Formal residential care varies greatly in type and quality and encompasses institutional care such as orphanages, places of safety for emergency care, transit centers in emergency situations, and all other short- and long-term residential care facilities including group homes. Its basic characteristic is care provided by paid staff and/or volunteers to a group of children in a nonfamily setting.

It is important to make a distinction between orphanages that are large-scale institutions, for example, housing more than 15 or even hundreds of children, and the more individualized setting of small group or “family style” residential care homes. Large-scale institutional care is shown to have poor outcomes for children and is not regarded as an appropriate option on the continuum of care.

For some children and youth, depending on their unique circumstances and preferences, formal residential care may be the best available option. Ideally, placement in residential care is temporary and transitional, ultimately leading to family care rather than becoming a long-term or permanent situation.

Gatekeeping—the careful assessment of individual needs and consideration of all possible family care options—is a critical component when children are placed in residential care to prevent unnecessary long-term placement.

There is a growing movement around the world to support the transition from reliance on formal residential care to greater investment in family-based care.

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