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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A Series on Alternative Care: Standards of Care in Child Care Institutions

Udayan Care and UNICEF, 01 Feb 2017

This booklet on standards of care in child care institutions is part of a Series on Alternative Care covering the latest legal and policy framework on Alternative Care in India, which has been presented in an easy-to-understand style so that they can be used as an effective reference material by all the stakeholders.

The System of Social Services in Bulgaria and the Process of Deinstitutionalisation of Children

V.K. Terziev - Conference Paper. Conference: The VII International Academic Congress “Fundamental and Applied Studies in EU and CIS Countries”, 01 Feb 2017

This paper examines the deinstitutionalisation process in Bulgaria.

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Sexual Behavior Among Orphaned Adolescents in Western Kenya: A Comparison of Institutional and Family-Based Care Settings

L. Embleton, J. Nyandat, D. Ayuku, E. Sang, A. Kamanda, S. Ayaya, W. Nyandiko, P. Gisore, R. Vreeman, L. Atwoli, O. Galarraga, M. A. Ott, P. Braitstein — Journal of Adolescent Health, 16 Jan 2017

The attached study compared the care environments of family-based care and institutional care to determine if care environment contributed to differences in sexual behavior and/or sexual exploitation of orphaned and separated adolescents.

National estimation of children in residential care institutions in Cambodia: A modelling study

Lindsay Stark, Beth L Rubenstein, Kimchoeun Pak, Sok Kosal - BMJ Open, 16 Jan 2017

The primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia.

Study on alternative care community practices for children in Cambodia

Carolyn Hamilton, Kara Apland, Maurice Dunaiski and Elizabeth Yarrow - Coram Children’s Legal Centre, 2017

This study commissioned by the Ministry of Social Affairs, Veterans and Youth Rehabilitation of the Kingdom of Cambodia and UNICEF Cambodia sheds light on how different forms of alternative care are being used in the community.

Action Plan for improving child care with the target of safely returning 30 per cent of children in residential care to their families 2016-2018

Ministry of Social Affairs, Veterans and Youth Rehabilitation - Kingdom of Cambodia, 2017

This Action Plan for improving child care, with the target of safely returning 30 per cent of children in residential care to their families 2016 - 2018, was developed to support the implementation of the Ministry of Social Affairs, Veterans and Youth Rehabilitation (MoSVY) Work Platform 2014–2018 and the Sub-Decree 119 on the Management of Residential Care Institutions, which was endorsed on 11 September 2015.

An In-Depth Study of Psychosocial Distress Among Orphan and Vulnerable Children Living in Institutional Care in New Delhi, India and Their Coping Mechanisms

Abhishek Saraswat & Sayeed Unisa - IUSSP 2017, 2017

This study examined the psychological wellbeing of children in institutions and their various coping mechanisms.

Roadmap to Ending Child Immigration Detention: Milestones to Include in the Global Compacts

Initiative for Child Rights in the Global Compacts, 2017

This roadmap to ending the detention of children in immigration from the Initiative for Child Rights in the Global Compacts outlines the commitments, examples of practice, reference documents, and guidelines for each stage of the strategy from June 2019 to June 2025.

Romania: Children in Public Care 2014

Manuela Sofia Stănculescu (main author), Vlad Grigoraș, Monica Marin, Cătălina Iamandi-Cioinaru, Emil Teșliuc, Georgiana Blaj (Neculau), Bogdan Corad, VoichiŃa Pop, Andreea Trocea - The World Bank and UNICEF, 2017

This book presents the results of this research on more than 52,000 children placed in public care in Romania (in special protection) who receive family or residential-type protection services as well as on the children at risk of separation from their families from the source communities.

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Towards the Right Care for Children: Orientations for reforming alternative care systems – Africa, Asia, Latin America

Samantha Chaitkin, Nigel Cantwell, Dr. Chrissie Gale, Dr. Ian Milligan, Catherine Flogothier, Claire O’Kane, Dr. Graham Connelly - European Union, CELCIS, SOS Children's Villages, 2017

This synthesis report contains findings of a study that conducted research in six South and Central American, Asian and African countries for the purpose of gaining understanding of the nature, extent, and scope of institutionalization and the feasibility of deinstitutionlisation.