Standard of care review report

This form is to be used to record a standard of care review for children placed in out-of-home care. Refer to the Child Safety Practice Manual, Chapter 9, Standards of care, for the procedures for conducting standard of care reviews for care services.

To record a standard of care review:

  1. create a ‘Matter of Concern’ (MOC) event in the child’s profile
  2. add any other relevant parties to the MOC event, including the carer or care service and any relevant staff members
  3. complete the ‘Record of concerns’ form in the MOC event
  4. delete the ‘Record of checks and consultation’ form from the MOC event
  5. For an Aboriginal or Torres Strait Islander child, create a ‘Recognised entity participation form’ in the ‘Information gathering/decision-making’ block
  6. do not create any additional forms, such as the ‘Child placement concern report’
  7. when the ‘Standard of care review report’ is completed and approved by the team leader, attach it to the MOC event under the ‘CPCR Assessment/Action’ block
  8. create and complete the ‘Closure form’ in the MOC event, to close the event and enable data reporting.

Subject child/children
First name(s) / Last name / DOB / Indigenous status / Client number
(add more rows as needed)
Carer / Care service details
Name of carer / Care service / Carer entity / Care service ID
Contact details
Affiliated FKC service / Organisation
Name of Coordinator/manager/ support worker and role / Contact details
Relevant staff members of a care service, where applicable
Name / Role / Contact details / ICMS Person ID
(add more rows as needed)
Concerns received (Include the concerns recorded in the ‘record of concerns ‘ in ICMS)
Information gathering and consultation (Record details of consultation and information gathered)
Decision to conduct the standard of care review
Rationale for decision
Decision made by / Name, position
CSSC / Date
Allocated officer / Name, position, CSSC
Plan
Key activity / Who is responsible / Key considerations
Discussion with carer / care service
Discussion with child / children
(add more rows as needed for additional activities)
Assessment
Record details of discussions with the carer or care service and the child. Provide rationale for the outcome decision, making reference to the discussions with the staff and child, and information gathered from other sources.
Discussion with carer/care service
Discussion with subject child/children
Other relevant information, including consideration of contextual factors
Outcome decision(record an outcome for each subject child)
Standards of care
(a)the child’s dignity and rights will be respected at all times
(b)the child’s needs for physical care will be met, including adequate food, clothing and shelter
(c)the child will receive emotional care that allows him or her to experience being cared about and valued and that contributes to the child’s positive self-regard
(d)the child’s needs relating to his or her culture and ethnic grouping will be met
(e)the child’s material needs relating to his or her schooling, physical and mental stimulation, recreation and general living will be met
(f)the child will receive education, training or employment opportunities relevant to the child’s age and ability
(g)the child will receive positive guidance when necessary to help him or her to change inappropriate behaviour
(h)the child will receive dental, medical and therapeutic services necessary to meet his or her needs
(i)the child will be given the opportunity to participate in positive social and recreational activities appropriate to his or her developmental level and age
(j)the child will be encouraged to maintain family and other significant personal relationships
(k)if the child has a disability - the child will receive care and help appropriate to the child’s special needs.
Child / Outcome (Standards met or Standards not met) / Standards not met (from list below), where applicable
Eg Johnny Williams / Eg. Standards met / Eg. (a) (b) and (d)
(add more rows as needed)
Rationale for decision (include the factors contributing to the child’s care meeting or not meeting the legislated standards)
Approval
Outcome approved by: / Signature:
Position:
CSSC: / Date:
Subsequent action
Review of placement agreement completed?(must be completed for a carer) / Y N N/A / Date:
By whom:
Review of foster carer agreement to occur? / Y N N/A / Date:
By whom:
Review of carer suitability to occur? / Y N N/A / Date:
By whom:
Action plan developed?
(must be completed for care service) / Y N N/A / Date:
By whom:

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Standard of care review report

Action plan

Care service
Name of care service:
Action plan (record action plan developed by the care service or attach a copy)
Action / Who is responsible / Complete date
Eg. Care service to provide staff with training on positive behaviour support techniques / Name, care service manager, to arrange training and ensure all staff attend. / Training to be organised by end of Feb. Training to occur no later than end or March.
Eg. CSO to attend team meeting to discuss child’s history of sexual abuse and implications for current behaviour. / Name, care service manager, to organise team meeting and invite CSO.
Name, CSO, to compile relevant information from child’s case files. / Meeting to occur by end of February
(add more rows as needed)
Action plan finalised
Action plan agreed to by (Name of TL/CSSC manager): / Signature:
Role:
Date: / Review date:

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