Foster and Residential Care Practices Compared

Correspondence to Dr Matthew Colton, Department of Social and Administrative Studies, Barnett House, Wellington Square, Oxford OX1 2ER Summary This paper reports what is, remarkably, the first systematic,in-depth, comparative study of foster and residential care practices.The overall research objectives were: (1) to delineate and comparecare practice in special foster homes (i.e., homes accommodatingchildren traditionally considered too old or disturbed for fosterplacement) and Children's Homes for older children in localauthority care; and (2) if possible, ascertain whether the responsesmanifested by children in such settings can be related to thecare practices they experience. The approach adopted was essentially sociological. A lengthyperiod of field-work in two local authorities featured the useof a range of research instruments and included the collectionof data on the following: the management of recurrent–mainlydaily–social events; children's community contacts; theprovision of physical amenities; the controls and sanctionsused by caretakers vis-à-vis children; the roles of caretakersand their behaviour and attitudes towards children; and thecharacteristics of children, their behaviour towards caretakers,perceptions of their social environments and progress duringplacement. Quantitative methods were used in data analysis becausethey provide a useful guide to the import of observed differencesbetween foster homes and Children's Homes. Care practice in the foster homes was, overall, significantlymore child-oriented than in the Children's Homes. Moreover,the responses of residential children appeared to fall shortof offering justification for the ways that the lives of suchchildren seemed to differ from those of foster children.     

Factors Predicting Admission of Elderly People to Local Authority Residential Care

Correspondence to Dr Ian Sinclair, Director of Research, National Institute for Social Work. Mary Ward House, 5–7 Tavistock Place, London WCIH 955 Summary Successful community care may partly depend on identifying thoseat risk of entering residential homes and targeting servicesto them. This article is concerned with how this identificationcan be achieved. It considers a sample of old people livingalone. in touch with home helps or social workers and followedup for between two and four years. The research examined thefactors likely to produce admission, and used discriminant analysisto predict it.     

Good Practice in the Education of Children in Residential Care

Correspondence to The Directors, New Horizons (Child Care) Ltd., Unit B, Silkmoor, New Street, Frankwell, Shrewsbury, Shropshire SY3 8LN, UK. E-mail info{at}new-horizonschildcare.co.uk Summary Research shows that the education of children in residentialcare is generally poor, in terms of both process and outcome.This has highlighted the uncertainty over how best to educatethese children and a pessimism over what they can achieve. Drawingupon the findings of an evaluation of a children’s home,this paper argues that children in residential care can havegood educational outcomes. It also shows that it is possibleto identify the processes by which these outcomes can be broughtabout. However, this largely positive assessment is predicatedupon education being defined broadly in respect of ‘process’and ‘outcome’. Moreover, it is important not tounderestimate the formidable challenges inherent in this work.While the multi-agency nature of this work gives rise to oneof the most significant, it has to be recognized that responsibilityfor the education of children in residential care falls primarilyto children’s homes. If children’s homes are tomeet the increasing expectations that are being made of them,national and local government will have to undertake a radicaltransformation of residential childcare, especially in termsof attitudes towards, and resources invested in, this sector.Central to this is the establishment of a qualified and properlysupported workforce.     

Entry into Residential Care

Summary This paper examines the interaction between the organizationalstructure of social services departments and procedures foradmission into residential care. By drawing on research experiencea 'placements table' is proposed which contains the key operationaldecisionstaken by the department when the client becomes a resident.It is argued that, in accordance with the structure of the department,it is possible to suggest appropriate staff to make each keydecision in order that departmental criteria for admissionsmay be met.     

Dependency and its Relationship to the Assessment of Care Needs of Elderly People

Correspondence to Dr Ian Gibbs, Social Policy Research Unit, Department of Social Policy and Social Work, University of York, Heslington, York, YO1 5DD Summary A number of previous studies of old people in residential homeshave suggested that a substantial minority are not in need ofthat form of care. The rapid growth in the number of peoplein private homes, supported by social security payments andentering without any independent assessment, has led to concernthat many more people enter residential homes without needingto be there. Social workers were employed in four areas to assess the needsof residents newly admitted to homes in the independent sectorand over eighty per cent were found to be in need of residentialcare. It is suggested that the measures of dependency used toindicate need in some previous studies fail to take into accountthe complex factors involved in deciding whether a person needsresidential care.     

The Effects of Group Living in a Residential Home for the Elderly

Summary The group-living system of care is becoming increasingly popularin residential homes for the elderly. This study examined purposefulactivity, as measured by engagement, in one such home beforeand after changeover to group living. It was found that engagementwas significantly increased after the changeover. In addition,life satisfaction was increased and orientation unchanged bythe changeover in a small sample of residents. These resultsare interpreted as supportive for the effectiveness of groupliving.     

The Children's Family Trust: a Unique Approach to Substitute Family Care?

Summary This article outlines the contribution made to child care since1945 by the Children's Family Trust in providing substitutefamily homes. Reference is made to some Trust policies whichhave aroused controversy over the years. Recruitment and supportof the substitute Parents is discussed, and a brief analysismade of the children for whom placement with the Trust may bemost appropriate. Comparisons are drawn between staff turnoverin Trust families and other residential homes, and between successand failure rates of placements with the Trust and in long-termfoster-homes. The final section assesses the role of the Children'sFamily Trust and its philosophy in contemporary child care.     

Short Term Care for the Elderly in Residential Homes: A Research Note

Please address requests for reprints to Dr. D. Boldy, Division of Health Sciences, Centre for Advanced Studies, Western Australian Institute of Technology, Kent Street, Bentley WA 6102, Australia. Summary Short term care for the elderly has expanded rapidly in thelast five years. The study evaluates short stay care in fourresidential homes using interviews with 42 clients, their main‘carers’, officers-in-charge of the homes and socialworkers. Whilst the service worked reasonably smoothly and provideda break for family carers there remains further potential forimproving the quality of service in the context of a full rangeof services for elderly people.     

Differential Assessment of Residential Group Care for Children and Young People

Summary Twelve qualitative variables frame the production of outcomesin residential group care for children and young people. Theseare used to examine contemporary themes in social care practicewith children and families. This assessment typology offerssocial workers, managers, researchers and policy-makers bothvalid and reliable baseline measures for use in evaluating residentialservices for children and young people. The typology also providescomparative interval measures for use in longitudinal evaluationsof quality. Close attention needs to be given to the impacteach of these variables has on the quality of residential groupcare services offered to children, young people and their familiesor significant others.     

Residential and Foster Care in the European Community: Current Trends in Policy and Practice

Correspondence to Dr Matthew Colton, Department of Social Policy and Applied Social Studies, University College, Swansea SA2 8PP. Summary This article compares residential care, foster care and theiralternatives in the countries of the European Community. Thefollowing common trends in policy and practice are examined:the decline of residential child care; changes in the populationof separated children; the trend towards small-scale provision;the development of an ecological perspective; increasing differentiationof care provision; professionalization; and alternatives toresidential and foster care. The pace of development is uneven across EC countries. Overall,the trends high-lighted are more apparent in the northern countriesthan in the southern states.     

Private Children's Homes

Summary The paper provides survey and intensive research material onthe private children's homes sector. It is shown that this sectoris currently in decline. Private homes are found to be shelteringchildren with long and complex care histories and to adopt adistinctive residential style. Although private homes providevaluable long term continuity, they are less likely to offerthe same range of community services as do residential settingsmanaged by the local authority and voluntary child care agencies.     

The Problems of Managing the Family Contacts of Children in Residential Care

Summary The study explores the problems of managing the family contactsof children in residential care. It focuses on the family linksexperienced by two children undergoing a two month long periodof observation and assessment. It is seen that the family linksof these children take a low priority, particularly as socialwork plans change and the informal world of the institutionbecomes pervasive. The outcomes of the two cases are charted.     

Determinants of Substitute Child Care Practice

Correspondence to Dr Matthew Colton, Department of Social and Administrative Studies, Barnett House, Wellington Square, Oxford CX1 2ER Summary The first part of this paper attempts to examine the factorswhich help to define foster and residential care practices.The discussion is informed by a comparative study of fosterhomes and Children's Homes, which was reported in the previousissue of this journal (BJSW 18:1). Overall, care practices inthe foster homes compared very favourably with those observedin the Children's Homes. It is argued that this finding owesmuch to the bureaucratization of Children's Homes. The secondsection considers the implications of my work for policy andpractice in the field of substitute child care. Use is madeof the insights provided by the preceding section to suggestways by which the major shortcomings identified by empiricalresearch might be ameliorated. This statement includes an argumentin favour of a significant expansion of family placement forolder children in public care, and a proposal for a child-orientedalternative to the sorts of Children's Homes visited.     

Private Residential Care for Older Persons: Local Impacts of Care in the Community Reforms in England and Wales

The 1990 National Health Service and Care in the Community Act, implemented in 1993, had as a prime objective the creation of social care markets. Prior to these reforms, private residential homes had enjoyed almost guaranteed state financial support for the care of residents, but since then, residential homes have had to compete amongst each other for a finite number of clientsfunded by limited local budgets. The withdrawal of guaranteed state support and the introduction of a marketplace have had negative impacts on many residential home businesses. Indeed, many homes are facing financial difficulties. This paper considers the actions and attitudes of proprietors under the new conditions, based on a three-stage survey in Devon. The private residential sector illustrates that local social care markets have the potential to produce negative outcomes that are far from ideal and, to some extent, the paper highlights a market failure. As a case study this research also demonstrates the value of undertaking locality-based detailed studies over time to investigatethe impacts of policy change.     

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.     

Filipinas as Residential Long-Term Care Providers

Summary

This exploratory study investigated reasons why Filipinas in Hawai'i have become the primary caregivers of elders in residential care homes and if they thought their children would follow them in this profession. A random sample of 173 Filipina care home operators (CHO), of which 95% were first-generation immigrants, was interviewed using telephone survey methods. Data were collected: to profile caregivers; to identify motivations for becoming a care home operator; and to gauge if they or their children would continue in this line of work. The sample was composed of middle-aged Filipina CHO with training and experience in elder care who concurred that the job fit their cultural values. About a third also felt that this job was open to immigrants and helped them buy a house. Twenty percent or less felt discriminated against because of this work. Although half the sample felt that women were better caregivers than men, only 38% felt that caregiving was primarily the responsibility of women. Almost 90% planned to continue with this work, but only 12% said it was likely that their children or grandchildren would become CHO, supporting the notion that choosing this profession had less to do with cultural values and gender expectations than with economic opportunities available to the current cohort of CHO. Given these findings, Hawai'i's capacity to meet future residential long- term care needs is discussed.     

Nursing Homes in England and their Capacity to Provide Rehabilitation and Intermediate Care Services

The numbers of older people living in residential and nursing home care in the UK have risen exponentially since the early 1980s when the closure of long–stay geriatric wards and changes in social security funding of care home places led to a rapid expansion of the care home industry. While the implementation of the 1990 National Health Service (NHS) and Community Care Act shifted the responsibility for the commissioning and funding of these services to local authority social services departments, the provision of most health services (such as general practitioner care, physiotherapy and specialist nursing services) to nursing home residents remains the responsibility of community–based NHS practitioners. Recently, the attention of policy–makers in the UK has been focused on the need to improve the throughput of the acute sector. Older people who have received treatment but are not yet able to return to their own homes are to be transferred into intermediate care facilities, often by using nursing home beds, with the aim of supporting short–term rehabilitation outside of the acute sector. This paper presents evidence from a study of health service provision to older people living in nursing homes in England. It examines whether nursing homes have the capacity to fulfil the rehabilitation and intermediate care function envisaged by policy–makers. It concludes that shortfalls in the provision of NHS services to nursing homes and difficulties faced by nursing homes in paying for health services themselves may hinder the rehabilitation potential of intermediate care placements in nursing homes.     

Adolescents in Care and their Social Workers: A Research Note

Summary There has recently been an increasing concern that young people,and especially those in residential care, should be encouragedto express their views, and that the views expressed shouldbe used in improving the care which they receive. The publicationof the Who Cares? booklet (Page and Clarke¹), and the emergenceof ‘Who Cares’ groups and the ‘Voice of theChild in Care’ organisation, is evidence of this concern.In sympathy with these developments has been a study of adolescents'perceptions of social workers, and a part of this research hasincluded a pilot study of the views of adolescents living intwo family group homes.     

Touch, Sexuality and Power in Residential Settings

Summary This paper examines areas of concern surrounding touch, sexualityand associated power in residential establishments. The placeof touch and the expression of sexuality are considered in relationto residents and staff. It is suggested that these are importantfactors in framing a concept of residential care based on rightsand duties, and that current practice often takes a limitedperspective of some of the fundamental needs of residents     

The Field Social Work Implications of Residential Child Care

Summary The workloads of field social work staff vary markedly, andlittle is known about the ‘burdens’ imposed by differentgroups of clients or cases. The research study reported hereset out to examine the extent to which field social work involvementin residential child care varied between individual childrenand to attempt to explain that variation in terms of the characteristicsof children, the characteristics and workloads of staff andtheir teams, the packages of services received by children andtheir families, and some general features of the residentialplacements. Field social worker involvement was measured interms of the number of contacts between ‘caseholders’and ‘case’ and the total amount of time spent onthe case over a three month period. The observed variationsin these two indicators were found to be significantly associatedwith the characteristics of cases and other factors. Indeed,these characteristics explained almost two-thirds of the variance.The empirical results have a number of policy implications whichare discussed under six heads: supply constraints, caseloadweighting, fieldwork organization, coordination and monitoring,out-county placements and travelling time, and comparative costings.