We are what we eat

Problematic eating behaviours and complicated relationships with food are common in looked-after children, who also have a higher risk of poor mental and physical health and social outcomes due to abuse, neglect, and other adverse childhood events.

The nutritional needs of looked-after children are inextricably connected to the other challenges they face, and supporting a healthy approach to food makes positive outcomes more achievable. Halliwell Homes has developed a Therapeutic Nutrition Programme for every child who lives in its residential homes, as part of its wider approach to addressing their emotional, behavioural, social and developmental needs.

“Statistically, looked-after children have a much higher risk of poor health in adulthood,” says Andrew Sheffield, nutrition lead at Halliwell Homes, who created the programme. “If we can give them a really good diet and teach them about healthy eating, hopefully that will diminish some of those risks as they get older.”

Therapeutic Nutrition Programme

The Halliwell Homes Therapeutic Nutrition Programme aims to ensure that residential homes provide every child with nutritious food, engaging food activities, and support to learn healthy eating habits. The programme runs alongside Halliwell’s Restorative Parenting Recovery Programme, which works with five- to 12-year-olds who have experienced trauma and rejection, helping them learn how to form and maintain healthy attachments, promoting education and encouraging positive lifestyle choices.

The programme includes:

• A nutritionist working as part of each residential home’s clinical team, to support the residential team with any specific nutritional concerns

• Nutritionist-led one-to-one, key worker, and group cooking sessions with children, to engage them in nutrition and cooking

• Training for all residential staff on nutrition and its importance for looked-after children, and in cooking skills to build confidence in cooking healthy food for and with children

• Training for managers on establishing therapeutic mealtimes

• Reporting and monitoring food intake in residential homes

Children’s needs

Children arriving in residential care often show symptoms of “food maintenance syndrome”, which can include bingeing, purging, food hoarding, or putting things in the mouth that are not food. “Bingeing and hoarding of food is common, perhaps because children have had food insecurity

in the past, or because they are feeling anxious,” says Sheffield. Fussy eating is also common. “It is hard to pick up sometimes whether it's because of the limited diet children had before, because they don't feel settled, or whether they are just a fussy eater, which some children are.”

Programme outcomes

The success of the programme will be tracked using a Nutrition Index, a three-monthly questionnaire which captures information about each child’s diet, knowledge of healthy eating and attitudes to food. Some questions are answered by key workers, and some are answered by the children with the help of flash cards.

By engaging children in choices about food, and the process of cooking healthy meals, the programme nurtures better relationships between carer and child, and boost social and life skills, as well as improving their diet. “We want to use those opportunities around food as a time to build a therapeutic relationship, improve children's health, and improve their knowledge and skills for the future,” says Sheffield. “When staff take children shopping and cook together, that will really help their relationship.”

Although the programme launched 18 months ago, Covid has limited opportunities for staff training, which will kick off in earnest in the summer. Sheffield has been able to visit homes to run food-related activities, and staff are now able to replicate these themselves – themed cultural events such as Japanese night are particularly popular.

Homes have replaced unhealthy after school snacks with a buffet of health options such as hummus and carrots. “I have seen some positive changes in how staff think about feeding the children,” says Sheffield. “The kids now expect they will come in and eat something a bit healthier, where before they wanted crisps or chocolate.” Children have always had an input into the weekly menu, but they are now encouraged to leaf through healthy recipe books to choose new and exciting meals. “They are experiencing new tastes and cultures,” says Sheffield.

The Nutrition Programme is seen as an inextricable part of Halliwell Homes’ Restorative Parenting Recovery Programme. “It is not an extra, it is something that underpins and wraps around all the other work that we're doing,” says Sheffield. “If children are feeling well because they're eating well, then their recovery is going to be better, their behaviour will be better, and their relationships will be better.”

Further information www.halliwellhomes.co.uk

To find out more about placing a child on the programme contact: referrals@halliwellhomes.co.uk or 0161 278 2531