Keep them safe… …and well

Kerryn BolandNSW Children’s Guardian

19 October 2010

Role of the NSW Children’s Guardian

• Accreditation of service providers against NSW out-of-home care standards

• Accreditation also acts as a ‘licence’• NSW Children’s Guardian is the independent assessor

of both government and non-government providers• Monitor performance of the NSW out-of-home care

system – Case File Audits

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New NSW Out-of-Home Care Standards

• The Standards were updated to:

- Incorporate contemporary research

- Align with the rights of children and young people

- Focus on outcomes• The Standards were reduced in number from 50 to 22• Draft National OOHC Standards cover the same areas

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The layout of the Standards is streamlined

• The Objective• The Standard• The applicable Legislation• Key messages from

research• The Assessment Criteria

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The Standards are grouped into4 Quality Areas

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New Title for the Standards

• To distinguish from VOOHC

• NSW Standards for Statutory Out-of-Home Care

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Out-of Home Care Health Standards

• NSW Standard 9 – Health and Wellbeing:

Objective– Children and young people are healthy and have access to

appropriate health and support services

Standard– Children and young people’s health and developmental needs are

addressed• Draft National Standard 4

– A comprehensive health assessment is provided to children and young people entering care, with ongoing medical needs attended to in an appropriate and timely way, and children and young people have their own written health record which moves with them if they change placements

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Monitoring out-of-home care Health and Wellbeing

• 2005-06 case file audit of 3 110 children and young people in statutory care

• Identified future priorities for case file audits– Health– Education– Connectedness

• Other uses for the data …

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Agency’s response to audit findings

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80%use audit results

to improvecasework practice

66%use audit resultsto also improve

planning, policy etc

Inform policy and practice

improvements

Health Case File Audit

• Some information collected on health from 2005• 2008-10 Audit over 2 years focus on health

– physical– emotional– mental health

• Expert advisory group• Commissioned research

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Health Case File Audit – what did we look at?

The practice of agencies in relation to:• Obtaining and recording health related information• Assessment of health status and needs• Special emphasis on mental health issues• Planning and monitoring and• Providing information to parents

Surveyed 3448 case files across government and non-government agencies.

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Collaboration with Health

• NSW Health Keep Them Safe (KTS) out-of-home care research advisory group

• Captured 32 additional items of health-related information on almost 1000 files

• Provided audit data to NSW Health regions and other audit categories

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Why focus onmental health issues?

Behaviour Issues:– Entering care– Education disruption– Social dislocation– Foster care breakdown

RANZCP Policy statement on the Mental Health Needs of Children in Out-of-Home Care

Clinical Child Psychology and Psychiatry Journal – Special Issue Mental health services for children in care, and those adopted from care

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The Results

Presence of a mental health issue

• 39% mental health issue

• Just over half of these kids had received some form of mental health assessment

Behaviour that jeopardised placement, education

• Nearly a quarter (23%) of kids had extreme behaviour problems

• Just over half (52.77%) had a plan to manage that behaviour

• 1 in 8 (13%) children on psychotropic drugs

• 47% with consents from the person who has parental responsibility

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Kids’ Perceptions

• NSW Commission for Children and Young People survey of kids’ wellbeing

• NSW Children's Guardian research on kids in residential care

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Where to from here?

• Continue to work with NSW Health to improve health outcomes for kids in care

• Work with Community Services to monitor roll out of health assessment scheme

• Re audit health in 2013

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