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Discussion Paper Series: A Future Program for Family Based Care Out of Home Care Foundations Project 1

Discussion Paper Series: A Future Program for Family Based CareOut of Home Care Foundations Project

Depar tment of Communi t ies Tasmania

Discussion Paper Series: A Future Program for Family Based Care Out of Home Care Foundations Project2

Contents

Part 1 - Context and Conceptual Framework 3

Part 2.1 - Program Design of Family Based Care 15

Part 2.2 - Recruitment and Registration of Carers 25

Part 2.3 - Pre-Service Training 29

Part 2.4 - Carer Assessment 33

Part 2.5 - Approval of Carers 39

Part 2.6 - Registration of Carers 41

Part 2.7 - Placement 45

Part 2.8 - Ongoing Training 49

Part 2.9 - Ongoing Support and Retention 55

Part 2.10 - Respite Care 63

Part 2.11 - Oversight and Monitoring 67

Part 3 - References, Glossary and Appendices 71

October 2018

The contribution of young people with an experience in out of home care, carers, child safety officers and Children and Youth Services, service providers and other non-government stakeholders is gratefully acknowledged.

The passion, dedication and commitment of those who work with and care for children and young people in out of home care is an inspiration.



Part 1 - Context and Conceptual Framework


Executive summaryOutcomes for children and young people in out of home care should be the same as for any child in the community and they have the right to the same expectations and hopes for their lives and future. The Tasmanian Government is responsible for working with non-government services and other key stakeholder groups to build and support a child safety system that produces positive outcomes for these children and young people, and their families and carers. This includes supporting the establishment of stable, caring and trusting relationships.

In Tasmania, family based carers support and care for the vast majority of children and young people in out of home care. Out of home care however is under considerable pressure. The number of children and young people coming into out of home care has continued to grow, coupled with an increase in the number of children and young people with complex needs and behaviours. While a growth in kinship care is reducing some of the pressure, a shortage of foster carers is placing additional strain on an already overburdened system.

The Strong Families, Safe Kids redesign of child safety services will reduce the number of children and young people entering out of home care. For those children and young people who are unable to live at home, it is imperative that family based care is strengthened and in particular, how we work with, train and support family based carers.

This paper considers a future approach to family based care, focusing on foster and kinship care, and identifies issues for discussion. It draws upon recurring themes within the research literature, commissioned reports and reviews and the collective wisdom of those working in the out of home care system across Tasmania.

Conceptual Framework for Family Based CareThe discussion paper proposes a conceptual framework for family based care comprising three components:

• the role of family based carers

• principles and purpose of family based care and

• elements of a future family based care program.

Role of family based carersThe role of family based carers is defined as providing the care needed for children and young people in out of home care to thrive and reach their potential.

Principles and Purpose of Family Based CareIf carers are to successfully fulfill this role, then it is essential they:

• understand their role in out of home care

• are valued and respected as a critical component in out of home care and participate as equal partners in the delivery of care and

• feel capable, confident and supported to provide the care needed for children and young people.

The purpose of a family based care program is to:

• recruit and retain sufficient numbers of carers to meet out of home care demand

• train and support carers to deliver the care needed by children and young people in out of home care

• enhance collaborative partnerships between those providing care for children and young people to drive decision making and delivery of care including involving children and young people in decisions that affect them, as appropriate

• develop integrated, consistent and transparent policies, procedures and practices which enable carers to fulfill their role and

• identify and implement ongoing improvements to family based care.


Figure 1: Elements of a Family Based Care Program

Summary of Points for DiscussionThe following summarises for discussion the core elements required in a contemporary family based care program.

Program Design of Family Based CareThe overarching approach to family based care should maximise stable, quality care for a child or young person in out of home care and include:

• an assessment phase that provides the time and space for an assessment of a child or young person’s developmental trauma and other needs, facilitates placement matching and achieves a planned move for the child or young person

• strengthened continuity of care for a child or young person in family based care and

• broadening family based care to encompasses intensive family based care for children and young people with complex behaviours and needs.

RecruitmentAn overarching recruitment strategy is required to improve recruitment processes and align recruitment activities between the Department of Communities Tasmania (the Department) and service providers.

Pre-Service TrainingA training framework is required to identify consistent base level training, induction and on-boarding processes for carers, including kinship carers.

Carer AssessmentA family based care program should include a review of assessment tools for family based carers, including specialist tools for Aboriginal and non-Aboriginal kinship carers and standardised requirements for assessors.

Approval of CarersConsistent processes are required for approving carers across the Department and service providers.

Elements of a Family Based Care ProgramThis discussion paper series considers the core elements that should make up the overarching program design of family based care. These core elements have been identified from research literature, current practice and stakeholder feedback.

PROGRAM DESIGN

Recruitment

Placement

Ongoing Training

Registration of Carers

Pre-service Training

Ongoing Support and

Retention

Respite Care

Approval of Carers

Carer Assessment

Oversight and Monitoring


Purpose This paper considers a future approach to family based care (focusing on foster and kinship care) and identifies issues for discussion.

Family based care may be defined as a placement which is in the home of a carer reimbursed for expenses for the care of the child (AIFS, 2017). Commonly referred to as home based care, there are four categories of family based care: relative or kinship care; foster care; third-party parental care arrangements; and other home based, out of home care (AIFS, 2017).

At its core, family based care brings a child or young person into an existing family or home environment. It recognises that experiencing a stable home and caring relationship is critical to a child or young person’s healthy development (Hek & Aiers, 2010 cited in Thomson, McArthur & Watt, 2016).

An effective family based care program is fundamental to the sustainability and capacity of the out of home care system to achieve positive outcomes for children and young people because:

• when carers do well, children and young people in their care do well (Thomson, et al, 2016)

• successfully retaining carers within the out of home care system assists recruitment of new carers through word of mouth (Richmond & McArthur, 2017) and

• family based care remains the most cost effective form of out of home care (Steering Committee for the Review of Government Service Provision, 2017).

The significance of the relationship between the carer and child or young person and the potential impact of carer wellbeing upon those in their care underscores the importance of a system which values and supports carers. Sufficient numbers of carers are needed so that children and young people may be placed with carers best suited and able to care for them (McGuiness & Arney, 2012 cited in Thomson et al, 2016).

This discussion paper proposes a range of issues for discussion with stakeholders to inform a future program for family based care.

Registration of CarersAn online carer register should be established that can be used by the Department and contracted non-government agencies to assist risk management and quality assurance.

PlacementA coordinated placement matching process is required, informed by needs of the child or young person and skills and capacity of the carer.

Ongoing TrainingA training framework is required to identify necessary ongoing training as well as training to assist the carer to meet a child or young person’s specific needs.

Ongoing SupportStrategies to support carers care for a child or young person while maintaining their own and their family’s wellbeing is required.

Respite CareImprovements are required to the use and availability of respite care so that it can better support family based carers while building a community of trusted people around the child or young person.

Oversight and MonitoringAn approach to oversight and monitoring is required which works with carers to review and support performance and provide the basis for a carer renewal process.


Invitation to CommentCommunities Tasmania is seeking your views on the points raised for discussion in this paper. You may respond to all sections or focus on those of interest to you or your organisation. Questions are provided at the end of each section as prompts however all comments are welcome. A full list of questions is provided in Appendix One.

Your written response may be sent to:

Email: [email protected]

Mail: Engagement and Innovation Division

Communities Tasmania

GPO Box 65 TAS 7001

The information you provide in response to the discussion paper will be considered in the development of a future program for family based care. If you would like your response in full or part to be treated as confidential, please clearly note this in your response.

Responses are required by 30 November 2018.

Consultation forums will also be held across Tasmania during November 2018. Please visit www.communities.tas.gov.au/children/oohc_project for information on consultation forums.

Any questions relating to upcoming forums may be sent to: [email protected]

Introduction and BackgroundFoster and kinship carers form the backbone of out of home care. Without their willingness to give their home, time, love and care, the future for children and young people unable to live with their parents would be even more tenuous.

Out of home care is also heavily dependent upon volunteer carers for its sustainability. As a consequence, how the Department and non-government agencies work with, recruit, train and support carers is critical if positive outcomes for children and young people are to be achieved while improving the sustainability of out of home care.

Scope of the Discussion Paper SeriesThis paper places the needs of children and young people at the centre. It recognises however, that unless carers are able to provide the care and support needed, positive outcomes are unlikely to be achieved for children or young people. The paper considers the place and value of family based care within the out of home care system and how family based care may be oriented to achieve the best outcomes for children and young people.

The discussion paper focuses on recurring themes within the research literature, commissioned reports and reviews. It also seeks to take account of feedback arising from preliminary consultation sessions conducted in 2017 with carers, young people with an experience in out of home care, Children and Youth Services (CYS), service providers and other non-government agencies.

The discussion paper considers the elements of family based care. How these functions are best delivered will be considered in the next stage, the drafting of a future program for family based care.

Carer payments are not considered in this paper. Informal care arrangements are also not considered although it is recognised that many kinship carers provide informal care outside the child safety system.

The discussion paper sits alongside existing policies in CYS, such as the placement hierarchy, which prioritises placement of children and young people with kinship carers, and wherever possible takes account of work underway on a permanency framework and an extension of care to age 21.

While family based care formally includes Guardians for whom there is a Transfer of Guardianship to a Third Party (Guardians), the paper does not consider the Transfer of Guardianship to a Third Party process or other processes which pertain to Guardians. However, it is noted where there are common issues such as in training and support. Residential care also sits beyond the scope of this paper and is only noted for its potential interaction with intensive family based care.


Challenges and Context for Out of Home CareOut of home care systems around Australia and internationally are experiencing a shortfall in the number of carers relative to the number of children and young people requiring care. This shortfall not only undermines placement matching processes, but increases the likelihood that children and young people are placed in other forms of care or in homes which may not best meet their individual needs or deliver the best outcomes.

The challenge of recruiting and retaining carers needs to be considered alongside greater numbers of children and young people requiring care and an increase in the numbers of children and young people with complex needs and behaviours (Conn, Szilagyi, Franke, Albertin, Blumkin & Szilagyi, 2013).

Kinship care remains the preferred option for placing a child or young person into out of home care because of the recognised benefits of ties to family, community and culture (Boetto, 2010). A shift towards kinship care is also being driven by a shortfall in the number of available foster carers (AIHW, 2016a; Boetto, 2010; Delfabbro et al, 2010, cited in AIHW, 2017). As a consequence, a significant and increasing proportion of children and young people entering out of home care in Australia are being placed into kinship care.

Research however indicates that levels of training and support are lower for kinship carers (Boetto, 2010). Kinship carers are also more likely to be older, single and female (Boetto, 2010) and experience higher levels of physical and mental health issues (Kiraly, 2015). Kinship carers may also be at higher risk of family violence and persist with providing care despite being under considerable strain (Baptcare, 2017).

The Situation in TasmaniaThe number of children and young people in out of home care continues to increase in Tasmania. Over the five years between 2012 and 2017, the number of children and young people in out of home care in Tasmania increased by 19.4 per cent, from 1 009 to 1 205. The rate at which children were placed into out of home care in Tasmania also increased, from 9.3 per 1 000 to 10.7 per 1 000 (AIHW, 2013; 2018). Over the same period, the number of children and young people in out of home care increased nationally by nearly 21 per cent from 39 621 to 47 915, at a rate of 8.7 per 1 000 (AIHW, 2013; 2018).

As shown in Table 1, the vast majority of children and young people in Tasmania live in family based care, with 93.5 per cent living in some form of family based care in 2016-17. Around 28 per cent of children and young people were living in kinship care, compared to a national average of 47.25 per cent (AIHW, 2018; ROGS, 2018). Of those placed with kinship carers, national data suggests over half (52 per cent) were placed with grandparents (AIHW, 2018).

Table 1: Children and Young People in Out of Home Care by Placement Type, Comparison 2012-2017 Tasmania and National Average

Type of placementTasmania

2012%

2012Tasmania

2017%

2017Australia

2017%

Kinship/relative care 306 30.3 338 28.0 22 639 47.25

Foster care 547 54.2 561 46.6 18 098 37.8

Other home-based care 82 8.1 228 18.9 3 932 8.2

Total home based care 935 92.6 1 127 93.5 44 669 93.25

Residential care 32 3.2 61 5.1 2 504 5.2

Independent living 8 0.8 5 0.4 167 0.35

Other (incl. unknown) 34 3.4 12 1 575 1.2

Total children 1009 100 1 205 100 47 915 100

Source : Australian Government Productivity Commission, Report on Government Services 2018, (Table 16A.18); AIHW (2013, 2018)


National data suggests most children and young people in out of home care are likely stay for two or more years. As at 30 June 2017, 68 per cent of these children and young people had been in care two or more years, and 41 per cent had been in care for 5 or more years (AIHW, 2018).

Tasmania has significantly lower rates of Aboriginal children and young people being placed in out of home care compared to national rates. Of those placed in care however, fewer Aboriginal children and young people are being placed into kinship care in accordance with the Aboriginal Child Placement Principle (AIHW, 2018). As at 30 June 2017 in Tasmania, 29.1 per 1 000 Indigenous children and young people were placed into out of home care, compared to national rate of 58.7 per 1 000 (AIHW, 2018). This rate remains significantly higher than for non-Indigenous children and young people at 8.5 per 1 000. In 2017, 41.3 per cent of Aboriginal children and young people in care were living in a kinship arrangement in Tasmania compared with the national average of 67.6 per cent (AIHW, 2018).

Foster and kinship carers both make a vital contribution to family based care although the nature of the contribution differs.

Data in Table 2 shows that approximately more than twice as many kinship carers commence and exit care each year compared to foster carers. This reflects some of the differences between foster and kinship care as kinship carers provide care for a child or young person with whom they have a significant connection and exit care if that child or young person leaves out of home care.

In contrast to national trends, foster carers tend to care for a higher proportion of children and young people than kinship care. In Tasmania, there are more foster carer households with a placement than kinship care in 2013, 2015, 2016 and 2017, as shown in Table 3. Foster carers also provide care for higher numbers of children and young people per household than kinship care. As at 30 June 2017, 55 per cent of foster carers cared for two or more children (AIHW, 2018). Over 48 per cent of foster carers cared for two to four children compared to 39 per cent of kinship carers while 6.8 per cent of foster carer households cared for five or more children (no kinship carer households cared for five or more children) (AIHW, 2018).

The number of foster carers exiting care has exceeded the number of those commencing care for the past four years.

Table 2: Number of Foster and Kinship Carers Commencing and Exiting Care 2012-17

Foster carers 2012 2013 2014 2015 2016 2017

Commencing care 88 64 58 58 55 59

Exiting care 59 49 71 107 56 68

Net shift 29 15 -13 -49 -1 -9

Kinship carers

Commencing care 139 149 135 121 111 99

Exiting care 69 98 142 179 194 96

Source AIHW (2013; 2014; 2015; 2016; 2017; 2018)


Table 3: Number Foster and Kinship Care Households with a Placement 30 June 2012-30 June 2017

Household Type30 June

201230 June

201330 June 2014

30 June 2015

30 June 2016

30 June 2017

Foster Care Households with a placement

194 210 196 214 233 249

Kinship Care Households with a placement

211 197 202 195 219 215

Total number of carer households with a placement

405 407 398 409 452 464

Source AIHW (2013; 2014; 2015; 2016; 2017; 2018)

In summary, data relating to Tasmania indicates that for children and young people in out of home care:

• the number of children and young people in out of home care continues to increase

• the vast majority of children and young people are able to live in family based care

• most children and young people will live in out of home care for two or more years (national data)

• Tasmania has lower rates of Aboriginal children and young people in out of home care compared to other jurisdictions, but the rate continues to be higher than for non-Indigenous children and young people and a lower proportion of Aboriginal children and young people are placed into kinship care

• kinship carers will enter and exit the out of home care system because of the nature of kinship care; foster care continues to care for higher numbers of children per household and cares for just over half of all households with a placement and

• more foster carers have exited care over the last four years than commenced care.


Ongoing Reforms in Out of Home Care in TasmaniaThis discussion paper series sits within a much broader reform agenda currently underway in Tasmania. The redesign of Child Safety Services known as Strong Families, Safe Kids seeks to build an integrated system able to ensure the wellbeing and safety of children and their families in Tasmania. Providing better support for at risk children and families through targeted, early and intensive intervention services offers the opportunity to reduce the number of children and young people entering the statutory child safety system. Such an outcome offers significant benefits to children, young people and their families. It will also benefit out of home care by reducing pressure on a system under considerable strain.

The discussion paper series also marks a continuation of the Out of Home Care Reform in Tasmania (the Blueprint) process which commenced in 2014. Phase 1 of the reform focused on the development of a continuum of care and delivery of a new range of services for siblings, residential care and therapeutic care, and special care packages for children with extraordinary needs. Phase 2 sought to reform the foster care system, with an initial focus on the recruitment, support, training, approval, registration and deregistration of carers. This work is now being undertaken as part the Out of Home Care Foundations project.

The Out of Home Care Foundations project is undertaking three key pieces of work, and was initiated in response to the Commissioner for Children and Young People Tasmania’s 2017 report Children and Young People in Out of Home Care in Tasmania and the CYS Strategic Plan for Out of Home Care 2017-19.

The first piece of work, the Outcomes Framework for Children and Young People in Out of Home Care (outcomes framework) (Department of Communities Tasmania, 2018a) sets out clear expectations of what successful out of home care looks like and will drive future development of policies, procedures and practices. The outcomes framework aligns with Tasmanian Child and Youth Wellbeing Framework (DHHS, 2018) which conceptualises wellbeing across the six domains of Australian Research Alliance for Children and Youth’s (ARACY) The Nest and the Tasmanian Child and Youth Wellbeing Outcomes Framework (draft) (Department of Communities, unpublished) which establishes population level wellbeing outcomes for all children and young people.

This discussion paper series considers family based care within the context of the outcomes framework and specifically how family based care may deliver the therapeutic relationships and loving, caring and stable homes needed for children and young people in out of home care to heal from trauma and thrive in the future.


A Conceptual Framework for Family Based CareThe discussion paper series proposes a conceptual framework for family based care comprising three components:

• the role of family based carers

• principles and purpose of family based care and

• elements of a future family based care program.

The Role of Family Based Carers CYS sets out its vision for out of home care as one where:

“All children and young people are raised in a safe, supportive and nurturing environment with every opportunity to reach their full potential” (CYS, 2017).

Family based carers are critical to achieving this vision. Most notably, it is through family based care that the majority of children and young people may receive the care and support they need to thrive and reach their potential. Mapping the contribution of family based carers across the outcomes framework provides insight to the breadth and significance of family based care in achieving positive outcomes for children and young people in out of home care. Appendix Two sets out the outcomes within each of the six wellbeing domains and identifies success factors relevant to and impacted by family based care.

Principles and Purpose of Family Based Care If carers are to successfully provide the care and support children and young people need to thrive and reach their potential, then it is essential carers:

• understand their role in out of home care

• are valued and respected as a critical component in out of home care and participate as equal partners in the delivery of care and

• feel capable, confident and supported to provide the care needed for children and young people.

The purpose of a family based care program may be defined as being to:

• recruit and retain sufficient numbers of carers to meet the demands of out of home care

• train and support carers to deliver the care needed by children and young people in out of home care

• enhance collaborative partnerships between those providing care for children and young people to drive decision making and delivery of care, including involving children and young people in decisions that affect them, as appropriate

• develop integrated, consistent and transparent policies, procedures and practices which enable carers to fulfill their role and

• identify and implement ongoing improvements to family based care.

The role of carers is defined as to provide the care and support children and young people in out of home care need to thrive and reach their potential.


Figure 1: Elements of a Family Based Care Program

In this series of papers, each element is considered separately, noting key messages from the literature, the current situation in Tasmania, feedback from stakeholders and points for discussion. Some sections identify questions to prompt feedback.

Each element is available to download separately, allowing readers to focus on those parts of the Family Based Care Program that are of most interest to them. The entire series can be downloaded as a single document if preferred.

Questions

1. Does the conceptual framework presented in this paper support a contemporary and effective family based care program in Tasmania?

2. What are additional factors or considerations that need to be taken into account?

ConclusionFamily based carers are critical to the sustainability of the out of home care system and to its capacity to achieve positive outcomes for children and young people. For the majority of children and young people in out of home care, family based carers provide the opportunity to live in a family or home environment and form the caring relationships to heal from trauma and thrive in the future. Furthermore, many of the outcomes that we seek for children and young people

contained in the outcomes framework, including children and young people being able to live in caring, loving and stable homes, feel safe where they live, receive the help they need to be physically healthy and mentally well, do well at school and learn the skills for life, will to a large extent be determined by the care and support they receive from their carer.

How we work with, train and support carers then becomes critical not just for the children and young people in out of home care for whom we are responsible, but to the out of home care system itself. This discussion paper canvasses a range of points for discussion which relates to the design of family based care and its place in the out of home care system, the training and support which critically impacts upon carer retention, and administrative processes such as recruitment, assessment, approval, registration and oversight.

The discussion paper invites you to comment on the points raised in the discussion paper. The information provided will be used to inform the development of a future program for family based care.

PROGRAM DESIGN

Recruitment

Placement

Ongoing Training

Registration of Carers

Pre-service Training

Ongoing Support and

Retention

Respite Care

Approval of Carers

Carer Assessment

Oversight and Monitoring

Elements of a Family Based Care ProgramThis discussion paper series considers the core elements that should make up the overarching program design of family based care. These core elements have been identified from research literature, current practice and stakeholder feedback.




Elements of a Family Based Care Program

Part 2.1 - Program Design of Family Based Care


The role of family based care within the broader out of home care system impacts on how we work with, recruit, train and support carers. A number of key themes within the research literature, reviews and reports inform the discussion points for a future approach to family based care:

• carer retention and collaborative partnerships centred on the child

• placement stability and continuity of care

• placement matching

• understanding the needs of children and young people and

• professionalisation of care.

More detailed information on these themes may be found at Appendix Three.

Key Messages from the Literature

Carer Retention and Collaborative Partnerships Centred on the ChildResearch suggests that an approach to successful retaining carers reflects the principles of partnership, respect and working with carers in a way which ensures they have the information and tools to meet the needs of the children and young people in their care. This includes:

• the quality of the relationship between the care team and the carer, level of carer involvement in the care team, and match between the child or young person’s needs and a carer’s capacities (Richmond & McArthur, 2017)

• carer access to information about the needs of children and young people, prior to and during care for the child (Octoman & McLean, 2014, cited in Child and Family Practice (CFP), 2015) and

• the provision of adequate financial support; honest and open communication, where carers are treated as respected members of the care team; and access to training and support which is timely, tailored and appropriate in times of crisis (Thomson, et al, 2016; KPMG, 2017).

Placement Stability and the Continuity of CarePlacement stability is a recurring theme in the literature for its importance in achieving positive outcomes for children and young people. It includes:

• a stable home and caring relationship between the carer and the child or young person is critical to the child or young person’s healthy development (Hek & Aiers, 2010 cited in Thomson et al, 2016)

• whether or not a child or young person experiences “…a sense of being loved or belonging” will critically influence the success of an out of home care placement (Boetto, 2010, p. 61)

• continuity and stability in care are likely to be “…the most important factor influencing outcomes” (Cashmore and Paxman, 1996, p. 2, cited in Bath, 2015, p. 312) and


• children and young people living in stable homes are more likely to be able to maintain relationships and stay connected with their community and education (Beauchamp, 2014, cited in CFCA, 2017).

Placement Matching While there is limited research into placement matching and placement decision making processes (CFP, 2015), common research findings include:

• placement matching needs to be holistic in nature and consider a range of factors related to the child or young person and carer (Department of Child Safety, Youth & Women, nd; CFP, 2015)

• the quality of the match between the child or young person’s needs and a carer’s capacities is important for carer retention (Richmond & McArthur, 2017)

• providing full and accurate information to carers on behaviours of the child or young person prior to fostering is linked to “…enhanced placement stability and improved outcomes for children and young people” (Octoman & McLean, 2014 cited in CFP, 2015, p.17)

• limited placement matching contributes to greater placement instability and poorer outcomes for children and young people. Placements are at a higher risk of break down when they are made quickly, in the absence of adequate consultation with children or young people and the carer (Osborn & Delfabbro, 2006; Farmer et al, 2004; Triseliotis et al, 2000; Farmer & Pollock, 1999 cited in CFP, 2015) and

• children and young people who experience behaviour-related placement breakdowns are less likely to achieve placement stability into the future (Kelly & Salmon, 2015 cited in CFP, 2015).

“Children who have two or more behaviour-related placement disruptions have only a 5 per cent chance of achieving placement stability 2 years later” (Kelly & Salmon, 2014, cited in CFP, 2015, p. 3).

Understanding the Needs of the Child or Young PersonUnderstanding the trauma experience and the needs of a child or young person entering care can inform the placement matching process (CFP, 2015; Bath, 2015). An American study found that unmet child behavioural need in the foster care placement formed the most significant reason for placement breakdown as reported by foster carers and case workers (Harnett, Falconnier, Leathers and Testa, 1999). As a result they recommended “…the creation of a structured system of individualised needs-assessment, service planning, and routine evaluation for all children with behavioural needs, regardless of placement type” (Harnett, 1999, p. 3).

For many children and young people in out of home care, a mutually reinforcing relationship exists between mental health problems and placement instability where “…placement instability may cause as well as exacerbate mental health problems and mental health problems significantly contribute to placement instability” (CPF, 2015, p. 2). This reinforces the importance of a timely assessment and understanding of a child or young person’s needs so that supports may be identified and put into place as soon as possible.

Professionalisation of CareThe professionalisation of foster care, which reflects the rising expectations on carers to provide higher standards and quality of care, is another strong theme within the literature and reflects a number of factors including:

• the shift away from institutionalisation of children and young people through the 1980s and 1990s (Delfabbro & Osborn, 2005) coupled with a desire to ‘normalise’ the care of children in the ‘least restrictive’ care environment (Bath, 2015)

• the growing body of knowledge around the neurobiological impacts of trauma upon child development (Conn, et al, 2013) and

• the increasing complexity of behaviours of children and young people coming into out of home care (Thomson et al, 2016).


These factors have contributed to the emergence of therapeutically informed models of practice in residential care and intensive family based care and at the same time, underlie an extension of trauma-informed approaches to foster and kinship care more generally (Thomson et al, 2016).

Some jurisdictions are incorporating specialist forms of care to deliver therapeutic care for a child or young person, particularly when they have been assessed as having complex behaviours and needs. Intensive family based care models, most of which tend to focus upon foster care, tend to feature specialised recruitment, training and support for carers and higher rates of carer payment (FACS, 2016).

The concepts of specialisation and stability of care are not by necessity a dichotomy and specialised care may be essential to support therapeutic care and placement stability for a child or young person. There may however be an inherent tension whether a child or young person’s needs are best served by maintaining stable care relationships or by specialisation, where children may be moved between care types, according to the carer best suited to their needs.

The Current Approach to Family Based Care in TasmaniaWhen a child or young person is removed under order by the Magistrates Court, the Department’s out of home care team will seek a placement for a child or young person. In an emergency placement, the lack of available carers and urgent timeframes may mean they are placed with a carer on an emergency basis or with whoever is available rather than a carer best able to meet the child or young person’s needs. At times little is known about the child or young person entering care and it may take a number of weeks for a child or young person’s behaviours and needs to be identified. It may also take time to fully identify a child or young person’s extended family members including who is best suited to care for the child or young person.

In other circumstances, information on the child or young person may be brought together using a needs assessment process which identifies information from a range of sources such as police, schools, family members and paediatric health assessments. These assessments are used to help determine supports for the child or young person and whether a child or young person requires care under a special care package.

The shortage of carers, compressed timeframes and limited availability of support services means that the current system in Tasmania has limited capacity to:

• assess the developmental trauma and other needs of the child or young person entering care to inform placement matching processes

• deliver the most appropriate type and level of care for the child or young person based upon their needs and behaviours

• coordinate a placement matching process between the Department and service providers to identify carers best able to meet the needs of the child or young person, including for kinship care and

• accommodate the wishes of children and young people to meet their carer and carer’s family prior to moving in with them and complete a planned transition to their home.

The current approach to family based care in Tasmania seeks to maintain continuity of care, where carers supporting a child or young person during a reunification phase will continue to care for the child or


young person if they are unable to return home. This approach also encompasses specialised care such as sibling group carers or short term special care packages which can provide intensive support for children and young people.

Current approaches also seek to accommodate particular skills, capacities and desires of carers if, for example, they are only available to care for children or young people on weekends as respite carers. The shortage of available carers means that at times carers who agree to care for a child or young person on an emergency basis or in respite care sometimes end up caring for them for much longer.

Stakeholder Feedback There was consensus from consultations conducted through 2017 and 2018 that:

• an approach to family based care needs to provide and maintain as much stability in a child or young person’s home and relationships as possible

• an approach which seeks to separate care according to whether it is temporary or permanent care potentially embeds further disruption to a child or young person’s home. Such an approach was not felt to meet a child or young person’s needs for placement stability. It was noted that in Tasmania a child or young person may live with the carer for up to three years before a decision is made on whether they will return home and

• therapeutic needs of children and young people are not always identified early enough when they enter care and this delay may jeopardise placement stability.

Other key themes included:

• children and young people feel that matching a child or young person with a carer and their family is critical, and that they should have an opportunity to meet carers before living with them, a view supported by other stakeholders

• there is a need to adopt a recognised therapeutic framework for family based care

• many carers feel more work is required to find kinship carers, and it is best where possible to place children and young people with their extended family members. They also feel there is a need to

work more with families of origin although some carers note this may be difficult at times, including for kinship carers and

• some carers feel that emergency care needs more attention, and emergency carers need to have everything ready to go (such as bedding) with the expectation that they may receive a child or young person at any time.

Points for DiscussionBased on the learnings from literature and the current constraints within family based care, a number of concepts are proposed for discussion:

• an assessment phase to provide time and space for an assessment of a child or young person’s needs, placement matching, and a planned move for child or young person

• strengthening continuity of care for a child or young person in family based care and

• broadening family based care to incorporate intensive family based care for children and young people with complex behaviours and needs.

Care during an Assessment Phase It is important to consider whether an ‘assessment phase’, or a period in which time is taken to assess the needs of the child or young person, may help ensure an appropriate placement which provides the stability and support required for the child or young person.

An assessment phase would aim to:

• assess the child or young person’s behaviours, support needs and care type, and the skills and abilities required of the carer. This could include assessment of a child or young person’s trauma experience

• facilitate a coordinated placement matching process between the Department and service providers in order to find a good fit for the child or young person with a carer. This may include working with the biological family to more fully identify a child or young person’s extended family, and identify who may be best able to care for the child or young person


• share information between the case manager and out of home care worker, carer, biological parent(s) or extended family members and other members of the care team as appropriate for the purposes of care planning and

• allow a planned transition to family based care, residential care or back to the biological family as appropriate for a child or young person. In the case of a child or young person moving to family based care or residential care, it could include the opportunity for a child or young person to prepare information about themselves to share with the carer, receive information about the carer and meet the carer(s) prior to living with them.

Such an approach would seek to improve placement stability and reduce unplanned placement changes for a child or young person. It recognises however that sometimes placements will end and that this is not the ‘fault’ of any one individual but reflects the complexity of out of home care.

There are a number of ways in which the assessment phase could be delivered including:

• retaining the child or young person within the family home while the Department engages with the family. Under the Strong Families, Safe Kids redesign there is potential for earlier engagement and intensive work to be undertaken with a family to improve the wellbeing of the child and family and reduce risk. Assessment of a child or young person’s needs, placement coordination, information sharing and transition could be undertaken in partnership with the biological family and carer before the child or young person enters out of home care

• placing the child or young person with another family member while work is undertaken to assess care options. For example, family group conferencing may help to identify who may be best placed within the extended family to care for the child or young person. This could help maintain connection for Aboriginal children and young people with family, community, culture and country as enshrined in the Aboriginal and Torres Strait Islander Child Placement Principle (FAHCSIA, 2009). A child or young person may still need to be placed outside the extended family at the conclusion of this process and

• placing a child or young person with a specialist transition carer in circumstances where the child or young person’s needs have not been assessed and is unable to be placed with a family member. This could be a specialist foster carer or into a residential care-type placement, for example.

Questions3. The Care during an Assessment Phase section

discusses the concept of an assessment phase prior to the placement of the child or young person in long term care arrangements with the aim of ensuring an appropriate placement which provides improved stability and support for the child or young person. How can this be best achieved? Provide reasons for your response.

4. Are there other options or issues related to care during an assessment phase not detailed in this paper? Provide details.

Thought Prompts• Is there merit in providing transitional care

for the purpose of completing a child’s needs assessment and placement matching? How might this be best provided, for example, in residential care or in family based care?

• How effective would an assessment phase approach be in the event of a placement breakdown for a child or young person (ie in advance of a new placement)?

• Should the concept of care as provided by a transitional carer apply to all children or for specific age cohorts such as children over the age of two or five?


Thought Prompts• Does the current continuity of care approach

to family based care deliver the best outcomes for children and young people? Are there things that need to be strengthened to assist carers?

• Does such an approach create difficulties for carers, for example, uncertainty whether children or young people remain in their care? How might these difficulties be overcome?

• How could carers work more intensively with families of origin to support the child or young person, particularly within the reunification phase? Are there particular models of intervention that could be used with carers to support children and young people and families of origin when reunification is the focus?

• Would it be appropriate to accommodate other carers seeking adoption or guardianship for children or young people if it was determined a child or young person was unable to return home? How could this work?

A Continuity of Care Approach to Family Based CareUnderstanding a child or young person’s needs and drawing upon this and other relevant information provides an opportunity to place a child or young person with a carer best able to meet their needs. In this way, an assessment phase may contribute to a continuity of care approach to family based care. Such an approach is child-centred and would see the carer supporting the child or young person while they remained in out of home care. It is based on the premise that for many children and young people ensuring a stable and caring home will help establish an environment in which secure attachment and supportive and healing relationships may develop.

Under a continuity of care approach, the carer’s role shifts in accordance with the phase of care and goals for the child or young person. For example, a carer may care for a child or young person through the reunification phase, providing practical and emotional support and care for the child or young person while they transition back to their biological family. If the child or young person was unable to return to their biological family however, then the carer would continue to care for the child through permanency.

A continuity of care approach is consistent with current practice in Tasmania and includes sibling group care and respite care. There is scope however to further formalise arrangements in order to develop clearly articulated roles and responsibilities for carers within the different phases of care. It would help ensure that carers:

• understand their role specifically in relation to the case plan goals for a child or young person and

• had identified support and training that may be necessary to meet the child or young person’s needs in each phase of care.

Questions5. A Continuity of Care Approach to Family Based

Care section discusses the importance of continuity of care to family based care and the need for clearly articulated roles and responsibilities for carers. Do you believe that this would improve outcomes for children and young people in out of home care? Provide reasons for your response.

6. Are there other continuity of care options or issues not considered in this paper? Provide details.


Family Based Care and Intensive Family Based CareChildren and young people entering care have differing needs. Identifying and understanding a child or young person’s behaviours and needs can identify the type and level of care most appropriate for the child or young person. While Child Safety Services currently offers a continuum of care for children and young people, there is an opportunity to broaden the scope of family based care to support children and young people with highly complex needs and behaviours.

Family Based Care Family based carers require training and support to deliver therapeutic relationship based care. A strengthening of family based care could include minimum standards for pre-service and ongoing training as well as tailored supports which may be stepped up or down to meet the needs of the child or young person and the carer. Family based carers could also be better integrated into the care team and care planning process to inform decision making and delivery of care. As a result, family based care could be made more flexible and responsive with targeted training and support to help the carer meet the needs of the child or young person in their care.

A therapeutic practice framework could be developed for working with carers in family based care. This could include for example, integrating Signs of Safety, a practice approach currently used with families of origin, with key principles of practice. These key principles could be drawn from existing training packages such as the Australian Childhood Foundation Level I and II training and/or from formal practice frameworks such as Developmental Dyadic Practice (DDP) or Trust-Based Relational Intervention (TBRI). HEALing Matters is another potential approach that could be used alongside a therapeutic approach to working with carers.

DDP is a therapeutic framework for “…supporting looked after and adopted children to recover from trauma through the parenting and support they receive, supplemented by therapy when appropriate” (Casswell, Golding, Grant, Hudson & Tower, 2014, p 19). It is a relational model drawing upon attachment and intersubjectivity theories and used in work with

parents, foster, kinship and adoptive parents and residential homes. It seeks to help parents or carers with “…day-to-day parenting based on principles of playfulness, acceptance, curiosity and empathy (PACE)” (Casswell, et.al, 2014, p. 19).

Like DDP, TBRI is a framework which draws upon attachment-based and trauma informed interventions to reduce behavioural problems and trauma symptoms for children and young people (Purvis, Razuri Howard, Casey, DeLuna, Hall, Cross, 2015). It centres on the caregiving relationship as a mechanism for healing and “…uses empowering principles to address physical needs, connecting principles for attachment needs and correcting principles to address fear based behaviours” (TBRI, website).

The HEALing matters program uses a trauma informed philosophy to improve health and wellbeing outcomes for children and young people in residential care (Skouteris, personal communication, October 12, 2017). The program will be piloted with foster and kinship carers in Victoria by Baptcare in partnership with Monash University in 2018 as an adjunct to Baptcare’s therapeutic model of foster and kinship care. The program seeks to use food and activity as a tool to improve communication and strengthen the carer-child or young person relationship while improving wellbeing of the child or young person.

Links to research papers on DDP and TBRI may be found at Appendix Four. Information on HEALing Matters may be found at Appendix Five.

Intensive Family Based Care

Some children and young people have highly complex or challenging behaviours and needs which require a higher level of care. Potential exists to broaden family based care to include intensive family based care in order to offer an alternative to or step down from residential or special care packages.

Common features of intensive family based care programs include enhanced assessment, training and support for carers, a strong care team/collaborative approach and a coherent practice model grounded in theoretical frameworks (McClung, 2007). An intensive family based care approach could be suitable for children and young people whose behaviours or needs include:


• a history of trauma, in particular, experiences of significant, high end abuse or neglect or physical harm including a history of unexplained non-accidental injuries or sexual harm

• a history of multiple placements

• living in residential or rostered care or are likely to move to residential or rostered care

• a high risk of or are offending or absconding

• a high risk of or are experiencing substance misuse and

• exhibiting sexualised behaviour.

The role of intensive family based care in relation to the continuum of care and program design needs careful consideration. There are a number of different programs operating interstate and three are discussed below to provide examples of how such programs may operate.

Trauma-informed Approaches to Intensive Family Based Care - The Treatment and Care for Kids (TrACK) program and the Circle program are trauma-informed approaches which develop and maintain a therapeutic relationship between the carer and child or young person in order to achieve placement stability and recovery from trauma. Carers work closely with a therapeutic specialist and case manager. Both programs feature a high level of support to carers although this may vary over the longer term and have the potential to also accommodate kinship carers.

The TrACK program works with children and young people in need of a medium to long term placement. It has been used to step down children and young people with complex needs who have experienced multiple placements or have been living in residential care or are at risk of moving to residential care, into foster care. It was recently evaluated and found in almost all cases to have achieved stability for those children and young people participating in the program (McPherson, Gatwiri & Cameron, 2018). The TrACK program was developed in partnership by the Australian Childhood Foundation and Anglicare Victoria.

The Circle program is a ‘front end’ intervention which targets infants and children first entering care with high level behavioural needs. Within the Circle program, children and young people may be supported to

return home, moved to permanent carers or retained with the same carer (Frederico, Long, McNamara, McPherson, Rose & Gilbert, 2012). It is delivered across Victoria by Berry Street and the Australian Childhood Foundation in partnership with a range of agencies providing foster care services.

Treatment Foster Care – Oregon (TFCO) is an evidence based model which employs a highly structured program and reward system to modify behaviour. Children and young people are placed with a specialist TFCO foster carer for a period of six to 12 months. It does not work with a child or young person’s underlying trauma but aims to stabilise a child or young person so they may be reunified with their family or be placed with a family based carer. The program is run only with foster carers. TFCO is currently being trialled in Victoria, with Anglicare Victoria trialling TFCO for adolescents (12-17 years) and OzChild trialling TFCO for children (7-11 years).

Further information on the Circle program and TFCO is included in Appendix Four while information on the TrACK program is included at Appendix Six.

Residential Care

It is likely that residential care will remain the most appropriate option for a cohort of children and young people. This includes specialist residential care for children and young people with high level needs. There may be other circumstances in which short term care in a residential setting allows a child or young person to transition over time to family based care or intensive family based care.

Figure 2: Potential interaction between the levels of care

Family Based Care /Intensive Family Based Care

Increasing complexity of need and behaviours of child or young people aligned with the support

required from carer and carer skills

Respite Care

Residential Care

Step down from

Residential Care to

Family Based Care


Questions7. The Family Based Care and Intensive Family

based Care section details a number of different approaches that can be used to broaden the scope of family based care. Which of the listed approaches would provide better outcomes for children and young people? Provide reasons for your response.

8. Are there other options or issues related to providing better support to children and young people with highly complex needs and behaviours that have not been discussed in this paper? Provide details.

Thought Prompts• Would a therapeutic practice framework for

carers add value to the delivery of out of home care within a family based care program? If so, what would be some of the core principles or values within such a practice framework?

• Intensive family based care models tend to focus upon foster care. Are there particular challenges to intensive family based care being used with kinship carers? Are there ways in which these challenges could be managed?

• How would you identify children and young people who would benefit from intensive family based care?

Summary – Elements of a Family Based Care ProgramIn summary, a future approach to family based care may maximise the opportunity for a stable home for a child or young person by allowing the time and space to understand a child or young person’s needs, to undertake a coordinated placement matching process and effect a planned move for a child or young person. Such an approach could also focus on providing continuity of care and extending the range of care provided to meet the needs of children and young people with highly complex behaviours.

Figure 3 provides an example of how transitional care and intensive family based care could be integrated into the out of home care system. It is not prescriptive but provides an illustration of how the different components could work together.

Figure 3: A potential approach to Family Based Care

Assessment Phase Reunification Phase / Permanency Phase

In Home

Kinship Care

Transitional Care

Residential Care

Family Based Care

Intensive Family Based Care

Home

Home

Residential Care




Part 2.2 - Recruitment and Registration of Carers


In Tasmania, family based care services are delivered under a hybrid model. Foster care services are delivered by Department and non-government service providers while the Department retains sole responsibility for kinship carers. This hybrid system has evolved over time with many examples of good practice. It has also given rise to inconsistent practice between service providers, between the Department and service providers, and within the Department.

The recruitment and registration process for foster carers is a lengthy one and commonly takes between six

to eight months. A shorter process is used for kinship carers.

The following sections cover recruitment, pre-service training, assessment, approval, and registration of carers. It will then follow with a consideration of placement, ongoing training, support and retention of carers and oversight and monitoring.

Figure 4 Flowchart of the Recruitment and Registration process below gives an overview of the recruitment to registration process with stages generally consistent across the Department and service providers.

Contact

Matching

On-going Training

On-going Support

Information Pack

Registration of Interest

Training

Carer Application

Assessment

Decision

Application is not ApprovedApplication is Approved

AppealCarer Agreement

> Checks

You contact our agency and we register your inquiry

You participate in assessment sessions

Checks are undertaken regarding your: > Health > Accommodation > Background and criminal record > Personal References

Our agency provides on-going training

Our agency provides on-going carer support

We send you an ‘information Pack for Potential Carers’

You register your interest in becoming a carer using the ‘Registration of Interest’ form

When a child or young person is matched with your family you decide whether to accept the placement

You complete an ‘Application to become a Foster Carer’ form

You complete a training course

If your application is approved you will be asked to sign a Carer ‘Code of Conduct” Agreement

If your application is not approved you can appeal the decision

Figure 4: Flowchart of the Recruitment and Registration process


Key Messages from the LiteratureThe literature discusses a number of factors which may impact upon carer recruitment. The most commonly identified factor is the level of carer satisfaction, as carer recruitment is ‘inextricably linked’ to carer retention through word of mouth (Sinclair, Gibbs & Wilson, 2004; Triseliotis, Borland & Hill, 2000 cited in Thomson, et al, 2016).

Other factors identified include:

• the use of effective recruitment techniques to attract potential carers that target the motivation of carers to care for children and young people, and the characteristics of successful carers (Thomson, et al, 2017)

• implementing inclusive, timely and responsive recruitment processes (Richmond & McArthur, 2017)

• building effective relationships with community groups such as the Aboriginal and Torres Strait Islander communities and culturally and linguistically diverse communities (KPMG, 2017) and

• for kinship carers, the importance of using workers with specialised skills to recruit kinship carers, including through early family group conferencing (Thomson et al, 2016).

The Current Situation in TasmaniaAttracting carers and taking them through a recruitment process is resource intensive for both the Department and service providers. Over the past few years, recruitment of foster carers in the south of the state has largely been undertaken by service providers although the Department has recently restarted recruiting foster carers. In the North and North West, recruitment is undertaken by both service providers and the Department. Recruitment of kinship carers is solely undertaken by the Department.

Across the state marketing activities are undertaken individually by service providers and the Department. There has been some joint promotional activity between the Department and at least one service provider on a local level.

Enquiries from prospective carers are received via websites, telephone or by people approaching the Department or service provider. Enquiries received by the Department will either be managed by the regional out of home care team or forwarded to service providers, depending upon local staffing capacity at the time. For at least three service providers, managing a potential carer through the recruitment process is handled by a single point of contact.

Stakeholder FeedbackA number of young people and carers felt that the broader community does not understand or have a positive perception of out of home care. They identified the need for a community education and promotion campaign to change this perception.

Carers feel that there is scope to target a broader range of people to provide care, particularly those working part-time. Carers also felt that prospective carers need to have realistic expectations when they initially express interest.

Carers believed that recruitment campaigns need to be resourced adequately. An example was given of a previous recruitment campaign where insufficient resources meant that enquiries from prospective foster carers could not be adequately followed up.

A previous Departmental internal review suggests that recruitment activities could be more targeted, for example, to couples without children or with grown children or according to cohorts needing care (such as older children and young people).

Points for DiscussionThe following points suggest potential opportunities for building on and strengthening our current approach to recruitment.

An overarching recruitment strategy could be developed which focuses on:

• developing a statewide coordinated community education campaign that delivers key messages about the needs of children and young people in care, the role of carers, personal qualities suited to the role of caring and the broad range of people who care for children. This education campaign could make use of foster care ‘champions’ including carers and young people (KPMG, 2017)


• ensuring the Department’s recruitment activities align or work together with those of individual service providers

• strengthening relationships with Aboriginal and Culturally and Linguistically Diverse (CALD) communities to maximise opportunities for children to be placed within their own cultural community or maintain cultural connection and

• recruitment processes which support family based care including intensive family based care or respite care as necessary.

A recruitment strategy could also consider:

• developing recruiting and marketing materials that target the qualities and motivations of carers

• running regular out of home care information sessions in conjunction with experienced carers, young people and biological parents to generate interest, provide basic information and give potential carers a realistic understanding of caring roles

• redeveloping the Department’s website to be more contemporary and appealing to potential carers. The website could also include online enquiry forms to automate basic processes and facilitate more a timely and informed response and

• ensuring recruitment campaigns are coordinated so prospective carers experience a responsive and seamless process taking them from an initial enquiry through to approval.

Questions9. The Recruitment and Registration of Carers section

discusses a number of changes to current carer recruitment practices with the aim of building on and strengthening our current approach to recruitment. Which of these ideas do you believe will be more effective? Provide reasons for your response.

10. Are there other carer recruitment improvement options or issues that have not been discussed in this paper? Provide details.

Thought Prompts• Are there better ways to target recruitment

of carers to ensure we are attracting people with the mix of qualities and motivations discussed in the research and valued by children and young people?

• Are there better ways to support recruitment of carers from specific communities such as the Aboriginal community or CALD communities?




Part 2.3 - Pre-Service Training


Pre-service training for carers is undertaken prior to a carer assuming care for a child or young person. It ensures that carers have a base level of information and education on caring for children and young people in out of home care.

Pre-service training could comprise three key components:

• orientation training which provides carer education on the key competencies to be a carer. This often includes training packages such as Shared Stories, Shared Lives

• induction training which provides information on the requirements to be a carer, such as the role of carers, their rights, responsibilities, code of conduct, legal requirements, and workplace health and safety and

• on-boarding processes, which may include additional support by an out of home care worker or peer/mentor carer.

Key Messages from the LiteratureThere is a significant body of literature and government reports calling for additional training so carers may provide therapeutic and trauma-informed care. This includes pre-service and ongoing training.

The KPMG (2017) report Foster and Kinship Care in South Australia recommends the development of a centrally coordinated training framework to ensure foster and kinship carers receive equal access to training. This training framework would identify a core curriculum of training, with some mandatory and elective training.

Foster carers often cite the impact of fostering upon their biological children as a reason to cease providing care (Noble-Carr, Farnham, Dean & Barry, 2005). Training which incorporates a whole of family focus aims to support biological children to understand what fostering is going to be like and gives them “…some strategies to cope with the challenges and issues that fostering could bring to their families” (Noble-Carr et al, 2005, p. 6). Wanslea Family Services and Berry Street both offer training and support packages to help biological children make sense of fostering.

For information on Wanslea resources, please see Fostering Together: Resources to support sons and daughters of foster carers at: www.wanslea.asn.au/wanslea/research-and-evaluation/. For information on Berry Street resources please see I care 2 Training and Support for Sons and Daughters of Carers at: www.childhoodinstitute.org.au/Resources

There is also increasing attention given to the different experiences of kinship carers (Kiraly, 2015) and growing recognition that kinship carers need access to training. Jurisdictions such as New South Wales, South Australia and the Northern Territory currently require kinship carers to undertake training. The Blue Card and Foster Care Systems Review recently completed by the Queensland Family and Child Commission (2017) recommends a training program specific to kinship carers be developed that includes flexible modes of delivery and be completed within six months of commencing care for a child.

The Australian Community Workers Association (ACWA) is trialling a pre-service training package for kinship carers called Shared Lives Relative/Kinship One to One during the period May to June 2018. While it is


based upon Shared Storied, Shared Lives, it is designed to be delivered in the carer’s home and includes additional material on grief and loss, shame and family dynamics (ACWA, website).

The Current Situation in TasmaniaPre-service training for carers in Tasmania currently varies across a number of domains, including whether carers are foster carers or kinship carers, whether foster carers are hosted by service providers or by the Department, and by region.

All foster carers in Tasmania attend pre-service orientation training. Kinship carers are not required to attend pre-service orientation training and feedback from those attending consultation forums was that many did not know about available training.

The Department and service providers use Shared Storied, Shared Lives in orientation training although the 2010 version of Shared Stories Shared Lives is generally regarded as being outdated. At least two of the service providers and the Department are either using or in the process of upgrading to the 2016 version of Shared Storied, Shared Lives. The updated package requires the trainer to be accredited to deliver the package.

Orientation training is considered resource intensive for both the Department and service providers and impacts upon the frequency of training. The duration and delivery methods for orientation training vary between three to five weeks and service providers are more likely to deliver training on weekends or in the evening. There has been some cooperation between the Department and service providers for joint training.

Service providers are more likely to include experienced carers in orientation training and two service providers also invite a panel of young people through the CREATE Foundation to participate in the delivery of the training. Historically the Department used a similar approach. The Department’s out of home care team in the north includes a representative from the Foster and Kinship Carer Association of Tasmania (FKAT) and an experienced carer in orientation training.

Stakeholder FeedbackCarers presented a range of views on pre-service training:

• orientation training needs to be run regularly so that ‘we don’t lose them’ and include family members

• training should have sessions run by experienced carers so potential carers understand the reality of being a carer, and include opportunities to hear from child safety officers and young people through the CREATE Foundation

• carers need induction training on the role, rights and responsibilities of carers and the code of conduct. This training also needs to include expectations around working with the biological family, reunification processes, complaints processes, managing disclosures and mandatory reporting and

• carers also need to know how to access information on the supports and resources available to help children and young people.

Service providers reinforced the need to be flexible in how training was delivered in order to meet the needs of carers.

Points for DiscussionThe following points suggest potential opportunities for building on and strengthening the current approach to standardise training and enhance pre-service training opportunities for carers.

A Training FrameworkThe Department could develop and be responsible for an integrated training framework for pre-service and ongoing training for family based carers. This framework could be developed in collaboration with service providers and key stakeholders to:

• establish consistent standards for pre-service and ongoing training

• apply to carers irrespective of whether the carer is hosted by the Department or a service provider

• meet the specific needs of kinship carers and Guardians

• develop training modules to meet commonly identified training needs


• maximise access for carers through flexible delivery of training and

• maintain flexibility for Departmental or agency-specific training which would complement and be in addition to the training standards.

Pre-service training could comprise three components:

Orientation Training

• the Department and service providers deliver a common orientation package such as the 2016 Shared Storied, Shared Lives and as necessary additional training modules, such as training or training materials for family members including biological children

• inclusion of co-facilitated training or structured opportunities to hear from young people with an experience in out of home care, experienced carers and biological parents and

• training for kinship carers that takes account of the unique needs of kinship carers and may involve modifying or developing a separate orientation package. This work could consider the outcomes of the ACWA trial due for completion in June 2018.

Induction Training

• training on the organisational and legal requirements of carers, including the role of the carer, rights, responsibilities, code of conduct, and organisation-specific policies and

• training on the out of home care system – such as information on placement, Case and Care Planning and the Permanency Framework. The role of carers in working with the biological family and how they can support reunification could also be considered within induction training.

On-boarding Processes• On-boarding processes could assist new carers

adjust to their role. This could include pairing a new carer with an experienced out of home care worker or experienced carer to assist them to settle in to their role.

Questions11. The Pre-Service Training section identifies a

number of potential methods for building on and strengthening the current approach to training carers. Which of these methods do you believe would be effective? Provide reasons for your response.

12. Are there other options or issues related to strengthening carer training that have not been explored in this paper? Provide details.

Thought Prompts• Should pre-service training be required

for partners of carers to ensure that key adults in the household have a base line understanding? How could we accommodate other family members such as the carer’s biological children or young people?

• Should pre-service training be required for kinship carers? What would be some of the barriers to this? How could they be overcome?

• What are some of the additional requirements that need to be considered for kinship carers in the type of training? What about in how training is delivered?

• What would be the preferred ways to deliver training, for example, small group training, one on one or a mixture? Is there a demand for online training?




Part 2.4 - Carer Assessment


Assessment processes include the range of pre-service safety checks conducted early in the registration process, usually before or during pre-service training. It also assesses the carer’s competencies and suitability to provide care and the type of care to be provided. Key Messages from the Literature

Pre-service safety checks The Royal Commission has recommended that “…in addition to a National Police Check, Working with Children Check and referee checks, that all foster and kinship carers should also have conducted:

• community service checks which include the prospective carer and any adult house-hold members of home-based carers

• a documented risk management plan to address any risks identified through community services checks

• at least annual reviews of risk management plans as part of carer reviews and more frequently as required” (2017, p. 25).

The recommendation for community service checks recognises that for many states, carer recruitment is undertaken by service providers in addition to or instead of, statutory child safety services and there is a need to ensure visibility of potential carer applications.

Assessment processes Assessor training, use of assessment tools and the quality of assessment tools are key issues determining the quality of the assessment (Richmond & McArthur, 2017). Assessment processes also need to be timely, responsive and respectful to individuals and families, and build a relationship with potential carers (Thomson, et al, 2016).

The Queensland Family and Child Commission report Blue Card and Foster Care Systems (2017) recently recommended that there be:

• an accreditation requirement for all assessors as per the selected assessment tool implemented or

• if there was no accreditation requirement for the assessment tool, that the Department identify minimum requirements including competency in standard assessment tools, experience, legislative knowledge, training and ongoing development.

In relation to kinship care, the Royal Commission (2017) recommends state and territory governments adopt a model of assessment which identifies the strengths and the support and training needs of kinship


carers. Such assessments need to ensure a holistic approach to support placements that are culturally safe and include ‘appropriately resourced support plans’.

The overrepresentation of Aboriginal and Torres Strait Islander children in the out of home care system reinforces the need for a culturally appropriate assessment tool for Aboriginal people and Torres Strait Islander carers (QFCC, 2017; KPMG, 2017; Thomson et al, 2016). Both the 2016 Step by Step assessment tool and Winangay assessment tool for Aboriginal and non-Aboriginal kinship carers have adopted a culturally sensitive approach (Richmond & McArthur, 2017). The updated Step by Step assessment tool was developed in consultation with Aboriginal out of home care services while the Winangay assessment tool has been developed specifically for use with Aboriginal kinship carer assessments (Winangay, 2017), drawing upon a strengths-based narrative approach (Blacklock, Gill, Hayden & Menzies, 2013). An information sheet on the Winangay assessment tool for Aboriginal and non-Aboriginal kinship carers is provided in Appendix Seven.

The Current Situation in Tasmania

Pre-Service Safety Checks A range of checks are undertaken as part of the assessment process for both foster and kinship carers. This includes:

• health and medical checks

• background record checks including a Tasmanian and National Police Check and a Working with Vulnerable People Check

• a housing safety check and

• a personal references check.

Assessment Processes In Tasmania assessments are most often completed using the 2010 Step by Step assessment package although at least one service provider has moved to the 2016 Step by Step assessment package. Initial feedback on the 2016 package is positive, with the assessor reporting they felt better able to work with referees, the carer’s support network and identify specific training needs for the carer.

Assessments are either undertaken by the Departmental out of home care team or service providers. At least two service providers assess carers internally and regard the assessment process as an important way to build their relationship with the carer. Another service provider outsources the assessment process, using assessors with a broad range of qualifications and experience. While the quality of assessments is generally regarded as sound by Department’s out of home care team leaders, quality varies by individual service provider. There appears to be no established requirements around minimum qualifications, training or experience for assessors.

The time taken to complete assessments varies although there is a consistent push across the Department and service providers to reduce the time taken to complete the assessment process. Time ranges from around six to eight weeks and up to 12 weeks, for an assessment to be completed.

Kinship carer assessments are conducted by the Department using a shorter process focused on safety checks and key competencies. This process recognises the often compressed timeframes in arranging kinship placements. The kinship assessment process has a number of levels:

• minimum safety checks in the event of an emergency kinship placement

• preliminary approval (Part A) including safety checks

• assessment of competencies and interim approval (Part B) and

• secondary assessment and final approval (Part C).

Preliminary approvals are completed by a response or case management child safety officer and approved by the relevant team leader before going to the out of home care team for an assessment of competencies and interim approval.

While Departmental team leaders have access to detailed information and outcomes of National Police Checks, Child Safety Checks and Working with Vulnerable People Checks, Departmental and service provider assessors may only receive the outcome of these checks.


Stakeholder Feedback

Pre-service safety checks No major concerns were raised during the consultation process around the safety check process for carers.

Assessment Processes The feedback from children and young people about assessment processes highlights the need to ensure that carers have the right personal qualities or attributes that suit caring for children and young people. This included recruiting carers who:

• can relate, interact and have something in common with children and young people

• have a sense of humour and are patient

• respect the child or young person and are mindful of their needs

• are willing to listen, make themselves available for one-on-one time and are committed to the child or young person and

• can show they care and treat children and young people in care ‘as their own children’.

“They don’t need to be professional people, they just need to love you for who you are” 11 year old, Launceston.

Carers expressed a strong view that assessors needed to be better trained and have experience in out of home care.

There was a view among some Departmental employees that the assessment process for kinship carers could at times be problematic. This was because preliminary approval (Part A) and safety checks rested upon an assessment of the safety of the child or young person rather than the capacity of the carer to look after the child or young person. This separation in focus could lead to difficulties down the track if the carer was

found to not be suitable during the assessment of competencies (Part B) or secondary assessment (Part C) process, as it is both difficult and undesirable to remove a child or young person from another family member.

In addition, some feedback was raised that the quality of an assessment may be impacted if an assessor does not have access to the full range of information from safety checks.

Points for DiscussionThe following points suggest potential opportunities for building on and strengthening our current approach to carer assessment.

Safety ChecksTo meet the Royal Commission’s recommendation around community sector checks, future safety check processes could also include an exchange of information between the Registrar (Working with Vulnerable People checks) and a carer register (to be developed) within Child Safety Services. More information on this register is included in the Registration section.

Assessment ProcessesThe Department could:

• review the suitability of upgrading to the 2016 Step by Step assessment tool or investigate the use of alternate assessment tools

• assess the suitability of an assessment tool for Aboriginal and non-Aboriginal kinship carers, for example the tool developed by Winangay

• include within the carer assessment process an evaluation of carer qualities and attributes valued by children and young people and supported by the literature

• consider what additional information can be shared with assessors from safety checks including the information considered and reasons for decisions and

• assist Quality Assurance by establishing standardised accreditation requirements for assessors.


Questions13. The Carer Assessment section identifies a

number of potential methods for building on and strengthening our current approach to carer assessment. Which of these methods do you believe would be effective? Provide reasons for your response.

14. Are there other options or issues related to strengthening carer assessment processes that have not been discussed in this paper? Provide details.

Thought Prompts• How can assessment processes take account

of the attributes or qualities of carers which are identified by the research literature and by children and young people as being important?

• What should be the minimum requirements for assessors?

• Is there benefit in having a separate assessment processes for kinship carers and foster carers?





Part 2.5 - Approval of Carers


Key Messages from the LiteratureStates such as Western Australia and Queensland have either moved to or are moving towards an approval panel for carer registrations. This has largely been in response to perceived issues with consistency and transparency in approval processes although the Queensland Family and Child Commission noted “…there was no strong evidence base to confirm that panels strengthen safeguards for children” (2017, p. 45).

The Current Situation in TasmaniaAll carer registrations are approved by the Department, with delegation sitting with regional out of home care team leaders. Approval processes however may vary by service provider. One provider undertakes their own approval process and provides the team leader in out of home care a final summary while another service provider convenes an assessment panel for carers with final approval remaining with the Department’s team leader in out of home care.

Carers moving to Tasmania from other states and territories are required to complete induction training and assessment in Tasmania prior to being approved, irrespective of their previous training and assessment, experience in providing care for children and young people, and results of their annual reviews.

Stakeholder FeedbackSome carers suggested a panel for approving carer registrations would improve decision making, improve consistency and be potentially more objective. There was support for the idea that the panel comprise a Departmental representative such as a team leader, a representative from service providers and a carer representative.

Service providers however felt the current approval process was suitable. Service providers and some Departmental employees questioned the value of approval panels and were particularly concerned that an additional layer of decision making would make the registration process even longer. An additional concern was raised about maintaining privacy of information for carers if a representative from another service provider was on the panel.

Some Departmental employees suggested there was a need for consistency in the approval process particularly in relation to where the approval authority resided.

Points for discussionBased on current understanding of approval processes used in Tasmania and stakeholder feedback the following points propose ways that could build on and improve our current processes:

• implement a consistent process for carer approvals required by the Department and service providers, with complete assessments being provided to the Department’s regional out of home care team leader

• final approval of all carer applications continue to be made by the Department’s regional out of home care team leader; this would help to address potential concerns about consistency in decision making. This could also incorporate a process to review decisions in the event of an adverse finding for prospective carers and

• consider a more flexible process to assess carers coming from other Australian states and territories while maintaining appropriate checks and balances.

Questions15. The Approval of Carers section presents methods

to build on and improve the current approval processes. Which of these methods do you believe would be effective? Provide reasons for your response.

16. Are there other options or issues related to improving carer approval processes that have not been explored in this paper? Provide details.

Thought Prompts• How well do current approval processes

meet the needs of carers when concerns are raised about a potential carer’s level of competency or suitability to care?




Part 2.6 - Registration of Carers


Once a carer has been approved they are formally registered on a system that identifies them as being suitable to care for children and young people requiring out of home care.

Key Messages from the LiteratureThe Review of Foster Care in England (Narey & Owers, 2018) notes that a national register of carers could contain a range of information about carers such as their date of approval, hosting agency, location, number of bedrooms in the home and vacancies for children and young people. Personal characteristics about the carer could also be included such as their age, gender, culture, religion, language, level of training and experience. It identified such a register could assist placement matching, vacancy management and help identify areas of need in recruitment.

A different approach has been adopted by the New South Wales (NSW) Children’s Guardian in the development of the NSW Carers Register. This is a “...centralised database of persons who are authorised, or who apply for authorisation, to provide statutory or supported out-of-home care in NSW” in order to promote the “…safety, welfare and wellbeing of children and young people in statutory or supported out-of-home care” (Children’s Guardian, website). The register provides a common resource which must be used by Departmental and non-government agencies to share information about carers and potential carers. A carer de-registered by one organisation may not be considered by another agency without first having a discussion about the person’s suitability to care.

The Children’s Guardian website (www.kidsguardian.nsw.gov.au/statutory-out-of-home-care-and-adoption/nsw-carers-register) outlines its guiding principles for the Carers Register as being to:

• “…operate to reduce the risk of inappropriate authorisation of carers

• record essential information only

• require agencies to certify that statutory and supported carers and relevant household members, have undergone minimum requirements for probity and suitability checks

• act as a licensing tool – it will issue an individual with a carer authorisation number, without which a person will not be able to provide statutory or supported out-of-home care and

• operate as a restricted access site, subject to strict privacy controls”.


The Current Situation in TasmaniaOnce a carer and the household is approved they are registered on the Child Protection Information System (CPIS). This information can only be accessed by the Department and there is no carer register for the Department and service providers to share information about carers, record approved and non-approved carers, identify carers deciding voluntarily to leave the system or carers who have been de-registered.

While there are some differences in how carers are exited from CPIS, a key limitation in the current process is that it is unable to distinguish between a carer voluntarily deciding to exit the system and one who is de-registered because they are determined to be unsuitable to care for a child or young person.

It is also important to be able to deactivate and exit a carer from the system if the carer is no longer available to provide care in order to maintain an accurate record of the number of carers within the system. This also identifies the carer and their history if they decide to return to family based care.

Points for discussionThe following points suggest potential opportunities for building on and strengthening our current approach to information sharing for carer approval and registration.

The Department could develop an online carer register for use by the Department and service providers to:

• provide a record of all carers who are approved or not approved, leaving voluntarily or de-registered. It could also flag carers for whom there has been a care concern raised

• assist quality assurance, for example, a carer may not be included on the register as approved or have a carer number issued until the relevant host organisation (Department or non-government agency) has confirmed completion of identified and agreed key activities (safety checks, training, induction)

• be used as a mechanism to record whether the carer has met the requirements for ongoing carer approval or renewal (see the section Monitoring and Oversight)

• assist risk management by identifying carers who were not approved for care elsewhere or de-registered (including interstate) by facilitating an exchange of information between agencies and between the Registrar (Working with Vulnerable People checks) and the Department and

• the online carer register could be modelled on the NSW carer register maintained by the Children’s Guardian http://www.kidsguardian.nsw.gov.au/statutory-out-of-home-care-and-adoption/nsw-carers-register.

Questions17. The Registration of Carers section discusses

how a central carer register (accessible by the Department and service providers) could provide a more consistent approach to carer registration and provide additional safeguards for children and young people. What issues should be considered as part of the implementation of a central carer register?

18. Are there other options or issues related to improving information sharing for carer approval and registration that have not been explored in this paper? Provide details.

Thought Prompts• What information should such a register

hold, and where would the level of authority need to reside for particular actions, such as to verify whether a carer has completed all safety checks, training and been assessed and approved as suitable?

• What safeguards would need to be in place to protect a carer’s personal information being stored on a register?





Part 2.7 - Placement


The focus of this section is on the operational processes for placement.

Key Messages from the LiteratureThere is extensive research on the importance of matching processes between children and young people and their carers to enhance placement stability and key themes were addressed in the Elements of a Family Based Care Program section.

The Current Situation in TasmaniaThe Department’s out of home care teams are responsible for arranging a placement for a child or young person when they come into care, when a placement breaks down or when there is a planned transition. The Department’s out of home care team may seek a placement with Departmental carers or through a service provider. If service providers don’t have capacity, the responsibility remains with the Department’s out of home care team to find a home for the child or young person.

Stakeholder Feedback Children and young people feel the matching process is really important and they want to get to know a potential carer prior to living with them.

Children and young people spoke about wanting to give the carer a profile about themselves and how carers can support them, including information on what they like to eat and don’t like to eat, their activities, routines (such as when they like to shower), whether they follow a particular religion, and friendships. They also felt it important that carers understand more about their needs. This would allow the carer to get training to support the child or young person, for example with anger management or depression.

Child safety officers and service providers spoke about the challenges in matching children or young people with carers. While there is every intention to find a good fit between a carer and a child or young person, there are significant constraints which hinder this process:

• low numbers of carers mean that matching is an aspiration which doesn’t tend to occur in reality

• in many cases little is known about a child or young person and their needs. It can take a number of weeks to understand these needs and


• out of home care teams may not know carers sufficiently well to match with children and young people, although this does not apply to carers working with the Department for some time. Departmental staff have limited access to information about carers hosted by service providers.

These pressures mean that at times multiple sibling groups or unrelated children or young people may be placed with a carer – usually a Departmental carer - which may not always be in the best interest of child or young person or those already living in the home. Alternatively, it may mean that a child or young person is placed into other, more expensive forms of care which does not meet the needs of the child or young person.

There was recognition that service providers do not tend to work in the same way as the Department with different practice standards around the number of children being placed with a carer. This led to unevenness in managing placements between the Department and some providers and placed additional pressure upon the out of home care team and Departmental carers.

Feedback also suggests that the Department will tend to look internally for a carer prior to going to service providers although this wasn’t necessarily written in a practice manual or policy.

While there are exceptions to the rule, there was a shared understanding that children and young people should not be placed into homes where there are existing children or young people on Transfer of Guardianship to a Third party orders. It was felt that placing children or young people into these homes may jeopardise the home for the existing child or young person.

Points for DiscussionWhile the concept of a coordinated placement matching process was flagged in the Elements of a Family Based Care Program section, it could include:

• a process driven by the needs of the child or young person as the primary consideration rather than by where the carer is based

• consideration of a range of information such as age and needs of the child or young person, other children or young people in the home, the presence of common interests, community, culture and belief systems between the child or young person and the carer and their family and information from an assessment of a child or young person’s trauma history, needs and likely supports

• consideration of a particular carer’s capacity and skills and whether there are additional training or support needs to care for the child or young person

• representatives of the Departmental out of home care team and each of the service providers in the region meeting to identify suitable carers

• information (as appropriate) on the child or young person being shared with the biological family and carer as part of the care planning process prior to and while the child or young person is in care

• allowing children and young people, carers and their families access to profiles about each other to help them get to know each other and

• providing children and young people an opportunity to meet potential carers and their families in an informal setting such as a park or playground, prior to the child or young person going to live with the carer as part of a planned transition process.

Questions19. The Placement section discusses the importance

of placement matching processes to improve placement stability and details a number of factors that could form part of a coordinated placement matching process. What factors do you think should be taken into account as part of the implementation of a placement matching process? Provide reasons for your response.

20. Are there other placement matching options or issues that have not been explored in this paper? Provide details.

Thought Prompts• What are some of the challenges in adopting

a coordinated placement matching process and how could they be overcome?





Part 2.8 - Ongoing Training


Ongoing training and support sit alongside each other because of their critical role in carer retention. Ongoing training is also often listed as a form of support and a factor in whether carers feel able to fulfill their role in supporting and caring for children and young people.

Ongoing training for carers is undertaken once a carer has been formally registered and is caring for a child or young person.

Respite care is considered separately from ongoing support because of its significance to carers.

Key Messages from the LiteratureAs discussed in pre-service training, additional training to assist carers provide therapeutic and trauma-informed care is a significant theme in the literature. This push is at least in part driven by increasing knowledge about the impact of trauma upon children and young people’s development and wellbeing, the increasing complexity of behaviour for many children and young people and the professionalisation of care.

The literature notes that:

• carers mostly welcome training, in particular training which draws upon adult-learning principles. Getting carer input about the training they need and involvement in training delivery (interaction over didactic) was also identified as beneficial. Training however needs to be accessible for carers and consider their caring needs (Richmond & McArthur, 2017)

• multi-session training programs of longer duration (10-16 weeks) are more beneficial than single sessions (Richmond & McArthur, 2017) and

• training approaches with the most promise are those which provide an opportunity for foster carers to apply their learning at home with the child in their care, while receiving feedback and support (Hek & Aiers, 2010 cited in Thomson, McArthur and Watt, 2016).

The Royal Commission into Institutional Responses to Child Sexual Abuse (2017) report into out of home care recommended that carers and caseworkers receive training to:

• “…ensure they hear and respond to children in out-of-home care, including ensuring children are involved in decisions about their lives…” (2017, p. 26) and

• understand trauma and abuse and its impact upon children and young people and receive training in trauma informed care so they can meet the needs of children and young people, including those with harmful sexualised behaviours.


The Royal Commission also recommended that state and territory government and out of home care service providers provide advice, guidelines and ongoing professional development for kinship and foster carers to prevent and respond to harmful sexualised behaviours of some children and young people in out of home care.

The Current Situation in TasmaniaFoster and kinship carers are not required to undertake ongoing training, nor is there additional training required for carers of children or young people with complex needs. At times training is offered statewide or by regional teams in response to an identified need.

A number of service providers offer further training once a carer has been formally approved by the department. For example, two service providers offer carers access to Australian Childhood Foundation Level I and Level II training on the impact of trauma on children while another is moving to include this training. Service providers also offer other training particular to their organisation.

The Foster and Kinship Carers Association of Tasmania (FKAT) also delivers training for foster and kinship carers. In the past this has included first aid training or training on the impact of trauma and practical strategies for managing trauma. The extent and range of training however is constrained by available funding.

Stakeholder FeedbackYoung people with a lived experience in out of home care spoke about a range of training needs for carers. These included training on:

• the developmental stages and needs of children and young people

• how to look after children or young people, for example, training in nutrition or how to care for children or young people with a disability

• understanding trauma and how to support children and young people living with trauma

• listening and communicating sensitively with children and young people and

• assisting young people transition to independence.

“Caring for a toddler is very different to caring for a teenager”.

“Don’t go too hard on them (children or young person), they might have had a hard time … have time with them”.

Carers also provided extensive feedback on training which included:

• training should be extended to kinship carers

• being able to access flexible modes of training which met carer’s needs, such as online and face to face training, group and individual training, and training being made available during the day but also during weekends and evenings and

• training being delivered by experienced people from the sector and not ‘trainers’.

Carers offered the following perspectives on ongoing training:

• while orientation training provides a foundation for carers, the real need for education begins when a carer assumes care responsibilities for a child or young person

• trauma training is necessary to help carers understand the symptoms, presentation and strategies to manage the trauma impacted behaviour and developmental needs of children and young people in their care

• when a child or young person has a specific need, appropriate training should be made available to the carer to assist them to support the child or young person in their care, for example, training on foetal alcohol spectrum disorder or autism and

• kinship carers may have some additional training needs such as how to manage changing family dynamics, managing conflict and coming to terms with their new role as a carer.

Service providers reinforced the need to be flexible in how training was delivered in order to meet the needs of carers.


Points for DiscussionThe following points propose ways that could build on and strengthen delivery of ongoing training to carers. It should be considered in conjunction with the training framework which was discussed in the section Pre-Service Training.

Ongoing training An ongoing training framework could identify:

• standards for ongoing training that all carers would be expected to undertake in order to maintain a carer’s approval for example, trauma training and working with the biological family. This training could be identified in a carer agreement

• other training which may assist the carer to meet the child or young person’s specific needs. This training could be identified by the carer, case manager, out of home care worker and other care team members as part of the care planning process.

Ongoing training could include:

• required or mandated training such as first aid or dispensing medication training

• general training such as in nutrition or online safety

• cultural competency training, including for children and young people who are Aboriginal or Torres Strait Islander or from a CALD background

• training to reflect the phase of care the child or young person is in, including reunification or permanent care phase for example, training for carers supporting children in permanency may include identity formation or parenting teens with trauma

• developmental training which targets the developmental stages and needs of different age cohorts, including for babies, toddlers and young children, children and adolescents, such as Secure Base or Circle of Security training for young children

• specialised training, such as how to support a child or young person with Foetal Alcohol Spectrum Disorder, or how to support a child or young person with anxiety or depression and

• carer oriented training on vicarious trauma, self-care and maintaining their own and their family’s wellbeing.

Example of ongoing training for carers and Guardians of pre-teens Anecdotal evidence suggests that a number of carers and Guardians find it increasingly difficult to care for children aged 10 years and above, with an increased risk of a breakdown in the home. Pressure may arise due to a number of factors such as the emergence of puberty, developmental needs around identity formation and experience of trauma. Some child safety officers suggested earlier, timely training for carers and Guardians could reduce the risk of placement breakdown. For example, when a child is turning eight or nine years of age, training on parenting pre-teens and teens with a trauma background could prepare carers to support the child in care through this phase. Support could also be provided to carers and Guardians at this age to help maintain the home or at least the relationship to help provide a sense of connection for the child.

Other components related to training:

• consideration of how training is delivered to maximise accessibility. This could include a mix of online and face to face training, sessions being offered during school hours, after work and on weekends. Where possible, training could be co-facilitated by experienced carers or using real life experiences

• ongoing training could seek to embed the 70 (on the job):20 (learning through others/mentoring): 10 (formal training) rule so that formal training sessions include opportunities to apply training or child-specific approaches. This could be run through small groups of carers with a specialist or out of home care worker or in the home between an out of home care worker and a carer

• where possible, training could be run jointly for child safety officers and carers particularly for training on trauma and its impact upon child development. This would assist in building a common understanding of trauma and build relationships between child safety officers and carers

• training for carers could form part of an accredited training process so that, while not mandatory, carers could gain credit toward formal qualification and


• quality assurance processes could be built in to review training programs for ongoing continuous improvement. Such processes could also include input from out of home care workers and carers on training needs.

Questions21. The Ongoing Training section proposes methods

to build on and strengthen the delivery of ongoing training to carers. What parts of this framework do you believe would be effective? Provide reasons for your response.

22. Are there other carer training options or issues that have not been considered in this paper? Provide details.

Thought Prompts• What should form the core components of

ongoing training for family based carers, for example, should it include training in trauma and working with a biological family?

• Would it be reasonable to require carers to undertake ongoing training to maintain their approval? What would this look like? For example, how much training would be reasonable for carers to undertake? Should there be a requirement to undertake particular types of training identified as necessary to support a child or young person?

• What would be preferred ways of accessing ongoing training for carers, such as online, one on one, small group, a mixture?





Part 2.9 - Ongoing Support and Retention


Ongoing support is required for carers as they continue to care for and meet the needs of children and young people in out of home care. The provision of ongoing support also has a positive effect on carer retention and satisfaction with the caring role. Key Messages from the Literature

Support for carers is a significant area for development as identified in national and international research, reports and various reform processes underway in Australia. Some of the key messages include:

• carers cannot be expected to care for children and young people who have suffered trauma if they themselves do not understand the impact of trauma, how to recognise trauma, and how to support the children and young people in their care affected by trauma

• carer support needs to be flexible, multi-factored and tailored

• support is necessary in the early stages of a placement, as the “…first six months of a placement are crucial, with 70 per cent of disruptions occurring within this timeframe…” (Jones, 2010, p. 9, cited in Richmond & McArthur, 2017)

• that while money is not a motivating factor it is an enabler and factor in retention. Financial strain, including through late reimbursements has been found to be a negative factor in retaining carers (Sebb, 2012, cited in Thomson et al, 2016) and

• there is also a need to recognise the impact of secondary or vicarious trauma upon carers in the ‘frontline’ caring for children and young people who have experienced trauma (Manley, Barr & McNamara, 2014, cited in Thomson et al, 2016).

Studies suggest a link between support and retention, with carers ceasing care due to “…burn out, lack of support, effects on their families, and the foster children being difficult…” (Bromfield & Osborne, 2007, p. 16). Supports which have been observed to assist carers to care and support children and young people while positively impacting retention include (Richmond & McArthur, 2017; Bromfield & Osborne, 2007; KPMG, 2017; Pell, 2015):

• a positive working relationship between workers and carers, particularly with the carer’s support worker

• the carer’s inclusion as a member of the care team

• training which is tailored to the individual needs and experience of carers


• access to respite care and in particular, regular respite care. Madden (et al, 2016 cited in Richmond & McArthur, 2017) noted that 92.5 per cent of carers felt that respite care had a positive effect upon their lives

• independent advocacy, support and mediation for carers including during allegations of care or care concerns and

• peer support for carers.

The Current Situation in TasmaniaThere is a marked difference in the level of ongoing support offered by service providers and the Department. The most notable difference may be attributed to the availability of out of home care workers to support carers and the provision of practical supports, including respite care.

Increasing demand has impacted on the amount of support the Department can offer to carers, and a number of child safety officers felt there was less support available now than in years past. Current staffing profiles in two of the three regions greatly inhibit the capacity of out of home care teams to support family based carers. Support in these teams tends to focus on accommodating a child or young person in a time critical scenario or trying to find an alternate home for child or young person when the carer is no longer able to provide care.

Where workers are able to support carers, support types include:

• one on one, telephone, and email contact with the carer

• arranging specialist support and advice as required, for example a psychologist or medical practitioner

• assessing the need for and providing regular respite care

• ensuring the carer is receiving regular and appropriate payments

• supporting carers to be compliant with competency standards and

• formal and informal reviews focusing on a carer’s strengths and areas for development.

Service providers work to lower staff to carer ratios than the Department. This enables them to provide ongoing support to carers particularly through regular home visits. One service provider stated that while they would visit experienced carers every four to six weeks, home visits would be undertaken as necessary for carers. This could occur if, for example, a carer was new to the role or if a child was starting a reunification process and the carer was under strain.

Another service provider spoke about developing a carer support plan for each carer which sets out available practical ongoing supports to assist the carer to manage peak times of stress. Service providers also offer ongoing supports such as a 24 hour telephone advice line and opportunities for peer support by organising morning teas or group training.

Carer involvement in care planning and care team meetings Current policy supports including carers in care team meetings but the extent to which this occurs is inconsistent. Data from 64 respondents to a FKAT 2015 survey found that 47 per cent of carers had never attended care team meeting and 21 per cent had never been involved in care planning.

Guardians There is limited capacity to support Guardians once a Transfer of Guardianship to a Third Party order is in place. This is described as consisting of a review of the child’s circumstances 12 months after the transfer of Guardianship and some limited additional support and referral services for Guardians and the children in their care until they reach 18. Guardians may receive additional support in circumstances where the Guardian is caring for an additional child or young person(s) on an order.


Stakeholder FeedbackThere was a consistent view among all stakeholders that carers need support if they are to provide a caring, loving and stable home for children and young people in their care. Ongoing support needs to be multi-dimensional with various support options available for when things are not going well or concerns are raised. One suggestion included using the Signs of Safety approach with family based carers in order to identify what was needed in a way which was respectful to carers.

Young People’s Views on SupportMany young people felt it was important that carers received ongoing support and knew what ongoing support was available. This could include being able to:

• access support groups where carers could debrief with other carers and ask each other questions. This was also identified as a way to link together children and young people

• access mentoring, especially to help new carers settle in

• phase new carers into the role rather than placing children and young people with them straight away

• have access to appropriate professional advice 24 hours a day

• receive therapeutic support as needed, including for the carer’s family

• have a break, as some young people recognised it could be hard for carers. One young woman spoke about being able to go on holiday camps to give her carer a break and

• receive practical support including having a big enough house if a carer was caring for multiple children or young people.

Some children and young people thought it was important not to put too many children or young people with a carer. Others noted that some carers could cope with large households and still provide the one-on-one time children and young people regarded as being particularly valuable.

Other children and young people felt it was important that ongoing support remained available when there was a Transfer of Guardianship to a Third Party order in place. This was considered necessary for the child or young person and the Guardian.

Carers’ Views on SupportThe Importance of Out of Home Care Workers

Having a positive relationship and connection with out of home care workers and case managers was considered pivotal to the wellbeing of carers. Having connection, trust and ongoing communication was considered fundamental to developing a partnership approach.

Many carers felt that ongoing support is critical to ensure the stability of placements, and placements may be jeopardised when this support is not available.

Ongoing Support for Carers

Carers spoke about a variety of supports which would assist them to care for children and young people, including:

• intensive support from an out of home care worker when a child or young person first comes into care, particularly for infants or when a child or young person had complex behaviours or disability

• support for kinship carers to manage family relationship dynamics and help settle a child or young person

• practical supports to help carers maintain a ‘normal’ life, particularly when looking after children or young people with high needs or multiple children and young people. This included assistance with cleaning, house maintenance and repairs or providing transport for children to family visits (particularly by kinship carers)

• access to a professional 24 hour telephone advice hotline and/or online portal to get practical advice or strategies was also felt to be useful. This could include for example, accessing information on communicating with young people or how to welcome or settle a child when they first come into the home


• peer support, including for kinship carers who were sometimes more isolated and

• support for carers when a child or young person leaves care.

Clarity and Consistency in Policies and Procedures

Carers spoke about wanting clarity and consistency in policies and procedures, including for:

• carer participation in care team meeting and planning processes. Carers want to contribute their views on the needs of the child or young person and to be involved in reunification planning

• a carer’s ability to make decisions for day to day care for the child or young person and potentially being able to assume more responsibility for those decisions

• financial payments, supports and reimbursements. The lack of clarity and consistency around financial support concerned many carers, such as out of pocket expenses for formal childcare and

• one support group for kinship carers spoke about the inequity of the payments for kinship carers depending on whether they sat inside or outside the statutory child safety system. Many informal kinship carers experience significant financial stress when they assume responsibility to care for children and young people, particularly if they are grandparents on pension or a family member unable to work.

Independent Advocacy and Support

Carers spoke about the importance of having access to:

• an independent psychologist or social worker to support carers in providing care

• therapeutic support such as grief and loss counselling and to manage vicarious trauma. The Employee Assistance Program was noted as available but inadequate and

• independent advocacy and support when there was a complaint made against a carer.

A number of kinship carers spoke about taking on kinship care because of love and a sense of obligation. It wasn’t a choice. It also often involved dealing with grief associated with the circumstances requiring a child or young person to be removed from the biological parent(s), who in many cases is the child of the kinship carer (carer feedback, Devonport).

Carers felt it was vital to have support to maintain a child or young person in the carer’s home. Some carers spoke about the lingering fear of abandonment within many children and young people in care and how detrimental a ‘failed placement’ could be to a child or young person’s wellbeing and development (carer feedback, Devonport).

Other FeedbackFeedback from out of home care teams included having flexibility to support Guardians when the home is under stress, including if a young person leaves for a time, in order to maintain the relationship between the carer and the young person. Such an approach was felt to draw upon trauma-informed care principles of rupture and repair.


Points for DiscussionCarers need ongoing support to care for a child or young person but also to maintain the wellbeing of themselves and their family. There are a range of issues that could be considered within a framework for ongoing support as follows.

Respite care is considered in a separate section.

A Strengthening of the Care Planning Process for Carers and Child Safety OfficersWhile collaborative care planning processes already form part of practice, there is scope for the process to be strengthened. An enhanced collaborative approach to care planning may facilitate:

• information sharing and improved joint understanding between carers, biological families, child safety officers, schools, service providers and other services about the care for children and young people

• input and contribution from carers to support achievement of goals, such as reunification or transitioning from care

• identification of specific training and/or support needs of children and young people and carers

• continuing work with the Department of Education to best meet the needs of children and young people and support their learning

• clarity around the role of the care team and support certainty in the day to day decision making for carers for children and young people under their care.

Intensive Support when a Child or Young Person Enters Care Intensive support could be available to carers when a child or young person first moves into a home. This intensive support could involve for example, weekly visits, child-specific education and support and other regular contact (such as telephone, text message) by the out of home care worker. The frequency and duration of this support could be reviewed in the care planning process. This intensive support may also be provided at key points of disruption, such as a failed reunification.

Ongoing Support and Home Visits by Out of Home Care Workers Carers consistently spoke about the need for regular and ready access to out of home care workers through face to face visits and regular telephone or text message contact. An agreed standard for family based carer visits could help ensure a base level of support for all carers. This could include for example intensive support for new carers, with visits conducted every four to six weeks for other carers. There could also be flexibility to increase visits if a child or young person was experiencing a critical event or if a worker felt the carer would benefit from additional support.

Supports across the Developmental Stage or Phase of Care Support for carers and guardians could be aligned with the key developmental phases for the child or young person in their care, such as when a young person reaches mid-teen years. For young people in particular, support to carers may need to be flexible in how it is provided and the context in which it is provided – including in circumstances where the young person has left home – in order to ensure the sustainability of the caring relationship and to deliver better long term outcomes.

Access to Therapeutic Support Carers and their families may be vulnerable to vicarious trauma as a consequence of caring for children and young people who themselves have experienced trauma. It is therefore important that these volunteers who provide an essential service are supported if they need it.

While a carer may be happy for a child or young person to return to their biological family, there may remain significant grief and loss for the carer and their family. Supporting carers and their families manage this grief could include access to grief and loss counselling, receiving updates on the progress of a child and young person through to ongoing involvement where appropriate by providing respite care for the biological family.


Practical Supports for Carers Practical supports for carers could include assistance with transport for children and young people to family visits, school or after school activities. It could also include assistance with undertaking repairs and maintenance on the house, cleaning or gardening.

Enhancing Peer Support There is potential to enhance the current level of peer support for foster and kinship carers through:

• formal peer to peer mentoring support for carers

• support for informal networks for carers to come together and support each other, such as through morning teas or play groups

• bringing all carers and families together in events such as A Big Day Out where carers, children and young people can come together in a region or across the state and

• using carer peer support groups as a mechanism for training. This would necessitate family friendly venues where young children could be looked after on site to allow carers to focus on training.

Formal Advocacy and Support Formal and independent support could be made available to carers when the carer may be in dispute with the Department about a decision or in the event that a carer is being investigated for a care concern. This advocacy support could include the provision of legal advice.

Access to 24 hour Telephone Advice Line and Online Portal A 24 hour telephone advice line and an online portal could provide an additional layer of support for carers. A call to the 24 hour professional advice line could also trigger a follow up contact by an out of home care worker as necessary.

An online portal could include information sheets and resources on how to assist children and young people on commonly identified issues, links to relevant supports and resources and including information on upcoming training. It could also provide a point of access for key policies for carers and the carer handbook.

An online portal could potentially include an online forum which would allow carers to connect with each other online, although this would need to be moderated by qualified staff.

“[We need to] protect foster care placements… and hold tight to those new, beautiful healing attachments”. Foster carer, Launceston.

Questions 23. The Ongoing Support and Retention section

proposes a number of actions that aim to build on and enhance support for carers. Which of these do you believe would be effective in providing enhanced support to carers? Provide reasons for your response.

24. Are there any other options or issues related to enhancing support for carers that have not been discussed in this paper? Provide details.

Thought Prompts• Is there value in standardising practice

to support carers? How could this be approached?

• Are there additional types of support that might be beneficial?

• Are there particular supports for carers which are particularly important?





Part 2.10 - Respite Care


Key Messages from the LiteratureRespite care is noted in the literature as being fundamental to carer support and retention (Thomson, et al, 2016; Richmond & McArthur, 2017). Respite care, in particular regular respite care, has been found to have a positive impact upon retention and the quality of care provided. There is also an identified need to recruit and train respite carers, including specialist respite carers for children with special needs (Richmond & McArthur, 2017; KPMG, 2017).

The literature also discusses community or hub-based models of respite care. The Mockingbird model is offered as a model which can positively impact retention and recruitment of new foster carers (KPMG, 2017; McDermid, Baker, Lawson, Holmes, 2016). Operating through a community hub approach, it integrates respite care and peer support, with a lead or hub carer supporting a group of families. In the United States a hub carer may support six to 10 families, with lower ratios in the United Kingdom.

The Mirror Family model, developed by Brunner and O’Neill (2009 cited in Department of Child Protection (DCP), nd), similarly seeks to create an extended family network for the child or young person. It emphasises the creation of a network for lifelong supportive relationships, and aims to add value to kinship care, foster care and permanent care systems (Brunner & O’Neil, 2009). Each mirror family comprises three roles: ‘A’ family, the primary home; ‘B’ family, the ‘aunties/uncles’ home providing a respite/emergency home and which may become the primary family if required; and a ‘C’ family, the ‘grandparents/godparents’ who offer a tertiary home with babysitting, mentoring, attending family celebrations or special events in the life of the child or young person (DCP, nd; Brunner & O’Neill, 2009).

Further information on the Mockingbird model may be found www.gov.uk/government/publications/mockingbird-family-model-evaluation, while information on the Mirror Family model may be found www.pcafamilies.org.au/uploaded-files/MF%20Article_1324009982.pdf

The Current Situation in TasmaniaRespite care policies state that provision of respite care is to be agreed by the child or young person’s care team taking into account the carer’s needs, the child or young person’s needs, issues of stability and consistency of care, and the relationship between the carer and the child or young person. Carers in Tasmania are able to access up to 28 days of respite care per year.

Service providers seem able to offer respite care more readily to their carers than the Department. Service providers tend to use a primary and secondary respite carer to maintain continuity of relationships for the child or young person. One service provider has flagged its plan to introduce the Mockingbird model in 2018.

Stakeholder FeedbackThe availability of respite care appears to be under significant pressure for Departmental foster and kinship carers, particularly in the south of the state. A number of carers around the state reported that they had never received respite care.

There was a consistent view across stakeholders that respite care could make a positive contribution to a child and young person and the carer. This included noting that respite care:

• could offer a broad support network for children and young people

• needs to be established slowly over time and maintain some consistency in how a child or young person is looked after so it doesn’t jeopardise their home relationship and

• could be used as a way to introduce new carers to the caring role.

Some carers had started their own informal version of community-based carer support as they felt it increased the numbers of ‘eyes’ upon children and young people, built relationships with other carers and provided broader support for children and young people.

Other carers spoke about the need for respite care to be flexible. One carer commented that instead of respite care, they would prefer the funding to cover travel and accommodation costs for the child or young person so they could join their foster family on holidays.


One Departmental carer in the North West of the state spoke about their experience where a relationship had developed between the respite and foster carer so that the respite carer is like an ‘aunty and uncle’ for the child or young person and also acted as a buddy for the primary carer, providing a connection between the carers.

Points for Discussion: The following points propose ways that could maximise the benefit of respite care.

Respite care could provide a key source of support to family based carers while building a community of trusted people around the child or young person. This may be through:

• use of primary and secondary respite carers to develop settled relationships with the child or young person and the carer. This could include consideration of formal or informal community or hub-based carer respite models such as the Mockingbird model or Mirror Family model

• greater use of a carer’s extended family and friends who know the child or young person and have a relationship with them. If the child or young person has a good relationship with the carer’s extended family, this could work well for both the child or young person and the carer. The carer’s extended family or friend relationships could be jeopardised however if there was a breakdown in the respite care relationship or in the relationship between the carer and the child or young person. In addition, use of extended family members could also reduce independent scrutiny on the wellbeing of the child or young person

• using respite care to introduce new carers to foster care and prepare them for their role. This could be for a period of time, such as three to six months. This could however become problematic once a carer started caring for a child or young person as it may mean that they are no longer able to provide respite care and

• respite care could be applied flexibly in order to meet the needs of the child and young person and the carer and their family. For example, if there are multiple children in the home, a carer could be provided alternative accommodation so that the respite carer can move in and minimise disruption for the children and/or young people. Policies could also be clarified on funding travel for the child or young person to accompany the carer on holidays instead of the child or young person needing to go to respite care.

There is also a need for clarity and consistency on the type of assessment which should be used to assess respite carers, particularly where there is a relationship between the carer and the respite carer.

Questions25. The Respite Care section details a number of

methods that could maximise the benefit of respite care to both carers and children or young people. Which of these methods do you believe would be most effective? Provide reasons for your response.

26. Are there any other respite care options or issues that have not been considered in this paper? Provide details.

Thought Prompts• Should the Department focus on recruiting

respite carers as a specific cohort, targeting people who are unable to provide full time care or can this be accommodated within normal recruitment processes?

• What would be the potential advantages and disadvantages of recruiting friends and family of the carer to provide respite care?

• What would be some of the barriers to using respite care more flexibly?

• What would be a reasonable position regarding the amount of respite care available for carers who have children with high needs or care for children in intensive family based care? What about for kinship carers who may be elderly or have health conditions?

• How do we ensure that respite care does not work against the needs of the child or young person for stability and attachment?





Part 2.11- Oversight and Monitoring


Key Messages from the LiteratureAll jurisdictions have requirements which carers need to meet in order to maintain their approval. These requirements tend to include carer reviews although the frequency of these reviews will differ. Some jurisdictions such as Queensland also require carers to undertake a specified number of hours of ongoing training to meet their renewal process.

The Royal Commission into Institutional Responses to Child Sexual Abuse report for out of home care recommends that “…all out-of-home care service providers should conduct annual reviews of authorised carers that include interviews with all children with the carer under review, in the absence of the carer” (2017; p. 25).

The Queensland Family and Children Commission also recommended that children and young people living with the carer be interviewed as part of the carer renewal process. Further, it recommended that there be flexibility for the reviewer to gather information from children and young people previously living with the carer, past child safety service employees with responsibility for the carer, previous agencies and the relevant school or child care service.

The Current Situation in TasmaniaOversight and monitoring consists of carer visits and annual reviews. There is no formal policy or standard on the frequency of carer visits, and the frequency of visits by the Department’s out of home care teams varies across regions.

Annual reviews are designed to:

• confirm carers are providing the care required to children and young people and

• ensure carers have what they need to provide that care.

The Department and service providers undertake annual reviews of their carers. For at least one service provider, the regional manager conducts the annual review so that the carer can raise any concerns regarding the level of support or relationship with the support worker.

There are differences in whether the service provider submits the review in full or at all to the Department. The responsibility to review carers resides with the service provider and there appears to be little capacity for quality assurance by the Department. Where this occurs, it tends to be through working relationships with providers rather than as a result of formal and discrete monitoring processes.

While reviews are required to be undertaken annually by service providers, this standard may not be met by the Department, with some reviews pushing out towards every two years. Completion rates are not reported upon.

A concern in care or quality of care triggers a formal response by the Department, irrespective of whether they are hosted by the Department or service provider. A new process governing complaints in care is under development.

Stakeholder FeedbackOne service provider commented it would be beneficial to speak with children and young people independently about their experience in care as part of the annual review process. This was discussed in the context of how settled a child or young person was feeling, whether they felt safe and their needs were being met.

Carers spoke about a need to update the annual review form so it reflects the level of carer experience. Carers also felt it provided an opportunity to question the adequacy and types of support provided to carers.

Feedback from child safety officers on the annual review form included that it provided little scope to identify with the carer potential areas for improvement or support needs or to include care concerns. Other child safety officers felt there wasn’t a strong connection between the annual review process and ongoing support for a carer. One Departmental out of home care team has adopted a Signs of Safety approach to conducting reviews as this was felt to be more conducive to a useful and positive conversation.


Points for Discussion:The following points suggest ways to improve our oversight and monitoring of carers.

A monitoring and oversight approach to carers could comprise:

• development of a Carer Home Visit Policy to identify standards for home visits to carers by out of home care workers, and which provide flexibility for more regular visits for carers for example, in the first six months if required

• identification of a carer ongoing approval or renewal process which could include annual reviews and other activities such as identified training and supervision with the out of home care worker. The outcome of the renewal process could be updated on the carer register and

• other reviews initiated in response to a care concern or quality of care issue.

A consistent approach to annual reviews by the Department and service providers could also be agreed and include:

• annual reviews being conducted by an experienced person with sufficient authority who is not the out of home care worker

• interviews with children and young people in the home as part of the annual review, without the carer being present

• inclusion of any care concerns or quality of care concerns, training and support needs

• the Department retaining responsibility to approve annual reviews or needing to be notified if annual reviews flag a concern and

• processes for follow up action, including identified training or support needs.

Annual reviews could draw upon a Signs of Safety approach which allow for a positive and strengths based discussion while being linked to carer competencies. The annual review process and documentation could also be updated and include space for information pertinent to the review such as any care concerns, training and support needs.

Questions27. The Oversight and Monitoring section details

a number of methods that could improve the oversight and monitoring of carers. Which of these methods do you believe would be effective? Provide reasons for your response.

28. Are there any other options or issues related to improving carer oversight and monitoring that have not been explored in this paper? Provide details.

Thought Prompts • Does there need to be a standard regarding

carer visits by out of home care workers, or should it be more flexible (in accordance with the needs of the carer)?

• What should be included as part of the process for carers to maintain their approval as a carer?

• How often should a carer renewal process be required? Should it vary in accordance with the experience of the carer and past reviews?

• What might be some of the processes that would be needed if a carer disagreed with a carer review?





Part 3 - References, Glossary and Appendices


References

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Australian Institute of Health & Welfare. (2014). Child protection Australia 2012-13, Child Welfare Series, 58. Australian Government: Canberra.





Bath, H. (2015). Out of Home Care in Australia: Looking Back and Looking Ahead, Children Australia 40(4), 310-315.

Blacklock, S., Bonser, G., Hayden, P., Menzies, K. (2013). Kinship care: Embracing a new practice paradigm. Developing Practice: The Child, Youth and Family Work Journal, 35, 54-66.

Boetto, H. (2010). Kinship Care: A review of issues, Family Matters, 85, 60-67.

Breman, R., MacRae, A. (2017). ‘It’s been an absolute nightmare’: Family violence in kinship care. Victoria: Baptcare.

Brunner, C., & O’Neill, C. (2009). Mirror Families: Creating extended families for life, Children Australia, 34(4) 6-12.

Casswell, G., Golding, K., Grant, E., Hudson., & Tower., P. (2014). Dyadic Developmental Practice (DDP): A framework for Therapeutic Intervention and Parenting. Child & Family Clinical Psychology Review, 2, Summer Issue, 19-27.

Child and Family Practice (CFP). (2015). Support Needs and placement matching in out-of-home care: A Literature Review. Queensland: Queensland Government.

Child Family Community Australia. (2001). Brief 5: Alternative Care: Comparative analysis of kin versus residential models. Strategic Directions in Child Protection: Informing Policy and Practice. Melbourne: Australian Institute of Family Studies.

Child Protection Systems Royal Commission. (2016). The life they deserve: Child Protection Systems Royal Commission Report. South Australia: Government of South Australia.

Children & Youth Services. (2017). Strategic Plan for Out of Home Care 2017-19. Hobart: Tasmanian Government.

Commissioner for Children and Young People. (2017). Children and Young People in Out of Home Care. Hobart: Office of the Commissioner for Children and Young People.

Conn, A., Szilagyi, M., Franke, T., Albertin, C., Blumkin, A., & Szilagyi, P. (2013). Trends in Child Protection and Out-of-Home Care. Pediatrics, 132(4), 712-719.

Delfabbro, P., & Osborn, A. (2005). Models of service for children in out-of-home care with significant emotional and behavioural difficulties. Developing Practice, 14, 17-29.

Department of Child Safety, Youth & Women (nd a). Practice paper: Placing children in out-of-home-care – principles and guidelines for improving outcomes. Retrieved from: www.csyw.qld.gov.au/resources/childsafety/practice-manual/ppplacinghomeprin.pdf


Department of Child Protection. (nd) Respite Care in the Out-of-Home Care System: Consultation Paper. Western Australia: Government of Western Australia.

Department of Communities Tasmania. (2018). Outcomes Framework for Children and Young People in Out of Home Care. Hobart: Tasmanian Government.

Department of Communities Tasmania. (unpublished). Draft Tasmanian Child and Youth Wellbeing Outcomes Framework.

Department of Families, Housing, Community Services and Indigenous Affairs. (2011). An Outline of National Standards for Out-of-Home Care: A Priority Project under the National Framework for Protecting Australia’s Children 2009-2020. Canberra: Commonwealth of Australia.

Department of Health & Human Services. (2018). Tasmanian Child and Youth Wellbeing Framework. Hobart: Tasmanian Government.

Family & Community Services. 2016. A Literature Review – Developing a Framework for Therapeutic Out of Home Care in NSW. Sydney: NSW Government.

Frederico, M., Long, M., McNamara, P., McPherson, L., Rose, R., & Gilbert, K. (2012). The Circle Program: an Evaluation of a therapeutic approach to Foster Care. Melbourne: Centre for Excellence in Child and Family Welfare.

Hartnett, M., Falconnier, L., Leathers, S., Testa, M. (1999). Placement Stability Study. Urbana-Champaign: Children and Family Research Centre.

Kiraly, M. (2015). A review of kinship carer surveys: The “Cinderella” of the care system? Child Family Community Australia, 31, Melbourne: Australian Institute of Family Studies.

KPMG. (2017). Foster and Kinship Care in South Australia: Final Report. Adelaide: Department for Child Protection.

McClung, L. (2007). Therapeutic Foster Care Integrating Mental Health and Child Welfare to provide care for traumatised children : A Literature Review. Victoria: Berry Street.

McPherson, L., Gatwiri, G., & Cameron, N. (2018). Evaluation of the Treatment and Care for Kids Program (TrACK). NSW: Southern Cross University.

Osborn, A., & Bromfield, L. (2007). Residential and specialised models of care. National Child Protection Clearinghouse, (9), Melbourne: Australian Institute of Family Studies.

Pell, A. (2015). Solving the Foster Care Conundrum: A Call to Action. Melbourne: Berry Street Childhood Institute.

Narey, M., & Owers, M. (2018). Foster Care in England: A Review for the Department of Education by Sir Martin Narey and Mark Owers. London: Department of Education.

Noble-Carr, D., Farnham, J., Dean, C., & Barry, E. (2015). Needs and Experiences of Biological Children of Foster Carers. Research to Practice Series, 8, Institute of Child Protection, ACT: Australian Catholic University.

Queensland Family & Child Commission. (2017). Keeping Queensland’s children more than safe: Review of the foster care system, Blue Card and Foster Care Systems Review. Queensland: Queensland Government.

Purvis, K., Razuri, E., Howard, A., Call, C., DeLuna., J., Hall, J., & Cross., D. (2015). Decrease in Behavioural Problems and Trauma Symptoms Among At-Risk Adopted Children Following Trauma-Informed Parent Training Intervention. Journal of Child & Adolescent Trauma, 8(3), 201-210.

Richmond, G., & McArthur, M. 2017. Foster and kinship carer recruitment and retention: Encouraging and sustaining quality care to improve outcomes for children and young people in care. Institute of Child Protection Studies, Canberra: Australian Catholic University.

Royal Commission into Institutional Responses to Child Sexual Abuse. (2017). Contemporary out-of-home care, volume 12. In Final Report. Royal Commission into Institutional Responses to Child Sexual Abuse. Retrieved from: www.childabuseroyalcommission.gov.au/final-report


Smart, J., & Walton, B. (2007). Children in care. CFCA Resource Sheet – October 2017, Australian Institute of Family Studies. Retrieved from: aifs.gov.au/cfca/publications/children-care

Steering Committee for the Review of Government Service Provision. (2017). Child Protection Services, Volume F, Chapter 16. In Report on Government Services 2017. Canberra: Productivity Commission.

Thomson, L., McArthur, M., & Watt, E. (2016). Foster Carer attraction, recruitment, support and retention. Institute of Child Protection Studies, Canberra: Australian Catholic University.

TFC Consultants Inc. Treatment Foster Care Oregon. Retrieved from: http://www.tfcoregon.com/PDF/One%20page%20Treatment%20Foster%20Care%20Oregon.pdf

Karyn Purvis Institute of Child Development. Trust-Based Relational Intervention. Retrieved from: child.tcu.edu/#sthash.hs8mOEld.dpbs


GlossaryCare and protection order: A legal order that gives child safety services some responsibility for a child or young person’s care and protection.

Care Team: A care team brings together those people involved in providing care and protection to a child or young person in out of home care for the purpose of sharing information and making decisions about the delivery of a child or young person’s care.

At a minimum, members should include the carer, out of home care worker, case manager, therapist/clinician (if engaged), parent and/or significant family members and child or young person (as appropriate). It may also bring in other members such as school social worker, general practitioner, paediatrician or other medical specialist, Aboriginal liaison worker, drug and alcohol worker, mental health worker, youth justice worker and other specialist services including secondary consultant services.

Case Manager: Case managers provide case management and case work services to children and young people for the purpose of ensuring that their safety; stability; and developmental needs are met.

Children and Youth Services, Department of Communities Tasmania (the Department): Children and Youth Services (CYS) provides a range of services and support that contribute to ensuring children, young people and their families are safe, nurtured and well. CYS provide statewide services comprised of:

Child Safety Service

Adoptions and Permanency Services

Services to Young People; including Community Youth Justice and Ashley Youth Detention Centre

Family Violence Counselling and Support Service

Program Support, Learning and Development; providing internal policy development, support and training.

Where responsibility for a service or program sits within CYS and the Secretary of the Department of Communities Tasmania more broadly, the Department is referenced.

Child Safety Officer: An employee working in Child Safety.

Child Safety Services (Tasmania): The role of the Child Safety Service is to protect children and young people who are at risk of abuse or neglect. In Tasmania, the safety of children and young people is covered by the Children, Young Persons and their Families Act 1997.

CALD: Culturally and Lingusitally Diverse.

Family Based Care or Home Based Care: Placement is in the home of a carer who is reimbursed for expenses for the care of the child. There are four categories of home-based care: relative or kinship care, foster care, third-party parental care arrangements and other home-based, out-of-home care.

Family group home: A home for children provided by a department or community-sector agency that has live-in, non-salaried carers who are reimbursed and/or subsidised for providing care.

Foster Care: A form of out-of-home care where the caregiver is authorised and reimbursed (or was offered but declined reimbursement) by the state/territory for the care of the child. (This category excludes relatives/kin who are reimbursed).

Kinship Care: A form of out-of-home care where the caregiver is:

• a relative (other than parents)

• considered to be family or a close friend

• a member of the child or young person’s community (in accordance with their culture) and

• who is reimbursed by the state/territory for the care of the child (or who has been offered but declined reimbursement).

For Aboriginal and Torres Strait Islander children, a kinship carer may be another Indigenous person who is a member of their community, a compatible community or from the same language group.


Other home-based out of home care: A care type where the child was in home-based out of home care, other than with relatives/kin who are reimbursed or in foster care.

Out of Home Care: Overnight care for children aged 0 – 17 years, where the state makes a financial payment or where a financial payment has been offered but has been declined by the carer. Out of Home Care is a specific program delivered within Child Safety Services.

Out of Home Care Worker: An out of home care worker may recruit, assess, train and support a carer. In this document it includes workers employed by the Department and service providers.

Permanency planning: The processes undertaken by state and territory departments responsible for child safety to achieve a stable long-term care arrangement (which can be broadly grouped as reunification, third-party parental responsibility orders, long-term finalised guardianship/custody/care, and adoption).

Residential Care: Where the placement is in a residential building whose purpose is to provide placements for children and where there are paid staff.

Reunification services: Services that seek to reunify families where separation of children from their primary caregivers has already occurred for child safety reasons.

Respite Care: A form of out of home care used to provide short term accommodation for children and young people, where the intention is for the child to return to their prior home. In family based out of home care, this may be organised in a planned and regular fashion to give the child/ren’s usual carers, parents or guardians a break.

Service Providers: Service providers are contracted to provide identified services for carers and/or children and young people in out of home care.

Special Care Packages (Tasmania): Specialised care and/or services are for children with extreme needs who require a specific support package. Each Special Care Package is developed to meet an individual child’s needs, including therapeutic, medical, disability or similar supports and may or may not include an accommodation component.

Therapeutic home based/foster care: The terminology used about this type of care lacks clarity. In Australia the following terms may be used to indicate this type of care: enhanced, intensive, specialised and therapeutic models of foster care. Particular programs apply explicitly theoretically based approaches (trauma, attachment, resilience) to meeting children’s individual and complex needs and ensuring that carers are seen as key therapeutic agents. In some programs, the therapeutic program is time limited.

Transfer of Guardianship to a Third Party: A person other than the Secretary may be granted guardianship for a child or young person under a care and protection order. Under such an order the guardian has the same rights, power, duties, obligations and liabilities as a natural parent of the child or young person would have.

Acknowledgements for glossary: AIHW (2017); Thomson, McArthur & Watt, 2016; Department of Health and Human Services website; CYS Practice Manual.


Appendix One

Consolidated List of Questions Conceptual Framework1. Does the conceptual framework presented in this

paper support a contemporary and effective family based care program in Tasmania?

2. What are additional factors or considerations that need to be taken into account?

Care during an Assessment Phase3. The Care during an Assessment Phase section

discusses the concept of an assessment phase prior to the placement of the child or young person in long term care arrangements with the aim of ensuring an appropriate placement which provides improved stability and support for the child or young person. How can this be best achieved? Provide reasons for your response.

4. Are there other options or issues related to care during an assessment phase not detailed in this paper? Provide details.

Continuity of Care5. A Continuity of Care Approach to Family Based

Care section discusses the importance of continuity of care approach to family based care and the need for clearly articulated roles and responsibilities for carers. Do you believe that this would improve outcomes for children and young people in out of home care? Provide reasons for your response.

6. Are there other continuity of care options or issues not considered in this paper? Provide details.

Family Based Care and Intensive Family Based Care7. The Family Based Care and Intensive Family

based Care section details a number of different approaches that can be used to broaden the scope of family based care. Which of the listed approaches would provide better outcomes for children and young people? Provide reasons for your response.

8. Are there other options or issues related to providing better support to children and young people with highly complex needs and behaviours that have not been discussed in this paper? Provide details.

Recruitment9. The Recruitment and Registration of Carers section

discusses a number of changes to current carer recruitment practices with the aim of building on and strengthening our current approach to recruitment. Which of these ideas do you believe will be more effective? Provide reasons for your response.

10. Are there other carer recruitment improvement options or issues that have not been discussed in this paper? Provide details.

Preservice Training11. The Pre-Service Training section identifies a

number of potential methods for building on and strengthening the current approach to training carers. Which of these methods do you believe would be effective? Provide reasons for your response.

12. Are there other options or issues related to strengthening carer training that have not been explored in this paper? Provide details.

Carer Assessment13. The Carer Assessment section identifies a

number of potential methods for building on and strengthening our current approach to carer assessment. Which of these methods do you believe would be effective? Provide reasons for your response.

14. Are there other options or issues related to strengthening carer assessment processes that have not been discussed in this paper? Provide details.

Approval of Carers15. The Approval of Carers section presents methods

to build on and improve the current approval processes. Which of these methods do you believe would be effective? Provide reasons for your response.

16. Are there other options or issues related to improving carer approval processes that have not been explored in this paper? Provide details.


Registration of Carers17. The Registration of Carers section discusses

how a central carer register (accessible by the department and service providers) could provide a more consistent approach to carer registration and provide additional safeguards for children and young people. What issues should be considered as part of the implementation of a central carer register?

18. Are there other options or issues related to improving information sharing for carer approval and registration that have not been explored in this paper? Provide details.

Placement19. The Placement section discusses the importance

of placement matching processes to improve placement stability and details a number of factors that could form part of a coordinated placement matching process. What factors do you think should be taken into account as part of the implementation of a placement matching process? Provide reasons for your response.

20. Are there other placement matching options or issues that have not been explored in this paper? Provide details.

Ongoing Training21. The Ongoing Training section proposes methods

to build on and strengthen the delivery of ongoing training to carers. What parts of this framework do you believe would be effective? Provide reasons for your response.

22. Are there other carer training options or issues that have not been considered in this paper? Provide details.

Ongoing Support and Retention23. The Ongoing Support and Retention section

proposes a number of actions that aim to build on and enhance support for carers. Which of these do you believe would be effective in providing enhanced support to carers? Provide reasons for your response.

24. Are there any other options or issues related to enhancing support for carers that have not been discussed in this paper? Provide details.

Respite Care25. The Respite Care section details a number of

methods that could maximise the benefit of respite care to both carers and children or young people. Which of these methods do you believe would be most effective? Provide reasons for your response.

26. Are there any other respite care options or issues that have not been considered in this paper? Provide details.

Oversight and Monitoring27. The Oversight and Monitoring section details

a number of methods that could improve the oversight and monitoring of carers. Which of these methods do you believe would be effective? Provide reasons for your response.

28. Are there any other options or issues related to improving carer oversight and monitoring that have not been explored in this paper? Provide details.

Are there other comments you’d like to make against any of the points raised in this paper or that you feel have not been covered in respect to family based care?



App

endi

x Tw

oO

utco

mes

Fra

mew

ork

and

Impa

ct o

f Fam

ily B

ased

Car

e by

Suc

cess

Fac

tors

Dom

ain

Love

d an

d Sa

feM

ater

ial B

asic

sBe

ing

Hea

lthy

Lear

ning

Part

icip

atin

gH

avin

g a

posi

tive

sens

e of

cu

lture

and

iden

tity

Out

com

e1.

1 C

hild

ren

and

youn

g pe

ople

live

in c

arin

g,

lovi

ng a

nd s

tabl

e ho

mes

2.1

Chi

ldre

n an

d yo

ung

peop

le’s

stan

dard

of

livin

g su

ppor

ts th

em to

re

ach

thei

r po

tent

ial

3.1

Chi

ldre

n an

d yo

ung

peop

le r

ecei

ve th

e he

lp th

ey n

eed

to b

e ph

ysic

ally

hea

lthy

and

men

tally

wel

l

4.1

Chi

ldre

n an

d yo

ung

peop

le r

ecei

ve th

e he

lp

they

nee

d to

par

ticip

ate

and

do w

ell a

t sch

ool

and

in tr

aini

ng

5.1

Chi

ldre

n an

d yo

ung

peop

le c

ontr

ibut

e to

de

cisio

ns a

bout

thei

r lif

e, c

are

and

futu

re

6.1

Chi

ldre

n an

d yo

ung

peop

le h

ave

posi

tive

rela

tions

hips

with

pe

ople

that

mat

ter

to

them

.

Succ

ess

Fact

ors

impa

cted

by

Fam

ily

Base

d C

are

Chi

ldre

n an

d yo

ung

peop

le

feel

they

are

car

ed fo

r an

d va

lued

.

Chi

ldre

n an

d yo

ung

peop

le

feel

set

tled

whe

re th

ey li

ve.

Chi

ldre

n an

d yo

ung

peop

le a

re tr

eate

d fa

irly

, w

ith r

espe

ct a

nd d

igni

ty

in a

ccor

danc

e w

ith th

eir

righ

ts.

Chi

ldre

n an

d yo

ung

peop

le

live

with

car

ers

able

to

supp

ort t

heir

need

s,

incl

udin

g th

eir

reco

very

fr

om tr

aum

a.

Chi

ldre

n an

d yo

ung

peop

le

have

thei

r m

ater

ial n

eeds

m

et.

Pers

onal

bel

ongi

ngs,

in

clud

ing

child

hood

ac

hiev

emen

ts a

nd

mem

ento

s, s

tay

with

the

child

and

you

ng p

erso

n w

hen

they

mov

e or

leav

e ca

re.

Chi

ldre

n an

d yo

ung

peop

le

are

assi

sted

to o

verc

ome

expe

rien

ces

and

impa

cts

of

trau

ma.

Chi

ldre

n an

d yo

ung

peop

le

mak

e he

alth

y lif

esty

le

choi

ces.

Chi

ldre

n ar

e en

gage

d ea

rly

in le

arni

ng a

nd a

chie

ve

educ

atio

nal m

ilest

ones

.

Chi

ldre

n an

d yo

ung

peop

le s

ucce

ssfu

lly

tran

sitio

n th

roug

h ke

y po

ints

in e

duca

tion,

in

clud

ing

entr

y to

pri

mar

y sc

hool

, sec

onda

ry s

choo

l an

d co

llege

, as

wel

l as

voca

tiona

l and

hig

her

educ

atio

n.

Chi

ldre

n an

d yo

ung

peop

le

are

supp

orte

d to

rec

over

fr

om tr

aum

a, le

arn

soci

al

skill

s an

d bu

ild e

mot

iona

l an

d so

cial

res

ilien

ce.

Chi

ldre

n an

d yo

ung

peop

le

deve

lop

age-

appr

opri

ate

lang

uage

, lite

racy

and

nu

mer

acy.

Chi

ldre

n an

d yo

ung

peop

le

are

enco

urag

ed a

nd

assi

sted

to c

ontr

ibut

e to

de

cisio

ns a

bout

thei

r ca

re

cons

iste

nt w

ith th

eir

age

and

abili

ty.

Chi

ldre

n an

d yo

ung

peop

le in

car

e kn

ow a

nd

unde

rsta

nd th

eir

righ

ts in

ou

t of h

ome

care

.

Chi

ldre

n an

d yo

ung

peop

le

feel

abl

e to

tell

som

eone

w

hen

thin

gs a

re g

oing

wel

l an

d no

t goi

ng w

ell a

nd

thei

r co

ncer

ns a

re a

cted

up

on.

Chi

ldre

n an

d yo

ung

peop

le m

aint

ain

sign

ifica

nt

rela

tions

hips

.

Chi

ldre

n an

d yo

ung

peop

le

spen

d tim

e w

ith s

iblin

gs

and

exte

nded

fam

ily w

here

th

ey c

hoos

e to

do

so a

nd

it is

safe

.

Tim

e w

ith fa

mily

and

ot

hers

is m

eani

ngfu

l an

d en

able

s po

sitiv

e in

tera

ctio

ns.

Chi

ldre

n an

d yo

ung

peop

le

live

with

thei

r si

blin

gs

whe

re p

ossi

ble

and

it is

safe

to d

o so

.


Out

com

e1.

2 C

hild

ren

and

youn

g pe

ople

feel

saf

e w

here

th

ey li

ve.

4.2

Chi

ldre

n an

d yo

ung

peop

le r

ecei

ve th

e he

lp th

ey n

eed

to

live

succ

essf

ully

on

thei

r ow

n w

hen

they

be

com

e in

depe

nden

t.

5.2

Chi

ldre

n an

d yo

ung

peop

le h

ave

the

confi

denc

e to

pur

sue

thei

r go

als

and

man

age

chal

leng

es.

6.2

Chi

ldre

n an

d yo

ung

peop

le a

re a

ble

to fo

rm

thei

r ow

n id

entit

y in

re

latio

n to

cul

ture

and

co

mm

unity

.

Rel

evan

t Su

cces

s Fa

ctor

sC

hild

ren

and

youn

g pe

ople

fe

el s

afe

with

thei

r ca

rer

and

thei

r ca

rer’s

fam

ily.

Chi

ldre

n an

d yo

ung

peop

le

have

a tr

uste

d pe

rson

to

talk

to a

bout

thin

gs th

at

wor

ry th

em.

Chi

ldre

n an

d yo

ung

peop

le

know

wha

t to

do if

they

fe

el u

nsaf

e.

Chi

ldre

n an

d yo

ung

peop

le

lear

n sk

ills

for

life

and

livin

g in

depe

nden

tly.

Youn

g pe

ople

are

su

ppor

ted

in th

eir

tran

sitio

n to

adu

lthoo

d an

d ha

ve a

pla

n fo

r th

e fu

ture

.

Youn

g pe

ople

kno

w h

ow

to a

cces

s su

ppor

t and

se

rvic

es in

the

lead

up

to

and

afte

r le

avin

g ca

re.

Youn

g pe

ople

mak

e po

sitiv

e lif

e ch

oice

s an

d de

cisio

ns a

bout

thei

r fu

ture

go

als

Chi

ldre

n an

d yo

ung

peop

le

have

soc

ial n

etw

orks

and

pa

rtic

ipat

e in

rec

reat

iona

l ac

tiviti

es.

Chi

ldre

n an

d yo

ung

peop

le

are

supp

orte

d to

dev

elop

an

d m

aint

ain

frie

ndsh

ips.

Chi

ldre

n an

d yo

ung

peop

le

feel

con

fiden

t abo

ut th

eir

futu

re a

nd h

ave

goal

s.

Chi

ldre

n an

d yo

ung

peop

le

are

resi

lient

and

abl

e to

ov

erco

me

chal

leng

es.

Chi

ldre

n an

d yo

ung

peop

le

have

a s

ense

of t

heir

iden

tity,

thei

r hi

stor

y an

d w

here

they

com

e fr

om.

Abo

rigi

nal a

nd T

orre

s St

rait

Isla

nder

chi

ldre

n an

d yo

ung

peop

le d

evel

op

and

mai

ntai

n a

conn

ectio

n w

ith A

bori

gina

l and

Tor

res

Stra

it Is

land

er fa

mily

, co

mm

unity

and

cul

ture

.

Out

com

e1.

3 C

hild

ren

and

youn

g pe

ople

hav

e tim

ely

deci

sions

abo

ut th

eir

long

-ter

m h

ome

Rel

evan

t Su

cces

s Fa

ctor

sC

hild

ren

and

youn

g pe

ople

ha

ve a

sen

se o

f sta

bilit

y in

th

eir

lives

.

Chi

ldre

n an

d yo

ung

peop

le

are

mat

ched

with

car

ers

able

to s

uppo

rt th

em a

nd

mee

t the

ir ne

eds.

Chi

ldre

n an

d yo

ung

peop

le

mee

t fos

ter

fam

ilies

be

fore

hand

to e

nsur

e a

good

fit.


Appendix ThreeKey Messages: Research Literature, Reviews and ReportsRetention of Carers in Out of Home CareThe challenge of ensuring a sufficient supply of carers has increased the focus upon retention of carers already within the system. The Centre for Excellence in Child and Family Welfare (2007, cited in KPMG, 2017) notes that the most effective retention strategy is the care and support of current foster carers. Similarly, Richmond and McArthur (2017) note that the quality of the relationship between the care team and the carer, level of carer involvement in the care team and match between the child or young person’s needs and a carer’s capacities are consistently raised as critical factors for retaining carers.

Octoman and McLean (2014, cited in CFP, 2015) found that carer access to information about the needs of children and young people, prior to and during their care for the child was the most important support for carers. This is followed by information that assists carers to manage behaviours. Other factors cited in relation to carer retention include: the provision of adequate financial support; honest and open communication, where carers are treated as respected members of the care team; and access to training and support which is timely, tailored and appropriate in times of crisis (Richmond & McArthur, 2017; KPMG, 2017).

Overall, the literature suggests that successful retention of carers is broader than providing individual supports to maintain a placement. Rather it reflects the principles of partnership, respect and working with carers in a way which ensures they have the information and tools to meet the needs of the children and young people in their care.

The Importance of Placement Stability Research shows that providing children and young people with stability, security and connectedness is crucial for healthy emotional development and is a strong predictor for outcomes (FaHCSIA, 2009). This research draws upon scientific knowledge into the impact of childhood trauma on physical, cognitive and behavioural development as well as “...the important

role the attachment relationship has in long-term social, health and mental health outcomes…” (Conn, Szilagyi, Franke, Albertin, Blumkin & Szilagyi, 2013 p. 717).

Whether or not a child or young person experiences “…a sense of being loved or belonging…” will critically influence the success of an out of home care placement (Boetto, 2010, p. 61). Cashmore and Paxman’s (1996, p. 2, cited in Bath, 2015, p. 312) study found that continuity and stability in care were likely to be “…the most important factor influencing outcomes…”, and Beauchamp (2014, cited in CFCA, 2017) observed children and young people living in stable homes are more likely to be able to maintain relationships and stay connected with their community and education. Bath (2015, p. 313) notes that continuity of care is frequently raised by young people as being necessary to develop “…longer-term, stable relationships with people, programs and places”.

Other studies note an association between placement instability and “…poor educational, employment, social and psychological outcomes (Johnson et al, 2011) as well as behavioural and emotional problems (Australian Institute of Family Studies, Chapin Hall Center for Children University of Chicago, & NSW Department of Family and Community Services, 2015)” (Smart & Walton, 2007, p. 6).

Concurrent planning is a concept which seeks to maintain stability or the continuity of care for a child or young person while they remain in out of home care. Using this approach children and young people are placed into a home where they may stay permanently if they are unable to return home to their biological family (Child Welfare Information Gateway, 2012). This approach recognises the importance of a stable home as a foundation for developing caring, trusting and stable relationships, and maintaining connections with education, culture and community. The Child Protection Systems Royal Commission in South Australia report handed down in 2016 recommends that concurrent planning receive greater focus within case planning, particularly while children are in their active attachment period.

Placement MatchingA literature review compiled Child and Family Practice (CFP) (2015) for the Queensland State Government into the support needs and placement matching for children and young people in out of home care found that while there was limited research into placement matching and placement decision making processes, common research findings included:


• limited placement matching contributes to greater placement instability and range of poor outcomes for children and young people, including poor psychological outcomes and educational problems. It also increased the likelihood of behavioural needs being overlooked and potentially compromised highly vulnerable children and young people with an adverse sexual history (Osborn & Delfabbro, 2006; Farmer et al, 2004; Triseliotis et al, 2000; Farmer & Pollock, 1999 cited in CFP, 2015)

• placements are at a higher risk of break down when they are made quickly, in the absence of adequate consultation with children or young people and the carer and “…when carers’ preferences about the characteristics of children to be placed are ignored…” (Schofield & Simmonds, 2009 cited in CFP, 2015, p. 18)

• children and young people who experience behaviour-related placement breakdowns are less likely to achieve placement stability into the future, with “…children who have two or more behaviour-related placement disruptions having only a 5 per cent chance of achieving placement stability 2 years later…” (Kelly & Salmon, 2014 cited in CFP, 2015, p. 3) and

• providing full and accurate information to carers on behaviours of the child or young person prior to fostering is linked to “…enhanced placement stability and improved outcomes for children and young people…” (Octoman & McLean, 2014 cited in CFP, 2015, p.17).

The Royal Commission into Institutional Responses to Child Sexual Abuse’s (2017) report into out of home care draws upon research and individual testimony of past survivors into institutional child sexual abuse in its recommendations. It highlights the significance of placement stability and placement matching in ensuring safety and wellbeing of children and recommends all institutions develop strategies to increase the safety and stability of placements, including:

• improved matching processes for children and young people with carers and other children and young people in a placement, including for residential care

• ensuring carers receive the information necessary to support a child or young person both prior and during provision of care to that child or young person and

• ensuring carers receive support and training to “…deal with the different developmental needs of children as well as managing difficult situations and challenging behaviour…” (Royal Commission, 2017; p. 28).

It also notes that placement matching processes should be “…rigorously assessing potential threats to the safety of other children, including the child’s siblings, in the placement…” (Royal Commission, 2017, p.27).

Placement matching needs to be holistic in nature and consider a range of factors related to the child or young person in order to determine:

• the type and level of care best suited to the child or young person

• the supports and services that may be required to support the child or young person

• the required skills and abilities of the carer as well as their potential training and support needs and

• the potential impact upon children already in the home (Department of Communities, Child Safety and Disability Services, website; CFP, 2015).

These factors include the type and likely duration of the placement, the gender and presence of siblings, culture, care needs, case plan goals, location and continuity of relationships, school, and safety issues (Department of Communities, Child Safety and Disability Services, 2013).

Understanding the Needs of a Child or Young PersonWhile the global needs of children and young people are broadly understood, identifying the individual needs of a child or young person upon entry into care may inform the placement matching process and in particular, identify the type of care and supports needed for the child or young person.

Unfortunately for many children and young people in out of home care, a mutually reinforcing relationship exists between mental health problems and placement instability where “…placement instability may cause as well as exacerbate mental health problems and mental health problems significantly contribute to placement instability…” (CPF, 2015, p. 2). An American study found that unmet child behavioural need in the foster care placement formed the most significant reason for placement breakdown as reported by foster carers and case workers (Harnett, Falconnier, Leathers & Testa, 1999). It recommended “…the creation of a structured system of individualised needs-assessment, service


planning, and routine evaluation for all children with behavioural needs, regardless of placement type…” (Harnett, et al, 1999, p. 3). Such a system would provide (among other things) clinical assessment of child or young person’s needs, collection and analysis of data, individualised service planning and enhanced standards for the provision of care.

Individualised assessment of a child or young person’s needs is already established as the basis for therapeutic planning and intervention within therapeutic residential care and intensive foster care (Bath, 2015). In recognition of the particular vulnerabilities of children and young people with a history of sexual harm, the Royal Commission (2017) recommended the use of professional assessments for children and young people to identify needs, supports and interventions.

Increasing Complexity of Needs for Children and Young People Entering Out of Home CareResearch consistently demonstrates high rates of mental health disorders, significant emotional and behavioural problems and externalising behaviours for children and young people in care. Delfabbro and Osborn’s study (2005) of 364 children and young people aged 4-17 years across four states, found that at least two-thirds were found to have significant conduct disorder problems, over one third experienced significant depression or anxiety, and 30 per cent had an intellectual disability. In another study, Octoman et al (2014) found around 60 per cent of children and young people in care have clinical levels of behavioural and mental health disturbance.

The Professionalisation of Care The professionalisation of care, which reflects the rising expectations on carers to provide higher standards and quality of care, is another strong theme within the literature. This shift towards professionalisation reflects a number of factors, including:

• the growing body of knowledge around the neurobiological impacts of trauma upon child development (Conn, et al, 2013)

• the shift away from institutionalisation of children and young people through the 1980s and 1990s (Delfabbro & Osborn, 2005)

• the increasing complexity of behaviours of children and young people coming into out of home care (Thomson et al, 2016) and

• a desire to ‘normalise’ the care of children and use the ‘least restrictive’ care environment (Bath, 2015).

While these factors may have contributed to the emergence of therapeutically informed models of practice in residential care and intensive or specialist family based care, these factors also underlie an extension of trauma-informed approaches to foster and kinship care more generally (Thomson et al, 2016).

Some jurisdictions are using specialist forms of care to deliver therapeutic care for a child or young person, particularly when these children and young people are assessed as having complex behaviours and needs. Intensive family based care models, most of which tend to focus upon foster care, tend to feature specialised recruitment, training and support for carers and higher rates of carer payment (FACS, 2016).

Some Australian jurisdictions also separate carers according to the phase of care for a child or young person. Western Australia for example requires its carers to nominate to be a temporary carer, permanent carer, or both. Temporary carers provide care for children for whom there has been no final decision for the child’s legal care and is limited to a period of up to two years. Permanent carers provide care where a decision has been made for a child to live permanently out of their parent’s care and include orders up to the age of 18, special guardianship orders and adoption.

The concepts of specialisation and stability of care are not by necessity a dichotomy and specialised care may be essential to support therapeutic care and placement stability for a child or young person. There may remain however an inherent tension whether a child or young person’s needs are best served by maintaining stable care relationships or by specialisation, where children may be moved between care types, according to the carer best suited to their needs.


Appendix FourTherapeutic Practice Frameworks and Intensive Family Based Care Programs

Additional Information on Therapeutic Frameworks for Working with Family Based Carers:A research paper describing Developmental Dyadic Practice and its developing evidence base may be found at: ddpnetwork.org/library/dyadic-developmental-practice-ddp-framework-therapeutic-intervention-parenting/

General information on Trust-Based Relational Intervention may be found at: child.tcu.edu . A research paper by Purvis, Razuri, Howard, Call, DeLuna, Hall & Cross (2015), called Decrease in Behavioural Problems and Trauma Symptoms Among At-Risk Adopted Children Following Trauma-Informed Parent Training Intervention is available on the website.

Please refer to Appendix Five for HEALing Matters.

Additional Information on Intensive Family Based Care ProgramsGeneral information on the Circle program, as delivered by Berry Street under Take Two may be found at: www.berrystreet.org.au/our-work/healing-childhood-trauma/take-two.

An evaluation of the Circle program is available at: 128.199.174.185/wp-content/uploads/2012/10/The%20Circle%20Program%20-%20An%20evaluation%20of%20a%20therapeutic%20approach%20to%20foster%20care.pdf

Information on Treatment Foster Care – Oregon may be found at: www.tfcoregon.com/about.html

Please refer to Appendix Six for the TrACK program.


Appendix Five

HEALing Matters Program Overview (Skouteris, provided as part of personal communication, October 12, 2017)

BackgroundChildren in out-of-home care (OOHC) experience a wide array of adverse physical and mental health outcomes, most likely as a consequence of maltreatment and potentially compounded by adverse experiences and placement disruption in care. One health risk that appears to have been overlooked is the prevalence of overweight and obesity of young people placed in OOHC. This evidence gap (particularly in Australia) is surprising given obesity is a major public health concern and the importance of early intervention is well established. Internationally, there are few studies that have trialled intervention programs designed to address overweight/obesity and unhealthy weight gain among young people living in OOHC.

Excessive weight and unhealthy lifestyles for adolescents in residential care - What do we know?Our formative research, supported by an Australian Research Council grant, established that young people living in out-of-home care (OOHC) are at substantially increased risk of excessive weight gain and associated morbidity.

What is the Healthy Eating, Active Living (HEAL) program?The HEAL program was designed to address the need for provision of a healthy food and physical activity environment in residential care units. HEAL was implemented only in residential care because the psychosocial and health outcomes for young people in this setting are poorer compared with those young people living in other OOHC arrangements and in the general population. HEAL is a 12-month program, inclusive of 6-months maintenance which aims to provide the young people in residential OOHC with information and practical opportunities to improve

their eating and physical activity habits. HEAL also targets their direct-care staff, providing professional development, resources and support to facilitate these behaviour changes among the young people.

In our formative research, HEAL was delivered by trained coordinators who were experienced with residential care and was evaluated using a randomised trial design, across three community service organisations in metropolitan and regional Victoria: Berry Street; The Salvation Army Westcare; and Wesley Mission Victoria. The (former) Department of Human Services, Hurstbridge Farm also joined in the program. Qualitative findings, based on interviews, indicated consistently that the HEAL program was very well received by the young people and their carers and resulted in:

• I ncreased participation in community sports groups, and meal preparation

• Increased availability of sports equipment

• Conscious effort by staff to provide healthy snacks/meals and

• Improvements in perceived adolescent self-esteem and independent living skills.

There is a clear theoretical rationale for addressing the healthy eating and physical activity habits of YP in OOHC

Both ‘Food For Thought’, developed by a team of sociologists and social workers from Stirling University, and the Children and Residential Experiences: Creating Conditions for Change (CARE) practice model, outline how food and physical activity are a powerful way of demonstrating trust, care, predictability, flexibility and attuned parenting, and can be used to facilitate communication, build relationships, autonomy and a sense of control. Hence, training, resourcing and supporting carers to positively influence a young person’s eating and/or physical activity habits provides an opportunity to:

• improve their skills and motivation to respond appropriately, and therapeutically to young people’s pain-based behaviour and

• prepare young people for a healthy future by using food and activity to normalise their experiences and promote socially acceptable behaviours.


It’s time to focus on preventionConsensus on the urgency and priority is clear: The Victorian ‘Roadmap for Reform: Strong Families, Safe Children project, ‘Looking After Children Framework’, and ‘The Home-based Care Handbook’ and Federal Government’s ‘National Standards for Out-of-home Care’, unanimously call for lifestyle interventions to improve the health of YP living in OOHC. However, current initiatives to improve health and wellbeing outcomes for young people in OOHC have focused on “problem-oriented” and “illness-focused” approaches. While these are an integral part of a holistic health care plan, evidence tells us that effective prevention reduces the likelihood of the onset of chronic disease such as type 2 diabetes, cardiovascular disease, asthma, stigmatisation, psychopathology, and body dissatisfaction.

What is the proposed HEAL project?The proposed project will inform intervention approaches to ensure children in OOHC live in a healthy home environment. Changing the home environment – to one that encompasses a healthy eating, active living philosophy/culture – will address the short- and long-term healthy consequences. HEAL provides a toolkit that is directly related to providing an adolescent friendly, skill building response to health within OOHC to promote improved practice, and ensure a young person’s health needs are being met.


Appendix SixTreatment and Care for Kids (TrACK) Program Overview(Australian Childhood Foundation, provided as part of personal communication, July 13, 2018)

Program OverviewThe TrACK therapeutic service delivered by the Australian Childhood Foundation (ACF) is designed to enhance and support placement stability and recovery for children and young people who have experienced abuse-related trauma, and whom display a range of challenging behaviours requiring therapeutic home-based care. The goal of the program is to enhance the therapeutic parenting capacity of foster carers, and support therapeutic work with the children. All TrACK carers participate in training and ongoing support with the ACF Therapeutic Specialist.

Therapeutic models of care require a multi-systemic, consistent and holistic approach across the range of environments in which the child or young person lives. Interventions are most successful when carers, support networks and professionals enact collaborative and intersecting functions that can achieve protective, reparative and restorative objectives for children and young people. As such, the Australian Childhood Foundation delivers therapeutic programs in partnership with Out of Home Care agencies where staff from both organisations engage in collaborative relationships with carers and create Therapeutic Care Team (TCT) processes with a range of other stakeholders in the child’s life, such as schools and other agencies. TCT structures and processes support these relationships and the development of a shared approach to the child, regardless of what setting the child/young person is in.

A TCT is formed around every child and young person in the TrACK program. TCT’s are an important aspect of therapeutic care helping to provide a “therapeutic web” in the system around the child. The TCT is seen as a powerful antidote to the fragmentation of service delivery that is often the experience of many children and young people with complex needs.

The TrACK program provides a framework that recognises factors that derail normative development, and works with children, young people, carers, families, and systems to build or re-build healthy developmental pathways. The program is based on the following elements:

Target GroupEligibility for the TrACK program requires the presence of the following:

• The child’s need for a medium to long-term placement

• An assessed need for an intensive support component to ensure the ongoing viability of the placement

• An identified need for specialised training and support for caregivers in order to provide a stable environment where the needs of the child/young person can be met and

• Challenging behaviour or complex needs of the child/young person requiring multi-service provision.

Criteria for AcceptanceThe following criteria must be met in order to refer a child or young person to the TrACK Program:

• The child/young person is 16 years or younger. Being under the age of 16 allows the young person to experience at least two years of placement stability and care.

TRAUMA INFORMED

SAFETY AND

NURTURE

RELATIONAL

COLLABORATIVESELF-CARE

STRENGTHS

BASED


• The child/young person has challenging behaviours and/or complex needs, which require multi-service provision. For example: previous multiple placements, Attachment issues, sexualised behaviours, defiant behaviours, low self-esteem, dysregulated arousal (as demonstrated through tantrums/outbursts of anger), poor social skills, disturbed or antisocial behaviour patterns.

• If the child/young person is not attending school, that there is a strong and achievable plan to return to some form of day program.

• The child/young person, despite their challenging behaviours and complex needs, can be placed in a home-based environment and has some capacity to develop and maintain relationships within the intensity of a family situation.

OutcomesThe TrACK program was evaluated by Southern Cross University in 2017. To date, 48 children and young people had been through the program during the 15 years of operation. Of those, 29 children had experienced more than three placements in the lead up period to their referral into TrACK. The striking feature of the data is the extreme instability that some of the children had experienced prior to TrACK, with 15 children having lived in more than six placements before TrACK. Seven of these children had experienced more than ten placements, with one child having experienced 18, and another child, 30 placements.

The single most compelling result emerging from this evaluation is that children who had experienced many placements and years of adversity were almost always able to achieve stability in TrACK. The term ‘stability’ here refers not only to placement, but includes stable and secure relationships within a family environment, and stability in experiencing long-term connection to an extended family that continued beyond the age of 18 when the young people officially left ‘care’. It also involves having hopes, dreams and aspirations for the future without concern or fears about basic survival.

Critical elements influencing the success of the TrACK program include:

• Therapeutically trained, experienced, capable carers who were prepared to commit to the long-term care and healing of children who had experienced significant adversity.

• A stable, long term Therapeutic Care Team that shared a commitment to the sustained focus on the child’s needs and the child–carer relationship. Carers consistently reported that they were not alone, that they had a long-standing relationship with other team members and that they knew that they had ‘round-the-clock’ support.

• The value of a clear theoretical and evidence-informed model of practice, which was conveyed, primarily by the Therapeutic Specialist, in a practical and accessible manner in response to the unique needs of each child. Practice models, which were based on the neurobiology of attachment (Baylin & Hughes, 2017), were familiar to professionals and carers, who were able to communicate the child’s needs using shared language and conceptual frameworks.

• The value of manageable caseloads for foster care professionals and Therapeutic Specialists which enabled time and space for reflective holistic practice.

• The importance of discretionary funding to enable carers to provide for children in ways that may enhance their development and healing.


Appendix Seven

Winangay Kinship Assessment Resources(Winangay Resources, provided as part of personal communication with Paula Hayden, March, 2018)

Winangay Kinship Care Assessment Resources Winangay Resources Inc have developed 2 kinship care assessment tools. Both tools are designed to assess kinship carer’s capacity strengths needs and concerns. The tools acknowledge the existing relationship kinship carers have with the kids and the knowledge they bring to the assessment about the kids and extended family.

Prospective carers for Aboriginal or Torres Strait island children should be assessed using the culturally appropriate Aboriginal tool. All other prospective carers use the second tool. (mainstream version)

Copies of the resources are provided to participants during training and are not available for independent purchase.

A collaborative way of working The Winangay Kinship Care assessment tools create a climate in which power is shared more equally between workers and carers and is an enabling process in which perspective knowledge and insights are valued. Prospective kin carers are partners taking ownership of the process recording their responses, identifying strengths, needs and concerns and strategies to address unmet needs. Workers facilitate the assessment process maximising opportunities for prospective kin carers and child/children to be heard. Carers and workers learn from each other in a mutually enabling and empowering process.

The assessment tools incorporate the National Assessment Principles (validity, reliability, flexibility, fairness) and Rules of Evidence (validity, genuineness, currency, sufficiency). Consistency is generated by gathering 3 different types of evidence.

Assessment Evidence Winangay assessment tools generates evidence from three sources:

1. Yarning (conversational) interviews

2. Strengths and Concerns assessment

3. Third party evidence.

This evidence is utilised to produce both a final report with recommendations and an action plan outlining next steps or further action.

1. Yarning (conversational) interviews

Both tools are comprised of 4 conversational ‘yarning’ interviews with plain English questions that respectfully explore all relevant factors particularly child safety. They are designed to build a trauma informed safe assessment environment and a positive relationship with prospective carers by using an informal and flexible yet rigorous process that generates comprehensive evidence

The Winangay Assessment Tools are underpinned by 4 Key Competencies:

1. Environment and meeting basic needs

2. Staying Strong as a Carer

3. Growing KiDs strong

4. Safety and Working Well with Other.

2. Visual cards

Winangay assessments use a set of visual cards aligned to each competency which identify key factors for a successful placement. The visuals on the cards reflect key components of quality care; they enable all carers to fully participate in the assessment process in a respectful inclusive way. The cards allow a strengths and concern assessment to be conducted, identifying strengths and determining what is working, what’s OK, and what concerns they might have. A graduated colour coded continuum from a significant strength (dark green) to a significant concern (dark red).


3. Third party evidence

A template is provided to gather 3rd party evidence from key community members and professionals. This allows verification of the information provided by the prospective carers. Confirmation from Elders, community leaders, teachers, health professionals, spiritual leaders and community workers adds rigour and increases confidence in the assessment outcomes.

Action Plan

Through the use of collaborative engagement, strengths based frameworks and solution focussed questions, workers work alongside prospective carers to identify strengths, unmet needs and concerns which may negatively impact on their capacity to meet the child’s needs. From this conversation emerges an Action Plan where workers and carers collaboratively record strengths, unmet needs and any concerns as well as services and support which may be required.

A review mechanism is built in to evaluate the extent to which needs have been met and concerns addressed. As one carer said: ‘What’s important to us gets included in the Action Plan, we work with the worker to decide what we all have to work on”

Final Report

A template is included to support workers in summarising and analysing the data and information gathered. It includes space for conclusions and recommendations.

Department of Communities Tasmania

[email protected]

www.communities.tas.gov.au/children/oohc_project

October 2018

Copyright State of Tasmania (2018)

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