Children and young people with intellectual disability, for whom no vacancy has been found in foster care or in nursing and care facilities, are located in social welfare homes. Currently the system of support for such persons does not provide them with proper care. Also, it is not free from legal defects which need to be repaired.
Specialist foster care is the most desirable form of support for children with intellectual disability. However, the number of specialist foster families in Poland is still too small. That is why, minors with intellectual disability are referred to the following social welfare homes: either the ones designed for children and youth with intellectual disability (where in fact adults are also placed), or combined social welfare homes, dedicated also to adults with this kind of disability.
In practice, there are no social welfare homes in Poland where only minors would stay. The age diversification in these facilities has an adverse impact on ensuring required support and safety to children and young people.
As of 31 December 2024, there were 35 social welfare homes for children and youth in Poland, offering nearly 2.5 thousand beds, as well as 65 combined social welfare homes with over 5.5 thousand beds. According to the data from the Ministry of Family, Labour, and Social Policy the number of vacancies for children exceeded 4 thousand. In reality, however, more than 1 thousand minors resided in these facilities, occupying 26% of the places reserved for them.
In line with the Strategy for the Development of Social Services, placing children in social welfare homes outside the foster care system, should be the last link in the support system, used exclusively in the absence of other opportunities of assistance. The problem is that the children who are sent to these facilities disappear from district statistics related to the foster care system. After they are placed in a social welfare home, a place in foster care is no longer searched for them.
Why are children with disabilities sent to social welfare homes?
The profile of children placed in social welfare homes is diversified. Some of them, because of serious health condition, require specialist care 24/7, yet they are sent to social welfare homes at their parents’ request who have full parental rights, pay for their children’s stay and eagerly participate in their children’s lives. Other children situated in these facilities come from foster families, from institutional care, are located there due to a difficult family situation or because they necessitated specialist, professional care and permanent supervision. Still other minors are referred to social welfare homes from dysfunctional families through the intervention process, but also due to the shortage of vacancies in family foster care or in care and medical facilities.
“In such cases social welfare homes are an alternative for a dysfunctional family or another place which cannot cope with demanding care related to the child’s disability. In that case the child’s stay is paid in part or in whole by the municipality which has sent the child to the social welfare home” –audit coordinator Marzena Baradziej said.
Age distribution of population – theory and reality
The NIK audit was conducted in 9 social welfare homes, 7 district family support centres and 7 county offices. The key audit question was if the care of children and youth with intellectual disabilities provided in 2022-2025 (until 30 September) in social welfare homes was proper and diligent.
In 2022-2025, most residents of all the social welfare homes audited by NIK were adults. “The places designed only for children were usually occupied by adults who – in accordance with the law – could stay in social welfare homes after they turned 30. In practice nearly all residents placed in social welfare homes as children stayed there until the end of their lives” – the audit coordinator explained.
The eldest residents of social welfare homes for children and young people were even 76 years old and in combined facilities the residents’ age ranged from 63 to 92. The youngest child who stayed in a social welfare home in the audit period was 7 months old.
Task performance and service access limitations
NIK has found that the audited social welfare homes completed their tasks related to social welfare and supported children and youth placed in those facilities. In all the social welfare homes, despite difficulties in access to specialists and long waiting time, the minors’ had their health needs satisfied. Also furnishing, clothes and toys were provided.
This does not, however, change the fact that the children who should be placed in foster care or nursing and care facilities are referred to social welfare homes.
The majority of children living in social welfare homes attended educational or upbringing facilities. Minor residents of social welfare homes had limited access to occupational therapy, medical and social rehabilitation.
Children sharing accommodations with adults
The NIK report revealed that in all social welfare homes minor residents shared their rooms with adults or seniors. Since younger and younger children are located in social welfare homes, it becomes increasingly challenging to provide them with space tailored to their needs at early stages of their development.
It also happened that district family support centres, following consultations with heads of the social welfare homes, refused to admit minors with intellectual disability, despite available vacancies. The heads justified it with the residents’ safety. That approach violated the principle of equal treatment of children and youth with intellectual disability, whose placement in a social welfare home was ordered by the court.
No efforts to help children and youth leave social welfare homes
Over half of social welfare homes did not take any efforts, also did not cooperate with the institutions which could possible help the children and young people leave the facilities. The most frequent reason provided was that it was not a task of social welfare homes. At the same time, all the district family support centres promoted foster parenting. Despite these measures, though, in the entire audit period, no specialist foster family was in place in the area of four facilities. In other districts the number of such families ranged from one to five.
The audit also identified system barriers in terms of support for families with children with intellectual disabilities which may end in placing the children in social welfare homes. They included institutional barriers (like the shortage of specialists providing support, lack of coordination between the social welfare, education and health system, insufficient staff prepared for work with families having children with disabilities, lack of financial support and barriers in access to services (long waiting time for health services, deficient offer of respite care services, stigmatisation and sense of loneliness in families).
Recommendations
To the Minister of Family, Labour and Social Policy
To initiate changes to the Social Welfare Act, Act on Family Support and Foster Care System and Ordinance on Social Welfare Homes in the following scope:
- introducing a requirement to place children and youth with intellectual disability in combined social welfare homes after excluding the possibility of locating them in social welfare homes for children and youth, upon meeting relevant safety requirements and in consideration of their specific emotional and therapeutic needs,
- establishing rules for the use of monitoring in social welfare homes, including collection, processing and storage of recordings,
- adapting the service standards in social welfare homes for children and youth, in view of their specific emotional and therapeutic needs, actual length of stay in social welfare homes and introducing the obligation to cooperate and exchange information with educational and upbringing facilities which they attend,
- establishing rules for safe storage and disposal of residents’ medications, particularly those containing psychoactive or narcotic substances,
- establishing rules for simultaneous placement in social welfare homes and foster care, as well as rules for terminating institutional care in cases of permanent placement in social welfare homes, which will prevent blocking of foster care vacancies and double financing of a child’s stay,
- introducing the so-called “long-term care,” which provides care for children and youth with intellectual disabilities even after they reach the age of majority, if they are unable to live independently.
To the Minister of Justice
- to prepare changes to the Mental Health Protection Act by introducing the obligation for the court to seek opinion of a forensic psychiatrist before issuing the ruling to place the child with intellectual disability for an indefinite time in a social welfare home.
The NIK audit also identified the following factors which contribute to placing children and youth with intellectual disability in social welfare homes: insufficient support for biological families, shortage of vacancies in specialist foster care, failure to provide courts with comprehensive information about the child’s situation or stopping to seek opportunities for minors to leave the social welfare homes after placing them in these facilities.
Therefore, NIK recommends that the Minister of Family, Labour and Social Policy as well as the Minister of Justice should develop joint strategy to support children who may be placed in social welfare homes and children already placed there, which aims at:
- providing their families with permanent access to long-term system forms of support,
- developing guidelines on searching foster or adoption families using e.g. social media to boost the search effectiveness,
- introducing an obligation for district family support centres to prove, at the stage of court proceedings concerning the placement of children in social welfare homes, that all possibilities of finding a vacancy in foster care have been exhausted,
- introducing an obligation for social welfare homes and district family support centres to cooperate with the guardianship court to search vacancies in family foster care for children placed in social welfare homes.
NIK recommends that the Minister of Family, Labour and Social Policy develop guidelines for:
- heads of social welfare homes, further specifying requirements regarding the form, dates or frequency of training in pre-medical first aid for therapeutic and care team employees in a way guaranteeing safety of residents of social welfare homes,
- governors, considering the need to register information on the age structure of residents of individual social welfare homes. The absence of this information may be misleading for the party requesting the placement of a minor in a specific social welfare home and for the courts adjudicating these cases.
Recommendations and good practices
Regardless of the de lege ferenda proposals and system recommendations aiming to refine the system for supporting children and youth with intellectual disability placed in social welfare homes, NIK has presented a catalogue of identified good practices to be disseminated by the Minister of Family, Labour and Social Policy among governors, the authorities that operate and commission the operation of social welfare homes for children and youth and heads of those social welfare homes. The catalogue includes:
- the family-based system of operating social welfare homes, i.e. dividing residents into groups and assigning permanent staff to them, including a permanent family caregiver, which may help increase their sense of stability, safety, build stronger bonds and strengthen the sense of belonging,
- increasing the number of meals for children and youth,
- ensuring access to psychologists in social welfare homes in the afternoon,
- assign a staff member working at a social welfare home on a rotating shift schedule as the primary point of contact for a child attending an educational facility to increase their availability.
