Acciones e investigaciones Sociales. Nº 46 (2025)

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Quality Assessment in Day Care Centers in Cantabria: A Program for at-risk

Children and Adolescents

Evaluación de la calidad en centros de día en Cantabria: un programa para

infancia y adolescencia en riesgo de desprotección

Jaime Burón1 , Laura García-Alba*1 , Iriana Santos2 , Julio Rodríguez-Suárez1 and Amaia

Bravo1

1University of Oviedo. Spain.

2University of Cantabria. Spain.

* Corresponding author: garcia.alba.laura@gmail.com

https://doi.org/10.26754/ojs_ais/accionesinvestigsoc.20254611368

Received 2024-12-18. Accepted 2025-03-03

Abstract

Background: Day Care Centers for Children and Adolescents (CDIA) are a resource widely used by

Social Services to support at-risk families, promote children’s well-being and keep them in their family

context. The aim of this study was to delve into these programs by means of a quality assessment

project. Methods: For this purpose, 357 participants involved in one of the 16 Day Care Centers in

Cantabria (Spain) were interviewed using an adaptation of the ARQUA system (Pérez-García, 2019),

including children, adolescents, families and practitioners. Results: The results highlighted great

satisfaction with the service, especially regarding the positive impact perceived in children and

families derived from a relationship-based intervention delivered in a safe space. Discussion:

Moreover, opportunities and potential areas for improvement are discussed regarding these services,

which can be considered useful and effective in preventing risk factors for families and children.

Keywords: Day Care Centers for Children; social risk; child welfare system; prevention; quality

assessment

Resumen

Introducción: Los centros de día para infancia y adolescencia (CDIA) son un recurso frecuentemente

utilizado por los Servicios Sociales para apoyar a familias en situación de riesgo, promoviendo el

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bienestar y el mantenimiento de la infancia en su contexto familiar. El objetivo de esta investigación

fue evaluar la calidad y funcionamiento de estos programas. Material y métodos: Para ello, se

entrevistó a 357 participantes entre niños/as, adolescentes, familias y profesionales involucrados en

la red de 16 centros de día de Cantabria utilizando una adaptación del sistema ARQUA (Pérez-García,

2019). Resultados: Se pone de manifiesto una alta satisfacción de todos los informantes con la calidad

del servicio, destacando el impacto positivo en niños/as y familias de una intervención basada en las

relaciones significativas en un entorno seguro. Discusión: Además, se discuten potenciales ámbitos y

oportunidades de mejora del servicio de CDIA, confirmándose la utilidad de este tipo de programas

para la prevención de los factores de riesgo y desprotección.

Palabras clave: Centros de Día para Infancia y Adolescencia; riesgo social; Sistema de Protección

Infantil; prevención; evaluación de calidad.

INTRODUCTION

The family can be considered the basic unit of coexistence in society, playing a significant economic,

social, and political role in social cohesion and sustainability (Pastor, 2021). In Spain, Organic Laws

1/1996 and 8/2015, as well as Law 26/2015 on child protection, emphasize the role of family as the

primary context of care and socialization for children. Similarly, the Organic Law 8/2021 on the

Comprehensive Protection of Children and Adolescents Against Violence (LOPIVI) highlights the

importance of the family, in all its forms, as the natural environment in which children and adolescents

thrive, establishing the need to support families in their educational and protective roles to prevent

risk factors and strengthen resilience.

It is important to note that, in some cases, situations of risk or lack of protection for children may

originate within the family itself, leading, in the most extreme cases, to out-of-home care

arrangements (Ramírez-Plata et al., 2024; Sarasa-Camacho & Robles-Abadía, 2025). However,

legislation clearly emphasizes the need to combine these measures with more preventive approaches

that address situations of mild and moderate risk, allowing for the preservation of the family context

whenever possible and in accordance with the child’s best interest (Besada & Puñal, 2012; Capella &

Navarro-Pérez, 2021; De Paúl et al., 2015; Molina et al., 2019).

To this end, it is essential to continue promoting policies and programs that support adequate

parenting processes and enhance families’ parental skills. These actions have greater long-term

effectiveness and cost-efficiency, positioning early intervention within family systems as the best

alternative to prevent situations of neglect (Arruabarrena & De Paúl, 2012). In Spain, there has been

an increase in programs aimed at promoting positive parenting through regional child welfare

services. However, the challenge remains to ensure that these programs are effective and meet

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international quality standards (Amorós et al., 2016; Hidalgo et al., 2023; Sánchez-Sandoval, 2024).

The present study aims to expand the available evidence on the quality and functioning of a preventive

program for children and families in Spain, the Day Care Centers for Children and Adolescents

(hereinafter, CDIA). CDIAs are a widely used resource within social services to support at-risk families

in their educational responsibilities, promote their children and adolescents’ well-being and prevent

situations of abuse and neglect.

Finding a standard definition of CDIAs is challenging in Spain. In fact, CDIAs are not explicitly

mentioned in the Social Services Reference Catalogue (2013), although there is a section that defines

the provision of "socio-educational care for children and adolescents" within the area of family

intervention and support. However, the common characteristics of most of these programs can be

summarized as follows: (a) preventive approach, (b) daytime care (after school, Monday to Friday), (c)

group-based settings, (d) individualized intervention, (e) focus on creating an educational space for

support, care, and supervision, and (f) a goal of reducing the level of risk for child neglect (Capella &

Navarro-Pérez, 2021; Hidalgo et al., 2018; Jiménez, 2016; Sánchez-Ramos, 2011; Yagüe, 2009).

Additionally, CDIAs frequently serve as liaisons and coordinating agents between social services and

families, schools, healthcare centres, local authorities, the justice system, and other services (García-

Mínguez & Sánchez-Ramos, 2010; Jiménez, 2016; Sánchez-Ramos, 2011).

According to their typology and intervention criteria, CDIAs can be classified into three distinct types

in Spain: community-based, primary care, and justice-related (Table 1). Primary care and community-

based CDIAs are similar. However, in primary care CDIAs, families must be receiving intervention

within the child and family social services system. In contrast, community-based CDIAs, while they

may aim to improve the well-being of children and adolescents, operate on a voluntary and open-

access basis, depending on the discretion of the entities providing these services. Additionally, these

models may be combined within a single program, as is the case with Centres Oberts (Open Centers) in

Catalonia (FEDAIA, 2006). On the other hand, justice-related CDIAs are used exclusively for the

enforcement of juvenile judicial measures. Unlike the other types, they do not have a primarily

protective and preventive approach, though they do maintain a socio-educational focus.

Table 1

Types of CDIA according to their characteristics in Spain

Name

Target population

Requirements

Purpose

Community-

based CDIA

General or at risk

• Agencies determine who

can participate

• Voluntary

Socio-educational and leisure

projects/programs to improve the

quality of life of children and

adolescents from a community-

based approach.

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Primary care

CDIA

At risk (mild or

moderate)

• Open case in social

services

• Case worker decision

• Compulsory

Reduce risk or neglect through a

safe socio-educational and leisure

space, supporting family

preservation

Justice-related

CDIA

Juvenile offenders

(14-18 years old)

• Court ruling with a judicial

measure

• Compulsory

Socio-educational approach with a

focus on crime prevention from a

formative and social perspective

Note. Own elaboration.

In the present study, we focus on primary care CDIAs as a measure adopted by Social Services,

assuming the definition established by Region of Cantabria (Spain), where this study was conducted.

According to its Framework Project for Day Care Centers and Cantabria’s Law 8/2010 on Child and

Adolescent Care, CDIAs are defined as a "resource within Primary Social Care Services (PSCS) that

provides daytime care from Monday to Friday, during after-school hours and holiday periods, for

children and adolescents (aged 6 to 17) whose families are unable to fully meet their care, supervision,

and educational needs." These programs aim to provide children and adolescents at risk of neglect

with a safe and enriching environment that addresses their needs through an educational space and

creative leisure activities.

Several circumstances justify the relevance of researching CDIAs. First, there is a scarcity of scientific

literature on these programs in Spain, with only a few regional studies conducted. Some describe

CDIAs role and functions in the region of Valencia (Ferrero, 2012; Capella & Navarro-Pérez, 2021),

while others analyze their transformative impact in reducing social risk indicators among children and

adolescents, highlighting differing perceptions among social agents in the province of Barcelona

(Cónsola et al., 2018). Additionally, research has documented the positive impact of CDIAs on the

quality of life of children and adolescents in the city of Seville (Hidalgo et al., 2018), demonstrating

significant improvements in their adjustment and development. These programs have been shown to

enhance physical and psychological well-being, autonomy, relationships, and social skills, while also

reducing internalizing problems in children and adolescents. The remaining studies mainly consist of

academic works (e.g., undergraduate and graduate theses) that have not extended beyond the

educational sphere and, therefore, have not undergone a peer-review process.

Secondly, there is a lack of national legislation to define and standardize the CDIAs as a service, with

the exception of the justice-related CDIAs (Organic Law 5/2000 on the criminal responsibility of

minors). This is partly due to the delegation of duties in the area of social services to the autonomous

communities, which creates discrepancies in legislation, coverage, funding, and intervention models

across the country (Pastor, 2020).

Finally, the term Day Care Center presents some complications, as it is not a unanimous designation

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and may lead to confusion if the target population is not specified (Sánchez-Ramos, 2011). This,

coupled with its complex translation into English, often confusing it with “nursery school” services,

hinders the identification of studies and experiences of similar programs in other countries. These

three factors prevent a thorough understanding of the service, its identification, distribution, and

variability across Spanish territory, as well as its comparative study with other similar international

experiences.

For all these reasons, the aim of this research was to assess the quality of the 16 CDIAs for children

and adolescents in Cantabria, considering the opinions and experiences of all the stakeholders

involved: staff, families, children and adolescents. Specifically, special attention was given to

evaluating the perspective of the children and adolescents, as the literature indicates that although

the promotion of children's participation in the child protection system has gained attention and is

recognized as essential (Pérez-García et al., 2019), it remains insufficient (Collins et al., 2021; Toros,

2021; García-Andrés et al., 2024).

METHODS

Participants

A total of 357 individuals participated in this study, all of whom were involved in the CDIA network of

the Region of Cantabria (Spain), which consists of 16 CDIAs. Table 2 describes their distribution by

group and gender. The first group consists of 71 children aged 6 to 11 years, with a mean age of 8.58

(SD=1.4). The second group comprises 91 adolescents over the age of 12 (M=14.12; SD=1.8). In these

two groups, an inverse gender distribution is observed, with the children's group being predominantly

male (59.2%) and the adolescent group predominantly female (58.2%).

The third group consists of family members (n=139), with an average age of 44.3 years (SD=10.2) and

a majority of women (84.9%). Lastly, the fourth group includes staff in the CDIA services, subdivided

into program coordinators (n=18) and regular staff (n=38). In both subgroups, the female presence

predominates, representing 66.7% among program coordinators and 89.5% among regular staff.

Table 2

Distribution of participants

Children

Adolescents

Families

Program Managers

Regular Staff

n(%)

Gender

29(40,8)

53(58,2)

118(84,9)

12(66,7)

34(89,5)

42(59,2)

38(41,8)

18(12,9)

6(33,3)

4(10,5)

71(19,9)

91(25,5)

139(38,9)

18(5,1)

38(10,6)

Note. Own elaboration. M=Male; F=Female

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Instruments

The instrument used in this study was the ARQUA-CDIA, an ad-hoc adaptation explicitly developed for

this research based on the ARQUA system (Residential Care and QUAlity), which assesses the quality

of residential care programs for children and adolescents (Pérez-García, 2019). The ARQUA system

was designed using the EQUAR quality standards for residential care, published by the Spanish

Ministry of Health, Social Services, and Equality (Del Valle et al., 2012). Given the absence of specific

quality standards for CDIA, the Child and Family Research Group (GIFI) at the University of Oviedo

developed the ARQUA-CDIA instrument by selecting 16 standards from the EQUAR framework (Table

3), removing the four that were exclusively related to residential care. Based on these standards, 66

items were formulated and administered to different informants according to their role (see Table 4),

generating a specific version of the instrument for each respondent group (children and adolescents,

families, regular staff, and program managers). The items use a 5-point Likert scale to assess the

degree of agreement or disagreement (1 = “strongly disagree”; 5 = “strongly agree”) for all respondent

groups except children aged 6–11, for whom a 3-level scale was used (1 = “no”; 2 = “sometimes”; 3 =

“yes”). Each item is accompanied by an open-ended question that allows participants to contextualize

or expand on their responses.

The standards from which the items are derived are organized into four general categories: (1)

Resources, (2) Basic Processes, (3) Needs and Well-being, and (4) Management and Organization (see

Table 3), following the structure of the EQUAR framework (Del Valle et al., 2012; Fernández-Sánchez

et al., 2023).

Table 3

Classification and Definition of Quality Standards in ARQUA-CDIA

Category

Standard

Definition

Items

(1) Resources

A. Physical Structure and

Equipment

Comfortable, safe, and accessible spaces, with aspects such

as location, capacity, equipment, and maintenance being

valued.

A1-A8

B. Human Resources

Sufficient, qualified personnel with ongoing training,

evaluating aspects such as initial supervision, periodic

training, and internship/volunteer programs.

B1-B3

(2) Basic

Processes

C. Referral and Admission

Admissions based on rigorous assessments and

communication of the intervention plan to children,

adolescents, and their families.

C1-C3

D. Initial Needs

Assessment

Use of appropriate tools to conduct psychological and

socioeducational assessments.

D1-D4

E. Individualized

Intervention Plan

Clear objectives following the initial assessment, reviewed

periodically.

E1-E3

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F. Discharge and

Transition to Adulthood

Advance planning of discharge and support for the autonomy

of young people.

F1-F3

G. Family Support

Family educational guidance in coordination with other

programs, evaluating the relationship between families and

staff.

G1-G6

(3) Needs and

Well-being

H. Safety and Protection

Guarantee of a safe and supportive environment based on

respectful treatment and appropriate protocols.

H1-H9

I. Respect for Rights

Consideration of cultural identity and grievance

management.

I1-I3

J. Development and

Autonomy

Educational context that facilitates learning and overcoming

difficulties.

J1-J2

K. Child Participation

Mechanisms that incorporate the opinions of children and

adolescents in the Individual Intervention Plan (IIP) and the

case plan.

K1-K3

L. Use of Educational

Consequences

Positive reinforcement and fair consequences to strengthen

relationships and learning.

L1-L3

(4) Management

and organization

M. SERAR

Use of the Residential Care Assessment and Recording

System (SERAR).

N. Leadership and Social

Climate

Role of coordination, effectiveness of meetings, and working

conditions.

N1-N4

O. Work Organization

Schedules and shifts that optimize care for children and

adolescents.

O1-O2

P. Staff Coordination

Communication and joint work with social services,

educational services, or other community-based services.

P1-P4

Note. Own elaboration.

Lastly, a series of open-ended questions are included under the section (Q) Others: Strengths and

Weaknesses, allowing children, adolescents and their families to provide an overall assessment of

their experience with the service (items Q1-Q3).

Ethical considerations

The study has been approved by the Ethics Committee for Research Projects of the University of

Cantabria (code 5/2020).

Procedure

After obtaining authorization from the Government of Cantabria, all CDIA centers were contacted to

inform them about the objectives and characteristics of the study and to request informed consent

from the legal guardians of underage participants. Subsequently, the CDIA centers were asked to

create a coding system to identify participants and organize data collection anonymously. Interviews

were conducted with all informants using the corresponding version of the ARQUA-CDIA instrument,

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each lasting approximately one hour. These interviews were carried out by members of the GIFI

research group, which is composed of professionals in psychology and social work with specific

training in the application of the instrument. The research team was responsible for presenting the

questions to participants, recording their quantitative responses to each item, and documenting their

answers to the open-ended questions accompanying each item in a password-protected database.

Prior to participation, all participants had been informed about the purpose and characteristics of the

study and were aware of the voluntary nature of their involvement, as well as the confidentiality

guarantees and secure handling of the information. The interviews were conducted between May

2021 and June 2022.

Data Analysis

Central tendency and dispersion measures were used to analyze the scores for each item (items A1-

Q3) using the SPSS statistical software (v.27). Participants' comments on each item were utilized to

illustrate the results descriptively. Additionally, a SWOT analysis (Sisamón, 2012) was conducted

based on the verbatim responses recorded for items Q4-Q6, which assessed the strengths and

weaknesses of the service as a whole. To achieve this, after familiarizing themselves with the data, the

research team generated a series of thematic categories under which the comments were coded.

Themes mentioned most frequently by participants (n ≥ 10) were incorporated into the SWOT analysis

(Figure 1) under the corresponding category.

RESULTS

The following section presents the results of the evaluation of the standards, grouped into the four

previously described categories: (1) Resources, (2) Basic Processes, (3) Needs and Well-being, and (4)

Management and Organization (Table 4).

Resources

This category receives a positive evaluation in CDIA, both in terms of physical infrastructure and

human resources. Regarding equipment, participants highlight its quality and suitability, with families

assigning particularly high scores to the well-mantained and tidy state of the center (MA8-F=4.88).

However, the educational team identified areas for improvement, such as accessibility (MA4-PM=3.56),

as not all CDIA have the necessary physical adaptations to accommodate children and adolescents

with reduced mobility. Additionally, they considered that the high child-to-professional ratio (MA3-RS=

3.37) may hinder individualized intervention. Concerning human resources, program managers highly

valued the supervision of interns and volunteers (MB3-PM=4.85). However, the staff expressed the need

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for more specific and frequent training to address better the profiles of the children and adolescents

they serve (MB2-RS=2.85). They suggested that training should cover a broader range of topics,

particularly the use of risk assessment tools for child neglect, intervention strategies for children and

adolescents with specific difficulties, issues related to sexual and gender identities, and the role of

social media.

Basic Processes

The assessment of the case referral and admission processes was positive. The staff expressed

satisfaction with their knowledge of case plans (MC1-PM=4.72), highlighting fluid communication with

social services. However, adolescents reported uncertainty regarding the objectives and duration of

their involvement in the CDIA (MC2-A=3.87 y MC3-A=2.11). Some stated that they understood what

aspects they would receive support in improving, but they were unaware of the specific reasons for

their placement and the exact length of their stay at the CDIA. Although the initial assessment of

children and adolescents is positively rated in terms of the time allocated to it (MD3-PM=4.13), program

managers considered that it lacked specific procedures to address the psychological and socio-

educational needs of children and adolescents, relying primarily on direct observations. Meanwhile,

Individualized Intervention Plans were considered valuable but impractical due to their complexity

and the limited time available for their implementation.

The promotion of children’s and adolescents’ autonomy emerged as a key aspect. Despite the absence

of clear procedures, professionals highly valued their cross-cutting approach (MF3-PM=4.28). However,

challenges were highlighted in ensuring that adolescents over 16 years old can access information

about Cantabria’s care leaving support service (SAJPA, in Spanish), which most of them were unaware

of (MF2-A=1.35). The standard that assesses family support received very high ratings, particularly

regarding the relationship between staff and families (MG5-F=4.88), with families reporting feeling well-

supported and heard. However, the lack of structured protocols to foster more consistent contact is

noted as an area for improvement.

Table 4

Distribution of Standards and Items for Each Informant in the ARQUA-CDIA Instrument

Children

Adolescents

Families

Program

Managers

Regular

Staff

MC (SD)

[1-3]

MA (SD)

[1-5]

MF (SD)

[1-5]

MPM (SD)

[1-5]

MRG (SD)

[1-5]

A. Physical Structure and Equipment

A1. Location

2.72(0.62)

4.43(1.00)

4.55(1.01)

3.94(1.00)

4.14(1,11)

A2. Facility

3.72(0.96)

4.18(1,04)

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A3. Capacity

3.83(1.15)

3.37(1,48)

A4. Accesibility

3.56(1.72)

3.66(1,53)

A5. Temperature

2.52(0.63)

4.41(0.88)

4.18(1,04)

A6. Equipment

2.93(0.26)

4.75(0.55)

4.22(1.06)

3.97(0,91)

A7. Mantenance

4.17(1.10)

3.61(1,31)

A8. Appearance

4.88(0.42)

A9. Schedules

2.58(0.72)

4.15(1.16)

B. Human Resources

B1. Trial period

3.36(1.91)

3.22(2,04)

B2. Ongoing training

2.85(1,50)

B3. Internships and volunteering

4.85(0.37)

4.33(1,27)

C. Referral and Admission

C1. Case plans

4.72(0.67)

4.39(1,05)

C2. CDIA intervention plan

1.81(1.00)

3.87(1.51)

4.59(0.81)

4.06(0.87)

3.75(1,25)

C3. Scheduling

2.11(1.69)

D. Initial Needs Assessment

D1. Psychological assessment

1.67(1.19)

2.53(1,62)

D2. Socio-educational assessment

2.44(1.41)

3.35(1,65)

D3. Assessment duration

4.13(0.83)

4.00(0,87)

D4. Operational tools

3.33(0.58)

4.38(0,87)

E. Individualized Intervention Plan (PII)

E1. PII format

4.38(1.36)

4.18(1,42)

E2. PII review

3.56(1.62)

3.71(1,42)

E3. PII development

4.07(1.44)

3.48(1,57)

F. Discharge and Transition to

Adulthood

F1. Discharge

2.83(0.70)

3.32(1,12)

F2. SAJPA

1.35(0.93)

2.55(1.81)

2.15(1,82)

F3. Autonomy promotion

4.28(1.18)

4.09(1,51)

G. Family Support

G1. Families’ opinion

4.77(0.64)

4.11(1.13)

4.79(0,48)

G2. Family meetings

4.67(0.85)

4.11(1.28)

4.36(1,22)

G3. Staff interest

4.81(0.58)

G4. Staff respect

4.92(0.38)

G5. Staff availability

4.88(0.52)

G6. Adolescents’ opinion

4.54(0.85)

H. Safety and Protection

H1. Staff trained in emergencies

2.29(1.40)

2.39(1.79)

H2. CYP trained in emergencies

1.40(0.83)

1.62(1.23)

H3. Abuse protocol

3.17(1.69)

2.77(1.72)

H4. Preventing inappropriate practices

4.94(0.24)

4.95(0.32)

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H5. Intervention skills

4.61(0.61)

4.41(0.86)

H6. Individualized time

2.61(0.68)

4.68(0.65)

3.67(1.03)

3.42(1.27)

H7. Positive/nurturing care

2.67(0.54)

4.52(0.82)

H8. Good relationship CYP-staff

2.91(0.33)

4.87(0.48)

H9. Engaged staff

2.76(0.63)

4.77(0.64)

I. Respect for Rights

I1. Cultural identity

4.72(0.46)

5.00(0.00)

I2. Complaints protocol

1.95(1.10)

3.64(1.75)

3.10(1.92)

4.11(1.32)

3.94(1.63)

I3. Addressing complaints

2.33(2.23)

4.44(0.93)

3.46(1.41)

J. Development and Autonomy

J1. Improvements

4.56(0.90)

4.43(0.91)

J2. Learning

2.77(0.60)

4.36(1.05)

K. Child Participation

K1. Participation mechanisms

4.79(0.47)

K2. Adolescents’ opinion on the PII

2.51(1.84)

3.67(1.63)

3.50(1.53)

K3. Opinion on the case plan

3.24(1.20)

2.85(1.60)

L. Use of Educational Consequences

L1. Fair consequences

4.49(0.88)

L2. Reasonable consequences

4.58(0.91)

L3. Rewards

4.08(1.42)

M. Program Management

M1. SERAR

3.72(1.56)

3.54(1.69)

N. Leadership and Social Climate

N1. Adequacy of the program manager

4.19(1.17)

N2. Team-coordination meetings

4.94(0.24)

4.74(0.60)

N3. Staff’s opinion

4.63(0.71)

N4. Working conditions

4.00(1.25)

O. Work Organization

O1. Staff schedule

3.11(1.39)

O2. Meeting time

4.97(0.16)

P. Staff Coordination

P1. Communication PSCS-SSS

4.39(0.98)

4.19(1.01)

P2. School coordination

4.28(0.89)

4.06(1.37)

P3. Coordination w/other CDIA

1.84(1.22)

P4. Coordination w/community

resources

4.17(1.25)

3.67(1.27)

Q. Final assessment

Q1. You enjoy attending

2.85(0.45)

4.78(0.65)

Q2. You like the center

2.88(0.37)

Q3. You have fun

2.85(0.43)

Q4. Strenghts

⚫

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Q5. Weaknesses

⚫

Q6. Other issues

⚫

Items answered by each informant

Note. Own elaboration.

Children’s scores are assessed on a scale from 1 to 3, while the rest of the informants are assessed from 1 to 5; CDIA = Day Care

Center for Children and Adolescents; PII = Individualized Intervention Plan; SAJPA = care leavers’ support service in Cantabria; CYP

= children and young people; SERAR = Evaluation and Recording System for Residential Care; PSCS = Primary Social Care Services;

SSS = Specialized Social Services; ⚫ = Assessed qualitatively only.

Needs and Well-being

In the area of needs and well-being, children and adolescents rated highly the good treatment and

the relationship with the staff (MH8-A=4.87), with most agreeing that it is one of the most positive

aspects of attending a CDIA. They were also very satisfied with the individualized time educators

dedicate to them, perceiving commitment and concern from the staff to help them. On the other

hand, the staff highlighted a lack of specific training about responding in emergencies and situations

where children and adolescents may experience an emotional or behavioral crisis. Regarding rights-

based practices, educators unanimously respected the cultural identity of the children and

adolescents (MI1-RG=5.00). However, knowledge of procedures for submitting complaints is limited

among children, adolescents and families: most were unaware of how to file a complaint, although

many also stated that they did not need to do so. Additionally, another of the best-rated aspects by

adolescents is the perception of significant improvements in their behavior, social skills, and academic

performance (MJ1-A=4.56). However, they point out that, in general, they do not feel involved in the

design and development of their intervention plans (MK2-A=2.51).

Management and Organization

Regarding the organization of the programs, the program managers mentioned the use of the

adaptation for CDIA of the Evaluation and Recording System for Residential Care (SERAR) for the

systematization, documentation and follow-up of the intervention (MM1-PM=3.72), but its full

implementation was limited by its complexity and lack of time. Leadership and the work environment

were highly rated, particularly the regular team meetings and coordination (MN2-PM=4.94) and the

recognition of the staff values (MN3-RS=4.63). However, dissatisfaction persists regarding working

conditions and work schedules (MO3-RS=3.11), with demands from the staff for higher compensation

based on their professional category and the duties they perform. Coordination with Primary Social

Care Services (SSAP) was considered effective (MP1-PM=4.39), although difficulties in collaboration with

other CDIA were identified (MP3-RG=1.84), with programs working independently.

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Other issues: strenghts and weaknesses

Additionally, the opinions of all the stakeholders were gathered on the main strengths, weaknesses,

or any other issues they wanted to raise regarding the CDIA (items Q4-Q7). The most frequently

mentioned responses were categorized into a SWOT analysis (Figure 1), dividing the issues based on

their internal or external nature and whether they were positive or negative.

A wide range of strengths was identified, particularly the quality of the care and support provided

(n=121) and the perceived good results and improvements in the children and adolescents (n=78).

These aspects were highlighted by families and the children, who particularly valued the new

friendships and learning gained through the activities and academic support received.

“They have helped me manage the situations that came up with my daughter. I was

overwhelmed, and they taught me guidelines to correct things. Everything they’ve advised has

been beneficial for us, and my daughter has improved a lot.” [FAM_112]

“Thanks to them, I’ve been able to raise my children.” [FAM_19]

“I like the CDIA because I made my two best friends here, and they’ve taught me to be polite

and organized with my homework. Also, we do a lot of activities, like going to the beach...”

[CHI_43]

Figure 1

Weaknesses, Threats, Strenghts, and Opportunities (SWOT) identified in the CDIA

Positive aspects

Negative aspects

STRENGTHS

 Care and help (n=121)

 Improvement and well-being (n= 78)

 Staff (n=47)

 Attachment and safe space (n=38)

WEAKNESSES

 Care and help (n=44)

 Improvement and well-being (n=41)

 Staff (n=22)

 Intervention model (n=10)

OPPORTUNITIES

 Improved family well-being (n=18)

 Coordination with PSCS (n= 14)

THREATS

 Working conditions (n=33)

 Coordination with SSS and other programs

(n=11)

Note. Own elaboration.

Internal

External

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Likewise, they also highly value the functioning of the educational teams (values, closeness,

atmosphere, etc.), perceiving that the CDIA allow the establishment of positive bonds in an

emotionally safe space for the children and adolescents.

“The staff is excellent both as educators and as people” [FAM_99]

“The best part is the trust with my educator; thanks to her, I feel good here.” [CHI_12]

“Here, I can talk about how I feel and the problems I’ve had without anyone judging me, and

the educators help me. They always tell me how I can try to solve my problems.” [ADO_23]

These strengths are complemented by other positive external factors, such as the perception, also

shared by families, that their situation and well-being had improved (n=18), and the positive

assessment of the coordination between the CDIA, SSAP, and other community resources (n=14).

These represent opportunities for more effective and coordinated intervention with families through

the PSCS.

“Everything seems fine to me; with the help of the professionals, you move forward because,

like in my case, I’m alone, so the center has helped me a lot, both the educators there and

here, and that’s what makes you feel better.” [FAM_73]

“We have a good relationship with the program manager and among ourselves. There’s also

very good relationship with the PSCS, and good referrals are made. We also have weekly

meetings with the high school. I think there's really good teamwork” [STA_17]

However, there are also areas for improvement identified from the external sphere, particularly

regarding coordination with specialized services, as well as concerning working conditions (n=33). In

this regard, there are mentions of the need for more staff, greater stability, and extended working

hours to reduce the child-to-professional ratio and improve care.

“Lack of staff and the little stability of the staff. In addition, they need to have a full-time

schedule. We can’t ask them to do things because of their schedules and lack of time. Also, it

causes a lot of staff turnover.” [STA_5]

“I would like the educators not to change every 6 months.” [FAM_49]

“There are educators with a lot of experience, they came from working in a residential

program. They have a lot of empathy, good listening skills, they understand the children...

We’ve always invested on them being social educators and for the training... but in terms of

work, they have little satisfaction (afternoon shifts, part-time schedule...) sometimes this

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interferes with their work.” [MAN_11]

On the other hand, internal weaknesses are identified regarding the care provided (n=44), primarily

related to requests from the children and adolescents for more activities or for these activities to be

more engaging or alternative to school support, as well as occasional issues in relationships with other

children and adolescents. Additionally, the remote location of some CDIA centers and the lack of

public transportation to access them were mentioned, along with the need for improvements in their

infrastructure.

“I would like there to be more activities outside and less focus only on homework.” [ADO_46]

“It’s too isolated from the community. It should be a program that is less isolated and more

integrated. The children could come on their own, or there should be transportation available

to get here.” [STA_10]

“The only bad thing about coming here is that it’s very far away, and some kids scream and

fight” [CHI_7]

“There are issues with the structure of the building, and I think continuous maintenance and

adaptation would be necessary.” [MAN_2]

Families mentioned difficulty bringing the children and adolescents at the scheduled times (n=22) due

to the short time available between the time children exit school and need to enter the CDIA.

“The worst part is the time they give us to come. They leave school at 2:30 p.m. and enter the

CDIA at 3:30 p.m.” [FAM_65]

Finally, some professionals pointed out the lack of a defined and effective working model (n=10) in

terms of documentation or procedures.

“On a documentary level, there's chaos; it's not clear what we have to do and what we don't.

There's also a lack of clarity regarding the roles of each professional, each position, and the

functions of a CDIA as such” [COR_8]

DISCUSSION

The aim of this study was to evaluate the quality of one of the programs for preventing childhood risk

and improving child welfare through family preservation in Spain, the CDIA. This is the first research

on the quality assessment of this type of program in Spain, highlighting a high level of satisfaction

from all the stakeholders involved and the appropriate capacity of the instrument to identify the most

valued aspects or those that could benefit from changes or improvements.

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Specifically, three main areas have been identified for discussion based on the analysis of the results

from this evaluation. First, issues related to intervention principles (1) will be discussed, including the

perceived positive outcomes and impact on families and children, as well as their well-being, the

power of affective relationships and the bond between children, adolescents, and professionals, and

the participation of children in their own process. Second, results related to the availability and

adequacy of human resources (2) will be addressed, meaning the conditions required by the work

teams to carry out the intervention. This will include discussions on issues such as the child-to-

professional ratio and the availability of continuous training. Finally, issues related to the

implementation of clear work models and monitoring of the intervention (3) will be presented, as

these are fundamental for tracking the achievement of objectives, with coordination and networking

being essential components in this type of program.

Regarding intervention principles and their results (1), data show that both children and families have

improved since attending the CDIA. Studies such as that of Hidalgo et al. (2018) affirm that these

programs positively impact the quality of life and development of children and young people. It is also

noteworthy that one of the most frequently mentioned strengths of the CDIA is the adequate

attention and support received from staff. Other evaluations and high ratings also related to the

educators' work include the bond, the emotional connection, and the support provided, which aligns

with authors who argue that relationships based on involvement, bonding, and affection make

educational intervention more effective (García-Mínguez & Sánchez-Ramos, 2010; Navarro-Pérez et

al., 2023). Children and adolescents rate the group component of being with their peers very

positively. In this regard, studies such as that of Capella and Navarro-Pérez (2020) agree that group

intervention in the CDIA supports personal development and resilience.

Similarly, these findings align with the study on quality in residential foster care programs by Pérez-

García et al. (2019), in which one of the most valued aspects is the affective relationship and the

support received from educators. This study also highlights the significant room for improvement in

ensuring that children and adolescents can effectively participate in the procedures and decisions

within their intervention process, as it is common for them to have doubts about the duration of their

involvement in the programs or to be unaware of the procedures for making requests or complaints

(Toros, 2021).

However, regarding the availability and adequacy of human resources (2), some aspects were less

positively rated and could pose a threat to the positive relationship and intervention carried out by

the educational team. Human resources are the core and driving force of this intervention, with the

potential of the staff being crucial in transforming the social reality and creating opportunities for

children, adolescents, and families (García-Mínguez & Sánchez-Ramos, 2010). While the teams and

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their skills are among the most valued aspects of the entire study, both by children and adolescents,

families, and from their own perspective, the working conditions of educators could interfere with the

quality of the intervention. The results highlight the need for more staff, more stability, and longer

working hours to reduce the child-to-professional ratios. Authors like Del Valle et al. (2012) argue that

direct care professionals should be sufficiently numerous, with interventions planned for each child

based on their individual needs and circumstances, considering an initial psychological assessment.

Although this is not part of the CDIA's responsibilities, it is perceived as necessary by the professionals

involved.

In addition, the scores suggest a demand from the educational team for a greater number and variety

of continuous training programs, which aligns with Rueda-Aguilar (2021), who identifies training as

one of the key factors in specific intervention with vulnerable children. The specific topics of the

requested training (e.g., trauma, emotional management in crises, and family intervention) also

coincide with the study by Tarín-Cayuela (2022), which highlights that the training interests of some

professionals in the CDIA programs of the Valencian Community focus on emotional management and

family intervention.

Finally, regarding the availability of a clear intervention model in the CDIA (3), the educational teams

consider that implementing intervention procedures and protocols is a valuable tool for program

management (Del Valle & Bravo, 2007), but they encounter difficulties in carrying them out.

Furthermore, these protocols are rarely adapted to the specific needs of the CDIA, with some

educators highlighting the need for a model of their own.

Another issue that the results highlight is the coordination with other resources. On the one hand, the

data show poorer coordination with Specialized Services and other community resources. For

example, adolescents report not knowing the leaving care support service (SAJPA). On the other hand,

there is a strong coordination with Primary Care Social Services (SSAP), which aligns with studies that

defend it as a fundamental principle of CDIA, acting as a mediator between Social Services, families,

and other stakeholders (Ferrero, 2012; Jiménez, 2016; Sánchez-Ramos, 2011). In addition, positive

feedback is received for the coordination with schools, an aspect that is important and valued as a

need, according to Cónsola et al. (2018).

Limitations

This study is not without limitations that may affect the generalization of the results. Firstly, there may

be a bias toward positive assessments of the services, as participants that accepted to take part in the

study may be those who have a stronger connection with the services or perceive better outcomes.

Secondly, by evaluating the CDIA in only one region and considering that these programs are not

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configured as a homogeneous resource, it would be expected to identify other strengths or challenges

in different areas. Finally, given that this is the first time an ARQUA instrument has been adapted for

these programs, it would be necessary to continue studying its validity, adapting it based on this first

experience for future research.

Conclusions and Implications for Practice

Implementing and promoting community-based programs by Social Services is essential for

preventing and ensuring the protection of children. In this sense, the positive feedback received from

users of the CDIA is noteworthy, and their comments confirm that these programs are fulfilling their

objectives, as outlined in the Framework Project for Day Care Centers in Cantabria. In this regard, they

appear capable of providing a "safe and enriching environment" for children and adolescents,

mitigating the risk of neglect through establishing positive working relationships between families and

professionals, and promoting habits and skills that positively impact the well-being of children and

adolescents. However, the results also prompt reflection on the appropriateness of conducting

evaluations to ensure that a quality service is being provided, adapted to needs, with adequate

resources, clear pathways for participation for children, adolescents and families, and based on

explicit models and quality standards. To achieve this, it is essential to have a highly motivated and

qualified professional team, capable of creating a safe space and working from a community-based

and networked model.

DATA AND MATERIAL AVAILABILITY

The data is not available in open access to ensure the confidentiality guarantees of the study.

DECLARATION OF GENERATIVE AI AND AI-ASSISTED TECHNOLOGIES IN THE WRITING PROCESS

Generative Artificial Intelligence or AI-assisted technologies have been used to support and improve

the translation process from Spanish to English.

CONFLICT OF INTEREST

There are no known conflicts of interest.

FUNDING

The first author of this study holds a predoctoral scholarship for the training of teaching and research

staff of the University of Oviedo (2022). The second author is a beneficiary of a postdoctoral contract

funded through the Margarita Salas Program (2021-2023), Spanish Ministry of Universities.

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AUTHOR CONTRIBUTIONS

Conceptualization: JB, IS, JRS, and AB. Data curation: JB and IS. Formal analysis: JB and LGA. Funding

acquisition: IS and AB. Investigation: JB, LGA, and IS. Methodology: JB and IS. Project administration:

IS and AB. Resources: IS and AB. Software: JB and LGA. Supervision: IS, JRS, and AB. Visualization: JB

and LGA. All authors contributed to writing, reviewing, and editing the article and approved the

submitted version.

ACKNOWLEDGMENTS

The authors wish to thank the children, adolescents, families, and professionals who participated in

this study for sharing their experiences with us and the Government of Cantabria and its network of

Day Centers for their willingness to conduct this research.

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