The care system for children in England, including residential care, has undergone a significant transformation in recent years. Much of what has happened in the homes has been driven by changes in policy, such as a shift in priorities towards fostering, with wide-ranging implications for those who manage, work and live in them.
Today the majority of homes are small, often four- or six-bed residences. According to the Department for Education (DfE), about 15% of children in the care system will have spent some time in a residential setting. The number of children living in homes, hostels or secure accommodation at any one time is 6,360 – about 9% of the total number looked after. In 1978 that figure was 32%.
More than half of all children’s homes are run by the private and voluntary sectors, while over a third of local authorities in England no longer run their own children’s homes; at one time the vast majority of places were in council-managed provision. This trend seems set to continue with almost half of all councils closing at least one home since 2008.
The children’s homes sector is subject to considerable scrutiny, particularly when it comes to safeguarding against abuse. The involvement of businesses in running homes has also proved controversial as many are perceived as putting profit above other considerations. Other issues centre around how local authorities commission services from an increasingly fragmented sector, and the recruitment and retention of adequately trained staff.
Providers also need to prove that safe, high-quality care is being consistently delivered, as well as complying with new regulations and demonstrating that outcomes for children are improved.
As children’s care provision has begun to veer towards fostering, the role that homes play has come under fresh scrutiny. Questions about which children end up in care homes and why, as well as whether those with more complex needs are in residential settings as “a last resort” – as one government report concluded – rather than as a positive choice, are common.
Children placed in residential care typically arrive as teenagers after multiple foster care placements. They tend to have complex needs including mental health, emotional and behavioural problems as a result of childhood trauma. According to government figures, 30% are placed as a result of abuse or neglect, while the same percentage has experienced significant instability with five or more different placements. Some 38% of children in residential settings have special educational needs. They are also more likely to be in contact with the criminal justice system.
The 2012 DfE report, Living in Children’s Residential Homes, states: “The emphasis on using foster placements wherever possible has meant that children’s residential homes have increasingly come to be used principally for older children with more serious difficulties, who may have difficulty settling in foster care or who may not want a foster placement.”
However, according to Alison O’Sullivan, president of the Association of Directors of Children’s Services, many children are placed in residential not simply as a consequence of their failure to settle in foster care – the last-resort option – but because of their complex needs and “the very specialist nature of the kind of therapeutic support that they need”.
O’Sullivan says the move toward smaller homes with fewer children has been a significant development, and can, when done well and adequately funded, create an environment of intensive support for children, including those with mental illness.
With 62% of young people in homes living with a significant mental health condition, many in the sector argue that radically improving the support available is an urgent issue, especially if the outcomes for children in the longer term are to be boosted.
The NSPCC children’s charity wants it to be a child’s “right” to receive specialist mental health assessments in care. The charity says current health assessments frequently fail to identifying the mental health needs for children in care and points out: “Our care system is there to provide safety, but also to help children overcome the abuse and the circumstances that brought them into care.”
Jonathan Stanley from the Independent Children’s Home Association, which represents providers, agrees that appropriate mental health care is “vital” because by the time a young person enters a residential setting the difficulties are often longstanding.
But government policy falls short because of its focus on early intervention. Stanley says priority should be given to the high proportion of older children in homes grappling with mental health difficulties. Such a policy, he says, would improve other outcomes.
