Case planning

Understand person centred planning

Person Centred Practice is a framework that empowers and enables people with disability to be at the centre of planning, and to live the life they want and deserve. It is outcome focused and provides clear plans for now and in the future to ensure the needs of the person are met with the assistance of the safety and support network. This approach originated in the disability sector but is now used broadly across different sectors such as mental health, probation and parole, and education.

Person Centred Practice moves away from ‘Service/System Centred Practice’ and models the approach of ‘doing with’ rather than ‘doing for’. This table provides a snapshot of the key differences between person centres and system centred practice.

The following video is a brief snapshot of a person centred review for a young boy with disability.

Engage the safety and support network

For some parents with disability, the presence and actions of their safety and support network are integral in enhancing their ability to meet the safety and wellbeing needs of their children. A safety and support network is a team of family, friends, community members, carers and professionals who are willing to meet with the child or young person, the family and Child Safety and work together to keep the child or young person safe. Network members are not ‘add-ons’ to the casework but are integral to case planning and safety planning. In this integrated practice approach, network members are essential to enhancing safety as they keep in regular contact with the child or young person and their families, take specific actions when situations become fragile or dangerous, and listen and respond to the child or young person and their worries.

An important difference between a safety and support network and a more general group of concerned people is that safety and support network members know the harms that have already been experienced and the worries and goals for the future. That is, they know the risk of future harm to the child or young person should nothing change in the family or if new issues emerge. The key premise for any safety and support network is that network members are:

• informed
• willing to help
  and
• clear about what they must do to respond.

Use the list of questions below to help start identifying or developing a safety and support network with the children and parents:

Who is currently in your life?

• Do they play a role regarding your disability?
• What is their understanding of your disability? Are they aware of the functional impact of your disability and what supports you require?
• Are they a positive or negative influence?
• What do they think, say or do about your disability?
• How do they make you feel about your disability?
• Who could be in your life but is not? What is stopping them from being in your life now?
• What do they think, say or do about your disability?
• If you could say one thing to them now, what would it be?
• What do you think their wish for you and your child is?

Who is helpful?

• Who is in your life now that is supporting you, or has potential to support you?
• Who has been in your life before, that if they were still, could help you?
• Who could be in your life to support you to be the parent you want to be?
• Who could support your children?
• What can we do to engage the support of this person?

Who makes it harder?

• Who is in your life now that gets in the way of you or isn’t helpful regarding your disability?
• Who has been in your life previously that has gotten in the way or made it harder for you?
• How can you work to keep those people out of your network?

Is change for everyone?

When we talk about case-planning, we often talk about ‘a parent’s readiness for change’, or ‘actions a parent needs to take to change their behaviour’. The focus in many case plans includes actions for parents to take in order to change their behaviours that are contributing to worries or harm, for example, ceasing problematic alcohol use or learning more appropriate parenting strategies.

When considering case planning with a parent with disability, the very nature of a disability is that it is likely to be permanent in nature. If the child protection concerns relate to the impact of a parent’s disability, it becomes less about ‘changing’ something that cannot be different, and more about supporting the family and adapting the environment.

Below is an example scenario:

Brad is a 40 year old father of three year old twin boys, Sam and Harley. Brad is paraplegic and has been in a wheelchair for most of his life. He recently moved into his elderly mother’s home as a way of saving money, however the house isn’t suited to his wheelchair. Brad has an NDIS plan which he feels isn’t adequately meeting his needs, but he hasn’t had the energy to seek a review. Brad feels very alone and sometimes feels so frustrated that he can’t do everything his boys want him to. The twins are very energetic. Brad suspects Sam has ADHD and believes the day care are equipped to support Sam with this. Brad’s family came to the attention of child safety after a notification was screened in describing the house as “pure squalor” with animal faeces in every room of the house. The twins had severe nappy rash and were attending day care in soiled nappies and dirty clothing on a daily basis.

An assessment occurs, establishing that there are no concerns regarding domestic violence or substance use but suggests that in addition to his physical disability, Brad also experiences periods of depression. Brad states he knows his home isn’t up to scratch but he’s in a wheelchair- he isn’t able to clean up properly, and wakes up feeling exhausted nearly every day. The assessment substantiates harm and risk of future harm, and an intervention with parental agreement case is opened.

Record the plan

As part of the case planning process, discuss with participants the way the meeting is recorded, and what the final case plan developed at the meeting will look like. While a standard departmental case plan or review report will be completed on our system, these documents need to be adapted or completed in a way that makes sense for the child and parent to give them to best possible opportunity to fully understand their goals and actions they need to take.

Some options for recording the meeting and case plan can include:

• The parent or child drawing or choosing pictures associated with goals, actions, worries or acts of protection.
• The convenor or facilitator documenting written minutes on a computer attached to a larger screen so all participants can see the minutes as they are typed.
• The convenor or facilitator writing the minutes on butcher’s paper on the wall, and / or drawing pictures on behalf of the family.
• The convenor or facilitator, or a family member, writing or drawing the content of the case plan using a medium of their choice.
• Using agreed upon phrases or words from the family and including these in the case plan document.

A person with an intellectual disability or hearing impairment may prefer more visual prompts or pictures. A person with a visual impairment may prefer that visual prompts are not used, and minutes are only to be written. A person with a physical disability may prefer to take minutes at the table rather than minutes being recorded on paper on the wall as it is more accessible to review a document in front of them rather than try and view minutes on different walls around the room.

Regardless of the way in which the meeting is documented, the process should be guided by the family so the record and contents of their meeting is accessible and understandable to them.

Recording tip: Parenting in pictures

Raising Children Australia has parenting in pictures (2019) - visual resources and simple text to use with parents relating to pregnancy, newborns, babies, toddlers, school age and teenage children. Using these visual prompts as part of a case plan can support a parent to remember and understand how to safety care for their child. Many of the resources have also been developed specifically Aboriginal and Torres Strait Islander families also.

The below parenting in pictures are an example of the general visual resources available on the Raising Children Australia website.

The below parenting in pictures are an example of visual resources for Aboriginal and Torres Strait Island families on the Raising Children Australia website.

Implementation

Once a case plan has been developed with the family, the next phase is implementation. When considering case plan implementation for a child or parent with disability, consider how your case work can continue to be person-centred and conducive so all people involved can complete agreed upon actions and achieve the case plan goals.

Some things that may require further consideration include:

• Consider how the parent or child’s disability might affect implementation and seek to adapt your approach. For example, a parent with an acquired brain injury may require repetition and being reminded of case plan goals and actions. Think of ways to work collaboratively with the parent and their safety and support network to ensure the parent stays on track with implementation such as setting time after contact to discuss their progress or a network member having a regular phone call with the parent.
• A parent may need you to complete an action prior to them being able to take an action. For example, a service may only accept a departmental referral prior to engaging with a parent. If this is the case, prioritise completion of your actions as soon as possible to reduce the barriers for a parent to achieve their goals. 
• Establish how often the safety and support network will meet and communicate, and how these meetings will occur. For some parents, the presence and robustness of a safety and support network is critical for a child’s safety and for a parent to be supported to complete actions and achieve case plan goals. Regular meetings and communication between safety and support network members can ensure that actions are progressing. If network actions aren’t progressing and this is impacting on the parent or child, this can be remedied and further addressed as part of your regular meetings.
• Change the approach if the plan isn’t working. Despite best intentions, there may be times when the current approach regarding the developed plan isn’t working. If this is the case, meet with the child, parent and safety and support network as soon as possible rather than waiting to formally review a case plan.
• Consider how effective and timely feedback can be sought from and provided to children, parents, and network members. How will we know if a child feels safe and is enjoying time with their parent? How will conversations about the quality of family time occur to enable a parent to continue doing well or support them to change unsafe behaviour? How will the network know when case plan goals are being met or there needs to be change on the level of support they are providing?

Review the plan

When preparing to review the case plan, revisit the principles of person centred planning to consider talking and planning with the child and parent, focusing on strengths and skills, and partnering with family and safety and support network.

Consider whether anything has changed regarding the parent or child’s disability since the previous case planning or review meeting occurred, and be prepared to adapt your approach if things have changed. Don’t assume that the functional impact of a person’s disability remains unchanged since the last formal meeting. For example, a parent with disability that is degenerative in nature may find it increasingly difficult to attend the service centre despite previously being able to do so for meetings.

Appreciative inquiry

As part of the review process, an appreciative inquiry approach can be undertaken to elicit information and develop a deeper understanding from the family and network about a family’s progress, strengths, the changes they have made and what other changes need to occur to help them to reach their goals. This approach can increase the family’s potential to recognise acts of protection and belonging, and strengths and resources.

Appreciative Inquiry is the co-evolutionary, co-operative search for the best in people, their organizations, and the relevant world around them … AI involves the art and practice of asking questions that strengthen a system’s capacity to apprehend, anticipate and heighten positive potential … AI practice focuses on the speed of the imagination and innovation.  Instead of negative, critical, and spiralling diagnoses commonly used in our organizations … there is discovery, dream, design and destiny” (Positivity strategist, 2018).

AI primarily consists of four processes, known as the 4 D’s:

1. Discovery. Identify the important topic, explore the positive experiences and moments, and look at the themes that are consistent in the positive moments.
2. Dream. Consider a vision that reflects the ideal future.
3. Design. Innovate ways to create the desired future.
4. Destiny. Ongoing and simultaneous Discovery, Dream and Design for continued positive growth.

Imagine you are working with Oscar, a father with an intellectual disability. He has supported contact twice per week for three hours with his toddler Dean, which have been going well. His contact was recently increased but Oscar hasn’t been attending.

Consider the following approaches when you meet with Oscar to discuss his contact with Sam:

Scenario 1

CSO: We increased your contact with Dean but you haven’t been attending as often as you should. If you don’t come to contact, we’re going to have to decrease it and no one wants that. Why aren’t you coming?

Oscar: I miss my boy. I feel awful. I guess I find it really difficult getting to the CSSC three times per week.

CSO: Dean misses you too, and it’s pretty awful for him as well. He shouldn’t have to be left waiting just because you can’t make it to contact. Don’t you understand that?

Oscar: I feel bad about it. I hate hurting him like that. I’m just not sure what to do.

CSO: I don’t understand why you can’t just get here. You need to figure it out. Just make sure you’re here on Monday OK? I don’t want to have to cut visits back.

Scenario 2:

CSO: You were attending contact very regularly up until four weeks ago when we increased your time with Dean.  You haven’t been attending the extra visits since our last meeting though. What’s going on?

Oscar: I miss my boy. I feel awful. I guess I find it really difficult getting to the CSSC three times per week.

CSO: Tell me about the times when you do come to contact with Dean … I know it’s a long way for you to catch the bus and you have to get up so early, but you’ve managed really well in the past. How are you able to do it on the days you find rough?

Oscar: I try and think positively, and remember how happy he is when he sees me. That really motivates me. I have a little picture of him on the wall in my unit and when I look at that, it gives me the kick I need to get out of the house sometimes. Other days though it all feels too much and I just need to stay in bed. Sometimes I forget to set my alarm.

CSO: Oscar, you’ve been doing a great job parenting Dean. Its so nice to hear you’re motivated by him when he’s happy to see you- What’s that like for the two of you?

Oscar: It’s the best feeling in the world. He means everything to me. I’ve been trying really hard with Sarah from the parenting service. She tells me what Dean needs and I’ve been trying to do that in contact, you know? Bringing him toys and healthy snacks and stuff.

CSO: That’s great Oscar. Please keep bringing the snacks and items for Dean to play with- It shows me and Dean that you understand what he needs. Can you think for a second about the best contacts you’ve had with Dean … What happens before you come to contact that makes it go so well? 

Oscar: Well… My alarm is set, so I wake up on time. I already have food for Dean because I bought it the day before, so no stress going to the shops beforehand. I have enough money on my Go-Card to get in to the office. I see Dean’s picture on my wall, and I’m feeling good about myself, motivated, happy to see him.

CSO: This helps give me an understanding of what you need to support you to come to contact Oscar. Perhaps we can give Sarah from the parenting service a call now and discuss how she can help you get into a routine so that every time you have contact, your day runs like this…

Some parents with disability may go through periods of time where they feel their disability complicates their circumstances, or stops them from being the parent they want to be. Appreciative inquiry can help can provide them with the space to identify what is working well, help them understand and analyse why it is working well, and then do more of it.

Some people with disability, particularly an intellectual disability, are more prone to acquiescence. Using an appreciative inquiry approach can give a person with disability the opportunity to talk in their own words about their views and the progress they have made.

Appreciative inquiry example questions

Below are some example appreciative inquiry questions for use with parents. These questions can be adapted to use with children and young people too! Remember appreciative inquiry has four domains to help you unpack the information you are looking for: discovery, dream, design and destiny.

Discovery

• When you are parenting at your best, what’s going on?
• What do you value the most about yourself as a parent?
• What is something you’re really good at?
• What is one of your proudest family moments?
• When have you felt most successful as a parent?
• What is great about your family?
• What situations tend to bring out the best in your family?
• What are the strengths of each family member?
• What do you value most about your family?
• What is working well in your family?

Dream

• If you could have a wish for your family what would it be?
• Imagine you are the best parent you can be- What’s happening for you? What are you doing differently and the same as you are now?
• What is the best possible outcome for your children?
• What would your children be saying or feeling if things were going as well as they could be?
• What’s possible in your family and who cares?
• What would it be like if you had your dream come true?
• What do you want more of for your family?
• What would your ideal family look like? Draw a picture of it.
• Where do you want to be as a family in 5 years? 

Design

• What would make your dream come alive?
• What would it take to create the change (s) needed in your family?
• What’s the smallest change you could make that would have the biggest impact?
• What could you stop doing because it no longer serves a purpose of being the parent you want to be?
• How can you support one another in taking the next step?
• What is one thing you can do to help your family succeed?
• What challenges might come your way and how might we meet them?
• If your success was completely guaranteed, what bold steps might we choose? 

Destiny

• Who else can be involved to support your dreams?
• Who else could inspire you to be the parent you want to be?
• What else do we need to think about to get to where you want to be?
• How are you already living your dream?
• What are you learning about yourself as a parent?
• What unique contribution can you make to creating family happiness?
• What is one thing you would like to change in you to benefit your family?
• What commitments are you willing to make to yourself and your family?
• What is the next thing we need to think about?