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1.2.2 Best Beginnings Plus

Last Modified: 22-Oct-2019 Review Date: 02-Jan-2018

Purpose

To guide staff in the referral, intake and service delivery of the Best Beginnings Plus (BB Plus) service.

Practice Requirements
  • Referrals to BB Plus will only be accepted if the family has an open case with the Department of Communities (the Department) or with a new child protection intake. 

  • Any concerns about the safety or wellbeing of a child or young person (including mothers or mothers to be) must be discussed with the case manager and the Intensive Family Support (IFS) team leader immediately to determine the most appropriate action.

  • Home visits must be conducted in accordance with the service delivery flowchart located in the BB Plus Service Delivery Flowchart (in related resources).

  • Best Beginnings Plus workers must attend all Multidisciplinary Case Consultations (MCCs) for cases receiving the BB Plus service.

  • Best Beginnings Plus workers must complete Child Protection Foundation training in the Child Protection Learning Pathway.

  • Training must be undertaken by the BB Plus workers before they administer a number of the programs specific tools and resources, including the Edinburgh Post Natal Depression Scale in related resources.   

  • All forms, matrices, questionnaires and scales listed in the BB Plus Program Checklist (in related resources) must be completed and, where indicated, entered onto Assist for data collection purposes. 


Process Maps

Best Beginnings Plus Service Delivery Flowchart

Procedures

  • Overview
  • Target group
  • Referrals
  • Service delivery
  • Home visiting
  • Service focus and intensity
  • Data collection
  • Client support costs
  • Child protection concerns
  • Matrix, tools and resources
  • Community Health Nurses
  • Multidisciplinary Case Consultations
  • Closure
  • Before and at closure
  • Transfer of clients
  • Overview

    The BB Plus service is delivered by BB Plus workers located in Intensive Family Support (IFS) teams. It is an earlier intervention, intensive home visiting program that works alongside families with infants or unborn babies at risk of neglect and/or abuse.

    Referrals to BB Plus will only be accepted if the family has an open case with the Department or with a new child protection intake.

    Best Beginnings Plus workers must complete Child Protection Foundation training in the Child Protection Learning Pathway. 

    Changes were made to the BB Plus program as a result of the Berry Street Childhood Institute A review of Best Beginnings as part of a Child Protection Strategy focussed on engaging earlier with vulnerable families July 2016, including that the service can now work with a whole family, not just the mother or father.

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    Target group

    ​Best Beginnings Plus is targeted to expectant parents or parents with an infant younger than 12 months old. Families eligible for the service must be open child protection cases.

    Priority of access is given to:

    • Aboriginal families
    • children in care who are parents or expectant parents, and
    • families involved in child protection pre-birth processes.
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    Referrals

    Referrals can be made in the antenatal period or until the infant reaches 12 months of age. Referrals can be made from within the Department or from a range of external sources including health services and community sector organisations (for e.g. Family Domestic Violence (FDV) and youth services).

    External referrals are made to the Department through the Central Intake Team (CIT) / Regional Child Safety (CS) teams, via Form 441 Child Protection Concern Referral Form. Where assessment indicates harm or risk of harm to the child in accordance with the Interaction Tool, the referral becomes an open child protection case and can be considered for BB Plus.

    Internal referrals are considered for:

    • children in care who are parents or expectant parents, and an assessment indicates harm or risk of harm to the child, or

    • parents who have children in out of home care, are expecting another child and assessment of risk for the unborn child indicates a referral to BB Plus may be an appropriate family support strategy to enable the child to remain in their care.

    Recording referrals

    Once it is determined that the referral meets the child protection intake threshold and the BB Plus referral criteria, the CIT/SC teams will open a case support service activity for BB Plus. The case is allocated to the IFS team leader in the relevant district.  The IFS team leader assesses whether to reject and close the case support service or accept it and create a service provision activity.

    If a referral is generated from within a district office for an open case the district office must record the BB Plus case support service activity. These referrals do not need to go back to CIT. 

    Refer to the Assist User Guide (in related resources) for further information.

    A separate case support activity should be opened for each child (for example, where there are twins). 

    Outcome of a referral:

    • service declined – the team leader enters the appropriate information onto Assist, including reasons for declining the referral, and the referrer is notified

    • wait listed – the team leader has all the required information to process the referral, however the BB Plus worker has no capacity; referrers are informed that the team leader retains the referral for review

    • referral pending – the referral has been received, but the team leader is awaiting further information from the referral source; the team leader reviews the referral when additional information is received, or

    • referral accepted – family is allocated for service delivery.

    The IFS team leader ultimately determines the outcome of the referral and enters any additional required information onto Assist.

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    Service delivery

    The service structure of BB Plus provides an outline for the program to engage families and work intensively to:

    • address the safety and wellbeing of children
    • improve parenting capacity and family functioning, and
    • increase social connectedness.

    BB Plus workers and child protection workers (CPWs) should jointly develop a plan for working with the family that is guided by the danger statements and safety goals. BB Plus workers workers may deliver the program and work with families case managed by CPWs in the Intensive Family Support Teams, Child Safety and Care teams. However they continue to be line managed by the IFS team leader.  

    • Statutory protection and care responsibilities remain with the CPW.
    • Any concerns about the safety or wellbeing of a child or young person (including mothers or mothers to be) must be discussed with the case manager/CPW and the IFS team leader immediately to determine the most appropriate action.
    • Home visits must be conducted in accordance with the BB Plus Service Delivery Flowchart 
    • If any concerns of family and domestic violence occur during the course of BB Plus involvement they must be reported to the CPW and the FDV Risk Assessment Tool  applied.

     

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    Home visiting

    Best Beginnings Plus is a home visiting service. It is flexible and visits may be with the family in the home or at agreed locations.  BB Plus workers should consult with Aboriginal and Culturally and Linguistically Diverse (CALD) staff on cultural matters before visiting families and invite specialist staff to attend home visits where appropriate.

    The BB Plus Service Delivery Flowchart (in related resources) provides an overview of the structured home visiting schedule for working with families to implement the service, including service focus and intensity and actions and activities to be undertaken at each period of involvement. 

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    Service focus and intensity

    The BB Plus service is delivered for up to one year. The service is divided into four periods of involvement and each period has a priority focus area that guides service delivery and actions.

    1. Pre-birth involvement - during this period the BB Plus worker engages with the parents, discusses the benefits and limits of the service and works with the family to develop a plan to ensure the baby's safety and wellbeing before and after birth.

    2. 0-3 months involvement - this period focuses on supporting the parents to create safety for their child and to meet their physical and emotional needs.

    3. 3-9 months involvement - this period builds on the parenting skills that have been attained, including responding to the child's rapidly changing development needs, and supporting the parents to address the issues impacting on their own wellbeing.

    4. 9-12 months involvement - this final period focuses on assisting parents to independently access family and kin networks and community resources for themselves and their child. The BB Plus worker will help them to identify a plan to continue to keep their child safe and respond to their needs once the service exits.

    The length of time the family has been involved with the service also influences the level of intensity, key process and frequency of visits, as shown in the table below.

    Length of involvement ​Level of intensity ​Frequency of visits ​Key processes ​Priority focus area
    Pre birth ​High ​Up to 2 per week Engagement ​Child safety & wellbeing
    ​0-3mths ​High ​Up to 2-3 pr week Engagement ​Child safety & wellbeing
    ​3-9mths ​Moderate ​Weekly-fortnightly ​Review ​Parent/s wellbeing & family functioning
    ​9-12mths ​Low Fortnightly-monthly ​Closure ​Social connected-ness
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    Data collection

    ​File notes and records are kept and placed on the family case file in Assist and in Objective. BB Plus workers do not maintain separate case files. All records of home visits, correspondence etc. are held in the one Objective case file for the family.

    BB Plus workers do not capture physical BB Plus documents into Objective (i.e. Ages and stages questionnaires, Edinburgh Postnatal Depression scale, Entry Form, Matrix, Program Checklist, Safe infant sleeping checklist) or maintain their own physical file.  These BB Plus documents must be handed to the Business Administration Team at their district to correctly scan into Objective and physically file into their Client Day File. The scanned image is officially processed by the Records Management Quality Assurance Team and an Objective reference is sent to you – Policy: Scanning of client records. The physical documents should then be filed by the Business Admin Team, not the BB Plus officers. 

    A list of forms, matrices, questionnaires and scales for completion and entry in Assist can be found in the BB Plus Program Checklist (in related resources).  

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    Client support costs

    ​Funding can be accessed to support progress towards achieving the safety goals for the family. You should explore all other funding sources before accessing client support costs and make sure that the family understands the purpose and limits of the Department's funding.  

    Client support costs must be discussed with and approved by the IFS team leader.

     

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    Child protection concerns

    ​If at any time a BB Plus worker has concerns about the safety or wellbeing of a child, or a mother under the age of 18 years, they must discuss this with the IFS team leader immediately to determine the most appropriate response.

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    Matrix, tools and resources

    ​A range of mandatory and optional tools and resources support the delivery of the BB Plus service. The child's age and stage of development, parenting capacity and period of involvement with the family should all be considered in determining the activities undertaken or tools and resources to be used.

    The Child Environment Matrix (CEM) assists BB Plus workers to develop goals with the family and measure progress and the effectiveness of service delivery.

    A new CEM must be completed at entry, six months, and at exit from the service. These results must be entered onto Assist. The matrix may be completed at other times with the family and are filed in Objective.

    Further information about the matrix and other service tools and resources, such as the BB Plus Safe Infant Sleeping Checklist, the Edinburgh Post Natal Depression Scale and the Ages and Stages Questionnaire can be found in the BB Plus Model & Practice and Procedures Guide in related resources.

    • BB Plus workers must attend all Multidisciplinary Case Consultations (MCCs) for cases receiving the BB Plus service.
    • Training must be undertaken by BB Plus workers before they administer a number of the programs specific tools and resources, including the Edinburgh Postnatal Depression Scale.
    • All forms, matrices, questionnaires and scales listed in the BB Plus Program Checklist must be completed and, where indicated, entered onto Assist for data collection purposes.

     

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    Community Health Nurses

    Community Child Health Nurses (CHNs) offer a range of services for families with babies and young children. As part of their role in screening and assessing child development and parental wellbeing, CHNs use a number of tools including the Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stage Questionnaires (ASQs) (at four months, 12 months and two years).

    To avoid duplication of work and families repeating the same assessments with a number of professionals, BB Plus workers should:

    • make contact with CHNs and advise of their involvement with the family;

    • where possible, carry out joint visits with the CHN to complete EPDSs and relevant ASQs; or

    • in consultation with the CHN, determine if a family is engaging well or has a strong working relationship with one professional and agree for that person to complete the relevant assessments and share the information accordingly.

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    Multidisciplinary Case Consultations

    ​Best Beginnings Plus workers must attend MCCs for all cases where the BB Plus service is being provided. Further information about MCCs can be found in Chapter 1.2 Intensive Family Support.

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    Closure

    ​The BB Plus service is delivered for up to one year, or until the safety goals have been achieved and the parents can meet the safety, wellbeing and developmental needs of their child.

    If the mother has another baby during the delivery of the BB Plus service and there are concerns for the safety and wellbeing of that baby, a new referral must be made.  

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    Before and at closure

    Before closing BB Plus workers must:

    • plan the closure with the family
    • link the family to an appropriate network of support including family, kin, community services and supports
    • address any concerns about the ongoing safety of the child (with the child protection worker)
    • discuss and gain approval to close the case with the IFS team leader.

    At closure BB Plus workers must:  

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    Transfer of clients

    ​Transferring clients between districts takes place in accordance with procedures set out in the section 'Case transfer for child protection concerns' in Chapter 2.2: Case allocations, management, transfer, requests for co-working or services and case closure.

    If a BB Plus client re-locates to an area not serviced by BB Plus, or if the BB Plus service in the new location has no capacity to work with the family, continuation of the service is negotiated at district director level.

    If a family is transferred to another area, or the BB Plus service is ceased for any reason the team leader in the area that accepted the initial referral must inform the relevant child health nurse. 

     

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