Specialist placements for tamariki and rangatahi with high needs

The National High Needs Hub (the hub) manages referrals, applications and placements to Oranga Tamariki care and protection residences and many of the nationally managed programmes. The hub consists of advisors within Residential and High Needs Services, Care and Protection Support and Operations who can provide you with advice and support options for care services and programmes for tamariki and rangatahi with complex or high needs.

The types of programmes the hub manages are intensive, specialised programmes, including our care and protection residences that meet the needs of tamariki and rangatahi in care with the highest needs and most challenging behaviour. These placements require planning and support, and will be one part of a comprehensive package for a tamaiti or rangatahi.

All tamariki and rangatahi in care are vulnerable and those who require intensive placements and programmes often face greater challenges than other tamariki and rangatahi. It is important to focus on the needs of te tamaiti or rangatahi and consider whether a residential placement, often away from their whānau or family and community, is in their best interests and how the programme can best match their needs.

Areas of complexity may include:

• harmful or concerning sexual behaviour
• alcohol and/or drug use
• significant self harm or suicidal ideation
• unsafe sexual activity which is also outside the ‘norm' for adolescent development, including prostitution and other sex work
• high levels of violence towards others
• excessive absconding, often these tamariki and rangatahi are missing for weeks or months at a time
• ongoing disengagement from education despite extra support and guidance
• intellectual disability
• mental health or learning difficulties that impact on their ability to manage in education settings or with everyday caregivers
• diagnosis of ADHD, conduct disorder, attachment disorders or depression or other diagnosed behaviour problems.

When we identify te tamaiti or rangatahi has a suicide risk, we place a suicide alert on CYRAS in the person characteristics section in the details tab for te tamaiti or rangatahi.
Staff resource: CYRAS Handbook – Creating a Person Record

A child/young person and family consult is completed to understand the needs of te tamaiti or rangatahi and consider what interventions may be appropriate. When completed this needs to be recorded in CYRAS.

Child/young person and family consult

All referrals are dealt with in the first instance by local and regional hub processes. Following the regional hub process, regional contacts will forward this referral to the National High Needs Hub for consideration about placement/programme options.

Before making a referral, consider the following questions:

• What does te tamaiti or rangatahi think about going into a programme? What will they get out of it?
• How will the whānau or family support the placement?
• What is the plan for te tamaiti or rangatahi to maintain links with their whanāu or family, friends and education while they are in a programme?
• What do other professionals including the lawyer for child think about them going into a programme?
• How will financial costs be met (such as travel costs for maintaining contact)?
• How will te tamaiti or rangatahi transition to their next placement?
• What is the contingency option for te tamaiti or rangatahi in terms of placement?

Most programmes require further documentation with the referral in order to determine if the needs of te tamaiti or rangatahi match their intervention. It is relevant to include the following in your referral to the hub:

• most recent court report or up to date case summary
• genogram
• a s128 plan or family group conference plan
• educational history and current records
• medical history
• most recent assessment report
• Substances and Choices Scale (SACS) and Kessler and Suicide screens
• Suicide risk assessment.

If te tamaiti or rangatahi has conduct disorder or extreme behavioural problems then a current psychological assessment or psychiatric assessment is relevant. If they have harmful or concerning sexual behaviour an assessment by an appropriate provider is required.

Hub referral process (JPG 126 KB)

Referral form – template (DOCX 137 KB)

When we identify te tamaiti or rangatahi has a suicide risk, we place a suicide alert on CYRAS in the person characteristics section in the details tab for te tamaiti or rangatahi.
Staff resource: CYRAS Handbook – Creating a Person Record

This decision is based on the information provided and the knowledge of what each programme delivers. The national hub will match the needs of te tamaiti or rangatahi with the service, based on the information and recommendation of the regional hub. This decision is based on the following factors:

• the identified strengths and needs of te tamaiti or rangatahi
• the risks te tamaiti or rangatahi poses to themselves and/or others and at what level these risks are
• the vulnerabilities of te tamaiti or rangatahi
• the previous interventions and supports that have been put in place to support te tamaiti or rangatahi and their whānau or family
• the other tamariki and rangatahi who are in a programme
• the distance between the community of te tamaiti or rangatahi and the programme and whether the needs can be met in that community
• where a tamaiti or rangatahi may transition to after a stay at a programme.

It is important that the information provided accurately describes te tamaiti or rangatahi. We are trying to prevent a cycle of placement disruption and ensure te tamaiti or rangatahi can successfully complete a programme and safely transition back to their community.

Shared Care Service Specification (PDF 725 KB) for care partners providing Shared Care

Harmful Sexual Behaviour, Early Intervention and Youth Service Service Specifications (PDF 1.7 MB) for rangatahi with harmful sexual behaviour or displaying concerning sexualised behaviour

Harmful Sexual Behaviour Services for Non-mandated Adults: Service guidelines