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eJOURNAL OF THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK (CYC-Net) – ISSN 1605-7406

ISSUE 124 JUNE 2009 •  CONTENTS •  HOME PAGE

PREVIOUSLY PUBLISHED CHAPTER*

Differential assessment of residential group care for children and young people

Leon Fulcher

Summary
Twelve qualitative variables frame the production of outcomes in residential group care for children and young people. These are used to examine contemporary themes in social care practice with children and families. This assessment typology offers social workers, managers, researchers and policy-makers both valid and reliable baseline measures for use in evaluating residential services for children and young people. The typology also provides comparative interval measures for use in longitudinal evaluations of quality. Close attention needs to be given to the impact each of these variables has on the quality of residential group care services offered to children, young people and their families or significant others.

Assessment is usually something that social workers do with clients and their families. It is less common to find social workers making assessments of those kinds of residential programmes which might best suit the identified service needs of their clients. This paper outlines a typology that was developed through cross-cultural practice and comparative research to assist social workers, social service managers and researchers match client needs with those services which would be most responsive to those needs. In this way, social workers may achieve more discerning assessments of group care services for children and young people rather than simply ‘finding’ a placement.

As a form of human service, residential group care for children and young people has been exported in one form or another from the so-called ‘Developed World’ to the so-called ‘Developing World’ since the eighteenth century (Fulcher, 1997). Orphanages, children’s homes, residential schools and youth institutions are scattered throughout the world, many having adopted Western designs and cultural protocols, often without much conscious reflection. Indigenous models of group care can also be found, as noted amongst the Maori peoples of New Zealand (Tait-Rolleston et al., 1997) and elsewhere in Polynesia (Shook, 1985).

Group care is here defined as a physical setting in which children or young people are offered care — physical nurturing, social learning opportunities, the promotion of health and well-being, and specialized behaviour training — over the period of 168 hours per week. A 168-hour timeframe is used since it represents a full week of group care where normally ‘the show must go on’ 24-hours per day, seven days a week including weekdays, week-nights and weekends regardless of whether social workers are on- or off-duty, at home sleeping or on-call. Residential group care may be provided for brief periods of a few hours or days as with crisis intervention services, or weeks such as in post-crisis placement planning with children, young people and their families. It is not uncommon to find residential services offered to clients for several weeks or months, or a full school term, such as in treatment for specific health or mental health problems, learning deficits or control of behaviour that places a child or young person-or others-at risk. Residential group care is also provided for longer periods, even years, as in secure custody and treatment regimes for criminal offenders or the criminally insane.

All these services are delivered through the medium of residential group living where personalized learning programmes may or may not operate to support planned care and treatment for individual children or young people and their families. Any attempt to monitor the quality of group care services for children and young people requires that valid and reliable measures be used to assess the interplay between organizational dynamics and interpersonal processes that are structural features of any group care service. This paper introduces a differential assessment typology, detailing twelve variables that are structural in the production of residential group care services. These qualitative variables may be used in combinations of three or more to facilitate evaluative triangulation, as for example, in identifying when a crisis occurred, where it happened and who was on- or off-duty at the time. Alternatively, the variables can be used together to compile differential assessments of group care services for children and young people at local, regional or national levels (Fulcher and Ainsworth, 1981; Fulcher, 1983, 1997).

The dolls in the doll’s house
In group care practice, each encounter between worker(s) and child(ren) is framed by an historical-cultural context that can be illustrated using the metaphor of a Doll’s House (Fulcher, 1988). In the Doll’s House one finds the Matruska Dolls metaphor that Bronfenbrenner (1979) used to articulate his ecology of human development, or what Leigh (1998) defined as an ‘anthropological-ecological model’. The Matruska Dolls contain the immediate setting where u child is, here and now (micro-system) that is nested within a network of relationships with others in different settings that impact on what is happening here and now with this child (meso-system). The immediate setting and network of relationships that surround each child or young person in care are, in turn, nested within organizational and institutional structures that find and administer education, health cure, youth justice and social services (exo-system). Those organizational and institutional structures operate within a social and economic policy environment that sustains dominant care ideals and expectations of public order within State prescribed norms (macro-system). Without a Dolls’ House, the Matruska Doll metaphor leaves out a significant feature of child and youth care practice in any culture — the importance of history and culture which gives meaning to every event that takes place between worker(s) and child(ren) in any given setting (Maier, 1979, 1987).

The assessment typology
Twelve qualitative variables that frame the production of group care services for children and young people are set out below, with initial questions posed for each variable. Taken together, the questions offer a simple questionnaire that will assist social workers, managers, researchers and policy makers in making comparative assessments of quality outcomes in the production of residential group care for children and young people. Such comparative assessments are vital, now — more than ever before — when resource scarcity places stringent requirements on the costs of residential care and greater accountability for minimum standards of service quality.

Comparative variable 1: Social and legal mandate to deliver child and youth care services

What is the social and legal mandate that established this Centre to receive and provide care for particular children and young people?

By what authority is this social and legal mandate awarded and what limitations does it impose on the performance of workers employed (or otherwise engaged) to provide care at this Centre?

Over the past two decades, major legislative and policy changes have altered the mandate of residential group care and the way these services feature in the national child welfare strategies of most western countries. Contemporary health and welfare policies have been shaped by ‘ideologies of best practice’ that include normalization, de-institutionalization, mainstreaming, use of the least restrictive learning environment, minimal intervention and diversion (Fulcher and Ainsworth, 1994). In both Old and New Worlds, children and young people still in receipt of residential group care have much more specialized needs. Increasing numbers of children once admitted to residential care are now placed more appropriately with extended family networks, foster families or in semi-independent living arrangements in the community. The need for specialist residential services persists, however, to provide for the needs of very troubled and troublesome children. This remains a challenge.

The social policy mandate to provide care is today very different from what it used to be. It is interesting to note how colonial structures such as the English boarding school and the old Approved Schools were exported to all parts of the British Commonwealth where they have operated for more than a century as imported forms of residential child and youth care (Fulcher and Masud, 2000). The Approved School system is now substantially different, but the English boarding school still has its Commonwealth equivalent in most parts of the New World, still educating the ruling elite for new generations. It should come as no surprise to learn that the 1950s policy vision of family homes for post-War English children was exported to many parts of the New World which was re-building after a decade of war.

Western visions of ‘best practice’ were eagerly imported to Commonwealth countries by civil servants touring the Old World to review child and youth care services. To this day, the term ‘family home’ confuses the development of quality foster care in New Zealand, since these two forms of childcare were considered, until very recently, to be one and the same! Family homes were residential homes designed for the placement of family groups and normally accommodated six to eight children with live-in house parents. In contrast, foster homes involve placements for one or more children with another family. A country like New Zealand prided itself in establishing a ‘God’s Own’ vision of European utopia in the South Pacific. Each new phase of social policy reform imported from post-war Britain was refined until, by the early 1980s, New Zealand had one of the most elaborate welfare states in the world.

Changes in the social and legal mandate for child and youth care services represent transformations in political and professional attitudes towards children. These reflect what Fox-Harding (1991) called ideological assumptions about family responsibility for the care of children. Social, political and economic changes in the New World over the past decade have been, in some ways, even more radical than Old World revolutions since the end of the nineteenth century. These New World revolutions may not have been so protracted or bloody, but the effects of social transformation have been no less significant. In the former Old World colonies of the South Pacific, ‘community responsiveness’, ‘targeting’ and ‘quality of services’ have become the rhetoric for public sector reform, cuts in public expenditure and non-intervention in the lives of children (Fulcher and Ainsworth, 1994).

Comparative variable 2: Siting and physical design of the centre

Where is this Centre located geographically in relation to the communities where these children and young people were living, and what access to transport is available for family members to visit, or for the residents to maintain links with school, work and community life?

To what extent does the age and architectural design of this Centre and the internal allocation of its public and private living spaces contribute to the achievement of identified care outcomes with particular children or young people?

In a rapidly changing world, there have been many changes in the architectural design of facilities used for residential child and youth care services. One generalization is to say that facilities are no longer located in isolated areas. Residential centres are now found nearer to where the majority of the population lives, where transport costs can be reduced and services made more readily accessible to families, professional groups and support services. Another generalization is to say that residential services are smaller than they once were. The residential care village can still be found, whether in nineteenth-century examples such as ‘Barnardo’s Village’ in East London, or ‘Quarriers Village’ in the West of Scotland.

Twentieth-century examples of therapeutic community villages can be found in Scandinavia and there are SOS Children’s Villages scattered throughout the developing world. There are ‘purpose-built’ residential facilities everywhere with the wrong purpose built into them! Facilities built in one decade have proven difficult to adapt as ideologies of best practice in the delivery of child and family services changed in subsequent decades. The idea that children in care should live in circumstances that do not distinguish them from other children is now common, and the doors in residential facilities also have fewer locks

A number of voluntary organizations found operating throughout the Commonwealth — notably Scouting, Outward Bound and the New Zealand ‘Spirit of Adventure’ sailing programme — use bushcraft, life skills training and group living to promote child and youth development. Programmes known as Kohanga Reo (language nests) combine childcare and Maori language recovery, using child and family group life as the active medium for learning (Te Whaiti et al., 1997). Changing care in a changing world means that colonial knowledge and indigenous knowledge are both being acknowledged to promote effective child and family services, especially in health care and education.

Comparative variable 3: Personnel complement and deployment of staff

How many workers are employed or otherwise engaged to provide 168-hours of care at this Centre over the course of any given day, week or month, and what designations are given to the roles and tasks assigned to each worker?

How are the care workers of all designations at this Centre, including management, rostered across a given 168-hour week and month to perform specific care roles and tasks with children or young people in pursuit of designated service outcomes?

The staff roster or work schedule is still one of the most important, and least used, data sources relating to quality outcomes found in any residential group care service. The most common arrangements are still either live-in house parenting with relief workers, or team work where staff are rostered on shifts to cover daytime, evening and night-time duties on a weekly or monthly timetable. With smaller facilities, there are generally-speaking fewer people to deploy and fewer live-in staff. In theory, at least, ‘community care’ means that services in the community are accessible to people through targeted expenditure and purchase of service, contracting with local providers. At the extreme, one can find several staff rostered around individual children or young people, offering planned programmes of care and specialized behaviour training.

The capacity of a team of carers to work closely together, with a shared vision and agreed practices, is vital if that care team is to deliver a group care service of consistent quality (Casson and George, 1994; Fulcher, 1991). The length of time that staff have been employed as care workers is not always indicative of quality performance with children in care (Fulcher, 1983; Burford, 1990). However, children and young people benefit enormously when they experience continuity in relationships with adults while plans are being worked out to place them more appropriately elsewhere (Maier, 1987). The ratio of male and female influences in the lives of children, and staff with life experiences not too far removed from those experienced by the young people in care, are also important determinants of quality (Fulcher, 1991). Each time one hears ‘Who’s on duty tonight?’ one obtains confirmation of how this variable impacts on the quality of a group care service. Children and young people make very discerning judgements about the carers in their lives, and about the care they receive from those carers. That is why there is often so little tolerance for superficiality or a lack of authenticity in life-space encounters with children and young people in care.

Comparative variable 4: Recurring patterns in the use of time and activity

What recurring patterns are discernible in the way that time is structured, from wake-up time to sleep-time in the daily lives of children or young people, and from weekdays, week-nights or week-ends on the part of care workers?

What activities are formally timetabled to occur for children or young people at specified periods of each day or week at this Centre, and what commonly occurs at other times, regardless of whether this involves unstructured or informal activities?

In residential group care for children and young people, the timing of activities is very important if daily and weekly rhythms are to be established and maintained, thereby facilitating opportunities for child development (Maier, 1979). Any young person who has lived in care knows how residents almost always know more about what’s happening in a residential centre than the staff do (except in the morning when nobody wants to get up for school). If purposeful use of time and activity is a core feature of quality care, then a starting point for evaluating these services must be the question: ‘How do the activities in which children or young people engage in this Centre support the mandated objectives of the service?’ A weekly Time and Activity Schedule can be used to collect valid and reliable data that is both readily available and easily compiled for this purpose (see the worksheet in Appendix A and Figure A1).

Another pattern highlights the extent to which transition periods are the times when predictable crises most commonly occur in the lives of children and young people. It is not surprising to find incidents occurring at the start or end of school days, after meals, the start and end of a weekend, or from one day to another, as in being home by midnight. Residential staff are encouraged to use the weekly Time and Activity Schedule to reconstruct a sequence of events in a Centre that may have developed into a crisis, as in formally reviewing events after an absconding, a theft, an assault or a suicide attempt. The Time and Activity Schedule can also be used for planning how to introduce new energy into group life (VanderVen, 1985), as well as providing a valid and reliable research instrument for use in service evaluations.

Comparative variable 5: Admission and discharge practices

What assessment protocols and rituals of encounter are employed with each new person arriving at the Centre and in joining the living group of other children or young people and care workers already living there?

What assessment protocols and rituals of separation are used to inform decisions and activities around each person leaving a particular residential living group at this Centre?

The way new members join into group living activities and the rituals associated with how members leave, are frequently neglected aspects of practice in residential group care. Considerable teamwork and staff commitment is required to connect with a frightened or angry young person entering a residential service. With staff turnover still high in many places, there are times when it is hard enough just ‘keeping the show on the road’, let alone offering a personalized care and treatment programme from the first ‘golden hour’ of opportunity (Fulcher, 1994).

Rituals of induction into group life that take account of the developmental needs of each new resident are basic to the efficient and effective use of this costliest of all forms of human service. ‘Rites of passage’, ‘graduation’, ‘termination rituals’, ‘rites of excommunication’, ‘expulsion’, and ‘last rites’ are important features of group life in any culture. It is in this sense that rituals of encounter between carers and children, and between carers and families, are critical to the quality of exchanges that follow. Would that practices around beginnings and endings with children and young people in residential group care were informed more directly by the collected wisdom of learned elders and teachers.

In using this variable to make assessments of the quality of a group care service, workers may want to give special attention to the interpersonal processes that a staff group puts in place for the admission and discharge of each new resident. If one makes reference to crisis theory, then the initial four to six weeks of a child’s stay will be critical. Those group care services that are most responsive to the needs of children and young people will frequently adopt the principle that the first hour that a child is with us is the most important. It follows, then, that the first day, the first weekend, the first week and the first month are the most important. A less helpful practice can also be found where care staff work from the principle that it is important for the child or young person to settle in and not be pressured to form relationships during the first month or two. However, this all too often results in the induction of new residents being handed over to the residents who implement their own rituals of encounter regardless of whether these are in the best interests of that child. One can see that we support a more pro-active approach to admission since theories associated with role socialization and cultural safety are too important to justify waiting (Fulcher, 1998). The same arguments hold for discharge planning since outcomes achieved with a young person are placed in jeopardy when endings are ignored or not carefully considered.

Comparative variable 6: Social customs and sanctions

What social rituals or customary practices are followed with children or young people over the course of any day, week, month or year at this Centre, and how did such rituals or practices become established?

What behaviours are subject to negative sanction or punishment at this Centre, and what is the nature of those sanctions? What behaviours are positively sanctioned or encouraged, and how is this done?

As referred to here, social customs involve the behaviour expected of residents and workers engaged in the provision of group care at a particular centre. There are both public and private customs, as found when observing children and staff together, and when observing them taking part in separate activities (Polsky, 1962; Roth, 1963). Interactions between residents and staff in residential group care have been the focus of on-going study in both the Old and New Worlds since the Second World War (Ainsworth and Fulcher, 1981; Davies and Knapp, 1981; Fulcher and Ainsworth, 1985). All such studies have reinforced the importance of public-private and overt-covert dimensions of group life in residential care services.

When considering sanctions that are used in a group care service, one needs to examine the rules that frame behaviour. These frequently involve economic or political acts by staff in authority to encourage or coerce children or young people into conformity with prescribed norms of conduct and social order (fines, withholding pocket money, gating, etc). Sanctions also reward behaviour, as in sanctioning a treat or outing. It is pleasing to see that some sanctions used in residential centres during the 1960s and 1970s, such as isolation rooms and physical restraint, are no longer so commonly used. The use of physical restraint with children or young people in care is now much more carefully regulated by law. At the same time, staff must be careful about sanctioning routine home visits at the weekends when these may result in young people simply returning to unsupervised activities, such as drug use, that placed them at risk in the first place. To be effective, sanctions — both positive and negative — need to be personalized and tailored to the needs of each child or young person. Otherwise, they simply become house rules and routines, often with little direct meaning for the children or young people involved.

Acknowledgement is given here to the important work of advocacy groups and policy reformers whose work in support of children’s rights have helped to close exploitative children’s homes, and thereby reduce institutional abuses and deaths of children in care by significant levels (Bukenya, 1996). Such reformers have done much to expose the emotional, physical and sexual abuse of children, so tragically linked with the history of residential group care. That residential group living has the potential to sanction abuse, as easily as it can stimulate pro-active involvement in the development of children, is testament to how powerful residential environments can be in shaping human behaviour and promoting good quality outcomes for children.

Comparative variable 7: Social climate of the centre

To what extent do workers and children or young people acknowledge the physical, emotional, cultural and spiritual safety of their group living and learning environment, and the social climate offered by this Centre?

To what extent does the organization of care work and interpersonal processes operating amongst care workers promote a social climate of group care that supports positive service outcomes for children or young people at this Centre?

The social climate of a residential service is grounded in the experience of every direct care worker who has learned to read subtle indicators in the rhythms of care with children or young people and take action. Such rhythms of care have physical safety and bodily comfort — tailored to the needs of each child — at the core of care. As Maier (1979) noted, care for the caregivers is an essential feature of quality in the delivery of group care services for children and young people. It is well known how Moos (1976) devised a methodology for measuring social climate in residential living environments that is now used world-wide in outcome studies of service production in group care.

The Relationship Dimension of social climate focuses on the extent to which residents and staff participate together in the activities that take place in their living environment. This dimension also focuses on the extent to which staff and residents support and help one another, and the degree of spontaneity and open expression that exists amongst the members. The Personal Development Dimension focuses on personal growth and self-enhancement for individual residents and this will vary from setting to setting, depending on policy mandate, funded purpose and performance objectives for particular children or young people. The System Maintenance
and System Change Dimension of Social Climate remains fairly constant across all residential environments, highlighting issues like orderliness, clarity of expectations, degree of control, and responsiveness to change that differentiates one group care service from another.

There remains a tendency to take research measures developed in one cultural context, such as North America or Western Europe, and apply these naively in other contexts, such as South Africa, New Zealand or Australia, and also Asia. Those seeking to evaluate performance outcomes in residential care often forget that social climate, like personality, is embedded in culture. Different cultures identify different issues when seeking to ensure that a social climate of care and support is offered to their children. The New Zealand Maori concept of tahawairua acknowledges a spiritual dimension of social climate that is not easily identified in European ‘Old World’ terms. Indigenous people from around the Pacific Rim, in the Americas, Asia and Africa are now speaking out. They are using Western law to reaffirm their own traditional knowledge and practices that may be more culturally responsive to the needs of their people (Fulcher, 1998).

Comparative variable 8: Links with family, school, and community

Who are the people who visit this Centre, for what purpose, and which children or young persons benefit from such visits?

What links and social networks are maintained or facilitated between children or young people living at this Centre and family members, peers, school or work mates, and others living elsewhere in the local neighbourhood or community?

Family involvement in residential services has long been identified with quality outcomes for children and young people in receipt of care (Burford and Casson, 1989). While there is often talk of family involvement, actual practice does not always prove the theory (Ainsworth, 1997). Families still have to go to enormous lengths to stay involved in the care of their children when the State intervenes (Pennell and Burford, 1995). It is in the nature of residential care that family involvement presents a paradoxical reminder that family relationships and circumstances contributed to out of home placement. And yet, successful placement within the extended family network is still likely to result in the highest quality outcomes for children in the longer term.

One cannot avoid making links with the formal education system when seeking to provide quality care for children in a residential care setting. One must hope that no child is now admitted to care, regardless of’ for how short a period, without someone checking out literacy, numeracy, basic communication skills and learning abilities that may be shaped by deafness, speech impairment or specific learning disorders (Fulcher and Small, 1985). This aspect of residential practice highlights inter-disciplinary activity, where different professional boundaries and roles have to be crossed in order to focus on the needs of individual children (Hopkinson, 1985).

In New Zealand, there is not much that is positive to say, at present, about the links between special education, health, mental health and welfare providers when children and families need specialist care and treatment services. And yet links with the local community remain central to the production of quality outcomes for children or young people at a time when new group care services are being established after the closure of old residential services a decade ago. Whether the community is welcoming, is responsive, is inclusive, or is reactive to the needs of children and families (Dunlop, 1998), positive links with community life are still fundamental to successful post-placement adjustment. In most places, however, community involvement just happens whether it is actively considered and planned by those working with a child, or not. Sadly, there are a lot of unreal expectations about community involvement on the part of policy makers and those who control funding decisions.

Comparative variable 9: Criteria used for reviewing and evaluating performance

By what performance criteria are decisions made about the admission, progress, length of stay and post-placement planning for each child or young person living in this Centre, and how is their performance monitored and reported on a daily, weekly, monthly or quarterly basis?

By what criteria are care workers recruited, trained and supervised in their care work, and what performance review protocols operate — either formally or informally — to guarantee minimum standards of quality for all services offered to children or young people living at this Centre?

In most parts of the Western world, those producing residential group care are now required to evaluate the services they produce with clients. This takes time and involves a lot of paperwork. Comparative study finds criteria ranging from vague comparisons of one young person being like another, to elaborate schemes that monitor and evaluate psychosocial development and behavioural competencies. Length of stay is one quality performance criterion upon which most agree, and this has reduced dramatically over the past two decades. In New Zealand, for example, the legislated length of stay for young offenders is now 8 to 12 weeks without further court action. While length of stay has become an important criterion in the evaluation of residential services, it is difficult to argue with those like Scull (1977) or Davies and Challis (1986) amongst others who have shown how cost has reduced length of stay more than any other influence.

As a practitioner in this field, currently the Joint Warden of a 260-bed University Hall of Residence for First Year students for the past 14 years, experience has shown how it is easier to talk about ‘Quality Outcomes’ than it is to produce them. The emphasis now is on measuring outcomes, and quality outcomes are essential when funding is dependent on performance. Children and families need to benefit from such measures, so long as quality is measured in
ways that involve these recipients of care services and take their views seriously. In New Zealand, service objectives for children and families have been linked with performance bonuses for staff in the post-1990 industrial relations arena (Harbridge et al., 1996). Ironically, the more practice and research expertise available in this field, the less one finds this practice wisdom readily available to front line caregivers. Most still work from the heart, and such an approach contributes to a lot of heartache (Guttmann, 1991).

Comparative variable 10: Theoretical, philosophical and ideological determinants of care

What beliefs or philosophy of care are given as justification for the way this Centre operates and the standard of care it produces for children or young people living here?

What taken-for-granted assumptions or ideologies frame external decisionmaking, referrals and quality standards for the provision of group care to children and young people living in this Centre?

The technical, moral and philosophical justifications used by producers of residential group care to account for their activities with the consumers of that service are not always open to scrutiny. Justifications given by junior staff to a supervisor concerning their actions with a child are usually framed in very personal terms that reflect basic attitudes, beliefs and moral values. Justifications can also be found embedded in religious beliefs (such as in the Rudolph Steiner movement or Islamic teachings), theoretical orientations (as with behaviour modification), political philosophy (as with the Jewish kibbutzim) or indigenous practices (as with Maori language nests). Israeli writers such as Eisikovits, Beker and Guttmann (1991) and Arieli and Kashti (1991) amongst others have shown how collectivist ideology that formed the basis for the kibbutzim movement, is closely related to the childrearing practices still found in these social laboratories today. The same can be said of the New Zealand Kohanga Reo centres (language nests) for those wishing their children to learn Maori language where practices are guided by traditional knowledge and practices handed down from the ancestors.

One still finds in both the Old World and the New, that few residential centres have a formal written statement that articulates the knowledge and value base which informs practice in that service. Collected wisdom (Philpot, 1984; Wagner, 1988; Kahan, 1989) substantiates the importance of a statement of purpose or mission that details and communicates a vision (Casson and George, 1994). More commonly, however, one finds that the value and knowledge base that informs practice in a residential centre is dependent upon a particular carer or carers, and little is written down. In an era of cost-benefit analysis and measurement of service outcomes (Knapp and Robertson, 1989), only those programmes that are clear about what they do and why they do it that way are likely to survive.

Comparative variable 11: Opportunity and social cost-benefit ratios in the delivery of group care services

To what extent does the financial reporting of income and expenditure distinguish between the cost of human and material resources in the operations of this Centre, and how detailed is the operating cost differentiation?

Is there a favourable Opportunity and Social Cost-Benefit Ratio in the outcomes produced for children or young people 6 to 12 months after leaving this Centre, given the cost of producing services while they were living in this Centre, or projected outcomes had they lived elsewhere?

No single variable will impact more directly on both the quantity and quality of residential group care services for children and young people in the twenty-first century than cost. Whether one focuses on the plight of children in the refugee camps of Africa, the Balkans or East Timor, or questions who pays for a young sex abuser requiring specialized medical care or residential treatment, the outcomes are now almost always framed by cost. Families able to pay for specialist treatment or with insurance cover can now access the best services available anywhere in the world. For those families who cannot pay, the situation is very different.

The New Zealand economic experiment (Kelsey, 1996) is one that has been closely followed by the international community. Fundamental to that economic experiment was the notion of a ‘purchaser-provider split’ where the ‘purchaser’ of services (usually government) is no longer responsible for the actual ‘provision’ of services. Under such limited liability arrangements, somebody else has contractual responsibility and obligations, not Government. This dual role is now considered fiscally and politically incorrect, even though such dual roles have worked quite effectively elsewhere. In New Zealand one also finds the separation of state sector functions between policy and operations. A standing joke has the right hand not knowing what the left hand is doing, except shuffling paper and answering ministerial questions.

Elsewhere (Fulcher and Ainsworth, 1994), it was shown how child and youth care service reforms in New Zealand have been re-shaped through the introduction of six ideologies of ‘Best Practice’, which, as mentioned earlier, included normalization, de-institutionalization, mainstreaming, minimal intervention, diversion and use of the least restrictive environment. However, behind the ideological camouflage, it is more accurate to say that services were re-shaped through implementation of monetarist economic policy and commercial accountancy practices that had little regard for best (or even good) practice in the delivery of services for children (Mason, 1992).

In concluding her analysis of New Zealand census data collected on four occasions between 1981 and 1996, Davey claimed there were ‘few areas of improvement in indicators of well-being for [New Zealand] children and young people’ (Davey, 1998, p. 250). Sadly, quality outcomes for New Zealand children between 1995 and 1998 were largely measured through public and private inquiries into deaths of children in care. Quality outcomes were also measured through questions about whether to provide free health care to children under the age of six, by disclosures of abuse and neglect of children in the hands of former carers or teachers, and by long-term expulsions of young people from schools. Even more worrying is the fact that New Zealand has had a youth suicide rate amongst the highest of all OECD countries for the past decade.

It is argued that the so-called ‘New Zealand economic miracle’ may not have warranted all the positive international attention it received, although the first election under Mixed-Member Proportional representation in 1996 introduced a new set of political ground rules that may shape how the ‘miracle’ is managed for the twenty-first century. These days, unless individual children and families are targeted for special consideration, thereby experiencing the shame of being labelled a family or child in need, they are on their own.

Comparative variable 12: The public policy environment and organizational turbulence external to the centre

What has been the extent of public policy reform, budget cuts and organizational re-structuring external to this Centre during the past three to five years?

In what ways do care workers, managers and others think that organizational turbulence and change in government, commercial and international affairs might impact on the standard and continuity of services offered to children and young people living at this Centre over the next twelve to eighteen months?

Legislative change and the re-structuring of residential services at neighbourhood level, as well as on a regional and national scale, have become commonplace in New Zealand, Australia and South Africa over the past decade, just as happened in North America and the United Kingdom a decade or two earlier. Research now offers important conclusions about how residential services are controlled by external forces, offering explanations for the way organizational turbulence —  external to residential services — impacts on the quality of outcomes produced for children and young people (Pfeffer and Salancik, 1978; Emery, 1977; Fulcher, 1988).

Changing care in a changing world is another way of saying that organizational turbulence is now commonplace in the provision of human services. There is less that is predictable in our world now, and there is much that is turbulent. The world was shocked by the massacre of children at Dunblane Primary School and killings at Port Arthur in Australia. Our lives were similarly touched by the faces of frightened African and East Timorese children fleeing their homes amidst the organizational turbulence associated with de-colonization in those worlds. That child and family care involves political activity is nowhere more evident than in the policies of ethnic cleansing that separated Yugoslav children from three different cultures, each with significant religious, political and military alliances into Croatia, Bosnia and Serbia, and then again between Serbia and Kosovo.

Organizational turbulence unleashed by the restructuring of state infrastructures, whether by military dictate, political mandate or straight-up market forces, continues to have a dramatic effect on children and young people the world over. There is much yet to be learned about how to sustain quality care in the midst of organizational turbulence and uncertainty. The alternative means accepting that children will keep being used as cannon fodder in the cross fires of agency re-structuring or civil war. The ends seem to always justify the means, no matter how many get hurt along the way. Debates continue about the value placed on the life of a child, or the impact of caring for a family member at home without support (Opie, 1992).

Conclusion
Twelve structural variables that frame the production of quality outcomes for children and young people in residential group care have been introduced and discussed with the aim of helping social workers, managers, researchers and policy makers make more carefully considered differential assessments of residential group care for children and young people. Cross-cultural practice and comparative research has shown that by giving closer attention to the impact of each variable on service delivery one is able to better match client need with service responses, thereby enhancing the quality of group care produced for children and their families.

As Gilligan noted, it is no longer sufficient to talk about permanency planning for children and young people when the research shows how the rhetoric of permanency ‘is so frequently unattained (or unattainable) in practice’ (Gilligan, 1997, p. 13). As a guideline for practice, permanency is rarely able ‘to accommodate the complexity of the issues involved’ in placement planning for children and young people (Gilligan, 1997, p. 13). Social workers need to ask serious questions about whether to place a child or young person in still another out-of-home placement with an extended family or a new foster home when failed placements of this kind are readily apparent. It is important to avoid the ideology that assumes now that any family placement is better than a placement in residential group care. This is not to advocate for using residential group care with every child. The challenge lies in trying to match the most appropriate services with assessments of client need (Parker et al., 1991).

As research reported by Daniel et al.(1999) has shown, better outcomes may well be found through a focus on the resilience of children and young people in receipt of out-of-home care. This can be achieved through provision of a secure base, realistic educational opportunities, meaningful friendships, encouragement of talents and interests, reinforcement of positive values and promotion of social competencies (Daniel et al., 1999, pp. 7-12). These practice researchers concluded that ‘social workers cannot do it all’ for children, young people and their families (1999, p. 13). Residential staff, foster carers and befrienders play a key role in reaffirming the importance of normative activities with children and young people, through legitimizing common sense approaches that strengthen relationships and place the emphasis on strengths instead of problems. Most important, these researchers highlighted the significance of giving children and young people experiences of continuity. This requires that those who are providing services need the space and time to be available when they are needed (1999, pp. 13-14).

When considering whether a child or young person requires out-of-home placement, no matter for what length of time, social workers need to assess whether there are positive reasons for deciding on peer group living in a non-family environment. Furthermore, social workers need to be clear about what it is they are looking for in terms of a service response, and what makes one particular residential service more suited to a particular client’s needs than another. Otherwise, placements in residential care will continue as twenty-first century dumping exercises relied upon only after repeated alternatives have failed.

_________

Appendix A: Time and Activity Schedule worksheet

Learning Objective: To identify and account for time and activity in the operation of this particular group care Centre. (Time refers to the maximum hours per week that children or young people and care workers are engaged in formal or informal activities. Activity refers to both client and staff activities which relate to the Centre’s operation and service objectives.)

Figure A1
Sketch or drawing:

  MON TUES WED THURS FRI SAT SUN
0700              
0800              
0900              
1200              
1300              
1500              
1700              
1800              
1900              
2100              
2200              
2300              
2400              
0600              

Materials: Staff work roster/schedule, graph paper, ruler, pencils, black pen and Activity Schedule (if available).

Procedure:

  1. Prepare a 7-day week calendar divided into 24-hour time blocks (see example above).

  2. Identify waking time and lights-out time for each day.

  3. Identify meal times, school/activity/work periods, recreation periods and time for chores.

  4. Identify all other ‘structured’ activities in which clients are expected to participate each day.

  5. Identify all free time periods and time which could be used for other programme activities.

  6. Identify all time periods when family members, school or work mates and others visit.

  7. Identify when changes of shifts occur and how many staff are on duty at any time during the 168 potential hours of care available.

As seen in the example in Figure A1, one immediate theme highlighted through compilation of a Time and Activity Schedule is the extent to which the staffing roster shapes the programme or whether the programme is planned for particular children.

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This chapter: Fulcher, L. (2001). Differential assessment of residential group care for children and young people. British Journal of Social Work, 31.  pp. 417-435.

*This is the fifth in a new series of chapters which the authors have permission to publish separately and which they have now contributed to CYC-Online. Read more about this program