Positive Futures 2006: achieving wellbeing for children and families 1 Residential care in NSW: current status and future development Christine Flynn Policy Officer, Out-Of-Home Care Association of Childrens Welfare Agencies Paper presented at the Association of Childrens Welfare Agencies Conference Positive Futures 2006: achieving wellbeing for children and families Sydney, 14-16 August 2006
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Positive Futures 2006: achieving wellbeing for children and families1 Residential care in NSW: current status and future development Christine Flynn Policy.
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Positive Futures 2006: achieving wellbeing for children and families 1
Residential care in NSW: current status and future development
Christine FlynnPolicy Officer, Out-Of-Home CareAssociation of Childrens Welfare Agencies
Paper presented at the Association of Childrens Welfare Agencies ConferencePositive Futures 2006: achieving wellbeing for children and families Sydney, 14-16 August 2006
Positive Futures 2006: achieving wellbeing for children and families 2
At 30 June 2005 • 10,041 children and young people in out-of-
home care
• Rate of 5.8 per 1,000 of the NSW population aged 0 – 17 years
• Same rate as Queensland, equal highest in the country
• Lowest rates are Victoria and Western Australia 3.8 per 1,000 in care
• Three hundred (300) or about 3% were placed in residential care
Positive Futures 2006: achieving wellbeing for children and families 3
Trends Numbers in Care at 30 June each year 1995 to 2005
Positive Futures 2006: achieving wellbeing for children and families 4
1995 6.00%
1996 7.70%
1997 7.20%
1998 6.00%
1999 3.90%
2000 2.80%
2001 2.80%
2003 2.20%
2003 2.10%
2004 3.10%
2005 3.00%
Trends: Percentages in residential care as a proportion of total number in care, 30 June each year
Positive Futures 2006: achieving wellbeing for children and families 5
Trends
• Minali, the last DoCS institution closed in the year 98/99
• Ormond, the other remaining institution had closed the year before.
• DoCS, in 2005, operated only three family group homes, scheduled for closure when current residents leave care. (These three homes were excluded from this research, which
focused on non-government services.)
Positive Futures 2006: achieving wellbeing for children and families 6
• Notions of normalisation grounded in social constructs of ‘family’ and its importance to healthy child development
• Research into factors affecting children’s emotional, social and cognitive development
• Higher costs of residential care in comparison to foster care
• Publicised cases of abuse and neglect in large institutions affecting public and government opinion
Reasons for the decline in residential care
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Trends
• Some contracting out of residential care to the non-government sector occurred in the 1990s
• Overall decline in residential care appears to have left a gap in the service system
• Significant emergence in NSW of fee-for-service placements offered by private for-profit companies and not-for-profit organisations
Positive Futures 2006: achieving wellbeing for children and families 8
Why we did the research
• To inform the out-of-home care planning, reform and service development process
• Part of the DoCS $1.2billion budget enhancement is tagged for OOHC services
• Most OOHC funding is to be rolled out in 2006/07 and 2007/08
Positive Futures 2006: achieving wellbeing for children and families 9
About the research
Project commenced in April and interviews concluded in July 2006, most residential care providers interviewed in April and May
Research team: Eric Scott, Louise Mulroney, Sarah Ludowici and myself, ACWA. A DoCS senior policy officer, Jeff Gild, assisted me to conduct Melbourne interviews
DoCS funds the ACWA Out-of-Home Care Development Project
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Definition of residential care used in this research:
Placement, funded by the NSW Department of Community Services (DoCS) under the Out-Of-Home Care (OOHC) Program or on a fee-for-service (FFS) basis, in a property owned or rented by an agency, in which one or more children or young people are placed and which are staffed by either direct care staff employed on a rostered basis or by house parents or principal carers, who are not regarded by the agency or themselves as foster carers.
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How we did the research
109 interviews using standard interview guides:
• 42 face-to-face interviews with residential care providers and 12 additional interviews with CEOs
• 21 interviews with non-residential care providers
• All seven DoCS Regional Directors
• Four peak organisations
• 23 interstate interviews
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Key results: Capacity & size
• Forty two (42) non-government providers of residential care
• 330 children or young people in placement
• Notional capacity of the residences was up to 420
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Key results: Capacity & size
Residences were generally small:
• 21 agencies had 83 residences with a capacity of only one
• 20 agencies had residences with between two and five places
• 11 agencies had residences with a capacity of six or more places
Positive Futures 2006: achieving wellbeing for children and families 14
Key results: Target group
• Residential care was predominantly being used for the high and complex needs group
• Some programs included siblings and older young people in transition to independence
• No specific residential programs for Aboriginal or Torres Strait Islander children or young people
• Most residents were statutory clients
Positive Futures 2006: achieving wellbeing for children and families 15
Key results: Age range
• Eighteen of 42 agencies provided residential care for children under 12
• Four agencies stated they had an open age range
• Two gave the lowest accepted age as six years
• Six gave the lowest age as eight years and
• Four specified 10 years of age as the minimum
Positive Futures 2006: achieving wellbeing for children and families 16
Key results: Duration
• In placements intended to last three months, average placements ranged from six weeks to two years. The longest was seven years
• In placements intended to last around 12 months, average placements ranged from nine months to two years. The longest was 2.5 years
• The longest current or recent placements overall were eight years, found in two agencies
• In four placements that exceeded four years duration, the intended duration was three months
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Key results: Individual residential placement
• 108 of the 330 residents were placed alone
• 107 with rostered staff caring for them
• 11 agencies only offered individual placements
• 27 agencies had provided them at some time in the past 12 months
• Average duration: a few nights to 3.5 years (reported by two agencies)
Positive Futures 2006: achieving wellbeing for children and families 18
Key results: Service models & programming
Staffing models
• Residential care was usually operated as the rostered staff model
• Only one agency ran a family group home model
• One hybrid (in between FGH/rostered staff) model
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Key results: Service models & programming
Programs
• ‘Individualised’ program – tailored to the needs and interests/preferences of residents
• School engagement was emphasised for all those of school age
• Structure in household programs and extent of community involvement varied, but not a great deal of differentiation was found across agencies
Positive Futures 2006: achieving wellbeing for children and families 20
Key results: Service models & programming
Aftercare
• 28 agencies provided aftercare services, with 25 reporting it was unfunded
• Of those 28, 11 had between one and five active aftercare clients and eight agencies had between six and 10 clients. Six agencies had over 11 active clients
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Key results: Service models & programming
Therapeutic programs
• Only few programs were described as therapeutic or described some therapeutic elements to their program
• Only one specialised in working with males who had sexual offending
• Some agencies employed or engaged consultant psychologists
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Key results: Staffing issues
• Recruitment difficulties for direct care and management level staff
• Lack of high level expertise in residential care
• Heavy reliance on casual direct care staff in FFS agencies and expertise lost if residences were closed and employment could not be guaranteed
Positive Futures 2006: achieving wellbeing for children and families 23
Key results: Agency contribution to funding
• Fee-for-service funding arrangements came close to meeting full cost of service delivery.
• Program (recurrently) funded residential care providers contributed an average of 25% to the cost (5-50% contribution range)
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Key results: Geographic distribution of services
Uneven distribution of residential care providers
• Metro West (Sydney) and Northern (NSW) regions had the largest numbers of providers, 11 in each
• Northern region had the largest number of fee-for-service providers with 9, while only two agencies were program funded for residential care
• Other regions (Metro South West, Hunter, Southern) also highly reliant on fee-for-service providers
Positive Futures 2006: achieving wellbeing for children and families 25
Key results: Properties used for residential care
High reliance on private rental properties for residential care
• 60% of total properties in use for residential care were private rental
• 29% were owned or under mortgage
• 11% were rented from public or community body
Positive Futures 2006: achieving wellbeing for children and families 26
Views and issues
1 More residential care is needed
2 Residential care should be an option for a variety of children & young people, not just complex needs clients
3 Age criteria revisited
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Views and issues
4 Residential care placements for living, not just waiting
5 High level of use of individual residential care criticised
6 Therapeutic and specialised model development
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Views and issues
7 Residential assessment service questioned
8 A workforce development strategy, a capital program, research and evaluation and improved recurrent funding are all needed
Positive Futures 2006: achieving wellbeing for children and families 29
Progress since 2005
ACWA issued a position paper on residential care, February 2006
Contains 17 recommendations for future development of residential care
Positive Futures 2006: achieving wellbeing for children and families 30
DoCS developments
• Articulating residential care models
• DoCS Costing Manual was published (v1, March 2006)
• ‘High and complex needs’ contracts include recurrently funded residential care placements
• Reliance on fee-for-service placements, and in particular one-on-one placements, has been reduced
• Some under 12 year olds have been transitioned to foster care placements
• DoCS is undertaking economic modelling work to inform planning
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Follow up of non-government agencies in early August 2006 showed:
• Some have tried to expand their residential services
using their own resources or via fee-for-service arrangements
• Fee-for service referrals have declined in most regions affecting the viability of some agencies
• Some agencies reliant on fee-for-service placements have closed
• Program-funded placement remain well-used within existing capacity
DoCS is yet to announce mechanisms for funding additional non-government OOHC placements
Positive Futures 2006: achieving wellbeing for children and families 32
Meanwhile
• Accreditation requirements and good practice wisdom continue to emphasise that residential care is not suitable for under 12 year olds
• Fifteen agencies have achieved five-year accreditation, including 10 offering residential care programs
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More work needs to be done to: • finalise residential care models and refine
costings
• determine the number and the distribution of new residential places
• establish new places and new models for different target groups
• address issues affecting quality and outcomes
• conduct research and evaluate residential care services and models
Positive Futures 2006: achieving wellbeing for children and families 34
Those interested can purchase the full report Residential Care in NSW
Order forms are available at the ACWA/CCWT table in the conference foyer or can be accessed on the ACWA web site: www.acwa.asn.au
The full report can be downloaded:http://www.acwa.asn.au/ACWA/publications/reports/reports.html
ACWA’s position paper on residential care can also be viewed and downloaded:http://www.acwa.asn.au/ACWA/publications/reports/reports.html