SHIFTING FROM INSTITUTIONAL TO NON-INSTITUTIONAL SERVICES
In order to reduce the current over reliance on residential care in developing contexts and better protect children’s right to grow up in a family, we need to scale back institutional services, and increase the availability of non-institutional child welfare services. Implementing this transition is a complex process called ‘deinstitutionalisation’.
1. RESPECTING CHILDREN’S RIGHTS AND INVOLVING THEM IN DEINSTITUTIONALISATION
Children (and their families) should be full partners in the transition process. They should be actively involved and consulted in the development, delivery and evaluation of the services they receive and provided with appropriate information in a manner which they can understand.
2. PREVENTION OF INSTITUTIONALISATION
The necessary steps should be taken to prevent the placement of individuals into institutions. Holistic policies are necessary for the support of families and other informal carers as well as for strengthening the inclusive capacities of communities.
3. CREATION OF COMMUNITY-BASED SERVICES
A range of available and affordable high-quality services in the community to replace institutional care needs to be built up. They should provide support for family and informal carers, starting with their individual needs and preferences. Their purpose is to prevent further admissions to institutional care, to provide placements for the persons currently in institutions and also to benefit those people who live in the community (with their families or otherwise), but without adequate support.
4. CLOSURE OF INSTITUTIONS
Institutions should be closed down in a way which ensures that no child is left behind in unsuitable conditions and that minimising any risk of trauma linked to a change in their living environment. Those with highest support needs should be given priority and planning should include the preparation of a plan for each child and the assessment of the training needs of staff wishing to work in the community.
5. RESTRICTION ON INVESTMENT IN EXISTING INSTITUTIONS
Processes of transition from institutional to community-based care typically take many years. Meanwhile, many children continue to live in unsuitable, harmful conditions. Therefore, some renovation of existing institutions may be required but should be limited to what is strictly necessary to look after the best interests of the child during transition.
6. DEVELOPMENT OF HUMAN RESOURCES
It is vital to ensure the availability of sufficient and well-trained staff with skills appropriate for community-based care, which is based on partnership, inclusive attitudes and an interdisciplinary approach. This may involve retraining and re-qualification of staff who previously worked within the institutional culture. By redeploying the personnel who can be trained to work in the community, resistance to the process of reform can be reduced.
7. EFFICIENT USE OF RESOURCES
A residential care facility is extremely costly. As far as is possible, and in the best interests of children, these resources should be transferred from the existing institution to new services. Re-use of existing resources ensures that the reform process is less expensive and more sustainable. Budgets for running costs can be transferred to cover the costs of running services in the community, such as small group homes and family support centres; at times, buildings can be reused for other purposes (where they are appropriately located and in sufficiently good condition).
8. CONTROL OF QUALITY
Systems of quality control should concern both the process of transition and the resulting services, with a clear focus on user satisfaction. The involvement of children, their families and their representative organisations in the monitoring of quality is crucial.
9. HOLISTIC APPROACH
Issues concerning transition from institutional to community-based care must be addressed across all the relevant policy areas, such as employment, education, health, social policy and others. Such a holistic approach should guarantee coordination and policy consistency across different branches of government as well as continuity of care, e.g. between childhood and adulthood.
10. CONTINUOUS AWARENESS RAISING
The transformation process needs to be accompanied by efforts to ensure that key professional bodies support it in terms of the values which they transmit to their current and potential members, as well as to the society at large. Simultaneously, the awareness of nonprofessional decision-makers and opinion-makers and of the broader public should be raised in order to ensure the consistency of their attitudes with the desired values.
(Source: Lumos' 10 Principles of Deinstitutionalisation, wearelumos.org)