Social Work Services Inspectorate for Scotland (1992) Another kind of home: a review of residential child care Edinburgh: Her Majesty’s Stationery Office 0 11 494235 8Though produced in the shadow of abuse inquiries in England and Scotland, this report by Angus Skinner stands in much the same relationship to the first Utting Report (1991) as the Curtis Report (Care of Children Committee, 1946) did to the first Clyde Report (Committee on Homeless Children, 1946). It is based on going out and meeting children and young people and seeing the conditions in which they were living rather than drawing solely on second-hand experience.
Key points
- Residential care should be considered a positive option, especially where chosen by older children.
- It is difficult to provide residential care on a domestic scale.
- Family care should be preferred for children under twelve.
- Children and their parents should be involved in developing statements of function and purpose.
- Relationships are central to development.
- There are eight fundamental child care principles.
- The use of residential care has declined but its cost has increased.
- All children should have somewhere where they can keep their private possessions safe.
- Care is preparation for adulthood, not for ‘independence’.
- Children should be able to be confident in formal complaints procedures but should be able to have informal complaints addressed as effectively.
- All children over twelve should be able to attend reviews.
- Buildings and physical resources need to be improved.
- Education and health care need to be much more integrated in meeting all a child’s needs.
- Family links need to be actively encouraged.
- Children need to be able to feel safe but there is no one way of preventing abuse.
- There need to be improvements in salaries, conditions and the training of staff.
- All staff should receive supervision.
- Officers in Charge should hold delegated responsibility for everything concerned with the day-to-day running of the home.
- Coherent planning of residential child care facilities is needed.
- Residential homes need an appropriate form of quality assurance.
- “Quality cannot be inspected in; it can only be developed from a commitment at all levels to the continuing importance of the service” (p. 88)
Content
In the Foreword he describes how he worked with Roger Kent and Rosemary Langland to review the written evidence, take oral evidence, visit 20% of the homes in Scotland and meet the young people. He also commissioned:
- a literature review,
- an evaluation of statements of function and objectives,
- a questionnaire for Officers in Charge in Scotland.
He comments that it is difficult to define what constitutes residential care but his focus had been on the 154 homes and schools in Scotland caring for children under the Social Work (Scotland)Act 1968.
He then offers The Report in Summary and begins Chapter 1 The purpose and role of residential child care by arguing that it is to “provide good quality care, support, education and opportunities for development” (p. 13). The key to good quality care is the “calibre and effectiveness of staff” but they need effective support. He argues that the specific advantages of residential care are:
- special skills,
- flexibility and creativity,
- shared care.
So local authorities should identify residential care as part of a fully integrated child care strategy.
He identifies five key uses:
- for emergency care,
- for long-term care where family care inappropriate,
- for additional specialist services,
- for complex care,
- to keep children together,
and recommends that young people should be able to express their views on placement and that informed views expressed by older children should be followed if possible. This also means that residential care should be considered a positive option and not a last resort.
He then acknowledges that it is difficult to provide care on a domestic scale in a residential home and recommends that family placement should be the preferred option for under-12s while placements for special services should only follow a thorough assessment and the establishment of clear placement objectives.
While accepting that there is no one way to provide residential care, he had found that fewer than half the statements submitted by homes complied with the regulations and only a minority provided a positive description of the home. Statements needed to:
- clarify the aims of the home and the population to be served,
- outline policy and good practice,
- define the means of monitoring,
and young people and their parents should contribute to them.
Arguing for the central importance of relationships to development, he then sets out the rights of young people, including being respected and having their parents respected, followed by a set of fundamental principles:
- indiiduality and development,
- rights and responsibilities,
- good basic care,
- education,
- health,
- partnerships with parents,
- child-centred collaboration,
- a feeling of safety.
In Chapter 2 The decades of change, he describes how the number of children in residential care declined by two-thirds but, because of the fall in the child population, the proportion only halved. However, there had been little change in the overall proportion in care or supervision, though this masked significant variations between regions as well as an increase in those in supervision at home.
While the ages of children in residential care were up, there was a significant trend away from voluntary care and most were now in short-term care. There had been a 10% decline in total cost but a 60% decline in the number of children in residential care and almost a tripling of the cost per child in residential care.
In Chapter 3 The quality of care, he looks in more detail at the implications of the principles set out at the end of chapter 1 based on the evidence he had obtained. He notes that preparation for admission was limited and that children in homes were more subject to adult supervision; they needed privacy and control of their own room. So he recommends that there should be locks on bedroom doors or a lock on a cupboard or drawer in shared bedrooms and opportunities to make and receive phone calls in private. He also recommends guidance for staff on residential care for young victims and abusers as well as in service training on racial awareness and anti-discriminatory practice.
Stepping outside his main focus, he recommends that as many children as possible with disabilities be discharged from long-stay hospitals into specialist residential care or family placements.
He stresses that care should be a preparation for adulthood, not just for ‘independence.’ Children have rights to a childhood and youth and to have all decisions about them made with the greatest care but these rights need to be balanced by responsibilities. In this context it is important that young people are confident to use complaints procedures but it will not always be appropriate to suspend staff immediately after a complaint is made. Moreover, there should be greater emphasis on resolving complaints informally than on using formal complaints procedures.
While arguing that all young people should be able to make confidential complaints and that all allegations of abuse should be dealt with externally and referred to the police where there is reasonable cause to believe that a child has been abused, he argues that rights and complaints are not central to quality child care but involvement in decisions is. Citing para. 19 of Social Services Inspectorate & Social Work Services Group (1991), he recommends that all children over twelve should attend reviews plus those under twelve who request it and are able to understand the process. No review should be postponed without consulting the young person and their parents and they should also be able to call an overdue review. More generally, all children and young people should be able to consider issues and make suggestions for the running of the home.
He also recommends that each local authority should consider supporting the organisation Who cares? in their region.
Children need appropriate buildings in appropriate locations but there was often poor maintenance of the fabric, though this was generally better in voluntary and private homes and there were problems in homes for young people with disabilities. So he recommends an accelerated replacement programme to agreed standards and improved access for young people with disabilities.
Though the food was generally good, children need the experience of shopping and preparing food at a domestic level; they should always have access to simple food and there should be no formal purchase arrangements or bulk-buying.
There were wide variations in the provision of personal care and clothing but the important thing was choice. Recreational budgets should cover weekend and holiday activities and transport should not carry distinctive markings.
He had identified many issues relating to the provision of education and variations in the ways people dealt with exclusions but only 43% of statements of function and objectives mentioned liaison with school, only 19% mentioned school in relation to reviews and even fewer mentioned arrangements for homework. So he recommends a review of existing arrangements for meeting the educational needs of children and an exchange of documents between social work and education departments to avoid duplicating educational assessments.
He recommends a full medical examination of children in care beyond six weeks and notes the variations in policies on smoking, where rates are higher in Scotland than in England. He recommends that all agencies have smoking policies including prohibitions on staff from smoking and using cigarettes as a reward. He also recommends that Who cares? should clearly discourage smoking.
In relation to sex education, he recommends that all staff be trained in this area, including in HIV/AIDS, and that key staff in adolescent units be trained to take a key role. Staff also need to be trained to deal with drug and solvent abuse.
He notes that improving family links increases the chance of a return home and that many parents find it easier to visit residential homes than foster homes; parents should be informed of significant events and may need help and support. So they should be given their own person to contact, along with a copy of the statement of function and objectives and a statement of rights and responsibilities on or before admission; they need opportunities to speak in confidence to their child or a staff member and to be informed of developments. He recommends creating national organisations for parents and young people.
He argues for a joint approach to meeting children’s needs and recommends joint training for education, social work and other disciplines on collaboration to provide quality residential care.
He stresses the importance of enabling a child to feel safe and the varieties of ways in which emotional and behavioural difficulties can be dealt with but also says that there is no single answer to the problem of abuse. He notes that the surveys suggested that those running homes experienced stress in dealing with children and young people from emergencies, inappropriate admissions, aggressive incidents, and so on. 39% of homes had experienced a violent incident in the last month including 58% of those with education on the premises, though this was more likely in smaller homes.
He lists the various measures used to control children and young people, noting that some small homes only used staff disapproval but this depended on having a personal relationship within which one could show disapproval of the act, but not of the person. He also notes the wide variations in local authority codes of conduct and argues that therapy as a way of dealing with problems is not a substitute for good care.
He recommends that the Inspectorate should produce guidelines on control and that inspectors review their application and the staff training given. He also recommends that statements of function and objectives should distinguish care, control and therapy and that local authority managers and inspection units should collect information on absconding rates and investigate patterns, causes and solutions.
He notes there has been a decline in the use of unruly certificates, which was in any case significantly lower than in England and Wales, and recommends a review of future needs for secure accommodation.
In Chapter 4 Staffing and training, he recommends that salaries and conditions be improved and gives the results of the survey of staff qualifications which showed that a quarter of Officers in Charge and half of Assistant Officers in Charge had no qualifications; 88% of other care staff had no qualifications.
Noting that there has been a long history of a low level of training, he discusses the possibility of moving to the European model but decides that it would not fit well with the recently announced DipSW approach.
He recommends that 30% of all staff and 90% of senior staff hold social work qualifications and 60% of staff hold qualifications to SVQ3. He recommends that all social work students have one group care placement and all residential staff have two weeks’ induction training and only be confirmed in post when they have been assessed as competent at SVQ2. He recommends increased funding for voluntary organisations to second staff for qualification, additional practice placements in residential care including in the voluntary sector and funding for additional teaching resources to expand social work training. He also recommends that the Scottish Office fund a centre for consultancy and development in residential child care.
Noting that the sickness/absenteeism rate is higher in residential care, he recommends that all staff should have regular supervision, that secondments should be used as part of staff supervision and development, that qualified staff should hold full case responsibility for children and that residential care staff should carry authority and budgeting responsibility for expenditure on the basic care, recreation and the developmental needs of children and young people.
In Chapter 5 Management, planning and inspection, he argues that the need is for commitment to “consistently good quality residential care’”(p. 79). Strategic planning is needed to deal with inappropriate accommodation, inadequate collaboration, emergency admissions, inappropriate mixes of children, the lack of integration in services and insufficient placements.
So he recommends local plans for social work services for children and families to include current shortfalls and joint provision with statements of function and objectives linked to the plan. Improvements are needed in middle management but also greater devolution of responsibilities to Officers in Charge.
He notes the ongoing discussion about approaches to quality management and quality assurance and their implications for residential care and recommends that agencies extend quality assurance to residential child care. He also recommends that inspections should always include some interviews with children and young people and their parents.
In Chapter 6 Conclusion, he says there is widespread concern over poor quality but staff are undervalued and ill-equipped; the reductions in the use of residential care have been a good thing but residential care is still part of the overall service. The important thing is consistency for young people because good quality residential care will always be needed and “Quality cannot be inspected in; it can only be developed from a commitment at all levels to the continuing importance of the service” (p. 88).
He concludes with a List of recommendations and the Appendices.
Discussion
Angus Skinner’s view of residential care is no sentimental attachment but a hard-headed assessment of its strengths and limitations; he recognises that it is most likely to be successful when all those involved in it, parents, children and their carers, are committed to it as the right choice for them and it provides the opportunities for children to develop towards adulthood (Wolins, 1969).
He also recognises that there is no one way of achieving this; it has to be a co-operative effort between parents, children and carers, and the carers need delegated responsibility be to able to respond flexibly to the range of needs and situations which they may be called on to deal with. In management terms, he recognises that residential care is a process operation which needs a different type of management from most of types of operation (Woodward, 1980) and makes recommendations which reflect what King et al. (1971) found was associated with quality care.
Overall, it is an outstanding report, combining awareness of established best practice at the time with sensitivity to the issues surrounding the care of young people outside their own families. The ‘Skinner Principles’ set out at the end of Chapter 1 have rightly become a benchmark for assessing good quality care and are as applicable to residential care today as they were the day the report was finished. The recommendation for a centre for consultancy and development found expression in the Scottish Institute for Residential Child Care which continues to this day and has supported the production of the Key Texts series for Children Webmag.
References
Care of Children Committee (1946) Report of the Care of Children Committee [Chairman: Myra Curtis] Cmd 6922 London: His Majesty’s Stationery Office See also Children Webmag February 2011.
Committee on Homeless Children, etc. (1946) Report of the Committee on Homeless Children, etc. (Chairman, James L. Clyde) Cmd 6911 Edinburgh: Her Majesty’s Stationery Office See also Children Webmag April 2011.
King, R D, Raynes, N V and Tizard, J (1971) Patterns of residential care: sociological studies in institutions for handicapped children London: Routledge & Kegan Paul See also Children Webmag April 2009.
Social Services Inspectorate & Social Work Services Group (1991) Care management and assessment: practitioners’ guide London: Her Majesty’s Stationery Office
Utting, Sir W B (1991) Children in the public care: a review of residential care London: Her Majesty’s Stationery Office
Wolins, M (1969, January) Group care: friend or foe? Social work 14 (1), 35–53 Reprinted in M Wolins (Ed.) (1974) Successful group care Chicago: Aldine
Woodward, J. (1980) Industrial organization: theory and practice (Second ed.) London: Oxford University Press