The Pith and Sinew of Residential Care

It struck me last week. My wife was meeting a girl from school, taking her to see her mother in hospital, cooking a meal, helping with homework, and later washing and ironing. I had been doing some odd jobs too, including an attack on the ground ivy that is threatening to take over large parts of Mill Grove. I also made a couple of trips to the local refuse amenity with one of the youngsters. But it was what Ruth was doing that began to bring everything into focus.

It took me back to the time when I was at a Barnardo’s residential school in Lanarkshire. I was spending a couple of days together with the staff, and one of them, called Jim, remarked that he felt that the most important interactions with children usually seemed to happen in between places, activities, tasks and planned events. He pointed out that it was vital for there to be resourceful adults on hand and available to be alongside young people at such times, and in the “in-between” places where they were likely to occur. When he was asked to clarify what he meant, he suggested that the gardener, maintenance men, cook and domestics were best placed in his particular residential community to be alongside the young people. In fact it was during his days off, when he was working on his car or garden, that he felt he had some of the best conversations with them.

Everything came into sharp relief when I thought about the all-encompassing trend towards what is often called a “contract culture”. The idea, as readers will well know, is to specify tasks and outcomes and to employ people to do these tasks and achieve the outcomes laid down. What could be more reasonable? What’s more, it is possible at every level, from a piece of work with a young person for, say, six sessions, to the running of prisons, or the social care of boroughs and councils. There is obviously something to be said for it, even if there is a lively debate about changes not unrelated to this in the NHS at present!

But you may have guessed the point that arises: who are the people that will be available in between tasks, contracts and activities? Let me clarify things: the precise nature of the role I am concerned about is that, although it can be conceived and understood, it is by definition impossible to describe in a way compatible with contracts. Let’s imagine that some bright person or organisation, decided to appoint “in between” people: that would immediately negate the function required. For then they would be employed to do this task, whereas the key to what Jim was saying is that it is precisely people who are not contracted to do something who are the ones young people are most likely to talk to and share with!

On the day when I decided to write this piece, every activity in which my wife was engaged gave her the opportunity to be alongside someone in a non-threatening, and unstructured way. So in the short drive from the school to the hospital she was able to listen to the feelings and thoughts of the girl. At hospital she was present to facilitate the relationship of mother and child (and for that matter, relationships with other patients). Without being obtrusive, she could observe the interaction between them. When cooking she was also chatting and distilling homework tasks into a manageable chunks, and finding a cardboard box with which a model house was constructed. And when ironing, there was the chance to reflect on things with one and another, as and when they chose to do so.

I doubt if there is anyone who fails to see the value of what I am describing. Indeed it could be taken as a description of the basics of parenting. This reminds me of another reason why I saw the light last week: one of our daughters came round with her three children, and Ruth and I were reminded of the multifarious tasks that go with parenting. Did we really do all that when we were young, we wondered?! It all came flooding back: night-time ear-aches and nappies, early rising and stories, bathroom and teeth, breakfast and getting ready for school including lunch, getting clothes on for school…and so on. There were in fact very few times when you sat down and chatted parent and child, one to one: it was all on the move, or, if you like, in between.

And residential care, however specialised, at its heart, or in its pith and sinew, will be richly textured enough for every such activity and many more to be times and opportunities to be alongside a young person. I am using the term, “alongside” because it is a favourite of mine. I do not mean sitting opposite, or carrying, standing or teaching, or in a group therapy session: it is much more relaxed, informal and spontaneous. Both of us are between places and between tasks (or we can multi-task) and that is when being alongside happens.

Recently I was with a young person who was taking a room in a hostel. I will not, for all sorts of reasons, say which one. There were staff at reception (although they weren’t gifted with looking anyone in the face). There was a support worker, and there were others, whose designations were not clear to me, on the other end of the phone. But when we found the room in a complete shambles, with broken glass all over the floor, and soiled bedclothes on the bed, there was no one from whom we could beg or borrow a vacuum cleaner or broom. There was simply no possibility of anyone being alongside the young person. No doubt people were doing their tasks, although I have still not found out who was responsible for cleaning the rooms after a guest had left. But I must remind myself that this was a hostel.

And you might say: of course, what do you expect of a hostel? If so, we are agreed that this is not what is meant by residential care. The former is primarily about providing a roof over someone’s head, whereas the latter is a total living experience of which each part is seen as having the potential for chatting, for learning, sharing, reflection, joking and fun.

The problem is that when I read brochures and prospectuses, Ofsted reports, and the like, I get little sense of the pith and sinew of a place, a community. Residential care is what happens before and after school, before and after counselling or therapy, between this place and that, between this event and that, between the evening meal and bedtime. And it is what happens when an adult is there with time and space to be available. Not, let’s make it clear, to do anything, not to listen and make a report: but to be alongside. And there is nothing quite like a car trip, cooking, washing, ironing, mealtimes, and even homework, for that.

Contracts may perhaps be able to specify the bones, but what I am trying to get at is the pith and sinew!

1 thought on “The Pith and Sinew of Residential Care”

  1. I absolutely agree with all of the above. I am a residential worker and have specific tasks to carry out during my shifts but in between times are the most constructive, when i am taking a young person out by myself it is easy to chat along and it is indeed, when i find out the most about that young person, not by questioning but by chatting happily, just like i did with my own children many years ago.

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