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

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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

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Trends Numbers in Care at 30 June each year 1995 to 2005

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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

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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.)

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• 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

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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

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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

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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

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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

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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)

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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

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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

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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

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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

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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

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Progress since 2005

ACWA issued a position paper on residential care, February 2006

Contains 17 recommendations for future development of residential care

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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

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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

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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

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Contact details

Christine Flynn, Policy Officer, OOHCAssociation of Childrens Welfare Agencies

Locked Bag 13, Haymarket Post Office NSW 1240Australia

Tel 02 9281 8822Fax 02 9281 8827

Email: christine@acwa.asn.au

Web: www.acwa.asn.au