Safety in residential care

graphic of residential care

When we take children[1] into the care of the state, a prime responsibility is their safety.

We have matched comments about safety given to the Office of the Guardian by children during our monitoring visits and advocacy with those from the December 2016 Royal Commission paper Safe and Sound.  There were overwhelming similarities.  In this article we blend the two sources to consider the questions ‘do children feel safe’, ‘when do they feel safe’ and ‘what would they suggest to make things safer?’

How safe do children feel in residential care?

Residents often feel unsafe in residential care. Bullying and harassment are common. Adolescents report that they are frequently worried by the threat of sexual harassment and assault. Older residents say that the impact of witnessing violence, self-harm and the abuse of fellow-residents, leaves them stressed and feeling unsafe.

Children generally think it is unlikely that they would be abused or harmed by a worker, although a small number report that they have encountered or heard about abusive staff. Some are concerned by the behaviours of ‘creepy adults’ and those who try to create inappropriate and overly-familiar relationships with them. Children assess how safe workers are based on their past experiences of abuse, by watching the adults’ behaviours and by how other residents act around them.

Many children describe residential care as feeling unsafe due to its instability and frequent changes of staff. Some relate times when they were moved to less safe residential care placements for no reason than that other young people could take their rooms.

A few adolescents report that adults outside of residential care take advantage of children in care, exploiting their need for a sense of belonging, accommodation and money. A few report that some children in residential care engage in prostitution.

When do children in residential care feel safe?

Children feel safe in a placement that is home-like and where young people feel welcome.  They like it where things feel ‘normal’ and where adults look out for them.

They want to see that organisations and workers take a resident’s safety seriously, that they are interested and take measures to protect them.

They feel safe when there are cordial relationships with their fellow-residents and workers, and that there are other supportive relationships, such as with a social worker or teacher, with people outside of the unit.

Really building relationships with kids works, because then they feel safer to come to you with pretty much any problem.  They’re not going to come to you with problems, even if it’s something as simple as being bullied, they’re not going to come talk to you if they think you don’t like them or don’t listen.

Safe and Sound, p 66

Stability and predictability are important.  Children need to know what is going to happen, and that any difficulties with fellow-residents can be resolved.  Routines, reasonable rules and an opportunity to have a say in decisions give them confidence and sense of control.

They believe that when they are safe, children and young people feel relaxed and calm and are less likely to be aggressive and to harm each other.

Younger residents tend to value security measures such as locks on doors, surveillance equipment and alarms.  In contrast, for older residents, these measures reinforce their sense that residential care is not home-like and is unsafe.

How could we make things safer?

Placements

Find more suitable care arrangements, particularly for those who are younger and more vulnerable and make better placement decisions that allow residents to have a say in how they are matched with other residents. Treat residential care as a long-term arrangement and make sure that changes are kept to a minimum.

Staffing

Train staff about the things that can harm children and their vulnerabilities, particularly their inexperience about sexual relationships and exploitation.  Have sufficient numbers of properly trained staff so that they have the time to develop relationships, are around and have the time to watch out for threats.

Cooperation

Train staff to take on parent-like responsibilities for protecting residents from harm.  Get staff to discuss with residents the risks and how to keep themselves safe. Get staff and residents to work together to identify safety risks and develop ways of dealing with them. Staff need to take the initiative in enquiring after residents’ safety because it is easier for staff to ask residents if they are being harmed rather than waiting for them to report it. Try to create an atmosphere where there are positive relationships between residents where young people can look out for each other.

Hearing the resident’s voice

Staff need to be prepared to listen when residents raise concerns and to be understanding and patient, even when the issues do not seem important at first.  Residents need to be informed that it is OK to raise an issue, what sorts of issues to raise and how to do it.  Make sure that it is safe to do so and that they will not suffer retribution.

A lot of the time it can feel like nothing happens [when an issues is raised] or it gets lost or stuck in the system… No matter what, [issues] should be followed up by someone and the young person should be kept in the loop with regular communication.

Young person in residential care

The Child and Young Person’s Visitor Scheme that is hosted in the Office of the Guardian is now well under way and we look forwards to presenting more of the views of children and the state of the system in future articles.

[1] We use the term ‘children’ to include children and young people up to the age of 18 years. We use terms such as ‘adolescent’ and ‘pre-teen’ to refer to specific age ranges within that group.

Care leavers need our support beyond 18

photo of Penny Wright

Penny Wright Guardian for Children and Young People in Care

A few weeks ago my office conducted a poll about extending support for children in care.  Our readership[1] of 1700 overwhelmingly supported the extension of assistance to young people in state care beyond the current deadline of their 18th birthday[2].  Many cited the very poor outcomes for care leavers under the current regime and others pointed out that most young adults in South Australia continue to need, and receive, support from their birth families well into their twenties.

In the light of this, I was very pleased when the Government announced its intention to fulfil an election promise to extend financial support for foster and relative-care families to allow young people exiting care to stay on in those placements.  There is no doubt that providing stability for those young people will make it more likely that they will be able to complete their education and make a more gradual and individualised transition into employment and housing.

However, it’s important to acknowledge that around ten percent of young people in care will not benefit from these changes. These are the approximately 500 young people who do not live in a family-based care but live in emergency or residential care accommodation. Sometimes they have not been able to be placed in a family because a suitable match is not available but, more commonly, there are simply not enough home-based placements to meet the need.

The experience of young people in residential care varies greatly.  Some live in smaller residential care properties which provide a more family-like environment, with a stable group of residents and a supportive and familiar team of carers creating a nurturing home.  For others, especially those in the larger buildings housing eight to twelve residents, their experience is one of instability, tension and danger where residents with a variety of needs are placed quite randomly, and frequently express their unhappiness by running away. These risks and conditions were clearly identified in Commissioner Margaret Nyland’s 2016 report, The Life They Deserve.

Children who have lived in residential care often have particularly pressing needs beyond the age of 18, reflecting the challenges they experienced before coming into care, and the acknowledged risks inherent in residential care environments. Trauma can delay development and affect a person’s ability to function fully and successfully. A number may be ‘technically’ 18 but significantly ‘younger’ in their understanding and maturity and ability to negotiate a complex world beyond the care system.

So, what kind of support can be built for these young people beyond their 18th birthdays?

Often children in residential care approach their 18th birthday with a mixture of excitement about their new independence and high anxiety about how they will manage outside a system they have relied on.

Just like young people in foster care, some young people in residential care would definitely benefit from being able to continue in the only home they know until they are 21, supported by workers with whom they have trusting and supportive relationships until they are mature enough to live independently. Many others would choose to leave, either because their experience has not been a safe or pleasant one or to escape the stigma of being in care or just to spread their wings.

Allowing young people to stay on beyond their 18th birthday, in a similar way to those in family-based care, would not be straightforward.   In residential care houses staff might find that accommodating the needs of adult late-teens at the same time as providing a safe and appropriate environment for younger children is challenging.

Fortunately, other jurisdictions and other services have models and lessons that can be learned.  In the UK, care leavers have the option of services from their local authority and a ‘personal adviser’ til age 25. For residential care leavers this Foyer model of transitional youth accommodation combined with support services would make an excellent starting point.  There is one operating today in Port Adelaide[3].  I expect colleagues in child protection could point me to a dozen other models that could be part of a solution, too.

The funding to support foster and kinship care beyond 18 is a welcome initiative and will provide significant benefits for young people who are comfortable in stable placements.  For those who choose to leave family-based care or for those in residential care who do not have this option the needs identified by our poll respondents remain un-addressed.

I will seek opportunities to engage with the government and other individuals and services in our community to ensure that the post-18 needs of young people in residential care are not underestimated or overlooked.

[1] Current subscribers to the Guardian’s Information Service.

[2] Should we extend the age of leaving state care beyond 18?

[3]Ladder Port Adelaide Foyer

What Youth Training Centre residents want from their community visitor

AYTC residents going for a football mark

Young footballers in the AYTC going for a mark at the Reconciliation Week game.

Community visits to the Adelaide Youth Training Centre will start this month.  Back in April we asked groups of residents about what they would like from the visits and what they hoped might result.

These are some of the things they said:

‘Why don’t you have a day when you are here each week – like a program?’

          ‘Speak to us as a group.  We might all have the same problem.’

‘Two weeks between visits is too long – you’ll miss all the lovely stories!’

          ‘There’s always stuff going on in the centre that we need more support on.’

‘[We need weekly visits because] anything could be happening in here.’

          ‘We ask the staff to contact you but then we have to wait a few days.’

‘Everyone should have your [phone] number as a pre-set when they come in.’

          ‘If I’m going through a rough patch or I’m not feeling confident, I won’t talk to you.’

‘Advocacy is making time easier.’

          ‘After you talk to the bosses, they treat us better.’

 

Community visitor programs – what we can learn from Oakden

[Oakden residents] lacked any voice themselves. They were entirely dependent upon others for their care and their safety”. – Commissioner Lander, p190 1

There are many lessons to be learned from the report by Commissioner Bruce Lander QC on the events at the Oakden nursing home, many of which can be applied to other facilities in our state.

Residents of the Oakden facility should have been protected from abuse and mistreatment by layers of overlapping protections which were the the domains of many different people at different levels of government, administration and service provision.

They, their families and the community, would have expected government and senior departmental officers to provide adequate resourcing and oversight and to have policies and procedures in place to ensure suitable levels of care, management and supervision. The training and professional standards of the staff working there should have provided another level of protection. Effective complaints procedures for residents and concerned others should have provided additional safeguards as should have accreditation inspections by external bodies.

Finally, the residents of Oakden relied on community visitors to bring an independent and critical eye to the conditions they experienced.

Commissioner Lander set out in forensic detail how each of these layers of protection failed and his report sounds a warning for any organisation that provides care for vulnerable people in a closed or secure environment.  Regarding the operation of the relevant community visitor scheme (CVS) –

…consideration needs to be given as to whether the CVS in its current form is an appropriate safeguard for those suffering mental illness who are housed or treated in treatment centres, limited treatment centres, or authorised community mental health facilities. [p307]

Commissioner Lander’s critique of aspects of community visiting at Oakden raised questions for all such schemes, not just those visiting mental health services. The Guardian’s Office is currently in the process of establishing two separate community visitor schemes, so the issues he described are instructive as we attempt to craft models for the protection and wellbeing of young people in residential care and in youth detention. These are some of the issues.

Should schemes use volunteers or paid visitors?

Volunteers are assumed to bring into the institution expectations and standards reflecting those of the broader community. Because volunteers are not paid, that could potentially mean larger numbers of visitors within a given budget allowing more frequent visits.  But is it reasonable to expect volunteers to accept the rigorous selection process, training and complex tasks required of a visitor? Commissioner Lander noted that some visitors to Oakden may not have had the necessary skills and support to identify problems, report them and intervene on behalf of residents. He favours a model in which visitors are paid, comprehensively trained, and operate within a rigorous model that has sound documentation and effective accountability mechanisms…


This is the first part of a longer paper which goes on to consider the use of volunteers as visitors, the concept of visiting versus inspection, unannounced visits, visitor independence and the place and value of visitor programs. For the full version, download Community visitor programs – what we can learn from Oakden.

1 Oakden: A shameful chapter in South Australia’s history.

Working together for children in care

photo of Penny Wright

Penny Wright Guardian for Children and Young People in Care

When the state takes over the parenting of a child, that parent has many faces, many hands and, hopefully, many hearts.

Pointing the way to a new and better child protection system, Commissioner Margaret Nyland wrote in her preface to The Life They Deserve

The new agency cannot operate in isolation. It should coordinate and collaborate with all other relevant departments and organisations, both government and non-government, to give children better outcomes.  It must also be proactive and engage the community to play its part in developing programs and systems…

Many of the good things we see happening for children in state care, and we do see many good things happening in our work, happen when the hearts and the hands of adults come together to recognise and understand a child’s needs and stay together to work through to a good outcome.  The joy for the child, but also for the adults, is palpable.  It is one of the reasons we do the work we do.

Sadly, some of the worst results we see for children are when people and organisations fail to work together closely and respectfully in the child’s interests.

Our recent survey of the state of cooperation and collaboration in child protection asked respondents to rate levels of cooperation and collaboration.   We chose 19 different relationships drawn from those identified in the work of Commissioner Nyland as being crucial to an effective child protection system.  In analysing the results, we applied the standard that cooperation and collaboration should occur either ‘frequently’ or ‘always’.  By that standard only one of those critical relationships was scored as achieving a pass mark by 30 percent of the respondents.  Most of the others were scored much lower and many were in single figures.   There were two areas that had improved since an identical survey conducted in June 2017 but it’s fair to say the improvements were small and were from a very low base.  Allowing for the limitations of the survey, it is clear that respondents thought that we are still far short of Commissioner Nyland’s ideal.

Just as useful for me, were many of the comments.  There were a few heartening stories of good and effective cooperation but there were many more of key stakeholders being omitted from case planning and decision making and important information remaining unshared.  Many attributed the failures to workload issues but others referred to organisational culture, policy and training.

My office observed a sample of the Annual Reviews of young people in state care over a period of ten years to 2017.  Annual reviews have been long mandated in the Department for Child Protection, and its earlier incarnations, in order to review the situation of each child and young person in state care.  It is a time to reflect and review and plan for the child’s future outside of the day to day pressures. It is a time to place a child at the very centre of thinking and caring. Annual Reviews occurred for up to 80 per cent of children in care in most years but attendance at the planning sessions by other than social workers and supervisors was rare.  In our report Office of the Guardian Audits of Annual Reviews 2007- 2017 we summarised:

Most offices have, over the 10 years of these audits, conducted annual reviews with only Department staff present with carers represented occasionally and birth parents and other professionals very much the exception.

If, as Margaret Nyland concluded, cooperation and collaboration are essential to an effective child protection system then major cultural and practice change is essential.  I look forward to supporting and contributing to such relationships, as my office grows into its new roles.

A Training Centre Visitor for young people in detention

Penny Wright is Training Centre Visitor in addition to being Guardian for Children and Young People. Work is well underway to set up the new Training Centre Visitor (TCV) Program established by the Youth Justice Administration Act, 2016.

At the heart of the new program is the obligation to listen to and promote the best interests of children and young people in the youth justice system. A major milestone is the commencement of Travis Thomas, the first Advocate to start developing relationships with residents at the two Adelaide Youth Training Centre (AYTC) sites.

The role of the TCV

The TCV will provide the South Australian community with independent scrutiny of the conditions and rights of children and young people in detention.  This is just the sort of independent oversight body’ proposed in recommendation 15.10 of the recent report of the Commonwealth Royal Commission into Institutional Responses to Child Sexual Abuse.

The TCV will promote the best interests of AYTC residents by mechanisms such as an advocacy service and ongoing visiting and formal inspection programs.  As is usual with independent positions of this sort, the TCV also can conduct inquiries about any matters referred by the Minister and can initiate an own motion inquiry about systemic reform.

Progress

With the recruitment of Advocate Travis Thomas to the team, work will prioritise dialogue with AYTC residents to advise them about the new TCV role and to build the relationship necessary to elicit and express their views, aspirations and needs.  Dialogue with other stakeholders will continue or be established, particularly AYTC staff and management, and the community and government agencies with an interest in youth justice.

The detailed work necessary to create an operational framework for the TCV Program is underway including the development of appropriate standards, guidelines and policies.  This will be done, as much as possible, to ensure that the TCV Program will work in line with international standards such as those that will come into force following Australia’s recent ratification of the Optional Protocol to the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT)

Special groups

Importantly, the Youth Justice Administration Act directs the TCV to respond to the needs of three particular groups of children and young people . They are Aboriginal and Torres Strait Islanders who are significantly over-represented, those who are under guardianship in the child protection system and those who have a physical, psychological or intellectual disability.

The TCV program will provide accessible, credible and culturally appropriate services that reflects and promote the views of AYTC residents about  their care, conditions, treatment and opportunities for development.  The program also will identify opportunities for improvements and promote systemic change in the youth justice sector.

The program will comply with Parliament’s requirement that all state authorities protect, respect and seek to give effect to rights set out in the United Nations Convention on the Rights of the Child and other relevant international human rights instruments affecting children and young people.  A focus for this will be reference to entitlements enshrined in the Charter of Rights for Youth Detained in Training Centres, also endorsed by Parliament.

Information sessions

The TCV Program team will host a series of information sessions in the coming months to provide further information to interested stakeholders.  If you would like further information or to attend, please email or phone Belinda Lorek or Alan Fairley on 8226 8570.

This story first appeared in the Guardian’s Newsletter for February 2018, downloadable here.

SA spends more on child protection and gets less – 2016-17 ROGS

diagram showing child protection services

The Productivity Commission’s 2016-17 Report on Government Services (ROGS) helps understanding of how the South Australian Government’s expenditure on child protection has changed and how it compares with other states.

Child protection services expenditure in SA per child* has increased significantly from $749 to $1,396 in the period 2013-14 to 2016-17 but the real interest is how this translates into the different services that comprise child protection:

  • in protective intervention services we spend $90 per child, which is just 41 percent of the national average
  • in family support services we spend $131 per child, 49 percent more than the national average – an increase of over 300 percent in the the period 2013-14 to 2016-17
  • in intensive family support services we spend $83 per child, roughly on par with the national average
  • in out-of-home care (foster, kinship and residential care), we spend $1,092 per child which is 91 percent more than the national average.

Out-of-home care consumed 78 percent of the SA child protection budget in 2016-17.

Why does SA spend 79 percent more than the national average on out-of-home care?

One of the reasons is that SA relies much more on relatively expensive residential care (properties staffed with paid workers) rather than home-based care (foster and kinship care). In 2016-17 in South Australia it cost, on average, $670,142 per child in residential care compared to $48,005 per child in home-based care.  Another reason is that SA has relied more than other states on so-called ’emergency’ care which makes use of private agency staff to provide care in rented accommodation – more costly but far less suitable to the needs of children.

*refers to a resident child 0-17 in the SA population as a whole.

There is much more detail in our paper South Australian child protection expenditure from the Report on Government Services 2018, available for download now.

 

Collaboration survey results – The views of Government and NGOs

This week we look at how perceptions of collaboration and cooperation in child protection differ between government organisations and NGOs.

Given that collaboration should occur ‘frequently’ or ‘always’  in no areas did more than half of Government or non-Government respondents report that this was the case.

Differences

Government respondents almost always perceived much higher levels of collaboration and cooperation than NGO respondents.  Averaging all areas, 23 percent of Government versus 7 percent of NGO respondents rated collaboration and cooperation as occurring ‘frequently’ or ‘always’ .

NGO respondents rated collaboration and cooperation much lower that Government respondents most significantly:

  • between organisations working with children in the courts on child protection matters
  • between Aboriginal and non-Aboriginal organisations on matters related to individual Aboriginal children
  • between organisations supporting children after sexual abuse

Areas of agreement

Government and NGO respondents agreed on a number of areas where levels of cooperation and collaboration never occurred or were not normal.  These included:

  • between government organisations, NGOs and universities and other training organisations on workforce planning
  • between heads of government departments on child protection matters
  • between government and Aboriginal organisations on policy about Aboriginal children in care
  • between DCP staff and the National Disability Insurance Agency

Comments from Government respondents

Communication between stakeholders is paramount in finding workable support and solutions… we just need to drop the walls and get on with the job holisicly!

We have excellent support from CAMHS staff and Residential care, also fabulous support from My Youth Health Nurse who visits regularly to assist young people. There has been an improved interaction between agencies and DCP to assist Aboriginal young people in care.

There is extreme variation of quality and quantity of collaboration and coordination between individuals and agencies involved in the care and protection of children and young people. In my area, it is of particular concern that there is such poor communication between DCP and other government agencies (principally DECD), as well as the NGO sector with regard to the training and development of DCP staff, workforce planning and aligning practice between DCP and non DCP workers who are charged with similar roles in the child protection system. Not only in this poor management and support of the workforce, it contributes to inconsistencies in knowledge, skills and practice and thus poorer outcomes for children and young people.

I work in child and adolescent mental health and part of my role is to work across the system for the purpose of creating or strengthening scaffolding for the child or adolescent and their carers. My experience is that when workers across the systems work collaboratively and cooperatively with each other the outcomes for the child ?? and carers can be positive in numerous ways and is heartwarming. Obviously this doesn’t always happen for many reasons, much of which I believe is work overload and insufficient supports for many workers leading to a stressed system and a lack of education and deep understanding of the effects of trauma and abuse on young people. However the system also has a band of many experienced and dedicated workers in all areas who support the strengthening of the system in the course of doing their jobs. Thanks for the work and role your organisation plays ??

Comments from non-Government respondents

This to me is still a huge area for practice development. It is too often the case that the systems around the child are the ongoing contributor to the complexities and anxiety placed on the child in care. It is clear through the many commissions that change is critical in collaboration and coordination, however I fear that the changes occurring are a result of a tick-boxing exercise and are not occurring in the spirit of collaboration and coordination across the sector.

Government departments frequently consult with stakeholders but it’s often shallow and doesn’t appear to have impact on decisions and policy. At the most basic level, care team planning for children in OOHC doesn’t have happen. Carers and NGOs are not respected and asked for input once decisions are made.  DCP have no idea of, or commitment to, real co-design or partnership.

**Comments have had minor proofing changes. Some comments have been edited for brevity and to minimise repetition.

Secure Therapeutic Care – Framing Principles

In October 2017, the Guardian provided advice to the Minister for Education and Child Development with reference to bills before State Parliament.  In it she discussed tensions between the child’s right to freedom and self-determination and the need to take appropriate steps to protect a child from danger and to aid their psychological recovery.

This advice is now available for download.

The UN Universal Declaration of Human Rights – 70 years on

The Universal Declaration of Human Rights is the foundation of international human rights law and just as relevant now as it was when it was created 70 years ago.

It represents the recognition that basic rights and fundamental freedoms are inherent to all human beings, whatever their nationality, place of residence, gender, national or ethnic origin, colour, religion, language, or any other status. It is the great grandparent of our own Charter of Rights for Children and Young People in Care.

Since its origins in the aftermath of World War Two, the Declaration has inspired more than 80 international human rights treaties and declarations, a great number of regional human rights conventions, domestic human rights bills and constitutional provisions. Together , they constitute a comprehensive, legally binding, system for the promotion and protection of human rights.

To mark its anniversary, this is the first of a short series of articles on the importance of understanding, promoting and safeguarding rights, particularly those of children and young people growing up in care.

Eleanor Roosevelt, widow of American President Franklin D. Roosevelt, is widely recognised as the driving force for the Declaration’s adoption

Eleanor Roosevelt, widow of American President Franklin D. Roosevelt, is widely recognised as the driving force for the Declaration’s adoption

Spurred by the global tragedy of the Second World War, the United Nations was formally created in October 1945 after representatives of the original 51 member countries signed or ratified the United Nations Charter. Early in its existence, the UN decided a roadmap was required to complement the Charter and to guarantee the fundamental rights of every individual. This ultimately led to the development and proclamation of the Universal Declaration of Human Rights.

The Declaration was drafted by representatives with different legal and cultural backgrounds, drawn from all regions of the world. Eleanor Roosevelt, widow of American President Franklin D. Roosevelt, chaired the drafting committee. Australia was represented on that committee by William Hodgson.

When the Declaration was proclaimed by the United Nations General Assembly in Paris in December 1948, the UN consisted of 58 member states. Since then, membership has grown to 193 and the Declaration has become a global document. In 1999, the Guinness Book of Records declared it the most translated document in the world and it has been translated into more than 500 languages. One of the most remote languages is Pipil – an almost extinct language spoken in El Salvador by less than 50, mainly elderly, people. In this way, translating the Declaration has also served to preserve culture.

Over time, international human rights treaties have become more focused and specialised, addressing a variety of defined social groups and issues, many relevant to our own community.  They include, for example, the Convention on the Rights of Persons with Disabilities; the Convention on the Elimination of All Forms of Discrimination Against Women and the Convention Against Torture and Other Cruel, Inhuman and Degrading Treatment or Punishment.

Particularly relevant to the work of the Guardian’s Office is the United Nations Convention on the Rights of the Child. Signed by 196 countries, and ratified by every member state of the UN, except the United States, the Convention came into force in 1990 and is the most widely ratified human rights treaty.

Under South Australia’s legislation, the Guardian’s Office is responsible for developing and implementing the Charter of Rights for Children and Young People in Care – which is just one of the ways the Universal Declaration of Human Rights and the United Nations Convention on the Rights of the Child influence our work.

In our next newsletter, we’ll look at the Convention of the Rights of the Child.

More information about the 70th Anniversary of the Universal Declaration of Human Rights can be found on this web page.

This story first appeared in the Guardian’s Newsletter for February 2018, downloadable here.