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Better Care, Better Services Forum 2013

Forum 2013

Showcasing Practice and Shared

Learning with Colleagues

The Better Care, Better Services Forum 2013 was held on 29 May. This e-booklet contains summaries of the presentations delivered by placement service organisations and the Department for Child Protection and Family Support and additional notes.

A joint presentation by

Centrecare, Create Foundation, Key Assets, Safe Places Community Services, The Salvation Army and the Department for Child Protection and Family Support’s transitional house and Duty of Care Unit.


Contents

Session 1: Caring Responsibly for Aboriginal and Torres Strait Islander Children ............. 3

Session 2: Better Care, Better Services – The Key Assets Team Parenting Approach ..... 5

Session 3: Creating Positive Memories.............................................................................. 6

Session 4: My Voice, My Right .......................................................................................... 8

Session 5: Better Care, Better Services…….Getting Better – Working Towards Better Practice in High Needs Transitional Services ................................................. 10

Session 6: From the Eyes of a Young Person - Experience in Residential Care ............. 12

Session 7: Dealing with Critical Incidents and Safety and Wellbeing Concerns in Care .. 14


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Session 1: Caring Responsibly for Aboriginal and Torres Strait Islander Children

Presented by Glenda Kickett and Helen Humes, Centrecare (Djooraminda) Djooraminda is the branch of Centrecare providing a range of culturally specific services to Aboriginal and Torres Strait Islander children and families including Placement Services (Out of Home Care and Tier 1 Family Group Homes). Our vision is to provide Aboriginal and Torres Strait Islander children with a positive experience of their time in care at Djooraminda, promoting and enhancing their cultural identity and life skills. Additionally to work with children today to develop their sense of self, identity, resilience and strengths for tomorrow - so that they may move forward as individuals and as community members. The Standards Monitoring Unit visit to the service assisted Djooraminda by

Informing our work

Align our work with the Better Standards Better Care

Guide practice and processes

Identify gaps in service and practice

Identify strengths and weaknesses

Strengthen processes and procedures

Strengthen Child Focused practice

Strengthening the Best Interest Principle

Professional Development

Djooraminda had some areas for action identified related to, for example: Abuse in Care and Critical Incidents - How is improvement being achieved?

Carer training Review of policy and implementation of training schedule.

Carer recruitment, screening, induction and training - How is improvement being achieved?

Recruitment undertaken in conjunction with Centrecare’s Human Resources division

Review of existing and development of new policies such as dealing with adverse Police Clearances; Recruitment, Induction and Employment Policy

Carers Manual updates Easy access to information for carers and staff, including regular updates (verbal

and written) at each at changeover and at Carer Meetings. Easy access for staff and carers to a folder which contains policy information. Provision of duty statements and job descriptions upon appointment.


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Training and guidelines supports skill development in managing children with difficult behaviours.

Development and implementation of individual safety plans training - How is improvement being achieved?

Changes in process incorporated into the Carer Manual and Care Plans Carers completed training in conjunction with the Australian Childhood Foundation. Each carer receives regular supervision.

Accessibility to policies and procedures - How is improvement being achieved?

Hardcopies of Carer Manual including updates which are progressed at Carer Meetings and Supervision.

Hardcopies of Cottage Manual with relevant policies, procedures and guidelines which will be reviewed on a regular basis.

Supervision to staff and carers - How is improvement being achieved?

Professional supervision for staff and carers in conjunction with Centrecare’s Professional Excellence Team

Monthly Carer meetings provide group supervision and support. Advice on recording of information about the service’s activities.

Standards Monitoring has informed future development in areas such as:

Djooraminda - Centrecare Policies. Cultural Supervision. Case work practice. Enhanced Processes of Primary Care Team. Identified Role for an Intake / Assessment Officer and a Cottage Care Support Worker. Implementation of a standard structural processes for the maintenance and care of

cottages.

In out of home care, there will always be challenges and these may be:

Systemic change - learning from the lessons of past approaches to caring for Aboriginal and Torres Strait Islander children.

Organisational congruency – ensuring the broader organisation is aligned with our approach to caring for children.

Considered and Intentional approach - maintaining a proactive rather than reactive approach and maintaining capacity to do this.

Staff wellbeing - looking after carers and support staff who are vulnerable to vicarious traumatisation and re-traumatisation.

Ameliorating the impact of the high turnover of staff on children; coaching staff and students or other adults of their influence and presence on a traumatised child’s day to day life.

Every interaction is an opportunity for healing For further information: Glenda Kickett, Executive Manager [email protected] and Helen Humes, Advisor, Cultural Development Program [email protected]


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Session 2: Better Care, Better Services – The Key Assets Team Parenting Approach

Presented by Fiona Gallagher

The presenter reflected on standards 4, 6 and 8 and how the Team Parenting model used within Key Assets enables support to foster carers in meeting the complex needs of children in their care. The Team Parenting model incorporates:

Systemic approach to stabilising foster placements

Carer is the agent of change

Multi-disciplinary meetings

Consistency and co-ordination of the care team

Reflective practice

A case vignette provided an example of how the Team Parenting approach was implemented in practice:

Standard 4 – responding to the needs of children and young people

Efforts in pre-placement matching through targeted recruitment; multidisciplinary meetings; preparation of carers through provision of training on impact of trauma and specialist health care; development of plans such as safety, passing away, health management and education.

Standard 6 – children and young people in placement

Immediate post placement and regular care team meetings; contingency and transitional planning; therapeutic and specialist support; maintaining family contact and social interaction.

Standard 8 – carer and staff recruitment, training, assessment and support

Access to cultural consultant for carers and staff; provision of ongoing training and critical incident debriefing; respite and 24/7 on call support; formal monthly supervision and annual review for staff and carers; practice reflection.

For further information contact Penny Bridges or Fiona Gallagher on 94319300.


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Session 3: Creating Positive Memories

Presented by Yvonne Hunt, Network Director

Staff from Oasis House accompanied a group of young people on an interstate holiday to Sydney. The idea came about as a result of consideration of the Standards (in particular Standard 6) and a review of the opportunities available to a “typical Aussie Kid” as recognised by the Alliance for Children in Care.

Provision of an interstate holiday was based on the premise that creating space for young people to engage in alternate experiences and challenges, provides opportunity for them to create new understanding and ways of coping with every day issues.

Along with the holiday experience, it would enable young people to develop better understanding of their capabilities in the areas of planning, endurance, self-esteem and team building through a series of structured and non-structured activities.

In practice, the staff team held a program night each Monday with the young people which considered:

accommodation option alternatives.

sightseeing options alternatives.

what to take - list of clothing, list of toiletries, what needs to be borrowed?, what needs to be bought?

how to pack - luggage choices/airline specifications.

how to save spending money - list of things that require spending money, setting target /weekly saving amounts, with staff providing support and encouragement to save.

airport behaviours - knowing travel plans, identification requirements, expectations of wait times, security issues, monitor flight departures.

Staff developed an information book to encourage ownership of the event, build excitement and provide direction for the young people.

Behind the scenes, staff were busy researching, budgeting, obtaining CPFS approvals, developing risk control measures (extensive), contingency plans and contact lists.

A review was conducted using information from debriefing with each young person and staff member, evaluation questionnaires and general discussions. The review found: What worked well:

Good planning overall, including the Monday night programs with young people. Activities were planned well and enjoyable for the group. Young people engaged well in the holiday events, particularly the Bridge Climb. Individuals faced their fears and overcame them with worker and peer support. Good understanding by staff and young people as to what was happening when and

where. Young people built their rapport with staff. Group work and feedback from participants


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What could be improved upon:

Better preparation for back up risk control and contingency planning. Exit strategies and behavioural management plans to be discussed at length with

group before camp. Staff allocated “communication time” whilst on holiday. Staff to have better understanding of the technology being used on holiday i.e

video camera.

For further information please contact: Yvonne Hunt Email: [email protected] Phone: (08) 9328 1655


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Session 4: My Voice, My Right

Presented by Petro Recchia, House Manager

The House is one of only two transitional houses operated by the Department for Child Protection and Family Support. The purpose of transitional houses is to provide short term therapeutic care to young people entering the care system or young people whose placement has failed and is in need of short term stability whilst an alternative and more permanent placement is found.

Referrals are generally immediate or on short notice with result that limited preparation for the young person can take place. The House has a strong philosophy of care underpin in the Therapeutic Care Model and the commitments to the Sanctuary Model.

To facilitate the participation of residents in determining the care that they receive, staff work in such a way as to demonstrate that the young person’s opinion is really valuable and that their safety and well being is of paramount importance. By way of example, the presenter outlined how new resident ‘Ally’, a 17 year old girl, was assisted to find her own voice.

When Ally presented she was quiet, withdrawn, tearful and unable to actively participate in any discussions regarding her needs and how she wanted to be treated. The normal response to questions was a bowed head and a shoulder shrug.

Ally was unwilling to be present at the initial Residential Care Plan meeting but agreed to sit with House Manager before and after the meeting. In that forum, Ally discussed what she wanted to achieve and afterwards whether the draft plan worked for her. Small adjustments were made in order to get it a workable plan for her.

All young people are invited to join staff in their weekly meeting where the progress of the young people is discussed. Ally refused though she was encouraged to listen in while sitting nearby. By week three, she sat at the meeting table and by week six, Ally was able enter discussion about her needs. Ally also asked staff she felt comfortable with to advocate on her behalf about more serious issues, such as drafting an email or to make representations to the house manager, her case manager or the greater team.

After three months, Ally had built her self esteem and confidence and was willing to sit in the review meeting and assert herself regarding her wants and needs.

After six months, Ally was comfortable to participate in the drafting of her Safety Plan and Therapeutic Plan with the staff and have open conversation about why some changes had to be made. Discussion about what is needed and what is realistic occurred and at that point that Ally developed her own strategy to stop self harming. Staff supported Ally to implement her strategy and there were no incidents of self harm during the remainder of her placement at the House.

To build this ability in Ally and the other residents, staff work in such a way as to demonstrate that the young person’s voice is really important and that their safety and well being is of paramount importance. Practice indicates that all young people are requested to participate in all aspects of decision making.


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On admission, residents identify their triggers, the possible consequent behaviours and preferred calming strategies. With this information, care staff develop a Safety Plan. Residents are also asked to develop their Self Care Plan which is assists young people to regulate themselves, usually listing four to six strategies that they could easily implement to soothe or self regulate. Participation in the house, life and community is also discussed.

The second phase on admission is to validate the resident’s rights and their right to be heard in the house, community and life. Staff have regular discussions with residents and follow through on matters arising. These discussions provide opportunity for staff to validate resident’s feelings. Residents are told about the Charter of Rights, which is displayed in the house. A laminated copy of the Charter of Rights and Advocate for Children in Care information is placed in the top drawer of each resident’s bedside table.

Thereafter, young people are encouraged to participate in the development and review of their plans: Residential Care Plan & Review; Safety Plans and Individual Therapeutic Plans.

How are young people heard in the House?

Young people are encouraged to speak to staff one on one. Staff will always listen and apply the seven commitments of Sanctuary to discussions with young people (open communication, democracy, social learning, social responsibility, emotional intelligence, non-violence and growth and change) in validating what they are saying, but also helping them to learn and grow from the issues and situations and develop the skills to advocate for themselves.

The House Manager maintains an open door policy; listening and validating resident’s feelings and guiding them back to discuss their issues with the appropriate person.

In weekly Residential Meetings, young people have the opportunity to discuss what they like in the house, what they want to change, activities and menu for the rest of the week and any other topics that impact on them and the other residents.

Staff Meetings are weekly and discussions occur regarding the progress and future goals for the young people and the general running of the house.

Shift Hand Over Meetings commence with a Community Meeting where often young people attend to get an indication of how staff are feeling and have the opportunity to share how they feel.

Summary

Help young people find their voice

Facilitate the development of their voice

Set realistic platforms for testing and experiencing using their voice and being heard

Create mastery

For further information please contact:

Petro Recchia

Email: [email protected]


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Session 5: Better Care, Better Services….Getting Better – Working Towards Better Practice in High Needs Transitional Services

Presented by Shaun Mays Safe Places WA Operations Manager

Safe Places is a not for profit organisation providing high needs residential accommodation for children and young people with high support and complex needs in Perth and Bunbury. Safe Places has 65 staff in WA and since 2009, has provided transitional placements for over 71 young people across WA, ranging from short emergency stays to placements of over two years.

The service was externally monitored by two assessors from the Department across period from December 2011 to November 2012. The sample comprised five of the young people aged from 14 to 17 years, one of whom identified as being from a CaLD background. They had been in placement with Safe Places for periods of between two and 24 months.

The monitors visited six houses across the Perth metropolitan area and spoke with three young people (one Aboriginal, One CaLD and one non Aboriginal), six Safe Places’ Youth Workers (one Aboriginal, one CaLD and four non Aboriginal) and six Management or specialist staff. Four Department child protection workers were also interviewed in relation the young person for whom they have case management responsibility. Safe Places also contributed feedback from six young people, 18 Safe Places Youth Workers, 10 Safe Places Case Managers and two Safe Places Zone Managers. The monitors identified a range of commendations in:

Well-developed policies, procedures, case documentation and guidance Highly developed operating and record keeping system Prompt reporting Well-developed WHS practice Participation of YP in care planning and their care environment Staff training and support Focus on cultural considerations Culture of organisation – feedback = opportunity for improvement Commitment to understanding and meeting the child’s needs. Application of therapeutic care approaches

Safe Places has a number of processes that support the commendations identified. For example:

Culture of organisation – feedback = opportunity for improvement. How is this achieved?

Monthly audit Formal staff input process Monthly supervision, fortnightly team meetings, monthly staff meeting Three monthly policy reviews Initial and continuing training and development


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Commitment to understanding and meeting the child’s needs. How is this achieved? Fortnightly team meetings with the young person Young person feedback forms Young person has Case Manager’s and Operations Managers’ contact numbers Care Map reviews include young person Creativity with case work and team management

Application of therapeutic care approaches. How is this achieved? One week Therapeutic Crisis Intervention (TCI) that all staff must pass. TCI embedding in practice and supervision Supporting documentation such as Care Maps and Positive Behaviour Support Plans. All documentation in line with TCI language and strategies. Case clinics

Safe Places had some opportunities for service improvement identified. For example:

Some young people surveyed only felt safe in the house they live in ‘some of the time’. How can improvement be achieved?

Teams to carry out security audit on property with young person. Teams to include young people’s “feelings of safety” in team meeting agenda and

discuss strategies for improvement if appropriate. Teams to document any expressed young people’s safety concerns in Weekly

Progress Report Teams to document action taken and plans made to increase young people’s feelings

of safety in Care Map

Young people’s belongings are left with Safe Places. How can improvement be achieved? Review and incorporate DCP guidelines around “Transferring a Child’s Personal

Belongings” Inform all Safe Places staff Develop Safe Places policy in line with DCP policy.

Staff and young people don’t know about the Advocate for Children. How can improvement be achieved?

Manager contacted DCP Advocate and briefed Case Managers Case Managers discussed role of Advocate with team making with young person

present DCP Advocate invited to WA Staff Meeting All Safe Places houses and offices have information (including contact details) of

Advocate.

For further information: Shaun Mays, Safe Places Operations Manager - Western Australia M: 0437 442 254 P: 1300 993 483 @: [email protected]

mailto:[email protected]


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Session 6: From the eyes of a young person - experience in

residential care

Presented by Katherine Browne, State Coordinator

The presenter discussed information from a Young Consultant with Create Foundation about their experience living in two different group homes during their period in the care of the CEO and comments from a Youth Advisory Group (May 2013). Of all the supporting standards, the most pertinent supporting standards to their experience in care were:

Supporting Standard 3.9 Services provide a safe environment for children and young people which include emotional, psychological, physical and environmental safety, and takes into consideration their age and any specific needs of the child. The young person’s positive feelings of safety were enhanced by:

The presence of carers and staff who were rostered on all the time and regularly checked in to see how the resident was feeling and if they needed anything, including during the night.

The close proximity of bedrooms to each other and the staff office. The approachability of carers and staff so could talk with them. The residents being collected from school.

The young person’s concerns regarding safety were that:

Placement of older boys with younger where the older used to be mean and pick on the younger boys.

In dorm style accommodation, staff were not present overnight in the room as procedure directed.

Feeling scared of staff and carers due to the manner in which the staff sometimes reacted to behaviour of residents.

These feelings of not being safe intensified the young person’s depression and consequently their schooling. Lessons for service providers:

understand the child or young person and act in a way that they will understand welcome young people and help them to feel at home make them feel like there is nothing to be afraid or scared of.

Other young people discussed that their feelings of safety were linked to the stability of having their own room and having privacy, without disturbances.

Supporting Standard 3.11 Services protect the child and/or young person from harm and use methods of behaviour management that do not involve physical or emotional punishment.

Behaviour support techniques used were:


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Two warnings first and then sent to bed on the third warning. This was a clear way of understanding what the consequences were of doing the wrong thing. If this was repeated, access to the TV in the resident’s bedroom would be lost for the weekend. It taught that if you really want things, then you don’t misbehave. TV was like a reward that you earned by being well behaved and doing your chores.

Early bedtimes or bed straight after dinner for swearing. This worked for the resident however if the staff approached you in an angry and threatening way, it was scary and may influence the resident’s subsequent behaviour.

Lessons for service providers:

Understand what the young person is feeling and give them a lot of care, especially during transitions between placements. At this time the young person will be quite angry or upset and rebellious.

If a young person is acting in an irresponsible manner, the carer should pull them up, give them a warning but not overreact and do it in a nice manner. Talk to them in a manner that they will understand. If one young person is starting a fight, take them outside, have a chat and then play basketball or something.

Don’t act in a way that is rude, scary or threatening.

Feedback from another young person focused on the importance of consistency of behavioural management. The example cited relates to Care Plan directive that the young person should be allowed to go for a walk if upset but at one placement, staff would call the police and report absconding. This differs in the current placement, where staff consider the person’s “issues” more, give space and the young person isn’t “told off”.

Supporting Standard 6.10 When placement changes occur, continuity of education and community activities are given a high priority. Schools are kept informed of matters of significant impact in the child’s or young person’s life. Schools can expect to contribute to the planning process and are expected to keep matters confidential. The young person’s positive feelings during transition were influenced by:

Participating in decision making – the young person felt that they had some input into school selection, a meeting and put all your thoughts on the table and they would be taken into consideration.

Continuity of community football was possible due to the former placement transporting the young person which enabled the season to be finished. It increased the young person’s sense of satisfaction and achievement of something good during this transition time.

Being able to continue the young person’s interests to avoid them from feeling that something was half done.

The young person’s concerns regarding transition were that:

Their perception was that there was no planning or preparation.

Upon placement changes, existing activities and schooling couldn’t be continued due to the physical distance between placements.

For further information please contact Katherine Browne on (08) 6399 0252


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Session 7: Dealing with Critical Incidents and Safety and Wellbeing Concerns in Care

Presented by Aileen Johnston, Manager Duty of Care Unit

The Department has an expectation that all critical incidents, standard of care concerns and The Department and non-government placement providers have agreed on protocols for responding to concerns about children in the care of the Chief Executive Officer (CEO). The protocols require that all allegations of harm to a child are reported to the child’s Departmental case manager, immediately upon the agency becoming aware of the concern. The protocols are currently being revised to reflect the Department’s change of practice in relation to responding to concerns about the standard of care. All critical incidents, standard of care concerns or allegations of harm to a child in the care of the CEO must be reported to the Department immediately. Agencies may have their own internal reporting requirements and procedures about reporting incidents which their employees should adhere to. These must provide adequate time to enable the agency’s compliance with the Department’s reporting timeframes in relation to critical incidents, standard of care concerns and allegations of harm. The Department will determine and advise the reporter whether the information will be responded to as a critical incident, standard of care concern or safety and wellbeing concern in care. A critical incident is defined as “any incident that is likely to result in a child experiencing loss, harm or injury and that may result in a potential legal claim for a child”. The Department has an obligation to protect all potential, viable legal claims for children in care. Examples include serious accidental injury, dog bites, victim of crime, death of a family member or significant person and car accidents. Some claims that have been pursued by the Department include injury from a brick wall falling on child while at school, electrocution during a cooking class, inheritance arising from the death of a family member and criminal injuries compensation claims. Standard of care concerns are acts or situations that indicate that a carer has failed to meet the carer competencies, but harm or risk of harm has not occurred. Examples include inappropriate physical discipline, substance use by the carer, unsafe or unhygienic home, verbal abuse or intimidating, degrading language, undermining family and cultural connections or restraint. Only a small number of Department workers who are authorised can restrain a child; carers and non-government workers are not approved to restrain a child under the legislation. A Safety and Wellbeing Concern in Care (formerly referred to as an Allegation of Abuse in Care) is defined as any disclosure or allegation that indicates a child has experienced physical, emotional, psychological, sexual harm or serious neglect. This is regardless of who is alleged to have caused the harm or who has advised the Department of the alleged harm. Therefore, the person who has allegedly caused the harm may be a parent, approved carer, Department or


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agency worker, another child in placement; or another young person or adult in the child’s life such as a boyfriend or school teacher. Reporting: All incidents and concerns need to be reported immediately, in practice, within a few hours in order that the Department can, depending on the nature of the incident or concern, ensure the child is safe; a thorough assessment or investigation is initiated; appropriate supports are offered to the child, carer and others; all parties are protected from further allegations and potential, viable legal claims for the child are protected. If in doubt, report. Incidents and concerns that arise during business hours should be reported to the case worker, their team leader or the district director. After hours reports should be made to the Crisis Care Unit. Written reports, following the verbal report, should be submitted to the case worker within 24 hours of becoming aware of the incident. What next: The process for responding to concerns varies depending on how the Department classifies the concerns. In relation to standard of care concerns the agency responsible for the carer is expected to complete a Carer Standard of Care Assessment. As part of the assessment the agency worker should discuss the concerns with the carer, listen to what they say, seek the views of the child’s case manager and relevant workers involved with the carer or the children. The aim of the assessment is for the agency and carer to develop a plan to address the concerns together so that the carer can continue in their role and improve their skill levels and the Department can be assured that children remain safe in the placement. . Ongoing unresolved standard of care concerns related to approved carers may be referred to the Duty of Care Unit for a carer investigation. The Department will investigate all Safety and wellbeing concerns: Where the safety and well being concern in care relates to an approved carer, a Carer Investigation will be undertaken by the Duty of Care Unit. Where the safety and wellbeing concern in care relates to an agency employee (who may be providing direct care), the District Office responsible for case management of the child will complete the investigation. Agency staff will be invited to participate in an initial planning meeting at the commencement of the investigation. If a child discloses harm it is important that you:

Remain calm and listen.

Accept what the child says.

Allow the child to express their feelings.

Don’t clarify words for the child, so as not to interfere with what they are saying.

Do not question the child for detail.

Reassure the child.

Tell the child you will pass the information on to their case worker.


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At the earliest opportunity write down the child’s disclosure, as accurately as possible. It is important to note that the child or the carer must not to be questioned in relation to the child’s disclosure, as

agency staff are not mandated under legislation to undertake investigations (only the police and specific Department officers are); and

questioning the child or carer may compromise any subsequent investigations undertaken by the Department and/or police.

For more information contact Aileen Johnston on 9222 2733.


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Excerpt from Foster Care Handbook for Foster Families, July 2010:


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