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1.2.2 Best Beginnings Plus - referral, service delivery and closure

Last Modified: 26-Jul-2018 Review Date: 02-Jan-2018

Purpose

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

Practice Requirements
  • Referrals to Best Beginnings Plus will only be accepted if the family has an open case with Child Protection Family Support districts or with a new child protection intake. 
  • Statutory protection and care responsibilities remain with the child protection worker.
  • Any concerns about the safety or wellbeing of a child or young person (including mothers or mothers to be) must immediately be discussed with the case manager / child protection worker and the Intensive Family Support (IFS) team leader to determine the most appropriate action.
  • Home visits must be conducted in accordance with the service delivery flowchart located in the Best Beginnings Plus Service Delivery Flowchart (in related resources).
  • Best Beginnings Plus workers must attend all Multidisciplinary Case Consultations (MCCs) for cases receiving the Best Beginnings Plus service.
  • Best Beginnings Plus workers must complete Child Protection Foundation training in the Child Protection Learning Pathway.
  • Training must be undertaken by the Best Beginnings Plus workers before they administer a number of the programs specific tools and resources, including the Edinburgh Post Natal Depression Scale
  • All forms, matrices, questionnaires and scales listed in the Best Beginnings 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
  • Matrix, tools and resources
  • Multidisciplinary Case Consultations
  • Data collection
  • Client support costs
  • Child protection concerns
  • Closure
  • Transfer of clients
  • Overview

    The Best Beginnings Plus service is delivered by Best Beginnings Plus workers located in 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.

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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 are 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 Communities 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 Communities through the Central Intake Team (CIT) / Regional Child Safety (CS) teams, via the Child Protection Concern Referral Form. Where assessment indicates harm or risk of harm to the child in accordance with the Duty Interaction Tool, the referral becomes an open child protection case and can be considered for Best Beginnings 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 Best Beginnings 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 Best Beginnings Plus referral criteria, the Central Intake Team / Regional Child Safety team will open a case support service activity for Best Beginnings Plus. The case is allocated to the IFS team leader in the relevant district who will decide if the case support service is rejected and closed or accepted and a service provision activity created.

    If a referral is generated from within a district office for an open case it is the responsibility of the district office to record the Best Beginnings 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 of the required information to process the referral, however the Best Beginnings 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 Best Beginnings 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.

    Best Beginnings Plus is delivered only in open child protection cases. Best Beginnings Plus workers and child protection workers should jointly develop a plan for working with the family that is guided by the danger statements and safety goals. The Best Beginnings Plus worker may deliver the program and work with families case managed by child protection workers in the Intensive Family Support Teams, Child Safety and Care teams. They will however remain line managed by the IFS Team Leader.  

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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. 

    Best Beginnings Plus workers should consult Aboriginal and Culturally and Linguistically Diverse (CALD) staff on cultural matters prior to visiting families and invite specialist staff to attend home visits where appropriate.

    The Best Beginnings 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 Best Beginnings 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 Best Beginnings Plus worker engages with the parent(s), 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 parent(s) 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 parent/s to address the issues impacting on their own wellbeing.
    4. 9-12 months involvement - this final period focuses on assisting parent(s) to independently access family and kin networks and community resources for themselves and their child. The Best Beginnings 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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    Matrix, tools and resources

    ​A range of mandatory and optional tools and resources support the delivery of the Best Beginnings 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 the Best Beginnings Plus worker 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 Best Beginnings Safe Infant Sleeping Checklist, the Edinburgh Post Natal Depression Scale and the Ages and Stages Questionnaire can be found in the Best Beginnings Plus Model & Practice and Procedures Guide in related resources.

    Community Child 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 and the Ages and Stage Questionnaires (at four months, 12 months and two years).

    To avoid duplication of work and families repeating the same assessments with a number of professionals, Best Beginning's 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 should attend MCCs for all cases where the Best Beginnings Plus service is being provided. Further information about MCCs can be found in Chapter 1.2: Intensive Family Support.

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    Data collection

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

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

     

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    Client support costs

    ​Funding for client support costs are available in achieving the safety and well-being goals for the family. Before accessing client support costs, all other funding sources need to be considered and families should be clear the funding goal is specific. 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 Best Beginnings Plus worker has concerns about the safety or wellbeing of a child, or a mother under the age of 18 years, they must immediately discuss this with the IFS team leader to determine the most appropriate response.

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    Closure

    ​The Best Beginnings 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 Best Beginnings Plus service and there are concerns for the safety and wellbeing of that baby, a new referral must be made.  

    Before closing the Best Beginnings Plus worker 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 Best Beginnings Plus worker must:  

    • complete the EPDS form
    • complete the CEM form
    • complete ASQs and ASQ-SEs
    • enter the appropriate forms and scores onto Assist 
    • provide a summary in the case plan and the service period on the effectiveness of the Best Beginning Plus service in gaining successful outcomes for the infant and family, and
    • close the file and send it to the appropriate line manager for endorsement and storage.

     

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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 Best Beginnings Plus client re-locates to an area not serviced by Best Beginnings Plus, or if there is no capacity of the Best Beginnings Plus service in the new location to work with the family, continuation of the service will be negotiated at district director level.

    If a family is transferred to another area, or the Best Beginnings 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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