1 VICTORIA S VULNERABLE CHILDREN OUR SHARED RESPONSIBILITY
2 Accessibility If you would like to receive this publication in another format please telephone the Industry, Workforce and Transformation Branch, Department of Human Services on This document may also be downloaded from the Department of Human Services web site at: Unless indicated otherwise, this work is made available under the terms of the Creative Commons Attribution 3.0 Australia licence. The licence DOES NOT apply to any software, artistic works, images, photographs or branding, including the Victorian Coat of Arms, the Victorian Government logo and any Victorian Government departmental logos. To view a copy of this licence, visit creativecommons.org/licenses/by/3.0/au It is a condition of this Creative Commons Attribution 3.0 Licence that you must give credit to the original author who is the State of Victoria. Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. ISBN (print) ISBN (on-line) March 2014 [ ].
3 PAGE 3 TABLE OF CONTENTS 1. Minister s foreword 4 2. Executive summary 6 Drivers for reform 6 A new vision for reform 7 Approach to reform 8 3. Development of this plan Sector consultation The views of children and young people Victoria s out-of-home care system A history of reform The current system The case for reform Identified challenges Performance of the system The balance of investment System integration A new vision for reform Reform strategy Approach to reform Longer-term reform deliverables A new funding model A new service delivery platform Immediate reform actions Improve the safety and wellbeing of children and young people in residential care Tender the delivery of therapeutic, outcomes-focused, care and support services Implement an outcomes monitoring framework Develop a complementary plan for Aboriginal children and young people New governance arrangements 38 Improving processes and reducing the administrative burden 39 Improving health and education outcomes 39 Establishing local networks Increase focus on stability and permanency Explore professionalised in-home support Provide additional support to reduce sexual exploitation Improve leaving care support Trial a new approach to kinship care Better engage foster carers 45 Improving carer recruitment 45 Respecting and listening to foster carers New approaches to commissioning Next steps References 48 Appendix A Statement of principles 49 Appendix B Outcomes framework 50
4 PAGE 4 1. MINISTER S FOREWORD Government, service providers and the community have a responsibility to do all we can to make sure the care vulnerable children and young people receive sets them on the path to a good life. Currently across Victoria, more than 6,400 children and young people are living in out-ofhome care. They are being looked after by thousands of foster, kinship, permanent and residential carers and many other support staff who work tirelessly to make sure that these children and young people live happy, safe and rewarding lives. Effectively caring for and improving the life outcomes of our most vulnerable and disadvantaged children and young people is an enormous challenge. At the heart of the challenge lies the fact that no government-funded or delivered system can ever truly replace a good parent in a child s life. This reality must drive our efforts to ensure we do a better job in supporting families to provide safe, stable, nurturing homes for all children and young people. Where families fail in looking after children, safety, stability and nurturing must be provided through our alternative care arrangements. Every year, the number of young Victorians who need out-of-home care is growing, and both government and the community are under increasing pressure to deliver the financial and human resources required to keep pace. Despite the good outcomes achieved for many children, multiple reports and inquiries here, inter-state and overseas have catalogued the challenges facing out-ofhome care systems and warned the structure is under significant stress. The traumatic impact of abuse and neglect on children and young people is significant. We know failure to provide stable, supportive care can further magnify this impact. This Government is responding to the range of challenges confronting the broad child protection system. In May 2012, we published Victoria s Vulnerable Children Our Shared Responsibility Directions Paper and allocated $336 million over four years from the Budget. That funding, together with allocations made in the and Budgets has taken the Victorian Government s additional investment in vulnerable children and families to more than $650 million over the past three Budgets. Through the complementary Victoria s Vulnerable Children Our Shared Responsibility Strategy , released in May 2013, the Victorian Government has formally accepted a shared responsibility for improving outcomes for vulnerable children. This is underpinned by our commitment to work better across portfolios that have responsibility for the health, social and economic determinants of vulnerability. In December 2013, the Government released a baseline performance data report as an important first step to understanding the challenges faced by vulnerable children and young people. This sets the baseline from which annual performance reports will measure our progress in reducing vulnerability and improving the lives of the most vulnerable Victorians. This plan is a statement of our intent to fundamentally reform the way the out-of-home care system operates in order to drive better personal, social and economic outcomes for children and young people in care. The proposed reforms align with our new model for integrated human service delivery Services Connect that is driving a more integrated and holistic approach to working with vulnerable Victorians. It also reflects the importance of a collaborative approach to reform between government, service providers, clients and other stakeholders as recommended in the report Service Sector Reform: A roadmap for community and human services reform. Through these reforms we intend to move our historical program-based funding for out-of-home care to a system that is more focused on the client and the outcomes we aspire to. To achieve this, we need a system that more closely integrates family support, preservation and reunification services with those that provide out-of-home care; a system that provides incentives for positive outcomes and is delivered from a local area-based platform. We want to provide the flexibility that is needed to encourage innovation in how best to meet the needs of children and young people in care, their families and their carers.
5 PAGE 5 We have consulted with service providers, the Commission for Children and Young People and other stakeholders to define this plan and will continue this collaborative approach throughout implementation. We recognise success depends on the support and input of service providers and experts as well as children and young people themselves. To begin this process, the Victorian Government will undertake a tender process during 2014 for the delivery of a more holistic, flexible and therapeutic care and support service for children in out-ofhome care and their families. This new approach will focus on the outcomes sought as opposed to service types, inputs or outputs. It will seek to create a service response which focuses on the overarching goal for each child and young person in a placement whether this is successful reunification with parents; placement in a stable, permanent care arrangement; or transition to independence. Other immediate priorities to strengthen our system are to: > > Realise legislative and practice reforms to help provide permanency and stability for children. > > Investigate opportunities to better support and grow our vital foster carer workforce. > > Increase the role of the non-government sector in assessing and supporting kinship care arrangements. > > Establish a practical approach to monitoring the outcomes being achieved for children and young people in care. Based on this information, a process for reporting on the wellbeing of children and young people in the care of each service provider will also be established. > > Commence immediate actions to improve the safety and wellbeing of children and young people in residential care. > > Develop a complementary plan for Aboriginal children and young people in out-of-home care. > > Explore innovative approaches to commissioning, targeted at preventing entry to care, supporting transition from residential care and improving leaving care supports. > > Establish a more collaborative and effective approach to governance and through this identify and act on opportunities for practical system improvements. The specification and implementation of change will take time, but it is enormously important. This holistic approach to reform will benefit both children and the sector. Importantly, the implementation of the plan will be supported by a funding package totalling $128 million over the next four years. I look forward to working with service providers, carers and children and young people in care to make this plan a reality. The Hon. Mary Wooldridge MP Minister for Community Services
6 PAGE 6 2. EXECUTIVE SUMMARY This plan articulates a reform strategy for out-of-home care that will deliver a more integrated, client-centred and outcomes-focused service system. It builds on Victoria s leadership in out-ofhome care and human services reform to present both immediate and longer-term actions to achieve three overarching goals: > > Improved outcomes improved personal, economic and social outcomes for children and young people in out-of-home care. > > Reduced demand slow the growth in the number of children and young people being placed in out-of-home care over the long-term. > > Sustainable delivery create the foundation for a more sustainable, efficient and effective outof-home care system. Drivers for reform The Victorian Government is committed to driving improvement across the delivery of human services. The Government s recent policy statement Services Connect: Better services for Victorians in need demonstrates the need for a more integrated, holistic, effective, efficient and sustainable human services system. Specifically, it highlights the need for more integrated service delivery, a stronger focus on outcomes and supporting service provider innovation through a more flexible approach to funding. The evidence for these reform directions is clear in the Service Sector Reform: a roadmap for community and human services reform. Recent reviews and reports also highlight the overall structure of the statutory child protection and out-of-home system is under significant stress and that the need for improvement and reform is pressing. Current challenges facing the system range from rising demand to a fragmented system that is not designed to enable the innovation and outcomes we aspire to achieve. In January 2011, the Victorian Government initiated the Protecting Victoria s Vulnerable Children Inquiry to investigate systemic problems of Victoria s child protection system. The final report, tabled in Parliament in February 2012, found: there are major and unacceptable shortcomings in the quality of care and outcomes for children and young people placed, as a result of statutory intervention, in Victoria s outof-home care system. Further, the Inquiry considers there are a number of long-term factors impacting on the outcomes and sustainability of the current approach to providing accommodation and support services to children in out-of-home care. Major reform of the policy framework, service provision and funding arrangements for Victoria s out-of-home care system is therefore urgently required. 1 The Victorian Government is committed to reform of the out-of-home care system. In May 2012, the Victorian Government published Victoria s Vulnerable Children Our Shared Responsibility Directions Paper and announced a program of investment to support reform. That funding, together with allocations made in the and Budgets has taken the Victorian Government s additional investment in vulnerable children and families to more than $650 million over the past three Budgets. This out-of-home care plan is part of a broader suite of initiatives to improve outcomes for vulnerable children. The Victoria s Vulnerable Children Our Shared Responsibility Strategy (Vulnerable Children s Strategy), released in May 2013, includes three goals focused on reducing child vulnerability. As of March 2014, 63 actions have been implemented and a further 40 are underway. This plan is a key mechanism to achieve goal three within the Vulnerable Children s Strategy. 1 Department of Premier and Cabinet Report of the Protecting Victoria s Vulnerable Children Inquiry Department of Premier and Cabinet, Melbourne, p.233.
7 PAGE 7 Goals and achievements Goal 1: Prevent abuse and neglect Reforms and achievements include: > > Additional 1,000 early childhood intervention service places each year to support children with a disability or developmental delay from birth until school age. > > A new Maternal and Child Health Memorandum of Understanding is now in place with the DEECD and the Municipal Association of Victoria for > > Expanded the Enhanced Maternal and Child Health Service. > > Reform of Student Support Services to help strengthen the early identification of children and young people at risk. > > New student online case system to support service delivery to vulnerable students. > > Established national Foundation to Prevent Violence Against Women and their Children. Goal 2: Act earlier when children are vulnerable Reforms and achievements include: > > Children, Youth and Families Amendment Bill 2013 to make the court experience more child-friendly. > > Provide more than 1,000 additional places over four years in voluntary Men s Behaviour Change Programs. > > Establish two new demonstration sites for the Adolescent Family Violence initiative. > > New operating model for statutory child protection. > > An additional 89 front-line child protection practitioners. > > Victoria Police established Taskforce Astraea to tackle child exploitation on the internet. > > Victoria Police has established 27 Family Violence Teams and 27 Sex Office and Child Abuse Investigation Teams across the state. Goal 3: Improve outcomes for children in statutory care Reforms and initiatives include: > > Permanent Care and Stability Project to increase rates of timeliness of permanent care arrangements. > > Zero fee training places for young people leaving care. > > Springboard program to assist young people leaving care to access education and employment. > > Pilot to assist in implementing Aboriginal guardianship in Victoria. > > Release of the five year plan for out-of-home care. > > A more child-friendly legal system and a new children s court in Broadmeadows; and statewide roll-out of new model conferences. > > 140 new therapeutic residential and foster care places. > > Comprehensive educational and health assessments and learning mentors for children in out-of-home care. The Victorian Government has also developed this plan in consultation with the sector and key stakeholders to define a clear reform strategy for the next five years. A new vision for reform More fundamental reform is required to reset how out-of-home care is funded and delivered across Victoria. Simply tweaking the current system by further increasing funding levels or establishing new stand-alone programs will not lead to the sustainable, systemic improvement we aspire to achieve. This plan recognises that some reform will take time to be achieved and that we must balance our effort between longer-term enablers and immediate opportunities to achieve the best results. The reform strategy is summarised in Figure 1 on the following page.
8 PAGE 8 Figure 1: Out-of-home care reform strategy Out-ofhome care goals Improved personal, social and economic outcomes for children and young people in out-of-home care Reduced growth in the number of children and young people in out-of-home care A more sustainable, efficient and effective out-of-home care system Reform directions Government as commissioner of outcomes Processes that support service co-design between government, service providers and clients Less prescription, more flexibility to support service provider innovation A more integrated and coordinated service system that holistically meets client needs A stronger focus on productivity and efficiency maximising public value from investment A more collaborative approach to system governance Targeted efforts to address overrepresentation of Aboriginal children and young people in care and improve their outcomes Longer-term reform deliverables A new funding model A new service delivery platform Improve the safety and wellbeing of children and young people in residential care Implement outcomes monitoring framework Tender the delivery of therapeutic, outcomes-focused, care and support services Develop a complementary plan for Aboriginal children and young people Immediate reform actions Establish more collaborative governance Increase the focus on stability and permanency Explore professionalised in-home support Provide additional support to reduce sexual exploitation Improve leaving care support Trial a new approach to kinship care Better engage foster carers New approaches to commissioning The reform strategy is informed by the multiple reviews and policy statements, including the Report of the Protecting Victoria s Vulnerable Children s Inquiry, which have shown there is a clear need to further improve outcomes being achieved for children and young people in out-of-home care. It also recognises there is a pressing need to ensure that the out-of-home care system and other support services that children, young people and their families rely on are structured and function as efficiently and effectively as possible. Approach to reform The journey that begins with the release of this plan will not be complete for several years and is in reality an ongoing process. The Victorian Government is committed to working collaboratively with non-government organisations and other stakeholders to deliver on the whole-of-government commitment to improving outcomes for children and young people in out-of-home care, as articulated in the Vulnerable Children s Strategy and in this plan. The reform process this plan signals will be a complex one. It is essential that it proceeds cautiously but not so cautiously that we unnecessarily delay the opportunity for significant reform. Figure 2 summarises the process and timing for development and delivery of this reform plan.
9 PAGE 9 Figure 2: Out-of-home care reform approach Develop options papers A new funding model A new service delivery platform Longer-term reform opportunities Implement outcomes monitoring framework for children and young people in care Tender for the delivery of therapeutic, outcomes-focused, care and support services Taskforce 1,000 Improving outcomes for Aboriginal children and young people in care Complementary plan for Aboriginal children and young people Other immediate system improvements 2014 work on options papers and immediate opportunities informs the development of longer-term reform strategies. A new funding model A new service delivery platform Tender Delivery of a new out-of-home care system Phase one roll-out Roll-out to targeted (or trial) areas to test approach Full roll-out Victoria s new out-of-home care system: Effective Sustainable Outcomes-focused Flexible Therapeutic Holistic Integrated The reform advisory group provides advice on future reform directions linked to the Community Sector Reform Council Governance Immediate reform opportunities Ongoing communication and consultation with sector, children and young people Release of implementation blueprint Roll-out Time
10 PAGE 10 Achieving the longer-term reform directions needed will require us to reconsider the types of services government funds; the mix of these services; the funding models and mechanisms we use; who is funded to deliver the services; and the spread of services across the state. The key longerterm deliverables are: > > A new funding model that supports more innovative services and promotes a stronger focus on the outcomes we achieve for children and young people. > > A process to establish a more integrated service delivery platform that better supports placement prevention and reunification, and responds better to the needs of children and young people in or exiting care. These two deliverables combine to support achievement of the overarching objectives of this plan to improve outcomes, reduce demand and enhance sustainability of the system. Importantly, they will build placement capacity across the state by unlocking current resources and creating much needed flexibility to support new approaches to how we find the safest, most stable and nurturing care arrangements for vulnerable children and young people. These longer-term deliverables will be informed by further consultation and a number of immediate reform actions. Three immediate reform actions identified include: > > A tender process for the allocation of new funding to trial new approaches to therapeutic care across the state. This new approach will place a more explicit focus on outcomes to be achieved for children in care and service providers will be encouraged to innovate to provide a more tailored service response for each child in their care. They will also be required to provide support to the child, their family and their carer to achieve each child s case plan goals. > > Trial of a new outcomes framework for all children and young people in care. Utilising an appropriate information management platform, the Victorian Government will establish a statewide planning, assessment and outcomes-measurement system for use by all governmentfunded out-of-home care providers. We will regularly report on the results of this process. We will also report regularly on a number of additional measures that will provide a picture of overall agency performance. > > Development of a complementary plan for Aboriginal children and young people that identifies specific actions to address the over representation of Aboriginal children and young people in out-of-home care and improve outcomes. To support this work the Victorian Government will establish a Reform Advisory Group which will be linked with the Community Sector Reform Council. This group will provide technical advice to the Department of Human Services (department) on the implementation of this plan and support appropriate consultative and information sharing processes to ensure that all service providers remain informed and engaged in the reform process. Informed by this advice and the experience of the immediate reform actions, the department will provide an options paper to the Victorian Government at the end of 2014 on the proposed direction for the long-term reform deliverables.
11 PAGE DEVELOPMENT OF THIS PLAN 3.1 Sector consultation In the spirit of improved collaboration and service co-design between government, service providers and clients, this plan has been developed with considerable input from out-of-home care service providers. During 2013, a series of workshops were held to consider how the out-of-home care system could be refined to achieve improved outcomes for children and young people in care. All organisations funded to deliver out-of-home care services in Victoria were invited to attend. The Department of Human Services, the Department of Education and Early Childhood Development and the Commission for Children and Young People also participated. At the conclusion of these sessions, a group of service providers presented a formal submission to the Victorian Government to inform the development of this plan. 2 This submission outlined sector challenges and opportunities, and offered a series of immediate, medium and long-term actions for consideration. Broadly, it called for: > > Measurable outcomes that respond to the needs and promote the wellbeing and development of children and young people in out-of-home care. > > More flexible, place-based services that can be tailored to the needs of children and young people. > > Fair and adequate funding arrangements. > > Workforce arrangements that support improved quality and responsiveness. > > Inclusive and representative area-based governance arrangements. Consultations concerning the specific challenges confronting Aboriginal children and young people in out-of-home care were also held in mid to late 2013, facilitated by the Commissioner for Aboriginal Children and Young People, Mr Andrew Jackomos. These consultations provided an opportunity for Aboriginal community controlled organisations and other providers to develop a submission for this plan and map out a process for further contribution to the complementary plan for Aboriginal children and young people. 3 The submission, provided in November 2013, highlighted concerns with the persistent and growing overrepresentation of Aboriginal children and young people in care, and the out-of-home care system s failure to ensure these children and young people remain connected with their families, community and culture. Concerns with poor outcomes and high rates of involvement with the youth justice system were also highlighted. The submission made a clear link with this overrepresentation and Australia s history of dispossession of Aboriginal people and historical child removal practices. 2 Anglicare Victoria, Berry Street, EW Tipping, Centre for Excellence in Child and Family Welfare, MacKillop Family Services, Salvation Army, Victorian Aboriginal Child Care Agency, Wesley Mission Victoria Five Year Plan for Out of Home Care Submission from Victorian out of home care Community Service Organisations. The full text of that submission is available at: 3 A joint submission from Victorian Aboriginal Community Controlled Organisations and Community Service Organisations Koorie Kids: Growing Strong in their Culture. The full text of that submission is available at: submissions/submission-koorie-kids-growing-strong-in-their-culture-nov13.pdf
12 PAGE 12 The submission recommended seven priorities that the complementary plan for Aboriginal children should consider: > > Priority One: develop an Aboriginal child and youth-focused cultural outcomes framework for out-of-home care, from entry to exit, which embeds Aboriginal children s rights around selfdetermination. > > Priority Two: create a comprehensive approach to address the cultural needs of Aboriginal children and young people in out-of-home care. > > Priority Three: build the capacity of Aboriginal families and communities to care for their children. > > Priority Four: place all Aboriginal children and young people in out-of-home care under the care, authority and case contracting/management of an Aboriginal community controlled organisation. > > Priority Five: extend and enhance the coverage of the Aboriginal child welfare sector so Aboriginal children and young people can access early intervention, home-based, residential and permanent care within the broader suite of out-of-home care services in the area they live. > > Priority Six: grow and better support Aboriginal carers. > > Priority Seven: ensure compliance to meet the intent of legislative requirements in the Children, Youth and Families Act 2005 as it relates to Aboriginal children and young people. The process for developing the complementary plan for Aboriginal children and young people is outlined later in this plan. 3.2 The views of children and young people The primary aim of this plan is to drive improvements for children and young people in out-of-home care. Every child and young person has the right to participate in the decisions that will impact on their lives. As discussed throughout this plan, one of our system s main failings is that we do not systematically collect information about how well children and young people in care are faring and in particular information from children and young people themselves. This plan proposes a means for much stronger, systematic engagement with children and young people in care concerning their experiences. We will collate information about their education, health and social outcomes, which will further inform policy and service provision into the future. While we have not historically had a systemic approach to ensuring the voices of children and young people in care are adequately heard, our new approach to gathering outcomes information will address this. The CREATE Foundation s Report Card was based on a national survey of more than 1,000 children and young people in care (162 from Victoria). It was designed to provide a benchmark for how the system is faring in 2013 from the perspective of these children and young people. It dealt with outcomes across all of the Looking After Children life domains (the framework used by all Victorian out-of-home care providers) and the National Standards for Out-of-Home Care. One of the issues the survey explored were the factors of good and not good placements as described by children and young people in care. The following finding was of note: without doubt, the experience of a warm, caring and supportive relationship defined the good placements. 5 4 McDowall, J.J Experiencing out-of-home care in Australia: The views of children and young people (CREATE Report Card 2013), Sydney: CREATE Foundation. 5 McDowall, J.J Experiencing out-of-home care in Australia: The views of children and young people (CREATE Report Card 2013), Sydney: CREATE Foundation, p.34.
13 PAGE 13 This relationship provided the foundation for other important positive outcomes in the areas of education, social and family connectedness, health and so on. This is not a surprising finding, but it underscores the vital role that foster, kinship or residential carers and others play in driving better outcomes for children and young people. It also underscores the importance of knowing you are living in a stable, permanent home. Providing this crucial relationship in the life of all children and young people in care is at the heart of our long-term vision for out-of-home care in Victoria. The Report Card provides a comprehensive picture of the things that are important to children and young people. It echoes the findings of the survey and focus groups undertaken by the CREATE Foundation to support the work of the Protecting Victoria s Vulnerable Children Inquiry (Cummins Inquiry). That research identified a number of issues of importance to children and young people in care, highlighting: > > The importance of having someone within their care environment with whom they have an emotional connection. > > The importance of participating in decisions that affect them. > > The importance of feeling and being safe in their placement. The CREATE report undertaken for the Cummins Inquiry identified a significant difference in feedback received from children and young people placed in home-based care compared with those who live in residential care. While the majority of children in home-based care spoke positively about their carers and generally being happy in their placements, those in residential care expressed real concerns regarding safety and with the negative influence and impact of some of the young people they were placed with. Negative peer influence is an issue all young people and their families will need to deal with from time to time. For children and young people in out-of-home care, however, the impact of negative influences can be more significant. This is due in part to the fact that for some children and young people their own experience of abuse and neglect makes them highly vulnerable to external influences and often contributes to a range of extreme behaviour. It is further magnified by the absence of strong parental figures in their lives, setting the clear values and boundaries all children and young people need. The young people consulted in the CREATE Foundation study emphasised the importance of assessing and matching young people before they are placed within a particular residential care unit. Numerous reviews have identified that in some cases appropriate matching of young people to placements had not been possible. This was due primarily to the system s inability to keep pace with the rising demand for placements particularly in home-based foster care. This feedback is important and relevant to the aspirations of this plan. Improving the system s capacity to match children and young people with appropriate placements is a major issue the plan must address. To date, our system has been responding to this issue via the establishment of contingency units short-term residential care arrangements, which are not recurrently funded, and which offer no certainty or stability to the child in care or the service provider. These arrangements are not ideal for supporting the development of a strong emotional connection with a carer, which children and young people have identified as central to a good placement. Significant efforts are already underway to reduce the use of contingency placements. Later in this plan we outline our proposed approach to increasing placement capacity in order to maximise opportunities for the development of the stable and nurturing relationships children and young people have identified as essential.
14 PAGE VICTORIA S OUT-OF-HOME CARE SYSTEM 4.1 A history of reform Victoria has a long history of leadership in out-of-home care. The shape of out-of-home care has changed considerably in recent decades, and will inevitably continue to change. The evolution of Victoria s out-of-home care system is illustrated in Figure 3 and detailed below. Figure 3: Victoria s history of reform More client-focused models of care Charitable organisations and government operate a mix of orphanages and reformatory schools. Some early home-based care models emerge at different times, however large-scale institutional care dominates. Early moves towards family group homes and foster care. Large-scale residential care still dominates. Family group homes and foster care gather more momentum. 85 per cent of children in residential care. More than 50 per cent of children and young people still in some form of residential care large and small-scale. Increase in homebased care Last of the state-run residential care institutions closes. Home-based care and smaller residential care services expand. Kinship care emerges. Increased focus on child development Increased focus on therapeutic care responses. Kinship care continues to grow. Home-based care now dominates Increased focus on therapeutic care, protection and support Future focus: Continued support for kinship care. Foster care continues to play a key role. Therapeutic care responses expand. Stronger focus on outcomes and tailored care responses. Greater emphasis on timely stability planning. System reform to Kinship care reduce demand the and improve predominant outcomes for care type. all children. Therapeutic care responses expanding. Residential care less than 10 per cent of total system. Pre Current Pre-1950, nearly all children in care lived in residential care. Many of these were living in large facilities operated by non-government organisations or one of the large state-run institutions of Allambie, Turana, Baltara or Winlaton. From the 1950s, more children and young people started moving into small family group home arrangements. Family group homes were typical suburban houses where a married couple would provide care for up to four children, in addition to any children of their own. In most of these cases, the husband would undertake paid employment outside the home, while his partner provided full-time care for the children. This move away from large institutions towards more normal home-like environments reflected the growing awareness that such facilities provided far from ideal homes for children and young people. Evidence of abuse and neglect of children in care within these institutions has now clearly emerged, and the ramifications of this treatment still impacts the lives of many of these now adult care leavers a fact acknowledged by the Victorian and other governments through their respective apologies to people abused and neglected in their care. During the 1970s the closure of large institutions created further momentum for home-based care arrangements. Non-government organisations were supported to move away from congregate care towards family group home arrangements and an expanded foster care program. By the 1980s, around half of all children in care were living in some form of residential care compared to 85 per cent in Most of these children were aged years, with younger children more often placed in foster care.
15 PAGE 15 The last large state-run residential institution Allambie was closed in In the decade that followed, the range of home-based care options expanded further and the move towards kinship care gathered pace as government set a clear policy preference for children to be cared for within their existing family or social networks wherever appropriate. Changes in industrial arrangements and the increasingly complex behaviours of children and young people placed in care also saw a shift away from family group homes towards rostered residential care services, where a rotating shift of staff oversee day-to-day care. Today no family group homes remain, and all children in residential care are cared for by a rostered staff team. The recent focus of reform has been on investment in therapeutic care responses. This has been informed by our growing understanding of the impact of neglect, abuse and trauma on a child s developing brain and type of care responses this requires. Services such as Take Two, therapeutic residential care and therapeutic foster care have provided many volunteer carers and staff with a much deeper understanding of how to care appropriately for children placed with them. This evolution of out-of-home care has led to a system that is shaped very differently to that of the 1950s. Currently, only about seven per cent of children and young people reside in residential care; 50 per cent in kinship care; 21 per cent in foster care; and 22 per cent in permanent care (often with kin or a previous foster carer). This structure reflects the Victorian Government s preferred hierarchy of responses for children in out-of-home care. Wherever possible, the preferred option is to prevent children and young people entering care in the first place. Many families experiencing difficulties are supported day-by-day to provide safe, stable, nurturing care for their own children. Victoria s relatively low out-of-home care placement rates reflect the fact that placement in care is seen as a last resort, a step taken only when the risk of harm to the child requires it. Where families fail to look after their children, however, alternative care arrangements are required and must provide a safe, stable and nurturing home for these children. Informed by an assessment of each child or young person s best interests, our preferred forms of placement are: 6 1. Kinship care where care is provided by a relative or existing member of the child or young person s social network. Kinship care has the benefit of both maintaining a child within their family/network and minimising any unnecessary intrusion in family life by government. 2. Foster care where care is provided by a volunteer carer in their own home supported by a community service organisation. 3. Residential care where care is provided in small, community-based houses staffed by rostered employees. 6 Wherever possible children and young people who are unable to return to parental care will be placed on permanent care orders. These orders grant guardianship of the child to a permanent carer who is most commonly a family member or a foster carer who had been caring for the child.
16 PAGE The current system Since 2002, the number of children and young people in out-of-home care has grown by 5.3 per cent per annum (Figure 4). 7 This far exceeds the growth in Victoria s 0 17 years population, which has increased by only 0.5 per cent per annum. For Aboriginal children and young people in care the rate of growth has been even higher 9.5 per cent per annum against a total Aboriginal 0 17 years growth rate of 2.2 per cent per annum. 8 Figure 4: Growth in the out-of-home care population Number of children in out-of-home care at 30 June Aboriginal children in Out-of-home care at 30 June each year Non Aboriginal children in Out-of-home care (includes unknown) at 30 June each year All children in Out-of-home care at 30 June each year If out-of-home care population had grown at the 0 17 population growth rate This rate of growth is significant, but compared with other Australian states and territories it is relatively modest. During the period 2002 to 2013, the out-of-home care populations in New South Wales and Queensland grew by 116 per cent and 150 per cent respectively, compared to Victoria s growth of 77 per cent. 9 Victoria s placement rate is the lowest in the country at 5.0 per thousand children and young people aged 0 17 years. This is below the Australian rate of 7.7 per thousand. New South Wales rate of 10.5 is more than double the Victorian rate, as is the Northern Territory s rate of 11.8 per thousand. 7 Department of Human Services data. 8 Department of Human Services data. 9 Department of Human Services Data drawn from Steering Committee for the Review of Government Service Provision 2013, Report on Government Services 2014, Productivity Commission, Canberra.
17 PAGE 17 Whilst comparatively contained, a key contributor to the growth in the number of children and young people in care in Victoria has been the increasing length of care placements. 10 The proportion of children staying in (non-permanent) care for five years or more has almost doubled over the last decade. 11 This fact demands attention, both to ensure opportunities to reunite children with parents are not being lost and to ensure more timely placement of children in stable, permanent care arrangements where appropriate. There is an urgent need to do a better job in making timely decisions about the long-term care of children, where there is minimal chance that the factors that led to their removal from home will change. Within Victoria there are significant variations in placement rates and placement types between areas (Figure 5 and Figure 6). 12 In part this reflects differences in levels of socio-economic disadvantage but is also likely influenced by service availability, variations in practice and service effectiveness on the part of both government departments and service providers. Figure 5: Placement rate by area Rate of children in out-of-home care per 1,000 children in the population (aged 0 17 years) Rate of Aboriginal children in out-of-home care per 1,000 Aboriginal children in the population (aged 0 17 years) Average rate of children in out-of-home care statewide Average rate of Aboriginal children in out-of-home care per 1,000 Aboriginal children Rate of children in out-of-home care per 1,000 in the population Outer Gippsland SOUTH Inner Gippsland SOUTH Western District WEST Central Highlands WEST Mallee NORTH Loddon NORTH Ovens Murray EAST Goulburn EAST Barwon WEST Brimbank Melton WEST Outer Eastern Melbourne EAST Hume Moreland NORTH Southern Melbourne SOUTH North Eastern Melbourne NORTH Western Melbourne WEST Bayside Peninsula SOUTH Inner Eastern Melbourne EAST Rate of Aboriginal children in out-of-home care per 1,000 in the population 10 Department of Premier and Cabinet Report of the Protecting Victoria s Vulnerable Children Inquiry, Department of Premier and Cabinet, Melbourne. 11 Department of Premier and Cabinet Report of the Protecting Victoria s Vulnerable Children Inquiry, Department of Premier and Cabinet, Melbourne. pp Department of Human Services data (Note that area relates to the area of the agency or DHS outlet providing out-of-home care services).
18 PAGE 18 The situation for Victorian Aboriginal children and young people is particularly concerning, as illustrated in Figure 5. The average placement rate of 59 per thousand far exceeds the non-aboriginal rate of five per thousand, and is slightly higher than the Australian average for Aboriginal children (56.9). This is clearly an issue that requires significant focus as this plan, and the complementary plan for Aboriginal children and young people, is implemented. Figure 6: Placement types by area Residential care Permanent care Foster care Kinship care 100% 90% 80% 70% 60% 50% % 30% 20% 10% % Southern Melbourne SOUTH Bayside Peninsula SOUTH Inner Gippsland SOUTH Outer Gippsland SOUTH Loddon NORTH North Eastern Melbourne NORTH Hume Moreland NORTH Mallee NORTH Western Melbourne WEST Brimbank Melton WEST Central Highlands WEST Barwon WEST Western District WEST Outer Eastern Melbourne EAST Goulburn EAST Inner Eastern Melbourne EAST Ovens Murray EAST The care profile of out-of-home care has changed significantly over the past decade, illustrated in Figure 7 below. 13 In particular, there has been a distinct shift away from foster care towards kinship care. This reflects a deliberate policy of placing children and young people in kinship care wherever it is possible and in their best interests to do so, in order to maintain family relationships and connections. It also reflects the ongoing challenge of attracting and retaining volunteer foster carers. 13 Department of Human Services data.
19 PAGE 19 Figure 7: Change in out-of-home care 100% 10% 7% Percentage of children in care as at 30 June 80% 60% 40% 20% 29% 24% 37% Residential care Permanent care Kinship care Foster care 22% 50% 21% 0 30 June June 2013 The shift towards kinship care is generally positive for the children, young people and families concerned. However, it does mean an increased role for government as government-employed child protection practitioners are responsible for the case management and supervision of the majority of kinship care placements (around 2,500 compared to the 750 placements supported by non-government organisations). 14 One of the issues that this plan will need to tackle is how we create a stronger role for the nongovernment sector in providing support for children in kinship care and their carers. The assessment and support of out-of-home carers and children in care are core skills of the non-government sector and future reforms should acknowledge and build on this expertise. Figure 7 also illustrates that there has been a considerable reduction in the proportion (though not the number) of children and young people who are in permanent care placements with a secure and stable caregiver. Given the importance of stable care arrangements to a child or young person s healthy development, there is a clear need for a much stronger focus on timely planning to improve permanency and stability through more permanent care placements. 14 Child protection practitioners now oversee around 43 per cent of all placements up from 33 per cent ten years ago.
20 PAGE THE CASE FOR REFORM 5.1 Identified challenges Reviews and reports over the past decade have demonstrated a number of challenges for out-ofhome care. Table 1: Identified challenges Increasing client complexity Rising demand A fragmented system Children and young people in out-of-home care have experienced significant abuse or neglect. There is evidence to suggest that for many children, they are entering care from increasingly complex family environments, and this is subsequently impacting on their own needs and behaviours whilst in care. Appropriately meeting their needs is an ongoing challenge for carers and other staff. The demand to find suitable new placements tests the capacity of the system to deliver quality care and diverts from efforts to prevent placements or reunite children with families. The historical approach of funding narrowly-defined service types has contributed to a situation where very few individual organisations now provide the holistic, integrated suite of services that families with a child in care, or at risk of entering care, need. As a result, in most parts of the state, a family with a child placed in out-of-home care may have dealt with one organisation when they received initial family services support; a second if they received more intensive placement prevention supports; a third when their child entered care; and a fourth when plans to return the child home were enacted. With every change of worker and organisation, existing relationships are lost; assessments are repeated; and the family has to tell their story again to a new set of workers. Services are not always where they need to be Outcomes are not measured adequately Innovation has been stifled Some services are unavailable in some parts of the state, and overall service availability does not necessarily accord with demand or demographic factors. The outcomes sought for children and young people in care have not been appropriately articulated, and adequate outcomes data has not been collected and assessed. The existing funding model does not provide incentives for a stronger focus on achieving outcomes. A program-specific approach to funding has meant that service providers have not been given the flexibility to innovate and develop new service models or more tailored responses that better meet the needs of children in care. Innovation has occurred but in inefficient and inconsistent ways.
21 PAGE 21 Performance is variable Every day, the lives of thousands of children and young people in out-of-home care are improved by the efforts of the foster, kinship, permanent and residential carers who look after them. However, we know that we can and need to do better in some areas. Statutory obligations around timely stability planning or development of cultural support plans for Aboriginal children in care have sometimes not been met. The approach to governance and the establishment of effective ways to identify and resolve issues that affect service effectiveness has been haphazard. In the area of placement provision, some service providers have consistently failed to provide the number of placements they are funded for, and the department s approach to addressing poor performance has been inconsistent. As a result, there are some service providers who, over the course of a year, fall well short of delivering on their contractual obligations. Numerous factors have contributed to this scenario chief among which is the ongoing challenge of attracting and retaining volunteer foster carers. However, the resultant mismatch between contracted targets and actual performance is unsustainable and needs to be addressed. Performance of placement prevention, reunification and leaving care support services has also been variable, with some of these services unavailable in some parts of the state. Timely supports are needed to prevent children entering care; to enable their safe return home; or to ensure a successful transition to independence. Training and keeping staff is a challenge There has been significant workforce capacity and retention issues both within and outside of government. This concerns both the volunteer and paid workforce. The need to address these challenges is at the core of the reform directions and approach articulated in this plan. 5.2 Performance of the system Our ability to meaningfully assess the performance of the system has been limited by a lack of readily available outcomes data concerning children in care. Given this lack of data, our analysis of performance in this section is, by necessity, focused on the much narrower aspects of service availability and continuum, and provider performance against funded placement targets. There are significant variations in the types of services available across different areas and in provider performance against funded targets. In home-based care, some service providers receive funding to care for more than 250 children while others are funded for as few as five. Similar variability exists for residential care, with individual service providers caring for between two and 100 children. During , service providers received funding to provide around 1,950 foster care placements each night; however only around 1,550 placements were provided a difference of around 400. This equates to an average performance level of 80 per cent, although some providers perform at close to 100 per cent while others are performing below 50 per cent This variation in performance, combined with the pricing structure of our funding model, means that some agencies effectively received funding of around $14,000 for each foster care placement they provided, whilst others received in excess of $50,000 per placement.
22 PAGE 22 Investment has increased significantly over the past five years, but much of the increased investment is benefitting a relatively small number of children. This mismatch between funding and performance needs to be addressed as part of our reform approach. There is a need to unlock the significant resources invested across the system in order to maximise the impact of the funding we have available. In recent years, total expenditure on placement and placement support programs by the Victorian Government has increased significantly, and many service providers also report they have invested significant amounts of funding from sources other than government to support children and young people in out-of-home care. Much of this new investment has been directed towards expanding our capacity to meet the therapeutic needs of children in care in particular through specific therapeutic residential and home-based care placements. These are important and effective placements, however they are currently available for only a small proportion of the total number of children and young people in care. Over the past five years, the number of children and young people in residential and foster care has risen only slightly the great majority of growth in placement numbers has been for children in kinship care arrangements. It is important that we continue to provide more opportunities for children and young people in care to receive the therapeutic care responses many of them need. One way of doing this is to continue to increase the number of therapeutic placements available. However, we also need to make sure that we capitalise on the growing body of knowledge and expertise within the system so that a larger proportion of carers and staff not just those working in specific therapeutic foster or residential care programs are equipped to provide therapeutic care responses. 5.3 The balance of investment Children, young people and families involved with child protection and out-of-home care will often access a wide range of services, such as early childhood, mental health, homelessness, or family violence services. A major aim of the Services Connect reforms is to create more integrated human services across multiple programs and portfolio areas. Through stronger integration and coordination, we seek to create a more effective and efficient response that better meets the needs of vulnerable Victorians. The analysis below takes a narrower focus, examining five service groupings which many children and families involved with child protection and out-of-home care will access family support services; specialist placement prevention and reunification services; home-based care; residential care; and leaving care support services. Figure illustrates the proportion of funding currently allocated to each of these services. 16 Department of Human Services data. 17 Variation in the proportion of funding of some services allocated across the Department of Human Services four divisions has also been noted for example the East Division has only 7 per cent of the total state funding for placement prevention services compared with 38 per cent in the North and South Divisions.
23 PAGE 23 Figure 8: Program funding 3% Family services 33% Placement prevention 40% Home based care Residential care 7% Leaving care 17% The high unit cost of residential care means that it accounts for almost half of all expenditure. While good quality residential care is an essential part of any effective out-of-home care system, we must ensure that it is used only when it is the most appropriate placement option. Residential care cannot be seen as a default placement of last resort, but must rather be used only when it is the best placement option for a child or young person. As part of our reform directions, as we develop more innovative and flexible approaches to home-based care provision, residential care will increasingly become the preferred placement option only for those young people whose needs and behaviours are so significant that they require a more expert, therapeutic and heavily supervised care response. The reform of the system will need to consider the balance of investment across this spectrum and introduce a broader range of support options. Central to this will be ways in which funding might better support more targeted placement prevention and reunification efforts. While innovative programs such as Stronger Families and the recently expanded Cradle to Kinder programs are having an impact, we must explore more opportunities to improve our approach to family preservation by making better use of existing resources. Family services play a vital role in preventing the issues that can lead to involvement with child protection and out-of home care. A good case could be made that Victoria s ability to contain its growth in out-of-home care relative to other jurisdictions has been due in large part to the growth in family services over the past decade. We must continue to explore opportunities to better leverage off the family services platform to prevent child protection involvement and entry to care. We should also explore how we better utilise the knowledge and skills of family services professionals in the reunification of children with their families. In doing this we must strike a balance with the need for family services to continue to support families at the very early stage of crisis and difficulty.
24 PAGE System integration In addition to varying levels of investment, the services offered across areas have been fragmented. A key example of this fragmentation is the divide that exists between the delivery of family support, placement prevention, reunification, out-of-home care and leaving care services. Ideally, children, young people and families in any part of the state should have access to a range of integrated, high quality services that prevent placement; offer a wide range of suitable placement types; support reunification; and enable transition to independence. This has not been the case. 90 agencies deliver just one service. Fewer than ten agencies deliver the full spectrum of services. Across the state, around 120 organisations are funded to deliver at least one of these five services. Of these, around 90 organisations deliver just one service. Only seven agencies deliver the full spectrum of services. Of these only four deliver the full spectrum within any one Department of Human Services local area. 18 While diversity of providers offers service users greater choice and can sometimes stimulate innovation, it is also appropriate to consider whether our current structure facilitates the integrated responses highly vulnerable children, young people and families need. We need to explore how service integration might be improved in future. This does not necessarily mean that only large organisations capable of delivering a full range of services can be effective in achieving positive client outcomes. But it does mean that we need to pursue much greater integration and coordination of services at the local level. 18 Department of Human Services data.
25 PAGE A NEW VISION FOR REFORM The structure and performance of the system of statutory child protection and out-of-home care have been the focus of a number of reviews and reports over the past decade each of them highlighting the challenges and shortcomings of the existing system and warning that the entire system is under significant stress. Within this context the Victorian Government has been pursuing a broad reform agenda, aimed at creating a more integrated, holistic, effective, efficient and sustainable human services system. These reform directions were clearly outlined in the May 2013 publication Services Connect: Better services for Victorians in need, which outlined the vision for a new model of integrated human services delivery in Victoria. This plan for out-of-home care is based on that vision, and informed by multiple reviews and policy statements, including the Report of the Protecting Victoria s Vulnerable Children Inquiry (Cummins report). The Cummins report, which was released in February 2012, made 90 recommendations to strengthen and improve the protection and support of vulnerable young Victorians including the development of this plan for out-of-home care. The Victorian Government s initial response, Victoria s Vulnerable Children Our Shared Responsibility Directions Paper was released in May In May 2013, a whole-of-victorian-government strategy, Victoria s Vulnerable Children Our Shared Responsibility Strategy was released. This underlined the shared commitment that exists across government to improve outcomes for vulnerable children, young people and families. It created a performance management framework to monitor these outcomes and committed to the establishment of local cross-government and community networks to drive improved service responses. On 1 November 2013, Service Sector Reform: a roadmap for community and human services reform was released. This report made several recommendations on the themes of government and the community sector working better together; client and community-led services; more focus on outcomes; reducing red tape; and creating better value. In response, the Victorian Government has adopted a number of principles (see Appendix A) and created the Community Sector Reform Council to advise on the implementation of community and human services reform. Services Connect is the model for integrated human services in Victoria, designed to connect people with the right support, address the whole range of a person s or family s needs, and help people build their capabilities to improve their lives. All of the out-of-home care reforms will be based on integration and workability with this joined-up service model that places the client at the centre of all practice. 6.1 Reform strategy Simply tweaking the current system by further increasing funding levels or establishing new standalone programs will not lead to the sustainable, systemic improvement we aspire to achieve. More fundamental reform is required to reset how out-of-home is funded and delivered across Victoria. This plan recognises that some reform will take time to be achieved and that we must balance our effort between longer-term enablers and immediate opportunities to achieve the best results. The reform strategy is summarised in Figure 9 on the following page.
26 PAGE 26 Figure 9: Out-of-home care reform strategy Out-ofhome care goals Improved personal, social and economic outcomes for children and young people in out-of-home care Reduced growth in the number of children and young people in out-of-home care A more sustainable, efficient and effective out-of-home care system Reform directions Government as commissioner of outcomes Processes that support service co-design between government, service providers and clients Less prescription, more flexibility to support service provider innovation A more integrated and coordinated service system that holistically meets client needs A stronger focus on productivity and efficiency maximising public value from investment A more collaborative approach to system governance Targeted efforts to address overrepresentation of Aboriginal children and young people in care and improve their outcomes Longer-term reform deliverables A new funding model A new service delivery platform Improve the safety and wellbeing of children and young people in residential care Implement outcomes monitoring framework Tender the delivery of therapeutic, outcomes-focused, care and support services Develop a complementary plan for Aboriginal children and young people Immediate reform actions Establish more collaborative governance Increase the focus on stability and permanency Explore professionalised in-home support Provide additional support to reduce sexual exploitation Improve leaving care support Trial a new approach to kinship care Better engage foster carers New approaches to commissioning The reform strategy is guided by three overarching goals for out-of-home care. These goals reflect the changes we aspire to achieve for clients, providers, government and the wider community: > > Improved outcomes improved personal, economic and social outcomes for children and young people in out-of-home care. > > Reduced demand slow the growth in the number of children and young people being placed in out-of-home care over the long-term. > > Sustainable delivery create the foundation for a more sustainable, efficient and effective outof-home care system. These goals are informed by seven reform directions. Reform directions are necessary to provide a set of more specific criteria against which we can assess the suitability of reform deliverables identified to achieve our overarching goals. The seven reform directions are: 1. Government as commissioner of outcomes. There will be a strong focus on articulating, measuring and improving outcomes for all children and young people in out-of-home care. 2. Less prescription and more flexibility to support service provider innovation. This will help inform the design of a more flexible funding model that supports innovation, whilst still ensuring appropriate levels of oversight and accountability.
27 PAGE A more integrated and coordinated service system that holistically meets client needs. This will include greater integration of services that maintain and reunite families, and those that provide out-of home care; and an improved capacity to provide the placements children need, not just the placements that are available. 4. A more collaborative approach to system governance. Government and service providers at the central and local level need to work together more effectively to shape long-term reform and address immediate issues impacting on the effectiveness and efficiency of the system. 5. Processes that support service co-design between government, service providers and clients. Including a more appropriate division of roles and responsibilities between government and non-government services; and effective, collaborative governance arrangements that support system improvement. 6. A stronger focus on productivity and efficiency maximising public value from investment. All governments across the western world are examining ways in which they can maximise the impact of public investment. For out-of-home care in Victoria, government and service providers must work together to identify opportunities to become more productive. 7. Targeted efforts to address overrepresentation of Aboriginal children and young people in care and improve their outcomes. The massive overrepresentation of Aboriginal children in care must be addressed. The complementary plan for Aboriginal children and young people in out-of-home care will assist with this. The reform strategy also articulates the longer-term deliverables and immediate actions required to realise the overarching goals of this plan. This approach recognises the need for both an investment in more fundamental system reform which will take time to design and implement and more immediate reform opportunities that can be achieved in the shorter-term to deliver early benefits. The longer-term deliverables are: > > A new funding model we need to change the way we fund to drive a stronger focus on outcomes; offer more flexibility to service providers to innovate and deliver better services; and unlock the potential impact of our existing resources. > > A new service delivery platform we need an approach that will create a more integrated and effective service system. The more immediate actions are to: > > Improve the safety and wellbeing of children and young people in residential care. > > Tender the delivery of a new therapeutic, outcomes-focused, care and support service. > > Implement outcomes monitoring framework. > > Develop a complementary plan for Aboriginal children and young people. > > Establish more collaborative governance arrangements. > > Increase the focus on stability and permanency. > > Explore professionalised in-home support. > > Provide additional support to reduce sexual exploitation. > > Improve leaving care support. > > Support kinship care. > > Support foster carers. > > Develop new approaches to commissioning. The following sections provide a detailed breakdown of how the plan will be implemented (Section 7); the focus of the long-term reform deliverables (Section 8); and immediate reform actions (Section 9). Together, the longer-term reform deliverables and immediate reform actions form the focus of work for this plan.
28 PAGE APPROACH TO REFORM The journey that begins with the release of this plan will be implemented over several years and is in reality an ongoing process. The Victorian Government is committed to working collaboratively with non-government organisations and other stakeholders to deliver on the whole-of-government commitment to improving outcomes for children and young people in out-of-home care, as articulated in the Victoria s Vulnerable Children Our Shared Responsibility Strategy and in this plan. It is essential the reform process this plan signals proceeds cautiously but not so cautiously that we unnecessarily delay the opportunity for significant reform. Figure 10 summarises the process and timing for development and delivery of this reform plan.
29 PAGE 29 Figure 10: Out-of-home care reform approach Develop options papers A new funding model A new service delivery platform Longer-term reform opportunities Implement outcomes monitoring framework for children and young people in care Tender for the delivery of therapeutic, outcomes-focused, care and support services Taskforce 1,000 Improving outcomes for Aboriginal children and young people in care Complementary plan for Aboriginal children and young people Other immediate system improvements 2014 work on options papers and immediate opportunities informs the development of longer-term reform strategies. A new funding model A new service delivery platform Tender Delivery of a new out-of-home care system Phase one roll-out Roll-out to targeted (or trial) areas to test approach Full roll-out Victoria s new out-of-home care system: Effective Sustainable Outcomes-focused Flexible Therapeutic Holistic Integrated The reform advisory group provides advice on future reform directions linked to the Community Sector Reform Council Governance Immediate reform opportunities Ongoing communication and consultation with sector, children and young people Release of implementation blueprint Roll-out Time
30 PAGE 30 In 2014, the key focus will be on initiating the immediate reform actions and using insights from these alongside broader research and consultation to develop options papers on each of the longer-term reform deliverables. In 2015, the focus turns to finalising the longer-term deliverables and ensuring key structures are in place to support roll-out. Assuming key components of the plan come together as anticipated, an implementation blueprint will be released in the second half of 2015 to inform roll-out in To assist the reform process, the Victorian Government will establish a Reform Advisory Group which will be linked with the Community Sector Reform Council. This group will provide technical advice to the Department of Human Services (department) on the implementation of a new outof-home care system. This will be supported by appropriate consultative and information sharing processes to ensure that all service providers remain informed and engaged in the reform process. Informed by this advice, the department will provide a set of options papers to the Victorian Government addressing the issues of alternative funding models and approaches to improving service integration.
31 PAGE LONGER-TERM REFORM DELIVERABLES Longer-term reform deliverables A new funding model A new service delivery platform Achieving the longer-term reform directions needed will require us to reconsider the types of services government funds; the mix of these services; the funding models and mechanisms we use; who is funded to deliver the services; and the spread of services across the state. The key deliverables can be broadly summarised as: > > A new funding model that supports more innovative services and promotes a stronger focus on the outcomes we achieve for children and young people. > > A process to establish a more integrated service delivery platform that better supports placement prevention and reunification, and responds to the needs of children and young people in or exiting care. These two deliverables combine to support the achievement of the overarching objectives to improve outcomes, reduce demand and enhance sustainability. 8.1 A new funding model The current funding model has created a fragmented and inflexible system. Children and families involved with the out-of-home care system are forced to engage with multiple organisations and workers, and service providers are unable to deliver services that would better meet client needs due to the restrictions placed around how funds can be used. Funding inflexibility drives a focus on just the presenting issue rather than a holistic response to individual or family needs and has resulted in a narrow focus delivering out-of-home care placements at the expense of placement prevention or reunification services. The Victorian Government seeks a system where funding to agencies is more significantly focused on outcomes rather than almost exclusively on outputs. Under such an arrangement, contracts would be awarded on the basis of defined outcomes, with much less prescription over the intervention employed to achieve those outcomes. Innovative child, youth and family-focused services could be encouraged and supported. As part of the development and implementation of the new funding model, consideration will be given to how all available funding might be freed up to create a system that can be better tailored towards the specific needs of each child. The Victorian Government seeks a system where funding to agencies is more significantly focused on outcomes rather than almost exclusively on outputs. Options to be considered include a model structured around a common base payment linked to each placement, which is then bolstered by an additional child-attached funding package, based on assessed needs. Packages could be reviewed on a periodic basis to ensure they keep pace with the changing needs of children and young people in care and reflect an efficient level of funding. 8.2 A new service delivery platform Vulnerable children and families involved with the out-of-home care system, or on the cusp of involvement, should not be forced to engage with multiple organisations and workers simply because it is administratively convenient for government or service providers. The Victorian Government seeks a system that is more integrated, with a seamless continuum of services, and which meets service delivery requirements differently as appropriate to specific communities.
32 PAGE 32 One way to achieve a more integrated service system is to reconfigure on a local area basis and encourage an integrated service delivery model by procuring packaged services from a specified number of providers. One way to achieve this is to reconfigure out-of-home care services on a local area basis and encourage integration by procuring packaged services from a specified number of providers in each area. Through this process supported by the new funding model we would seek to create greater integration between the services intended to maintain or reunite children and young people with their families, and those that provide alternative care and post placement supports. This does not necessarily mean that only large organisations capable of delivering a wide range of service responses can be effective in achieving positive client outcomes but it does mean that much greater integration and coordination of services will be sought and supported at the local area level. There are various types of organisational arrangements that might be pursued to achieve this more integrated approach, but a one size fits all formula is unlikely to work for every part of the state. Any reconfiguration of services will need to be mindful of the impact on transient populations (such as homeless children and families) and some specific cohorts such as Aboriginal Victorians or culturally and linguistically diverse groups. Given the high rate of Aboriginal children and young people in out-of-home care, we must be particularly mindful to ensure that any reconfiguration of the service system will be of benefit to Aboriginal children, young people and families. The Victorian Government has a clear commitment expressed in various documents including the Human Services Aboriginal Strategic Framework to improving outcomes for Aboriginal people in Victoria; working in partnership with Aboriginal Victorians to achieve this; and ensuring the cultural competence of human services. The submission from Aboriginal community controlled organisations and other service providers stated an aspiration for all Aboriginal children and young people in care to be cared for and/or case managed by Aboriginal organisations. Service reconfiguration offers opportunities to test this vision, where it is appropriate and in the best interests of Aboriginal children and families to do so. Also for consideration is the role of government in the future provision of out-of-home care. Currently, government child protection practitioners oversee around half of all out-of-home care placements and the appropriateness of this arrangement requires review.
33 PAGE IMMEDIATE REFORM ACTIONS Improve the safety and wellbeing of children and young people in residential care Implement outcomes monitoring framework Tender the delivery of therapeutic, outcomes-focused, care and support services Develop a complementary plan for Aboriginal children and young people Immediate reform actions Establish more collaborative governance Increase the focus on stability and permanency Explore professionalised in-home support Provide additional support to reduce sexual exploitation Improve leaving care support Trial a new approach to kinship care Better engage foster carers New approaches to commissioning 9.1 Improve the safety and wellbeing of children and young people in residential care This plan is focused on improving outcomes for all children and young people in out-of-home care. Within the out-of-home care population, however, the relatively small number of children and young people who live in residential care are often those who have experienced the greatest levels of trauma, and who therefore require the most expert therapeutic care and support. Part of the long-term vision we seek for the Victorian out-of-home care system is for children and young people to only be placed in residential care when it is the best placement option for them as opposed to the only placement option. Accordingly, our long-term vision is that the proportion of children and young people placed in residential care will reduce over time and that all residential care placements will become therapeutic placements where the child or young person s therapeutic needs are met and our successes measured against the achieved outcomes. The Victorian Government has already started down this reform path, securing the 40 trial placements with ongoing funding, adding another 40 places and committing to a further 60 places in the next eighteen months, taking the total to 140 before the end of Making this direction a reality will take time and significant reform. As a starting point we will need to create alternative placement options to accommodate some of the children and young people residing in residential care, whose needs could be better met in new, therapeutic home-based care or other non-residential care arrangements. This will be achieved through tailored funding packages to provide individualised placement solutions for some children and young people currently living in residential care. Realising this vision will require a process whereby all children and young people residing in residential care, and those who might enter residential care in the future, are assessed to determine their suitability for an appropriately supported therapeutic home-based care arrangement. During 2014 a locally led process will review the current life situation of all children and young people residing in residential care. This review will have two main aims: 1. To assess the potential for each child or young person to be placed in alternative, nonresidential care arrangements by making greater use of tailored funding packages to provide therapeutic home-based care. These packages will be funded at levels commensurate with the care needs of the child or young person. 2. To identify any one-off supports that might immediately improve the safety and wellbeing of each child and young person in residential care. As a first priority, the circumstances of children and young people in contingency placements will be assessed. Based on the results of this assessment, a tender process outlined below will occur during 2014 for the delivery of a more holistic, flexible, efficient and therapeutic care and support service.
34 PAGE Tender the delivery of therapeutic, outcomes-focused, care and support services During 2014, the Victorian Government will begin a tender process for the delivery of a more holistic, flexible, efficient and therapeutic care and support service. Funding will initially be made available in this way for a two-year period in order to test a new approach, more clearly focused on the outcomes sought for children and young people as opposed to service types, inputs or outputs. The funding will build placement capacity in each division one benefit of which will be a reduced reliance on inappropriate contingency arrangements and an increase in the number of children and young people living in more stable, nurturing and cost effective placements. The new service will also test our capacity to take a more integrated approach to the achievement of longer-term case plan goals for children and young people in out-of-home care. Led by a key worker, the new service will work with children, young people, their families, carers, child protection staff and others to achieve each child s overarching case plan goal whether this is for reunification with parents; placement in stable, permanent care arrangements; or a transition to independence. The process will seek submissions from service providers for the provision of therapeutically informed care and support services that will: > > Meet the therapeutic needs of children and young people. This will be measured by monitoring the outcomes achieved. Appendix B provides a proposed set of personal outcome indicators to be monitored as part of this new approach. > > Adopt a more flexible and tailored approach. Children, young people and carers are the focus of support including through the effective use of brokerage funding. > > Support children, carers and families through the provision of a key worker. The key worker role will be consistent with the vision articulated in the Services Connect delivery model where one worker will lead the implementation of the child or young person s case plan. This means that the key worker may be required to play a lead role in reuniting children with their parents; in supporting a child s transition to permanent care; or in supporting their transition to independence. Regardless of case plan direction or placement type, the key worker will follow the child and play a lead role in supporting the child, their family and their carer in the achievement of these goals. > > Access other programs and services. The service provider will integrate with and leverage off other programs and services in a local area to achieve the specified outcomes and the fulfilment of the child s case plan. > > Explore all alternatives to residential care. Supporting the transition of children and young people from residential care to well supported therapeutic foster or kinship care placements, where this is appropriate, will be a priority, through the use of tailored and flexible supports for carers and children. > > Demonstrate cultural sensitivity. The care will ensure that Aboriginal children and young people in care remain genuinely connected to their community and culture. This submission process offers service providers an opportunity to consider their approach to outof-home care and develop new responses that will drive improved outcomes, service integration and greater efficiencies. It is an important first step in the broader reform agenda. An evaluation of the services established through this process, and in particular the outcomes achieved, will inform the further reform of out-of-home care. 9.3 Implement an outcomes monitoring framework The existing out-of-home care system has not had a systematic approach to articulating and monitoring the outcomes we want to achieve for children and young people. While there is regular reporting on data such as placement stability and critical incidents, and occasional studies such as
35 PAGE 35 the Child and Family Services Outcomes Survey, the lack of a systematic approach to monitoring outcomes has been one of the system s most significant weaknesses. While this is the case, the Victorian out-of-home care system does make use of a practice framework Looking After Children (LAC) that offers a strong platform for a much more comprehensive understanding of the outcomes being achieved for children and young people in care. In 2007 an initial analysis of a sample of children and young people in care, based on their agency held LAC records was undertaken. A second analysis was then conducted in 2011 looking at the records of another sample of around 500 children. The findings from both cohorts of children were very similar and showed that while the majority of the children in care were faring well in most areas of their lives, there was a sizable proportion (up to 40 per cent) who were not doing well in at least some areas. The 2011 data had an additional question which asked whether the child had had a previous assessment and if so what change there had been in each of seven areas of their lives (health, education, family and social relationships, and so on). Of the approximately 60 per cent who had been in care long enough to have had a previous assessment, around half had improved outcomes across all areas of their life after they came into care. This type of insight into how children are faring in our care is extremely valuable however it is not appropriate that this level of understanding can only be gained episodically and in administratively complex and costly ways. The first step in addressing this will be the adoption of a set of agreed outcomes for children and young people in care. Services Connect: Better services for Victorians in need outlined a high-level set of outcomes (outlined in Figure 11) and while these will be the subject of future consultation and refinement, they provide a sound starting point. 19 Figure 11: Indicative outcomes for children and young people in care PERSONAL Children and young people in and leaving out-of-home care enjoy good health and wellbeing. ECONOMIC Children and young people in and leaving out-of-home care have the skills and support necessary to participate in the economy to their fullest ability PERSONAL, ECONOMIC AND COMMUNITY OUTCOMES SOCIAL/ COMMUNITY Children and young people in and leaving out-of-home care are safe and positively connected to friends, family and their local and cultural communities through healthy and supportive relationships. 19 These outcomes will build on those contained in the Victoria s Vulnerable Children s Our Shared Responsibility Strategy and fulfil the strategy s commitment to develop further measures around the wellbeing of children in out-of-home care.
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