1. Keep them safe… …and well Kerryn Boland NSW Children’s Guardian 19 October 2010

2. 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 19 October 2010 | 2

3. 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 19 October 2010 | 3

4. The layout of the Standards is streamlined The Objective The Standard The applicable Legislation Key messages from research The Assessment Criteria 19 October 2010 | 4

5. The Standards are grouped into 4 Quality Areas 19 October 2010 | 5

6. New Title for the Standards To distinguish from VOOHC NSW Standards for Statutory Out-of-Home Care 19 October 2010 | 6

7. 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 19 October 2010 | 7

8. 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 … 19 October 2010 | 8

9. Agency’s response to audit findings 19 October 2010 | 9 80% use audit results to improve casework practice 66% use audit results to also improve planning, policy etc Inform policy and practice improvements

10. 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 19 October 2010 | 10

11. 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. 19 October 2010 | 11

12. 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 19 October 2010 | 12

13. Why focus on mental 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 19 October 2010 | 13

14. 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 19 October 2010 | 14

15. Kids’ Perceptions NSW Commission for Children and Young People survey of kids’ wellbeing NSW Children's Guardian research on kids in residential care 19 October 2010 | 15

16. 19 October 2010 | 16

17. 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 19 October 2010 | 17