NUMBER 946 • 20 APRIL • residential care
What helped to make this home ‘a star’ for us was:
(a) Staff had a culture of learning
This was a staff group with a culture characterised by learning from one another and from others about good practice. In describing what they did with young people during the course of the days, weeks and years they were resident, staff demonstrated how they operated at the frontier of young people’s needs. They knew how to handle transference of anger from a child to a member of staff after a rejection at home; they knew how to help a young woman out of severe depression and a serious overdose, even though none of them had psychological training or formal social work qualifications. Their sense of effectiveness contributed to their self-esteem: they knew what they were doing and why they were doing it, and could appreciate the small and large successes they had with young people. Importantly they were able to challenge others’ practice – with a social worker who wanted to move a young person out of the home when she reached 16, they cited a coffee-stained copy of volume 4 guidelines to The Children Act 1989 (Department of Health, 1991), as a reason for keeping the child until she was ready to move. They kept her until she had turned 18. They knew the young people so well that they were able to learn with schools how to continue to educate even the unruly, and to learn with health services staff how to provide appropriate health care. All staff made time for talking to others inside and outside the home.
(b) Management was supportive of the staff group
Staff were supported in their good practice by a line manager, wholly committed to residential care who spent regular time (a morning once a month) in the home. The senior manager, also, had experience of residential care and regarded working towards a plan for all children in need that included residential provision, as a very important part of the management task. The director in this authority was accessible, prepared to hear and respect a plausible argument from any member of staff.
(c) Work to improve network communication was an ongoing and regular occurrence
Staff also sought to improve communication with the network. For education, this meant the authority, and the schools. With health, staff felt that local GPs were possibly easier to educate about the needs of young people in care, than were other health services, e.g. psychological services. Mental health services for young people were very thin on the ground (National Priorities Guidance 1999/00 -2001/02 (Department of Health, 1998b) highlights the need for increased provision). Relationships with the police, the voluntary housing sector, and neighbours were all good because the staff in this home regarded making proper relationships with these local people as being as much a part of their ongoing task, as having a clear plan for meeting each individual child’s needs, and working with the group of young people as a whole. In other words this was a staff group which regarded the network around each young person and the home as being important. People came into this home regularly, and staff went out of it, often on their own time, to visit families, to regular meetings at schools or to talk to aggrieved neighbours, even though they rarely got mileage allowance for distant visits.
(d) Staff made time to reflect about work
If residential care is to be effective in meeting the needs of young people, then carers have to know what these needs are before a placement begins. This is often dependent on the field social worker who sees residential care (and a particular home) as being in a position to meet these needs, and who in most areas is responsible for the care plan. Unfortunately, field social workers are not always in a position to make a complete assessment of a child’s needs at the point when a child needs accommodation. Sometimes, in emergency, there is no plan. It is therefore extremely important that field social workers and carers should work together as soon after a placement is made in assessing the full range of a young person’s needs. Ideally they should work together to identify their goals for the young person and for his or her family, in line with the Looking After Children guidelines, and the Quality Protects objectives for children. Goals should be specific enough to guide the immediate work to be done, and should identify the longer term goals and the hoped-for outcomes of the placement. Plans should also identify who does what, and when and how the immediate work will be reviewed, to check that field social worker and care staff are not working at cross purposes. Time for reflection should be built into any plan to allow each set of staff and the child and family to learn from one another about what has changed. This applies to formal reviews, which serve different purposes from informal communications, which will be much strengthened if field social workers and care staff are working together towards the same ends. In more informal contacts, by phone or in person, what has gone well as well as what has gone badly should be learned from, if the professionals most closely involved are really going to meet complex needs. However, to do this, both field social workers and direct carers need management support: if there is no workload space to reflect, as part of the ongoing task, then decisions will be taken `on the hoof’, and staff concerned may well undermine one another’s work and begin to mirror the family splits which brought the young person into care. The staff in the home which was `a star’ for us used the actual research meetings (one morning each month) to reflect on the progress of the residents, and were determined to continue with such meetings with their line manager once the research was completed.
Archer, L. (2002) What Works in Residential Care: Making it Work. Scottish Journal of Residential Child Care, Vol 1, pp. 8-9