London's Pulse: Medical Officer of Health reports 1848-1972

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Bromley 1968

[Report of the Medical Officer of Health for Bromley]

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71
Despite efforts to forestall the gap in continuity of Wardens, a
situation arose where we were without a Warden for several weeks.
Although a small group of the social work staff agreed to cover
the hostel, living in for periods of up to a week at a time, it was
inevitable that this situation would put residents into a state of
confusion and some unrest was experienced. The experience was
not without value; the social workers who undertook this work
gained considerable insight from living in direct contact with the
residents and had a clearer understanding of the role played by the
Warden of a hostel.
In September 1968 we were fortunate in the appointment of a
Warden and Matron who had considerable experience in residential
work. By appointing a young and comparatively inexperienced
Deputy Warden, we hoped to strike a balance between
the staff, giving the residents mature, stable, parental-like figures
on the one hand, and on the other a younger person with whom
most of the residents might identify as someone more able to
understand them, being nearer their own age. While these roles
have worked quite well, problems have arisen over leave and
off-duty.
Social Work in the Hostel
We have established that there is a need for hostel care for
some patients, but because they are hostel residents this does not
necessarily lessen their need for social work services. In fact, their
needs are often greater than those mentally disordered persons
living at home. The hostel resident will either have no home or
will be too disordered to live at home. The Warden is not expected
to undertake all the social work necessary at the hostel. He has
to stand in loco parentis to the residents and, therefore, to some
extent, becomes emotionally involved with them, and one of the
primary requisites for a social worker is to avoid emotional involvement
with his clients.
Therefore, we have a senior social worker responsible for the
social work problems at the hostel, but residents who have already
had the services of a social worker within the Authority are
encouraged to maintain such contact. The social worker must be
able to stand aside and see the problem in perspective, to feel
unlike the Warden with but not for the resident.
Apart from this difference of roles, the Warden has little time
to undertake the amount of social work which his "residents" need
to learn how to stand alone. There is clearly a social work element
in his job, but the nearer he becomes to being a parent of his
group, the more likely he is himself to need help and support from
the social work service.
Group Work
During the past few months, we have been developing the ideas