1. Getting it wrong – the example of children in residential care
Peter McGill

2. The current picture
About 3000 children and young people with learning disabilities in residential schools, residential social care placements and health facilities
About 700 of these in 52-week residential schools costing £108 million (£160k per child)
Challenging behaviour a key risk factor (99% prevalence in 52-week school sample)
Most placements out of area, reducing family contact, increasing vulnerability and feeding adult out of area residential care placements

3. What leads to placement?
Complex needs
Almost complete absence of early intervention
Limited availability of evidence-based provision around challenging behaviour
Limited/poor quality professional support to families
Limited access to/exclusion from short break/respite care
Exclusion from educational provision
Family strain and coping difficulties
Limited (often complete absence of) active care management to meet child/family needs
Residential care as an “easy” solution for commissioners

4. What would it take to change things?
Early and continued, family-centred, evidence-based support around challenging behaviour
Facilitated access to local generic and specialist provision (especially short breaks)
Competent and inclusive local services
Proactive approach including prevention and early intervention
“World class” commissioning – who are the people, what are their needs now and into the future, what capacity is required to meet these needs

5. But this requires… Real commissioning
Coordination across education, health and social care
A strategic approach to the totality of local provision
Sufficient, and sufficiently skilled people
Full inclusion of families as partners in commissioning and provision

6. Peter McGill P.McGill@kent.ac.uk Tizard Centre University of Kent
Contact Information:
Peter McGill
Tizard Centre
University of Kent
Canterbury
Kent
CT2 7LZ
United Kingdom