Catherine Street - Providing Residential Services for Children and Young People: A Multidisciplinary Perspective

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PROVIDING RESIDENTIAL SERVICES FOR CHILDREN AND YOUNG PEOPLE: A MULTIDISCIPLINARY PERSPECTIVE

Providing Residential Services for Children and Young People

A Multidisciplinary Perspective

Catherine Street PhD
London School of Economics and Political Science

First published 1999 by Ashgate Publishing

Reissued 2018 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright Catherine Street 1999

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Publisher's Note
The publisher has gone to great lengths to ensure the quality of this reprint but points out that some imperfections in the original copies may be apparent.

Disclaimer
The publisher has made every effort to trace copyright holders and welcomes correspondence from those they have been unable to contact.

A Library of Congress record exists under LC control number: 99073624

ISBN 13: 978-1-138-33183-9 (hbk)

ISBN 13: 978-0-429-44703-7 (ebk)

Contents

Guide

Catherine Street has written a timely and challenging study of the services we provide for children and young people whose psychiatric and behavioural disorders are so severe that they require long-term residential care and treatment. The services that these children and young people need are highly specialised and inter-disciplinary in character. They are also high-cost services, requiring continuous co-ordination and monitoring as needs change over time.

Meeting these needs effectively would still be a difficult task under the most favourable and supportive circumstances. Recent policy developments, however, have compounded the difficulties which both the purchasers and providers of specialist residential care confront. For many years, policy-makers have encouraged greater reliance on community-based services at the expense of residential provision. The creation of quasi-markets and new purchaser-provider arrangements in social care has resulted in a contraction of statutory forms of direct provision and an increasing reliance on non-statutory agencies and units.

Faced with the ever-tightening restraints of budget cuts, local authority social workers, community-based health personnel and local education authority officers have delayed seeking the expert and expensive forms of residential health treatment, education and care that some of these children require. Consequently, residential units are having to cope with a growing number of 'last resort' requests for their services. Effective treatment is often delayed to the detriment of the health and future prospects of these children. In this context of unpredictable demand and a high incidence of emergency admissions many residential units are finding it increasingly difficult to stay in business. In this field of social and health care, quasi-markets are reducing rather than increasing consumer choice.

Catherine Street's research describes a network of specialist child care services that is currently operating under conditions of continuous crisis and confrontation. The findings of her enquiry show that 'some areas of the country are now almost totally lacking any form of residential provision' for these acutely distressed, difficult and vulnerable children. Her conclusions are further confirmed by those of Sir William Utting in his 1997 report, People Like Us.

Catherine Street's study however, adds new dimensions and insights to the current debate about the pros and cons of services provided on a residential basis. Her research is based on extensive interviews with the providers of residential therapeutic services. She describes, in telling and convincing detail, the financial uncertainties they live with, the problems of staff morale that beset them and the frustrations they experience when care contracts are prematurely terminated through a lack of funds. Nevertheless, the real casualties are the vulnerable children and parents who have to cope as best they can.

Providing Residential Services for Children and Young People: A Multidisciplinary Perspective clearly highlights the extent to which our increasingly stringent legal requirements and rising social expectations are not being matched by the extra resources needed to raise standards of care in this small but important sector of services for children and young people, Catherine Street provides us with an up-to-date analysis of the policy trends which have created the current crisis in residential services. She describes the incidence of child psychiatric and behavioural disorders in the United Kingdom, and the complex processes of diagnosis, care-planning and treatment involved. She sets out a realistic agenda of proposals for the improvement of these services.

In summary, Catherine Street has written an exemplary work of social investigation that will be widely read and discussed by policy makers and practitioners concerned with child care and protection. This is a work that will deservedly take its place in the best traditions of British applied social science research.

Robert Pinker
Professor Emeritus of Social Administration
London School of Economics and Political Science

Many people gave a considerable amount of their time towards this research study and their support and advice was invaluable in drawing together information from a diverse range of sources. In particular, thanks must go to the staff working in residential services for children and young people who made themselves available for interview and those working in the many purchaser settings who very generously provided budget and service planning information from their organisations. Without their cooperation, this work would not have been possible.

The assistance of staff in the libraries of the NSPCC, the National Children's Bureau, St Peter's Hospital at Chertsey and those in charge of maintaining the database of 'Care Base', the Children's Placements Network, is also gratefully acknowledged. A number of the tables in this book are presented with the permission of the Department of Health and also the Children's Society. Crown copyright material is reproduced with the permission of the Controller of Her Majesty's Stationery Office. The agreement for these tables to be used here is much appreciated.

This research project formed the basis of a PhD undertaken in the Department of Social Policy and Administration at the London School of Economics and Political Science and was supported by a scholarship from the Economic and Social Research Council. At the LSE, specific thanks are due to Professor Bob Pinker for his constant support, encouragement and constructive suggestions on the editing of the fieldwork data.

Transforming a PhD thesis into a book is a significant task. A number of friends provided much needed assistance in commenting on and checking chapter drafts and for this, a special thank you is due to Jan Ramsey, Kathy Riddell, Gerry Harrison and Shelagh Allsop. The process is also extremely time-consuming and generates huge amounts of paper. A final word of thanks therefore goes to my family for their support and interest in this work - and especially to Simon and Christina, much appreciation for their love and patience whilst I have been preoccupied working on this text.

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