companion primer
12 PRINCIPLES OF HIGH-QUALITY RESIDENTIAL CARE, AND HOW WE ACHIEVE IT
Applied Research for Vulnerable Children + Families
For leaders committed to excellence for vulnerable children and the communities that care for them, CAFO’s Center on Applied Research for Vulnerable Children and Families is a trustworthy bridge between research, practice, and care reform that provides the best available guidance to inform the most effective care for children.
To learn more, visit cafo.org/ovc
The Christian Alliance for Orphans affirms the historic Christian understanding - conveyed in Scripture and affirmed by social science - that God intends the family as the essential environment for children. We believe the ideal outcome for every orphan is to know the love and nurture of a permanent family. Our world’s brokenness at times makes this goal unattainable. Thus, alternative forms of care are sometimes necessary. This reality calls us to affirm two seemingly opposing convictions at the same time. Decades of research assert that the ideal place for a child to be raised is within the context of a loving, nurturing family. Family should always be our first priority when considering placement, as we know it most naturally provides what is in the best interest of the child. That means we should thoroughly consider whether family strengthening, family reintegration, kinship care, adoption or foster care can meet the needs of a child before considering small group care. However, for certain children in certain contexts with certain needs, high-quality, family-like, small group care may be the best option to help them thrive. How do we identify the children who will be best served by small group care? How do we ensure children who are better served in another setting receive those placements? How do we set up group care to lead to successful outcomes?
12 PRINCIPLES FOR HIGH-QUALITY RESIDENTIAL CARE
1. Care should always focus on the best interest of the child. All children have the right to a placement setting that best suits their needs. For most children, this will be a family setting, achieved by biological family, kinship care, adoption, or foster care. For a small subset solutions may look a bit differently, in the context of small, family-like group care. Care decisions must be made based on what fosters a child’s short - and long-term wellbeing, rather than what is easiest for programs or caregivers. Learn more about the best interest of the child: https:// www.faithtoaction.org/exploring-the-continuum-of-care/
2. A continuum of care options is required in each context. In order to make decisions based on a child’s unique strengths and needs, we need to have a range of care options available in any context, including family care, adoption, foster care, and residential programs. No child should be in residential care simply because it is the only option in a given context. Where family options don’t exist, we must develop them. Learn more about family care solutions: https://www.faithtoaction.org/ exploring-the-continuum-of-care/
3. Excellent gatekeeping comes before successful outcomes. Gatekeeping is the decision-making process to prevent unnecessary family separation and to ensure a placement that is in the best interests of the child when separation does occur. Around the world, a high percentage of children in residential care could live in family care via reintegration with biological family, kinship care, adoption, or foster care. The population best served by residential care is narrow, and typically includes older, high-risk OVC who need the intensive support that high-quality residential care can provide. Excellent gatekeeping is vital to ensure each child is in the placement that best serves them. Learn more about gatekeeping: https://www.faithtoaction.org/exploring-thecontinuum-of-care/
4. Good residential care is difficult. For contexts in which residential care is the only available option, it may seem simpler to continue that model and do it really well, rather than considering other care models. Residential care should never be the default option, and is extremely difficult, time-intensive, and expensive to do well. Organizations should only operate small group care when they are able to provide the necessary funding, staff, and support to meet the needs of the limited, high-needs population that will be best serve by family-like group care. Learn more about residential care standards: https://www.faithtoaction.org/exploring-the-continuum-of-care/
5. Size is not the only factor in determining quality of care. Large institutional housing is never the answer. When discussing the difference between institutional care and residential care, overall size, type of housing, and child-to-staff ratios are often raised as differentiating factors. Certainly, thinking through these important components is vital to establishing a family atmosphere. However, it is entirely possible to have institutional, impersonal care in a small group setting.
6. Approximate family in all aspects of care. What every child needs most is the love, belonging, and protection that comes most naturally from living in families. For youth unable to thrive in a family setting, small group residential care must approximate family life. In the home space, this will mean remaining with the same caregivers and in the same space for as long as possible (rather than “advancing� through multiple dorms), connection to caregivers long after graduation (for example, having the caregivers name on a grandchild’s birth certificate), and long-term community (such as family reunions).
7. Children need to be part of the community. Children who live their life on a compound, going to school, eating meals, and working and playing within a very limited and controlled environment are unlikely to be able to transition to living independently in their community. It is vital that all children be given the opportunity to regularly connect with adults and children outside the residential care center, to worship, attend school, and participate in local community life, and to gain a keen knowledge of the local vernacular and culture, in order that they can seamlessly transition to adulthood in that context.
8. Children should be prepared for independent living when they reach adulthood. Eventually, every child will become an adult, and one of the most important ways to love them well is to ensure they are equipped for independence. The test of whether a program is successful is not whether a child is happy or getting good grades, but rather whether they are able to tackle adulthood successfully, holding a job, maintaining healthy relationships, and eventually raising their own children well
9. Do not confuse transitional and permanent care. In some cases, small group care is needed temporarily. This can include emergency situations such as separation from parental care in natural disasters, parental illness, or political displacement. Sometimes, transitional care may be needed to prepare a child for family care, such as in the case of children who have been living on the streets or trafficked reintegrating with their families. Access to high-quality short-term care is vital, but use good gatekeeping and case management to ensure those children in need of temporary care don’t end up in long-term residential care.
Eventually, every child will become an adult, and one of the most important ways to love them well is to ensure they are equipped for independence.
10. Stability and permanency are important to wellbeing. When small group care is identified as the best option for a youth, part of approximating family is cultivating permanency and belonging. Moving children between rooms, homes, and caregivers is not healthy or appropriate for their development. Further, limiting transitions with other children in their group/home/family will allow for the stability necessary to thrive. Commitments of caregivers, and relationships between children and caregivers, should be as long-term as possible, ideally extending well beyond graduation from the program.
11. Consider unintended consequences of making care available. Starting (or even maintaining) residential care programs can have unintended consequences. In many communities, sending a child to the local residential care center can be seen as an easy answer to lack of resources. Having an alternative care option available may lead families to place their child in care unnecessarily. This must not happen, and vigilant gatekeeping and holistic family strengthening options are vital to preventing inappropriate separation from family.
12. Build capacity to build families and communities. In some situations, residential care providers are the ideal fit to provide community services that prevent unnecessary separation of children from families. Opening up chairs in a school to community children, providing daycare or after school care, or offering counseling services to families at risk are all ways residential care providers can repurpose current resources to be part of keeping families together. Learn more here: http:// www.faithtoaction.org/register/
To learn more about high-quality residential care and how we achieve, it, visit: cafo.org/ovc
To learn more, visit cafo.org/ovc
Š 2020 Christian Alliance for Orphans