This short article is primarily concerned with, what the authors consider to be, two important considerations in any form of residential child care, particularly long-term: 1 The great need for a coherent overall philosophy, which is clearly understood by all members of staff. It is felt that, all too often, assumptions are made about general agreement, which are not necessarily borne out by observed practice. 2 The need for the meticulous selection of primary caring staff, followed by relevant in-service training rather than an overreliance upon, what are sometimes, quite arbitrary qualifications. The article attempts to present a broad profile of a unit which, although it does not claim to represent the ideal, is nonetheless beginning to assume a purposive and identifiable character. The point is made that clinicism, professionalism and academic discussion are important but they are not the only considerations. The children must remain the raison d'etre for such a unit, not the justification. The authors hope to have conveyed their conviction that cooperation and communication between the members of a multidisciplinary team presents the most practical and the most productive approach to the care of profoundly and multiply handicapped children.