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Moving Forward: Implementing the 'Guidelines for the Alternative Care of Children'

The RAF method for quality assurance in residential settings for children, Israel

Focus 14: Developing reliable and accountable licensing and inspection systems

The RAF (Regulation, Assessment and Follow-up) Initiative has been implemented by the Ministry of Social Affairs to improve the quality of care. It involves an external inspection element with an internal quality assurance approach. Developed in Israel, the RAF is a method for regulation and inspection aimed at improving the quality of care provided by a facility or service using an objective, systematic and uniform method of regulation. It was implemented in 85 residential settings serving 5,000 young people aged 6-18, in order to improve the quality of care – and ultimately the quality of life – for the children residing there. The RAF uses a ‘tracer’ approach, where a set of well- defined problems or conditions, which characterise the residents in a setting, serve as tracers for the evaluation of the quality of care. Examples of tracers include low achievement at school, aggression, depression and anxiety.

In addition there is a set of comprehensive indices designed to check the functioning of the institution as a whole. These indices are more general in nature and include for example, safety, personnel and nutrition. Information is collected by inspectors both on the personal and institutional level, with a strong emphasis on utilising the client as a key source of information, along with staff interviews, documentation and observation. The monitoring process has seven main stages and follows a regulation cycle. The data from RAF has served as a basis for a structured treatment plan for each child and there is evidence of an improvement in the quality of care and the well-being of children. In addition, the impact of RAF has been shown in an improvement in work procedures, decision-making processes and personnel qualifications.

For more information see: Zemach-Marom, T. (2008) The Relationship Between Research and Practice in Implementing the RAF Method for Quality Assurance in Residential Settings in Israel. In R.J. Chaskin and J. Rosenfield (eds) Research for Action: Cross National Perspectives on Connecting Knowledge, Policy and Practice for Children, Oxford: Oxford University Press. (http://oxfordindex.oup.com/view/10.1093/acprof:oso/9780195314083.003.0005)

International Social Service, Oak Foundation, SOS Children's Villages International, unicef, ATD Fourth World, Better Care Network, Family for every child, ngo group for the crc, PEPFAR, RELAF, Save the Children, USAID