Residential Care

Residential care refers to any group living arrangement where children are looked after by paid staff in a specially designated facility. It covers a wide variety of settings ranging from emergency shelters and small group homes, to larger-scale institutions such as orphanages or children’s homes. As a general rule, residential care should only be provided on a temporary basis, for example while efforts are made to promote family reintegration or to identify family based care options for children. In some cases however, certain forms of residential care can operate as a longer-term care solution for children.

Residential care can be a positive alternative for some girls and boys when it is used appropriately and meets certain standards. For example, small group home living arrangements or supported independent living can work well in cases where children (often older teenagers) don’t feel comfortable in a family setting, or where large groups of siblings want to stay together. Similarly in cases where children have suffered trauma, severe abuse or neglect, have a severe disability or require specialised support, small group settings where trained staff can provide therapeutic care may be an appropriate care option. As much as possible, residential facilities should be small, community-based, organised to resemble a family-type or small-group situation and allow for sufficient staff to provide individualised attention to children.

It is important to distinguish between residential care and institutional care, which should only be used as a last and temporary resort for children. Institutional care refers to large-scale group care within big institutional facilities and has been associated with a wide range of problems for children including physical, social and emotional under-development - with babies and infants under the age of three especially vulnerable to lasting harm. Long periods in an institution can deprive children of positive individual attention from consistent caregivers, make it difficult for them to assimilate back into a family and community, and are often linked to increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline.

In recent years, deinstitutionalisation has been at the heart of national care reform efforts, which seek to reduce reliance on institutional care and to promote family and community based care options for children instead. This includes efforts to promote ethical volunteerism within residential care centres, educate donors and to avoid proliferation of orphanages and children’s homes after humanitarian emergencies.

The documents in this section outline residential care options for children, examine the damaging impact of institutions, explore family and community-based care alternatives and describe care reform efforts including initiatives around ethical volunteerism.

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Swept Away: Street Children Illegally Detained in Kigali, Rwanda

Human Rights Watch, 01 May 2006

This report details the conditions of children held at an unofficial detention center in Kigali, Rwanda, held in overcrowded buildings and suffering from a lack of adequate food, water, and medical care, and subjected to abuse.

Policy on Alternative Care for Children - Cambodia

Kingdom of Cambodia, 01 Apr 2006

This document presents the full policy on the alternative care of children in Cambodia.

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Overuse of institutional care for children in Europe

Kevin Browne, Catherine Hamilton-Giachritsis, Rebecca Johnson, Mikael Ostergren , 25 Feb 2006

This article discusses the use of institutional care for children in Europe and shows that it remains common place despite the evidence of harm for children, including attachment disorder and developmental delay.

Provisional Protective Measures: The Principles to Be Observed During the Institutionalization of a Child (2 of 3)

International Social Service and International Reference Center for the Rights of Children Deprived of their Family (ISS/IRC), 2006

A brief 2-page overview of appropriate residential institution characteristics. Includes information on staffing, and the optimum size of each family-like unit.

Lesotho: Guidelines & Standards: Residential Care For Vulnerable Children & Youth

UNICEF, 2006

A situational analysis of policy and care surrounding children affected by HIV/AIDS in Lesotho. Includes a comprehensive, practice-oriented discussion of alternatives to residential care, placement procedures and standards of residential care.

Focus on the Right of Children with Disabilities to Live in the Community

Ines Bulic, Geert Freyhoff, Judith Klein, and Camilla Parker, 2006

Advocates for the right of children with disabilities to live in the community. Provides recommendations on how to ensure a successful transition from institutional to community-based care. Focuses on the importance of family support and the right to education.

TransMONEE Database

UNICEF Innocenti Reserach Centre, 2006

A website that contains statistical information on children in 27 countries across Central and Eastern Europe. The site contains relevant child protection indicators, including the number of children in institutional care.

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Provisional Protective Measures: The Principles to be Observed During the Institutionalization of a Child (3 of 3)

International Social Service and International Reference Center for the Rights of Children Deprived of their Family (ISS/IRC), 2006

A brief 2-page document that highlights the importance of child participation, post care planning, guarding against abuse, and connecting residential institutions with the surrounding community.

Violence Against Children in Care and Justice Institutions

United Nations Secretary General's Study on Violence Against Children , 2006

This is a chapter from the United Nations Secretary-General’s Study on Violence Against Children that specifically explores the factors contributing to violence against children in institutional care and justice institutions. This chapter includes sections on the sources of violence against children in institutional care, the impact of institutional care on children’s health and development, and the populations of children most likely to become institutionalized.

Alternative Care for Children Without Primary Caregivers in Tsunami-Affected Countries: Indonesia, Malaysia, Myanmar, and Thailand

UNICEF, 2006

An assessment of alternative care responses for children without primary caregivers in tsunami-affected regions of Malaysia, Myanmar, Indonesia, and Thailand. Includes good practices, recommendations, and detailed country reports.