A program that provides safe and secure care for children aged 3 to 23, facing abuse, neglect and other significant risk factors.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Targeted and specialist
- Continuing care
Australian Study
Risk of Bias
Cost
Target Age Group
About
SAFE Homes was developed by the State of Connecticut to help promote stability for children with the need for out-of-home placement. The program provides short-term care for children who cannot be cared for in a family setting due to abuse, neglect or other significant risk factors. The program provides immediate, safe and secure, 24-hour care in a home-like setting. A range of interventions and services are delivered for up to 60 days to children with significant mental or medical health needs and high-risk behavioural management needs. SAFE Homes was designed for first-time placements, unlike most prior permanent planning efforts designed for children experiencing extended histories of out-of-home care.
Aims
- Prevent and reduce re-abuse and of out-of-home care
- Improve family reunification
- Reduce child protection system contact.
Impact
Evidence suggests that SAFE Homes was effective in reducing new substantiated incidents of child maltreatment. Results for reducing out-of-home care and child welfare system costs were mixed. There was negative results for family reunification, with a smaller proportion of children living at home at 12 months follow-up. Results were based on a study using the State of Connecticut’s Department of Children and Families’ administrative data.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Child protection system contact | Yes | Not found | Not found |
| System | Family reunification | Not found | Not found | Yes |
| System | Out-of-home care | Yes | Yes | Yes |
| Cost | Child welfare system cost | Yes | Not found | Yes |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
SAFE Homes has an evidence rating of Supported+.
This means that SAFE Homes has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, long-term impact on at least one child and family outcome.
This assessment is based on one research output of QE design. SAFE Homes has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | Not identified or included |
| Quasi-experiment | 1 |
The evidence has some concerns with risk of bias.
We can be reasonably confident about the results and quality of evidence from the included study.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- This study used administrative from the State of Connecticut’s Department of Child and Family Services.
Sample
- Participants were 684 children (342 intervention, 342 control).
- Children were included in the sample if (a) the removal was the first placement for the child; (b) they entered out-of-home care between the dates (inclusive) of 1 April, 1999 and 31 December, 2000; and (c) they were aged 3 to 12 at the time of entry into care.
Implementation
Delivery model, mode and setting
- SAFE Homes is delivered in-person to children and families.
- The program is delivered in an out-of-home setting in the community.
Target cohort
- Children at risk of maltreatment
- Children aged 6 to 13.
Program delivery
- SAFE Homes is delivered by private agencies that have contracts with the State to operate the program.
- The program serves 12 children on average. Under the new SAFE Home program, the number of sites and total beds available for children is reduced from 16-bed facilities to 8-12 bed facilities.
- SAFE Homes staff facilitate scheduling of evaluations, provide transportation to appointments, supervise visitations and provide a range of other case management and intervention services.
- SAFE Homes staff also attend interagency case planning meetings and are expected to testify in court, when appropriate.
- In addition, SAFE Homes staff provide modest after-care services for up to 2 months after discharge to facilitate the implementation of treatment recommendations after children are returned home or placed again with kin, in a foster home or in another community-based setting.
- Children are accepted 24 hours per day, 365 days per week and operate with a no reject, no eject policy.
- The expected length of stay is 45 days.
- The 4 most important features of SAFE Homes are:
- Consolidated resources to facilitate assessment and treatment planning
- Community-based permitting placement of children in close proximity to birth families, facilitating visitation, evaluation and crisis-intervention treatment
- Allowing siblings to stay together when placed
- In most cases, allowing children to continue in their school of origin during the assessment and treatment planning process.
Duration and intensity
- SAFE Homes involves the delivery of a range of interventions in a 24-hour, home-like setting for up to 60 days.
Guides and manuals
- We were unable to locate implementation guidelines and training protocols for SAFE Homes.
Staffing
- Mandatory staffing ratios are 1:5 for day, evening, and night-time shifts. Most SAFE Homes provide greater staffing during peak hours to provide age-appropriate recreational and therapeutic activities.
- A range of clinical personnel deliver appropriate therapeutic activities.
Training
- We were unable to locate any information on training requirements to implement SAFE Homes.
To our knowledge, SAFE Homes is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of SAFE Homes.
References
Studies identified and included in the review
- DeSena AD, Murphy RA, Douglas-Palumberi H, Blau G, Kelly B, Horwitz SM and Kaufman J (2005). SAFE Homes: is it worth the cost? An evaluation of a group home permanency planning program for children who first enter out-of-home care. Child Abuse & Neglect 29(6): 627-643.
Studies identified but not counted towards the evidence rating due to study quality
No studies that were identified were excluded due to study quality.