With adequate funding, these homes can provide intensive support for the
62% of residents with significant mental health conditions
Photograph: Brand New Images/Getty Images
care system for children in England, including residential care, has
undergone a significant transformation in recent years. Much of what has
happened in the homes has been driven by changes in policy, such as a
shift in priorities towards fostering, with wide-ranging implications
for those who manage, work and live in them.
Today the majority of homes are small, often four- or six-bed
residences. According to the Department for Education (DfE), about 15%
of children in the care system will have spent some time in a
residential setting. The number of children living in homes, hostels or
secure accommodation at any one time is 6,360 – about 9% of the total
number looked after. In 1978 that figure was 32%.
More than half of all children’s homes are run by the private and
voluntary sectors, while over a third of local authorities in England no
longer run their own children’s homes; at one time the vast majority of
places were in council-managed provision. This trend seems set to
continue with almost half of all councils closing at least one home
The children’s homes sector is subject to considerable scrutiny,
particularly when it comes to safeguarding against abuse. The
involvement of businesses in running homes has also proved controversial
as many are perceived as putting profit above other considerations.
Other issues centre around how local authorities commission services
from an increasingly fragmented sector, and the recruitment and
retention of adequately trained staff.
Providers also need to prove that safe, high-quality care is being
consistently delivered, as well as complying with new regulations and
demonstrating that outcomes for children are improved.
children’s care provision has begun to veer towards fostering, the role
that homes play has come under fresh scrutiny. Questions about which
children end up in care homes and why, as well as whether those with
more complex needs are in residential settings as “a last resort” – as
one government report concluded – rather than as a positive choice, are
placed in residential care typically arrive as teenagers after multiple
foster care placements. They tend to have complex needs including
mental health, emotional and behavioural problems as a result of
childhood trauma. According to government figures, 30% are placed as a
result of abuse or neglect, while the same percentage has experienced
significant instability with five or more different placements. Some 38%
of children in residential settings have special educational needs.
They are also more likely to be in contact with the criminal justice
The 2012 DfE report, Living in Children’s Residential Homes,
states: “The emphasis on using foster placements wherever possible has
meant that children’s residential homes have increasingly come to be
used principally for older children with more serious difficulties, who
may have difficulty settling in foster care or who may not want a foster
However, according to Alison O’Sullivan, president of the Association
of Directors of Children’s Services, many children are placed in
residential not simply as a consequence of their failure to settle in
foster care – the last-resort option – but because of their complex
needs and “the very specialist nature of the kind of therapeutic support
that they need”.
O’Sullivan says the move toward smaller homes with fewer children has
been a significant development, and can, when done well and adequately
funded, create an environment of intensive support for children,
including those with mental illness
With 62% of young people in homes living with a significant mental
health condition, many in the sector argue that radically improving the
support available is an urgent issue, especially if the outcomes for
children in the longer term are to be boosted.
The NSPCC children’s charity wants it to be a child’s “right” to
receive specialist mental health assessments in care. The charity says
current health assessments frequently fail to identifying the mental
health needs for children in care and points out: “Our care system is
there to provide safety, but also to help children overcome the abuse
and the circumstances that brought them into care.”
Stanley from the Independent Children’s Home Association, which
represents providers, agrees that appropriate mental health care is
“vital” because by the time a young person enters a residential setting
the difficulties are often longstanding.
But government policy falls short because of its focus on early
intervention. Stanley says priority should be given to the high
proportion of older children in homes grappling with mental health
difficulties. Such a policy, he says, would improve other outcomes.