No. 1910

Care Workers and Residential Care

As mentioned, care workers represent the most important, most influential discipline within residential care. They are the ones that fill in 'those other 23 hours'³ with children by means of the situations they arrange in the group and beyond, by means of the social climate they create, and — not least — by means of the way they shape the relationship between themselves and the children (cf. Kok, 1997). Or, to quote Clough, Bullock and Ward (2004, p. 118): 'It is not surprising that the quality of the relationship between adult carer and child is frequently cited as a key factor in successful practice in (...) residential care'. But what do we actually know about these care workers in residential settings?

Functioning

In the Netherlands Van der Ploeg was one of the first academics to perform empirical research on the role and significance of the group leadership in residential care (Van der Ploeg, 1984; Van der Ploeg, et al., 1981). Around 30 years ago, he initiated a study that examined which factors might explain the fact that some care workers function much better than others. In this setup, he applied the assumption that the chance of making a positive contribution in the development of a child in residential care will decline in proportion to the degree to which the care worker emits signals that he or she is performing the work under too much stress (Van der Ploeg, 1984, p. 9). Stress is inherent in the work of the residential staff. When a care worker cannot handle this, there is a real threat of dysfunction and — in the long term — a burnout, which is a phenomenon that refers to physical and emotional exhaustion as a result of the excessive demands that are made upon the possibilities and resources of a working person (cf. Freudenberger, 1977).

In Van der Ploeg's study, the functioning of the care workers (N = 239) was determined by means of diverse criteria. The two most important of these were (1) the judgement that the group worker him or herself gives, as well as the judgement of others on this functioning, and (2) feelings of wellbeing/distress, and of satisfaction/dissatisfaction that the group worker experiences. The following factors appeared to enhance the chances of functioning poorly as a group worker.

They have been divided into four levels, in order of importance:

Personality of the group worker — with the indicators:
a. Risk personality (referring to aspects such as structural anxiety, negative self-image, neurotic complaints, and inadequate, passive coping style)
b. Drastic adverse occurrences or 'life events' in one's own life, with which one has not come to terms
c. An authoritarian personality, or the inclination towards one
Team — with the indicators:
a. No support from direct colleagues
b. Perceived tension within the team/organization
Community or group — with the indicators:
a. Presence of many 'extremely unmanageable' children⁴
b. Negative appraisal of group climate by the children
Organization — with the indicators:
a. Too much or too little influence on decisions in the organization
b. Many staff changes within the organization

Van der Ploeg himself said it was remarkable that the 'level of education' factor did not play a role as a predictor of the capacity to function well. He consequently formed the conclusion that the professional training for this activity (at the end of the 1970s) apparently did not make a clear contribution to the level of functioning of group workers, at least not to the extent that this led to recognizable differences.

Job satisfaction

In later research Van der Ploeg and Scholte (1998) focused on a single aspect of functioning, namely the job satisfaction of residential workers. This study indicated that those who were best educated were the least satisfied, probably because residential work offered too little status and insufficient career opportunities. The results of this second research confirmed the importance of adequate supervision and support (cf. level 2), and a balanced participation of workers in the organization (cf. level 4).

Studies on job satisfaction and the corresponding problem of staff turnover among group workers have been carried out in many countries over the past few years. ⁵ Data from the Netherlands and the UK show that the proportion of group workers who are (moderately to extremely) satisfied with their work ranges from around two thirds to three quarters of the staff. ⁶ According to Tham (2007), job satisfaction is mainly determined (or threatened) by factors at organizational level: an insufficiently supportive or cohesive climate in the organization is more often cited as a factor in job dissatisfaction and staff turnover than the challenging nature of work in child welfare (see also Petrie et al., 2006).⁷ In agreement with these findings, Colton and Roberts (2006) established by means of logistic regression that, in a sample of 129 residential childcare workers, job satisfaction could be well predicted by the following four (compiled) variables:

Training — items concern the available training possibilities, the general attitude toward training and education, and the feeling of being sufficiently trained oneself
Recruitment and staffing needs — items concern the deployment of extra staff where necessary, the staff turnover, and consultation with the management on such topics
Communication — items concern being informed of current affairs, the accessibility of and support from the management, and contact with colleagues
Support systems — items concern participation in staff meetings, case discussions, and evaluation meetings with parents and children.

An analysis with these predictors resulted in a model with Significant reliability which produced, taken as a whole, 84% accurate classifications of satisfaction/dissatisfaction among group workers. The first two variables — (1) the organization's acknowledgement of training requirements, and (2) ensuring good staffing — were the strongest predictors.

Colton and Roberts (2006) also established, partly to their own surprise and probably to their own disappointment, that a high score on job satisfaction was no guarantee whatsoever for group workers staying in the job. They refer to other factors —like status of the job, salary levels, alternative career opportunities, and family commitments — as also having an influence on such decisions (see also Smith, 2005).

The literature suggests that job satisfaction is an important precondition for high-quality care. However, this says little about the way group workers actually perform their duties. Questions that arise in this context include: What is the precise content of the social care activities of the group workers? Do they apply a certain approach? Is this aligned to the needs of the children? And which outcomes does it produce? Such questions penetrate to the heart of residential care.

ERIK KNORTH. ANNMIEK HARDER, ANNE-MARIE HUYGHEN, MARGRITE KALVERBOER & TJALLING ZANDBERG

Extract from: Residential Youth Care and Treatment Research: Care Workers as Key Factor in Outcomes?
International Journal of Child and Family Welfare 2010/1-2, pp. 49-67

References
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COLTON, M. J., & ROBERTS, S. (2006). The retention of residential group workers. International Journal of Child and Family Welfare, 9 (3),160-177.
FREUDENBERGER, H. J. (1977). Burn-out: Occupational hazard of the child care worker. Child Care Quarterly, 6 (2), 90-99.
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ZEGERS, M. A. M., SCHUENGEL, C., VAN IlZENDOORN, M. H., & JANSSENS, J. M. A. M. (2006). Attachment representations of institutionalized adolescents and their professional caregivers: Predicting the development of therapeutic relationships. American Journal of Orthopsychiatry, 76, 325-334.

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