child & family health service

AnnualReport2017 - 2018

Secure babies Strong families Safe communities

Secure babiesStrong familiesSafe communities 53 Adelaide St Footscray Victoria 3011 Australia

Tel + 61 3 9689 1577 Fax + 61 3 9689 1922Web www.tweddle.org.au child & family health service

child & family health service

contents1 About Tweddle

2 Our Services and Highlights

3 Tweddle Board Members

4 Leadership Report

6 Assessment & Intake

7 Residential Service

8 Parenting Assessment and SkillsDevelopment Service (PASDS)

9 Day Stay Program

10 In Home Support Service

11 Childbirth Education

12 Community Programs - MyTime

13 Prison Program

14 Working Out Dads

15 Professional Development & Research

16 Corporate Report

17 Life Governors, Thank you to Donors, Friends & Partners

18 Our People

19 Quality

20 Declarations and Compliance

21 Organisational Chart

22 Governance and Accountability

Annual Report2017 - 2018

Annual Report2017 - 2018

1Babies and toddlerswithin their families

The first 1000 days of babies’ lives (from conception to the age of two) is vital to support

optimal positive shifts in a child’s life trajectory. This drives Tweddle

to work with families in this important period.

2Partnerships

Partnerships with familiesand organisations are key to

providing services in a seamless and connected manner.

3Development and

Trauma-informed careOur work is informed by an

understanding of child development and the impact of trauma on the

baby or toddler.

4Underpinned by evidence

Our program design and implementation will be

underpinned and validated by documented scientific evidence.

5Sustainability

We will explore new, efficient, cost-effective opportunities to

operate and grow, guided by the best available evidence in our field.

Our five pillars

The financial report and accompanying notes have been prepared in accordance with the model accounts as issued by Government and the Australian Accounting Standards. Please note that in 2017/2018, no Directors received payment.

Tweddle Child and Family Health Service is a statewide early intervention and prevention health service. Tweddle offers interventions to babies, toddlers and their families to promote the preservation, reunification and restoration of health and wellbeing where there is distress and disruption in the infant/parent relationship.

Tweddle has developed and evolved in response to community needs throughout its 98 year history. Tweddle focuses on good health which is fundamental to wellbeing and the foundation of resourceful families who are well connected to and within their communities.

The vulnerability of parents, children and families to distress occurs along a continuum. Tweddle understands that this vulnerability may:

occur at any time, for any family, depending on the balance of stressors applied and resources and supports available be increased when parents experience high levels of stressors at times when they have depleted resources and limited supports be reduced when parents are helped to build their resources and their supports in order to manage stressors and the impact on themselves and their children.

Maternal & Child Health

General Practice/Doctors

Family Violence, ChildFirst/Child Protection/Integrated Family Services, Disability, Housing, Drug & Alcohol

Referrals to Tweddle

64%

15%

21%

OurVisionSecure babies Strong families Safe communities

TweddleValues C Collaboration A Accountability R Respect E Engagement

OurPurpose

AboutTweddle

3,613 mums,dads, babies & children

attending a Residential, In Home, HoPES, PASDS or Day Stay program

New Strategic Plan

Peer Support Worker Pilot

Leadwest Canberra delegation endorses Centre of Parenting Excellence

World Association of Infant Mental Health - Working Out Dads Poster Presentation

New Parenting Workshops in Brimbank

Daughters of The West Partnership

Stronger Communities Gellibrand Grant – Education Centre upgrade

Collier Charitable Fund – Learning To Play – Trauma Informed Play Project

William Angliss Charitable Fund – New family playground upgrade

Fathers and Attachment Seminar

Volunteer panel – Hearing The Voice Of The Consumer

New Brimbank Breastfeeding Clinic

Marce Conference and OPEN Research Symposium presentations

HoPES Program continues in Geelong and Footscray

Bennelong Foundation & CFECFW partner for Working Out Dads, sponsors

New Mytime locations in Maidstone and Essendon

New Residential POD opens

Tweddle Car for staff and family transport

MeetingsAttended

Position Professional Affiliation

Tweddle Board members also attend subcommittee meetings as well as working groups on a needs basis. These include: Governance & Executive Remuneration Finance, Audit & Risk Property & Redevelopment Lobbying & Advocacy Clinical Governance

Assessment and Intake service

Residential Parenting program

Parenting Assessment and Skill Development Service for Child Protection clients

OurServices

As a government funded early parenting centre, Tweddle provides a range of services to families with babies and toddlers with a focus on

the first 1000 days (0-2years). Services are delivered in partnership with other organisations and directly in the community.

Highlightsof 2017 - 2018

Social support services and family therapy

Childbirth Education Program

Community based Day Stay Programs

In Home Support Service

Parenting support for families with additional needs

Prison Program

Lactation Support

HoPES Program

Tweddle Board Members

Dr Nicole MilburnDPsych, Bsc, PGDipPsych, CCAPS, MAPS

Ms Doris WhitmoreBBus(Acc), MBA, FCPA, GAICD

Ms Melanie TelfordBCom/BA, GDipAppFinInv

Dr Tam NguyenPhD, GradDipSono, BSc/BE(Bioeng), MBA, FRSPH, FAIM, MAICD

Ms Jordana HunterPhD candidate, BCom (Honours – Economics), LLB

Ms Carla De CampoBA

Dr Jane EdwardsPhD, MMus, BMusResigned March 2018

Assoc Prof Leanne Beagley PhD, PGDipFamTher, BAppScOT, MBusL, GAICD

Ms Rosalie FlynnBA, PGDipLib, PGDipOrgBeh, MBus

Ms Heather JohnsonBA, BA/BSocWk, MSocWk, MBAResigned September 2018

Dr Owen BradfieldMBBS(Hons), BMedSc(Hons), LLB, MBA, RACGP, ACLMResigned March 2018

Private Practice Clinical Psychologist and Infant Mental Health Consultant, Take Two,

Berry Street Victoria.

Executive positions in several NFP organisations combining program strategy, design and

implementation, governance and compliance.

Finance professional with experience in financial management, business partnering

and process improvement.

Research administrator with clinical research experience in biomedical engineering. Senior

executive at St Vincent’s Hospital Melbourne and Adjunct Associate Professor at RMIT University and an Honorary Senior Fellow at the University of Melbourne.

Fellow in the School Education Program at the Grattan Institute public policy think tank. Extensive public policy and economics expertise, currently completing a PhD in education system reform.

Experienced communications professional with extensive government, advocacy,

industrial and policy expertise.

Child and family mental health specialist. Educates students across a range of allied health

disciplines including the Master of Child Play Therapy at Deakin. Director of the Association for the

Wellbeing of Children in Healthcare and Associate Professor Mental Health at Deakin University.

CEO, Western Victoria Primary Health Network. Board Director at Eating Disorders Victoria (Vice President),

the Melbourne Anglican Diocesan Corporation and the Western Alliance Academic Health Science Centre, Chair Victorian PHN Alliance Adj Assoc, Prof Deakin University.

Health and community services sector consultant with expertise in workforce planning, organisation behaviour, HRM and HRD, Clinical Supervision Skills

Review Tool, and a capability framework for DHHS / NDIS transitioning.

Management Consultant with a focus on service reviews, strategic planning, business improvement and change management.

Specialist General Practitioner and Health and Medical Lawyer, Deputy Chairperson of the

Patient Review Panel and Chairperson of the Law Institute of Victoria Health Law Committee.

Board Chair

Chair: Clinical Governance

Treasurer Chair: Finance, Audit and Risk Committee

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In June 2018, Tweddle’s new residential ‘Family Strengthening Unit’ (FSU) opened its doors, providing the opportunity for us to offer education and support to two hundred additional families every year, although we are still a long way off our redevelopment goal.

A new Centre of Early Parenting Excellence would almost double our capacity to care for those most needing trauma informed, attachment focused services. This is a message we have continued to take to the streets, offices and boardrooms locally, nationally and internationally.

Every week across Melbourne’s north, east and south, hundreds of specialist residential mother/baby unit

and early parenting centre beds are available to exhausted parents and babies1.

In contrast, every week in Melbourne’s west, struggling families have 36 residential mother/baby unit and early parenting centre beds2, and most of these are for acute psychiatric care. This is in a region where 250 babies are born each week. Statistics confirm that every week, 50 of these babies will be born to a mum who develops postnatal depression and a further 25 will have a dad who develops postnatal depression.

1 Masada, North Park, The Queen Elizabeth Centre, Mercy O’Connell Family Centre, Mitcham Private, Cabrini, Waverley Private, Austin Health Heidelberg and Monash in Clayton (Mother baby units & Early Parenting Centres)2 Tweddle, 30 beds Werribee Mercy MBU 6 beds

Most people who have postnatal depression are not severely impaired enough to warrant a psychiatric admission but suffer significantly nonetheless.

These figures highlight the geographic disparity occurring for families living in Melbourne’s west. Tweddle’s role is not only in preventing the escalation of families to acute clinical settings but averting the need for families to travel long distances during times of fatigue and distress.

Without specialist interventions, a baby with a parent experiencing sub-acute mental health difficulties is at risk of reduced social, emotional, cognitive, educational and physical life outcomes. We know that more broadly, this contributes to deleterious economic and societal outcomes. Tweddle’s work straddles primary, secondary and tertiary healthcare services. Our highest referral source (64%) is from Maternal & Child Health Nurses who are unable to offer intensive long-stay residential support such as provided by Tweddle.

It is not enough for Tweddle to sit back and simply do what we do well. Despite our specialist expertise and 98 year heritage as a public hospital, we must continue to advocate for those whose voices can’t be heard. For Tweddle, we know that it is the voice of the infant.

It is for those infants and their parents that we continue to develop new programs, lobby for increased capacity, advocate for infant mental health and improve infrastructure. We will continue to do this work and with your help we can do more.

Leadership Report

The Board, management and staff would like to acknowledge the dedicated Department of Health and Human Services teams that support Tweddle’s work. We extend our gratitude to the Hon. Jenny Mikakos MP, Minister for Families and Children and Minister for Early Childhood Education. We would also like to thank the Hon. Jill Hennessy MP, Minister for Health and also the Hon. Martin Foley MP, Minister for Mental Health.

The Ministers and their staff allow Tweddle to provide critical support programs to over 3,000 mums, dads, babies and toddlers every year.

We are also grateful to a number of partners who help amplify our voice, “secure babies; strong families; safe communities.” They include Tim Watts MP, Bennelong Foundation, the William Angliss Charitable Fund, Collier Charitable Fund, LeadWest, the Centre for Excellence in Child & Family Welfare, Rotary Club of Footscray and the Department of Justice and Regulation. We are particularly grateful to the Friends of Tweddle who have designed and developed the welcoming atmosphere of the FSU and the north end of the residential unit.

We look forward to another productive year promoting the importance of infant mental health, secure attachment and the first 1000 days.

Ms Jacquie O’BrienChief Executive Officer

Dr Nicole Milburn Chairperson, Tweddle Board

“It is not only children that experience growing pains.”

04 05

The Assessment & Intake (A&I) team are the heartbeat of Tweddle. The staff are often the first contact for families who are struggling with a range of parenting challenges. The health professional referral is triaged by the A&I Coordinator/Duty Worker who then provides a holistic risk assessment to determine the most appropriate program.

Tweddle’s residential program has been operating for many decades in a decaying building which was originally built for student nurse accommodation in the 1950s. Over the last twelve months, volunteer group, The Friends of Tweddle, led by Ms Jo Norton, renovated the northern end providing beautiful, home-like bedrooms, relaxed sitting areas and a wonderful playground.

The new ‘Family Strengthening Unit’ is now open, with plans for the southern end to undergo renovations, courtesy of The Friends of Tweddle.

Tweddle introduced ‘Learning to Play’, a trauma informed play therapy and attachment building program offering group sessions, one on one sessions and staff capacity building with thanks to the Collier Charitable Fund.

The focus of Tweddle’s Residential program continues to be strengthening attachment, repairing parent/child relationships

Assessment & Intake

that have experienced trauma and helping build the confidence and capacity of vulnerable parents.

We introduced a new ‘meet and greet’ session on a Friday for families who may be anxious about attending the residential program. This popular initiative enables families to tour the facilities and meet some of our staff prior to their admission.

Tweddle programs are underpinned by the growing body of evidence relating to the adverse impact on vulnerable babies and toddlers who experience traumatic stress in the critical first 1000 days (conception to age 2).

Child and family vulnerability can result from a number of risk factors. These can include a combination of mental health challenges, family violence, social isolation (including the experience of new migrants), homelessness, exhaustion, disability and financial stress.

All families who are experiencing multiple risk factors are encouraged to attend Tweddle for a pre-admission interview so that they can meet the staff and view the facilities. Many clients speaking with their A &I clinician disclose stories of trauma and distress, although sometimes not until they are participating in their Tweddle program.

HoPESTweddle’s Home Parenting Education and SupportProgram (HoPES) changes family’s lives. The HoPES team are exceptionally caring professionals, dedicated to interrupting intergenerational trauma in its tracks. The eight-week intensive home visiting program supports family preservation and reunification for families with babies and children 0-5 years.

The focus is to preserve and strengthen the family unit using a strength-based approach and a family partnership model of care. Specialised staff rebuild attachments betweenbabies/children and their parents. A priority is to build sustainable family functioning, community connectedness and connecting families back to culture.

PROGRAMS

3 Intake & Assessment

Staff

Average minutes for a telephone assessment call

91.3% of families (4 or more risk

factors)

52% of families(5 risk factors)

70-80 intake family support calls per week

40 minutes

3 HoPESStaff

Intake call questions

80calls

1594completed assessments

32 risk factors assessed

Total funded Residential & in-home families

*reduced due to redevelopment555

2016 - 2017

476*2017 - 2018

The families are provided with strategies to support their children and protect them from potential re-exposure to trauma (e.g. abuse, neglect, family violence).

Following on from the initial pilot in 2017/18, Tweddle secured funding from the Department of Health and Human Services to provide the HoPES program in Barwon for 20 families and in Footscray for a further 8 families. Additional families have been supported through brokerage funding.

This is an exciting new and innovative program creating real change. We are currently evaluating progress and hope to maintain this service for families experiencing vulnerability and trauma.

2 Regions Geelong & Melbourne’s West

2 28 Families

Total HoPESclients

54

06 07

Residential Program

11 Families Supported

weekly1229 total funded in home and

residential parents, babies, toddlers

Tweddle provides a 10 day residential Parenting Assessment and Skill Development (PASDS) program for families referred by the Department of Health and Human Services (DHHS). This is a strengths based child focused and family centred program that prioritises families from diverse backgrounds.

The staff who work in the PASDS team have education and experience in the fields of early childhood, infant mental health, family therapy, midwifery, maternal and child health, mothercraft, paediatric and mental health nursing and psychology. This year we implemented our Peer Support Worker pilot, to ensure all clients have access to peer support.

With an emphasis on family preservation, reunification and attachment, an initial parenting competency assessment is undertaken over the first few days. This assessment enables parents and staff to identify strengths and potential areas for growth. In partnership with parents, a skills development plan is established and enacted. This assists parents in their quest to provide best practice parent/child interactions, strategies to support their child’s development, safety, feeding, nutrition, hygiene practices, routines, sleep and settling, and knowledge about how to care for an unwell child. Cradle to KinderTweddle delivers the Cradle to Kinder program in partnership with Melbourne City Mission, Kildonan Uniting Care, IPC Health Care and Early Childhood Management Services (ECMS) in the Brimbank Melton and North East Melbourne areas.

Cradle to Kinder is a whole-of-family service response commencing at pre-birth and provides intensive and long term key worker support, education, information and interventions for children until they reach the age of five years. This program is able to work alongside young pregnant mothers (under 25 years) where a report to Child Protection has been received and where there are identified vulnerabilities and significant

concerns about the wellbeing of the unborn child. Priority access is offered to young mothers who are or have been, in out-of-home care, identify as Aboriginal or Torres Strait Islander women and whom may have a learning difficulty.

“It was really good to speak to someone who had been on my journey.”

Tweddle’s Peer Support WorkerThis year Tweddle introduced a Peer Support Worker (PSW) pilot to offer peer support for Tweddle (PASDS) families. Planning included reviewing academic literature as well as using a co-design approach with the peer support worker Sav, who has a lived experience of both child and family health services. This approach helped to define the required qualifications, values, activities and expectations. Sav successfully applied for a Certificate IV in Mental Health Peer Work scholarship. Our Peer Support Worker works as an advocate for clients and provides timely and accessible information regarding consumer’s rights and responsibilities, helping clients to problem solve and navigate the various health and welfare systems.

The Peer Support Worker is able share his own experiences and contribute to the development of resources and services. This type of relationship provides the scaffolding for the Peer Support Worker to have one on one conversations with clients, build trust and empowerment and to help set goals.

The Peer Support Worker has worked with over 80% of the clients and two families have returned to Tweddle as visitors to meet with Sav and their 10 day PASDS team. The feedback from clients, their families and staff has been positive. Tweddle is proud to be supporting Sav’s study efforts which are already being rewarded.

Total number of Day Stay

families Geelong/

Whittlesea/ Maribyrnong/

Brimbank

Total number of Day Stay

families Collaborative

Terang/Bacchus Marsh

Tweddle has been operating day stay programs in the community for more than 20 years and currently provides programs in six municipalities:

Maribyrnong in FootscrayBarwon in GeelongBrimbank in Kings Park in partnership with Brimbank CouncilWhittlesea in Mill Park in partnership with City of WhittleseaMoorabool in Bacchus Marsh in partnership with Djerriwarrh Health ServicesCorangamite in Terang in partnership with Terang and Mortlake Health Service

The Maribyrnong and Terang Day Stay programs provide support for mums, dads and their children up to 3 years of age. Our Geelong, Kings Park, Whittlesea and Bacchus Marsh Day Stay programs support parents with babies up to 12 months.

Parents contact Tweddle for many reasons. These include lack of sleep due to an unsettled baby or wakeful toddler, difficulties adjusting to being a new parent, anxiety and depression.

During each program, staff work in partnership with families building on their strengths and offering practical strategies to increase confidence and positively enhance infant mental health and attachment relationships. Following the program, families are referred to the Maternal and Child Health Service, a specialist service or to a community program.

Feedback from participants is tremendously positive and 99.5% of families would recommend the program.

Day Stay

Parenting Assessment and Skills Development Service

PASDS

155 mums, dads, babies & toddlers admitted

“I found the whole day very

informative. I feel empowered leaving here now and hope

l can continue to practice what I’ve learned. Staff were so warm and l felt at ease from the

moment we came through the door.

Thanks.”

“Very relaxed process, I felt that

we were able to put forward our views and thoughts. I felt

what was being delivered was

not being forced upon us, a certain amount of flexibility

to how we do things was shown.”

Total Day Stay Families

Total Day Stay mums, dads, carers, babies,

toddlers

2,179

8952016 - 2017

8922017 - 2018

543

352

547

345

2016 - 2017

2016 - 2017

2017 - 2018

2017 - 2018

08 09

In Home Support and Fee Paying Service

Tweddle offers a Childbirth Education program in a relaxed, community setting in partnership with Western Health. The classes are conducted by enthusiastic, knowledgeable midwives with additional training in childbirth education who encourage and support active participation in pregnancy, birth and early parenting.

The program assists expectant parents to gain knowledge and preparedness to manage the birth and early parenting transition and provides participants the opportunity to meet other parents and share experiences.

Topics include:Informed choiceProgress of labourWhen to go to hospitalPractical coping measures to manage labourGetting to know your babyEarly parenting and transitioning to parenthood.

This year in partnership with Carrington Health Tweddle participated in a pilot of Baby Makes 3 which provides expectant parents with an opportunity to talk about the changes they are likely to experience in becoming a parent and what it means to them and their relationship.

Feedback from participants has been very positive.

Childbirth Education

“Very informative and gave the

necessary steps needed on the journey towards

and during parenthood. My

partner learnt more than he anticipated.”

“I really enjoyed the opportunity to talk with the other

mums-to-be. The staff member was very

friendly, approachable and extremely

knowledgeable. She made me feel a lot more comfortable

about going into labour and what the birth might be like.”

For many families, attending a residential or day stay program

presents barriers to accessing specialised parenting support. Whether

it be transport issues, childcare challenges or for cultural reasons, the

option of having a practitioner visit a family in their home is essential.

Tweddle provides government funded and fee paying In Home Support

programs, telephone support and a private Day Stay clinic. The fee paying service

is available for families who may not fulfil the criteria for a funded Tweddle program

or for families that prefer to be seen quickly.

In Home visits are provided by experienced and caring health professionals who offer

education, practical strategies and support around early parenting. The holistic

service provides flexible, timely one on one parenting support and an opportunity

for parents to learn new strategies in their own family’s environment.

Feedback from participants is tremendously positive and 100% of families

agreed they would recommend the service.

“The Tweddle Staff member was extremely helpful and patient. She took the time to answer our many questions and repeated answers if needed until we understood a

concept. She made us feel confident that we could achieve set goals with our baby. This is a fantastic program which I know will have a big impact on our family life.

Thank you.”

“Surprised about how holistic and in depth the program was on a personal level (in a good way!)”

720total childbirth education

expectant families

10 11

“Very positive

experience, reassuring that

we’re on the right track. The home

visits were really useful and helped us to see

situations in real context.”

MyTime groups across Melbourne’s West

MyTime groups provide facilitated peer support to families raising a child with a disability or chronic medical condition. It is governed nationally by the Parenting Research Centre. Children below school age may also attend groups with their parent or carer.

MyTime provides an opportunity for people who are living similar experiences to support each other. Peer support groups expose people to varied ways of reacting to and coping with their challenges, gives them a chance to share positive experiences, and leads to an increased sense of belonging and wellbeing.

Facilitators work with group members, helping them get to know each other and learn more about the services and supports in their area. Play helpers keep children, including under school aged siblings, busy and active in activities such as singing, drawing, playing with toys, blocks or sand so members can spend time catching up with one another.

This year MyTime staff helped members to become familiar with the National Disability Insurance Scheme (NDIS). We partnered with the Association For Children with A Disability (ACD) to deliver workshops that are designed to build parents’ confidence around the NDIS. Tweddle staff have also undertaken NDIS professional development.

Two MyTime groups relocated (Essendon and Maidstone) which meant a phase of rebuilding. We are delighted to be located at Maidstone within a community hub where the MyTime program complements many of the existing services.

MyTime has welcomed three new staff to the team. Their experience and skills have added to the positivity within the MyTime program. We would like to acknowledge Wyndham City Council and Hobsons Bay City Council for subsidies received to support MyTime.

Dame Phyllis Frost Centre - Parenting Program Tweddle has been providing parenting education programs to men and

women in the custodial system for more than 16 years. Tweddle’s Prison

program provides incarcerated mums with an opportunity to build on their

strengths, learn new strategies, maintain positive connections with their child

and increase their parenting confidence in a supportive environment.

The program is facilitated one day per fortnight and comprises group work

in the morning for mothers with children in and out of their care and prison

carers. The group program consists of four sessions, which includes practical

parenting advice, peer discussions and a forum for the women to share

parenting strategies and ideas. Individual parenting consultations are

provided in the afternoon.

Tweddle was also pleased this year to have the opportunity to work with

Corrections Victoria to draft a Framework, Assessment, Review Suite and

Practice Guide for the Mothers and Children Program.

Prison Program

MyTime

110Members who

regularly attend groups

6

Locations:Essendon, Maidstone, Wyndham Vale, Point Cook, Werribee Gold, Newport

“MyTime provides the type of support that you can

only get from people who have been there.”

“I learnt in my parenting group the importance of playing with your children and that it is not too late to repair and

change.”

“I know that I can fix my

relationships with my children and

that you never stop being a parent, whether you are

there or not.”

“I didn’t think it would be this easy to feel included,

MyTime has opened so many doors for me.”

12 13

“We celebrate things other parents would just never understand. It’s so nice

to appreciate these achievements.”

Tweddle Child & Family Health Service, in partnership with the Murdoch Children’s Research Institute (MCRI), launched the second round of Working Out Dads for Wyndham, Brimbank, Melton, Maribyrnong, Hobsons Bay and Moreland dads.

We are grateful to the program’s key funding partners, the Murdoch Children’s Research Institute,the Centre for Excellence in Child and Family Welfare through The Department of Health and Human Services and The Bennelong Foundation for making the crucial evaluation program possible. Thanks also to community sponsors Hede Architects, Alan Mance Motors, The CWA of Footscray, The Seddon Community Bank (Bendigo Bank) and local resident and dad Mr Craig Rowley for supporting the 100 Dads project.

Working Out Dads is a free after-hours therapeutic parenting program for dads of 0-4 year olds, held in fitness centres featuring facilitated discussion and exercise, handouts and text messages. Themes cover parenting, relationships, mental health, fitness and well-being.

The objective of Working Out Dads is to connect, support and strengthen the capacity of dads in the very early years of parenting. There is also a goal to become less isolated and more resilient and supported during the transition to early parenting and to promote healthy lifestyle choices.

The Working Out Dads MCRI evaluation aims to address a significant gap in knowledge about the effectiveness of early intervention and prevention approaches to promote the health and well-being of fathers in the early years of parenting. Research will help to inform policy and best practice in promoting the mental health of fathers and the prevention of family conflict. Our vision is that this program becomes a statewide early intervention program that supports relational development within the family and beyond.

Tweddle and Working Out Dads partners and sponsors recognise the crucial role dads play in the lives of their children, partners, families, workplaces and communities.

Tweddle is sharing their early childhood, infant mental health and parenting expertise, delivering professional seminars, workshops, courses and reflective practice groups. These have been attended by 288 professionals from Maternal & Child Health, Midwifery and Nursing, Allied Health, Early Childhood, Family and Community services as well as Tweddle staff.

This year 26 Maternal & Child Health and Allied Health students attended Tweddle programs for their course placements, providing the opportunity for Tweddle practitioners to share their clinical expertise.

Tweddle delivered nine parenting education sessions in partnership with Maribyrnong and Brimbank Maternal and Child Health Services which were attended by 122 parents. Four sessions were conducted in multi-cultural playgroups with bi-cultural community workers in attendance.

Tweddle is participating in a two-part research project with Royal Melbourne Hospital to identify staff knowledge and confidence in assessing families experiencing family violence with a practitioners and client component. Education will be delivered to practitioners based on the results and recommendations.

Tweddle launched a trauma informed play therapy program called ‘Learning To Play’ with thanks to the Collier Charitable Fund. An accredited trauma trained play therapist works intensively for 4 hours each week with babies, toddlers and their parents and to build the capacity of staff working with increasingly complex families in residential care.

The program is based on PlaySteps, a research validated play therapy program for families with children 0-3 years. Many of the families who participate in the sessions have experienced trauma which can impair the ability for parents to recognise and interpret their child’s cues and how to respond. The program involves filming parent/child play interactions which the parent and facilitator watch together, discussing the possible meanings for the parent and the baby/child.

The facilitator’s feedback is strengths based and an assessment tool is used which guides the feedback and areas for skill development. The facilitator then provides support, education and coaching to meet the unique needs of the parent and child. The focus is on helping parents and their children to feel safe and experience a positive playtime together.

When families begin to play together, perceptions of each other are changed, communication is accomplished in less direct ways, and individuals experience a decrease in resistance. During sessions, the Learning To Play facilitator conveys a deep respect for children’s ability to solve problems and make choices, restoring a sense of self-esteem.

Working Out Dads

Professional Development & Research

Learning To Play

60dads supported

locations

288health professionals trained

122 parents attended community workshops

26Maternal and Child

Health student placements

14 15

6

Finance, IT and InfrastructureIt has been a busy year with the redevelopment of our new family pod, the ‘Family Strengthening Unit’ which will provide support to an additional 200 families a year. A volunteer team led by Friends of Tweddle drove the refurbishment of the residential unit and the new family pod. New furnishings create a beautiful boutique hotel-like environment for residential families.

In addition to the residential unit, the Friends of Tweddle provided an upgrade to the administration building. The reception area and hallways received new flooring, paint, furnishings and lighting, creating a bright new welcoming ambiance for staff, families and visitors.

The donation of new audio visual equipment from the Morgan family has enabled the screening of educational videos in our lounge area.

We are grateful to the Maribyrnong City Council for their auspicing support and to the office of Mr Tim Watts MP, Member for Gellibrand and his staff who endorsed Tweddle’s Stronger Communities grant application. As a result, Tweddle was successful in securing funds to refurbish our Education Centre.

A William Angliss Charitable Fund grant helped us to purchase new outdoor play sets, replace 44 square metres of soft fall and provide the installation of a new inbuilt sandpit for toddlers. Tweddle received a Department of Health and Human Services Safety Capital Works grant which will help us to make significant safety upgrades to our Adelaide Street facilities.

Regular server upgrades and maintenance continue to ensure the integrity and security of data stored on

Corporate ReportTweddle’s Client Information Technology system TWEQ.

A new website was launched and continues to evolve as we incorporate consumer feedback.

The Finance, Audit & Risk Committee meets regularly to review the financial reports and to make recommendations to the Board. The Committee has provided invaluable guidance throughout the year.

The Finance and Corporate Services teams are focussed on increasing efficiency, reducing the administrative burden on clinicians and providing clear information for decision making.

Communications & CommunityTweddle is reliant on the kindness and vision of volunteers, donors and philanthropists and we are thankful to many for their support.

This year the Collier Charitable Fund supported ‘Learning To Play’. This new program sees an accredited trauma trained play therapist working with babies and toddlers and their parents as well as building the capacity of staff.

Tweddle’s Working Out Dads program was made possible with support from Centre for Excellence in Child & Family Welfare through DHHS funding, the Bennelong Foundation and community sponsors. Tweddle partnered with The City of Maribyrnong to deliver the Sleep Play Love parenting workshops.

Thank you to Ms Tania Morgan, Knit One Give One (KOGO), Inner West Mums and Bubs, Linen House, Lead West, Fay Stankovich and Brenda Cottee for many hours of in-kind work, advocacy and generosity.

14,240facebook: engaged users

25,415website pages viewed

VolunteersWe would like to acknowledge our tireless volunteer concierge Ms Carol MacDonald who proudly represented Tweddle at the Minister for Health Volunteer Awards. Thanks also to Ms Jo Norton and her team from “Friends of Tweddle,” for transforming Tweddle from a tired and clinical looking residential parenting unit to offering modern and beautiful looking living spaces and play areas for stressed parents and babies.

Fundraising, donations and grants over $500

Total $311,194William Angliss Charitable Fund Collier Charitable Fund Maribyrnong City Council Department of Justice and Regulation Stronger Communities (Gellibrand) Centre for Excellence in Child & Family WelfareRotary Club of Footscray Bennelong Foundation 6A FoundationMs Jacqueline Stephens DHHS Safety Capital Works The CWA of Footscray The Seddon Community Bank (Bendigo) Craig Rowley Hede Architects Alan Mance Holden Joel Burstyner B C HorsfallVirginia Kelly

Giving Tree and Give NowThanks to all donors to Tweddle’s Give Now platform. Our ‘Giving Tree’ displays a flush of gold engraved leaves acknowledging the kindness of parents and businesses in our community.

Life Governors

Mrs Margery Maskell

Mr Valentino Adami

Ms I Brennan

Mr Ian Broadway

Mrs Loris Charlton

Ms Julie Collette

Ms Prue Digby

Mrs Diana Gibson

Ms Louise Glansville

Mr Kenneth Hambly

Ms Betty Hassold

Dr Nigel Hocking

Mr Graham Jasper

Mr Rod Jones

Mrs Denise McGregor

Mrs Gwen Redman

Ms Hilary Russell

Ms Lesley Yates

AcknowledgementsSam Burrone Design

16 17

Quality has been front and centre of all Tweddle activities as we strive to deliver high quality safe care to our community. This has been particularly so over the past year where the organisation successfully participated in its periodic accreditation process.

Tweddle’s entity status means that the organisation is required to demonstrate how we have improved our services against two sets of standards during a four (Equip6) and three (DHHS) year period. Compliance against both standards was a rigorous, consumer focused program which measured the effectiveness of the organisation’s healthcare service delivery.

Our accreditation status sends a clear message to the community that Tweddle, its management and staff, are committed to excellence and have a strong continued focus on safe, effective, personal and connected care services.

Tweddle would like to acknowledge and commend the efforts of all involved, particularly the consumers for their contribution to the accreditation process.

There have also been a number of government reforms guiding our focus and priorities including the continued rollout of the Safer Care Victoria Strategic Plan and activities. Our Annual Quality Plan and Quality & Safety Committee Workplan is aligned to the 5 pillars of their plan.

Tweddle has commenced upgrades to its risk management system to facilitate an approach to the identification and analysis of incidents for effective monitoring and proactive responses to emerging trends. We actively seek to engage our consumers and staff to incorporate a wide range of views and are continuing to work toward a systematised approach to their involvement in all service planning and delivery. Tweddle is keen to build its consumer advisory group and welcomes interested community members.

Quality

The following professional development activties

were undertaken this year.

External TrainingEngaging Infants (RCH)

Infant Led Work and Recovery from Trauma

(Wendy Bunston)

Solihull Approach to Parenting (Helen Stevens)

Western Division Child Protection

Community Education

NWMRPCP Identifying and Responding to

Family Violence

Responding to Disclosures of Sexual Assault

Responding the Child Abuse

4 Key Drivers of Employee Engagement

VACCA Cultural Addendum

DHHS Standard 4 Cultural Sensitivity

WHW Family Violence Community Education

Community and Cultural Awareness (Wayla)

VACCA Trauma Informed Cultural Awareness

Professional Development

The Tweddle workforce as at 30th June 2018 was comprised of 40.86 permanent and part time staff on the payroll and a nursing bank of 21. The professional profile of staff is as follows ;

Staff Profile EFT EFT 2016-17 2017-18Registered nurses 10.29 12.18

Early Childhood Professionals 16.34 15.95

Psychologists N/A 0.47

Social Workers 1.85 1.6

Corporate Staff 11.54 9.96

Medical specialists N/A N/A

Community Services 0.7 0.7

Casual Staff 22 22

Mandatory and Internal TrainingFamily Partnership Model

Keys to Caregiving

Health Literacy (e-learning VPCP)

Open Disclosure

Fire & Emergency

Manual Handling Train the Trainer

Hand Hygiene Australia

CPR & Anaphylaxis (Premium Health)

Parenting in the Context of Family Violence (Webinar AIFS)

Responding to Disclosures of Child Abuse & Neglect (Webinar AIFS)

Piccolo Development Tool

ConferencesStatewide Maternal Child Health Conference 2018

OPEN (CFECFW) Symposium 2017

Parent Engagement Conference 2017

AAIMHI National Conference 2017

WAIMH 2018

Early Childhood Forum 2018

Our People

62 staff

Quality Highlights

Accreditation against both Equip6 and DHHS standards achieved

Quality Boards ‘How We Are Doing displayed across all sites

Commenced review of all staff Position Descriptions

Rollout of Staff Immunisation Program

Rollout of Consumer Participation Framework

Continued Bi-annual Workplace Culture Surveys

Continued involvement in AAPCH benchmarking activities

Implementation of Staff Reward and Recognition Program

“All staff went out of their way to support us. Our family is healthier

and stronger for coming”.

“It is clear a lot of effort goes into creating a positive experience

and environment that is friendly and homely”.

“To have this service available was a life saver for my family”.

18 19

Organisational ChartDeclarations and ComplianceIncorporationTweddle Child and Family Health Service is a Public Hospital as noted in the Health Services Act 1988 (Schedule 1).

Freedom of InformationThere were five requests for information under the Freedom of Information Act 1982. The requests were responded to within the statutory time period and no requests for review were received.

Quality AccreditationTweddle’s public hospital status means that the organisation is required to demonstrate how we have improved our services against two sets of Standards during a four (Equip6) and three (DHHS) year period.

Building Act 1993Tweddle fully complies with the building and maintenance provisions of the Building Act 1993.

Medical RecordsThe maintenance of medical records was undertaken in full compliance with the Department of Health and HumanServices reporting requirements and the provisions of the Privacy Act 1988 and the Health Information Act 2003.

The Protected Disclosure Act 2012There were no disclosures under the Protected Disclosures Act 2012.

National Competition PolicyTweddle complies with the Victorian Government guidelines when tendering out service contracts.

EnvironmentTweddle has an Environment Management Plan and a five-year Asset Management Plan which ensures that our objectives are met. These include:

reducing the amount of wasteencouraging the use of recycled resources, all paper used is 100% recycledgreen purchasing; we use green suppliers for gas and electricityseparating office waste into reusable, recyclable, compostand true waste partscommunicating environmental performance throughregular reportingencouraging staff to reduce environmental impactsensuring new capital works incorporate environmentalsustainability principles

Consultants A total of 4 consultants were engaged in 2017-2108 totalling $14,142.50. Contractors engaged for fees exceeding $10,000 NIL

Occupational ViolenceThere were 8 code grey incidents (threats against staff). There were 5 workplace injuries with no lost time and no Workcover claims.

Information and Communications Technology (ICT)The total spent on ICT Business as usual excluding GST was $64,226.26

Safe Patient Care Act 2015Tweddle has no matters to report in relation to its obligations under section 40 of the Safe Patient Care Act 2015.

Carers Recognition Act 2012Tweddle complies with its obligations under Section 11 of the Carers Recognition ACT 2012. Tweddle recognises carers for their efforts and dedication for the social and economic contribution to Tweddle and to the community.

Data IntegrityI, Mr Vince Di Stefano, certify that Tweddle Child & Family Health Service has put in place, appropriate internal controls and processes to ensure that reported data accurately reflects actual performance. Tweddle Child & Family Health Service has critically reviewed these controls and processes during the year.

Health Purchasing PoliciesI, Mr Vince Di Stefano, certify that Tweddle Child and Family Health Service has put in place, appropriate internal controls and processes to ensure that it has complied with all requirements set out in the HPV Health Purchasing Policies including mandatory HPV collective agreements as required by the Health Services Act 1988 (Vic) and has critically reviewed these controls and processes during the year.

Conflict of Interest I, Mr Vince Di Stefano, certify that Tweddle Child & Family Health Service has put in place, appropriate internal controls and processes to ensure that it has complied with the requirements of hospital circular 07/2017 Compliance reporting in health portfolio entities and has implemented a ‘Conflict of Interest’ policy consistent with the minimum accountabilities required by the VPSC. Declaration of private interest forms have been completed by all executive staff within Tweddle Child & Family Health Service and members of the board, and all declared conflicts have been addressed and are being managed. Conflict of interest is a standard agenda item for declaration and documenting at each Executive Board meeting.

Financial Management Compliance attestationI, Mr Vince Di Stefano, on behalf of the Responsible Body, certify that Tweddle Child & Family Health Service has complied with the applicable Standing Directions of the Minister for Finance under the Financial Management Act 1994 and Instructions.

Other InformationAdditional information in accordance with FR22 of the Financial Management Act 1994 has been prepared and is available on request. Information pertaining to declarations, pecuniary interests, travel, research, promotions, occupational health and safety, industrial relations, committees, consultancies and contractors is also available on request.

Director Finance and Corporate ServicesTweddle Child and Family Health Service

Other information Information required in accordance with FR22 of the Financial Management Act 1994 has been prepared and is available on request.

Financial results There were no major changes or factors which affected the achievements of Tweddle’s operational objectives in 2017-2018

2018 2017 2016 2015 2014 $ $ $ $ $Total Revenue $5,541,563 $4,977,200 $4,560,011 $4,349,884 $4,368,593 Total Expenses $ 5,437,440 $4,937,147 $5,053,154 $4,589,832 $4,393,430 Net Result for the Year $ 104,123 $ 40,053 ($ 493,143) ($ 239,948) ($ 24,837) (before capital & specific items)

Total Assets $12,615,530 $12,215,257 $11,141,883 $10,373,867 $10,584,018 Total Liabilities $ 1,287,903 $ 1,120,113 $ 896,733 $ 801,192 $ 874,774 Net Assets $11,327,627 $11,095,144 $10,245,150 $ 9,572,675 $ 9,709,244 Total Equity $ 11,327,627 $11,095,144 $10,245,150 $ 9,572,675 $ 9,709,244

PsychologistPeer Support

Worker

Early Parenting

PractitionersPlay

HelpersEarly

Parenting Practitioners

Early Parenting

PractitionersFacilitators

Early Parenting

PractitionersTeam

LeadersTeam

Leaders

Early Parenting

Practitioners

A&I Coordinator/Duty Worker

Team Leaders

Day Stay

Prison Program

Coordinator

Prison Program

MyTime Coordinator

MyTime

In Home Support Service

Coordinator

In Home Support Service

Key Workers

Cradle toKinder

Early Parenting

Practitioners

PASDS Care Coordinator

Manager High Risk

Manager Barwon HoPES

Residential Services

Nurse Unit Manager

Senior Clinical Practitioner

Senior Infant Mental Health

ClinicianManager Community Programs

Community ProgramsResidential Program

HoPES Program

High RiskPrograms

Director Finance and Corporate Services

General Manager People, Quality & Performance

General Manager Professional Education

& Research

Director Clinical Services/Nursing

Payroll Manager/Assistant

Accountant

Operations Coordinator

Clinical Administration Officer

Receptionist

Senior Administration Officer

Executive Assistant/Manager Corporate

Services

Chief Executive Officer

Board of Management

Health InformationManagement

Media & Communications

PASDSDomestic Team

20 21

The Committees meet prior to Board meetings with special meetings being held as needed. The Board undertakes evaluation of its performance at all meetings as well as a yearly assessment to ensure a focus on continuous improvement.

Tweddle, as a public hospital, is also required to comply with a range of legislation and health sector policy including government policies for financial and human resource management practice.

The Board reviews its policies and procedures each year. Key activities for the Board in 2017-18:

The delivery of a new strategic plan 2017-2021Redevelopment commencement of Tweddle’s Footscray site and Opening of the new Family Strengthening Unit

Tweddle’s Clinical team is managed by the Director Clinical Services/Nursing, Ms Kirsty Evans and the Corporate Services team is managed by the Director of Finance and Corporate Services, Mr Vince Di Stefano.

Tweddle is accountable to the people of Victoria through The Hon. Jenny Mikakos MLC, Minister for Families and Children. In addition, the Board is appointed by The Hon. Jill Hennessy MLC, Minister for Health.

We are grateful for the direction and funding provided by the Department of Health and Human Services (DHHS) which enable us to support over four thousand families every year. Organisational direction and strategy andmonitoring performance occurs by the Board and all members participate on at least one sub-committee, in order to monitor and provide strategic direction:

Governance and Remuneration Committee, chaired by the Board Chairperson Finance, Audit and Risk Committee, chaired by the Treasurer Clinical Performance Committee, chaired byDeputy Chair Projects Committee convened on an as needsbasis

Governance and Accountability

We certify that the Tweddle Child and Family Health Service Report of Operations 2017-18 has been

prepared in accordance with the Department of Health and Human Services Guidelines: Lodging

annual reports in parliament 2017-18 and the Financial Reporting Directions (FRDs) issued by the

Department of Treasury and Finance.

Dr Nicole Milburn Chairperson

Date: 14 September 2018

Ms Jacquie O’Brien Chief Executive Officer

Date: 14 September 2018

Mr Vince Di StefanoDirector Finance andCorporate Services

Date: 14 September 2018

Attestation

22

child & family health service

contents1 About Tweddle

2 Our Services and Highlights

3 Tweddle Board Members

4 Leadership Report

6 Assessment & Intake

7 Residential Service

8 Parenting Assessment and Skills Development Service (PASDS)

9 Day Stay Program 10 In Home Support Service

11 Childbirth Education

12 Community Programs - MyTime

13 Prison Program

14 Working Out Dads

15 Professional Development & Research

16 Corporate Report

17 Life Governors, Thank you to Donors, Friends & Partners

18 Our People

19 Quality

20 Declarations and Compliance

21 Organisational Chart

22 Governance and Accountability

Annual Report2017 - 2018

Annual Report2017 - 2018

1 Babies and toddlerswithin their families

The first 1000 days of babies’ lives (from conception to the age of two) is vital to support

optimal positive shifts in a child’s life trajectory. This drives Tweddle

to work with families in this important period.

2Partnerships

Partnerships with familiesand organisations are key to

providing services in a seamless and connected manner.

3Development and

Trauma-informed careOur work is informed by an

understanding of child development and the impact of trauma on the

baby or toddler.

4Underpinned by evidence

Our program design and implementation will be

underpinned and validated by documented scientific evidence.

5Sustainability

We will explore new, efficient, cost-effective opportunities to

operate and grow, guided by the best available evidence in our field.

Our five pillars

child & family health service

AnnualReport2017 - 2018

Secure babies Strong families Safe communities

Secure babiesStrong familiesSafe communities 53 Adelaide St Footscray Victoria 3011 Australia

Tel + 61 3 9689 1577 Fax + 61 3 9689 1922Web www.tweddle.org.au child & family health service