The Blog

Full Spectrum Early Intervention Needs Residential Options Too

The Early Intervention Foundation's (EIF) aspiration to end late intervention should be accompanied by research into residential options for children.

We must not close our eyes to any option that will benefit children. Full spectrum research could go beyond a focus on what people currently see as being 'early intervention,' which is often family and community based only.

We should be inclusive and expansive. We need an understanding of the benefits of all settings and services. This will need us to look again at the solutions residential settings can bring. We have used our residential settings differently in previous decades, not as the last resort of today but as addition or when necessary alternative to families and communities.

We also have more to reclaim and renew from our residential tradition. Remember, many ideas being used by early intervention services were tried and tested in residential settings long ago.

Residential care is the 'laboratory' or at least the 'observatory' of social care. Focussed needs and settings allow creative ideas to be explored. If they are helpful for this most needy group of young people then they will be for all others too.

So it is concerning that we have no contemporary residential research in England. People keep referring to residential research when most providers were municipal. We do know how things have changed markedly in residential settings. Ofsted inspections show that quality has risen sharply in the last decade. We need research to catch up with reality.

The EIF seeks a 'single source of independent, comprehensive and authoritative assessment, advice and advocacy'. This cannot exclude options but should be inclusive; a partial evidence base is always misleading. It should address the reality that some children have high level needs. We must not allow the current circumstances that are allowing a 'compromised care' choice on the basis of cost alone to persist. This group of young people must not be forgotten. The reality is we see late interventions every day when young people arrive at children's homes well into adolescence following failed and serial placements before reaching where they needed to be at the start and having endured too many 'short term, expensive and ineffective' family and community based services' as the EIF describe'.

It is time to take a positive view of the support that residential resources can offer to the early intervention agenda. If early intervention is to be meaningful for all children and all needs it must include all options. In previous decades where we had extensive early intervention we still found higher level needs. Indeed, it was ideas about how to meet universal and general needs that often originated in specialist residential settings.

Take the example of nurture classes developed by the Inner London Education Authority. These are now commonplace in schools across the country. Back then, they mainstreamed many ideas in residential settings and in many ways are the forerunners of the thinking around emotional well-being. They did not remove the need for residential settings but brought ideas from that tradition and settings to the family and community.

Making the point that what was true then can also be so today and to recognise all experience and evidence we might note a recent report from London Councils ('An analysis of changes in the numbers of Looked After Children in London'). It says: 'Perhaps of more interest in this study, is that there were even fewer respondents to the questionnaire who could demonstrate a correlation between increased availability of early help services and a reduction in the number of looked after children. This may be related in part to the stage of development of early help services in most boroughs, but in general London assistant directors felt that such services were targeted at a different group of families and that those where children were at risk of harm would still come to the attention of children's social care. In short, there was no evidence to suggest that such risks were being averted by earlier intervention.'

The boroughs that experienced the greatest decrease in numbers of looked after children had one overriding feature in common. This was that senior managers had a very detailed knowledge and understanding of their looked after children population. The assistant directors spoken to in these boroughs gave accurate information about, for example, age patterns, proportions accommodated or in care, and the impact of actions taken to reduce numbers of children who they felt were either not benefiting, or not likely to benefit, from being looked after.

Other countries of current interest such as Denmark use residential solutions earlier. We must study their whole system and 'what works'. Picking and choosing misses the learning. These countries still use residential care for specialist needs too but whilst we know a little about social pedagogic homes we know less about what they call 'treatment homes.'

Reading some early intervention commentaries, it is easy to think that needs will decrease and higher level services will no longer be needed. It isn't necessarily the case. We are talking about elemental needs that have been with us throughout history, and are maybe part of the human condition.

We must reopen our eyes to using residential care positively and expanding the options for family and community based services. If we are to be successful with plans to get the right child in the right place at the right time we cannot exclude any option that can afford a child a sense of security, continuity, commitment and identity; experience and evidence tells us that can be a residential child care setting as much as any family.