Equipping the milk kitchen at a home for abandoned babies

VISION

Shepherd's Keep is a home for abandoned babies, HIV positive or not, from birth to 6 months old. Our mission is to provide:

• A high care facility for babies from birth to six months old
• A 24 hour facility
• High adoption rate
• Individual holistic medical/nutritional plans
• Hospice for terminally ill babies
• AIDS awareness training and counselling

OVERVIEW

Shepherd's Keep provides a loving temporary home for abandoned HIV/AIDS-affected babies in Durban. This 24-hour facility for babies up to 6 months old has a 90% adoption rate and an extraordinarily professional and dedicated approach. This project will equip the home’s milk kitchen, used daily for the preparation of formula and meals. Each baby has an individual feeding plan and protecting them from infection is vital. Hundreds of bottles of formula and meals are prepared in the kitchen, which needs easy-to-clean stainless steel worktops and shelves, measuring and mixing utensils and stainless steel containers for sterilising bottles and teats.

WHAT WE LIKE ABOUT THIS PROJECT

• The highly professional and dedicated approach to the treatment of abandoned babies at Shepherd’s Keep. These children are given the very best care with a caregiver to baby ratio of 1:3 or 1:2 for older babies or those with special needs.
• The focus on placing the babies through adoption means they don't become institutionalised – 90% of the babies are placed within 6 months.
• The impact on the life chances of the babies at Shepherd’s Keep is immense: of the 97% of babies who arrive HIV positive, 75% revert to negative status within 6 months because of the excellent nutrition and expert medical care they receive.
• The building housing the facility and milk kitchen has been recently refurbished and is owned by Shepherd's Keep.

EXPECTED LIFE CHANGE

An investment of R 67,550 will provide safe nourishment for at least 25 abandoned babies a year. As the kitchen renovation is making use of long-lasting, durable and specialised equipment and fittings we expect this investment to benefit many babies over a number of years.

• When a child is rescued from a life in institutions, the state benefits because they are relieved of the financial burden of caring for that child until adulthood.
• The facility provides employment for 19 staff members – most of them are sole breadwinners and single parents. Staff are also extensively trained and developed.

Direct life change is estimated at R540 per person.

NEED

The number of abandoned babies continues to rise and the social system cannot cope. There is a severe shortage of round-the-clock places of safety available to authorities and overburdened orphanages and places of safety are proof that adoptions are not taking place or taking place with unsuitable parents which means that children are taken out of the system only to be thrust back again, broken-spirited and rejected.

With survival uppermost on the list of priorities, these homes barely have the time or resources to consider infection control which places these babies at risk of HIV infection or re-infection as well as a host of other life-threatening diseases associated with poverty and cramped conditions.

Children also get inadequate care and nutrition at state-run child care facilities and there is little hope of adoption for many of them. This means they grow up in institutions without the benefit of a loving family and the social values that go with it. Inadequate medical attention means that some babies are left with permanent damage and conditions that could either have been avoided or corrected with the necessary treatment.

STRATEGY

Shepherd’s Keep is a 24 hour, fully staffed facility with high care medical equipment including incubators and phototherapy lights. The focus is on placing the babies in family environments within 6 months. A private social worker is committed to each baby at Shepherd’s Keep and starts by investigating placements with biological families, then to local adoption and finally, international adoption as a last resort.

Staff are intensively trained and stringent infection control measures and regulations are in place. Each baby is on an individual meal plan designed to give them optimum nutrition.

The facility enjoys high-level medical back-up from a paediatrician at Bluff Medicross.

ACTION PLAN

Preparation

• Get quotes for the new equipment that is needed and select the preferred service provider
• Get quotes for removing the old fixtures and fittings and installing the new equipment that is needed and select the preferred service provider
• Set a date for the renovations to take place
• Set up an alternative milk kitchen that will be used while the milk kitchen is being renovated – adjacent to the milk kitchen is a nursery which is ready to be sterilized for use during renovations.

Implementation

Shepherd’s Keep staff will move the existing milk kitchen equipment into the sterilized adjacent nursery.

The contractor will:

• Remove and clear existing cupboards and worktops in milk kitchen.
• Prepare and install new sinks.
• Install new stainless steel mixing pot, dispensing container and urns.
• Complete plumbing and electrical installation.
• Install new dishwasher and fridge and check functionality.
• Plaster and repair if walls are chased for piping.
• Install stainless steel trolleys and shelving.
• Paint and finish walls.
• Clean up and remove any rubble from site.

Monitoring

The work will be monitored on site by the Director, Matron and Administrator. They will make sure that standards are maintained and functionality is practical and user-friendly. Matron, in particular, will ensure that her high standards are maintained and that a workable milk kitchen is the end result.

ORGANISATIONAL EVALUATION

Founded in 1998, Shepherd's Keep is well-run, with a focus on delivering an exceptionally high standard of care, including palliative care and physical therapy, to abandoned babies while looking for an adoptive family.

There are extensive procedures and systems in place for monitoring staff activities and the level of care delivered to the babies. A good deal of internal staff training ensures quality performance and key leadership personnel have a range of relevant skills and expertise. The matron is currently mentoring the supervisor so that she can hand over her duties when she retires. Shepherd’s Keep is driven by passionate and committed people and is considered by many to be ‘best practice’ in this field. The organisation is well networked with local police, children’s services and hospitals.

Due to the high quality of service, running costs at Shepherd’s Keep are high and the organisation is reliant on a small pool of funders and gifts in kind. However, they are working on a strategy to boost the sustainability of their finances in 2008.

RISK PROFILE

Key Strengths

• Concept: The facility has been designed specifically as a transition home and is well-maintained. The renovated milk kitchen will therefore assist Shepherd’s Keep in achieving their aim of providing excellent care for abandoned babies.
• Design: The kitchen has been designed to be practical, user-friendly and sterile. Specialist suppliers will be contracted to renovate the kitchen thereby ensuring that the design is appropriate for the use. The use of stainless steel will assist the staff in ensuring that the kitchen is kept sterile.
• Capability: The staff have previous experience of overseeing renovations in the existing building.
• Control: Shepherd’s Keep has good financial controls and oversight in place. The board is reliable, accessible and a good resource of skills – two external members in particular provide invaluable advice and input around labour, corporate governance and fiduciary responsibilities.
• Sustainability: Shepherd’s Keep own the building and are using long-lasting stainless steel fittings for the milk kitchen.
• External:

Key Risks

• Design: As Sheperd’s Keep does not have financial reserves, there isn’t a dedicated budget for the maintenance of the kitchen equipment. However, this is mitigated by the fact that specialist equipment is being purchased and stainless steel has a long life span.
• Control: The board could have more external people – it currently consists of four family members and three external people.
• Sustainability: Financial sustainability is a risk as they only have reserves for 3 months although they are shifting their focus to sustainability in this area and investigating possible strategies.
• External: Quality of workmanship and reliability of the contractor used for the milk kitchen renovation can only be determined once the work has been completed.