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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Family Tracing for Children Without Adequate Documentation

Better Care Network, 12 Sep 2019

In this video, Dy Noeut and Kim Malin of New Smile Organisation (NSO) discuss their experience of conducting family tracing as a part of reintegration efforts in the context of an unregistered orphanage where children’s files contained missing and inaccurate information.

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Caregivers’ relationship with children, Other staff and the organisation

Saxena Ratna & Shekhar Shashank - Institutionalised Children Explorations and Beyond, 12 Sep 2019

The aim of this review is to analyse the existing published studies regarding these caregivers’ relationships, with a focus on programs in South Asia.

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The Impact of the Care Setting on Child Rehabilitation

Better Care Network, 12 Sep 2019

In this video, Sreyna and Chenda, two practitioners from Hagar Cambodia, discuss their learning regarding the impact of the care setting on child rehabilitation.

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Participatory Peer Research in the Treatment of Young Adults With Mild Intellectual Disabilities and Severe Behavioral Problems

Louis Tavecchio, Peer Van der Helm, Xavier Moonen, Mark Assink, Geert Jan Stams, Inge Wissink, Jessica Asscher - New Directions for Child and Adolescent Development, 11 Sep 2019

This study provides an illustration of a research design complementary to randomized controlled trial to evaluate program effects, namely, participatory peer research (PPR). The PPR described in current study was carried out in a small sample (N = 10) of young adults with mild intellectual disabilities (MID) and severe behavioral problems [in residential care in the Netherlands].

Young Children in Institutional Care: Characteristics of Institutions, Children’s Development, and Interventions in Institutions

Megan M. Julian, Junlei Li, Annie Wright, Pamela A. Jimenez-Etcheverria - Children’s Social Worlds in Cultural Context, 11 Sep 2019

In this article, institutions in Russia, China, Ghana, and Chile are described with reference to the circumstances that lead to children’s institutionalization, resident children’s social-emotional relationships, and unique characteristics of each country’s institutional care (e.g., volunteer tourism in Ghana, and shifting demographics of institutionalized children in China).

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Examining the relationship between the needs of children and young persons living in residential care and critical incidents using the Singapore CANS assessment tool

Grace S. Chng, Wan Fen Yip, Lydia Pek, Ming Hwa Ting, Chi Meng Chu - Developmental Child Welfare, 10 Sep 2019

This study had two aims: first, it sought to test whether Children and young persons (CYPs) who entered residential care with higher level-of-care (LoC) scores on the Child and Adolescent Needs and Strengths (CANS) tool, indicative of higher needs or more intensive services required, were more likely to experience a critical incident. Second, it aimed to test the various needs separately with the occurrence of critical incidents to delineate the impact of each individual need on critical incident.

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Organisational models of health services for children and adolescents in out‐of‐home care: health technology assessment

T Mensah, A Hjern, K Håkanson, P Johansson, A K Jonsson, T Mattsson, S Tranæus, B Vinnerljung, P Östlund, G Klingberg - Acta Paediatrica, 04 Sep 2019

Decades of research confirm that children and adolescents in out‐of‐home care (foster family, residential care) have much greater healthcare needs than their peers. A systematic literature review was conducted to evaluate organizational healthcare models for this vulnerable group.

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Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody

Joanne M. Chiedi, Acting Inspector General - U.S. Department of Health and Human Services, Office of Inspector General, 01 Sep 2019

The authors of this review from the U.S. Office of Inspector General conducted qualitative analysis to identify the most significant challenges that facilities faced in addressing the mental health needs of children in the Office of Refugee Resettlement (ORR) custody.

Foster Care and Reintegration: Different Portuguese Similarities

Rachel Baptista, Maria Helena Zamora, Eduardo Santos - International Journal of Advanced Engineering Research and Science (IJAERS) , 01 Sep 2019

This article examines the family reintegration process for those in care in Portugal and Brazil.

Deinstitutionalization of OVC In Ghana’s Central Region Factors That Impact Alternative Care In Bawjiase And Surroundings

Beugre, Anita Princia W. - Leiden University, 01 Sep 2019

Set in Central Region Ghana, using Country-Side Children’s Welfare Home (CCWH) as the main case study, this thesis investigates the underlying factors that are preventing families in the Bawjiase and surroundings from opening their homes and hearts to vulnerable children.

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