Residential care: an effective response to out‐of‐home children and young people?

Abstract

A B S T RA C TThe ever-growing number of out-of-home children in Italy over the last decade has urged an assessment of the available care services. Although foster care is spreading rapidly, many young people are still housed in residential facilities. Reflection on residential care quality has intensified at both a national and an international level. This paper presents the results of a study on residential care facilities for children and young people in the region of Northern Italy (Lombardy). Four dimensions of 'quality' are considered: efficiency, effectiveness, participation in planning and intervention, and empowerment of children and their family relationships. The combined effects of these dimensions are defined as 'relational quality'. The results show that residential care facilities are generally good, while Social Services resources often appear inadequate for interventions aimed at birth families (efficiency). The well-being of children in residential care facilities is high, even if they tend to move from one facility to another, rarely returning to their birth family (effectiveness). The involvement of children and their families at different stages of the care path is limited (participative approach). Finally, the most critical element is the failure to properly involve birth families (empowerment).bs_bs_banner

Participation of youth in decision‐making procedures during residential care: A narrative review

“…Several studies do report on indirect effects of participation during residential care in terms of young people's experiences related to the (lack) of participation (Brown et al, 2011;Carrà, 2014;Fudge Schormans & Rooke, 2008;Hepper et al, 2005;Roesch-March, 2014). In Figure 2, we present a schematic overview of the outcomes we found, which related to the young person's participation process.…”

“…Challenges and facilitators related to the young person's care trajectory and treatment are shown in four studies and refer to the number of prior placements (Southwell & Fraser, 2010) and the stages of the care path (Carrà, 2014;Hepper et al, 2005;Salamone-Violi et al, 2015). With regard to prior placements, young people who experienced less than four alternative placements prior to their stay in residential care reported more often that their caregivers (professionals) listened to them compared with their peers reporting more than four placements (Southwell & Fraser, 2010).…”

“…Focusing on meaningful participation (Brown et al, 2011;Carrà, 2014), studies either reported a rationale why participation was necessary, which related to the young person (e.g., autonomy and valuing the role of the young person), or related meaningful participation with care effectiveness (e.g., service delivery and reduction of inadequate planning). One study (Carrà, 2014) In the studies included in this review, the young people have limited possibilities to "meaningfully" participate in decision-making while staying in residential care (cf. Sinclair, 2004).…”

“…Several studies do report on indirect effects of participation during residential care in terms of young people's experiences related to the (lack) of participation (Fudge Schormans & Rooke, 2008;Hepper et al, 2005;Roesch-March, 2014), such as distressing feelings and passiveness due to lack of participation (see also LeFrançois, 2008;Polvere, 2014). Only Carrà (2014) focused on the connection between participation and outcomes. The author reports that a higher level of youth participation in decision-making is significantly, but moderately, associated with care effectiveness in terms of the young person's level of emotional well-being.…”

Parental empowerment and child behavioural problems during youth care involvement

“…This statistic may indicate that, during treatment, no significant attention is paid to strengthen children's parents in their complex home environment. Therefore, elements of FCS directed at families during children's out‐of‐home treatment are increasingly being proposed and used to support an optimal development of children, to promote a successful family reunification, or to stimulate acceptance and parent–child bonding when returning home is impossible (Berrick, Cohen, & Anthony, ; Carrà, ; Haans, Robbroeckx, Hoogeduin, & Van Beem‐Kloppers, ; Hair, ; Knorth et al, ). Parental empowerment is an important factor in this approach.…”