Practice Framework for Out of Home Care....2 Possability Practice Framework for Out of Home Care About Us Possability (formerly Optia) is a not-for-profit organisation with more than

Practice Framework for Out of Home Care.

2 Possability Practice Framework for Out of Home Care www.possability.com.auwww.possability.com.au

About Us

Possability (formerly Optia) is a not-for-profit organisation with more than 25 years’ experience in disability services. In 2013, we began providing Out of Home Care in North West Tasmania. In 2015, in response to the Tasmanian Government’s Out of Home Care reforms, we extended our services across the state.

We work with children who have needs such that they cannot be cared for by foster families. We provide a nurturing and secure environment, with specialist support to meet their individual needs.

About the Practice Framework .................. 4

Practice Framework .................................... 5

Purpose, Vision and Values ......................... 6

Practice: Approaches and Actions .............. 8

Research and Evidence ............................... 12

Outcomes .................................................... 12

Case Study: How does our Practice Framework work for Toby? ........................ 13

Useful Resources ......................................... 15

Possability Practice Framework for Out of Home Care 3

4 Possability Practice Framework for Out of Home Care

About the Practice Framework?

The Practice Framework for Out of Home Care is designed to be a best-practice guide for Possability staff, grounded in core organisational values, legislation and evidence-based research. The Practice Framework reflects recent Out of Home Care reforms in Australia and focuses on high quality, person-centred service provision.

In accordance with the National Framework for Protecting Australia’s Children, Possability believes:

“All children have the right to be safe and to receive loving care and support. Children also have a right to receive the services they need to enable them to succeed in life.” (COA, 2009, P. 6)

Possability creates safe, secure and predictable environments for children and young people. We build trusting relationships, communicate expectations, listen and act consistently. We restore and improve the health and wellbeing of the children and young people in our Out of Home Care environments.

Possability provides individualised support planning and includes children and young people in decision-making. Increasing placement stability is a priority, and we create opportunities for self-discovery and personal growth. Possability works to ensure children and young people have access to education, and encourage engagement in learning and skill development. Our approaches are positive, child-centred, inclusive, trauma-informed and evidence-based.

The Practice Development Framework for Out of Home Care allows us to better meet the needs of the children and young people we support. It centres on the individual and realises the importance of creating positive, nurturing environments.


Practice Framework

Legislation, Standards and PrinciplesDisability support models and practice frameworks, including the new Disability Services Framework and the New Zealand Disability Strategy, are grounded in key principles and legislation (SEE DHHS,

2009; ODI, 2001). Standards including quality, safety and upholding personal rights, for example, underpin frameworks that guide actions. Possability’s Practice Framework is informed by these same standards, but also by our own core organisational values.

Organisational Values

Purpose (Mission & Vision)

assures

Legislation, Standards, Human Rights & Governance

A Good Life

leads to

Client Outcomes

ensures

Practice (Approaches & Actions)

drives

Organisational Strategy

underpins

Research

produces

Evidence

informs & guides


Our Vision

That all people supported by Possability will have the maximum potential to lead a good life.

Our Mission

To empower people with additional needs to achieve their vision of a good life, by delivering excellence in support.

Purpose, Vision and Values


Our Values

HumanityHuman rights and dignity underpin all our decisions and actions. We believe that every individual has the potential to grow and the right to determine how their life will be lived.

HonourWe take pride in our work, are true to our word, honour our commitments and treat our colleagues and clients with integrity and respect.

InnovationDriven by our commitment to excellence, we are continually learning, taking on new challenges, and constantly finding ways to excel in the dynamic world we operate in.

AccountabilityWe know where we are heading and why. By being efficient, effective and persistent we find ways to make things possible and deliver results.


Practice: Approaches and Actions

The main focuses of recent Out of Home Care reforms have been on quality and safety in service provision. There is a demand for approaches that increase placement stability, are child-centred, and responsive to need. The practices we employ must also be appropriate for supporting children who have experienced trauma (SEE THE NATIONAL FRAMEWORK FOR

PROTECTING AUSTRALIA’S CHILDREN AND THE

INTEGRATED STRATEGIC FRAMEWORK FOR NEW

DIRECTIONS FOR CHILD PROTECTION IN TASMANIA).

Possability’s actions are therefore guided not only by our values, but also by the current directions in the sector and evidence-based best practice demonstrated through research.

Possability’s approaches therefore include:

> child/youth-centred approaches

> inclusive practices

> trauma informed practices

> positive behaviour support

Child/youth-centred approachesAll actions by Possability staff are aimed to achieve the desired outcomes for the individual child or young person, including short-term goals and life goals (SEE STIRK

& SANDERSON, 2012, P. 13). The child/young person is always included in conversations, planning and decision-making (SEE COA, 2011;

COA, 2009; UNICEF, 1989).

Some of our actions include:

> understanding the child’s life story and planning according to expressed needs and life aspirations

> planning with the child, family and other key stakeholders, with a focus on health and wellbeing, and ensuring the child is safe and secure

> implementing, reviewing and adapting care plans to suit individual circumstances and need

> providing opportunities to engage in various experiences that are meaningful and engaging.


“A home is not merely a shelter. A real home has hearth; a sense of warmth and comfort. A real home has heart; it’s a place of emotional warmth and emotional connection. Home is a place of privacy where the occupant can control who comes in and who does not come in. A real home has a sense of identity. It has roots, it is where the person belongs…” (MCCLEAN, 2014)

Inclusive practicesThe National Framework clearly states the need to uphold the child’s right to participate in decisions that affect their life and to feel a sense of belonging. The literature more broadly also demonstrates a need for children to have a sense of belonging through stability and security. Possability therefore:

> creates warm, caring, secure, and familiar environments that empower children to make choices

> keeps children safe and protects them from harm

> establishes routines, clearly communicates expectations and acts in a consistent manner

> creates a sense of home, where ‘home’ is defined as:


Positive behaviour support approachesPossability employs positive behaviour support approaches as these are complementary to other practices including trauma-informed approaches, child-centred approaches and inclusive approaches. Further to this, the positive behaviour support model aligns with our core values and the legislation.

The key actions of Possability staff that are associated with these approaches include preventing problem behaviour where possible and responding when necessary by:

> creating environments designed to meet individual need, and knowing the person and their cues for communicating that they are not coping

> focusing on skills development, including skills that replace problem behaviour, and coping and tolerance skills

> responding to the needs that are being communicated through behaviour, and offering assistance and understanding.(SEE LAVIGNA AND WILLIS, 2012)


Trauma-informed practicesTo create a sense of home, and to abide by the principles of trauma-informed support, Possability staff start with building trust. As many children and young people in Out of Home Care have experienced trauma in their lives, we focus on establishing a relationship through respectful communication. We listen, ask about, and honour the opinions and choices of the children and young people we support. We recognise that people may be scared, frightened and angry, so ‘winning the argument’ is not as important as establishing trust. Staff communicate clear boundaries, but they are compassionate and caring at all times. Promises that are made to children and young people are kept. Staff compliment and encourage the children and young people we support and find positives on which to focus. Possability is guided by the fact that children and young people who have “multiple, positive healthy adults invested in their lives improve” (SEE PERRY & HAMBRICK, 2008). Furthermore, we understand the importance of feeling connected to others:

“People who are connected to others who know and care about them lead happier and healthier lives than people without relationships.”

(COUNCIL ON QUALITY AND LEADERSHIP)

Possability staff reduce arousal by creating and maintaining a consistent, safe and stable environment (SEE PERRY & HAMBRICK,

2008). Our approach is to respond in a calm, caring manner in the face of crisis, by modelling ‘co-regulation’ (SEE ANGLIN, 2002).

We reduce arousal and model self-regulation by:

> providing the basic needs of shelter, food and clothing, and empowering the person to have choice, control and security of access to these

> acting in a way that is consistent and predictable i.e. ‘doing what we say we will do’

> teaching the person how to be self-sufficient and meet their day-to-day needs

> remaining calm while connecting to the emotional tone or message the person is conveying

> providing an appropriate role model to the person who is aroused

> supporting the person to take cues for appropriate emotional responding

> teaching the person how to regulate arousal and emotion.


Research and Evidence

The Out of Home Care reform papers, strategic plans, and National Practice Frameworks all highlight the need for practices to be evidence-based. The practices that are currently included in Possability’s Practice Framework have been shown through published research to be effective. Furthermore, these practices are consistent with Possability’s values and the legislation and frameworks under which Possability is contracted to provide services. All of Possability’s practices are grounded in protecting the rights of the individual child or young person, and in providing high quality and effective support.

To ensure that Possability continues to deliver current best practice we will:

> regularly consult with and always value the input of all children and young people we support

> reflect on and monitor our services by conducting research and measuring outcomes

> continue to research and innovate to generate new practices and evidence

> attend forums and conferences to share knowledge, learn about new directions and build collaborative partnerships with key stakeholders

> monitor literature, review emerging trends, implement and evaluate new practices

> regularly review the practice framework that guides our actions

> promote development and provide opportunities for staff to engage with relevant education and training.

Possability aspires to and achieves high standards. These standards are guided by our values, the legislation and new directions in service provision. The outcomes we seek to achieve include:

> social and economic participation

> enhancement in health and wellbeing

> increased goal attainment.

The outcomes are delivered by being aware of the direction we are taking, and being committed, motivated and courageous. Achieving excellence in service provision leads to outcomes for the organisation and the individual. When we create opportunities for growth, discovery and learning in secure, safe environments, this leads to our clients building their skills and participating socially – in the home, school and community – and in the economy. This way our clients achieve goals, which in turn enhances their health and wellbeing.

Outcomes


Case Study: How does our Practice Framework work for Toby?Twelve-year-old Toby arrived on a Friday afternoon at temporary accommodation operated by Possability. His foster carers contacted his Case Manager that morning after an incident the night before. They said his things were packed and he was not welcome to come back after school. He was transported to the house by a worker who knew nothing about his situation. The information provided was that he took medication, that he could be aggressive, and that there was a history of physical abuse and possibly sexual abuse as well. He arrived at the door with all his possessions in two large plastic zippered bags.

The staff member recognised that Toby was likely to be frightened and anxious. First, the staff member showed Toby where he would sleep, where he could put his things, where to find the toilet and where to find food and drink. The staff member told Toby he could help himself to anything he liked and encouraged him to make a drink and a snack.

Practices:

> providing the basic needs of shelter, food and clothing, and empowering the person to have choice, control and security of access to these

The staff member then invited Toby to play one of the DVDs he had in his bag. Over the course of the evening, they helped Toby to unpack his belongings and find out what he would to eat and his favourite activities, noting this in writing. The next day a staff member talked a bit more with Toby about his food preferences, and they made up a menu plan for the coming week and put it on the fridge after shopping for the groceries. All staff then followed this plan. The staff member also set some short-term goals about things Toby would like to do in the coming week and checked if he had any plans for the week. Toby believed he was due to have an access visit on Thursday.

The staff member emailed the Team Leader to find out about the visit.

On Monday the Team Leader in turn contacted the Case Manager to check on this and also to ask the Case Manager to meet with Toby to give him an idea of how long he would be staying. The Team Leader visited Toby to let him know about his access visit and organise an activity plan. Staff followed the menu and activity plan.

Practices:

> routines are established and expectations are clearly communicated

> acting in a way that is consistent and predictable i.e. ‘Doing what we say we will do’

After Toby’s access visit he was angry and upset, yelling that no-one listened to him and that he wanted to go home. He also threw objects and slammed his door. Staff used active listening and offered a preferred activity of a new video game. They did not reprimand him or order him to clear up. The next day the Team Leader asked him how he would like staff to help him when he was upset. He said if he went to his room and slammed the door he wanted to be left alone. The Team Leader also asked him how he was getting on with staff, and Toby identified staff he enjoyed working with and others who were “boring” and “annoying”. The Team Leader adjusted the roster to phase in more shifts by preferred staff and others with similar attributes.

Practices:

> responding to the needs that are being communicated through behaviour, and offering assistance and understanding

> remaining calm while connecting to the emotional tone or message the person is conveying

> providing an appropriate role model to the person who is aroused

> regularly consulting with and always valuing the input of all children and young people we support


After a month in this temporary arrangement, Possability suggested a move to a more permanent house closer to Toby’s school. Toby was involved in the transition, helping to pack up his belongings, arranging furniture in the new house, and selecting a new quilt cover and posters for his room. A rewards system and daily timetables were introduced to encourage Toby to participate in household chores. The schedule was predictable. Staff considered that routine was very important as Toby still needed to know what to expect and why, because it made him feel safer. They established trusting relationships with Toby by listening to him, reassuring him and giving him space to calm down when he needed it. It was necessary to allow Toby the space and opportunity to self-regulate his emotions.

All promises that were made were kept. Staff employed consistent approaches and responses, and they followed the same procedures around preventative and reactive strategies. Staff complimented and rewarded Toby when he was well presented and behaved well, and made a conscious effort to find other things to compliment him on.

Practices:

> creating environments designed to meet individual need, and knowing the person and their cues for communicating that they are not coping

> acting in a way that is consistent and predictable i.e. ‘doing what we say we will do’

> teaching the person how to be self-sufficient and meet their day-to-day needs

> supporting the person to take cues for appropriate emotional responding

> teaching the person how to regulate arousal and emotion

Toby also met monthly with Possability’s Practice Development Consultant, so that Toby could raise any concerns or issues with an independent person. They also discussed the things Toby wanted in life. Some were outside Possability’s sphere of influence, such as going home; however, they liaised with his Case Manager to arrange for Toby to have photos he could put up of his family. Toby talked a lot about wanting to be a “normal boy”. By this he meant making friends and being able to have friends over to play or for a birthday party. Possability organised for Toby to attend Kommunity Kids, which also resulted in him seeing a White Lion mentor. The counselling and mentoring provided Toby with the opportunity to talk about his emotions and his life. The Kommunity Kids program allowed him to socialise, engage in a range of activities, have fun in a safe and secure environment and make friends. Some of the social skills he learned were then transferred to the school environment. He also joined a circus program. On his birthday he had a party at McDonalds for two friends followed by a trip to the movies.

Practices:

> planning according to their expressed needs and life aspirations

> promoting a sense of belonging through stability and security

> creating warm, caring, secure, and familiar environments that empower children to make choices.


Anda, R.F., Felitti, V.J., Bremner, J.D., Walker, J.D., Whitfield, C., Perry, B.D., Dube, S.R., & Giles, W.H. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174-186.

Anglin, J. (2002). Pain, normality and the struggle for congruence: Reinterpreting residential care for children and youth. Birmingham, NY: Haworth Press.

Asay, T.P., & Lambert, M.J. (1999). The empirical case for the common factors in therapy: Qualitative findings. In Hubble, M.A., Duncan, B.L., & Miller, S.D. (eds.), The heart and soul of change: What works in therapy, (pp. 33-56). Washington DC: American Psychological Association.

Bath, H. (2008). The three pillars of trauma-informed care. Reclaiming Children and Youth, 17(3), 17-21.

Children, Young Persons and Their Families Act 1997 (Tasmania). Retrieved on 1 December, 2015, from: http://www.austlii.edu.au/au/legis/tas/consol_act/cypatfa1997399/

Commonwealth of Australia [COA] (2009). Protecting Children is Everyone’s Business: National Framework for Protecting Australia’s Children 2009-2010. Retrieved on 1 December 2015 from: https://www.coag.gov.au/sites/default/files/child_protection_framework.pdf

Commonwealth of Australia [COA] (2011). An outline of the National Standards for out-of-home care. Retrieved on 1 December 2015, from: https://www.dss.gov.au/sites/default/files/documents/pac_national_standard.pdf

Department of Health and Human Services (2014). Out of Home Care Reform in Tasmania. Children and Youth Services. Retrieved on 1 December 2015, from: http://www.dhhs.tas.gov.au/children/out_of_home_care_reform_in_tasmania/introduction_to_out_of_home_care_in_tasmania

Department of Health and Human Services (2008). New Directions for Child Protection in Tasmania: An Integrated Strategic Framework. Child and Family Services. Retrieved on 1 December 2015, from: http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0017/63161/DHHS_version_KPMG_June08_FINAL.pdf

Department of Human Services (2014). Out-of-Home Care: A Five Year Plan. Victoria’s Vulnerable Children, Our Shared Responsibility. Victorian Government.

LaVigna, G.W., & Willis, T.J. (2012). The efficacy of positive behavioural support with the most challenging behaviour: The evidence and its implications. Journal of Intellectual and Developmental Disability, 37(3), 185-195.

LaVigna, G.W., & Willis, T.J. (2005). A positive behavioural support model for breaking the barriers to social and community inclusion. Tizard Learning Disability Review, 10(2), 16-23.

Useful Resources

LaVigna, G.W., & Willis, T.J. (2002). Counter-intuitive strategies for crisis management within a non-aversive framework. In D. Allen (ed.), Behaviour management in intellectual disabilities: Ethical responses to challenging behaviour. Kidderminster, UK: British Institute of Learning Disabilities.

McDowell, J. (2013). Experiencing out-of-home care in Australia: The views of children and young people. The CREATE Foundation. Retrieved on 1 December 2015, from: http://create.org.au/wp-content/uploads/2014/12/2013-CRE065-F-CREATE-Report-Card-2013-Web-File-web.pdf

McClean, B. (2014). A sense of home. Retrieved on 1 December 2015, from: www.bild.org.uk/EasySiteWeb/GatewayLink.aspx?alId=5006

Perry, B.D., & Hambrick, E.P. (2008). The neurosequential model of therapeutics. Reclaiming Children and Youth, 17(3), 38-43.

Perry, B.D. (2006). Applying principles of neurodevelopment to clinical work with maltreated and traumatized children: The neurosequential model of therapeutics. In N.B. Webb (ed.), Working with traumatized youth in child welfare (pp. 27-52). New York: Guilford Press.

Stirk, S., & Standerson, H. (2012). Creating person-centred organisations: Strategies and tools for managing change in health, social care and the voluntary sector. London, UK: Jessica Kingsley Publishers.

The Council on Quality and Leadership (2010). What really matters: A guide to person centred excellence. Towson, Maryland: The Council on Quality and Leadership.

The Family Violence Act 2004 (Tasmania). Retrieved on 1 December 2015, from: http://www.austlii.edu.au/au/legis/tas/consol_act/fva2004158/

The Safe at Home Program. Retrieved on 1 December 2015, from: http://www.police.tas.gov.au/programs/safe-at-home/

UNICEF. Children in Australia. Retrieved on 1 December 2015, from: http://www.unicef.org.au/Discover/Australia-s-children.aspx

The United Nations Convention of the Rights of the Child, 1989. Retrieved on 1 December 2015, from: http://www.unicef.org.au/Upload/UNICEF/Media/Our%20work/childfriendlycrc.pdf


www.possability.com.au

Head Office175 Collins StreetHobart 70001300 067 842

North Office3 Archer StreetRocherlea 725003 6326 5457

North West Office12-14 Simpson Street Somerset 732203 6435 2113

Documents

Practice Framework for Out of Home Care....2 Possability Practice Framework for Out of Home Care About Us Possability (formerly Optia) is a not-for-profit organisation with more than