Background to the Research

• Providing a caring and nurturing environment that meets the needs of young people presents a considerable challenge to both commissioners and providers of residential child care services. An issue of concern reported frequently by managers and staff in residential care is that of 'keeping order' - of dealing appropriately with disruptive and challenging situations that arise within children's homes. It was to address this concern that in 2006 SCIE commissioned this Knowledge Review. The overall aim of the Knowledge Review was to identify what is known about effective working with challenging and disruptive situations in residential care.
  

Research Approach

• The specific objectives of the research were to address the following questions:
  • What are the nature, incidence and social context of challenging and disruptive situations in children's residential care?
  • What are the possible causes and effects of these situations?
  • Which young people and staff are associated with, involved in, and affected by these situations?
  • What promotes effective practice in dealing with challenging situations?
• To answer these questions two different methodologies were used. Firstly, a systematic Research Review which evaluated and summarised research from 33 publications. This provided an international picture of the nature, incidence and context of anti-social and disturbing behaviour in residential child care, the causes and effects of such behaviour, and the impact and effectiveness of different management and staff approaches.
• Secondly, a Practice Survey was conducted in NI. This gathered information from a variety of sources which included: analysis of policy documents; contextual information from England; a mapping exercise of challenging situations in residential child care in NI; and interviews and focus groups with a wide range of people representing all those with a policy or practice interest in children's residential care, including staff and young people from five children's homes.
  

Main Findings

• Challenging behaviours ranged from defiance and non-compliance through to different types of violent behaviour against peers, staff or self. Although incidents of serious violence were rare, anxiety about serious incidents seems to be as stressful as the actuality.
• A range of factors were reported as triggers for challenging and disruptive situations including: young people's individual attributes and past experiences; group dynamics; staff approaches and relationships with young people; institutionalised nature of some homes and associated, rigid rules and regulations and lack of adherence to Statements of Purpose for children's homes due to the shortage of places for young people and demands for emergency placements.
• The research review found no clear evidence of the success of particular structured interventions, including TCI, the most common approach currently used to deal with challenging situations in NI. In the practice survey, staff reported variable levels of success in their application of such interventions. Staff often reported feeling powerless in their ability to keep young people safe even when they knew that they would be placing themselves at serious risk in the community.
• When a young person engaged in serious and/or repeated physical assaults against staff or peers, staff suggested there were no meaningful consequences for the young person.
• However, styles of working were shown to have a major impact on the effective management of challenging situations. It was suggested by young people and adults that only staff who are able to demonstrate a clear commitment to young people, listen to them and understand and respect them can adequately manage challenging situations and effectively defuse potentially disruptive behaviours.
• Alongside the need to build relationships, was the need for effective team working. A number of factors that enhanced this were identified including:
  • Clear policies and procedures; regular team meetings and supervision;
  • Opportunities for team development and team debriefings to discuss challenging situations when they occur.
• Other means of building a skilled team were identified as being:
  • More targeted training and support for staff;
  • Contracting support from specialist professionals; and
  • Increasing staffing levels.
    

Conclusions

• Peer relationships and group dynamics are a primary source of disruption within the group care context of residential care, therefore, maintaining good order depends on effective management of these relationships. The research suggests a need for:
  • A range of differentiated homes within the continuum of care;
  • Adherence to agreed Statements of Purpose;
  • Small homes, preferably fewer than six young people; and greater clarity and understanding of policy and procedures.
• Success in responding to the complex needs of young people who come into residential care depends upon having the 'right' staff team. This should include:
  • Staff with the skills mix, qualities, attitudes, motivation to relate to young people and build positive relationships with them;
  • A reduction in the reliance on temporary bank staff; and
  • Competent management for the maintenance of good order including, clarity in generating and applying rules and procedures, and promoting strong teamwork.
• The dominant theme running through this study is the fundamental importance of the relationship between staff and young people and the extent to which young people are involved in, and feel a sense of belonging within, the home. Young people identified skilled staff as those who:
  • Know young people and can anticipate difficult situations;
  • Are calm and consistent;
  • Can successfully de-escalate situations;
  • Know how to physically restrain a young person appropriately;
  • Listen to young people;
  • Take an interest and get involved in activities with young people; and
  • Refrain from playing power games or constantly engaging in verbal battles with young people.
• This mix of staff skills can be achieved: through the recruitment and selection process; specific training; and greater use of the perspectives of young people. There is still a shortage of rigorous research on the impact of interventions in residential care. It is crucial that the impact of interventions is robustly evaluated to identify the most valuable aspects of these interventions and the key elements to be further developed. A high priority should also be given to establishing a system for recording and monitoring to ensure that a sound and accurate picture of the occurrence of such incidents may be obtained.