What are the Helpful and Unhelpful Ways in Which the Key Working System is Implemented in Children's Residential Care Centres?

TABLE OF CONTENTS

Acknowledgements

Abstract

1. Chapter 1: Introduction
1.1. Concept of Research
1.2. Research Justification
1.3. Research Aims and Objectives
1.4. Summary

2. Chapter 2: Literature Review
2.1. Literature Review Outline
2.2. Attachment Theory
2.3. The Role of the Key Worker in Residential Care
2.4. Summary of Literature

3. Chapter 3: Methodology
3.1. Introduction to Methodology
3.2. Rationale
3.3. Research Aims and Objectives
3.4. Method
3.5. Ethical Considerations
3.6. Revisions
3.7. Concluding Methodology

4. Chapter 4: Data Analysis, Results, and Findings
4.1. The Role of the Key Worker: Perceptions of Their Role and Challenges
4.2. Residential Care Agencies Evaluation of Key Working and Assignment of Key Working Role
4.3. Key Worker’s Attachment and Relationships With Young People in Care
4.4. Concluding Data Analysis and Findings

5. Chapter 5: Discussions, and Implications for Practice
5.1. Summary of Findings
5.2. Unexpected Findings
5.3. Strengths and Limitations of Research
5.4. Implications for Practice and Recommendations
5.5. Opportunities for Further Research
5.6. Summary and Conclusion

6. Appendices
6.1. Transcription of Interview: Participant #2
6.2. Interview Design

ACKNOWLEGEMENTS

I would like to take a moment to acknowledge the people surrounding me that have supported me throughout my time on the MA in Therapeutic Child Care (MATCC) course. It has not been an easy journey, and to have this dissertation handed in and complete is an accomplishment. I would like to thank my tutor Colleen McIntosh for always having an open ear, and listening to me throughout my struggles, allowing me to get to the point where I have a completed my study. I would also like to give thanks to Peter Kieran for always having time to give advice, sending emails with crucial and important information for my dissertation, and always being patient. I would like to give appreciation to Damien McLellan, and Dorothy Casey for their insights throughout the 2 years of the MATCC.

I'd also like to take time to note that I would not have been able to get to this point without the support of my peer group at the MATCC.

A special acknowledgement for my Team Leader, Stephanie Reardon, for dedicating time to cover my shifts in the last week of my dissertation so that I could complete my work with no distractions.

I would like to dedicate this dissertation to my mother, Mary Kennedy. The loving support she has given me throughout my life has provided me with the strength needed to take on difficulties in life, and still continue on with my educational ventures. Thank you for always being there.

ABSTRACT

This piece of research aims to explore the helpful and unhelpful ways in which key working is implemented in children’s residential child care. This study places an emphasis on the benefits of attachment when working with young people in care, and how the implementation of key working facilitates building attachments between young people and their key workers - as well as other aspects of key working in residential child care. To achieve this, the researcher completed research on Attachment Theory and its importance for emotional and psychological growth in young people, as well as the role of the key work.

To obtain data for this study, 4 practicing social care workers currently in the role of key worker in a children’s residential centre were interviewed. The findings indicate that key workers place value on attachments with young people as a means of achieving positive outcomes for the young people in their placements. It was found that further research could be complete in this area in relation to disorganized attachment disorder, and the implications young people with disorganized attachment disorder have on the effectiveness of the key working system in residential care.

CHAPTER 1: INTRODUCTION

1.1. CONCEPT OF RESEARCH

This dissertation will focus on the key working system in residential centres for young people, and the help and unhelpful ways in which this system is implemented in residential care. The topic of research was chosen due to past personal experience of the researcher, and what was deemed as a sometimes flawed use of the key working system in children’s residential care centres. While conducting this research, there was a desire to benefit practice, and the practice of others working in residential child care.

1.1.1. Background of Researcher

The researcher has experience that accumulates to over 5 years working in residential child care. 3 years of that consisted of key working with 4 different young people under the age of 18. Two of which presented with intellectual disabilities. 2 years of the author’s experience is that of a social care team leader in which the research managed multiple young people’s cases, and overviewed the key working system in place at the two respective residential units. In this period the researcher witnessed many flaws in the way in which organizations implemented the key working system. Specifically, the lack of focus on attachment and relationships between key workers and young person - missing out on potential therapeutic benefits that secure attachments have for young people.

1.2. RESEARCH JUSTIFICATION

Examining the National Standards for Children's Residential Centres (2001) - there is a shortcoming of information on the role of the key worker, and how this role should be implemented in residential care. The researcher claims that through his own experience that residential centres often apply their own meaning to the role of key worker, and this results in many different outcomes for the young people in care - that of which will be discussed in Chapter 2: Literature Review. The

National Standards for Children ’ s Residential Centres (2001) are the guide to which children’s residential care centres should function. The researcher found it did not put adequate emphasis on attachment, and the psychological and emotional benefits gained from a secure attachment. The researcher also found that the lack of guidance around key working in the National Standards for Children ’ s Residential Centres (2001) is of concern. This will be discussed further in Chapter 2 - Literature Review.

The researcher found concerns when practicing as a key worker, that residential centres placed an emphasis on the administrative capabilities of a key worker, and not how capable they were to work with their assigned key child, or if they had any previous relationship with the young person in question. Mallinson (1995) stated that, the scope of this role [key worker] became limited to an internal function of residential care. This study aims to explore why this is the way in which the key working role may be implemented in children’s residential centres. This study will include research on Attachment Theory and the relational values that a secure attachment has for young people in care. This research aims to demonstrate that key working should intentionally contemplate the value of secure attachments.

The Skinner Report (1992) describes the relevance of every young person having a Special Person during their placement in residential care. The Skinner report went onto state that the function of residential care could only be achieved through, positive relationships between staff and young people in a safe, stable, and caring environment (Skinner, 1992: 18-19). Therefore the study will be analysing the relational benefits of key working in residential care, specifically investigating Bowlby’s Attachment Theory as a segment of Chapter 2: Literature Review.

Although an emphasis will be placed on Attachment Theory and explore the benefits that secure relationships have on young people, an overall analysis of the implementation of the key working system in residential care will take place during this study. Research demonstrates a lack of insight into the role of the key worker.

Amy McKellar's and Andrew Kendrick's (2013) research piece in the Scottish Journal of Residential Child Care, titled, Key Working and the Quality of Relationships in Secure Accommodation, found there was a lack of research on the role of the key worker. Their small scale study allowed for useful insight into the role of the key worker. This validated that research would be beneficial in finding the helpful and unhelpful aspects of key working in residential care. To assist the research being as beneficial as possible, the final research question was designed as, what are the helpful and unhelpful ways in which the key working system is implemented in Children's Residential Care Centres?

1.3. RESEARCH AIMS AND OBJECTIVES

The aim of this piece of research was to explore the role of the key worker, particularly with reference to Attachment Theory to demonstrate its positive affects when working with young people in residential care. As a result, the objectives for the study were:

To explore the role of the key worker: perception of their role and challenges

To examine residential care agencies' evaluation of key working, and assignment of the key working role

To examine key worker's attachment and relationships with young people in care.

To utilize research findings to design a list of helpful recommendations on how best to implement the role of the key worker in residential care.

1.4. SUMMARY

Concluding this introductory chapter, this study will look at and analyse research on the helpful and unhelpful ways in which key working is implemented in children’s residential centres, with the intent of forming a set of helpful recommendations, and discussing the implications this research has for practice in the social care field. The recommendations will be developed based on primary research, but also including content in the review of literature in Chapter 2: Literature Review. The next chapter will explore Attachment Theory, its benefits, and the current role of the key worker in residential child care.

CHAPTER 2: LITERATURE REVIEW

2.1. LITERATURE REVIEW OUTLINE

In this literature review, I will explore the key working relationships with young people in residential care, the role of the key worker, and the importance of attachment-based relationships for young people in care. For the purpose of reflective practice, I will refer to myself in the first person throughout Chapter 2.

Based on my key working experience in residential care, I am aware of the positive influences the theories of attachment can have on young people in care. I believe that key working in residential care should be based on forming attachments with the young people in our care. However, judging from my own personal experience, the implementation of key working in residential care is flawed. I have practiced in 4 separate residential centres, within 2 different organisations, over a span of 5 years. These experiences have left me examining if key working in residential centres is implemented with the attachment, and emotional needs of the young people in mind. I wish to examine the different roles of the key worker in residential care, and demonstrate the positive influence a key worker can have on a young person’s placement when a secure attachment is formed. In this literature review chapter, I plan to cover;

- Attachment theory; a summary and why it's relevant to working with young people in residential care.
- The role of the key worker as well as literature and theories on the key worker role.
- Conclusion; The theories of attachment mentioned, and literature and research on the key working role, concluding how it's applicable to my research.

2.2. ATTACHMENT THEORY

In this section, I will explore Attachment Theory and its importance to young people in residential care. Mary Ainsworth states that a secure attachment is crucial to a child's development. According to Atwool (2007:14), Ainsworth explains that a secure child acquires an understanding of the mind, and has the capacity to reflect on the internal state of self and others. By implementing key working in residential care under an attachment model of care, we can assist the young people to better understand their own emotions and behaviours. In the following text, I will inspect the theory behind attachment, and literature that will support the value of attachment for young people in residential care.

Bowlby (1958, in Holmes 1993: 218) described attachment as;

The condition in which an individual is linked emotionally with another person usually but not always, someone perceived to be older, stronger, and wiser than themselves. Evidence for the existence of attachment comes from proximity seeking, secure base phenomenon and separation protest.

Attachment Theory stems from the psychodynamic approach derived from the work of Sigmund Freud (Atkinson, Wells, 2000: 5). According Atkinson and Wells (2000), the term psychodynamic suggests an active process, which is evident in the way the psyche, consisting of the mind, emotions, spirit, and sense of self constantly interacts in a dynamic way. Interaction occurs on two levels, interpersonally - in relating to people and objects outside the self, and intrapersonally - within the self, which involves concepts such as ego integrity, the unconscious, and defence mechanisms (Atkinson, Wells, 2000: 5).

Freud stressed the importance of the mother-child relationship (O' Brien, 2008: 60). Freud believed that early experiences in life affected a person in their later lives (O' Brien, 2008: 60). Melanie Klein inspired by Freud's theory developed the Object Relations Theory, which suggests that the loss of an object could have a potentially negative impact on a person's later life (O' Brien, 2008: 60). As an example, take the object being the mother, and the loss of the mother perhaps through

death or separation of some kind, can cause negative outcomes for the child in their later life. Bowlby agreed with Klein that early experiences shaped a person in their later life, and developed his Attachment Theory based on this concept (O' Brien, 2008: 60).

Although Bowlby agreed with Klein's concepts, he did not agree that it would just be the loss of any object that would affect the child's life but instead the object became actual family relations (O' Brien, 2008: 60). Bowlby believed that there was an instinctual aspect to the relationship between a child and their mother (O' Brien, 2008: 61). According to O' Brien (2008) Bowlby believed that maternal deprivation i.e. a disruption in the relationship between a mother and a child in the early years, would lead to a negative impact on the child's mental health later in life. Bowlby stated that there was one critical relationship in a person's life, and this was between the mother and child (O' Brien, 2008: 61). He called this 'Monotropism'. Bowlby stated that there was a critical period between birth and 3 years in which a mother must maintain her attachment with her child (O' Brien, 2008: 61).

Mary Ainsworth, who agreed with Bowlby's Attachment Theory, developed it further explaining why children who had weak or no attachments with their mother, later found it difficult to form attachments. Mary Ainsworth developed a theory of 3 different styles of attachments from her studies of mother-infant dyads (Atwool, 2007: 11). Main and Soloman later added a fourth classification (Archer, Burnell, 2003: 67). The 4 types of attachment classifications are;

Type A - Avoidant Attachment

Type B - Secure Attachment

Type C - Ambivalent Attachment

Type D - Disorganized Attachment

As stated, Mary Ainsworth argues that secure attachment (Type B) is very important for a child's development. According to Atwool (2007: 14), Ainsworth details that a secure child acquires an understanding of the mind, and has the capacity to reflect on the internal state of self and others. Bowlby refers to this attachment as a 'Secure Base' based on Ainsworth’s research (Atwool, 2007: 14). Ambivalent attachments (Type C) form in children who have unreliable, inconsistent, and intrusive responses from their attachment figure (Atwool, 2007: 14). Ainsworth believed that there can be an uncertainty of the worthiness of self when a child has suffered from an ambivalent attachment. Self-regulation is not achieved in this attachment category (Atwool, 2007: 14).

Avoidant attachment pattern develops due to an unresponsive and rejecting relationship (Atwool, 2007: 14). They see others as unavailable and hurtful. These young people may become controlling, and other's emotional/mental state is seen as unimportant (Atwool, 2007: 14). They find it difficult to place value on their relationships. I have worked with young people who demonstrated this type of attachment also, in which they found it difficult to accept love and care, and purposely attempted to sabotage the attachment through their behaviours. Main and Solomon extended Ainsworth's 3 categories and added disorganized attachment to the attachment classifications. Disorganized attachment occurs when parents fail to reduce the stress associated with anxiety, discomfort and pain (Archer, Burnell, 2003: 67). Disorganized attachment could occur where parents are neglectful or abusive i.e. domestic violence (Archer, Burnell, 2003: 67).

Often the young people in residential care will present with either avoidant, ambivalent, or disorganized attachments. However, if going by the theory discussed, it is the secure attachment i.e. the Secure Base that we should aim to achieve in residential care. A secure attachment or the Secure Base should be the goal of a residential facility in assisting young people to understand their internal self, and also have the capacity to relate to others. Residential care can provide the perfect residential setting in which we can provide attachment for the young people through implementation of an attachment based key working system. Bowlby (1988: 10) in his book, A Secure Base mentions the role of the primary caregiver (or in this case a key worker) as a Secure Base for a young person. Bowlby (1988: 10) defines the role of the Secure Base to the young person as, one of being available, ready to respond when called upon and perhaps assist, but to intervene actively only when necessary.

In their book, Therapeutic Residential Care for Children and Young People: An Attachment and Trauma -Informed Model For Practice, Barton, Gonzalez, and Tomlinson (2008: 43) state that Attachment Theory can provide a useful interpretive frame for carers, support staff, and others to understand better the needs and challenges of traumatized children in residential care.

Theories such as Attachment Theory can provide a comprehensive understanding of the emotional, psychological, and behavioural functioning of abused and neglected children in care (Barton, Gonzales, Tomlinson, 2012: 43). Bowlby's Attachment Theory and his fundamental view that the attachment of the infant to the caregiver is of central importance in the infant's development remains true according to Barton, Gonzalez, and Tomlinson (2008: 43). Cameron and Maginn (2009 in Barton, Gonzalez, and Tomlinson: 28) argue that, Bowlby's theory has stood the test of time remarkably well and current neurological studies are able to confirm both the positive impact on childcare (extensive development of neural pathways and brain growth), and the negative (lack of brain growth and development).

Glaser and Prior (2006: 15) propose an attachment is a tie based on the need for safety, security and protection. This need is the paramount in infancy and childhood, when the developing individual is immature and vulnerable.

Adrian Ward discusses the detrimental consequences of a young person that does not have the opportunity to attach and is left unintegrated. Ward and McMahon (1998: 18) identify,

If integration does not happen, the child is left either with a chaotic inner world, or with very little awareness of the difference between his own inner world and other people's feelings or external reality.

After the exploration of the literature on Attachment Theory, it is apparent that it is crucial to the development of the young people in a residential setting that they have a secure attachment. Providing the young people with one individual who is open and emotionally available for an attachment with them is key to their development in residential care; hence the use of the key worker role. It is vital that key working is implemented in residential centres, in a manner that allows for young people to attach to their respective key worker. Often the key working role is implemented taking into consideration the administrative needs of the centre. This in turn can be detrimental to the placement of the young person in care, as they do not have an emotionally available staff member to which they can attach. I will discuss the role of the key worker further in the next section of this literature review.

2.3. THE ROLE OF THE KEY WORKER IN RESIDENTIAL CARE

The role of the key worker is an important one in residential care for young people, and I will demonstrate this in the following text. It would be the opinion of Adrian Ward (1993), that a key worker is the key element for a young person making positive progress in their placement. Ward (1993: 67) argues that;

Each client needs to know that at least one individual worker in the place has a clear understanding of his/her personal needs, wishes, and rights - one worker that is, in addition to the head of the unit.

Ward (1993) affirms that the young person should have someone special to relate to, and an individual who thinks they, the young person, are special also, and in turn build a trusting relationship. This is the role of the key worker in a children’s residential centre (Ward 1993). The relationship should not be confused with that of a family member i.e. parent. There are personal boundaries for a young person when working with their key worker, but it is expected that emotions and vulnerability are involved in the relationship as this will allow for attachments to build with the young person (Burton, 1993). Burton (1993) believes that our inner, most personal selves do the work, however it is important to remain professional in maintaining personal boundaries. Burton (1993: 48) states, the worker remains a worker throughout, but we are using inner resources, and knowledge - the most personal, tender, and vulnerable areas of our inner selves to do the work.

2.3.1. Key Working Role: Administrative

Utilizing my experience as a key worker to form a professional opinion, I can maintain that residential child care does not always meet the emotional and attachment needs of the young people. Reflecting on my practice as a key worker in residential child care, I have experienced many different management styles, which in turn allowed me the opportunity to observe the key worker role being implemented in different manners. The two approaches I have experienced and observed key working is at an administrative level i.e. Focus is on the paperwork, records, policies and procedures of the centre. The other is an attachment based model, in which the key worker is seen as instrumental in carrying out therapeutic work with the young person in the centre, by means of forming secure attachments with the young person. This trusting relationship will allow for the young person to engage with his key worker at a personal level.

Boddy, Cameron, Petrie, Simon, Wigfall (2006: 82) identify that;

Key working can operate on various levels. It can be an administrative function, so that all paperwork, records, and necessary procedures relating to one resident are maintained by one staff member.

Boddy, Cameron, Petrie, Simon, Wigfall (2006) define exactly what most of my key working experience have been thus far. The administrative aspect of key working is focused on at an extensive level, and it detracts from the value of attachments that can often help young people progress in their placement, and develop a sense of self and others. Under the many different management styles I have experienced, unit managers will often expect that the administrative aspect of the key working role be adhered to before looking after the needs of the young people - even if this is not their conscious intention. Additional time in the office is normal in order for reports to be complete before a deadline. Administrative time in the office often reduces the time available to the young people. When extra administrative work is applied due to being assigned the key worker role, this often defeats the purpose of what I believe the key working role to be about - working with young people at a personal level.

Studying the English key working system in residential child care; Boddy, Cameron, Petrie, Simon, Wigfall (2006: 83) found that 60% of key workers took a procedural/administrative approach to their roles in care, while only 40% took into consideration a relational approach. When studying mainland European countries, Boddy, Cameron, Petrie, Simon, Wigfall (2006: 83) identified that 90% of residential centres work under a pedagogy model of care, which focuses on a relational model of care. When inspecting this model of care, their findings identified improved overall outcomes for the young people in their care (Boddy, Cameron, Petrie, Simon, Wigfall, 2006: 83). These figures demonstrate that residential centres are not clear about the role they wish their key workers to take on. Although when they do take on a relational approach, Boddy, Cameron, Petrie, Simon, Wigfall (2006: 83) argue that the young people do have overall better outcomes. There are currently no statistics on the Irish key working system or relevant studies that include information that would allow residential centres to best define the role of the key worker. Examining the standards that inform our practice, National Standards for Children ’ s Residential Centres (2001), in Irish residential care, we do not have a clear distinction on the role of the key worker. National

Standards for Children ’ s Residential Centres (2001) do not outline the goals the key worker should set out to achieve when working with young people in residential care.

2.3.2. Key Working: Legislation Informing Practice

The National Standards for Children's Residential Centres (2001), is a set of standards drawn up by the Department of Health and Children, in conjunction with the Social Services Inspectorate and the Health Service Executive (HSE). The standards focus on aspects such as; functionality of the residential unit, management, child protection, children's rights, safe guarding, health and safety, education etc. There is no set standard in relation to managing the inner world of the young people, attachment, emotional and relational needs that are so very important to young people in care, and if so, are expeditiously referenced in the standards.

The National Standards for Children's Residential Centres (2001) neglects to determine how best to implement the key working role in a children’s residential unit. The National Standards (2001) simply mention that a young person is entitled to a key worker, referencing words such as “psychological” and “emotional” with no explanation on how to meet these needs. Inspecting the National Standards for Children's Residential Centres (2001: 18) the key working role is poorly represented;

Staff are aware of the emotional and psychological needs of young people, and through the key worker role and the general ethos of the centre, facilitate the assessment and meeting of those needs.

The National Standards (2001) acknowledges the psychological and emotional needs of a young person, but how can these be addressed by a key worker? In my research, I hope to identify how these needs can be met, supported by the literature mentioned in this chapter, through interviewing already practicing key workers. I will next go through the benefits of key working applied through an attachment based approach that I have experienced, supported by literature. I expect to demonstrate the benefits of working under an attachment based approach to key working, supported by the following literature.

2.3.3. Key Working Role: Attachment

I first distinguished the benefits of key working when a change of management came into place at a centre I worked. This unit manager believed in the value of the therapeutic process and therapeutic communities. The manager taught me the benefits of attachment and relationships that come with key working if implemented correctly under an attachment based approach, derived from a therapeutic model of care. This manager worked in conjunction with therapeutic consultant and psychotherapist Damien McLellan in a previous position, and worked under the therapeutic model of care in a residential centre for young people. Damien McLellan (2010) in journal ‘ International Journal of Child and Family Welfare ’, names the 11 principles of a therapeutic community as;

An emphasis on group work as a medium for therapeutic work and decision making with the young people.

The use of community meetings as a medium for both practical therapeutic business between young people and the staff team.

A willingness of the staff team to commit to medium/long-term individual therapeutic relationships with the young people.

An emphasis on the potential for therapeutic communication between young people and staff based on everyday interactions.

Commitment to a personal and involved style of working, in which the quality of relationships between young people and staff plays a central role in the treatment process. Commitments to the physical and personal ‘Environment’ for its contribution to the work. Engagement of community with other key systems in young person’s life such as education, family and other developmental needs.

The use of psychodynamic theory rather than the sole use of behavioural, cognitive or other theoretical framework.

An emphasis on the role of each worker rather than focusing on their rank.

A commitment to the value of a full system of staff support and supervision, including the use of consultancy.

Sanctions are not to be used by the staff team as a manner of behaviour modification in the community.

Adrian Ward explored the aims and goals of a therapeutic community in his book, Therapeutic Communities for Children and Young people. Ward (2003: 119) argues what he feels the structure of a therapeutic community can achieve;

The therapeutic community approach is one that is holistic or systematic, that it entails at working at many different, but interconnected levels towards achieving an overall therapeutic task. This means, among other things, that the therapeutic work with young people is not confined just to the 'therapeutic hour' of planned individual sessions, nor to the equivalent in group work, family work or community meetings, or in classroom work. The therapeutic work is also potentially ongoing in all the other times and contexts in which the young person is involved, and especially in the course of everyday life and the social and other interactions which this entails. Thus there may be incidents or moments in everyday interactions which may affect the young person in unexpected ways, or which opens up the possibility of communication and insight, perhaps triggering memories of earlier events and feelings, or maybe giving some hint of underlying anxieties or fears of current or future events in their lives. It is in these moments, and with the sometimes fleeting feelings which they may engender, that some of the most useful work can be done. This is the work which I have called 'Opportunity Led Work', partly to draw to attention the opportunities of communication which this style of working may offer.

The 11 principles of a therapeutic community allow for the stated Opportunity Led Practice in children's residential centres. My unit manager applied her knowledge of the therapeutic community and allowed the staff team to work under the basis that attachment was the key to successful outcomes for young people in residential care. She applied this to practice through the key working system, and applied three factors that keyworkers needed to build secure attachments (a Secure Base) with young people in care;

'Opportunity Led' work as an opportunity for young people and staff to develop. Building trust with the young people through open, and honest interactions. Working on a personal level with the young people.

My unit manager believed that trusting relationships assisted in the development of the Secure Base, and identified the key worker as the potential Secure Base for the young people residing at our residential service. Referencing Erikson's Stages Psychosocial Development when looking at building trust with young people is paramount. Erikson argued that all young people go through the stage of ‘Trust vs. Mistrust’ (Ramirez, 2004: 141). It is important to establish trust for a young person in our care as this leads to the young person engaging with the staff team and in turn their key worker. This is established by Erikson's Stages of Psychosocial Development, 'Trust vs. Mistrust'. Ramirez (2004: 141), explains;

Establishing trust is essential to creating healthy relationships. If a child's cries are met with love and consistency, then he comes to trust that they will be met in the same way in the future. This sense of trust is the child's first experience of a relationship. When a child's needs are attended to sporadically, or not at all, he develops a mistrust.

Bush (2001:26) states that, those that receive inconsistent care may grow to mistrust people in this world. In stage one, it is important to develop a secure attachment to help the young person develop trust for their primary caregiver. Bush (2001:26) states of Erikson's Stages of Psychosocial Development,

Secure attachment is most likely to develop when the caregiver responds sensitively and appropriately to the infant, and so the infant can use the caregiver as a safe base for exploration. Emotional availability plays an important role in infant development since it helps to create an atmosphere of that fosters enjoyment, curiosity, and more opportunities for learning. Erikson believed that it was the overall quality of care of the child by the parent that determines whether basic trust or mistrust is formed.

The development of secure attachment (Secure Base), allows the young person to trust and provides more opportunities for learning (Bush, 2001: 27). It is the feeling of this trust due to a secure attachment in his/her placement that allows for the successful development of young people in our care. Bush (2001: 27) goes onto state;

The achievement of a basic sense of trust in their relationship with their caregivers enables children to become increasingly interested in new people, places, and experiences. Insecurely attached infants may not learn as well from their parents/caregivers.

Winnicott (1963) explains how he feels a key worker should practice effectively in their role.

Winnicott (1963) very much supports the attachment and relational models of care, and states that to provide a therapeutic key working relationship or a therapeutic working relationship in general, You apply yourself to the case. You get to know what it feels like to be your client. You become reliable for the limited field of your professional responsibility. You behave yourself professionally. You concern yourself with your clients' problems. You accept being in the position of a subjective object in the clients life, while at the same time, you keep both feet on the ground. You accept love, and even in the love state without flinching or acting out your response. You accept hate and meet it with strength rather than revenge. You tolerate your client ’ s illogicality, unreliability, suspicion, muddle, fecklessness, meanness etc. And recognise all of these unpleasantness as symptoms of distress. You are not frightened nor do you become overcome with guilt feelings when your client goes mad, disintegrates, runs out in the street in a night dress, attempts suicide and perhaps succeeds. If murder threatens you call the police to help not only yourself but your client. In all these emergencies you recognise the clients call for help, or a cry of despair because of a loss of hope of help. In all these respects you are in your professional area, a personal deeply involved in feeling, yet at the same time detached, you know the limits of your powers to alter a crisis situation. If you can hold the situation together, the possibility is that the crisis will resolve itself, and then it will be because of you that a result is achieved.

It is with the aforementioned literature, I support the attachment based approach to the key working role. I have experienced many beneficial outcomes for the young people that I have cared for under the attachment based approach. I have experienced both sides of the key working role; administrative and attachment based. The centres I worked at that applied an administrative focus to the function to their key worker positions have had less positive outcomes, often resulting in breakdown of placements. The centres that have focused their attention on attachments as a means of engaging the young people in their placement, have lead for a more positive experience for both the young people at the centre, and the staff working. Supported by literature, I confidently will go ahead to research the ways in which key working is being implemented in children’s residential care by interviewing currently practicing key workers. I hope to back the literature in this chapter, with my own primary research.

2.4. SUMMARY OF LITERATURE

Concluding, I believe that Attachment Theory should be the instrumental theory applied to all residential care centres. Bowlby's theory of attachment allows for a better understanding of the inner world of the young person, and the literature provided demonstrates the positive outcomes it can have for young people; trusting relationships, security and confidence to achieve, better understanding of self and others etc. As seen above by the literature provided, the key worker role is one that has vague meaning in residential care. The two roles often applied, and sometimes mixed together; administrative approach, and the attachment based approach. Literature above states that often the role of a key worker is one of an administrative function, and my experience from working in residential care supports this observation. However, it is crucial to note and take into existence the opportunity for key workers to be that 'special' relationship for young people, and can be contributory to the positive outcomes for young people in our care through secure attachments or 'Secure Base'.

Exploring the evidence on the matter, I hope to link through my research that a helpful recommendation for the implementation of key working in residential care, would be to apply an attachment based approach. I will interview currently practicing key workers in the field at present, and get their views and opinion of their roles as a key worker, and attempt to extract information that will authenticate that key working is best implemented under an attachment based approach. I endeavour to construct a list of recommendations for currently practicing centres on an effective approach to key working. I am anticipating that this will allow unit managers to implement key working in a manner that will benefit the attachment, psychological, and emotional needs of the young people in their care. This can also offer a mean to meet the National Standard's (2001) requirement of meeting the emotional and psychological needs of the young people.

CHAPTER 3: METHODOLOGY

3.1. INTRODUCTION TO METHODOLOGY

This chapter will describe the research methods utilized to gather data on the research question, what are the helpful and unhelpful ways in which the key working system is implemented in Children's Residential Care Centres?

This chapter will discuss the methodology used in this study and describe why Qualitative research through the medium of semi-structured interviews was the method through which the researcher gathered the primary data. This chapter will also discuss the procedures the researcher followed in conducting these semi-structured interviews including; justification of research method, explaining how the research methods were devised, ethical considerations, and revisions noted that would have benefitted the study.

3.2. RATIONALE

The significance of key working in residential care, and the opportunity for attachment - supported by the benefits of attachment for young people - inspired the researcher to conduct this study. It was considered from the researcher's own personal experience of working in the role of key worker, that it often did not fulfil a Secure Base for the young people in care. Discussing with fellow colleagues in the field, the researcher found that the key working role often placed emphasis on the internal function of the residential centre, i.e. the administrative aspect of the functioning of the centre, and less on forming secure attachments necessary for young people to develop emotionally and psychologically. Mallinson (1995) stated that, the scope of this role [Keyworker] became limited to an internal function of residential care.

The researcher noted that research on the topic of key working was limited. Amy McKellar's and Andrew Kendrick's (2013) research piece in the Scottish Journal of Residential Child Care explain the limited research conducted on the key working system in residential care. Their research piece was titled, Key Working and the Quality of Relationships in Secure Accommodation. This justified the researcher’s decision to undertake research on the key working role, which would be beneficial to practice in residential child care. It was decided at this point to look at the importance of Attachment Theory in the development of young people, and how key workers can meet the attachment needs of young people in care. In demonstrating the importance of attachment for young people in care, the researcher would try to define a practical role for the key worker in meeting this need, and to develop a list of helpful recommendations on the implementation of the key working role in residential care, while also indicating what to avoid.

3.3. RESEARCH AIMS AND OBJECTIVES

The aim of this piece of research was to explore the role of the key worker, particularly with reference to Attachment Theory to demonstrate its positive affects when working with young people in residential care. As a result, the objectives for the study were:

To explore the role of the key worker: perception of their role and challenges

To examine residential care agencies' evaluation of key working, and assignment of the key working role

To examine key worker's attachment and relationships with young people in care.

To utilize research findings to design a list of helpful recommendations on how best to implement the role of the key worker in residential care.

3.4. METHOD

The research method utilized was a qualitative method through the use of semi-structured interviews. Debus (1995: 2) states, Qualitative research is a type of formative research that offers specialized techniques for obtaining in-depth responses about what people think and how they feel, to gain insight into attitudes, beliefs, motives and behaviours of the target population.

A qualitative approach was selected since the phenomenon could be explored in depth and a fuller understanding of what occurs between young people and key workers in a secure relationship could be obtained.

Rather than wandering onto field sites as disinterested observers, attempting the impossible task of trying to catalogue everything in setting, we can use the visible orientation of the participants as a spotlight to show us just those features of context that we have come to terms with if we are to adequately describe the organization of their action (Goodwin, 2002: 1508).

3.4.1. Design and Semi-Structured Interviews

It is assumed that the knowledge necessary to address the objectives can be found in the views and experiences of key workers in a children's residential care setting. In a semi-structured interview, questions are planned carefully before entering the interview; however, the order of questions may be alternated, or interview questions may be added or omitted, depending on the direction of the interview (Miles, Gilbert, 2010: 65). The researcher confirmed the use of semi-structured interviews as they are suitable to more complicated research questions, where quantitative methods would not deliver the level of detail sought (Miles, Gilbert, 2010: 66). Semi-structured interviews can be flexible, and the course of the interview can change to remain relevant to the participant and also the question, allowing for further exploration of the topic (Miles, Gilbert, 2010: 66). All interviews were semi-structured to allow the participants the opportunity to express their individual feelings and opinions (King, 1994, cited by Robson, 2002). The interview used a format of open questions, prompts and probes to draw information from participants on topics being explored (Robson, 2002). The semi-structured interviews took place face to face in order to maintain confidentiality and anonymity while building rapport between the researcher and participants. The interviews lasted approximately 10-20 minutes. The length of time of an interview was never certain, taking into consideration the variable of the way in which participants express themselves i.e. speed of talk, and how much they want to say about the topic. Interviews were taped, and a sample transcript of an interview is available in the appendices.

The questions for the interviews were devised in conjunction with the professional and educated advice of lecturer of the MA in Therapeutic Child Care course. The researcher designed the interview questions utilizing fellow students as they are all practitioners in the social care field. These steps were undertaken by the researcher to ensure that the interview questions were relevant to the current key working system in social care, and would allow for relevant data to be gathered that would benefit the study.

All semi-structured interviews were conducted by the researcher. These were recorded, and all transcribed for purposes of data analysis. Two of the interviews took place in a place of work of the participants and researcher. The other two, took place in the homes of the participants. The settings and times were chosen by the participants to facilitate their personal lives. An example of a transcribed interview can be found in the appendices.

3.4.2. Participants

There were four semi-structured interviews conducted. Five were planned; however, due to time constraints a fifth interview was never conducted. The participants were chosen by the researcher, and were a mix associates of the researcher that have worked with in a residential care setting as a key worker, and professionals working in the field as a key worker with no previous relationship to the researcher (Ratio 2:2). There were specific criteria for selecting research participants. Each participant was required to:

- Hold a relevant qualification that allowed them to work in the social care field i.e. Bachelor of Arts in Social Care
- Be working as a key worker in residential child care at time of the interview.
- Have a minimum of 1 year’s work experience in practicing in residential child care.

All participants were female, and had various experience in the social care setting.

Fig. 1 - Participant Data

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3.4.3. Role of the Researcher

My role in the interview was to ask the questions, and guide the interview in a means that made it possible to gather the data I needed. My presence may have affected the answers of the participants, especially with 2 participants, as they knew me on a personal level. This may have resulted in less honesty. No further concerns were taken into account when conducting the semi-structured interviews in relation to my role or presence.

3.4.4. Data Analysis

The key worker interviews were analysed using the six steps of Thematic Analysis described by Braun and Clarke (2006). This method was chosen as the purpose of the analysis was to identify themes relating to elements of key worker practice.

Step 1: Becoming Familiar with the Data

Interviews were recorded using my smart-phone's recording application, and then transcribed using Microsoft Word as the word processor. Doing this process personally allowed a familiarity with the data to be developed, additional to that gained during the interview process. Step 2: Generating Initial Codes

Interview transcriptions were highlighted with marker, identifying initial codes i.e. developing relationships with young people, assignment of key workers etc.

Step 3: Searching for Themes

Within each subsection of the codes, themes were identified from the interview transcriptions. Step 4: Reviewing Themes

As the analysis developed, some codes were renamed in order to more effectively label related items.

Step 5: Defining and Naming Themes

Once a set of final themes had emerged, these were defined and named based on the type of data they contained. For example, the theme “Relationships”, which was generated from the participants responses to questions regarding the importance of attachment, contained examples where participants had discussed the use and value of building relationships with young people in their practice.

Step 6: Producing the Report

The findings were then written up.

3.5. ETHICAL CONSIDERATIONS

Ethical issues present in the study were minimal due to the research design. The research design limited the number of ethical concerns. Only consenting adults were involved in the research process and the method of data collection was semi-structured interviews. Care was taken to ensure that participants in the interviews were comfortable and happy to answer the questions. A debriefing was offered to ensure that participants were able to discuss any issues which caused distress, as well as the opportunity to reflect on the procedure and interview schedule. All participants engaging in the interviews gave verbal consent to being interviewed. All were informed of the research being undertaken. All participants were made aware that their responses would be treated confidentially, as well as their identity and any details of a personal kind. This is evident in the transcribed interview available to read in the appendices.

Denscombe's (2007) The Good Research Guide for Small Scale Social Research Projects were also taken into consideration when conducting this study:

Respecting the rights and dignity of those who are participating in the research project.

Avoiding any harm to the participants arising from their involvement in the research.

As a means of ensuring that ethical principles were adhered to, semi-structured interviews with social work professionals instead of young people residing in the residential care centres were considered the most ethical manner to conduct this research.

3.6. REVISIONS

This was the researcher's first piece of primary research, and the length of time of interviewing and then transcribing was underestimated. The researcher left limited time to conduct and transcribe interviews. This section of the research work was difficult, and time-consuming. Perhaps more interviews could have been conducted if the researcher allowed more time, as well as identifying themes more clearly.

3.7. CONCLUDING METHODOLOGY

In this chapter the researcher has identified the methods implemented in the research - qualitative research through the means of semi-structured interviews. The chapter has attempted to validate the research and justify the reasons behind conducting qualitative research to gather data for the research. The chapter outlined how the researcher's semi-structured interviews were devised, and why the researcher chose semi-structured interview as a tool for gathering data. The researcher has also used the chapter to reflect on the ethical issues faced, and the revisions that would be made to the research. In the next chapter, the researcher will look at the findings, and data concluded from conducting the research for the study.

CHAPTER 4: DATA ANALYSIS, RESULTS, AND FINDINGS

This chapter will report the findings of the semi-structured interviews conducted as part of this study. The method used to extract the data as discussed in the previous chapter, was Thematic Analysis. The data will be presented under subheadings which reflect the coding of the semi- structured interview, and also take into consideration the aims and objectives of the research. Tables will be presented under the themes identified, and broken down into subthemes in the table.

4.1. THE ROLE OF THE KEY WORKER: PERCEPTIONS OF THEIR ROLE AND CHALLENGES

Participants were asked about the perception they currently held on their role as a key worker. Participants were asked a series of questions about their role. A code identified in the semistructured interviews was the role of the key worker. This was broken down into themes of,

Current tasks taken on by key workers in their role.

Challenges faced by key workers in their role.

Improvements key workers would make to their role.

4.1.1. Current Role of the Key Worker

Table 1a will demonstrate the sub-themes that arose when participants were asked what they perceived their role as a key worker to be at the moment in their current place of work.

Table 1a: Current Role of the Key Worker in Residential Care

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Complete All Administrative Documentation for 50.00% (2) Young Person

Table 1a shows the sub-themes that arose when participants were asked about what they felt the current role of the key worker consisted of in residential child care. Advocating on behalf of the young person was the most popular answer given in response to this question. Participants found that mentioning needs of the young person and assessing or meeting these needs was part of their role as a key worker in their residential care units currently. Despite only 1 participant mentioning administrative practices in their current role as key worker, when asked if they found their role was affected by the administrative practices of the centre, and administrative responsibilities that come with the key working role, 3 (75.00%) of the participants said yes. Only 1 (25.00%) said no.

4.1.2. Challenges in the Key Worker Role

Table 1b demonstrates the subthemes identified in relation to the challenges that key workers currently face in their roles in residential child care.

Table 1b: Current Challenges in the Key Worker Role

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Table 1b displays that the most significant challenge of the key worker role is more responsibility. Although all participants mentioned extra responsibility, none flagged it as an aspect they disliked about their role as a key worker. Participant #2 mentioned, Well I suppose it's a great team here, so ehm you do have the support of your work mates which is brilliant. But you do take on a lot of responsibility as a key worker. Participant #2 also stated that although there is more responsibility, team members are “happy” when assigned the role. Lack of time was mentioned by participant #1 and participant #4. Participant #1 stated, I ’ m a key worker with very limited opportunities to spend time with my key child. She flagged time constraints due to other duties affecting her ability to spend time with her young person. When participants were asked if key workers received training when assigned their role, 100.00% of participants said no, however, participants did not flag this as an overall issue that would have a negative impact in carrying out the role. Participant #2 stated, the training, not so much, but there's a lot of support.

4.1.3. Improvements to the Key Worker Role

Table 1c accounts for the subthemes that became apparent when discussing changes and improvements participants would put in place to improve the role of the key worker.

Table 1c: Changes and Improvement Participants Would Make to Key Worker Role

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Table 1c demonstrates the improvements and changes participants would make to the role of key working in residential care. It should be noted here that there was considerable variation in the responses given by participants during the interview. Some of this appeared to be due to the understanding of the interview questions, and so questions were often reworded in order to seek the information needed. The responses were coded and a number of changes and improvements to the key working role were identified (see Table 1c). Majority of the results returned establishing that there needs to be more emphasis on the key worker - young person relationship. Positive memories and experiences with a young person and their key worker were also identified as an important factor in key working. The concept of creating memories was brought up by participant #1 and participant #2, while participant #4 focused on creating more positive experiences for the young person with their key worker. More support, and time were also determined by the participants as changes that need to be made to the key working role to improve the implementation of the key working system in residential child care.

4.2. RESIDENTIAL CARE AGENCIES' EVALUATION OF KEY WORKING, AND ASSIGNMENT OF THE KEY WORKING ROLE

This subsection will discuss Residential Care Agencies' perception and evaluation of the key working system. This subsection will discuss the themes of; organization's attitudes towards key working in their residential centre, how companies assign key workers, and how the participants would assign key workers in comparison to how it is carried out by their organizations. The themes apparent in this code were:

Organizations perception and value of key working system.

Comparative data on the assignment of key workers; organization compared to key workers. Table 2a will demonstrate the subthemes apparent when asked how the participants felt their organizations perceived the key working system.

4.2.1. Organizations Perception of Key Working System

Table 2a - Organizations Perception and Value of Key Working System

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Majority of the participants found that there was value put on their position of key worker and that the company recognized the value of the key working system. Participant #1 felt that there was little value put on her role as a key worker, and that her organization in general felt there was little value to the key working system in place. Participant #4 mentioned in her interview, despite her company noting the value of key working, that she felt key workers were not appreciated enough.

4.2.2. Assignment of Key Workers

Table 2b will display a comparison of how organizations assign their key workers in comparison to how the participants feel would be the ideal way to assign key workers.

2b - Comparative Table on Assignment of Key Workers

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All participants stated that young people have no input into who their key worker is when they are first admitted to a residential centre. However, participants #2, #3, and #4 stated that if a key worker leaves the staff team during the young person's placement at the centre, young people are consulted about which available team member they would prefer to be their key worker. Participant #1 stated that young people never have a say in who is assigned their key worker.

4.3. KEY WORKER'S ATTACHMENT AND RELATIONSHIPS WITH YOUNG PEOPLE IN CARE

This subsection will explore the data gathered on the key working relationship and attachments with the young people. The code 'Attachment and Relationship' was developed when conducting the semi-structured interviews. The themes developed when discussing this in the semi-structured interviews were;

Benefits of secure attachments and relationships with young people in care. Implications of disorganized attachment on key working.

4.3.1. Benefits of Secure Attachments

When discussing attachments and relationships all participants (100.00%) mentioned that secure attachments assisted young people to develop and progress in their placements. When participants were asked if relationships affected the young person in a positive manner, participants all agreed yes. Participant #4 stated,

Our relationship is important for their feelings of self-worth and knowing that someone cares about them. It ’ s [building relationships] an important aspect of the care system, as in helps them feel like the centre is their home, that they are safe there, and that staff are there to care for and protect them.

Participant #3 commented in regards to relationships,

The attachment or relationship that the key worker has for a young person is key to the development and success of their placement. It also allows for the young person to gain the opportunity to develop and learn attachment styles for later relationships in life. It gives the young person the chance to feel love, have someone to think about them and care for them, which helps them to do the same in external relationships outside of the centre.

Table 3a will look at the subthemes that developed when participants were highlighting the benefits of a secure attachment with a young person.

Table 3a - Benefits of Secure Attachment with Young People

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Table 3a demonstrates the subthemes accounted for when interviewing participants in relation to the benefits of secure attachments with young people. All participants (100.00%) were in mutual agreement that it allows for the young person to feel as if they have someone to go to at any given time during their placement. This links in with majority of the participants linking an important role of the key worker being advocacy in table 1a in subsection 4.1. Participants also mutually agreed that secure attachment allows for key workers to implement positive role modelling for the young people in their care. Table 3a - benefits of secure attachment, can be linked in with table 1c - improvements to be made to the key working system. In table subsection 4.3 it is identified that all participants agree that secure attachments are beneficial for the progress and development of young people in care. While in subsection 4.1 in table 1c, it is displayed that 75.00% (3) of participants feel that there needs to be more emphasis placed on the relationship between the key worker and young person. This demonstrates a distinct theme of the importance of attachment in children’s residential care. This data will be further discussed in Chapter 5.

4.3.2. Implications of Disorganized Attachment Disorder on Key Working

Another theme identified was disorganized attachment disorder in residential care, and its effect on the feasibility of the key working system in residential care. The interviewer asked if the participants felt if the interrupted care histories of many of the young people in care affected the feasibility of the key working system in residential child care. All participants 100.00% agreed that it did affect the feasibility of the key working system. On the next page is table 3b which shows how the participants responded to the affects disorganized attachment would affect the feasibility of the key working system.

Table 3b - Implications of Disorganized Attachment on Key Working

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Table 3b demonstrates that all participants feel that young people with disorganized attachments do not engage in the key working system as much as young people with other form of attachment issues, or young people who are capable of building secure attachments. 100.00% participants agreed that it contributes to the breakdown of future placements, while participant #4 and #1 felt that relationships could still be formed but it would take longer.

4.4. CONCLUDING DATA ANALYSIS AND FINDINGS

In this chapter the researcher laid out the data and primary research gathered through the form of semi-structured interview. The method displayed and implemented was Thematic Analysis. In the next chapter the researcher will discuss the findings that have been described in this chapter.

CHAPTER 5: DISCUSSION, CONCLUSION, AND IMPLICATIONS FOR PRACTICE

This section will now discuss the findings that have been described in the previous section. The strengths and limitations of this piece of research will then be discussed, before the potential implications of the findings will have on practice. Finally, there will be some discussion around opportunities for further research and closing comments.

5.1. SUMMARY OF FINDINGS

As stated in the introduction, in line with the research objectives, this research examined how the residential child care organizations implement the key working system in residential care, and what key workers perceptions were on the role of the key worker in residential child care today, including benefits of attachment to young people in care. These aspects were examined to answer the research question of, what are the helpful and unhelpful ways key working is implemented in residential child care? From the evidence collected, it seems that this question can be partly answered in this study. This section has been divided into headings representing the research objectives so that the findings are laid out clearly.

5.1.1. To Explore the Role of the Key Worker: Perception of Their Role and Challenges

There seemed to be evidence of sensitivity to the needs of the key worker in participant responses at interview. Participants seemed to appreciate the individual needs of their young people as well as perceive themselves to be role models to these young people, which links in with Bowlby’s (1958) explanation of attachment in the literature revised for this research. Bowlby (1958, in Holmes 1993: 218) described attachment as;

The condition in which an individual is linked emotionally with another person usually but not always, someone perceived to be older, stronger, and wiser than themselves.

75.00% of participants found that they were advocates on behalf of their young people, and there was a needs-based focus on the young people when carrying out their role as a key worker i.e. meeting the emotional and behavioural needs of the young people, and independent living needs of the young person.

Interviews suggested that participants saw themselves as caring individuals with heavy emphasis on relationships as a means to successful key working. Participants found relationships as integral to the engagement of young people in their placement. As seen in the literature, Bush (2001: 27) agrees with this statement,

The achievement of a basic sense of trust in their relationship with their caregivers enables children to become increasingly interested in new people, places, and experiences. Insecurely attached infants may not learn as well from their parents/caregivers.

All participants recognised that changes needed to be made in their practice as a key worker. The exploration of change highlighted a possible pattern in the problems with the key working system in residential care services. Whilst key workers had ranked ‘More Responsibility’ as the #1 challenge in their role, they also determined lack of time, and planning around the role as a downfall (See table 1b). All participants mentioned management being responsible for the implementation of the key working system in their respective centres. This identified a lack of sensitivity on management’s behalf in relation to providing adequate planning and allocated time for key worker’s to carry out their roles efficiently. Keeping up with the paperwork which recorded each child’s developmental progress was a challenge that key worker’s identified. 75.00% stated that administrative practices of the key working role affected their role as a key worker overall - see subsection 4.1.2. Boddy, Cameron, Petrie, Simon, Wigfall (2006: 82) agreed that key working can operate on this level also and identified that;

Key working can operate on various levels. It can be an administrative function, so that all paperwork, records, and necessary procedures relating to one resident are maintained by one staff member.

Participants were capable of highlighting that changes need to be made to the key working role, and the changes identified linked in with the challenges they faced in their roles. 75.00% of participants mentioned that more emphasis needed to be put on the relationships between key working and young person, as well as creating positive experiences and memories for the young people. All participants mentioned in one way or another time and planning. Participants clearly outlined in their interviews that more time to spend with the young people and planning especially around young person goals, and administrative tasks should be put in place by management for key workers so their roles can be carried out efficiently - though one participant did highlight that there was support available in her centre.

5.1.2 To Examine Residential Care Agencies' Evaluation of Key Working, and Assignment of the Key Working Role

The organisation of the role by residential care agencies is such that, young people don’t usually choose their key workers when admitted to a residential care service. All participants highlighted their unit managers as the figure that decides what key worker the child receives when they are admitted into care. Key worker allocation was mainly organised by patterns of working, and what team member was available at the time or who best suited, rather than young person preference. This might suggest an administrative aspect to the role of the key worker, which might also impact the way the role is used to support early relationships between key worker and young person - therefore linking in with participant’s most prevalent improvement to the role being more emphasis on the key worker and young person relationships. However, most participants understood why management chose to assign key workers in this way - and some participants agreed that they would not change the way in which key workers were assigned. Although participants earlier stated that there was a lack of time and planning put in around the key working role, they all stated that there was at least some value placed on their key working role by management and their organizations (See table 2a).

5.1.3 To Examine Key Worker's Attachment and Relationships with Young People in Care

The sample of participants in this study generally drew on their experiences as practitioners when building their relationships with children. All participants (100.00%), determine a secure attachment as important to the stability of a young person’s placement in residential care, see subsection 4.3. This links in with literature sourced by Ward and McMahon (1998). Ward and McMahon (1998: 18) state,

If integration does not happen, the child is left either with a chaotic inner world, or with very little awareness of the difference between his own inner world and other people's feelings or external reality.

When participants were asked about what the benefits of a secure attachment with their key worker offer young people in residential care services, 100.00% agreed that it allows for a young person to have one person to go to when they are in need. Ward (1993: 67) agreed that this is an integral function of key working in residential care,

Each client needs to know that at least one individual worker in the place has a clear understanding of his/her personal needs, wishes, and rights - one worker that is, in addition to the head of the unit.

100.00% of the participants also agreed that positive role modelling was a benefit for young people who have secure attachments in residential care. 75.00% of the participants stated that they felt a secure attachment allows for security and safety within their placement. As stated in Chapter 2: Literature Review Glaser and Prior (2006: 15) also propose that attachment serves the primary purpose of providing safety and protection for the young,

An attachment is a tie based on the need for safety, security and protection. This need is the paramount in infancy and childhood, when the developing individual is immature and vulnerable.

Participants also felt that children who had secure attachments with key workers benefitted from positive decision-making in relation to behaviours, positive engagement in placement, and learning how to attach to other individuals.

5.2. UNEXPECTED FINDINGS

The research included a question in relation to the disorganized attachments of some young people in the care system. Expecting to find that attachment would also benefit their placements, all participants (100.00%) stated that they felt interrupted care histories that often caused disorganized attachment disorder in young people, affected the feasibility of the key working system in residential care. Though 2 participants did state that relationships could still be formed, but it would take longer.

5.3. STRENGTHS AND LIMITATIONS OF RESEARCH

Limitations on the amount of interview time meant that, in some cases, it was difficult to fully explore some issues. This, coupled with difficulty in securing a quiet, private setting for interviews to take place in in some cases, may have impacted the quality of the data that was obtained. Also, one participant who had not been in the role for much time was unable to answer some of the questions adequately. Whilst this is not a limitation of the method used in the study, it may reflect the overall quality of the data collected. Furthermore, there were some question misunderstandings. These were addressed by rephrasing the question, but there still may have been an impact on the data obtained.

5.4. IMPLICATIONS FOR PRACTICE AND RECOMMENDATIONS

When looking to identify the implications for practice that this research has highlighted, and recommendations that can be highlighted, we need to look at the helpful and unhelpful ways that key working is currently implemented in residential care. Participants found that the current implementation of the key working system allowed them to advocate on behalf of young people in their care. Participants identified a needs-based function of the key working role, claiming that responsibilities of the key worker included assessing the needs of the young people, but also meeting emotional, behavioural, and psychological needs of the young people, as well as building the independent living skills needed by young people. These roles of the key worker work in conjunction with the National Standards for Children's Residential Centres’ (2001: 18) expectation of the key working role;

Staff are aware of the emotional and psychological needs of young people, and through the key worker role and the general ethos of the centre, facilitate the assessment and meeting of those needs.

Unhelpful ways in which the key working system is currently implemented, is the assigning of the key workers- although conflicted opinions on this is shown in the data gathered (see table 2b) - all participants state that the young person has no say in who their key worker is when being admitted to the centre. Participants also identified that lack of planning and timing was present in the current implementation of the key working system. All participants commented on either planning or timing in their interviews - and agreed that this had implications on their practice as a key worker, and how efficiently they could carry out their role. Participants commented on wanting more time to spend with their young people, and also better planning around the administrative work that comes with the role of the key worker. 75.00% of the participant stated that the administrative aspect of the key worker role affected the quality of practice when working with the young people.

5.4.1. Recommendations

After analysing the data gathered, and improvements that participants found could be made to the key working system in current residential care, I have formulated a list of helpful recommendations that could help improve the implementation of key working in children’s residential centres. The recommendations are as follows;

Identify current strengths of key working system i.e. advocacy and the needs-based focus currently upheld by the key working system, and maintain these strengths. Ensure that an attachment based approach is implemented in relation to key working. Recognizing the role secure attachments play in achieving positive outcomes for young people in care.

Review the policy in regards to the assigning of key workers, and ensure that it’s meeting the best interests of the young people in care.

Plan and identify time for key workers to fulfil their role during handover. Ensure their responsibility to the young people is met - as well as ensuring time is allocated to key workers to complete administrative work.

More emphasis to be placed on creating positive experiences with key worker and young person - this could include budgeting for more day trips and activities. Ensuring that the memories are recorded as this is seen as placing value on the young person’s time in care, and helps build positive memories between young person and key worker.

Special needs assessment to be carried out on young people with disorganized attachment disorder, and flexibility in approach to be taken to ensure positive outcomes in placement. Recognize building relationships and achieving positive outcomes could take more time.

5.5. OPPORTUNITIES FOR FURTHER RESEARCH

There are opportunities for further research in the area of disorganized attachment disorder, and the key working system. How can key working be implemented to meet the needs of young people with disorganized attachment? This could be an opportunity for more research on the matter.

5.6. SUMMARY AND CONCLUSION

Key workers seem to be adaptable, motivated and engaged professionals, and it seems of paramount importance that they are fully supported in order to continue providing young people with the best start in life. However, some of the evidence gathered suggests that in some instances, the role of key worker may be in place to meet the internal functional needs of the centre. In this chapter the research has outlined the helpful and unhelpful ways in which key working is implemented in residential centres today, and a list of recommendations formulated to assist improve the implementation of key working, and possibly eliminate the unhelpful ways in which key working is implemented. The unhelpful ways in which key working is implemented outlined; lack of time, lack of planning, and administrative function of the key working role distracting from work with the young person. Advocacy and the current needs-based focus taken on by the key working system are the helpful ways in which key working can be implemented in residential centres. It also identifies that most residential centres, despite displaying challenges in the way in which they implement the key working system in residential care, place value on key workers. Summarizing all that, the research concludes with a list of recommendations (See section 5.4.1.) that hope to improve how key working is implemented in residential child care today.

6. APPENDICES

6.1. TRANSCRIPTION OF INTERVIEW: PARTICIPANT #2

Interviewer: Can you describe your child care experience and training thus far?

Interviewee: I attended ehm Dundalk institute of technology. I studied three years of 'Applied Social Care', and was awarded my ordinary degree in September 2012. During my placements I would have completed two 12 week work experiences. One was in ISPCC in Drogheda, and the other was in a mainstream residential HSE house in Drogheda, called Crystal House. Both placements, I felt I participated well and learned a lot, and ehm, and I got my first social care job in Daffodil care services, and that was over a year ago.

Interviewer: What's your current position in Daffodil Care Services? And you are a Key Worker at the moment?

Interviewee: New key worker, yes.

Interviewer: New key worker... so how long?

Interviewee: 2 months

Interviewer: 2 months, great! It's obviously a new role and new experience for you.

Interviewee: Yup

Interviewer: Ok, so how have you found the process of assigning key workers in Daffodil Care Services, like what is the process of assigning key workers?

Interviewee: Ehm, so when they receive a file. Management would go through the file and identify who they believe would be best suited to the child, based on the child's needs, and that workers experience, and ehm try and match them up as best as possible.

Interviewer: Do the young people ever have an input into who their key worker is?

Interviewee: Generally ehm when a young person comes in they won't know the staff team, so it puts more on the management team to understand the needs of the child and who would be best placed. There would be some cases when a key worker has a left, and the young person voices their opinion on who they would like to take over from their previous key worker.

Interviewer: That is listened to?

Interviewee: Absolutely.

Interviewer: Ehm, what is your view then on how your current centre assigns key workers?

Interviewee: Ehm, I think it's really fair and as I said I worked in the company a year and we haven't had a high turnover of young people. At this time around, I was available and the manager thought I was best available, so it was really good.

Interviewer: Is that ideally how you would assign key workers if you were in a position to assign the key workers to young people?

Interviewee: I think it works well here, so yeah, like when I was on my work placement, that's the way it would have been done as well.

Interviewer: And you think that's fair?

Interviewee: Yup.

Interviewer: What does the role of the key worker consist of in your company?

Interviewee: Well the most important part is advocating on behalf of the young person, trying to assess the needs of the young person based on what the young person feels their needs are, what the social work department think their needs are based on their files. Working towards preparing a young person for leaving for care, in the best way possible. So if they came in here with basic skills, you'd try build up their independent living skills or assist them with emotional or behaviour problems, and if that was their main concern or focus, we'd try help them before they move on.

Interviewer: Is there any extra jobs or tasks you have to take on as a key worker?

Interviewee: Well I suppose we're a great team here, so ehm you do have the support of your work mates which is brilliant. But you do take on a lot of responsibility as a key worker.

Interviewer: Is there any training in your company for key workers?

Interviewee: The training not so much, but there's a lot of support.

Interviewer: In your opinion, what is the most important role of the key worker to their key child?

Interviewee: As I said, to advocate on their behalf.

Interviewer: Ok, so from your experience how important do you find a secure attachment with a key worker to their young person?

Interviewee: Hugely important, as I said like I'm new to key working so I'm in the process of building up that attachment with my key child. But like it's already starting to show, she’s getting there to building up that attachment with me, when she has a problem she knows she can come to me, she looks forward to when I am on shift.

Interviewer: Is your role as a key worker affected by the administrative practices in your centre?

Interviewee: Ehm, no. Say that again, sorry.

Interviewer: Is your role as a key worker affected by the administrative side of the centre, like paper work?

Interviewee: Ehm, No, as I said we have a fairly good balance here. So everyone on the team knows how to do all the paperwork that needs to be done on a weekly basis. I know I can say to my team that if I have a monthly key working report to be complete, I can say to the guy, “Look I need an hour to get this done” or if I have a support work session planned that I'll need to take my young person for X amount of time.

Interviewer: So your fellow staff members see the importance of having an attachment to your person then as well?

Interviewee: Very much so.

Interviewer: Do you feel your relationship has had a positive influence on the young person's placement?

Interviewee: Yup, I do ehm, I just think we were matched up very well. We have similar interests. That you know, I'd like to think in some way she looks up to me. She has expressed her interest in becoming a social care worker after she leaves care. I'd like to think I had something to do with that.

Interviewer: How do you think having a key worker influences a young person's placement?

Interviewee: It's that one person they know they can come to when times get tough. So yeah I think if I was a kid in care, I'd want to know I had that one person to come to. So I think it's hugely important.

Interviewer: How do you think your key working role influences your practice in your centre, in comparison to the normal social care working role?

Interviewee: There's more responsibility you know and you're not just coming in for the sake of it, its kids’ lives.

Interviewer: Do you put a special focus on a young person when you're a key worker?

Interviewee: Absolutely, if we have a plan for that day, before I come in making sure I am prepared and I bring in what I said I'd have in with me. Follow through with our plans.

Interviewer: How do social care workers generally perceive their roles as key workers? How do they perceive being assigned the key working role? So are other staff members who were assigned key worker, were they happy about it, sad about it? How did they feel? What's their perception?

Interviewee: In my previous experience, most people are happy when they are assigned a key child. However, I know in one case there was somebody I worked with that there was so much going on for them with personal life and college. They decided it was more stress than they actually needed, but with the support of the rest of the team that was there, ehm, within a matter of days, it was fine. It became positive.

Interviewer: So, having a key worker who's coming in stressed and their head not really in it, what kind of difference does that make to a young person's placement compared to a key worker who comes into the role happy?

Interviewee: Well if you're a key worker or not a key worker, I think it's very important to leave your personal baggage at the door. But yeah, I can imagine if someone is coming into work and the young person that they're key worker for, if they're coming in and their heads not in it, I can imagine it can be very damaging, for their relationship and for that young person.

Interviewer: Would you make any changes to the role of the key worker if you were unit manager?

Interviewee: It would depend on the organization. If I was to manage my current centre, I think they have it fairly spot on. However, in another house I worked with that has had a high staff turnover. There was a high changing of key workers for a young person, and I think that affected the young person and not in a positive way.

Interviewer: Ehm, Ok. So do you think the young people admitted into residential care centres in Ireland, taking into consideration their interrupted care histories of many young people in care affect the feasibility of key working? So what I mean by that is a lot of young people that come into our care, they have many interrupted attachments, so do you think that impacts the feasibility of key working systems in general?

Interviewee: Absolutely, yeah, ehm, when I was on my placement I worked with a girl who had a huge amount of placements that broke down. We were in the mind-set of this is a long-term placement for you, you're going to do great here and she just said, “I've heard all of this before”. It was very sad to hear. That she had such a negative view of the care system in Ireland but it was totally understandable. So yeah, I think it would have a huge effect.

Interviewer: Do you think having a stable key worker would have benefited her in the long run?

Interviewee: Yeah I do, on top of high turnover of key workers, she had a high turnover of social workers. So she had nobody stable in her life whatsoever.

Interviewer: Do you think the fact she had no one stable was an influence on why her placements continued to break down?

Interviewee: Yes, yes.

Interviewer: Ok, do you have any other suggestions, thoughts or ideas on key working?

Interviewee: I suppose my own take on key working is to try be as hands on as possible and creative as possible and what has worked really great here is creating memories. It's the best thing you can do for a young person. They look back on their time, and say, “Well my upbringing may have been shit, but look these are memories that I created over how many years” and try give them the best experience as possible.

Interviewer: Creating value on their placement?

Interviewee: Yup

Interviewer: Thanks, that's the end of this interview.

6.2. INTERVIEW DESIGN

Key Working in Residential Child Care Interview Questions

1. Introduction to the research.

- Explain research purpose.
- Explain interview procedure.
- Explain respondent’s right to not answer any particular question; and to stop the interview at any time.
- Explain aspects of confidentiality.
- Explain that the respondent can contact a member of the MATCC Staff Team if unhappy with any aspect of the interview / research.

2. Ask about:

- Training.
- Past child care / residential child care experience - job titles; time in each and duties responsibilities of each.
- Current position held - job title; for how long; and duties and responsibilities.

Confirm their Key Worker status

3. Discuss their position as a Key Worker in particular. How long have they been in the role; and how many young people have they been Key Worker for? Did they ever have more than one Key Child?

4. In your experience of being a Key Worker;

- How have you found the process of assigning Key Workers in your respective residential centre?
- What criteria have been used to do this?
- Have the young people had an input in the implementation of Key Workers?

[Refer to all different organizations and their policy on assigning a Key Worker].

5. What is your view about how Key Workers are assigned?

6. Ideally, how would you assign Key Workers, taking young people into consideration?

7. From your experience;

- What has your role of being a Key Worker consisted of?
- What tasks have you been expected to carry out?
- Did you receive any special training for this role?

8. In your opinion, what's the most important role of a Key Worker to their Key Child?

From experience, how important do you find a secure attachment with a key worker is to the young person?

9. Describe your relationship with your current Key Child?

- Is it affected by the administrative practice in your centre?
- Do you feel your relationship has had a positive influence on your young person's placement?
- Do you feel your relationship and attachment formed with the young person was important for the young person's progress, and development at the centre?

10. How do you think having a Key Worker influenced the placement of the young people in your centre, and their overall behavioural and emotional development?

11. How does being a Key Worker influence the way in which you practice in your organization, comparing to if you were not in a key working position?

12. What's your general perception on the basis of how key workers have been assigned in other residential organizations? Taking into consideration administrative needs of the centre vs. their duty to the young person.

13. How do social care workers generally perceive their role as a key worker from your experience?

14. Would you make any changes to the role of a Key Worker?

- If so, what changes would you make?
- Would you change how Key Workers are assigned in residential care?
- If so, what would you change?

15. Do you think that the young people admitted into residential care services in Ireland, taking into account the interrupted care histories of many of the young people in care, affect the feasibility and effectiveness of key working?

16. Do you have any other thoughts/ideas/suggestions about key working?

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