Quality of Care, Continuity and Outcomes

Three key dimensions need to be monitored in order to capture the experiences of young people in residential care:

(1) the quality of care provided and experienced in the homes young people are living in, (2) the extent to which residential services are leading to stable long-term caring living arrangements, and (3) the extent to which young people are reaching their educational, vocational and relationship aspirations. While quality care is fundamental, tracking service trajectories is equally important: a disconnected series of high quality placements is unlikely to serve any young person well. Conversely, while many outcomes tracking systems focus on permanency and stability, a long-term stable placement in an unsupportive home is likely to do more harm than good. Finally, it is important to evaluate the extent to which high quality care leading to stable long-term caring living arrangements actually leads to the positive outcomes. Many young people who enter residential care have needs and gifts that may require more than good care.

Building on the recommendations developed in the Panel report, we have identified a set of indicators designed to monitor the quality of care provided within every placement, track service trajectories across placements, and assess short and long term outcomes for young people. We have tried as much as possible to identify indicators that are already being measured or could be feasibly measured using existing data systems, however some indicators will require the introduction of new data collection systems. For each indicator we identify potential data sources, suggest a timeframe for implementation, and, where available, provide examples of jurisdictions that currently report on similar indicators.

Indicators should be initially reported and treated as descriptive indicators rather than evaluative. It is important to report as quickly as possible on a range of indicators to ensure transparency and establish confidence in the residential care system through public reporting without imposing an arbitrary set of performance indicators that oversimplify and potentially distort service and program priorities. Through public reporting the quality of the indicators will improve over time, while trend and comparative analyses and multi-method studies will help to determine their appropriate contextualized interpretation as potential performance indicators.

The recommended list is not intended to be an exhaustive list of relevant indicators. One of the functions of the Quality of Residential Care Branch/Division’s Advisory Council will be to recommend gathering additional information as required. For instance, the suggested indicators related to education do not include more detailed information about the educational supports being provided to young people, such as homework support, peer to peer support or tutoring. Similarly, the proposed family support indicators only track amount of contact; a survey of family perspectives on the support they receive may be important to develop eventually. A growing number of programs are tracking outcomes from youth using various self-report instruments; consideration will need to be given to how to best use these data to assess program success.