Would We Know It If We Saw It? Assessing Quality of Care in Group Homes for Youth

Abstract

This article proposes and examines a parsimonious framework for assessing quality in therapeutic residential care. The synthesized conceptual framework includes four potentially critical domains of quality: setting, staffing, safety, and treatment. Data from a recently completed quasi-experimental study of group homes were used to examine prevalence of various key indicators within each of these domains and to explore relationships between these indicators and youth-level outcomes. Findings suggest that, among this sample of licensed homes in a southeastern state, licensure may be an initial indicator of baseline quality. Beyond this most basic level, utilization of an evidence-informed model (in this case, the teaching family model) was associated with better outcomes. Net of model, findings suggest that positively focused motivational systems, youth’s perceptions of staff’s fairness and helpfulness, provision of age/interest-appropriate toys/books/games, more preservice training, and prohibition of physical restraint were all associated with better outcomes for youth. Additional work is needed to assess the generalizability and utility of this framework for assessing quality in group homes.