Child Abuse on the Internet: Ending the Silence

The Melbourne Health (MH) Social Work Residential Care Team (RCT) was established in 2002 as a new and innovative approach to aged care. The service employs three full-time social workers and an Allied Health assistant with previous experience in aged care. The RCT works across the MH continuum of care with inpatients recommended for residential care. The service is predominantly patient- and family-focused, but is also consultative to meet the education needs of MH staff and the community. This paper discusses the MH Social Work Residential Care model, reviews data collected since RCT implementation and the benefits shown for patients, their families and interdisciplinary staff. This paper discusses pressures and factors that impinge on the ability to discharge patients to residential care and explores recommendations for ongoing clinical practice as well as recommendations that the RCT has submitted to management for further consideration.     

Developing practice learning and teaching in residential child care

The Residential Child Care Initiative was created in order to increase the numbers of qualified staff in residential children's homes in England. This paper explores some of the issues affecting practice placements for residential staff who undertook qualifying training between 1992 and 1997. Themes and issues arising from these experiences, with examples from practice, are considered in terms of their relevance to practice learning in group care situations for all social work students, highlighting the reciprocal benefits for students and residential services for children.     

Preventing the residential placement of young children: A multidisciplinary investigation of challenges and opportunities in a rural state

Estimates suggest that most children placed in state custody have mental or behavioral health problems. Many of these children are difficult to place with foster families and ultimately are referred for residential care. Residential care is expensive relative to other alternatives and the effects on child outcomes do not seem to justify the expense. This study identifies systemic factors contributing to the residential placement of young children and opportunities for service improvement in a rural state. Key informant interviews and surveys were used to synthesize a broad array of professional perspectives. Remarkable consensus across multiple groups suggests that young children are best served in a family setting. Strategies to reduce residential placement and improve outcomes of young children are discussed.     

Chapter 3 Residential Care Facilities for the Elderly

Abstract

Residential Care Facilities for the Elderly (RCFEs), known as board and care homes, are licensed in California and many other states for non-medical care in the community. RCFEs are examined here to provide illustrative issues in the definition of types of long-term residential care. The research examines physical functioning, social supports, and course of residential placement for 109 RCFE residents (mean age 84 years). A significant portion of the residents had personal assistance needs not usually provided at the RCFE level (75% assistance with medication, 52% used walking aids, 29% assistance in bathing). Additionally, a third of the residents had restricted social supports and social activity. Residents report declines in functioning and support as reasons for moving to residential care. Length of residence in the facility (range less than a year to 15 years) was not related to physical functioning or social activity. These findings do not support “aging in place,” within the facility, as the rationale for increased need for assistance in residential care. Implications include the need to maintain the social model of residential care ample for the majority of residents while assuring the availability of a higher need for assistance of a significant portion of the residential care population.     

Assessment of the needs of youth in residential care: Development and validation of an instrument

This article presents the development of a Residential Care Youth Needs Assessment (RCYNA) instrument. In two studies, initial evidence regarding the RCYNA psychometric properties was obtained using a sample of youth in residential care. Results show adequate levels of content and face validity, reliability and concurrent validity.     

Activity Engagement in Residential Care Settings: Findings from the National Survey of Residential Care Facilities

Assisted living and similar residential care is an important source of care for elders, including those with dementia. Meaningful activities may help residents maintain function, improve self-esteem, and enhance quality of life. Using data from the 2010 National Survey of Residential Care Facilities, this study identifies the extent of resident engagement in different types of activities; examines the extent to which cognitive status, other resident characteristics, and residential care community characteristics relate to activity engagement; and, among cognitively impaired residents, assesses whether being in dementia-specific settings is associated with activity engagement. Compared with persons without cognitive impairment, those with severe cognitive impairment are less likely to go on outings (79% versus 36%) and talk with family and friends (85% versus 72%). Residents with mild to severe cognitive impairment have higher participation in leisure activities than other residents if they live in dementia-specific settings (73% higher) than those who do not.     

Needs assessment of youths in residential child care in Portugal / Evaluación de necesidades de jóvenes en acogimiento residencial en Portugal / Evaluación de necesidades de jóvenes en acogimiento residencial en Portugal

Residential child care in Portugal is the most common protection measure in cases of family separation, since family foster care is still very rare. However, little is known about the needs of these children and young people. The purpose of this study is to describe the profile of adolescents close to legal adulthood who are in residential care, comparing it with a Spanish sample. The sample is composed of 345 young people aged 16 to 17 on whom information has been collected regarding their history of protection, family background, schooling, mental health and offending behaviour. A Spanish sample was selected as a comparison group (N = 384). The results reveal the complexity and special seriousness of the profile of young people in residential care in Portugal compared to a Spanish sample, highlighting a high presence of mental health problems and especially suicidal behaviours. Given these results, efforts should be focused on developing specialized residential care programmes adapted to the specific needs of these young people.     

Workforce Issues in Residential Care Facilities in Rural China

This study examined contemporary frontline workforce issues related to residential care for elders in rural China. Residential facilities in rural China are in transition from exclusively providing shelter to childless elders to providing long-term care for frail elders. These facilities are also under pressure to improve the quality of services that they provide. The study is based on in-depth interviews with administrators and field observations of facilities. The study focused on the following issues related to the workforce: recruitment and retention, training, work environment, workforce organization, regulations, compensation, and career ladders. The implications of resident characteristics for demands on the work force were examined. The study found that lack of skilled personnel is one of the major reasons that the overwhelming majority of facilities deny admission to frail and demented elders. Improving workers’ skill is critical if these facilities are to meet the increasing demand for institutional long-term care needs.     

Ideology,Context, and Obligations to Assist Older Persons

Are older adults responsible for meeting their own needs, is it their children's obligation to care for them, or is there a collective responsibility to see that older adults have their needs met? The purpose of this study was to examine the normative obligations of individuals, family members, and the government to provide for the needs of older adults. The authors examined how ideological beliefs and contextual circumstances are related to beliefs about obligations to older persons. Data were collected from phone interviews of a sample of 270 adults who were over 40 years old. The results indicate that ideological beliefs were better predictors of normative obligations than were contextual variables. Future research should reflect the complex relationships among ideological beliefs, contextual circumstances, and normative obligation beliefs.     

Relationship between collective efficacy and contextual performance among university athletes in Japan

The purpose of this study was to clarify the relationship between collective efficacy and contextual performance among university athletes in Japan. We carried out 305 university athletes (201 males, 104 females) from 14 teams in various geographic areas in Japan. The average age of the participants was 19.91 years (SD = 1.01). The kinds of sports were soccer, basketball, baseball, volleyball, and so on. Then, using Collective Efficacy Questionnaire for Sports (CEQS; Sandra E. Short et al., 2005) and Contextual Performance Scale (Ikeda, and Furukawa, 2008), we examined the relationship between collective efficacy and Contextual performance. In conclusion, this study provided the following three remarks. 1) There are relationship between collective efficacy and contextual performance. 2) Contextual performance execution level improve collective efficacy. 3) It is important to always recommend contextual performance in own team to strengthen the collective efficacy more.     

A review of private residential care in Hong Kong: implications for policy and practice

Hong Kong government policy encourages and facilitates families to care for their older members as long as possible by providing families and their older relatives with community support services. Residential care for the elderly is viewed as a last resort. Due to the inadequate supply of community support services, the long period of care required, and the gradual breakdown of values of filial support, families may increasingly give up their caring roles and seek residential care for their dependent elderly relatives. A shortfall in subsidized residential care may lead to needy elderly persons' being cared for in private residential facilities. The demand for private residential care is projected to increase, despite criticism about the standard of care provided. Although an Ordinance, a Regulation, and a Code of Practice for residential care homes are in place to control, monitor, and upgrade private residential care in Hong Kong, problems remain that put the elderly at risk of receiving substandard services. These include the existence of substandard private aged care homes operating either with or without a license; the provision of substandard "places" to the elderly under the government's "bought place" scheme and "enhanced bought place" scheme; ineffective inspection; a lack of grading to indicate the quality of private aged care homes; and a general neglect of the quality of care. We provide recommendations to address these concerns. This requires paying attention to both the quality of care, as well as to the physical environment of homes.     

Official conceptualizations of person-centered care: Which person counts?

Numerous studies have indicated that a “psycho-social” person-centered care approach, involving the delivery of a compassionate, respectful model of care, leads to a high quality of life, particularly for older people living in residential care. This has prompted policy-makers to endorse this approach. Yet, some commentators have argued that the model of person-centered care in official government policies equates to a “consumer-based” rather than a psycho-social approach, as it focuses solely on offering service-users more choice and on promoting independence. However, as such arguments are made in the absence of any empirical analysis, it is unclear both whether such a distinction exists in practice, and, if so, how this alternative model developed. This study explores the development of minimum standards for residential care settings for older people in Ireland in order to address this gap in our understanding of person-centered care. Findings confirm that a consumer-driven model of person-centered care underpins the Irish Standards; residential care is portrayed as a hotel-like service and residents as discerning consumers, which may be unsuitable for older people in residential care with limited capacity to make key choices. Analysis indicates that this model can be seen both as an extension of consumer-driven policies endorsed by many neo-liberal governments, and also of policy-makers' fears of losing their autonomy when they reach the “Fourth Age”. This study is particularly illuminating, given the similarities between the Irish care system with England, Scotland, Wales, Northern Ireland and Australia.     

The Inside Out? Views of Young People,Parents, and Professionals Regarding Successful Secure Residential Care

Although adolescents often seem to improve in their functioning during residential care, there still is little knowledge on what factors are important in achieving these changes. The present study aims to identify the care factors that are important for adolescents’ behavior change during secure residential care. We conducted in-depth interviews with eight adolescents, their parents, eight group care workers and seven teachers concerning their in-care experiences. Both adolescents and parents commonly attributed changes during secure residential care to the treatment environment. Group care workers and teachers did not have a clear, consistent view on the treatment aspects causing positive change with the adolescents. According to the adolescents, good professionals apply a fine balance between rules and freedom, show empathy and are available for support. The view of parents corresponds to this image. Although group care workers are perceived as available for support, adolescents tend to make little use of this help if they experience personal problems during care. The results highlight the importance of responsiveness of secure residential care professionals to the needs and perspectives of adolescents and parents.     

Managing the process of change in residential child care: A consultancy approach

This article explores the impact of a consultancy undertaken with groups of residential child care staff within a large local authority who were experiencing considerable changes in their working environment as a result of a review of residential care structures. The authors were invited to engage directly with staff on an individual and group basis to help them work through the barriers they perceived to changing their approach to practice. The theoretical underpinning for the work was Charles Handy's [1993, Understanding Organisations (Harmondsworth, Penguin)] belief that change is more likely to have a positive outcome when staff have an investment in and contribution to the change processes. The model of change utilised within the sessions with staff was Kurt Lewin's three stages of 'unfreezing', 'change' and 'refreezing'. The consultancy raised a number of issues about the process of change and how this can be achieved within the residential child care context. In particular, it highlighted the problems of assuming that change is a linear process which can be directly controlled and managed in the flux and uncertainty which characterises this sector.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

Moving mountains armed only with a teaspoon: the work of a ‘centre of excellence’ for residential child care

The Centre for Residential Child Care was established in 1994 as a direct result of the Scottish Office report ‘Another Kind of Home—A Review of Residential Child Care’. In 1997, the Kent report ‘Children's Safeguards Review’ praised its work. The role of so-called ‘centres of excellence’ has at times been queried. This paper seeks to clarify what have been the issues that have faced the Centre, how it has resolved them and what it has found to be key areas of work which have helped the development of good practice. The creation and experience of this Centre is described, its genesis, structure and work outlined, and comments made about what can be deduced from this experience about the role of so-called ‘centres of excellence’ in improving the quality of direct practice.     

Eignen Sich Stadtteile Für Den Nachweis Von Kontexteffekten?

Contextual influences of the neighborhood on individual attitudes and behaviors are often tested by means of characteristics of officially defined areas, e.g. boroughs or census tracts. Using such measures can cause problems if the chosen areas are too big to allow for analyzing contextual effects. The study finds that mean neighborhood disorder increases fear of crime only if this effect is tested for small neighborhoods (Stadtteile) of less than six to eight square kilometers, using data on three German cities (Hamburg, Kiel and Munich). Analyzing bigger neighborhoods can lead to serious underestimation of the contextual effect.     

‘Who do I turn to if something really bad happens?’ Key working and relationship-based practice in residential child care

ABSTRACT

This article explores the psychodynamics of relationship-based practice from the perspective of young people in residential care. This research involved qualitative semi-structured interviews with 10 care leavers, aged 18–24 years, who had been in residential care in Ireland. Drawing selectively from that research, this article reports their views and experiences of key-working and how relationship-based practice acted as a reparative method within their experiences of care and aftercare. Similar to previous research, this study underscores the necessity to ensure that children in care are cared for and supported by a trusted adult. In addition, based on this study, the role of a key worker appears capable of providing this ideal type of supportive relationship. It also highlights the importance of the care system working to provide consistency and support for the young people and confirms the importance of relationships with trusted adults, such as key workers.