AN EVALUATION OF SPRINGFIELD HOUSE ANN HUNT, Secretary, Springfield House Management Committee, 120-122 Burwell Drive, Witney, Oxfordshire Introduction

Springfield House, Witney was opened in January, 1978 by the Parent Teacher Association (PTA) of Springfield School, Witney, and the local education authority ESN(S) school for mentally handicapped children in West Oxfordshire. It provides short-term care, not just for children at the school but for children from any area. It is owned and managed by the PTA and receives a 25,000 annual grant, initially from joint financing funds. During the financial year 1978-9 the House cost 210,610 to run.

At the beginning of 1980, 32 parents of children at present attending Springfield School were asked for their views on the way the House was functioning. The results of the survey were used to evaluate Spring- field House at the end of its first two years of opera- tion. It was also hoped to encourage parents who were still ambivalent about the home to use it when they needed short-term care for their children, to give them “permission” to share care without making them feel they then became “uncaring” parents.

Setting-up Springfield House In the early 1970’s there were two forms of short-

term care available in the area, two social services hostels and the subnormality hospital. As in many areas, the “short-stay” beds in the social services hostels had gradually reduced in number as more children were placed for long-term care. Therefore, short-term care was only available to a few families willing to admit they were experiencing severe stress. In addition, the hostels could not take the special care children who needed extra care for their additional physical or behavioural handicaps. Care for these children was provided in an isolated subnormality hospital, housed in a converted “temporary” hospital, remaining from World War 11, to which very few parents were willing to let their children be admitted, even for short periods of time. So, not only were the parents most in need of short-term care for their children unable to get what they felt to be acceptable care but, for the majority of parents, there was no break at all available.

It is perhaps a reflection of the intensity of need for more short-term care that the PTA of Springfield School, never attended by the parents of more than 40 pupils, raised 230,000 in the four years following the launching in 1973 of their Development Fund to buy a hostel. One of the drawbacks of many forms of care is their inevitable “economic77 size, usually far larger than a normal family house. The PTA wanted to provide accommodation as far as possible like most of their own homes and, instead of convert- ing a large old house, they purchased a pair of semi- detached three-bedroomed houses on an ordinary, private estate. These were converted into one house,

Ann Hunt is now Secretary of the Tuberous Sclerosis Associa- tion, with a research grant from the Simon Yudkin Memorial Trust

providing three bedrooms for children (a maximum of six residential children), a large living room, a dining- room, kitchen, utility room, office and staff accommoda- tion. Much of the conversion work and decoration was done by parents and local volunteers, and the total price to buy, convert and equip Springfield House by January 1978 was E24,OOO.

Springfield House One of the problems of providing adequate short-

term care is the access to such care by parents. Having to negotiate through social workers or doctors, having to accept a booking when - and for the length of time - offered by the agencies, can be too daunting to some parents, who may feel ambivalent anyway about leaving their child. It was felt to be essential that bookings at Springfield House should be on a self- service, “cafeteria”, basis. Apart from the peak sum- mer holiday times when the residential care may be fully booked several weeks ahead, parents book directly with the houseparents, and can use the home at a few hours’ notice. Day care is also available in school holidays and weekends, and some parents have used the House for a couple of hours in the evenings when both parents were working. The senior houseparent’s family lives in the House, and very little separation is made between “family” and “children”. Extra staff are employed temporarily at peak holiday times but, in general, children are just absorbed into the houseparents’s family life. The arrangement is more akin to good foster care, with the accommodation and salary of the foster-parents paid by the PTA, than the normal provision of staff coming into the House to work. However, this is sometimes not in accord with the traditional view of what short- term care should be and to investigate parents’ views in this respect was one of the purposes of the evalua- tion which also sought to find out why some parents were not using the House and to encourage the hesitant parents to do so.

The survey The parents of 32 children attending Springfield

School were interviewed. 20 parents had used the House, 12 had not. Only four children had previously had short-stay care in either the social services hostels or the subnormality hospital. From the admissions book, over the two years 1978 and 1979 since the home was opened, the 20 “users” had 125 separate residential bookings from 1 to 14 nights in length. They had also used the House for 89 half-day and 97 day bookings. This is a total of 311 bookings in the two years. Most children had used the House for quite short stays. In addition, 33 other children, from Oxfordshire and other areas, had used the home, generally for longer residential care of up to the maximum stay permitted of four weeks.

The children included in the survey

all ages had used the House. The children ranged from 3 to 16 years. Children of

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Number of mentally handicapped children (of the 32 parents interviewed) with additional handicaps

Behaviour Physical Sensory Epilepsy Problems

Additional handicap Yes No Yes N o Yes N o Yes No Users 4 16 3 17 7 13 13 7 Non-users 2 10 0 12 1 11 5 7

Total 6 26 3 29 8 24 18 14

The multi-handicapped children at Springfield School were well represented among the users of the House. Parents were asked whether they had regular contact with either a social worker or a health visitor. 14 parents had contact with both. I0 had contact with neither - it would have been difficult for them, had they been suffering stress, to obtain short-term relief, had it not been for the self-service nature of Spring- field House. Comments of parents who had used Springfield House

Parents were asked if they were satisfied with the care offered. 17 were, one was satisfied with the general care but felt not enough nursing care was available, two parents were dissatisfied. When asked if they would continue to use the House, 18 parents would, including one of the dissatisfied parents; the other such parent would prefer a foster-care scheme. The parent whose child needed nursing care was seeking planned care in a paediatric hospital ward, but would use the House if this arrangement could not be obtained. She would not accept a placement in a subnormality hospital for her child.

Parents were also asked what changes they would like to see in Springfield House. Of the 18 satisfied parents, eight could suggest no changes. The remaining 10 parents offered a variety of suggestions:

Number of parents

Satisfied parents’ suggestions Planned play area in garden/more secure fencing 4 More planned play inside House 3 More walks and activities outside House 2 Use of volunteers to play with children 1 More directed play 1 Less television 1 Clothes to be listed 1 Easier access for emergency booking 1 Other comments PTA run it very well 4 Nice to have in an emergency as a back-up 1 Dissatisfied parents’ suggestions More directed play needed 2 1 to 1 care needed 2 Not enough nursing care 1 Plan a better garden 1 Untrained staff 1 Other comments Child’s glasses not put on 1 Coat missing at end of visit 1

The similarities of comments made by satisfied and dissatisfied parents, may simply mean that some parents are more willing to class themselves as dis- satisfied than others. However, the number of com- ments on play illustrate a common worry of parents of children using short-stay care - that their child may not get the level of individual attention provided at home. Action taken on the comments

By the time the questionnaire was finished, the fencing around the back garden had already been im- proved. Better concreted areas and an outside play-

shed will allow the children to play in the garden without the constant supervision that had been a problem before with some of the overactive children. Play outside should now be possible even in showery weather. More staff are to be employed in peak times so that children can be taken on more out-of-home activities, while the running of the House continues.

With regard to the problem of specialised nursing of special care children with “extra” problems, the local Health Centre has agreed to provide a district nurse who will visit daily when such a child is in residence. The Centre already provides medical cover.

As there are only two members of staff, during term- time the houseparents are not expected to be at the House during the day when children are not present. Should a parent need emergency care and be unable to contact anyone at the House, a message can be left at the child’s school, and the child will be taken from the school direct to Springfield House.

It is always difficult to maintain the balance between a family home atmosphere with normal domestic routines (as was the original intention of the home) and the need for extra staff and volunteers to keep the children occupied. However, from the parent’s comments, it seems that the House needs to provide more directed play activities for the children. One or two children can be easily absorbed into a family routine, but five or six need more careful planning.

Parents’ reasons for not using Springfield House The 12 parents who had not used Springfield House

all knew of its existence, and 9 knew it was for day- care as well as for longer periods of care. When asked why they had not used the House, the most frequent reply was that close relatives looked after the child when necessary. Since the survey three of these 12 parents have used the House.

Number of parents

Reasons given for not using House Family (grandparents, sisters, aunts) looks after the child 5 Child presents no problems 3 Only just moved into the area 2 Cost (f2 per night) 1 Child too difficult to feed to leave anywhere 1

The usual fee for Springfield School children is &2 per night, f l per day, 50p per half day. Other children pay a full economic rate. All 32 parents were asked if the daily charge influenced their use of the House. 26 said it made no difference, two were sup- ported by the Social Services anyway, and four would use the House more if it were free. Conclusions

Prior to Springfield House opening, very few child- ren had received short-term care (8 out of 32). Since then 20 of the 32 children have used the home, which therefore appears to be fulfilling a need previously unrecognised in the area. The House has been used regularly, not only for residential care, but also for day care.

Most of the parents were satisfied with the care provided, although many were able to offer construc- tive criticism which will be of use in the future develop- ment of the home. The daily charge did not appear to be a very important factor in the frequency of use of the home and parents appreciated the ease with which they could make a booking.

Springfield House has obviously justified the efforts of the PTA. It is hoped that it will continue to receive the support of the statutory agencies in the area.

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