arqua-p: a comprehensive evaluation system for residential care in portugal sónia rodrigues, jorge...

ARQUA-P: A COMPREHENSIVE EVALUATION SYSTEM FOR RESIDENTIAL CARE IN PORTUGAL

Sónia Rodrigues, Jorge F. Del Valle, & Maria Barbosa-Ducharne

Introduction Portugal: localization and demographic data; Residential Care (RC) in Portugal Evolution of RC and quality; Theoretical Framework: the bioecological model; Lack of research on RC Quality and its importance; Arqua-P as a Comprehensive Assessment of Portuguese Residential

Care quality Established protocols;

Objectives Method Results Discussion Conclusions

ARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

RESUME

Sónia Rodrigues

PORTUGAL

± 10.000.000 Population

± 2.000.000 under 18 years;

0,36% of Portuguese children or youngsters in Residential Care (more than 1/300)

(PRODATA, 2014)ARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

INTRODUCTION

In Portugal:

8000 children in RC (ISS, IP, 2013);

More than 90% of all the children in out-of-home care in RC;

After a slightly decrease number of children in RC grow again since 2011(CNPCJR, 2014);

Foster care placements have fallen constantly over this period to a minimum of 4.4% in 2013;

99% of babies (under three years old) in care, are placed in RC.

INTRODUCTIONARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

In Portugal:

48% of the Portuguese RC institutions are gender specific; (ISS.IP, 2014)

Siblings often put apart in different centres;

Caregivers without specific qualifications; Centres without a complete

professional/specialized team; The law does not set a time limit; Long periods living in RC.


Residential Care in Portugal

± 8000Children and

Young People in Residential Care

194 LIJ(Homes for

Children and Youngsters)

-6 Specialized-

126CAT

(Temporary Care

Centres)

7Others

(Institutions without

convention with Welfare

Services)

7 AA (Autonomy’s Apartments)

ISS.IP (Welfare Services), January of 2014

18Casa Pia

Santa Casa de

Lisboa

11Madei

ra

41 Azores

Entities with

responsibility in RC

CNPCJP Nacional

Walfare Services (ISS.IP);

Azores (IPRA);Madeira (IPRAM);Casa Pia;

Sta. Casa da Misericórdia de Lisboa

CNISUM

RC CENTRES

Private; Non-profit; Solidary

role.

INTRODUCTION

Institutional

Model

Family Model

Specialized Model


Welfare type of care;

Large homes;

No specially qualified staff;

To meet basic needs.

Normalization; Respect for each individual differences; Personalized care; Caregivers with professional expertise

and capable of establishing close relationships;

Open facilities; Integration in the community; Small number of children (less than 12); Ratio (Del Valle, Bravo,

Martinéz & Santos, 2012).

Legislation; Political ideology; Staff qualifications and training; Other community resources; The setting of the residential

home; Geographical surroundings; The children’s problems; Families’ problems...

INTRODUCTION

Residential Care Services are influenced by:



FRAMEWORK

The staff, with their personal histories;

Children with their development histories;

Context formed by the culture and the social environment

Changes over time.

Theoretical Framework:The Residential setting can be seen as a Bioecological Model (Bronfenbrenner, 2000)

RC must answer to each child’s necessities and not in reverse (Calheiros, Lopes & Patrício,

2011) and be provided on

time (Aldgate & Stathan, 2001)

Quality as a dynamic concept that follows

the adequacy of resources and

services provided by RC to the needs and

characteristics of children and young

people in care

Is associated with psychological adjustment,

wellbeing and satisfaction with life

experienced by children and

youngsters in care.

Quality


QUALITY

INTRODUCTION

The ideas of quality and assessment are inextricably linked;

Accommodating subjective, plural and contextual aspects to this concept requires the involvement of all people in context (including the children);

Collecting information from different sources and types;

Benefited from a multiplicity of perspectives and understandings;

Mixed methods.ARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

Quality of Portuguese Residential Care: Lack of Knowledge

INTRODUCTION

Limited Research in

RC

(Bravo & Del Valle, 2009b)

Even More

Dramatic in

Portugal

(Mota & Matos, 2008)



INTRODUCTION

Assessment on services in RC;

Needs of the children and young people in RC;

Match institutional offer with the real needs of the children and youngsters in care.

ARQUA-P: Comprehensive Assessment of Portuguese Residential Care Services

Protocols: With entities with responsibility in RC

University of Porto

CNPCJP Nacional

Walfare Services (ISS.IP);

Azores (IPRA);Madeira (IPRAM);Casa Pia;

Sta. Casa da Misericórdia de Lisboa

CNISUM


OBJECTIVES

General ObjectiveAssessment of the quality of the Portuguese

RC system.

Pilot Study Objectives

To test the adequacy of the measures, data collection instruments and procedures;

To complement the training of the research team.

OBJECTIVES


OBJECTIVES

Specific Objectives ( from the global research project)

To survey the current reality of RC in Portugal;

To evaluate the resources and services provided by RC institutions;

To identify the characteristics and needs of children and young people in RC, including psychological adjustment, strengths and difficulties, self esteem, personal wellness, subjective happiness and satisfaction with life;

To evaluate the quality of RC institutions assessing the adequacy of service offered to the identified needs;

To compare the quality of RC system in Portugal with the international reality;

To produce a scientific basis for policy-making and management in this area.

OBJECTIVES

METHODS

80 RC Institutio

nsNational,

representative and random

sampling, based on the type of

institution, obtained by a

computer program

developed for the purpose.

A team of at least two researchers will visit for 1 or 2 days each institution (depending on the institution’s size);

Participation in research is strictly voluntary for all participants (including the institution);

The visit is previously prepared: information about the study is provided;

Clear-cut identification codes for all participants (whose key is only handed by the research team on the visit day and destroyed afterwards);

An informed consent is signed by all the participants.


The visit Guided tour of the whole building;Documental analysis; Interviews Administration of Questionnaires to young people, over

12 years old, in group context;Caregivers’ individual filling out inquiries; and

solicitation to fill out inquiry by the children’s teachers (these will be send by mail later on ).

METHODSARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

Quality Standards

ARQUA-P

Dimensions

ARQUA-P


METHODS

(Rodrigues, Del Valle, Bravo,, Barbosa- Ducharne 2014)

ARQUA

• Quality assessment in Spain Del Valle and GIFI of Oviedo University

• GIFI, Universidade de Oviedo

Portuguese RCContext

• RC system characteristics in Portugal

• Walfare Services Quality Manuals for RC

(Del Valle, Bravo, Martinéz, & Santos, 2013)

ARQUA-P system: Instruments

METHODSARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

Resources (localization, equipment, human resources); Children needs (safety and protection, respect of rights, basic needs,

school and training, health and life style, normalization and integration, development and autonomy, participation, use of consequences).

Basic processes (admission, assessment of needs, case project, adult life transition, family support);

Management (leadership, institutional climate, organization, human resources coordination, registers).

ARQUA-P


METHODS

21 Dimensions evaluated in a 5-point Likert Scale

Instruments: Measures of adjustment

• CTRF 1½-5, CBCL 6-18, TRF 11-18, YSR (Achenbach & Rescorla, 2001), translation Gonçalves, Dias e Machado

ASEBA: Achenbach’s System of Empirically

Based Assessment• (Rosenberg, 1965), translation Santos e

Maia, 2003 and validation Romano, Negreiros e Martins, 2007) (EAR- Escala de Auto Estima de Rosenberg)

Rosenberg Self-Esteem Scale (RSES)

• (Diener, Emmons, Larsem & Griffin, 1985),

translation Neto, Barros e Barros, 1990 (ESCV - Escala de Satisfação com a Vida).

The Satisfaction With Life Scale (SWLS)

• (Lyubomirsky & Lepper, 1999), translation Pais-Ribeiro, 2010 (EFS- Escala de Felicidade Subjectiva)

Subjective Happiness Scale (SHS)

• (Goodman, 1994) translation de Simões, s/d (in Marzocchi et al, 2004)

Strengths and Difficulties

Questionnaire (SDQ)• (Sandin, 1997) translation Baptista (1999);

validation Carvalho, Baptista & Gouveia 2004

Positive and Negative Affect Schedul (PANAS-

N)ARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

METHODS

ARQUA-P quality assessment of each RC centre

METHODS

interobserver

agreement

Scored at all the 21 dimensions and registered in a 5- point Likert scale.

Final evaluati

on score

Descriptive analysis of the Portuguese RC system According to

international standards to quality of RC.

Current State of the Research Project Pilot study

6 institutions: 4 small (under 16 children); 1 medium size (between 16 and 30 children); 1 large (more than 30 children).

Total children/youngers living in care: 114 Aged between 2 months and 20 years old; Participants: 81 children and young people in

care 7 directors; 62 caregivers; 6 liaison agents in the welfare services; 15 Teachers

DISCUSSIONARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

Preliminary results of pilot study


RESULTS

Positive oriented self-esteem of adolescents and young people correlates positive and significantly with all the ARQUA-P dimensions;

Average positive levels of Life Satisfaction (LS) in young people in RC, although significantly lower than the LS level reported by normative adolescents. LS: M = 21.61 (DP = 8.02)

LS correlates positive and significantly with several dimensions of ARQUA-P (quality measure) in special with the “Safety and Protection” dimension.

Great amount of data available.

CONCLUSIONS

Convenience sampling procedure

Lacks representativeness over the Portuguese RC system.

Generalization of the results should not be made.

Instruments and

methodology

testingPreparation of

larger research


A larger number of participants from a broader type of RC units must be heard and additional data collected.

Limitations and Recommendations


CONCLUSIONS

How do these institutions work?

What services are provided?

What are the needs of children and young people in care?

Do these services really suit the children’ and youngsters’ needs?

Which therapeutic strategies and routines are implemented in the context?

(Rodrigues, Del Valle & Barbosa-Ducharne, 2013)

Aldgate, J., & Statham, J. (2001). The Children Act Now: Messages from Research. London: The Stationery Office.

Bravo, A. & Del Valle, J. F. (2009a). Intervención Socioeducativa en Acogimiento Residencial. Santander: Gobierno de Cantabria, colección documentos técnicos. Disponível em: http://www.gifi.es/administrador/publicaciones/archives/65706_Int_soc_acores.pdf

Bravo, A. & Del Valle, J. F. (2009b). Crisis y revisión del acogimento residencial. Su papel en la protección infantil. Papeles del Psicólogo, 30 (1), 42-52. Disponível em: http://www.papelesdelpsicologo.es/pdf/1655.pdf

Brofenbrenner, U. (2001). Making human beings human: bioecological perrspectives on human development. Thousand Oak,CA: Sage.

Calheiros, M., Lopes, D., & Patrício, J. N. (2011). Assessment of the needs of youth in residential care: development and validation of an instrument Children and Youth Services Review 33, 1930-1938 . doi: 10.1016/j.childyouth.2011.05.020

Courtney, M. E., & Iwaniec, D. (2009). Residential care of children. Comparative perspectives. Oxford: Oxford University Press.

Del Valle, J.F., Bravo, A., Martinéz, M. & Santos, I. (2012). Equar: Estándares de calidad en acogimiento residencial. Madrid: Menisterio de Sanidad, Servicios Sociales e Igualdad.

Del Valle, J. F. & Fuertes, J. (2000). El Acogimiento residencial en la protección a la infancia. Madrid: Pirámide.

Gomes, I. (2010). Acreditar no Futuro. Lisboa: Texto Editora.

Instituto da Segurança Social, IP. (2007a). Manual de Gestão da Qualidade das Respostas Sociais: Lar de Infância e Juventude. Lisboa: ISS, IP. Retrieved November 20, 2013, from: http://www2.seg-social.pt/preview_documentos.asp?r=21429&m=PDF

Instituto da Segurança Social, IP. (2007b). Manual de Gestão da Qualidade das Respostas Sociais: Centro de Acolhimento Temporário. Lisboa: ISS, IP. Retrieved November 20, 2013, from http://www2.seg-social.pt/preview_documentos.asp?r=21644&m=PDF

Instituto da Segurança Social, IP. (2014). CASA-2013 Relatório de Caracterização Anual da Situação do Acolhimento das Crianças e Jovens. Lisboa: ISS, IP.

Johansson, J., Andersson, B. (2006). Living in: Experiencies in a treatment home for adolescents in Sweden. Child and Youth Care Forum, 35, 305-318.

Mota, C., & Matos, P. (2008). Adolescência e institucionalização numa perspectiva de vinculação. Psicologia & Sociedade, 20 (3), 367-377.

Rodrigues, S., Barbosa-Ducharne, M., & Del Valle, J.F. (2013). La calidad del acogimiento residencial en portugal y el ejemplo de la evolución española. Papeles del Psicólogo, 34(1), 11-22.

UNICEF (2006). United Nations Secretary-General’s Study on Violence against Children. Retrieved November 20, 2013, from: http://www.unicef.org/violencestudy/5.%20World%20Report%20on%20Violence%20against%20Children.pdf

REFERENCESARQUA-P: A Comprehensive Evaluation System for Residential Care in Portugal

http://www.gifi.es/administrador/publicaciones/archives/65706_Int_soc_acores.pdf

http://www2.seg-social.pt/preview_documentos.asp?r=21429&m=PDF

http://www2.seg-social.pt/preview_documentos.asp?r=21644&m=PDF

http://www.unicef.org/violencestudy/5.%20World%20Report%20on%20Violence%20against%20Children.pdf

“Every child needs at least one adult who is irrationally crazy about him or her.”Bronfenbrenner (1997)

Thank You!

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arqua-p: a comprehensive evaluation system for residential care in portugal sónia rodrigues, jorge...

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