Developing Your Children's Home Model of Care

What a model of care is and why it matters

A model of care describes the approach your home takes to looking after children. It sets out the needs you aim to meet, the practice approach you will use, the outcomes you want children to achieve, and how you will organise staffing, environment and daily life to deliver those outcomes.

The model of care is not a document. It is the thinking behind the document. A home that has a written model of care but where staff cannot describe the approach in their own words does not really have one. The model of care should be understood and used by everyone in the home, from the provider to the newest residential worker.

The legal and regulatory foundation

The Regulations do not prescribe a specific model of care. They require the home to have a clear philosophy, to meet children's needs, and to deliver the Quality Standards. The model of care is how the home chooses to meet those requirements.

The Quality Standards (Regulations 6 to 14) set out the outcomes children should experience. Your model of care should explain how your approach will deliver each of those outcomes for the children you support.

Knowing the children you will support

The model of care starts with the children. Who are they? What ages, backgrounds and needs will they have? What have they experienced before coming to your home? What do they need from the adults around them?

A home that says it supports 'children aged 8 to 18 with emotional and behavioural difficulties' has not really defined its model of care. That description could apply to dozens of very different homes. The model of care should be specific about the children, their needs, and how the home will respond to those needs.

Being specific about the children also means being honest about who the home is not for. A home cannot meet every need. Defining the children you will support also means defining the children you will not accept, and being clear about that in the admissions criteria.

Child-centred question

If a child moved into this home, would they feel the adults had thought about what children like them need, or would they feel like they were fitting into a system designed for someone else?

Defining your practice approach

The practice approach is the method or philosophy that guides how staff work with children. There are many approaches used in children's residential care, including social pedagogy, attachment-informed practice, trauma-informed care, therapeutic communities, and psychodynamic approaches. Some homes draw on several. The important thing is not which approach you choose, but that it is understood, consistent, and applied across the staff team.

A common weakness is the home that claims to be 'trauma-informed' but where staff cannot explain what that means in practice. If your model of care references a particular approach, your staff need to understand it, your training needs to support it, and your daily practice needs to reflect it.

Outcomes: what success looks like

Your model of care should define the outcomes you want children to achieve. Outcomes are not the same as activities or services. An activity is 'providing therapy'. An outcome is 'children develop better emotional regulation and feel more in control of their responses'.

Outcomes should be specific enough to know whether you are achieving them. They should cover the areas in the Quality Standards: care, wishes and feelings, education, enjoyment and achievement, health, relationships, protection, and care planning. For each outcome, the model of care should explain how the approach will deliver it.

Outcomes should also be honest about what the home can and cannot achieve. A home that claims it will transform every child's life is setting itself up to fail. A home that is clear about what it can realistically offer, and what it will need help with, is more credible and more useful.

Admissions and matching

The model of care should drive the admissions criteria. If the home is designed for children who have experienced trauma and need a therapeutic environment, the admissions process should assess whether each child's needs match that environment. Admitting a child whose needs do not match the model of care is not fair to the child or to the children already in the home.

The admissions criteria should be clear about the ages, needs and behaviours the home can and cannot support. They should be used consistently, not relaxed when the home has a vacancy and needs income. A home that admits children who do not fit its model of care because it needs the placement fee is not operating its stated model.

Staffing implications

The model of care should drive staffing decisions. If the model is trauma-informed, staff need training in trauma-informed practice. If the model involves therapeutic work, staff need the skills and supervision to do that work. If the model is based on building long-term relationships, the staffing structure and rotas need to support continuity.

Staffing ratios, qualifications, rotas and supervision should all flow from the model of care. A home that claims a therapeutic model but staffs at minimum ratios with unqualified staff is not delivering its stated model. The model of care should be honest about the staffing it requires, and the provider should resource it accordingly.

The physical environment

The physical environment should reflect the model of care. A home that aims to provide a therapeutic, calming environment should not feel institutional. A home that supports children who may go through periods of distress needs spaces that can absorb that distress safely. A home that supports older children preparing for independence needs facilities that support cooking, laundry and independent living skills.

The environment is not just about the building. It is about how the space is used, how it feels to children, and whether it supports the approach you have described. A beautiful building with a cold, institutional atmosphere is not delivering a therapeutic model.

Education, health and therapeutic support

Your model of care should explain how the home will support children's education, health and therapeutic needs. Some homes provide education on site. Others work with local schools. Some have in-house therapists. Others work with external services. The model should be clear about what the home provides directly and what it accesses externally.

The model should also be honest about the limits of what the home can provide. A home that claims to provide 'full therapeutic support' but has no qualified therapist and relies on occasional external input is not being honest about its model. It is better to describe accurately what the home offers than to overstate it.

Reviewing and evolving your model

Regulation 16 requires the registered person to keep the Statement of Purpose under review and, where appropriate, revise it, notify HMCI of revisions and send HMCI a copy within 28 days. There is no fixed statutory annual review frequency. If the model of care changes, the Statement of Purpose should be updated so it remains accurate and consistent with practice.

Changes to the model of care should be reflected in the Statement of Purpose. If the model changes significantly, the SoP should be updated and Ofsted should be informed. A home that has drifted from its stated model without updating its SoP is a common inspection finding.

Common model of care mistakes

• Writing a generic model of care to satisfy the SoP requirement rather than to guide practice
• Claiming a therapeutic or trauma-informed model without training staff to deliver it
• Admitting children whose needs do not match the model because the home has a vacancy
• Not updating the model or SoP when the home's practice has drifted
• Staffing at minimum levels while claiming a model that requires more intensive support
• Describing outcomes as activities rather than as changes in children's lives
• Not involving staff or children in developing or reviewing the model