5. Conduct a standards of care review - carers

This section outlines the procedures for responding when a standards of care review is recorded in relation to a child in out-of-home care and placed with a carer.

Child Safety will conduct a standards of care review to determine if the standards are being met, and where not met, what actions are required to meet the standards and improve the level of care provided to the child. Where a carer is supported by a foster and kinship care service, Child Safety will work collaboratively with the foster and kinship care service to conduct the review.

A standards of care review is different to an investigation and assessment of a harm report. A standards of care review is not an investigative response that utilises a forensic approach and formal ‘interviews’ of the carer and child are not to be conducted.

Key activities

The key activities for conducting a standards of care review include:

  • having the standards of care discussion with the carer
  • talking with the subject child to understand their experiences in the placement
  • exploring and analysing the broader context of the child’s placement, to identify factors that contributed to the standards of care not being met, if required
  • assessing the information to determine an outcome
  • taking action to improve the standards of care provided to children, where required.

Note: When a standards of care review is recorded, there is no legislative obligation to advise the child’s parents of the concerns. Practice considerations may apply, and discussion with the senior team leader will assist to identify the level of information that could be provided to parents.

5.1 Plan the standards of care review

Prior to commencing the standards of care review, develop a plan for addressing the key activities of the review, in partnership with the foster and kinship care service, the CSO with case responsibility for the subject child, the senior team leader, and the senior practitioner.

The CSSC responsible for the standards of care review will lead the planning process. While some of the required decisions may have already been made during the initial consultation process with key stakeholders, the purpose of planning is to determine the following:

  • who will be responsible for discussing the standards of care with the carer
  • who will be responsible for talking with the child
  • what additional information is required and how it will be sourced
  • the responsibilities of each person involved in completing the review
  • plans for responding to issues and difficulties that may impede the review process.

The planning process must ensure that the following commencement and completion timeframes can be met:

  • commencement within five working days - a standards of care review is commenced when either the face-to-face discussion with the carer occurs, or when the child is talked to about their placement
  • completion within four weeks - a standards of care review is completed when the carer has been advised of the outcome and where appropriate, a review of the placement agreement has been completed.

The Standards of care review checklist is available to assist staff in the review process.

Determine who will have the discussion with the carer

Flexibility can be exercised when planning for who will have the standards of care discussion with the carer. This can be undertaken:

  • conjointly by the CSO and the foster and kinship care service
  • by staff of the foster and kinship care service supporting the carer
  • by the allocated CSO.

Where the discussion with the carer is a joint activity involving the CSO and the foster and kinship care service, the senior team leader and foster and kinship care service will reach agreement about who will lead the discussion and the roles of the respective staff involved.

Where it is agreed that the foster and kinship care service will have the discussion with the carer, the senior team leader and the foster and kinship care service will reach an agreement as part of the planning process, about responsibilities, timeframes and the documentation required from the foster and kinship care service.

All carers involved in the concerns received must be included in the standards of care discussion. Where there is a joint certificate of approval, it is preferable to have both carers participate in the standards of care review discussion.

As part of the planning process, consider and decide who will verbally advise the carer of the standards of care review and:

  • make the arrangements to discuss the matter
  • discuss the option of the carer to have a support person, should they elect to do so.

Decide who will talk to the child

It is preferable that the child, where age and developmentally appropriate, be engaged in a face-to-face informal discussion with a CSO with whom they are familiar. Where there are multiple subject children, the senior team leader from the CSSC responsible for the standards of care review will negotiate who will be responsible for having the discussion with each child.

As part of the planning process, consider and decide the following matters:

  • who will talk to the child and the location for this discussion
  • the arrangements to provide the child with a support person, should they elect to have a support person, and provide the child with a copy of the Information sheet for children and young people (PDF, 178 KB)
  • where there is more than one CSO, how details of the discussion with the child will be documented and provided to the allocated CSO.

It is not appropriate to interview the child at school or a day care centre using powers under the Child Protection Act 1999, section 17, when conducting a standards of care review.

Record the standards of care review plan

Complete the review plan section of the 'Standards of care review report' and include:

  • the outcomes of consultation between Child Safety staff, the foster and kinship care service and the recognised entity, where applicable
  • the decisions made in relation to the standards of care review plan
  • the actions to be undertaken, including who is responsible and the timeframes for their completion.

Seek the senior team leader’s approval of the plan and ensure that all relevant persons are aware of their responsibilities for the activities of the review.

5.2 Conduct the standards of care review

Commence the standards of care review

The standard of care review is commenced when there is a face-to-face discussion with either the subject child or the carer about the standards of care. Commencement will occur within five working days of the response decision.

Guiding principles for the review process

The purpose of a standards of care review is to determine whether or not the standards have been and are being met. The principles guiding the review process are:

  • recognising that the responsibility for the provision of quality care to the child is a shared responsibility between carers, the foster and kinship care service and Child Safety, and that there is a need to explore the broader context of the care team responsibilities that may have contributed to standards of care not being met
  • using an enquiry and strengths-based approach rather than an interrogative or blame approach - for further information, refer to practice resource Standards of care - key concepts and definitions (PDF, 26 KB)
  • providing the child with a voice in the process in a way that respects that their best interests are the central focus of the care team
  • having a collaborative and flexible process to completing the key activities of the review so that the best outcomes for the child can be achieved
  • ensuring that carers receive assistance to address any concerns about the quality of care that is being provided.

Discuss the standards of care with the carer

The review discussion will focus on the standards of care that require review, using the guiding principles outlined above. To ensure a fair and transparent process, the carer will be given information about:

  • the standards of care that are under review
  • the presenting issues or concerns that support the need for the review
  • the purpose of the review
  • the timeframes and possible outcomes of the review.

The discussion will be undertaken in the least intrusive manner whilst at the same time ensuring that it is thorough and that sufficient information is discussed with the carer to enable an outcome to be determined. The carer may also be supported by another appropriate person during the discussion, if they request this, to facilitate their participation. Refer to the Information sheet for carers and staff members (PDF, 176 KB).

A clear discussion with the carer about the standards of care being provided to the child will:

  • establish the carers understanding of the specific standards of care being reviewed and how the carer applies the standards in their daily care of the child
  • allow the carer to provide their own account of the circumstances surrounding the presenting issue or concern that gave rise to the review
  • encourage the carer to discuss their experience of supporting the child and meeting their needs, including both the challenges and successful experiences
  • identify the actions or inactions of care team members that contributed to the child’s care not meeting the standards of care
  • explore the areas of carer support that are working well, and areas of unmet need for the carer or the child.

When talking to the carer, use questions that will allow discussion of situations when the carer has met the standards of care and where applicable, not met the standards of care for the child. Assist the carer to identify what they may do in a similar situation, to help them identify their capabilities and needs, and what assistance is required to assist them to meet the standards of care in future.

Discuss the standards of care with the child

The discussion with the subject child will occur in a familiar environment and will be managed in a way that minimises the trauma to the child. The purpose of talking to the child is to ensure they are given the opportunity to be heard regarding their experiences in the current care environment.

Formal interviewing of the child at school or a day care centre, using powers under the Child Protection Act 1999, section 17, must not occur.

The face-to-face discussion with the child must not occur in the presence of the carer. Use broad, open-ended questions that encourage the child to talk, exploring both the positive experiences in their care environment and any worries the child has.

As part of the discussion, the child will be:

  • provided with information in a child friendly and age appropriate manner
  • given the opportunity to express their views, experiences and wishes about their current placement and the quality of care being provided by the carer
  • supported by another appropriate person during the discussion, if they request this, to facilitate their participation. Refer to the Information sheet for children and young people (PDF, 178 KB).

Analysing and assessing contextual information

A holistic assessment requires that a broad range of factors be considered prior to reaching an outcome for the standards of care review. This recognises that carers are one part of the child’s care team, and that the actions or inactions by others can also impact on the standards of care provided to the child.

In addition to the discussions with the child and carer, consider the systemic context in which the care to the child is occurring. This widens the focus of the assessment to allow the identification of actions and inactions by either the foster and kinship care service or Child Safety, where these may have contributed to the concerns. These considerations will include, but are not limited to:

  • whether the child’s placement was and continues to be appropriate for the child
  • the frequency, adequacy and nature of contact by the CSO with the child and the carer
  • the frequency, adequacy and nature of support provided by the foster and kinship care service or Child Safety to the carer, given the carer’s level of experience and needs and the complexity of the child’s needs
  • the training provided to the carer and responses to any previous requests for support by the carer
  • whether the key activities in the child’s case plan are being actioned in a timely and responsive way by the CSO and other members of the care team
  • the progress of actions following the outcomes of previous standards of care reviews or harm reports
  • the presence of additional stressors in the carer household such as a new placement, personal stress or issues with the management of the child’s challenging behaviours.

5.3 Decide the outcome

Once all of the information has been gathered, Child Safety is responsible for determining an outcome for each subject child. To do this:

  • seek the views of the foster and kinship care service, particularly where they have had an active role in the standards of care review
  • consult with the senior team leader and senior practitioner
  • take into account the contextual and systemic factors that have impacted on the child’s care.

There are two possible outcomes to the standards of care review:

1. Standards met

This outcome is recorded when the information from all sources has been analysed and it is determined that the care provided to the child is in accordance with the standards of care, and there is no indication that the child has experienced harm.

2. Standards not met

This outcome is recorded when the information from all sources has been analysed and it is determined that the care provided to the child has not met the standards of care, and there is no indication that the child has experienced harm. In reaching this outcome, the specific standards of care that have not been met, as outlined in the Child Protection Act 1999, section 122, must be identified.

This is not necessarily a finding of wrongdoing by the carer. It is a finding that the care provided to the child, collectively by the child’s care team, has not met required standards.

When this outcome is recorded, the identification of a ‘person responsible’ is not required, even though actions may be required by specific people to ensure the standards of care are met in the future.

This reinforces that a partnership approach is required to ensure the standards of care are being met for the child, and that where the standards of care are not met, this might be due to the actions or inactions of the carer, or any other member of the care team with monitoring responsibilities under the Child Protection Act 1999, specifically the foster and kinship care service and Child Safety.

Actions required when harm or suspected harm become apparent

If during the assessment of the standards of care review, it becomes apparent that the child has experienced harm or it is suspected that they have experienced harm, immediately discuss the information with the senior team leader and senior practitioner. The decision to record a harm report will be made by the CSSC manager.

In this circumstance, record the information in relation to the harm in the open ‘Standards of care review report’ and identify harm in the ‘Outcome decision’ section of the report. A Harm report will be automatically created in ICMS. Following this, respond in accordance with 7. Investigate and assess a harm report.

5.4 Advise relevant parties of the outcome

When the senior team leader responsible for the standards of care review has approved the outcome, provide verbal advice of the outcome to:

  • the carer
  • the manager or co-ordinator of the foster and kinship care service supporting the carer
  • the subject child, where age and developmentally appropriate
  • the CSO of all children placed with the carer.

If requested by the carer or the foster and kinship care service, provide written advice of the outcome, using the Letter to carer - standard of care review outcome.

In addition, alert all parties to applicable complaints and review mechanisms. Refer to 7. What if a person wants to make a complaint or seek a review?

5.5 Respond when the standards of care are ‘not met’

When the outcome of the standards of care review is ‘standards not met’, a review of the placement agreement for the child must occur. In addition, where considered appropriate, any of the following options may also occur:

  • a review of the foster carer agreement for the carer
  • a review of carer suitability.

The review of the placement agreement must occur prior to the finalisation of the standards of care review by the senior team leader.

The responsible CSSC, in consultation with the carer and foster and kinship care service, must identify the actions required to address identified issues to ensure that the carer is able to meet the standards in the future. The key questions that will inform the required actions are: 

  • what happened?
  • what factors contributed to that happening?
  • what is required in order for the child’s care to be consistent with the standards of care?

The actions required to achieve the standards of care for the child will correspond to the specific standards of care that have not been met, and will be incorporated into the review of the placement agreement for the child and the review of the foster carer agreement, if applicable, as outlined below.

1. Review the placement agreement for a child

Where the standards of care have not been met for a child, undertake a review of the placement agreement to:

  • clarify the goals and outcomes for the placement
  • identify any specific support needed for each child, for example, financial or therapeutic support
  • identify any additional support needed for the carer, for example, training or financial support to assist them meet the standards of care for the child – refer to the practice paper Carer support (PDF, 502 KB) Carer support (RTF, 326 KB).

For further information, refer to Chapter 5, 1.9 Complete a placement agreement.

2. Review the foster carer agreement

Where the standards of care have not been met for a child placed with a foster carer, and it has been determined that the child will remain with the carer, consider whether a review of the foster carer agreement is required with the foster carer, to review:

  • the type of care to be provided
  • the placement types for which the carer family is able to provide care
  • the current needs of the foster carer family
  • the ‘development and support plan’ to incorporate any further action required
  • any support needs and strategies for managing or resolving conflicts of interest, if applicable, for a Child Safety employee who is also a carer - refer to Chapter 8, 3. What if a carer or carer applicant is also a departmental employee?

Where the carer is not supported by a foster or kinship care service, the PSU will be responsible for reviewing the foster carer agreement. Where the carer is supported by a foster and kinship care service, that agency will review the foster carer agreement. The CSSC may also be involved in this process when a carer has a history of not meeting the standards of care.  For further information, refer to Chapter 8, 4.11 Review the foster carer agreement.

3. Review carer suitability

The CSSC manager may determine that a comprehensive assessment of the carer’s suitability and ability to meet the standards of care is required where:

  • there has been a pattern of standards of care reviews or harm reports
  • the concerns are of a repetitive or serious nature
  • concerns continue to be identified about the carer’s ability to meet the standards of care despite previous actions being taken by the care team to address matters.

The CCSC manager is responsible for ensuring that the review is conducted by a person with the appropriate level of skill. It is not appropriate to delay the review process because of the carer’s renewal of approval date.

For further information about the review process, refer to Chapter 8, 4. What if a review of carer suitability is required?

5.6 Record the standards of care review

To finalise the record-keeping for the standards of care review, following the review of the placement agreement or where applicable, the foster carer agreement:

  • record the information gathered during the standards of care review, the assessment and recommended outcome in the 'Standards of care review report' in ICMS
  • seek senior team leader approval for the ‘Standards of care review report’ in ICMS which will close the standards of care event.