CAFWAA PRACTICE SYMPOSIUM

Rydges Eagle Hawk Resort 2003

Canberra - 17-19 September 2003

WHEN CARE IS NOT ENOUGH

The Potential of Treatment Models in Out-of-Home-Care

Agency Showcase: Barnardos Australia

Achieving stability in foster care through a specialist approach:

Barnardos Temporary Family Care and Find-A-Family programs

Deirdre Cheers, Senior Manager South East Sydney

Tina Smith, Senior Manager Adoption and Permanent Care

Program Identification

Name of project: Barnardos Find-a-Family

Location: 60-64 Bay Street, Ultimo, NSW, 2007

Sponsoring agency:Barnardos Australia

Program Design

Program objectives

Find-a-Family provides a specialist foster care service with a focus on children who have a history of care away from their birth families, where restoration is unlikely and there is a need for stable, long lasting foster placements. Barnardos often provides care for children where there have been multiple placement breakdowns within the government and non-government child welfare sector in either foster care or residential care.

Theoretical foundation and supportive research

  • Secure family environment provides best for the needs of most children;
  • Children require stability in a placement with the same carers in order to develop to their full potential;
  • The child, the birth family and the carer have the right to know the long-term plans for the child's future at the earliest possible opportunity;
  • Contact must be considered in every care plan to meet a child’s need for a sense of identity through a realistic understanding of personal history.
  • The first priority of Barnardos is to provide for the needs of the child.

Program structure

  • There are four Adoption and Permanent Family Care Teams, two in Sydney, one in the Illawarra and one on the NSW Central Coast.
  • There is also a team based in Sydney providing a recruitment, intake and support service to the Sydney and Central Coast teams. The South Coast office is unable to utilise this central service due to distance and therefore they manage all their own recruitment, assessment, intake and training.
  • The Bay St office has an Office Manager and Secretary and the two coastal offices have only part time secretarial support.
  • The teams all have a Manager or Joint Manager and 4 - 5 workers.

Program components

The Find-a-Family Program is made up of matched placements, bridging or intake placements, respite care, adoption and post adoption services and after care.

Program processes

Workers aim to recruit carers who are skilled, knowledgeable and informed and who can remain involved with a child until adulthood. This is crucial for children with emotional disturbance and challenging behaviours but recruiting families is time consuming and difficult. The competency based assessment process for prospective applicants is intensive and involves a number of individual and joint interviews with all the family members. Carers also have to attend a three day training program over three weeks which provides information about the program and highlights the roles and responsibilities of carers and the Agency.

Paramount to the success of the child’s placement is the ability to match them with the most appropriate family for their individual needs. Carers are usually recruited by advertisements with reference to the particular child. Children themselves may be involved in drafting their own non-identifying descriptions and are always consulted as to their desires with regards to a suitable family.

Post placement support and resourcing of carers is a major and critical part of our work and the importance placed on this by team members. For every new placement the caseworker visits the child at home on a weekly basis and then after a period of 3 - 6 months, the frequency of the visits are negotiated between the caseworker and the family, most decreasing to fortnightly and then to monthly visits. This post-placement support by the caseworker contributes substantially to the survival of the long-term permanent placements. The caseworker is responsible for implementing the Care Plan in partnership with the carer which could involve, in addition to behaviour management strategies, organising early intervention support, speech/language therapy, occupational therapy, counselling, paediatric or psychiatric assessments for the child. Respite care, one weekend per month, is provided for all our Permanent Carer families.

Intervention techniques

Case management is provided by Find-a-Family which involves provision of specialist services, resourcing of carers, provision of relief from face to face care and support with educational issues.

Agency nominated performance indicators

The Agency monitors moves in care and the success of the placement into permanent care. Care plans are monitored through the Looking After Children guided practice tool, LACES database. Find-a-Family also has a specific outcome based statistical program.

Available reports are:

  • Number of children and young people in care
  • Age of children and young people in care
  • Gender of children and young people in care
  • Placement frequency
  • Number of moves in care
  • Number of moves in care following permanency placement
  • Number of school placements
  • Caseworker visitation rate to placement
  • Care Plan objectives for children and young people in care
  • Duration and frequency of planned respite care

Program modifications since start-up date, if any, and why

When the program was first established the children awaiting placement with permanent families were accommodated in a specialist residential unit which was staffed by a Program Manager and at least six residential care staff. This unit was closed six years later and was replaced by a bridging placement program which created a more flexible intake system which could respond to as many children as required. It allowed children to be treated as individuals away from the contamination of the disturbed behaviour of others, provided a minimum number of relationships for children to manage, continued to focus on a therapeutic environment and was more cost efficient and effective to run in terms of quality of care.

Program Details

Date of start-up

In 1984 the program was set up based on the UK Family Finders program, with funding from the NSW Department of Community Services.

Staff-client ratio

Find-a-Family caseworkers carry an average caseload of 10 children in care per full time equivalent worker, in addition to post adoption and after care work.

Staff numbers, qualifications and experience

At present there are 33 staff at Barnardos Find-a-Family.

The educational background of the caseworkers and Program Managers is varied.

13 staff have Social Work degrees

4 staff are Psychologists

4 staff have social science, education or psychology degrees

8 staff have Welfare or Social Work diplomas or equivalent

In relation to staff retention:

5 staff have been with Barnardos over 10 years or 13.5%

10 staff have been with Barnardos between 5 and 10 years or 32.5%

5 staff have been with Barnardos between 3 and 5 years or 13.5%

13 staff have been with Barnardos under 3 years 40.5%

It should be noted that in the 20 years it has been operating FAF has expanded from 9 staff to the present 33. Some new positions are very recent.

Program capacity

Since 1984 we have serviced approximately 350 children and young people. At any one time approximately 130 children are supported in long-term care. In addition 50 children and young people are receiving support through After Care or Post Adoption.

The average age of a child at time of referral is 6 years 9 months whilst for children who have been adopted it is 4 years 1 month. The average time a child stays in Intake prior to a permanent placement is 9 months.

Over 100 children have been adopted through our FAF and the average age of adoption is 9 years. We accept on average 20 new referrals each year.

Cost per client

Program costing within Barnardos Find-a-Family is based on the Purdon costings, most recently accepted by the Care 2001 Working Group. Current Purdon costing per caseworker is $111,258 per annum for all salary and on costs, this covers all work components related to casework and carer recruitment as well as supervision, administration and travel costs. Note it does not include office space rental component or direct care costs for children on the caseload. Find-a-Family costs are approximately $17,116 per child for casework/program costs. In special circumstances and depending on degree of client complexity (leading to reduced numbers on particular caseloads) program costs may be up to $25,00 per annum. Carer allowances range from $175 per week to $700 per week per child, payment rates are set depending on the level of difficulty of recruiting a carer to cater for specific needs. Direct care costs therefore range from $9,100 to $36,400 per year, this brings total cost per client served to a range of minimum $26,216 to maximum $61,400 per annum.

Client Details (aggregated data)

Age and gender

Barnardos Find-a-Family focuses on children aged between 2-12 years at time of referral. At present 57% are male and 43% female.

Eligibility criteria

The children and young people accepted into the program are those who have been permanently removed from their birth families by the Courts and who are under the parental responsibility of the Minister to the age of 18 years, or whose parents have signed consent for their adoption. Almost all are under the parental responsibility of the Minister for the Department of Community Services. Barnardos Find-a-Family focuses on children aged between 2- 12 years and specialise in providing a service for "hard to place" children, large sibling groups and children who require culturally specific placements.

Evaluation

When, by whom and method used

Barnardos has a current collaborative research grant with the University of New South Wales utilising the Looking After Children materials. LAC is a comprehensive system for planning, decision-making, reviewing and monitoring the care of children. This project is monitoring the long-term outcomes for children and young people within Barnardos Find-a-Family. As part of this research, using LAC material and other methods, a 10-year longitudinal study of children and young people referred to Find-a-Family throughout a three-year period is underway. Barnardos is now into the sixth year of this project, under the leadership of Dr E. Fernandez of the University of New South Wales. Dr Fernandez is a substantial researcher into out-of-home care in NSW, and has published a book called “Significant Harm”.

Source and rate of referrals

Barnardos Find-a-Family receives the majority of referrals directly from the Department of Community Services as children referred for permanency care away from parents need to be under the Parental Responsibility of the Minister to the age of 18 years.

Client follow-up data (ie. How long were the benefits maintained and how these were measured)

Of children referred to the program, 80% are successfully placed within their first permanent family placement and will remain there until independence. After a referral is accepted children within the program move on average 1.9 times or 1.3 when placed in permanent care. One third of the children placed in permanent care are adopted.

Program Identification

Name of project:Temporary Family Care (TFC)

Locations:Auburn, Canberra (ACT), Penrith, South East Sydney, Warrawong (NSW South Coast)

Sponsoring agency: Barnardos Australia

Program Design

Program Objectives

  • Protect children
  • Support families to enable them to provide safe care
  • Empower parents
  • Provide outreach assessment of family functioning and strengths
  • Pro-actively work to restore children in care quickly
  • Maintain children in families through respite care
  • Prevent “drift” into unplanned care

Theoretical foundation and supportive research

Core principles of TFC are based in of child development theory, and the related area of attachment. Infants and young children develop bonds with care providers, and display attachment behaviour. Development into adulthood (physical, emotional and psychological) is linked with these bonds ands attachments. Early work such as that of Bowlby showed the extreme distress caused to young children when separated from parents. More recently research into early brain development is reinforcing the importance of stability of care in the early childhood years.

Research into needs of and outcomes for children in care (Thorpe 1988, Jackson and Thomas 1999) indicates the importance of both stability and continuity, key concepts which contain different implications for children depending on whether they are placed in short or long term care. A Care Plan for restoration and permanency with family, as in TFC placements, means that children need to see parents frequently in care, and retain continuity of other relationships via placement in their own area.

Berridge’s (1997) review of research into foster care comprehensively outlined factors for children, families, carers, agencies and workers and highlighted practice implications for provision of different types of care. Other UK studies such as Stone (1995), Packman and Hall (1998) and Aldgate (1999) outline the importance of specialisation in care programs if permanency with family is to be actively promoted as the goal of care.

Program structure

TFC programs ideally operate in small localised teams, geographically based within clearly defined catchment areas. This serves to enhance local networks for early referral of families where protective concerns exist. Recruitment of potential TFC carers is maximised within local communities and associated networks. Ideal team size for TFC programs is minimum 2 and maximum 6 full time equivalent casework staff, supervised by a Program Manager, and with clerical support. Allied to the TFC casework team is the pool of temporary carers, sufficient for the numbers of referrals of families to the program. Weekend carers will usually be fully matched with children and families, and there will be sufficient short term carers in the TFC program to always have 2-3 more carers available than there are children in need of placement; this ensures that back up support is always available to carers, from one another (in addition to casework support).

Program components

  • comprehensive initial child and family assessment
  • after hours (24/7) program availability for intake, parent and carer support
  • immediate short term care available to children as required, to reduce risk
  • regular respite care for children, with the same matched carer family
  • specialised carer recruitment to the specific task of care

Program processes

TFC programs operate on a case management approach, a primary caseworker being allocated to each family. The overall approach is that of family support, based in the belief in and commitment to the ability of families to parent their children, unless otherwise proven through the legal process. In circumstances where children are before the Court case management is shared with the statutory authority, practice roles and responsibilities being worked out as soon possible following referral. In shared case management situations the TFC worker always retains responsibility for direct supervision of the foster placement. Case Review meetings are held according to the Looking After Children case management system schedule, the first of these being within 4 weeks of a child’s entry to care, and all parties (parents, carers, workers, children and young people) are consulted prior to the meeting, and attend.

Intervention techniques

  • home visiting to parents and carers
  • ongoing assessment vis the Looking After Children case management system
  • participation by all parties in development of the Care Plan
  • immediate and direct contact between parents and foster carers, usually in the TFC carer home
  • increased carer allowance to reflect greater than usual expectations and requirements of TFC carers, and participation in restoration processes and plans

Agency nominated performance indicators

  • Number of families and children in program
  • Ages of children in program
  • Gender of children in program
  • Care Plan objectives for children entering care
  • Number of children restored to care of family following care
  • Placement frequency by age of child/young person
  • Length of stay in care
  • Frequency of contact with parent while in care
  • Location of contact with parent while in care
  • Changes of school placement whilst in care
  • Caseworker visitation rate to family and carers
  • Duration and frequency of planned respite care

Program modifications since start-up, if any, and why

Carer payment rates vary across the 5 Barnardos TFC programs, depending on demographics and the ease with which carers can be recruited. All programs pay above the standard foster care allowance reimbursement rate.

In inner Sydney, traditionally an extremely difficult area from which to recruit carers, in 1999 a system of assisted housing and enhanced payment for specific short term carers to enable them to care for large sibling groups, was initiated. Three such carers are currently operational and receive assistance from Barnardos with subsidised housing, sliding scales of reimbursement rate (depending on the number in the sibling group placed), and motor vehicle.

In ACT the TFC program has recently been split into 2 sub-programs, being “Planned and Crisis Care” (PACC) and “Respite Care”. This separation was initiated in order to achieve more reasonable supervision structures within smaller teams (the TFC team had grown larger than the optimal size of maximum 6 full time equivalent staff), and also to enable the PACC team to focus on detailed restoration work.

Program Details

Date of start-up

Auburn1985/86

Canberra (ACT)

Penrith1987

South East Sydney1984 (prior auspice Waverley Council)

Warrawong (NSW South Coast)1990 (prior auspice Illawarra Family Support)

Staff-client ratio

Barnardos Australia utilises the Hudson caseload formula in all out-of-home care programs, this includes Temporary Family Care. This formula allocates time spent in all associated to a client-for example carer recruitment, administrative duties, travel time, allocated leave, etc etc. For TFC programs the primary client is considered the family, therefore families, not individual children, are counted on caseload. A full time equivalent (35 hours per week) TFC worker may carry caseloads as follows: