By John Burton

Date Posted: Sunday, 13 June 2010

 

John Burton has over forty years’ of experience of working in and managing in a wide range of social care settings. He has been an inspector and teacher, an advocate for residents and relatives, and a campaigner for improving social care standards. He is the author of two books, including ‘The Handbook of Residential Care’, many contributing chapters and countless articles relating to care as a vocation and a profession. In his current role as an consultant and external supervisor John helps caring organisations to evaluate their services and improve them. Presently John is involved in founding and establishing the ACM – Association of Care Managers. Details of this can be found at www.caremanagers.org.uk 

 

Greendale : the running and working of children’s homes

 

These are some of the working notes for a private organisation running a small number oinvolved in helpingf children’s homes in the Midlands. The work was done within the last five years, and the issues are those that arise in most children’s homes. I have anonymised the organisation and changed some details. The homes have made good progress since this work was done, and it should be said that the proprietors were fully committed to excellent principles and high ideals. (This makes all the difference!) I offer these notes in the belief that they may be of help to other people running and working in children’s homes. There is nothing unusual about the issues or indeed about my advice and comments.

 

Greendale – the organisation and its management

After visiting Northfield and Southfield on August 26th and 27th, I met with Henry and Dorothy (proprietor and service manager) at the head office on August 28th. We spent the morning discussing the homes and the organisation, and were joined in the afternoon by Clare and Chris (home managers).

In this part of my review report, I highlight issues that we discussed and make recommendations for development.

Following the introduction, I will set out various perspectives or frameworks through which to look at the organisation:

primary task
family/parenting
staffing
money/budgets
a system of roles, relationships, responsibilities, boundaries, and
accountability
communication.

 

1. Introduction

1.1 This review of Greendale was initiated by a communication from Henry Bolton following two highly critical inspection reports on the two homes in question. Having initially got very good inspection reports at Southfield (the first home to be opened), Henry was concerned about the homes individually but also about the direction of the whole organisation.

1.2 We agreed that I would visit both homes (spending a full day in each) to conduct an in-depth review, and then spend a day with the owner and the manager of the organisation, and then with the two homes’ managers. The review is in three parts: Northfield, Southfield, and the whole organisation.

1.3 When I review any organisation, I first look at what it actually does, and that can only be seen in the homes themselves. My focus is on practice not paperwork (although it seems that OFSTED’s main concerns were with paperwork). By spending a (long) day in each of the homes, I have – to some extent – seen what life and work is like. I should explain that I am able to pick up a lot in a fairly short time – one clue leads to another. Each detail tells me something about what is happening generally, both in that particular home and in the organisation as a whole. Issues that are evident on the ground in each home all have a connection with the organisation itself. (For example: staffing policy and practice; how money and budgets are handled; supervision throughout the organisation; communication at all levels; decision-making and boundaries.)

1.4  Any child living in a Greendale home needs love, stability and dependable care. Greendale’s slogans, while being (quite properly) idealistic and laudable, mean little if it’s quite clear to the children that they are not evident in everyday care practice or in their everyday experience of living in the homes.

1.5 If staff don’t work as a team, if they are constantly changing, if they are themselves immature and inconsistent, and if they are short-term, temporary workers, they cannot possibly provide the basis for “renewing belief, reconstructing children’s lives, and building for their future”.

1.6 A children’s home must be a “home” – the building, the people, the relationships, the care. A building that they can call “home”. A place where they can rely on adults. A team which will support you and is trustworthy. A place which has firm foundations and sufficient stability not to let you down. This is how belief will be renewed, lives reconstructed, and futures built.

1.7 It should also be remembered that the homes exist for children who have very troubled and emotionally deprived lives. We should not think that a children’s home is “good” because the children are “good”, and everything runs smoothly. The problems that the children bring with them are what the homes are in business to work with. There will be damage; there will be rows; the children will test the staff to the point of destruction. These are the difficulties that the home and staff work through. Success may be seen as (for example) the child going to college and getting some qualifications, but the real success and real work is in all the ups and downs and the commitment that eventually got them there!

1.8 The mistake that many organisations make is to consider that when things go wrong, the faults are confined to individuals and to specific teams. It is quite clear to me, having met and discussed all the issues in depth with Henry and Dorothy, that Greendale – as a whole organisation – is willing to accept responsibility and to make changes. However, I should also point out that not everything can be attributed solely to organisational failures or faults. There are individual and team failures and people shouldn’t hide behind the “system” when they themselves bear direct individual responsibility for mistakes.

1.9 Greendale has sufficient high ideals and good experience to know all the above already. The organisation has achieved high standards (in the first two-and-a-half years at Southfield). The potential is that, through this process of review and re-evaluation, Greendale (the homes and the organisation) can regain the excellent practice of the past. I see every reason why it can do so.

 

2. Primary Task

2.1 The idea of the “primary task” is useful. The primary task is what the organisation exists to do, or the task without which the organisation would not exist in the first place. In Greendale’s case, the primary task is to care for children in a “home” and you could add  “renewing belief, reconstructing children’s lives, and building for their future” (the Greendale slogan).  Once you have defined your primary task, you can then test all activity against it. If you find that you are spending your time for example sitting at a computer doing work that has no relevance to “renewing belief, reconstructing children’s lives, and building for their future”, then you should stop what you are doing and get back to the primary task.

2.2 If you find that administrative work at the head office is beginning to dominate the organisation and that it can’t be clearly linked with the welfare of the children, then it’s time to reorganise your work.

2.3 Furthermore, systems that “defend”  – and thereby detach – staff or the organisation against the difficulties of carrying out the primary task are always ready and waiting to grow and multiply. For example, the rewards system (I suggest) is much more to do with staff needs than with residents’ needs. A locked “staff” lavatory that provides for the comfort and privacy of staff, and leaves children to use lavatories that are not private and have no soap and towel, is evidence of defending against the difficulties and threats of the primary task. The use of offices is frequently an avoidance of the primary task. We all do it! The point is to work against what you know is bound to happen if you allow it to. These are largely unconscious processes. We don’t plan or consciously intend to set these defences up, but in any work that is emotionally demanding and stressful these systems of defence are constructed without our realising what we’re doing.

 

3. Family/parenting

3.1 We know that we are not the children’s parents or family. Yet in providing a “home” and “care” (primary task) we are carrying out a parenting role. The organisation itself is a sort of parent and has created a sort of family. This is not just an idea or a theory; this is what the children themselves say . . . how they see it when it’s working well. Therefore the organisation, the owner, the service manager, the homes and their managers, and the staff are all in parenting roles. They have to create and “hold” a sort of family. Most of the children have experienced homes that are incapable of providing the love, consistency, and parenting that they need, and this is what they’ve come to Greendale for (primary task).

3.2 The owner (who is a real, known person in this organisation) is “father” to the whole organisation. His actions will be felt by the children as those of a father. He has to model (for children and staff) a “good” father. Likewise, the service manager will be seen and experienced as a sort of mother, and, again, she sets the tone for the whole organisation. (I am talking of symbolic roles here. Male and female is not particularly relevant, nor of course is it necessary for these roles to have a mother/father relationship between themselves.) It is the “parental” role that is important to the children – the feeling that they are in a sort of family where there is grown-up care, concern and authority.

3.3 As in most families, as children grow up, as they become adults, there are tensions and renegotiations about how they take on independence, self-determination and adult authority. This process also takes place in a good organisation – especially one that really is dealing with children growing up. The parents must let go of some of their control. They must watch mistakes and yet be there to pick up the pieces. In an organisation like Greendale, this is a good and proper part of the organisation’s (and the children’s) development – to be worked through.

3.4 And all of this will also take place with the head of home, staff and children. The more it is worked at – and with – throughout the organisation, the more the children will benefit from the process.

 

4. Staffing

4.1 The OFSTED inspections picked up deficiencies in staff recruitment.

4.2 I gathered that both homes have had difficulty recruiting and retaining suitable staff. It’s essential to stick to recruitment policies, to ensure that CRB checks are completed and that references are followed up. If you have doubts about a reference, get further referees. In most cases, it is important to speak with referees as well as to read the reference carefully. Then, when you have appointed staff, give them your backing, and work through any difficulties. (Again, this is so important for the children – it parallels their own experience of coming into the home. And the experience for staff of being accepted, believed in, but with clear and disciplined expectations and supervision, can be passed on by them in their attitudes to the children.)

4.3 The whole staffing and pay structure needs review and redesigning so that staff feel that they are joining an organisation which, if they work well, will further their career.

4.4 Staff pay is spoken and written of in terms of an hourly rate. Residential child care is a professional task and should be paid as such. (See also 5. “Money and budgets” below.)

4.5 The aim should be to build permanent, long-term staff teams. There is too little sense of – or expectation of – permanence.

4.6 Details such as making sure staff are paid on time, every time (including during a bank holiday period) are very important. (This relates to the parenting/family issues above.)

4.7 Creating a staffing/HR function at head office is a good step in the right direction, but this should not undermine or reduce the manager’s role in selecting and then being responsible for the recruitment and induction of staff to their team. (See responsibilities and boundaries below.)

 

5. Money and budgets

5.1 I found that money was misused in both homes and this had a detrimental affect on the children.

5.2 I think the first step is to draw up realistic budgets for each home (including staffing), and to make the home managers responsible and accountable for them. Without being able to use a budget (the main tangible resource for the primary task) managers cannot plan and cannot truly involve staff and residents in a creative, therapeutic, and realistic process of managing the home’s resources. At present, the approach that is encouraged is spend what you’ve got and more will come along next week. The children see the home living hand to mouth, and if you haven’t got the cash you kick up a stink until you get some! This is not good learning for the children (primary task).

5.3 The manager and everyone else should be aware that each home is dependent on income and that the budget will be affected by a drop (or increase) in income. However, this should not be misused as a short-term control on spending or to pressurise managers to accept residents they should not.
6. Roles, relationships, responsibilities, boundaries and accountability

6.1 In my view, one of the problems for the organisation is a lack of clarity or awareness about roles, relationships, responsibilities, boundaries and accountability. So, a lack of clarity and awareness all round!

6.2 This problem can be seen from a psycho-social angle and from an organisational systems angle.

6.3 For the residents of the homes clarity in these areas is essential. They need to know who is their key-worker, who is in charge of the home (parenting), who is going to be there with them in the home and when, who decides on what, and who they’ve got to face up to when they’ve broken an agreement or otherwise messed up. (And that “facing up to” is dependent on the quality of the RELATIONSHIP between the grown-up and the child.)

6.3 All staff at all levels in the organisation must be clear about their roles and responsibilities. The manager of a children’s home should be in charge of everything within the boundary of the home, and should be accountable for everything within that boundary. But if you start removing essential elements of that responsibility the boundaries become blurred and accountability is lost. The budget is an example. The manager must be given sufficient resources to do the job, but with those resources the manager must then take on the managerial responsibility and be accountable.

6.4 When something isn’t being done, it is very tempting for a manager to intervene and do it for whoever isn’t carrying out their responsibility. In no time at all, roles are muddled, boundaries blurred and the line of accountability is broken. The job of the manager is to work with whomever they are managing and help them to accept and discharge their own responsibilities rather than take those responsibilities away from them. If they are genuinely not up to the job, then a capability process should be instituted and followed through.

6.5 The boundaries of the home are very important to the children. It really does matter to the children if their sitting room is being used as a training venue and if their home is “invaded” by a whole lot of people they don’t know. The use of the office is a boundary issue, but it is one that staff must lead on and become much more disciplined about before they can expect the residents to respect the boundary of the office door.  So, you can think about boundaries in a physical sense but with very strong psychological implications.

6.6 But you can also think about boundaries in a purely psychological and symbolic way: boundaries in roles and relationships; in confidentiality and privacy; in security; in behaviour.

6.7 And there are important boundaries such as time-keeping and work/personal boundaries (e.g. use of mobile phones).

 

 

7. Communication

7.1 Communication within the organisation and within each of the homes can be improved.

7.2 There are plans to bring the staff together and give a better sense of direction and shared values. This will help a lot but needs to be done in conjunction with improved communications in the homes with the teams and the residents.

7.3 One of the keystones to good work and effective communication will be supervision. The work cannot be done properly without it. My impression (from talking with several staff and managers) is that there isn’t a well-established system. At best, supervision is patchy. There must be a clear line of supervision from owner all the way through to new, basic-grade staff. Supervision starts with induction. A new worker needs a discussion on their very first day in the home, and this will set a pattern of regular, reliable, in-depth supervision. I would recommend that, whenever possible, legible notes are made at the time rather than the supervisor having to take further time out typing up notes. The purpose of supervision is to be
Held (symbolically), listened to, encouraged;
Challenged, confronted, stimulated;
Disciplined, informed, answerable. (Houston 1990)
(Bear in mind the parallels with direct work with the children.)

7.4 Another keystone of good work is effective handovers. A handover is a meeting not a set of notes! At a handover information is communicated; the work of the previous shift is reviewed; the next shift is planned and jobs are allocated. Children like to see handovers taking place – and even to take part. Of course there may be confidential information that has to be handed on in some other way but if you can do handovers in the kitchen or the dining room, children soon get the idea, and handovers can develop into truly creative and therapeutic events. Handovers should take place at every change of shift and should start on time.

7.5. Regular (weekly or fortnightly) staff meetings are also essential. If it is not possible to rota everyone to be on duty, pay anyone who is off duty to come in for the meeting. (One way of making this more cost-effective is to make the staff meeting day a supervision day as well.) One of the purposes of a staff meeting is to think about and discuss the WHOLE home – trends, what’s going on beneath the surface, how are we doing as a team, where are we going? In addition it’s important to review the work with individual children (primary task) and plan consistent team approaches.

7.6 Avoid communicating solely by notices, memos, and notes. On their own, they simply don’t work. But they are also a way of avoiding the issues. Look at all your notices: are they necessary? Do they work? Are they signed and dated? What issue are they helping you to avoid? Some notices, memos, and notes are useful but only to make a record or as a follow-up/reminder to what has already be said. But most of this written material is institutionalising and ineffective.

7.7 What the organisation is seeking is good, direct and effective communication throughout. People talk and listen. Clear, accurate records are kept. Issues and problems are identified and tackled, person to person. People are told when they are doing well. Only those matters that have to be kept confidential are not out in the open.

 

8. Recommendations

Below is a summary of the main recommendations to be found in the review. For the detail, look at the relevant paragraphs in the review.

8.1 Use the review
to open up discussion and plan for the future. Through discussion, develop a way of thinking about what’s going on “beneath the surface”, about the meaning of events, about the causes rather than just the events themselves. Look at things from different angles and look for parallels occurring in the whole organisation. This is how you will work with the children. Rather than “Joanna (or Jim) is behaving very badly today; what sanctions should we impose?” ask yourselves “What is causing Joanna to behave like this today – what happened – why – who’s talked with her – let’s get to the roots of this. When we understand it, we can change it. When we help Joanna to understand it, she can change it. ” The same with the home as a whole and the organisation as a whole.

8.2 Use the concept of the “primary task”

to distinguish between work and effort that is well directed and work that does not benefit the children/young people.

8.3 Create a parenting/family model  for the organisation – a model or culture that permeates the whole organisation and creates “homes” and relationships for the children that are in themselves therapeutic.

8.4 Review staffing structures to achieve more stable, effective and confident teams.

8.5 Use money and budgeting as therapeutic tools by integrating them into the management and practice of the homes.

8.6 Clarify and define roles, relationships, responsibilities, boundaries and accountability.

8.7 Improve communication throughout the organisation working particularly at the key areas of Greendale as a whole organisation, supervision, handovers, team meetings, and direct person-to-person communication. Examine all written communication for effectiveness and avoidance.

 

goodenoughcaring  editor’s note

Other articles relating to issues raised in this piece include :

Residential Care Do We Still Need It?   by John Stein which can be found at
http://www.goodenoughcaring.com/Journal/Article149.htm

Being a Residential Child Care Worker in England by Harald Stoelting which can be found at http://www.goodenoughcaring.com/Journal/Article145.htm
.