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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Toolkit for a Residential Childcare Institution Situational Analysis in Kenya: Pilot in Kisumu, Nyamira, Kiambu, and Kilif

Ministry of Labour and Social Protection, State Department for Social Protection, Department of Children's Services - Republic of Kenya, 01 Feb 2020

This toolkit is developed for use by the Department of Children’s Services (DCS) and its partners engaged in care reform in Kenya. The tools herein are designed for a rapid situational analysis of children’s care institutions/statutory care institutions (CCI/SCIs) and the children living in them, and as a complement to any information already existing in the child protection information management system (CPIMS) or other government endorsed data.

Situational Analysis Report for Children's Institutions in Kisumu County

Ministry of Labour and Social Protection, State Department for Social Protection, Department of Children's Services - Republic of Kenya, 01 Feb 2020

The purpose of the situational analysis is to provide a snapshot of Charitable Children’s Institutions (CCIs), other private childcare institutions and Statutory Children’s Institutions (SCIs), and the children living in them in Kisumu County, Kenya.

Situational Analysis Report for Children's Institutions in Five Counties: Kiambu, Kilif i, Kisumu, Murang’a and Nyamira Summary Report

Ministry of Labour and Social Protection, State Department for Social Protection, Department of Children's Services - Republic of Kenya, 01 Feb 2020

The purpose of this situational analysis is to provide a snapshot of charitable children’s institutions (CCIs), other private childcare institutions and statutory children’s institutions (SCIs) in Kenya, and of the children living in them.

Attachment provision in the Saudi orphanages: Exploring the narratives of residential staff

Antigonos Sochos & Najla Al‐Jasas - International Journal of Social Welfare, 27 Jan 2020

This qualitative study explored the accounts of 50 residential childcare staff in Saudi Arabia, aiming to identify ways in which staff and residential institutions may function as attachment objects for the children in their care.

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The Use of Sleep Medication in Youth Residential Care

Beate Oerbeck, Kristin Romvig Overgaard, Vidar Hjellvik, Jørgen G. Bramness, Berit Hjelde Hansen, and Lars Lien - Journal of Child and Adolescent Psychopharmacology, 23 Jan 2020

The purpose of this study was to investigate the use of sleep medication and concomitant psychotropic medication in children and adolescents placed under residential care (RC) in Norway.

Child maltreatment, maladaptive cognitive schemas, and perceptions of social support among young women care leavers

Nadine Lanctôt - Child & Family Social Work, 21 Jan 2020

The purpose of the study was to evaluate the associations between child maltreatment, cognitive schemas of disconnection/rejection reported in emerging adulthood, and social support perceived in emerging adulthood among young women who have exited placements in residential care.

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Correlates of Entry into Congregate Care Among a Cohort of California Foster Youth

Lindsey Palmer, Eunhye Ahn, Dorian Traube, John Prindle, Emily Putnam-Hornstein - Children and Youth Services Review, 17 Jan 2020

In the current study, the authors identify specific child protective service experiences and mental and behavioral health characteristics that are predictive of moving from a family based foster placement to a congregate care placement.

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Staff support and adolescent adjustment difficulties: The moderating role of length of stay in the residential care setting

Adena A. Hoffnung Assouline & Shalhevet Attar-Schwartz - Children and Youth Services Review, 12 Jan 2020

This study examines the link between perceived staff social support and emotional and behavioral adjustment difficulties of adolescents in educational residential care settings (RCSs) designed for youth from underprivileged backgrounds in Israel.

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Why Place Matters in Residential Care: the Mediating Role of Place Attachment in the Relation Between Adolescents’ Rights and Psychological Well-Being

Eunice Magalhães & Maria Manuela Calheiros - Child Indicators Research, 07 Jan 2020

For this study, a sample of 365 adolescents in residential care settings in Portugal completed a set of self-reported measures, specifically, the Rights perceptions scale, the Place attachment scale and Scales of psychological well-being.

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Early childhood deprivation is associated with alterations in adult brain structure despite subsequent environmental enrichment

Nuria K. Mackes, Dennis Golm, Sagari Sarkar, Robert Kumsta, Michael Rutter, Graeme Fairchild, Mitul A. Mehta, Edmund J. S. Sonuga-Barke - PNAS, 07 Jan 2020

To investigate the impact of childhood deprivation on the adult brain and the extent to which structural changes underpin these effects, the authors of this study from PNAS utilized MRI data collected from young adults who were exposed to severe deprivation in early childhood in the Romanian orphanages of the Ceaușescu era and then, subsequently adopted by UK families.