Gateway and Family Support Services
Midterm Review Report
February 2012
Acknowledgements
The contribution of the following individuals in preparing this Report is gratefully acknowledged:
Steering Committee
Mercia Bresnehan, Ingrid Ganley, Mark Byrne,
Noel Mundy, Marita Scott, Penny Egan, Nick Evans, Wanda Buza and John Hargrave
Reference Group
Jeremy Harbottle, Di Caney, Bev Funnell, Di Bester, Denise Brazendale, Noelene Fittock,
Mary D’Elia, Ulo Raabus, Mark Pitt, Donna Evans, Anne French, Nick Goddard, Christine Long,
Raylene Cox, Jennifer Thain, Kate Wilson, Robyn Yaxley
Project Team
Julian Joscelyne, Diana Darcey and Baden Phillips with Anna Oakley,
Andrew Peschar and the Performance and Evaluation Team.
Table of Contents
1 Executive Summary and Recommendations 5
1.1 The Review 5
1.2 Major Findings 6
1.3 Recommendations 8
2 Glossary of Acronyms and Terms 12
3 The Review 14
3.1 Terms of Reference 14
3.2 Scope 14
3.3 Review Methodology 15
4 Context 16
4.1 Drivers for reform 16
4.2 The Gateway/IFSS Model 17
5 Outcomes for Children and Families 21
5.1 Impact on the statutory child protection service system 21
5.2 Experience of direct service providers 23
5.3 Desktop review of cases 25
5.4 The experience of families 26
6 Value for Money 32
6.1 Context 32
6.2 Service level 32
6.2.1 Planned capacity 32
6.2.2 Gateway activity 33
6.2.3 IFSS activity 33
6.3 Cost 35
6.4 Service quality 35
6.5 Achievements 36
7 Operational Aspects of the Service System 38
7.1 The Gateway Community Based Access and Assessment Service 38
7.1.1 Summary of the model 38
7.1.2 Information sharing 39
7.1.3 Community Referrals to the Gateway 41
7.1.4 Child Protection Services Referrals to the Gateway 43
7.1.5 Gateway/IFSS referrals to Child Protection Services 45
7.1.6 The Common Assessment Framework 45
7.1.7 Timeliness and Completion of Assessments 46
7.1.8 The allocation process (Weekly Allocation Meetings) 48
7.2 Family Support Services 49
7.2.1 Summary 49
7.2.2 Assertive outreach 50
7.2.3 Capacity to commit with hard to engage and resistant families 51
7.2.4 Ongoing Outreach 52
7.2.5 Intake and Assessment 53
7.2.6 Case Management 53
7.2.7 Casework 54
7.2.8 Practical Support and Skills Development 54
7.2.9 Action Learning / Action Research 55
7.2.10 Sustained, Enduring Support 57
7.2.11 Brokerage 57
7.2.12 Access for Aboriginal Children, Young People and Families 58
7.2.13 Cultural and Linguistic Diversity 59
7.2.14 Participation in Area Advisory Groups 59
7.2.15 Collaborative Working Relationships 60
7.2.16 Links to other Initiatives 61
7.2.17 Links to other Service Systems 61
7.2.18 Early Years Parenting Support Services 62
7.3 Relationship to FAHCSIA Funded Services 66
7.3.1 FAHCSIA Service Approach 66
7.3.2 Consultation comment 66
7.3.3 Discussion and Findings 67
7.4 Information and Reporting 68
7.4.1 Data collection and reporting arrangements 68
7.4.2 MACSIMS 69
7.4.3 Future Directions 69
7.5 Governance and Program Management 70
7.5.1 Governance at sector level 70
7.5.2 Governance at Program and Service level 71
7.5.3 Operational management 71
7.6 Workforce 73
7.6.1 Worker qualifications 73
7.6.2 Consultation comment 73
8 Future Directions and Areas for Development 75
8.1 Drawing the threads together 75
8.1.1 Where we are today 75
8.1.2 National trends 76
8.1.3 The 2011 Select Committee on Child Protection 77
8.1.4 Auditor General’s Report 78
8.1.5 Evolution or revolution 78
9 Appendices 80
1 Executive Summary and Recommendations
“I know that the Gateway shouldered most of the responsibility with this family.” – Service Provider
“I have been in the welfare system myself since I was 10 or something like that, Youth Justice and parole and stuff as well. I didn’t think this would be any different than all the other stuff they had made me do, but [my worker] wouldn’t let me play the system, she just knew what to do. She made me sit up and listen. They saved my life.” – Client Comment
1.1 The Review
Major reform for family support services was implemented in September 2009 with $31.5M over four years provided to establish a new community based common access service (the Gateways) funded to ~$2M per year and new Integrated Family Support Services funded to ~$4M per year. The model is described at 4.2.
In addition, $1.2M was directed to new Early Years Parenting Support Services (EYPS) recognising the importance of the early years including for unborn children and $1.4M established new Targeted Youth Support Services (TYSS) for adolescents, 50% funded by each of the DHHS Reform Unit and Housing Tasmania.
These services were in addition to ~$1.2M funding to existing Family Support Services which were, over the subsequent period, required to modify their service models to work with the new arrangements. $1.0M of other pre-existing family support services had their focus moved to providing a reunification service for CPS, to get children safely home where that could be achieved with intensive family support.
These arrangements are underpinned by amendments to the Children, Young Persons and their Families Act 1997 which, inter alia, established the intake services and provided for improved information sharing between services.
With the current funding allocation ending at 30 June 2012, this review was undertaken as part of standard program management and to provide advice on the effectiveness and value for money of the model.
The Terms of Reference for this review were to:
1. Assess the extent to which the service system is delivering the objectives of the reform of Family Support Services (FSS), including:
· high quality assessment, referral and service access
· integrated FSS to a superior professional standard, in order to
o assess the improved service capacity for families who may not come into contact with Child Protection Services (CPS)
o reduce the number of families notified to CPS by improving access to and responsiveness of community based services
o minimise client re-notifications and the progression of families into the CPS system.
2. Evaluate the relationship of Gateway and FSS with other services systems, including:
· therapeutic, counselling and support services (Sexual Assault Support Services, Alcohol and Drug, Mental Health, Gamblers Help etc)
· Statutory services (Child Protection, Youth Justice, Police, Education, Justice, Family Violence Counselling and Support Service)
3. assess the extent to which the reformed service system is delivering improved outcomes for families
4. assess the extent to which the reformed service system is delivering value for money for government.
5. provide advice to Government on future directions and any priority areas requiring development.
The methodology for the review is at 3.3.
1.2 Major Findings
This review has established that Tasmania is well served by the Gateway and Family Support Services model, and that the service system is functioning as intended. Key features such as the Community Based Child Protection Team Leader, Gateway services, Integrated Family Support Services and case allocation processes are working effectively. The client survey provides heartfelt feedback from parents about the value of the services and the skills of their workers.
The operational aspects of the system are discussed in some detail, and in line with continuous quality improvement, there remain areas that will benefit from service development. This will continue the enhancement of what is already a good model of service that is working for children and families.
It was very clear there has been a significant culture and practice shift in the sector with good coordination and cooperation fostering environments in which robust discussion and sharing of views can occur with respect, and where there were numerous examples of great outcomes for children and their families.
This review has demonstrated that the Gateway/IFSS model has slowed the rate of entry to Out of Home Care (OoHC) and a large number of children have been referred to and received family support rather than being on child protection. However, there is continual demand for all services and a necessity for the Gateway/IFSS model to continue to be funded.
If this reformed service system is not sustained in its current form the likely repercussions include future significant service capacity issues within statutory systems such as CPS and OoHC.
This review establishes that there are quantitative and qualitative measures that establish the intended outcomes are being achieved:
· Children have been diverted from the statutory system, with an overall downward trend in the net admissions of children to out-of-home care since implementation of the reforms
· Of 247 children referred for family support from the Child Protection Service (CPS) in a 6‑month period, in the subsequent 6 months, only 34 (13.8%) had a subsequent substantiation, with only 17 (6.9%) being admitted to out-of-home care.
· A client survey conducted by independent consultants provided consistent and emotive feedback about the difference to the lives of children and their families the services have made. Case studies and feedback comments are provided through this report to reflect the reality for many parents, and the subsequent changes to their lives — often where intergenerational issues have been addressed.
· Stakeholder consultation through community forums and one to one meetings evidenced a significant improvement in working together, consultation and cooperation between services including those outside the new alliances and with CPS, and a maturing of a partnership approach focused on client outcomes.
In looking at the extent to which the new model is delivering value for money the broad parameters were that assistance would be provided to up to 3 400 families per year, that the services could be established within available funds and that they would meet quality standards. Review findings are:
· Based on Gateways dealing with all Level 1 interventions (information advice, referral one-off crisis or episodic brief intervention) and ~50% of Level 2 (low-intensity case management, casework and secondary consultation) the KPMG modelling anticipated ~2 000 per year, (Table 2, p. 32) while client activity data is showing ~8 000 per year (Table 3, p. 33).
· IFSS, based on the KPMG modelling would deliver the other 50 per cent of Level 2, and all the Level 3 (medium level support) and Level 4 (high level support), a total of 1 360 cases. Statewide IFSS client activity data for the period 1 July 2010 to 30 June 2011 shows a total of ~1 800 cases, with ~1 500 of those substantive casework (Table 4, p. 34).
· Both services were established with budgets within available funds and within the anticipated range in the Request For Proposals (RFP) process, and neither has made representations for additional funding, although they have indicated some pressure points they are managing, such as ‘Active Holding’ of families awaiting allocation to a family support worker.
· The Department’s Community Sector Quality and Safety Team confirm that both lead agencies are engaged with and compliant with the Quality and Safety Standards Framework. Both agencies have a Quality Advisor and provided evidence of a continuous improvement approach to services.
At an operational level the review has established that the service system is working well, but that there are some areas for further development. The areas requiring further attention include:
· A significant and welcome maturing of the relationships between sector organisations and Gateways/IFSS and CPS has occurred, and this should be supported. It became apparent that a shared understanding of and working within the intent of the information sharing arrangements of the Children, Young People and their Families Act (1997 and 2009 Amendments) by all services could further improve outcomes for children and families.
· There remain opportunities to ensure consistent feedback to referrers at location level about the outcomes of referral, and at key points in casework by all providers, particularly where they are involved in linked services or service systems.
· There was good evidence that CPS and the Gateways/IFSS were constantly improving how they worked together, with strong support for the Community Based Child Protection Team Leader (CBCPTL) role, but that CPS staff was less positive about the achievements of Family Support Services than Family Support Service staff.
· The Common Assessment Framework (CAF) and the need for it was understood and agreed upon, but there was frustration with a long delay in implementing the revised tool. The revised, computerised, semi-automated tool will ensure better referrals to CPS.
· Practice development, including through Gateway/IFSS lead agencies’ processes and Practitioner Networks was building capacity across the sector, including with smaller organisations with less infrastructure and professional supervision, and this area will need to continue to be developed.
· The current client data platform, IRIS (Information Reporting and Information System), was acquired out of necessity to have a functioning reporting system to record referrals information and activity levels while providing case management functionality for services in a networked environment at the time of reform. However, it does not provide the level of functionality and robustness required for the medium-longer term.
· There were regular monitoring and reporting arrangements in place, but at the Department’s end they were confused (Riley and Riley review); and with current structural arrangements in Disability and Community Services (DCS) it was timely to install consistent arrangements at both an Area and Statewide level, without creating additional administrative and process burdens.
· Workforce was an area of considerable interest, but it was recognised this could not be substantively dealt with in this review. It was however an area for attention at sector level through other processes.
Additionally the House of Assembly Select Committee on Child Protection Report[1] found that investment in early intervention appears to offer best value for families, community and government (F112) that Gateway is an effective early intervention mechanism (F114) and recommends continuation of the Gateway/IFSS (R108), for additional resourcing to allow more time to work with complex cases (R115).
In relation to future directions, this review points to national data showing that the most common maltreatment types across Australia are emotional abuse and child neglect[2]. Emotional abuse includes verbally abusing, terrorising, scapegoating, isolating, rejecting, ignoring and/or witnessing family violence. Neglect refers to failure to provide basic needs — food, shelter, clothing, supervision, hygiene, medical attention — consistent with disadvantaged socio-economic conditions and with the stories told by parents in this report. The alignment of Gateway and IFSS service provision to date with these priority needs is testament to the relevance and appropriateness of the model and services delivered. Work is ongoing within the services to tailor services to match community and family needs.
1.3 Recommendations
Recommendation 1: That the Gateway/IFSS model continues to be funded at current levels, noting the model is delivering value for money, positive outcomes for children and families and is successfully diverting children from the higher cost statutory systems of Child Protection and Out of Home care. The new model has also been successful in strengthening the broader sector through skills development, capacity building and quality assurance processes.