Home sweet home? Professionals' understanding of ‘home’ within residential care for unaccompanied youths in Sweden

The number of unaccompanied minors arriving in Sweden continues to rise. The majority are placed in residential care units. This qualitative study aims to increase the understanding given by the professionals to the concept of ‘home’ within the framework of residential care for unaccompanied young people. Data are based on participatory observations at two residential care units, followed up by individual interviews with staff. The findings confirm that the concept of home has a complex meaning involving both objective aspects such as physical buildings, and more subjective components that can be seen as state of mind. The staff's desire to offer an ‘ordinary home’ fails because of the surveillance, their dominant positions and especially due to the legal restrictions that were not initially meant for this target group. Unaccompanied young people have to be considered based on their own specific needs in order to make it possible for society to offer the most suitable care.     

Missing years of abuse in children's homes

This paper reflects upon the historic abuse of young people living in children's homes. Beginning with a recognition of ‘individual abuse’, it explores, first of all, the reasons why young people were abused, including: (1) the status of childhood and being in care; (2) the application of ‘approved’ treatment methods; (3) the failure of managerial, organizational and inspection systems; and (4) the institutional critique and the popularity of preventative policies. Second, by identifying common themes arising from this account, it is suggested we need to rethink the way abuse has been conceptualized. Individual direct abuse, sanctioned abuse, organized systematic abuse and system outcome abuse are discussed. Finally, the paper reviews recent changes in law, policy and practice, including the Children Act 2004, designed to prevent abuses happening again. It is argued that challenges still remain in addressing structural inequalities, improving protection, balancing needs and rights, extending protection to different groups of young people and in having a preventative vision for children's homes.     

Offending behaviour in care: is children's residential care a ‘criminogenic’ environment?

This paper focuses on offending behaviour and children in residential care. The paper considers whether children's residential care is a ‘criminogenic’ environment, i.e. whether this type of care environment helps to provide the conditions that produce crime or criminality. The paper draws on the findings from recently completed research on 10 children's homes in a large county local authority in England. This paper focuses on the patterns shown in trend data collected on problematic and offending data across these homes over a 7‐year period (2001–2007) and a 1‐year cohort study of 46 young people. Interviews with care staff and young people are used to contextualize these patterns. The data provide evidence of an environment where conflict and offending behaviour are common. It is argued that the residential care environment, particularly for older teenagers, often presents a set of risks that tend to reinforce offending behaviour and that this is in part due to its ‘last resort’ status.     

Longing to belong: children in residential care and their experiences of peer relationships at school and in the children's home

Resilience literature has stressed the potential of both children's educational experiences and their friendships to act as protective factors against adversity. However, less is known about how children living with adversity navigate these ‘everyday’ aspects of social terrain and the particular challenges that they face. This paper explores the meaning and experience of peer relationships to one group of children living in residential care in Ireland. Drawing on a larger study of school and care, it explores data gathered from 16 children, aged 8 to 18, who were living in eight different children's homes on the east coast of Ireland. The findings suggest that the children were acutely aware of their ‘care’ status and developed a number of strategies to manage this identity in school. It appears that more often than not, children described being left to their own devises to manage friendships and peer relationships. Thus, despite being a crucial source of both stress and support, peer relationships did not appear to be regarded as an issue that adults should be involved with. This raises questions for practice about what children should be supported with and the way in which peer relationships are potentially overlooked by social work, residential and school staff.     

Young people's and carers' perspectives on the mental health needs of looked-after adolescents

While the mental health needs of looked‐after young people have been described in a number of clinical studies, the views of looked‐after adolescents themselves concerning their mental health needs have only rarely been reported. This study used focus groups to elicit the ideas and experiences of looked‐after young people in two local authorities in England. Front‐line carers in the region were also surveyed. Young people and carers were agreed in highlighting the damaging effects of the discontinuity and change experienced in the looked‐after system. Young people emphasized the importance of exercising choice and control when seeking and receiving support and identified the value of positive role models provided by ‘survivors’ of the care system. Carers reported high levels of risk behaviour, particularly self‐harm, among young people in children's homes. These differing perspectives need to be openly acknowledged and negotiated within care settings in order that relevant and accessible therapeutic and support services can be offered to looked‐after adolescents.     

The proof of the pudding: What difference does multi‐agency working make to families with disabled children with complex health care needs?

More than 20 years of research with disabled children, young people and their families has highlighted the need for the different professionals and services that support them to work more closely together. The British policy and legal framework for ‘joined up working’ has never been stronger. However, there has been an assumption that multi‐ or inter‐agency working will inevitably be a ‘good thing’ for families. This paper discusses findings from a 3‐year research project which looked at both the process and impact of multi‐agency working on families with a disabled child with complex health care needs. Interviews with 25 parents and 18 children and young people who used six developed, multi‐agency services were carried out. Findings suggested that the services had made a big difference to the health care needs of disabled children but were less able to meet the wider needs of the child and the family – particularly in relation to social and emotional needs. Multi‐agency working appeared to make some positive, but not significant, differences to the lives of families.     

Predicting after-care outcomes: the importance of 'felt' security

Young people who ‘age out of care’ generally do not have the continuing source of emotional, social and financial support that is available to most young people in their transition to early adulthood. They therefore face the challenges of making various transitions with fewer resources and less support, and at an earlier age and in a less graduated way than young people of the same age in the general population. Some, however, manage this process more successfully than others. The current study examines the links between stability, perceived or ‘felt’ security and later outcomes for young people 4–5 years after leaving care. It is based on a four‐wave longitudinal study over 5 years of 47 young people leaving care in New South Wales, Australia. Felt security in care, and continuity and social support beyond care were the main significant predictors of these young people’s outcomes 4–5 years after leaving care. While stability in care was important, this may be as a means to an end–building a sense of security, belonging and a network of social support.     

Risk,resilience and identity construction in the life narratives of young people leaving residential care

The role of residential care for children has developed very differently internationally, but in all cultural contexts, there are questions about the extent to which it can help young people recover from high risk backgrounds. In the UK, residential care has come to be seen as the placement of last resort, yet new government guidance on permanence has suggested that residential care can provide security and a sense of belonging. Narrative analysis of interviews with 20 care leavers identified their different pathways from birth families through residential care to early adulthood. Some experienced a transformation from a negative sense of self as victims or ‘bad children’ to survivors, while others continued to struggle. Key to successful turning points were four interacting factors, all associated with resilience; connection, agency, activity and coherence. These narratives revealed the importance of nurturing relationships and a sense of ‘family’, and also the role of support after leaving residential care, when transitions workers helped them to move on but stay connected. The study highlighted how residential care leavers from adverse backgrounds attribute very different meanings to their experiences, which affects identity construction, resilience and the need for support.     

Research Review: Young people leaving care

This paper reviews the international research on young people leaving care. Set in the context of a social exclusion framework, it explores young people’s accelerated and compressed transitions to adulthood, and discusses the development and classification of leaving care services in responding to their needs. It then considers the evidence from outcome studies and argues that adopting a resilience framework suggests that young people leaving care may fall into three groups: young people ‘moving on’, ‘survivors’ and ‘victims’. In concluding, it argues that these three pathways are associated with the quality of care young people receive, their transitions from care and the support they receive after care.     

Residential care: an effective response to out‐of‐home children and young people?

The ever‐growing number of out‐of‐home children in Italy over the last decade has urged an assessment of the available care services. Although foster care is spreading rapidly, many young people are still housed in residential facilities. Reflection on residential care quality has intensified at both a national and an international level. This paper presents the results of a study on residential care facilities for children and young people in the region of Northern Italy (Lombardy). Four dimensions of ‘quality’ are considered: efficiency, effectiveness, participation in planning and intervention, and empowerment of children and their family relationships. The combined effects of these dimensions are defined as ‘relational quality’. The results show that residential care facilities are generally good, while Social Services resources often appear inadequate for interventions aimed at birth families (efficiency). The well‐being of children in residential care facilities is high, even if they tend to move from one facility to another, rarely returning to their birth family (effectiveness). The involvement of children and their families at different stages of the care path is limited (participative approach). Finally, the most critical element is the failure to properly involve birth families (empowerment).     

Interpretative phenomenological analysis of young people's lived experiences of therapeutic residential care

Concerns of maltreatment and poor outcomes persist in residential care despite numerous government inquiries and recommendations. Young people in residential care continue to be the most vulnerable and marginalized group in the out‐of‐home care population. Young people's voices are also underrepresented in research. Existing studies predominantly focus on service evaluations in which individual voices of young people are overshadowed by adults' perspectives. Other studies examine the perspectives of young people in out‐of‐home care as a homogenous population, limiting understandings of the subjective experiences of young people in residential care. This study focused exclusively on young people's lived experiences in Australian therapeutic residential care, utilizing interpretative phenomenological analysis. The young people in this study revealed experiences of peer victimization, ambiguous loss and uncertainty during transitions. These findings suggest that more work is required in order to provide safe and healing environments and experiences for young people in therapeutic residential care. Each individual voice captured in this study offers valuable insights into how residential care practitioners can strengthen practice to enhance protection, engagement, connection with families and leaving care support.     

Young people leaving care in Sweden

The transition from a placement in care to an independent life can be a problematic phase for young people. In Sweden, special care‐leaving services are almost non‐existent. What then happens to young people when they leave a placement in out‐of‐home care? This paper draws on the results of a study in which 16 young care leavers between the ages of 18 and 22 years were interviewed. Telephone interviews were also performed with the young care leavers' parents, social workers, foster carers and institutional staff. The aim of the study was to investigate how young care leavers perceive the transition from care to an independent life. The Swedish welfare model, the prolonged transition to adulthood and the family‐oriented welfare discourse have been used as analytical perspectives. The results show that young care leavers have a pronounced need for social, emotional, practical and financial support. Whilst such support is occasionally provided by foster carers and residential staff, it is seldom given by social services or biological parents. This group is at risk of facing severe problems in the transitional phase from care to independent life, a fact that is not acknowledged by the Swedish welfare system.     

Participation of youth in decision‐making procedures during residential care: A narrative review

Participation in decision‐making procedures of young people in care is considered a key element that affects their current or future living circumstances and might improve the quality of decision‐making on and delivery of provided services. This narrative literature review, covering the period 2000–2016, focuses on the opportunities of young people to participate, the challenges and facilitators to participation, and the outcomes of care related to participation. Sixteen studies met our search criteria. Several studies show that young people seem to have limited possibilities to “meaningful” participation in decision‐making. Various challenges and facilitators in the participation process emerge with regard to the level of the young person, the professional, and the (sociocultural) context. None of the studies provides evidence for a connection between the “amount” of youth participation in decision‐making and/or treatment during the care process and the outcomes of residential care. Implications for research and practice are reflected upon.     

Resilience of Young People in Residential Care

Children and young people in residential care may have experienced or may experience various difficult, life-threatening events, such as neglect, abuse, or violence and maltreatment known as adversities. Despite this, some of them are able to function and even prosper and this has been attributed to the development of resilience. In this qualitative empirical study, we focus on the under-researched area of how young people in care reflect on and cope with such adversities. The exploratory research comprised of semi-structured interviews with young people in two different care settings – re-education centres and children’s homes. The results showed that the sample of 34 young people had experienced 73 adversities prior to leaving residential care and that half of them were not able to resolve some of these adversities. It was found that methods for dealing with adversity change during time spent in care and that a combination of various individual strategies, adaptation and accepting support are effective. The findings also indicate that the development of resilience may vary according to type of residential care setting specifically, whether these facilities allow the development of multiple individual strategies for dealing with adversities, or whether they provide social support. The article discusses implications for future research and practice in residential care.     

The cognitive approach to information-seeking behaviour and information use

The cognitive approach to ‘information behaviour’ centres upon the idea of meaning. Meaning is involved not only in all aspects of information generation, transfer and use, but also in the way people define themselves, their lives and their actions.The cognitive approach, therefore, draws attention to the need for a bridge between the meanings of everyday life and the information that may have relevance for everyday life. In this sense, of course, ‘everyday life’ is different for every person—for some it may involve research as an everyday activity, for others the practice of a profession, for others, involvement in business and commerce.The aim of this paper will be to explore these concepts in the context of research into information behaviour in the everyday world of work, where individuals may be constrained to a greater or lesser degree in their ability to define the content, direction and function of their work and where the diversity of roles may prevent the emergence of coherent groups capable of expressing clear needs for information support.De Mey's presentation of the ‘cognitive paradigm’ will be examined and parallels to elements of such a ‘paradigm’ will be sought in the world of work.Throughout, the paper will draw upon the author's present and past research.     

Collaboration between service users and professionals: Legitimate decisions in child protection – a Norwegian model

The aim of this study is to examine the conditions for achieving free and open communication in collaboration. The context is child protection where ‘the best interest of the child’ is at stake. First, a theoretical standard based on free and open communication and equal partnership (deliberation) is presented. Secondly, an explorative analysis is undertaken of the collaboration process between professionals and service users in two review groups regarding two young people, Jane and Tom, both of whom appear to have psychosocial problems living in residential care. Thirdly, on the basis of this analysis, recommendations on how to improve collaboration in review groups are made. The findings show that collaboration has several functions: formal decision‐making, legitimate decision‐making and learning. There is a need to clarify the purpose of collaboration and strengthen structural arrangements as well as develop guidelines for handling challenges at different levels.     

Moving from ‘what we know works’ to ‘what we do in practice’: An evidence overview of implementation and diffusion of innovation in transition to adulthood for care experienced young people

Global research has shown that most young people who are care experienced are not prepared to transition to independent living at 18 years of age and require support into early adulthood. We used rigorous systematic methods to identify English-based peer reviewed and grey literature describing innovations relevant to care experienced young people as they transition into adulthood, with a focus upon lessons for their implementation and diffusion. We synthesised the evidence narratively and organise data linked to seven key areas important to the transition to adulthood: (1) Health and well-being; (2) relationships; (3) education and training; (4) employment; (5) participation in society; (6) accommodation; (7) other. Twenty-five papers met our inclusion criteria. This review has found that, whilst there are a broad spectrum of innovations taking place within the social care environment for care experienced young people to support their transition into adulthood, there exists limited insight into how best to support implementation and diffusion of evidence-based innovation. We drew upon the ‘Consolidated Framework for Implementation Research’, developed in the setting of clinical service delivery, to highlight challenges in implementing and diffusing evidence-based innovation for care experienced young people transitioning into adulthood.     

Young people leaving care: health, well-being and outcomes

This paper focuses on the health and well‐being of young people making the transition from care to independent adulthood. It draws on findings from a wider study of outcomes for young people leaving care in England. Notably, the study used, as its key outcome indicators, measures of general and mental well‐being. In doing so, it was able to explore the interrelationship between these areas and young people's overall progress after care. The paper explores the extent to which young people experience difficulties related to physical and mental health, disability and emotional and behavioural problems. It will show that such difficulties can impact upon and be influenced by overall well‐being and post‐care progress in more traditional outcome areas such accommodation and career, and will suggest that the transition from care itself can adversely affect health and well‐being. The paper considers these issues within the context of a changing policy framework which has given increased priority to the health and well‐being of young people in and leaving care, particularly in light of the Children (Leaving Care) Act 2000. It considers the ways that young people are supported to address health and well‐being and the implications for and impact on leaving care services.     

Factors that contribute to high turnover among residential child care staff

In this paper we draw on our own empirical research and that of others to consider the factors that contribute to high staff turnover in residential child care. First, we focus on the problem of retaining staff in children’s services. Second, we turn our attention to the factors that contribute to staff turnover in residential care: namely, perceptions of the service; of children and young people; and of human resource issues. Third, we attempt to draw out the implications of high turnover for policy and practice. The negative image of residential care has persisted in the wake of a plethora of abuse scandals. The increasing emotional and behavioural problems presented by the children cared for, and the violence and verbal abuse directed at staff are key retention issues. Moreover, poor conditions of employment contribute to staff perceptions of the work as a short‐term career choice only. The potential means of resolving these problems are explored, and the future research agenda highlighted.     

Driving outcomes: learning to drive,resilience and young people living in residential care

There are continuing concerns about the experiences offered to older adolescents being looked after (‘in care’) in the UK and, especially, to care leavers. Questions are asked about the limitations of State care compared with normal family life. This paper reports on an initiative to provide driving lessons to a group of six young men living in residential homes in one city. It links with resilience theory – how individuals can have relatively good outcomes despite early adversity. A qualitative study was undertaken to explore the effects of the initiative, including individual interviews with young men, heads of homes in which they lived and children's services managers. The overall results indicated that the initiative was very worthwhile. The lessons were a significant part of young people's lives. Possible effects on young people were divided into personal, instrumental and social. Benefits were reported from all parties concerning young people's self‐esteem and self‐confidence, as well as in forging close relationships with supportive adults. Driving would not be seen as a panacea for complex personal histories and structural problems, yet this small experiment suggests that driving lessons could be of disproportionate benefit and there is a moral obligation to provide them in any case.