HOUSE OF SMILES: A HOME FOR CHILDREN WITH DISABILITIES ANNUAL PLAN

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Table of Contents

1. Background
2. The Problem(s)
3. House of Smiles (HOS) Project
4. Project Philosophy
5. Summary of Strategic priorities for 2003
6. Goal Statement
7. Objectives
8. Limitations, constraints and risks

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Background (TOP)

Changing social-economic conditions, the return to political stability, an increasing population, increased private investment and improvement of the rural infrastructure have marked the recent years of Cambodia's development.

However, alongside this transition are emergent new social problems that have called for urgent attention. These include: increased urbanisation with the migration of rural poor to Phnom Penh in search of work opportunities; increased youth unemployment; an increased prevalence of HIV/AIDS; and increased incidence of child abuse, trafficking and prostitution, to mention but a few of the challenges to Cambodia's development.

The Problem(s) (TOP)

Orphaned and abandoned children with disabilities are among the most vulnerable groups in Cambodia. Forty percent of the orphans at the Nutrition Centre (a government orphanage) are severely disabled, and as many of the children are close to 6-years of age, the orphanage is considered ill equipped to effectively support the growth and developmental needs of these children.

To date some attempts have been made to integrate orphaned or abandoned children with multiple disabilities into the community, however, there remains much need to develop appropriate care and accommodation facilities that will allow these children to reach their fullest potential. The concept of House of Smiles is advocated as a model of alternative care for orphans with disabilities .

House of Smiles (HOS) Project (TOP)

The House of Smiles, formerly known as the Group Home pilot project, was established in August 2000 with five children (3 boys, 2 girls). Carers (house-mothers) were selected to provide care on a shift basis aiming to facilitate the development of the children's skills in daily living activities, education and other areas of development. With the support of MOSALVY and DAC the children were included in the local community and schools. Throughout the pilot phase Hagar provided financial support of the home.

A project review was conducted in November 2001and a number of recommendations were made concerning management and the longer-term sustainability issues. However, the overall conclusion of the report was positive stating that the HOS:

"has performed extremely well and has earned well-deserved praise for the positive changes which have been produced in the children who live there. It will inevitably be referred to as a model or benchmark for other projects, which will provide services for children with similar levels of disability in the future".

Project Philosophy (TOP)

The emphasis of the HOS is placed on the child being as independent, or as involved, as possible in activities of daily living, whilst also maximising opportunities for integration within the local community. The HOS model can provide an appropriate environment for children to receive the emotional, physical and social support they need, as well as the opportunity to participate in most of the regular school activities with other children living in the community.

Summary of Strategic Priorities for 2003 (TOP)

During the course of 2003 the following strategic priorities will be implemented:

• Increased community integration:
  i) Proactively engaging with the community to raise awareness of disability issues;
  ii) Seeking to integrate some of the disabled children into local schools and/or to take part in local activities;
  iii) Investigate the needs of disabled children living in the area, with a view to facilitating management or technical support and/or respite facilities.
• Action research process - consciously developing a process of reflection and learning in order to develop longer term strategies and advocacy of best practice and models of community care for orphans with disabilities.
• Strategic 5-year plan - development of a long-term plan for the House of Smiles, the current year 2003 being seen as a 'bridging' year between the pilot and a 5-year term proposal.
• Funding options - assisting in development of a foundation for fund-raising and disbursement; investigating the potential of child sponsorship; developing a long term funding strategy.

Goal Statement (TOP)

To develop a community based alternative model of care, rehabilitation and integration for children with disabilities.

Objectives (TOP)

1. Each child has the opportunity to develop to their fullest potential

1.1 Children have an individual development care plan.
Staff will develop for each child an individual care plan defining the learning, therapy and development objectives and activities that will be done. Technical staff will assist in monitoring progress by using specially designed monitoring charts and help the staff to adapt the plan according to needs. As much as possible staff will listen to and be aware of the child's own aspirations for their development and help to fulfil these. Technical staff will provide quarterly progress reports on each child.

1.2 Promotion of independent living.
Staff will encourage children to be more independent in daily living activities such as personal hygiene, washing and dressing etc. Independent living will also encourage children to attend school with minimal assistance from the carer, in order that the child does as much for him/herself as possible. An important part of this will be continued training in sign language in order to increase functional capacity and psychological well being.

1.3 Children are happy and healthy.
Every effort will be made that the children live to their fullest potential. This will involve ensuring that children have the opportunity to attend play -groups, and organised activities such as swimming, music and dance. Celebration of birthdays and other events in the National calendar will be part of the children's annual schedule.

Where feasible the project will seek to develop small gardening schemes, so that the children can join with others in the community in 'learning through growing'. This may also include raising small animals where appropriate.

Staff will investigate the potential of a play-group at the Centre for Child Mental Health (CCMH), and participating in events held in the locality as provided by other organisations.

2. Each child has access to educational opportunities according to their capacity

2.1 Children benefit from learning/social environment.
Children will be encouraged to share their learning within the HOS and where possible will be helped to do homework and extend their learning. The HOS Coordinator will play an important role in liasing between the schools and HOS to ensure that learning practices and good behaviour are reinforced within the home. A system of tools will be developed for monitoring the children's educational performance and development.

2.2 Children regularly attend learning facility/school.
Children will be facilitated in attending special or local schools as appropriate. Regular reports of progress will be provided by the teacher/trainer.

2.3 Relations developed with local government school.
The HOS Coordinator will liase and develop relations with local schools and to look of opportunities for the children to join certain activities and/or join the school on a regular basis. Where appropriate some resources may also be shared.

3. Children live in an environment, which is safe, practical and homely.

3.1 Children are safe and secure
The HOS Coordinator will be responsible to ensure that there is adequate safety and security within the home environment. This will include making sure that equipment and facilities are well maintained and any damage repaired promptly.

3.2 Aids accessible to promote maximum independence.
An assessment of the existing facility will be made as soon as possible to determine the accommodation needs of the HOS. This is particularly important as the girls get older and will require greater privacy. If possible the existing facility will be extended/adapted, including refurbishment of toilet facilities, however an alternative home may need to be located, if space is seen to be limited. Living aids such as hoists, bars etc. will be provided as required.

3.3 Children have personalised area.
Each child will be given the opportunity to design or personalise their own living/sleeping space with pictures, photos and soft furnishings in order that they have an individual area.

4. Advocacy, networking, development of alternative care models

4.1 Strategy developed for promotion/advocacy of disabled children in the community.
The 3-partners of the project will work on developing strategies that promote the HOS model and actively discuss merits or otherwise of the approach. Where appropriate this will be linked to fund-raising and development of the Koumar Pikar Foundation.

4.2 Productive networks developed with other groups.
Representatives from the HOS will aim to meet at ¼ intervals with other groups involved in similar areas of work. If there is interest, this may be extended to a wider forum of carers.

4.3 Defined strategy and concept of HOS model of care.
During 2003 the 3-partners will develop a concept paper detailing the philosophy of the HOS. On the basis of this information a 5-year proposal will be developed outlining the longer-term strategy for the home.

5. Positive relations developed within the wider community

5.1 Community leadership is familiar with and promotes the HOS.
The HOS Coordinator will be responsible to develop active relations with the official leadership and community groups operating within the locality. S/he will aim to increase the understanding and look for ways of increasing integration with the community.

5.2 Surrounding community has regular contact with HOS children and staff.
During 2003 a simple survey will be conducted to investigate local knowledge and attitudes towards the HOS and disability in general. It is hoped that this information will be useful in getting a better understanding of issues and lead to building bridges with the community.

As part of this strategy it is also hoped to make contact with other disabled children living in the community, with a view to getting a better understanding of the particular needs of disabled children and their carers living in the community. In the longer term this may lead to the HOS being able to provide technical, management and social support to carers in enabling them to better care for their children at home.

5.3 HOS children have friendships with local children.
The children will continue to be encouraged in developing friendships with neighbouring kids, by inviting them to share in play times and occasional meals. Also children will be encouraged to go outside to watch TV and take part in some of their friends' family life. Joint gardening and other events/activities are planned to help in developing positive relationships.

6. All staff are enabled to develop their learning

6.1 Staff has satisfactory knowledge, skills and attitude for their jobs.
During 2003 the current training programme for staff will be reviewed and updated. Staff will participate in defining their learning needs and different learning opportunities will be resourced. It is anticipated that regular inputs from the CBR team will be helpful in promoting independent living and other specialist training will be bought in as required. Training in sign language will continue to form an important aspect of the learning. Informal weekly training and discussion/support for the staff will be continued.

It is planned that the current role of the Administrator be revised to that of 'HOS Coordinator'. Essentially, this will involve greater responsibility for: monitoring different aspects of the project; coordination between the HOS and Foster home, especially in relation to children with disabilities; and increasing representation and relationship building within the local community and associated institutions.

6.2 Staff has opportunity for personal reflection and development.
It is important that staff will be given the opportunity to reflect on and develop their own learning opportunities. A system of annual performance development review will be implemented. Staff will be encouraged to initiate and participate in team-building and other creative activities' as these are available. It is planned to hold an annual event to recognise and celebrate the work and contributions of the carers.

7. Effective management of the HOS maintained

7.1 Standard systems, policies and guidelines followed.
In order to continue to develop and rationalise the management of the HOS, staff will participate in review and development of working policies and procedures e.g. guidelines of how to manage child illness and emergency situations. Where appropriate this will be conducted together with the Foster Home in order to standardise certain practices.

7.2 System of planning, monitoring and review implemented.
During 2003 the HOS Coordinator will be facilitated in adopting 'action, reflection, learning' processes to project management. Clearer systems will be developed for monitoring and evaluation of different aspects of the work. Regular progress reports will be provided to donors and government according to their requirements. It is proposed that the staffing component/ratio will be reassessed during the year.

Other recommendations made from the Nov. 2003 review will be implemented.

Limitations, constraints and risks (TOP)

1. Funding - establishing a long term funding base for the home will be essential.
2. Integration with public schools - The education system in general, schools and teachers in particular, are seen to have a low capacity and awareness of issues relating to disabled children. Challenges exist in areas of access and acceptance of children with special needs into mainstream schools.
3. Capacity and responsibility of Government staff - maintaining active involvement of government departments will be essential to ensure that the HOS model is promoted and adequately supported.
4. Adult with disabilities - presently there is no provision made for severely disabled adults. Although the oldest child in the HOS is only 13 years old, consideration will need to be given to the long-term future.
5. It is likely that the expatriate technical support of DAC will be reduced in 2003. Therefore capacity building of the staff and particularly of the HOS Coordinator will be imperative.