What is unsuitable care?

What makes a care setting unsuitable? An unsuitable alternative care setting is one that does not promote a child’s best interest or full and harmonious development. It is a setting that does not respond to the specific needs and circumstances or wishes of a child. An unsuitable care placement is where the rights of a child are not being met, including those of protection and access to other services such as health and education. In unsuitable care, a child does not feel genuinely cared for.

What are the some of the attributes that indicate an unsuitable care setting – like for example those that are found in large residential institutions and detention centres? Factors include:

• Large size, with many children – also leading to impersonal treatment
• Failure to provide individual attention and address such issues as a child’s relationships and attachment to other people
• Lack of attention to psychosocial and emotional well-being of a child
• Closed facilities where children are not allowed out – meaning they do not live among, belong to, or interact as part of the local community, from whom they are effectively isolated. This may be due to facilities with closed access in and out, and/or located in remote rural areas
• Regimented daily routines for children that focus on meeting basic day-to-day material requirements, as for example food, clothing, and shelter rather than supporting children in their social and emotional development, and in their preparation for the future
• Lack of safeguarding – insufficient concern or no system that ensures the protection of children
• Collective living arrangements which only provide shared amenities and offer no privacy – as, for example, the use of dormitories
• Facilities where needs for warmth, hygiene, and comfort are not provided for
• Strict regimes often concentrating on needs of staff rather than on those of individual children.
• Poorly qualified and unmotivated staff and a lack of constructive staff supervision
• Constant change of carers and other staff, meaning children cannot form attachments and relationships with their carer/s
• Lack of access to specialist services, especially health, psychosocial support, special education needs, legal procedures etc.

In addition, unaccompanied and separated children should not be accommodated with adults. Children should always be provided accommodation in separate spaces and should certainly not be made to share a bedroom with adults in a transit centre or emergency shelter, for example.

All the attributes of unsuitable care listed above can seriously affect a child’s emotional and physical well-being. Perhaps you recognise these factors as applying to many of the living situations that are currently being provided to unaccompanied and separated children on the move in reception centres, emergency centres, transit centres, and detention centres. You might identify these conditions from your knowledge of large residential child care settings – ‘institutions’ – such as ‘orphanages’ and ‘large children’s homes’. And indeed, we should not forget that some of these unsuitable factors may also be found in family-based and family-like care, if not provided to a good standard.

You may be working in some very difficult circumstances – perhaps you still receive very large inflows of refugees and migrants, perhaps the only available alternative care options are those that have conditions outlined above as being unsuitable. However, as practitioners and others who care, we are sure you all strive to provide the best possible alternative care and wish to improve unsuitable care settings in any way you can. To help you think about and work towards possible changes, in the next course steps we will consider standards and attributes for suitable alternative care. We will then look at some examples of care services for unaccompanied and separated children that were developed in line with the ‘suitability’ principle.