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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Russia Country Report

N/A, 2003

Country report of Russia on the situation of children in residential care in anticipation of the Second International Conference on Children and Residential Care: New Strategies for a New Millennium, to be held in Stockholm 12 – 15 May 2003.

Designing Research to Study the Effects of Insitutionalization on Brain and Behavioral Development

Charles H. Zeanah, Charles A. Nelson, Nathan A. Fox, 2003

An overview of the largest longitudinal investigation of institutionalized children less than 2 years old ever conducted.

Investigation into the Condition of Shelters in Rio de Janeiro

Brazilian Association Terra dos Homens (ABTH) and Exola, 2003

This research study provides statistical information on institutional care of children under the age of 12 in Rio de Janeiro, Brazil. Interviews with institutions and children are conducted, and reasons for separation from family, length of time in care, status of family relationship, religious orientation and financial support of the institutions are highlighted.

UNICEF Statement for Stockholm Conference on Residential Care

Rosemary McCreery, 2003

A statement, by UNICEF for the Stockholm Conference on Residential Care, which recommends a move away from institutional care for children and offers the ‘protective environment’ framework as a solution which encourages protective legislations and policies, public debate, government commitment and the need to listen to the children. The statement includes lessons learned about the issue of children without family care and recommendations for reform.

Mapping the number and characteristics of children under three in institutions across Europe at risk of harm

Professor Kevin Browne and Dr Catherine Hamilton-Giachritsis, 2003

This 15-month project aimed to map the number and characteristics of children under three placed in European institutions for more than three months without a parent as this information was previously unknown.

A Last Resort: A Growing Concern About Children in Residential Care

Andrew Dunn, Elizabeth Jareg, and Douglas Webb, 2003

This paper outlines the International Save the Children Alliance’s position on residential care. It addresses the proliferation of residential care, its negative impact on children and the need for international attention. The paper presents the work of Save the Children and other agencies in order to highlight relevent issues and to provide a guide for those working with separated children.

Community Based Care for Separated Children

David Tolfree, 2003

A paper discussing the shortcomings of systems in which separated children are placed into residential/ institutional forms of care. It also considers community-based and some other forms of care as alternative approaches to preventing unnecessary separation of children from their families.

Residential Special Schools, National Minimum Standards. Inspection Regulations

Department of Health, UK, 2002

A set of standards for ensuring the welfare protection of children in residential special schools. It includes standards and outcomes relating to children’s rights, protection, and care, as well as staffing, organization and management.

Institutions vs. Foster Homes: The Empirical Base for a Century of Action

Richard P. Barth , 2002

A review of institutional care and family-centered care with a discussion of both positive and negative aspects of group care. This review paper is primarily focused on showing the inefficacy of group care and recommending other forms of care such as kinship care and even foster care as options that are more cost effective and better for children’s development.

Children's Homes National Minimum Standards: Children's Homes Regulations

Department of Health, England, 2002

A set of standards for ensuring positive welfare, health and education in children’s homes. It includes standards and outcomes on planning for care, quality of care, complaints and protection, care and control, environment, staffing, management and administration, and specialist provision.