Advisory Council in Child Care : Care and Treatment in a Planned Environment

The Key Texts are the classics from the past, which helped to shape today’s services. Some are books, some are research reports, some are papers or chapters in books and one is a Government policy document. We have selected a score of texts, and are offering a “digested read”. They are being published at a rate of two a month. The digests cover a standard pattern, setting the context of the text, describing its contents, analysing its impact then and its relevance now, and suggesting further reading.

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Advisory Council in Child Care (1970) Care and treatment in a planned environment: a report on the community home project London: Her Majesty’s Stationery Office 0 11 340214 7

The Advisory Council in Child Care was one of a number of committees set up by the Home Office to advise it on its responsibilities for child care, some of which it had held since the 19th century and some of which it had acquired through the Children Act 1948. In preparation for the integration of the approved schools, some of which dated back to the time of Mary Carpenter, the remand homes which had been set up under the 1908 Children’s Act, the children’s homes which local authority Children’s Departments had managed since 1948 and the voluntary homes managed by organisations such as Barnardo’s and the National Children’s Home into a comprehensive system of child care under the Children and Young Persons Act 1969, the Advisory Council undertook a number of projects of which this was perhaps the most fundamental.

The report represents one of the few attempts to integrate the educational model of childcare which is still alive in continental Europe with the therapeutic model which had come to dominate childcare in English speaking countries. Although it failed in the sense that its ideas were discarded only a few years later by the newly established Social Services Departments, it is a rare attempt to encapsulate what is involved in running a home for children with emotional and behavioural difficulties.

Key Ideas

  • environmental therapy
  • participation in decision-making
  • positive reinforcement rather than penalties
  • creating a learning environment
  • family and community involvement
  • planned admissions and discharges
  • small group living with respect for children’s privacy
  • opportunities for children to carry out normal domestic activities including cooking meals
  • non-residential assessment

Contents

In the ‘Introduction’, the authors set out the background to the project, the attempts to draw on a wide range of experience to inform the report and the framework of the report.

In Chapter 1 ‘Children and their needs’, the authors argue that most children in care are there because of background factors, including broken families, social and emotional factors, difficulties outside their homes, disability, mental health, ethnicity and unsuccessful prior placements. Their problems may present in a range of behavioural difficulties but the focus of the project is on those children whose symptoms include anti-social and aggressive behaviour.

In order to deal with these symptoms it is necessary first to meet children’s physical and relationship needs in ways that assure them of a sense of worth and offer them the security to learn, to make mistakes, to appreciate the needs and feelings of others, to make decisions, to communicate and to achieve. However, children in care usually have needs beyond these and staff will also need to maintain family relationships and further their education.

The authors argue that all these things do not have to been provided through long term residential care but may be provided through partial- or non-residential care or any combination of all three. Nor do all these needs have to be met in the one setting; some might be met through community resources.

The ages of children in such homes may be 8-18 and some homes may be mixed sex homes.

In Chapter 2 ‘The living situation’, the authors argue for environmental therapy in which positive acceptance underpins relationships, emotional and behavioural responses are recognised as normal and dealt with as such by staff, children are involved in decisions about daily living and positive reinforcement rather than penalties are used to manage behaviour.

Participation and shared decision-making will enable children to learn how to live harmoniously and to develop agreed social controls; even where staff have to make certain decisions, they will be made in consultation with the children. Rather than authority being external, it will come from the group of staff and children of which the child is a member and through which children will share in daily living including all the routines, ceremonies and customs that develop.

The authors envisage that each community will have rules but these must not suppress behaviour so that the symptoms of a child’s disturbance cannot be discerned and the child helped to understand the impact of their behaviour on others, a process which may need adapting to the child and the stage in their development.

Children should contribute to the care of the establishment in some way, they should have an amount of pocket money which they are free to spend as they see fit and staff should not seek to prevent them from making mistakes but support them in dealing with the consequences of their mistakes.

Children should be treated as individuals, with personal possessions, privacy in personal care and in relationships and respect from staff. They need support to deal with their sexual development, their communication and any religious interest they may have. With few exceptions, children’s families will be involved in planning for and regular contact with the child, and children will be encouraged to join in community activities and helped to make constructive relationships with members of the local community.

A group focus should inform the management of a home; children should have access to groups and to adults outside their own group. The authors argue that small homes do not have the breadth of staff available to meet children’s needs, that children should see both men and women carrying out roles in the groups and that successful group management is a result of good staff communication rather than the quality or quantity of particular staff.

There should be preparation for admission and for discharge and access to specialist facilities for children with medical or other conditions and everyone who works with a child should be encouraged to contribute to the child’s record.

In Chapter 3 ‘The staff’, the authors argue that the staff should create an environment which is shared with the children; they need to be people who enjoy working with children, who can bring their own interests to the job, who can accept the difficulties presented by children with emotional and behavioural difficulties and can call on help when needed but who can see their work as part of a wider environment in which the child’s family plays a part. For this they need sound leadership from a director who is both at the centre of the work of the staff and part of the wider networks of which the home is a part.

The authors envisage homes having administrative staff, part-time staff in a range of roles from specialist subject teachers to clerks, night staff, students, trainees and volunteers. They recommend that staff work an 80 hour fortnight so that every other weekend is free and that child care staff spend at least two days in the home as part of the selection process.

In Chapter 4 ‘Staff training’, the authors draw on work by the Central Training Council in Child Care to argue that the child care worker’s role is to mobilise all the resources available to promote the welfare and healing of children which involves assessment, planning and working with the child’s family. They suggest that study of the individual child, structures and patterns of society, communities and residential institutions and social work should be complemented by practical experience and that staff should have opportunities for further professional training.

In Chapter 5 ‘The buildings’, the authors argue that homes should be close enough to community facilities to be able to use them, organised in living group areas with the option for children to have single bedrooms or a clear space in a shared bedroom dependent on the child’s wishes. The living group areas should include spaces for noisy and for quiet activities along with educational areas which may be used as a school during the day and as spaces for hobbies in the evening. Children should also be able to have pets.

The authors also make recommendations for the rooms to be used by the administrative and other staff, for spaces for visitors, whether family or professional, and for the staff, recommending that the director should not have an office but rather a study in which people can feel relaxed and at ease. They stress the importance of having rooms and facilities in which children can perform domestic tasks such as cooking, washing or ironing and suggest arrangements for basins and toilets which reflect what children might find in a modern house.

They recommend that any staff accommodation should be arranged to allow independent access and that there should be space for car parking for non-resident staff and for outside activities, whether educational or leisure, for the children.

In Chapter 6 ‘Education’, the authors argue that education should be integral to the life of a home but envisage that there would be specific educational provision on site, at least initially, for the majority of the children covering basic education, creative activities, physical education and science. There should be a library and the opportunity for those unable to move into a local school to study technical subjects in preparation for employment. Part time work outside the home should be encouraged as part of preparation for work.

In Chapter 7 ‘Assessment’, the authors look forward to the integration of the previously separate facilities for the assessment of children. They argue that assessment should be undertaken, albeit using the facilities of an assessment centre, on a non-residential basis if at all possible and that recommendations on treatment should not be confined to specific types of intervention. The assessment should be based on existing information and a study of the child and their family’s history and current circumstances.

They also make a number of recommendations relating to the environment of an assessment centre, the staff and education which reflect their earlier recommendations before discussing the process of diagnosis, the nature of a case conference, treatment implications, the form of the assessment report and the place of assessment within the Children Act 1969.

In Chapter 8 ‘The next stages’, they outline the next steps envisaged for the project.

Discussion

Though a mere 78 pages long, this report presents an ideal of children with emotional and behavioural difficulties being dealt with in a planned, holistic fashion living their daily lives in a respectful and accepting environment in which both their wider developmental needs and their specific difficulties are dealt with sensitively by teams of staff who use of a wide range of interventions from noisy games to quiet reading, domestic activities to outings, schooling to keeping pets and who maintain the children’s links with their families and the community.

It needs to be considered alongside Spare the child (Wills, 1971), a dramatic account of the difficulties involved in changing entrenched attitudes within the old approved school system, which involved the subordination of education to a Freudian approach rather than, as the Committee is advocating, an integration of the two.

Perhaps most striking in comparison with other authors in this series who, if they approach the subject, tend to approach it indirectly is the emphasis on respecting children and making relationships with them which assure them of a sense of worth. The emphasis on participation which had found different expression in Homer Lane (Bazeley, 1928), Makarenko (1936), Neill (1962) and the children’s republics in the aftermath of the Second World War (Brosse, 1950) marks the beginning of a renewed interest in the contribution children might make to their care, exemplified in Roy Parker’s address to the NCH Conference the following year (1971) and the Who Cares? Project (Page and Clark, 1977).

The report’s advocacy of parental involvement reflects what had been known within the approved school system for many years (Heywood, 1978) while the stress on staff bringing something of their own interests to residential care echoes the experience of Winnicott and Britton (1957). Their recognition of the significance of personal space and buildings can be seen in the way Homer Lane approached the development of the Little Commonwealth (Bazeley, 1928) and was to be explored by Bettelheim a few years later in A Home for the Heart (1974) but features very little in other texts on residential care, the notable exception being Blumenthal (1985). Their advocacy of on-site education was to receive unexpected support from Taylor and Alpert (1973) and Fanshel and Shinn (1978).

It also goes much further than anything currently available today in seeing residential units as both embedded in and potential resources for the community – a theme taken up fifteen years later in a very different world by Berridge (1985).

The suggested size of units (60 residents), the occasional sex-stereotyping of male and female roles in residential care and the limited attention to recording may jar for a modern reader. But these are small points alongside the breadth of the vision, a vision which, had it been implemented with, for example, modifications to take account of changing views about the size of residential units, might have avoided the incarceration of so many young people in the 21st century.

References

Bazeley E T (1928) Homer Lane and the Little Commonwealth Allen & Unwin, London

Berridge D (1985) Children’s homes Blackwell, Oxford

Bettelheim B (1974) A home for the heart Thames & Hudson, London

Blumenthal G J (1985) The development of secure units in child care Gower, Aldershot

Brosse T (1950) War-handicapped children: report on the European situation Publication No 439 United Nations Educational, Scienti?c and Cultural Organization, Paris

Fanshel D and Shinn E B (1978) Children in foster care: a longitudinal investigation Columbia University Press, Guildford

Heywood J S (1978) Children in care: the development of the service for the deprived child Routledge & Kegan Paul, London, third edition

Makarenko A (1936) Road to life: translated by Stephen Garry Stanley Nott, London Originally published as Pedagogicheskaia poèma

Neill A S (1962) Summerhill: a radical approach to education Victor Gollancz, London.

Page R and Clark G A (Eds) (1977) Who cares? Young people in care speak out National Children’s Bureau, London.

Parker R A (1971) Planning for deprived children National Children’s Home, London

Taylor D and Alpert S W (1973) Continuity and support: following residential treatment Child Welfare League of America, New York

Wills, W. D. (1971). Spare the child: the story of an experimental approved school Penguin, Harmondsworth

Winnicott D W and Britton C (1957) Residential management as treatment for difficult children. In Winnicott D W (Ed.), The child and the outside world: studies in developing relationships, chapter II:6, pages 98-116 Tavistock, London

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