Addressing the emergency in emergency care

12 September, 2017

Nyland care environment graphicIn emergency care (sometimes referred to as commercial care or, previously in the media, ‘kids in motels’) children are housed in temporary accommodation (such as houses and units) by rotating shifts of workers with minimal specialist training employed by commercial providers.

These arrangements are very unsuitable for children in out of home care.  They do not support the psychological needs and social development of young, vulnerable and often traumatised children. The circumstances also place them at greater risk of abuse.  The Office has observed, and received reports from other sources, of ongoing problems in the quality of care provided for children in emergency care placements.

When the Guardian’s Office started monitoring the circumstances of these children in 2005 they numbered 10 and this grew to a peak of 217 in October 2016.

In 2016-17, based on weekly reports received by the Guardian’s Office:

  • the average number of children per night in emergency care was 190
  • the average length of stay was 178 days
  • about one third of children were 9 years old or younger.

Reviewing emergency care, Commissioner Nyland said ‘Reliance on emergency care by commercial carers should cease in all but genuine emergency circumstances’.

The Government accepted that recommendation and subsequently worked to cease commercial care as a priority.  It has attempted to do this by rapidly expanding the number of residential care placements and transferring some existing commercial care environments into Government management.  At the same time, the number of children coming into care has increased as the prevention and early intervention strategies designed to support families and children to safely stay together have not yet started to have effect.

Numbers of children and length of stay in emergency care in 2017

graph showing trens in emergency care in 2017

A focus on reducing the number of children alone can be problematic.  As this graph shows, while numbers of children in emergency care have been reduced, the average length of stay of those remaining has become longer.  Further, as the Guardian has commented,

… finding a suitable alternative placement involves much more than just finding a bed. A good placement has to consider not just what is best for the child or young person but what is in the interests of residents who already live in that placement… [The Office has seen] a number of placement changes  that were hastily planned and executed, poorly matched and did not involve the input of the children.

For detail about the full range of Government responses to the problems in emergency care see our March 2017 post  A place to call home for children in state care – emergency care

 

Strengthening the voice of young people in state care

Amanda Shaw Guardian

20 June 2017

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I recently had the opportunity to speak with the Legislative Council Select Committee on Statutory Child Protection and Care specifically about the Children and Young People (Safety) Bill 2017, following my two written submissions in January and February.

All three submissions were about  the children and young people whose interests I represent – the almost 3,400 in state care and those detained in the Adelaide Youth Training Centre.

I would like to share some of the things I said to the Select Committee:

‘Underpinning what we do is the drive to make transparent what is happening for children and young people in state care and to strengthen their voice and capacity to influence what happens in their lives.  It is a commitment to the fundamental rights of children and young people.

‘The concepts of safety, best interests and wellbeing of children and young people are not mutually exclusive. It is in a child’s best interests to protect them from harm, protect their rights and promote their development in age, stage and culturally appropriate ways.

‘When children are at risk of harm, or indeed harmed, there must be action to protect and heal. What this looks like should depend on an individual child’s needs in those specific circumstances.  Some will need services and supports to maintain them safely within their home and with their parent/s.  And it will be in their best interests, and promote their wellbeing, to do so. Sadly, some will need intervention to place them in an alternative environment in order to secure their safety and wellbeing. And it will be in their best interests to do so. We’ve heard that directly from children in care.

‘Legislative reform, including the current Safety Bill, is only a part of the significant change needed to promote the safety and wellbeing of children and young people in South Australia. It does contribute incremental improvements in this overall context and substantial innovations in specific areas (for example the proposed community visitor scheme for children and young people in residential and emergency care).  But, legislation alone will not revolutionise the system that children and young people currently live within.’

‘We all have to look at other crucial factors, especially policy reform and organisational culture.

‘In our advocacy and monitoring work we often see a significant disconnection between policy and implementation.

‘The transformation of our child protection and out of home care requires cooperation and collaboration within government, between government and non-government organisations, with academia and the community … and we all must listen respectfully to those most directly affected – the children and young people who live this.’

This article first appeared in the Guardian’s Newsletter in May 2017.

A place to call home for children in state care – residential care

house and heart graaphic7 February, 2017

One of the greatest issues facing us when we remove children from their birth families is finding safe, stable and nurturing homes in which they can live.

In the second part of this three-part article we look at the problems in residential care identified in Commissioner Nyland’s October 2016 report and the Government’s response in December.

The first part of the series, on home-based care appeared on the Guardian’s website on 24 January, 2017.

 

Residential care historically fulfilled two functions.  It was the placement of choice for young people where home-based care was assessed as not being suitable and a time of assessment or a temporary  alternative for the few children who could not be found a home-based placement. The growth in the number of children in state care and the dearth of home-based care placements in recent years has meant that it has become a staple of the system, currently accommodation over 10 per cent of the children in state care.

In her report Commissioner Nyland described a system in which many children were unhappy in unsuitable environments in which children as young as nine years were housed.  Some children lived in fear and were allegedly subject to abuse from other children and workers.  She recommended an extensive program of reform which emphasised improved recruitment, training and supervision of staff, clearly articulated and enforced standards of care and a strengthening of the voice of the young residents.  Most of her recommendations have been accepted by the Government.  These are the major changes.

  • There will be more stringent recruiting of residential care workers including psychological testing (R138) and strict probation and review requirements will be introduced (R139).  The Government has also accepted in principle the recommendation that supervisory staff in residential care should be better trained and qualified (R147).
  • It will be required that residential care youth workers will be properly supervised and, where necessary, performance managed (R148).
  • There will be ongoing training for residential care workers with an emphasis on the risks and dynamics of abuse in institutions (R140).
  • Single person shifts will not cease but the Government has accepted in principle that the use of commercial carers in residential care should cease (R150).
  • Outsourcing of residential and emergency care will continue and expand as residential care is expanded, contrary to Commissioner Nyland’s recommendation although the Government has promised increased scrutiny on the quality of outsourced care (R151).
  • Improved processes and pathways for residential care staff to observe and report concerns about the behaviour of staff with respect to children will be introduced (R142).  A tracking system will bring together and respond to information collected about suspicious staff behaviour from various sources (R143).
  • Residential care will be streamed to better meet the needs of different young people with provision for short-term assessment placements and therapeutic placements for children with high needs and will incorporate measures by which the system’s performance can be evaluated (R146).
  • Residential care houses will be developed where there is need in regional areas (R217).
  • The Government has accepted in principle that no child under 10 will be housed in residential care (except as part of a sibling group) and that no house will accommodate more than four children but will only commit to considering the closure of large units (R149).
  • The Government has accepted the idea of a whole-of-sector model of therapeutic care to be rolled out across child protection, including residential care (R146).
  • There will be proper recording and tracking of physical restraint used against children in residential care (R133) and (R141).
  • A community visitors scheme in residential care and emergency care houses will be introduced (R137).
  • Children in residential care will be supported with an education program to understand their rights (R136) and have a direct line of complaint to the Chief Executive of the Department for child Protection (R134) and a quarterly report on those complaints will be provided to the Guardian for Children and Young People (R135).

The full paper A place to call home for children in state care is available for download.

A quality care environment – emergency care

19 September, 2016

Themes from Nyland  #3

The team from the Guardian’s office have analysed the 850 pages and 260 recommendations from The life they deserve: Child Protection Systems Royal Commission Report[1].  We have extracted some themes and priorities to allow us to critique the government’s response, judge the improvements over time and to shape our own work.  What follows is a description of the issues and a short list of things to watch for in the reform process. We will post the rest of the series over the next few weeks. [2] 

About 80 percent of children under the guardianship of the minister are cared for in home-based care arrangements with the remainder in residential care and emergency care. 

In emergency care children are housed in temporary accommodation (such as motels, caravan parks and short-term rentals) by rotating shifts of workers with minimal training who are provided by commercial organisations. [3] 

These ‘emergency’ arrangements are intended to be short-term and stop gap until a more suitable placement can be identified. However, children remain in these circumstances for much longer than the term ‘emergency’ implies.

These arrangements are very unsuitable for children coming into care, do not support their psychological needs and social development and place them at risk of abuse.

The risks of sexual abuse in rotational care have been well known by the Agency for many years.

Commissioner Nyland observes that not only is this style of care unsuitable for most children it is significantly more costly than either home-based or residential care.

She concludes:

Reliance on emergency care by commercial carers should cease in all but genuine emergency circumstances. This will take some time, and require considerable investment in building other care options, including the capacity of the residential care workforce in the Agency.

While this is being done she recommends ‘greater scrutiny and supervision’ of staff, their pre-registration with the responsible government agency and a tightening up of standards for their selection and appointment.

The risk of children being cared for by commercial care workers on single shifts (that is, working alone) is substantial.  Single shifts should cease immediately.  Carers employed through a commercial agency should be restricted to shifts with two workers at any one time.

As reform progresses we look forward to seeing:

  1. Plans and a schedule for reducing the numbers of children in emergency care to emergencies only, aligned with plans to proportionately increase the supply of quality residential and home-based care.[4]
  2. The immediate ending of single person shifts.
  3. A review of service agreements with commercial agencies who supply emergency care staff to tighten up staff selection criteria, prevent staff from working in emergency care for multiple agencies, seek pre-approval prior to placing staff and require agencies to report concerning behaviour.

Please join the discussion via the reply box leaving a name and an email address in the spaces provided.  We will remove them from the published post if you request in your reply.

1 Unless otherwise noted all quotes are from The life they deserve: Child Protection Systems Royal Commission Report,

2 This is not intended to be a précis of Commissioner Nyland’s report which provides a very clear and readable summary.  Because of the Guardian’s mandate, our analysis will tend to focus on issues for children in out-of-home-care.

3 Numbers in emergency care have grown to over 200 since the Commissioner considered the matter has become the defacto permanent care arrangement for numbers of children and some young children.

4 Efforts to ‘get the numbers down’ in the past  without growing capacity in other areas have led to children being placed into unsuitable home-based or residential care placements.  The experiences of children when moving placements must be central. Movements must be planned, new placements matched to the needs of the child and the child must have the opportunity to view and discuss the placement.

New indicators focus on Aboriginal culture and connection

New indicators to be rolled out by the Guardian’s Office in the last quarter of 2016 will  strengthen and sharpen the focus on Aboriginal[1] culture and community connection in its monitoring of residential care.

In her report last week The Life They Deserve, Commissioner Margaret Nyland recognised the over-representation of Aboriginal young people in the child protection system and the significance of maintaining community and culture for them.

Aboriginal children flourish best when they can safely enjoy their land, language, community and culture…

… some Aboriginal children need to reside with non-Aboriginal carers.  Supporting the cultural needs of these children is not tokenistic, but profoundly important…

There is a need to re-focus cultural support in Families SA (…) to ensure that all practitioners have access to advice and support in specific cases, as well as more strategic guidance and training. [2] 

The new indicators have been in development since 2015 when a consultation with young people and the Murraylands community and a review of the literature made clear the importance of maintaining cultural connections in the development of a healthy identity in young Aboriginal people in care.

Senior Policy Officer Alan Fairley said, ‘The indicators align with the Standards of Alternative Care in South Australia which emphasise the right of Aboriginal children in care to know about their cultural identity and their community and to live in a place where people understand and respect their culture.

‘The new Indicators will help us decide whether the care arrangement:

  • makes the child or young person central by helping them understand their current situation and how they can contribute to decision making
  • promotes contact with appropriate people and activities
  • uses appropriate service methodologies and tools
  • enables the effective involvement of a range of carers and other service providers, and
  • has a culturally supportive physical and social environment.

‘And most of all, Advocates will be listening and talking with young people and reporting on how they see their cultural connection being supported.’

For further information about the development of the new Culture and Community Indicators, contact Alan Fairley, GCYP Senior Policy Officer, at alan.fairley@gcyp.sa.gov.au 

We love to hear and publish your comments. Please use the reply space below.

[1] We will use the term Aboriginal to include people of Torres Strait Islander descent in this article.

[2] From Chapter 16 of the Child Protection Systems Royal Commission, The life they deserve: Child Protection Systems Royal Commission Report, Volume 1: Summary and Report (Government of South Australia, 2016) available at http://www.agd.sa.gov.au/child-protection-systems-royal-commission

This item was also published in the August 2016 Guardian’s Newsletter.

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Four major concerns for children in care and custody

3 May 2016

One of the Guardian’s Office’s functions is to advocate for children and young people in state care and youth justice detention whose issues are not adequately represented elsewhere. Four issues have consistently dominated requests to the Office for advocacy. They are:

  • unsatisfactory placement
  • lack of participation in decision-making
  • being or feeling unsafe
  • lack of contact with significant others

From 1 July 2012 to 31 March 2016, in 578 enquiries concerning 659 young people in care and detention, these four issues have consistently presented as the prime reasons for seeking the Office’s assistance.(1)

Unsatisfactory placement

Children consistently express preference for a small, home-like environment, if not a family then something that is on the scale of a domestic dwelling with a small number of residents and a long-term stable group of carers. Getting along with fellow house members, being included and feeling comfortable and secure seem of most concern.

Lack of participation in decision making

‘Not listening to me’ is a frequent refrain when children and young people seek advocacy. It is often linked to a substantive issue.  But the failure of adults to appear to actively listen and try to understand and then to explain what they will do and keep the child or young person informed sometimes seems even more important to the child or young person than the original issue.

Being or feeling unsafe

Bullying and actual physical violence means that a child or young person is actually unsafe. Children and young persons also report feeling unsafe where there is consistent acrimony and aggressive behaviour, violence and physical restraint going on around them even if they are not directly involved.

Lack of contact with significant others

Failure by adults to support regular contact with siblings, by birth and sometimes those with whom they have lived, with birth family and extended family and even with ex-carers is a regular cause of concern for young people.  In some cases safety or exceptional practical difficulties are the main cause but often, with advocacy, contact can be increased and regularised by planning and consistent effort by families, workers and carers.

(1) The data on which this is based records requests from two populations, those in state care (approximately 3000) and those in youth justice detention (approximately 50). A small number of young people are in both populations. The Office’s monitoring activity in residential care houses and the Adelaide Youth Training Centre mean that those residents are more familiar with our Advocates and so more likely to request advocacy.  In a very small number of instances, the Advocates have themselves initiated advocacy in the child’s best interests and these are in the data from which we draw the conclusions. In some requests for advocacy multiple issues are present. Those have been categorised by the prime presenting issue only.

Australian Children’s Commissioners and Guardians’ November 2015 meeting

At the November meeting were, NSW Children's Guardian Kerryn Boland, WA Commissioner for Children Colin Pettit, NT Children’s Commissioner Colleen Gwynne, CEO of the Victorian Commission for Children Brenda Boland, Tasmanian Children’s Commissioner Mark Morrissey, ACT Commissioner for Children Alasdair Roy, National Children’s Commissioner Megan Mitchell and SA Guardian for Children and Young People Pam Simmons.

At the November meeting were, NSW Children’s Guardian Kerryn Boland, WA Commissioner for Children Colin Pettit, NT Children’s Commissioner Colleen Gwynne, CEO of the Victorian Commission for Children Brenda Boland, Tasmanian Children’s Commissioner Mark Morrissey, ACT Commissioner for Children Alasdair Roy, National Children’s Commissioner Megan Mitchell and SA Guardian for Children and Young People Pam Simmons.

The Australian Children’s Commissioners and Guardians’ (ACCG) met in Canberra on 25 and 26 November 2015.

The purpose of the ACCG is to strengthen the quality and effectiveness of strategic advocacy to promote and protect the safety, well-being and rights of children in Australia, particularly the most vulnerable or disadvantaged.

Aunty Violet Sheridan welcomed to country all ACCG participants.

The ACCG welcomed Colin Pettit as the newly appointed Western Australia Commissioner for Children & Young People.

Among the topics discussed were esafety for children, countering violent extremism and youth justice facilities and the rights of the residents.

The ACCG Communique from the November 2015 meeting is available for download.

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Young people tell the Royal Commission how the care system should be

a group of young people at the Royal Commission consultation.

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Thirty-five young people under, or previously under, the the guardianship of the Minister gave their views of the child protection system in a consultation with the Child Protection Systems Royal Commission on the afternoon of 25 March 2015.  The young people were invited to work through a series of scenarios involving an imaginary family and their children and to speculate what could and should be done to support and protect them.

Guardian Pam Simmons said that she was very pleased with the result.

‘As always the young people amazed us with their thoughtfulness, enthusiasm and generosity and I know that the Royal Commission will benefit from the immediacy and relevance of the young people’s contribution.’

While views differed on some of the detail, one young person summed up for all with, “The children must be heard -in their own words.”

The consultation was a partnership between the Royal Commission, CreateSA and the Guardian’s Office, who will share the outputs from the session, with the support of Red Cross SA who provided an excellent meeting space.

 

Wellbeing of children and young people in care 2010-11

The Guardian’s Office monitors the circumstances of children under the guardianship, or in the custody, of the Minister. The feedback and findings collected during monitoring activities are reported in detail to the agencies involved and to the relevant Minister.

In the 2010-11 report we focussed on children’s safety, security and stability of placement, contact with family, friends and cultural community and participation in decision-making.

The report Wellbeing of Children and Young People in Care 2010-11 summarises the collected information.

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