Good practice in social care for refugees and asylum seekers
Key messages from the research
This guide has been developed from a focused literature review and a practice survey to establish the evidence for good practice in meeting the social care needs of asylum seekers and refugees (see SCIE Report 31)
Focused literature review
The aim of the literature review was to examine the research evidence to identify positive outcomes and good practice in social care provision for asylum seekers and refugees. It involved a systematic search of published and unpublished material and web-based sources for the period 2000−2008. In 2013 this initial search was updated to include items from 2008 onwards.
The aim of the practice survey was to explore what is currently happening in social care provision for asylum seekers and refugees. This included:
- exploring the views of asylum seekers and refugees on needs for social care and their suggestions for good practice in responding to these
- consulting with practitioners and third sector organisations on their experience and views of good practice in social care for asylum seekers and refugees
- Identifying practice examples.
- The literature identified was patchy, with only a small number of studies evaluating outcomes from social care provision. In relation to children and young people, there were a healthy number of studies but the majority concerned unaccompanied asylum seeking children, rather than refugee or asylum seeking families. For adults a reasonable number of studies were identified in relation to mental health, although these were predominantly focused on mental health needs. Few papers were identified looking at social care provision for disabled asylum seekers and refugees and only one paper considered older refugees. A small number of other papers identified relevant issues, such as training and advocacy. The updated search, for evidence from 2008 onwards also showed a very small number of papers concerning refugees and asylum seekers and social care specifically. Like the original search there were a higher number of studies looking at unaccompanied asylum seeking children than examining the situation for adults. There was some notable work concerning female refugees and asylum seekers, LGBT groups and the victims of human trafficking. The search identified several new pieces of legislation and guidelines, and tool kits which may be of use to social care professionals.
Another issue that emerged from the 2013 search was concern surrounding the wellbeing of migrants detained under the UK Immigration Act in immigration removal centres (sometimes referred to as detention centres). The literature highlighted both the adverse effects of detention on detainees and also a lack of access health and social care services.
- The practice survey indicated that there are significant problems for asylum seekers and refugees accessing social care provision. For children and young people, the Children Acts provide a framework for provision and a number of practice examples illustrated how their needs could be met both by local authorities and refugee and community organisations, usually working in partnership to deliver positive outcomes. For adults, access to social care provision was more restricted with a lack of clarity about eligibility, language, lack of awareness of the function and nature of social services, limited understanding of the social care needs of asylum seekers and refugees, trust and an absence of culturally appropriate provision proving to be major barriers. Relatively scant evidence was found of a strategic approach in this area and few examples of aggregated needs assessments identified. The majority of good practice identified related to provision by refugee and community organisations, local authority children’s services or immigration and asylum teams.
- The synthesis of the findings from the literature review and the practice survey indicated some broad principles that need to underpin the delivery of social care services for asylum seekers and refugees. These are:
- a humane, person-centred, rights-based and solution-focused approach to the needs of asylum seekers and refugees
- respect for cultural experiences and migration
- non-discrimination and promotion of equality
- decision-making that is timely and transparent and involves people, or their advocates, as fully as possible in the process
- promotion of social inclusion and independence
- A holistic approach.
4. There was strong agreement from both the literature review and the practice survey as to what good practice in social care should look like. The areas for suggested good practice are:
- Clarity regarding entitlement to social care and responsibilities for provision for refugees, asylum seekers and refused asylum seekers. There is a need to review the appropriateness of thresholds for care and to ensure strategies are in place to increase access to social care. These include provision of accessible information and support, universal gateways, availability and use of interpreters and outreach via community organisations.
- A full and thorough assessment of needs for social care as early as possible in the asylum process.
- Early identification of and access to psychological and therapeutic support to address post-traumatic stress disorder (PTSD) and other mental health problems delivered within a holistic approach.
- Effective communication, including readily available and effective interpretation services, with an understanding of both the cultural and service context.
- Advocacy, with the aim of increasing choices and access to appropriate provision and empowering individuals.
High-quality service provision
- Focus on outcomes.
- Culturally sensitive and competent provision, with staff understanding the cultural context, and the issues pre-and post-arrival in order to respond appropriately to the diverse needs of refugees and asylum seekers.
- Provision of training and supervision for social care professionals.
- Engagement and working in partnership with community organisations that have specialist knowledge.
Facilitating self-organisation and innovation
- Participation and involvement in service provision.
- Services that enable asylum seekers and refugees to self-organise and develop their own sources of support.
- Provision of services by community organisations and including asylum seekers and refugees.
Strong partnership working
- Working across organisational boundaries to deliver services that respond to needs in a culturally appropriate way.
- Commissioning community and voluntary sector organisations to deliver social care.
- Co-location of services and multi-agency working.
Six critical steps were identified that provide a foundation for good practice:
- Securing organisational commitment to promoting the wellbeing of asylum seekers and refugees.
- The development of strong multi-agency partnerships with a clear focus on asylum seekers and refugees, at both strategic and operational levels.
- The development of a local strategy based on a joint strategic needs assessment to enable local authorities and their partners to plan and develop services for current and future populations of asylum seekers and refugees, as well as other migrant populations. This includes the application of existing policies that provide a framework for the provision of social care – particularly equality and diversity policies. It also includes a clear acknowledgement of the contribution of community and voluntary sector initiatives and sustainable investment in these to enable them to further build their capacity.
- Methods for engaging with and involving a diverse range of asylum seekers and refugees in the development of appropriate services.
- Workforce development, including training and supervision, to strengthen the capacity of staff to respond positively to the diverse needs of asylum seekers and refugees.
- Monitoring and review to assess the extent to which positive outcomes are achieved and equalities monitoring to assess access to, and experiences of social care by asylum seekers and refugees.
5. Local authorities need to be supported in their role of providing access to appropriate personalised provision for asylum seekers and refugees by recognition of their responsibilities to preserve the rights of asylum seekers and refugees. This support includes appropriate levels of funding to enable local authorities to discharge their responsibilities and clear guidance from the Department of Health (DH) and the Home Office.
6. The review identified significant gaps in the evidence base for good practice in social care. There is a need for further research in this area including:
- mapping access to community care assessment and access to personal social services
- focusing on the needs and service delivery options for children in families, disabled asylum seekers and refugees, older refugees, women and other groups that have also been identified as vulnerable
- evaluating outcomes for social care interventions for asylum seekers and refugees
- processes for mainstreaming the needs of asylum seekers and refugees within broader local authority agendas.