A child or young person's journey through residence
Updated: 13 June 2017
What's Important To Us
We want children and young people to reach their full potential. Residential care provides a safe and stable placement for children and young people when they are not able to be placed in the community. A residential placement is a supportive environment with a focus on thorough assessment, so that we understand and meet the needs of the child or young person. The goal of any residential placement is to create sustainable behaviour change which enables the child or young person to return to their community.
This key information provides guidance for residential staff working with children and young people in a residence.
Residential care provides a safe and stable placement for children and young people when they are not able to be placed in the community. The goal of any residential placement is to create sustainable behaviour change which enables the child or young person to return to their community.
Preparing for arrival
When a child or young person first arrives at a residence, they will probably be really anxious about having left their family, friends and places that they are familiar with. Be prepared for their arrival by familiarising yourself with any information already known about them.
- Check CYRAS for information and identification of any needs, strengths and risks.
- Review their Tuituia assessment if one has been completed by their site social worker.
- Check with the social worker that you have all the information you need.
Talk with the child or young person's site social worker about what you think the child or young person needs to bring with them to the residence. This will include:
- their custody order
- medical consent
- sufficient clothing and personal items for their residential stay
If these items are unavailable on the day of admission, ask the site social worker for these to be provided as soon as possible.
Use the residential assessment triangle to think about where in the residence this particular child or young person is best placed. Talk to your team leader about the group dynamics in the residence and any other factors the team leader will need to consider when making this decision.
To understand more about what the child or young person may be going through at this particularly difficult point in their life.
During the admission process, reassure the child or young person and acknowledge that they may have concerns about the residence and not knowing how things work or who to talk to. Let them know that they will get an introduction and orientation to the site as soon as you've completed admission.
Also make sure you:
- arrange for a staff member to show them around once you've completed the admission. Let them see where they will sleep and other key parts of the residence as soon as possible as this will help lessen their anxiety.
- take the time to explain some of the details around residential routine
- introduce them to staff members that they can talk to if they need help
- provide them with a copy of the Charter for Children and Young People in Care, and talk with them about it, answering any questions they might have about their rights.
Talk with the child or young person about who they want to have contact with from home while they're in residence, and make sure that they understand the process for this. If there are people that have been deemed unsafe for a child or young person to have contact with during their residential stay, make sure you explain why.
Initial screening and checks
Complete the screens for the admissions process which will help you to assess the child or young person's physical and emotional health upon arrival. This includes:
- an SKS (Substances and Choices Scale and the Kessler and Suicide screens)
- an initial health check
- a MAYSI-2 check for young people in youth justice residences.
When this initial screening process identifies any immediate health needs (e.g. sight or hearing) or mental health needs, take action to address these.
If the child or young person has arrived at the residence with any medication, hand this to the nurse or shift leader as soon as possible. It is important that medication is kept secured and safe at all times and that the child or young person receives it when required.
The child or young person's property is recorded on a property sheet, signed by the young person and labelled when they arrive so that they don't lose anything during their stay. Some items will not be allowed in the residence so be careful about what goes into the unit with the child or young person and what will be kept safe for them until they leave.
Engaging with the child or young person
When a child or young person is placed in residential care, it is important that we understand their strengths and needs and support them to change their behaviour and improve their wellbeing.
- Manage your interactions with the child or young person to reinforce that they are safe and their views are respected.
- Let them know that even when they get something wrong, they can use this experience to learn new things - these are ‘teachable moments'.
- Make sure that children and young people feel safe in their placement; they will not be able to focus on making changes and trying new things if they feel unsafe.
- Role-model pro-social behaviour. Children and young people who enter residential care may not have had adults in their life who have been able to guide them about appropriate interactions with others and how to resolve conflict in a safe way. This is an ideal opportunity to role model behaviour which encourages children and young people to see different ways of interacting with others.
Be prepared for times when they need more support
There are times in the residence that children and young people may be more anxious and/or vulnerable (e.g. before a Court hearing, prior to family/whānau coming for a visit).
Familiarise yourself with both the operational plan and Individual Care Plan for the child or young person. These will assist you in making sure that your responses to children and young people correspond to their needs.
If you need more information, talk to the child or young person’s case leader. Take note of anything that you may need to watch out for, particularly at night time or after certain activities like phone calls or visits.
Help them raise concerns
An important part of a child or young person's stay in a residence is that they know they can raise any concerns that they have.
- Help them become familiar with the grievance process when they arrive at the residence, and discuss this with them regularly.
- Hand out grievance forms when they are asked for and, where appropriate, support the child or young person to complete these.
- Make sure the children and young people are aware of Grievance Panel members and their roles, as well as their right to choose to have independent advocate support with their grievance.
Hold regular forums for children and young people to talk about their rights in and out of residence, and to get their views. This is a great way to engage children and young people, and helps us understand areas which we could build on as a service.
Each residence has a dedicated medical team that can help you to administer medication correctly. Staff members who are designated to administer medication (i.e. shift leaders and team leaders) should go over the medication files with the nurse and clarify any instructions which may not be clear to them.
See full details on administering medication in the Working with tamariki and rangatahi in residences policy
Behaviour change practice
All children and young people need routine, structure and boundaries to help them be successful. In the residential setting the care team is best placed to promote behavioural change. Your ability to develop and maintain warm and nurturing relationships, as well as enforcing consistent behavioural limits, will have a significant impact on children and young people's ability to make sustainable changes.
To support best outcomes for the children and young people in residential care, maintain an approach that is consistent with the Ministry of Social Development's Code of Conduct. We expect you to:
- use respectful and professional language at all times
- attend all training workshop opportunities in behaviour change practice
- consistently model values such as respect, honesty, and responsibility
- take responsibility for their own behaviour
- recognise when mistakes are made and take appropriate action, e.g. apologise
- maintain effective communication with children and young people and with other staff
- manage conflict constructively
- have a positive attitude to work.
Our residences provide a structured day with opportunities for developing and practicing behaviours and skills that children and young people need for everyday living.
All staff working in the residential environment receive training in the ‘punctuated practice’ approach. Punctuated practice is about keeping everyone safe in our environments using safe strong practice. It works best when we are connected and engaged with children and young people.
Punctuated practice is used to:
- accurately identify both appropriate and inappropriate behaviours demonstrated by children and young people
- respond in a timely manner at the appropriate level (when a response is necessary).
Punctuated practice is dependent on staff being well connected with the child or young person so we can understand the triggers and early warning signs of escalating behaviours.
It is important to recognise that behaviours can quickly escalate from low level to high level. We should be looking out for triggers and early warning signs so we can intervene as early as possible at the lowest form of intervention.
It is important to review your responses to high level behaviour to assess if the behaviour started as high. It may be that it started as medium or low level behaviour and was not appropriately identified at the time, so escalated to high level. Discuss this in the shift debrief.
Operational plans are individualised for each child and young person and provide management strategies for care team staff to consistently manage specific risks or behaviours of concern. Operational plans include triggers for behaviour and strategies for staff to influence positive behavioural change and de-escalate difficult behaviour.
Points and levels behaviour change system
We use a contingency approach (a ‘points and levels' behavioural system) with children and young people to help shape desired behaviour. The points and levels system emphasises recognition of and attention to pro-social behaviours, aiming to increase their use by the child or young person.
The system incorporates a ‘response cost' component designed to help the child or young person understand the negative consequences and disadvantages of reliance on inappropriate behaviours. In tandem with this, we focus on teaching the child or young person the appropriate behaviours to use in place of the inappropriate behaviours. Through this approach we aim to reduce the child or young person's reliance on inappropriate behaviours as a way of functioning.
The points system incorporates the use of ‘levels' to support the child or young person's progress in learning and maintaining the behaviours and skills they will need for a successful and sustainable transition from the residence. As the child or young person is able to consistently demonstrate pro-social behaviours, they will be recognised by graduating through the 1, 2 and 3 level incentive system.
The points system:
- is designed for practicality, simplicity and ease of use by staff
- is designed for ease of understanding and ‘use' by the child or young person
- is completed with the young person by the care team with the shift leaders
- is in operation 24/7; across daily routines, programmes and school sessions in the residence
- is computer based for efficiency and to facilitate regular evaluation of the young person or child's progress against specific objectives within their behaviour management plan
- ensures an emphasis on recognising and rating the positive behaviour demonstrated by children and young people. Ratings are weighted to ensure positive behaviours carry a higher tariff, in comparison with inappropriate behaviours.
Teachable moments and pro-social modelling
The care team has huge potential to positively impact on the children or young people's wellbeing, motivation and behaviour change. As you spend the most time with the children or young people, you are there when most ‘teachable moments' happen.
Teachable moments are learning opportunities at times when the child or young person behaves inappropriately or is having difficulties managing distressing feelings like anger, frustration or anxiety. Care team staff can help the young person to problem solve, develop coping strategies, or make appropriate choices. With your support, children and young people can then learn and practice the skills to manage their feelings and behaviour in a socially acceptable way.
Because they are more familiar with you and the residence environment, the children or young people are also more likely to be open about their core beliefs, attitudes, behaviour and feelings with you than they might be in a session with a therapist. This gives you opportunities for open discussion with the children or young people.
The residential environment also provides an ideal opportunity for positive role modelling. Social learning theory has shown that pro-social modelling is a very effective way for children or young people to learn to perform new skills and behaviours. The care team have a crucial role in making this approach work in the residential environment.
Shift planning and debriefing
When planning for a shift it is important that any other professionals that may require access to the children and young people, such as health and education professionals, or programme providers, are considered and consulted in the planning as appropriate. Make sure you have a good understanding of the time that is set aside for each activity and how you can change the plan throughout the shift if this becomes necessary.
Shift debriefing ensures that all information from the shift is captured, and any information about specific children and young people is passed on to the appropriate people within the wider residential team for follow up. Debriefs review the effectiveness of the planning and measure this against a variety of areas including safety, communication, teamwork, and strategies for managing both the group and individual needs amongst the children and young people. There may also be occasions where a serious incident has occurred during the shift, and it is important to remember that a Psychological First Aid debrief is available.
Visual checks of children and young people in their rooms at night are complemented by audio monitoring.
The frequency of visual checks of children or young people is determined in their operational plan.
During the night one ground check is to be completed of the residence building. This includes checking the perimeter of the residence and the outside of all bedroom windows.
The ability to provide secure care is an option to prevent children or young people being a risk to themselves or others, when there is no alternative to ensuring safety. This is not a punishment — it's a way to manage a particular behaviour. It is important that children and young people are given a clear explanation as to the reason that they have been placed in secure care.
The child or young person's Individual Care Plan and/or operational plan may also need to be altered after they have been in secure care to outline different or stronger interventions which are hoped to help prevent further incidents.
When an incident occurs in a residence, working together as a staff group will ensure the best possible response.
Make sure the incident details are recorded on SOSHI in full so that there is an accurate account of what occurred. This is important as incident reports can be used to support and evidence social work reports, court reports and other documentation. Record the category of the incident on the incident report and follow the required actions depending on the chosen category.
Once the incident has been resolved, help to settle the child or young person involved and take note of any other children and young people you may need to monitor as a result of the incident.
Security and emergency management planning
Because we have the care of the children and young people 24 hours a day, seven days a week, we need to have appropriate measures in place to deal with any event that may arise.
Familiarise yourself with the Security Management Plan and the Emergency Management Plan so that you know what to do in an emergency and how to assist in maintaining security.
Preparing the child or young person to leave the residence
Residences are not a destination for anyone, but rather part of the care journey to meet a child or young person's permanent care needs. From the child or young person's very first day in a residence, planning for transition from residence will be captured in their Individual Care Plan.
Transition planning will identify the needs of the child or young person, including:
- care arrangements
- family/whānau support
- education and/or vocational options
- linking into appropriate health services and other identified specialist support services (such as alcohol and drug counselling or anger management support).
The team that sits around the child or young person – which will include family/whānau, residential staff, the site social worker, health and education providers, significant others and the child or young person themself - will develop and monitor the objectives of the transition and make sure that:
- planning around transition begins as soon as the child or young person is admitted into the residence
- information about the child or young person is shared appropriately with those involved with the child of young person
- post placement visits are arranged
- there is assistance to help get the placement back on track if it is needed.