Safe Start Service Model

Introduction

This document provides an overview of the Safe Start and the context of where it sits within the Child and Family Support System. It articulates the scope of the program, key values and principles, objectives, and outcomes. The service delivery practices, outputs and service elements are described, and the service flow is represented.

This document should be read in conjunction with Department of Human Services and Safer Family Services policy and practice guides.

Child and Family Support System

During 2018–2019 the SA Government undertook an extensive process of research and co-design aimed at drawing on evidence-informed knowledge and practice. This was combined with lived and professional experience, to design the Child and Family Support System (CFSS) to ensure that South Australia delivers the best possible outcomes for children and families. The remit of the CFSS is to work with families to support them to keep their children safe and well at home in family, community, and culture. CFSS has a focus on the following four priority population groups:

• Young parents (where mothers are aged under 23 years and fathers aged under 25 years)
• Families of infants deemed to be at high risk in their first 1,000 days
• Aboriginal families with multiple and complex needs
• Young people experiencing vulnerability and at risk of having children who may go on to enter the child protection system.

The Department of Human Services has lead responsibility for implementing the CFSS, in which Safer Family Services plays a key part.

Safer Family Services (SFS) provides help and support to children and their families at risk of harm, neglect, and/or domestic and family violence. SFS purposefully and assertively intervenes to disrupt the patterns of intergenerational trauma and increase the number of children able to be safely cared for in their homes, and to remain connected to culture and community. This is particularly relevant for children and families with multiple and complex needs.

Safe Start

Safe Start is a program within Safer Family Services (SFS) and Relationships Australia SA (RASA) which plays a critical role in the delivery of the CFSS.  Safe Start provides direct services to families with infants in the first 1,000 days. Safe Start works collaboratively with other SFS services and government and non-government partners to improve the social, health, and wellbeing outcomes for infants, children, and young people in South Australia.

Vision

Children are safe and well at home, in family, community, and culture.  They are connected to supports within their local regions that will enhance their development and strengthen the adult-child caregiving relationship.

Guiding Values

Safe Start is underpinned by the values that are guided by the United Nations Convention on the Rights of the Child (1989) and consistent with Safer Family Services Case Management Framework (2020).

• All children have the right to grow up in an environment free from neglect and abuse. Their best interests are paramount in all decisions affecting them.
• Improving the safety and wellbeing of the children is a national priority.
• The safety and wellbeing of children is primarily the responsibility of their families, who should be supported by their communities and governments.
• Australian society values, supports and works in partnership with parents, families, and others in fulfilling their caring responsibilities for children.
• Children and their families have the right to participate in decisions affecting them.
• Policies and interventions are evidence informed.
• Children’s rights are upheld by systems and institutions.

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Guiding Principles

Many services and programs including Safe Start are playing a critical role in supporting families to keep children safe and well at home and reduce the need for children to be removed from their families to ensure their safety.

Safe Start is guided by the principles of the Case Management Framework that works with the family, whilst keeping a Child-Centred approach. This is done through:

• Proactive engagement
• Strengths-based approach
• Logical processes
• Partnership with children, families and partnering agencies
• Systemic links to broaden referral pathways
• Outcomes driven to achieve a family’s goals
• Culturally responsive in an inclusive approach that respect culture and see culture as a strength
• Holistic processes to encompass all factors to the child and family’s safety and wellbeing
• Dynamic to be open to change and responsive to needs as they arise.

The CFSS is made up of a spectrum of services that are able to respond to different degrees of complexity and the safety concerns for children and families. These services work directly with families to ensure their safety and wellbeing. Services providers are governed by their own core principles informing service operation, which spans from community capacity building through to intensive case management.

The Roadmap for reforming the Child and Family Support System 2021–2023 outlines key steps that the Department of Human Services is taking to improve early intervention services for children and families with complex needs. These steps are in line with the whole-of-government strategy, Safe and well: Supporting families and protecting children.

Safe Start will also be guided by the Aboriginal Co-Design Principles identified throughout the CFSS Co-Design Process undertaken in 2019.  These principles include:

• Aboriginal and Torres Strait Islander children are front and centre
• Services are family-focused
• Cultural strengths are reflected
• Aboriginal and Torres Strait Islander’s right to self-determination is reflected
• The truth of our shared histories, the hurts, the strengths, and the healing are acknowledged and reflected.

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Aboriginal Cultural Practice

The over-representation of Aboriginal children and families in contact with the statutory child protection system is well documented. We see and acknowledge that Aboriginal people experience disproportionate levels of disadvantage and hardship, along with continued negative impacts from historical events and policies. Safe Start recognises the ongoing impact that colonisation, dispossession of land, and loss of culture has had on community. Safe Start is committed to developing an appropriate service response for Aboriginal children and families and sees culture as a protective factor.

Safe Start is committed to working restoratively, building on the resilience and strengths of Aboriginal people, working with, listening to, hearing, and acknowledging cultural identity, and translating this into practice.

Engaging with families with multiple and complex needs, in the best interest of the children and young people, often means working within an environment that is dominated by fear and anxiety due to the power imbalances. Assertive engagement and relationship-based case management are the approaches used to deliver support. For Aboriginal children and families, support and engagement to keep children safe and well, is done in culturally responsive ways.

In addition, by keeping children at the centre of our involvement, we will work collaboratively with adult focused services that values Aboriginal family-led decision-making and self determination to ensure that, when they are supporting adults in families, they are mindful of children’s needs (as a priority) to be safely cared for within that family. This ensures that, when we are supporting adults in families, we are contributing to building a trauma responsive and healing system for everyone.

Service Description

Safe Start works with infants in the first 1,000 days (pre-birth to 24 months) and their families who are experiencing complex issues. It provides coordinated, targeted, and culturally responsive engagement. Safe Start provides support to infants and their families to improve their safety, health, development, and wellbeing outcomes where child protection risk factors exist. Safe Start is committed to ‘Closing the Gap’ and enhancing interaction with health, wellbeing, and developmental outcomes for Aboriginal infants and their families. Safe Start does this through building strong local Aboriginal partnerships to guide interventions and case planning guided by formalised cultural consultation.

The key objective of the Safe Start is to engage at-risk women and their partners through the antenatal period. Safe Start will assist with building on the family’s level of protectiveness and understanding, and their connection to kinship and community to strengthen their parenting capacity in preparation for the birth of their child. Safe Start will also provide support to families who have infants with a disability or complex needs, and child protection concerns. Safe Start will assist families in navigating the most appropriate pathways and in accessing services.

The Safe Start model is based on a collaborative, empowering practice, with a strengthens-based approach. Safe Start staff will work alongside families, colleagues, and agency partners, to provide an integrated and holistic approach. This model of practice supports the engagement of families earlier into the pregnancy and enables services to engage, that may not have been connected.

Safe Start operate in various geographical locations across South Australia:

• Northern Metropolitan Adelaide
• Southern Metropolitan Adelaide
• Western Metropolitan Adelaide
• Limestone Coast
• the Far West (Whyalla and Port Augusta).

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Service Objectives

• Assertively engaging with children and families to provide high quality and appropriately tailored intervention services, that attend to their safety and wellbeing, and improve health and developmental outcomes
• Children and families are connected to responsive services to meet their needs in a timely manner
• Cultural responsiveness reflected in partnership approaches in all engagement with Aboriginal and Torres Strait Islander infants and families, which includes the principle of family-led decision making, and the right to self-determination
• Culturally and Linguistically Diverse (CALD) families will be supported in ways that acknowledges and recognises cultural diversity and practices
• Deliver services with openness, honesty, and transparency with families, and have difficult and challenging conversations about child protection risks
• Utilisation of the Information Sharing Guidelines to ensure that information is appropriately shared where there is a threat to the safety and wellbeing of children and families
• The Children and Young Person’s Safety Act (2017) and other relevant legislation will be complied with and used where appropriate.

Service Outcomes

The following outcomes should be read in conjunction with the CFSS Outcomes Hierarchy that provides a shared view of outcomes for all services in their efforts to ensure children are safe and well at home in family, community, and culture.

Child and Family Outcomes

Family Safety: Children and families

• obtain appropriate nutrition, housing, accommodation and financial stability to support children and families to stay safe and well at home
• are free from family violence, abuse and neglect, drug and alcohol abuse, physical, sexual or emotional abuse and harsh parental discipline
• are supported to address their disability and mental health needs.

Well-being: Children and families

• are supported to address their emotional well-being and reduce parenting stress
• are supported to enhance child development, child behaviours, child health and mental health.

Family functioning: Children and families

• improve their relationships and parenting capacity, and learn different ways of problem-solving, communication patterns, behaviour management and parenting styles, to support family relationships.

Capability to influence decisions: Children and families

• are empowered to achieve personal capacity to affect change
• develop self-efficacy, self-advocacy, and capacity to make decisions
• achieve self-determination.

Capability to achieve potential: Children and families

• develop insight into their strengths and resilience, to empower and encourage engagement with training, education, and employment, and develop personal skills.

Access to community supports: Children and families

• seek help and support when needed
• engage with support services, and extended family supports.

Connection to culture: Children and families

• see strength in their cultural, linguistic diversity, and spiritual well-being
• participate in cultural activities
• take time to connect and spend time on country
• seek support from cultural groups.

Program Outcomes

• Staff become stronger allies to Aboriginal people, ensuring self-reflection, practicing cultural humility and respect, and building their cultural fitness and responsiveness
• Partnership is developed and maintained with services that support the needs of the client group

System Outcomes

• Children, young people, and their families are diverted from the Department for Child Protection system for intervention under the Child and Young Person (Safety) Act 2017, and in turn reducing the trajectory of entering other statutory systems
• Focus on improving safety and family functioning
• Align outcome-focused efforts across the system, working for children, young people, and parents/caregivers to be safe and well in families
• Influencing decisions and reaching potential through self-determination
• Connect and support in communities and through culture.

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Service Scope

Safe Start will engage with infants in the first 1,000 days (pre-birth to 24 months) and their families with a high level of complexity, maintaining a focus on the reduction and elimination of child protection risk and vulnerability.

Safe Start will undertake comprehensive assessments and case management intervention for families and seek to connect families to appropriate services in their community. This will assist in mitigating the child protection risks, and support families with infants in the first 1,000 days (pre-birth to 24 months) to thrive within their homes, connected to culture and community.

In scope

• Infants (pre-birth to 24 months) and their families
• Unborn Child Concerns
• Infants (pre-birth to 24 months) and their families where there are child protection risks
• Pregnant women who are identified as part of the major birthing hospital High Risk Infant case review meetings (for example, Strengthening Links, Early Links, and Northern Links)
• Siblings of infants (pre-birth to 24 months)
• Interagency investigations and responses, whether as lead agency (as nominated by Department for Child Protection) or party to strategic discussions and assessment, as outlined in the Interagency Code of Practice.

Out of scope

• Children 25 months and over
• Infants under the Guardianship of the Chief Executive, Department for Child Protection (DCP)
• The direct investigative process of child protection matters that require Department for Child Protection, Child Protection Services and SA Police criminal and forensic assessments.
• Infants and families whereby complexity and vulnerability exist in absence of child protection risks.

Regions

Safe Start operates in various geographical locations across South Australia:

• Outer Northern Safe Start: will take eligible referrals for families living in the City of Playford and City of Salisbury
• South Safe Start: will take eligible referrals for families living in the City of Marion and City of Onkaparinga
• Limestone Coast Safe Start: will take eligible referrals for families living in the City of Mount Gambier
• Far West Safe Start: will take eligible referrals for families living in the City of Whyalla and City of Port Augusta.
• Inner Northern and Western Safe Start is led by Relationships Australia SA and will take eligible referrals for families living in the City of Charles Sturt, City of Port Adelaide Enfield, and City of West Torrens

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Service Outputs

Service Domains

Safe Start will deliver across the following service domains:

1. Working directly with infants, their siblings, and families
2. Consultation, assessment, and case management
3. Develop and support community connections and service accessibility to support vulnerable children and families.

Service Elements

Safe Start offers the following service elements that incorporate Assertive Engagement and Case Management, providing:

Direct Case Work

• Direct case work includes, but is not limited to, the following elements:
• Engage in and develop professional helping relationships with infants, siblings, their families, and communities
• Home visiting to engage and support infants and their families
• Ensure practice is informed by cultural consultation, and interpreters are used as required when working with culturally and linguistically diverse families
• Support to engage with internal and external services
• Delivery of agreed case planning that involves the family-led decision making
• Co-working with other service providers including case conferencing, joint meetings, and home visiting.

Indirect Case Work

Indirect case work includes, but is not limited to, the following elements:

• Consultations with service providers regarding infants, children, young people, and their families
• Sharing information of at-risk situations to keep infants, children, and young people safe
• Cultural consultations to ensure cultural safety in families and communities
• Providing support, information, and resources, in response to the needs of families
• Attending meetings directly related to the needs of families
• Recording case notes on the case management system in a professional and timely manner.

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Partnership

SFS recognises that the skills, resources, and knowledge required to respond appropriately to the complex issues related to the care and protection of infants, children, and young people are beyond the capacity of a single agency. Safe Start works in partnership and engages proactively with infants and families, across the CFSS and with other relevant key stakeholders to support integrated responses to address the needs of infants and their families. These partnerships form the basis for the successful operations of the program.

Primary partners in this work include:

Internal to SFS:

• Strong Start
• Aboriginal Practice Team
• Child and Family Safety Network (CFSN), including external network partners
• Child Wellbeing Program
• Clinical Practice team
• Community Development Coordinator Program
• Family Practitioner Program
• Metropolitan Aboriginal Youth and Family Services (MAYFS)
• Multi-Agency Protection Service (MAPS)
• CFSS Pathways Service.

External to SFS:

• Aboriginal Community Controlled Organisations (ACCOs)
• Aboriginal Community Controlled Health Organisations (ACCHOs)
• Department for Child Protection (DCP)
• Department for Education
• SA Health
• South Australian Housing Authority
• Non-government organisations
• SA Police.

SAFE START/DCP Partnership

A critical component of Safe Start is the inclusion of Department of Child Protection (DCP) High-Risk Infant (HRI) specialist response (funded by DCP) to provide guidance, partnership working and a pathway to the statutory system where required. DCP HRI specialist practitioners allocated to respond to Safe Start across the state.

The role of the Department of Child Protection High-Risk Infant specialist response can include (as required):

• Attendance at case conferences to provide recommendations and advice where necessary
• Attendance and participation in the CFSN
• Joint home visits to discuss child protection concerns and encourage engagement with Safe Start
• Joint case work on very high-risk cases
• Consultation and advice
• Working in collaboration with the allocated Safe Start worker at point of escalation back to DCP office
• Undertake cultural consultation as required.

Partnership Principles

• Communication that is clear, regular, timely, and relevant, underpins quality partnership
• Appropriate information sharing can contribute to keeping children safe
• Respect for each other and the strengths and contributions that all parties bring to the work
• Clarity around the roles and responsibilities supports improved outcomes
• Shared commitment to the best interests of the child
• Valuing the voices of Aboriginal and Torres Strait Islander peoples
• Self-determination and the values that underpin the right to one’s own economic, social, and cultural developments
• Valuing and celebrating diversity
• Perseverance in finding solutions to issues as they arise
• Transparency about organisational agendas and future intentions
• Equality between agencies delivering services.

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Practice Approaches

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Appendix B: Acronyms

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Appendix C: Glossary