer – to be consistently there for a child (who as a consequence of their earlier childhood experiences is struggling with boundaries) when the foster carer may well be working through boundary issues with his or her own children. It is a big call to make on a single foster carer or indeed a foster couple. For the foster carer it is a 24/7 job and there can be no doubt that foster parents, dealing with the kind of young persons I described earlier, become tired and exhausted. It’s a very demanding job and even if you are a couple there will be times when you have to sleep only to find that a young person who hasn’t had regular boundaries doesn’t differentiate between two or three o’clock at night and two or three o’clock in the day.

So how do you cope when you are up with a troubled young person at two or three o’clock in the morning and yet you have to get up to cook the breakfast and get young people to school or out to work in the morning? Well for the children I am describing you need to have a team of people who together make up a sum of resilience which allows them to cope with these difficulties. This is a team of people in which there is always someone, capable of looking after the young person, always someone to continue almost seamlessly take up the young person’s burden and to carry on afresh. If we cannot show a young person that we can contain them in their worst moments, then their problems will only get worse. If their acting out is managed, then young people feel contained.

Children with attachment difficulties

For those young people I have described as having attachment problems there is an expectation, an insistence even, from those responsible for placing such a child in a foster family that the young person will “attach’ to their new carers. I believe this puts undue pressure on someone who has attachment difficulties and what can be helpful for children in a residential child care environment is that you can give them the opportunity to make choices about who they feel able to attach to at their own pace and in the meantime you can give them tools and help them to use those tools which in turn will help them to find making relationships a less anxious and fearful notion. There’s the difference. There is not a driving demand as there often is when children are placed in a foster family that because they are in a family they must be a part of that family. This sets up a very difficult emotional situation for everyone to deal with. In residential child care while the intention is that good attachments are made the child is under no immediate pressure to attach to an adult.

Strangely enough when a young person attaches to a member of staff they seldom pick the most popular one. It’s usually someone who has done something for them that they didn’t expect. It is always some little gesture that tells the child this is someone who offers them a privacy which is theirs and theirs alone. It is seldom, if ever, the person that everyone runs to when he or she starts a shift.

Children with addictive problems

Children with addictive problems can be helped in residential child care. When I say addictive problems you may immediately think of drugs or alcohol. I am talking about those behaviours, but I am also talking about addictive behaviours in terms of risk taking behaviours – like going out and stealing cars and other criminal activities. Sometimes I feel young people like this really need the children’s home and the group and this is something I will talk about later. I think a children’s home can help these young people to regulate their behaviour. They have lost the norms of their wider community and they have taken on the norms of the groups of people for whom these addictive behaviours are norms. They need help to be returned to the kind of helpful social norms which many of them will have known in their past. These norms are more related to a functioning even if not a perfect society.

It’s difficult to do this in a “two parents, couple of children” type of foster family. Families find it very difficult to deal well with these behaviours I think in a children’s home there is the potential of using the group to regulate a young person’s behaviour and I think that works really well.

Some people call the use of the group, “group therapy” but I don’t call it that. I actually like to think of it in terms of the values of the group and of the group using their values and that is something that the adults in the residential setting can help shape and form. The group is a strength of residential child care. The values of the group do influence a young person who has the kind of addictive behaviours I have mentioned. The group allows a young person to consider the way he is operating and to think about the consequences for him. How this works is that if a young person listens to what is going on the group and accepts its decisions this helps him but it is also rewarding to the group and confirms its purpose. This happens during formal group meetings but also very often during informal group discussions which – though they may not do it consciously – express what we would understand as positive societal values. In this way these values are imposed on the individual by the group. It focuses them on where certain behaviours will get them and makes them think about where they want to go as young adults. The individual begins to see how others in the group have gained their rewards, and not material rewards, but personal internal ones like respect from others that is not gained by threat. What the group does is it shows an individual how respect because it is a healthy self-respect is a positive thing and not a negative thing.

Children who have suffered emotional trauma

I’d also like to say something about helping young people who have suffered emotional trauma earlier in their childhood. I’d like to do this by discussing a young person who came to us who had been in a number of foster families and children’s homes. Every one of these placements had broken down. Here we had a young person who had most recently been in several children’s homes and she had been moved on from them because she had been quite destructive in different ways, including assaulting staff and destroying property. She was a really difficult girl for us to deal with. She was very traumatised. From about the age of three her childhood up to the age of 12 had been chaotic and she had been the victim of a multiplicity of abuses. She had been placed in care for a number of reasons, not least her behaviour, Yet it seemed to us that time had not been taken to help her deal with the pain of her past. At the age of 12 she had witnessed the violent death of a close relative which was related to drug abuse and this had not in any way been dealt with by her or her previous carers. She had looked for friends but had built up a network of people who were really making matters worse for her. She came to us and in the first 6 months we tried to help her behave within acceptable norms and by the time she had decided to try to do that she also expressed her intention not keep up with the group of friends she had made before. How did this happen? Well the adults and the young people who make up our group, our community, in our home, persuaded Lisa to stay in some evenings and once she had tried this she began to rest. This was not as easy to achieve as it may seem on reading this article on your computer screen. This development took place after the group had shown Lisa that they could tolerate and then contain her acting out behaviour without rejecting her. She needed to rest emotionally. This wasn’t a conscious thought on her part. It was the group who showed her that people could get something from just being in the house and doing normal things. These were experiences she had never had before in her life: staying indoors, having dinner at the table, washing up the dishes, watching television and having conversations with people about ordinary things. Lisa, at the age of 16 and a half, left us about two months ago. Given her history it seemed amazing that she had been with us for 18 months. Moving on carries trepidation, but Lisa left us hopeful and confident about her placement at a project offering accommodation for young adults who are making preparation to set out on their adult lives. Lisa told us her 18 months with us had been the most peaceful months in her entire life her life. For me, resting from the trauma of early life is a big deal for young people of Lisa’s age. So few get the chance to do this.

Residential care now: a risk averse project?

I think that in the current economic climate residential child care has a job on its hands to re-define its role. I think residential child care has got off too easily in the past by being quite wishy-washy about itself and making quite unjustifiable claims about being therapeutic this and therapeutic that. What we have to show is that we can plan an environment which is real for the children and young people. What I mean by that is, it has to be an environment that helps young people manage setbacks. We work with young people whose childhood has not helped them to develop resilience to setbacks and our task is not helped by the risk averse nature of so many of the regulations which bind residential care at the moment. We are required to protect children from just about every experience of risk. If we as adults go along with this then we cultivate children who will not be able to cope with the problems thrown up by everyday life.

All the policy and documentation about safeguarding the child is actually loaded towards preventing a child taking a risk because their experience brands them as vulnerable but I think we’ve got the balance wrong here. Yes, we have to protect children but we need to teach them to protect themselves but you can’t do that by taking away from them all the tools they’ll need to help them learn to protect themselves. We need to trust and respect children’s capabilities more. The adults can’t do everything for them but having developed a good relationship with a young person we can begin to give them advice that they can use to protect themselves. I don’t mean telling urban myths such as there is potentially a paedophile lurking behind every garden hedge but, simple information like what are the things people do to be aware of what is around them and the straightforward solid evidence based precautions that everyone takes when they are out and about. One might say for instance, “If you get drunk and end up lying in a shop door there is a significant chance someone may do something that will seriously harm.” The idea I’m trying to get over here is that rather than protecting young people from everything, it is more important to teach them to protect themselves. Where we can’t teach then the safeguarding process can take over but we cannot protect young people from everything they have to learn to protect themselves.

I think this kind of teaching is a big role – some might link it with social pedagogy – and it is one which residential child care should take on.

Foster care or residential child care?

The plain answer is that both have their place. Nonetheless it concerns me that these days we are moving increasingly speedily towards the universal use of foster care to solve troubled children’s problems without any thought of the consequences. I think this is wrong but I know why it is being done. It is being done for economic reasons. It won’t work because human beings are not homogeneous. We should remember that some need this and some need that. For human beings there is no such thing as one size fits all. The idea that foster care is right for all children in care is wrong. Some children fare better with multiple carers. I know this because I lived in a community of multiple carers when I was young. You can do very well in such a community. Yes your biological family has parental responsibility for you but the community also cares for you when your parents are absent. We need to move back to this kind of caring as a society, but I am talking here specifically of residential child care and it can only do what I am suggesting because at its best residential child care brings with it experienced and well trained group workers who carry with them special knowledge and insight. A proviso here is that this can only be achieved by having properly trained workers and if only we could guarantee a properly trained work force throughout residential care what energy for good this would achieve. If as a community we valued the work that these people do, then they in turn would do a fantastic job. If I had a family : a mother, a sister, a brother, perhaps even a father that cared for me and with whom I had bonded but with whom I could not for any reason currently live, why would I want another family? I am sure I wouldn’t. I might value more someone who could begin to teach those things that my family had missed out, and that I,as a child am supposed to learn as I grow up.

Parenting and training

Sometimes as adults I think we forget what we are supposed to be doing with parenting. We are supposed to be equipping children with the skills they need to be good adults. What we’re doing is looking only at ways of making them happy without thinking that our role too is to make them good adults. If young people don’t get this from their parents then I believe residential childcare can step in and do this well but we need quality workers to achieve this. I’m asked often what I mean by “quality workers.” The answer is those who have had a good training and I don’t mean the kind of training that is about jumping through all the regulatory hoops, neither do I mean the kind of training that is about learning all the policy and procedures off by heart so that I can watch my back. Though the latter may have some peripheral significance, we need a kind of training, which will identify those workers who have relationship building skills and those with tenacity. Workers who do not have these skills tend not to last. Equally NVQ does not work. It does not train workers to deal with the situations they face in what is a highly skilled and complex job. If we want to appoint highly skilled workers we need to raise the bar not only in skill training but also in the remuneration of residential child care workers. We struggle to attract people who may have the potential and some desire to do this work. Its poor pay and modest training requirements make it difficult for an adult who, as well as wishing to do our work at a high level, also wants to be able to afford bringing up a family of his or her own.

What we end up with are poorly recompensed, poorly trained members of a workforce which is understandably failing to deal with complex issues like loss, separation and troubled attachments. Social workers criticise residential workers when things go wrong but they have been required to understand these things at degree level while residential child care workers deal with them at NVQ level.

By educating them to a higher level I don’t mean that residential child care workers should come out all the same from some higher educational sausage machine. If you like they can be quiet, they can be noisy, they can be bossy boots and they can be non-assertive.

Underestimating children

Children need to be able to deal with different kinds of adults. We do underestimate children’s capacity to do this. In our desire to be uniformly regulatory we have tried to block these channels of experience and in doing so we have done children a disservice. The fact that we have more mental health issues with our young people who have been in care is not surprising. We have not taught them how to cope. When I was young and I cut or grazed my knee I could run home and someone in the family would dress my wound and comfort me. When this happens to children in care there will be a hospital visit and the child will be checked out to make sure that nobody has done something to him. So what would normally be seen as a normal childhood experience now becomes a reason for checking if the child has in some way been abused. How can a child feel secure in such circumstances? It is a travesty. For the child or young person in care it is as if we, as representatives of society, have the prerogative to tell you the child the value and the meaning of your experiences. It is as if we are saying we do not trust you to manage your life. We will dictate to you, which is the best way for you to develop. In effect we as workers are saying we do not trust you to lead your lives.

The defensive nature of residential child care

I believe this imperative not to trust children is related to how defensive we as residential child care workers have become in our work. We must not allow you the child choice because we are fearful for what it might mean for us. Equally we cannot express our healthy love towards you, or even give you a hug for fear that you or someone else will interpret it as a form of abuse. The irony is that we as adults have created a culture in which children are encouraged not to trust adults. Worst of all adults don’t trust other adults to look after children even within families. When we can’t even take a photograph of our own children while they are engaged in a school activity what does that says about us as a community?

Developments like this- not being able to sit around as a family to look at photographs of children playing or performing at school photographs- each in their small but invidious way work against the family as a unit and indeed against the group in a children’s home. Children who are admitted to children’s homes so often have had no special family moments. They haven’t eaten together in their families and they haven’t even watched television together. When we try to create or re-create this experience it can be strange for them.

The future of residential childcare: does Ofsted have a place in it?

These are developments that make me believe we will need more children’s home in the future but I fear that at the rate they are closing certainly in the private sector as a consequence of the trend toward the fostering panacea there may not be sufficient resource left on which to effectively blow our own trumpet.

Perhaps we could call for legislation to address this, not that I think there are any politicians who are interested in residential care just now but I don’t think legislation ever really helps. Legislation reacts to incidents. It is seldom shows foresight. For instance legislation following the baby P case was intent really on covering all the loopholes in previous legislation and this results in defensive practice in our field as well as in the social work and social care fields.

I think the former National Centre for Excellence in Residential Child Care offered a good counterpoint to the defensive trends in our work by providing evidence that looking after children in groups could be what it should be: at once an intimate and educative project. The Centre’s closure was a real loss for residential childcare because while it was there it gave us the sense of having our own professional body. When it closed it felt as if we were being de-valued as a profession. The Centre it seemed to me was a symbol of a national recognition of the positive nature of the residential child care sector.

Now what organizations do we have which could in anyway be described as standing up for us? I suppose I should mention Ofsted, our national inspection body. I’m afraid `I have a problem with Ofsted. I think that Ofsted is not quite sure if it is fish or foul yet. It continually changes the criteria of the way it inspects.

Of course our problems are related to limited finances and in the current climate is an understandable concern but care managers are finding that Ofsted become concerned only about the safeguarding issues rather than finding out about how well a child is doing and how happy they are in their residential child care placement or considering if the placement is meeting the needs of the child in terms of the emotional development. An inspector should be looking at how comfortable the child feels in the placement and that the care of the child in the home is effective. I really do have a problem with the way we as residential workers are pulled up in a very pedantic way about not having recorded something and we are required to record some very esoteric things. There is so much written recording to be done that it does get in the way of theprimary task. The galling thing for us as residential child care workers is that nobody actually reads many of these records. None of these records actually enhances the child’s experience of care. I believe we need to record the things that matter. There’s got to be a way of recording happiness. We have know way of knowing from the records we have to keep about how a child is progressing towards being a socially aware and reasonably content human being. Instead we do record Regulation 42 which asks us to record how many times a young person has met with his social workerand what meetings they’ve been to. There is a whole raft of detail to record that has to do with the role of the social worker that is really not ours.

Ofsted also places undue pressure on us in other ways. They want us to structure keywork meetings in a particular and formal way but I know as a keyworker that the best meetings are in less formal settings. For instance I have a young man who at the moment who can’t sit still long enough to have a formal meeting. Instead we run together down to the park and we walk around and have very helpful – that is helpful for both of us – keywork meetings. I then have to go back and record it and that takes me a long time because he’s been so relaxed and so he has had so much more to say. Now recording that kind of meeting is worth the effort. Now this boy would never sit down and have the kind of meeting Ofsted demand and when they see my record of the meeting I have describe Ofsted deny its significance. They say it doesn’t count because it wasn’t “properly planned session.”

These are issues that need to be addressed and I don’t believe Ofsted have the commitment to do it, they spend their time constantly changing their modus operandi.

The private sector

I work and manage residential child care resources in the private sector and the latter has its disadvantages particularly now that the whole country is in a difficult economic position. The problem for the private sector is that is predicated upon the need to make a profit and when profits are threatened then the private sector has to squeeze its services. This may influence the type of food we buy or whether we have to alter the way that we provide a service in order for it to cost less. Now what may be lost in this is a thing that a child particularly enjoys or it may even mean taking away things which hold good memories for the child. As private providers we have to squeeze services becauseotherwise they are not cost effective for us.

In addition to this what we can provide can be influenced by local authorities making cuts that we hadn’t planned for. So the holiday experience you were going to provide has to be adjusted to become a much less interesting experience than the one you had planned. When new staff are appointed they are less experienced and less well trained because the salary budget has to be cut.

I think some local authorities have become aware that they have gone too far interms of placing a financial squeeze of private sector residential child care. So many homes have closed down but local authorities have not yet found a way to re-approach the residential sector. At the moment there are more referrals coming into the private sector but the financial situation strictly limits the amount local authorities are prepared to pay for residential child care.

What that means is that residential child care has become a place of last resort – really a last resort – to the extent that a request for funding of residential placement for a child has to go to director level in the local authority before a decision can be made.

The advantage of the private sector is that when the economy is going well it is able to provide services quickly without having huge bureaucratic services to slow down its capacity to plan and create new services quickly and at the time they are needed. Equally when the going was good children’s homes could afford to seek out specialist personnel like child therapists to offer staff support in particular cases. This does not happen any more. No private children’s home can afford that expenditure.

Staff training has suffered. Very little is now done and even the statutory training has suffered. Instead of happening once every three months it now occurs only every six months. There are quality training providers whose fees we can no longer afford. Training is no longer of the quality we would like. We are providing justenough training to allow us to tick the boxes we are required to tick.

Conclusion

Residential child care will survive because it is actually needed. They can’t do without residential child care. I am sure it will be restructured and I think there will be changes in the kind of children and young people who will come into residential child care. I don’t mean necessarily that there will be a move towards dealing with what is so often euphemistically called “the more difficult end.” I think residential child care will be able to demonstrate that it has something to offer less vulnerable children and young people. I don’t think our sector of child care will sink butI think it will shrink and will become more specialized in nature. We will be able to offer certain young people a kind of care which is much more in line with what they need rather than what has become the panacea- foster care.

Residential child care has to become more professional and get itself more respected. It can do it through better training which can only lead to having more insightful and effective staff serving children and young people.