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Objective: This constructivist‐grounded‐theory study explored how foster and kinship carers conceptualize and experience their role. Background: Internationally, amid growing emphasis on home‐based care for children and young people living outside parental care, issues such as carer shortages, dissatisfied carers, and placement instability present significant challenges. Method: Sixteen carers (seven foster carers and nine kinship carers) from a regional area in Victoria, Australia, participated in in‐depth interviews following constructivist‐grounded‐theory protocols. Results: Six categories reveal the central ways carers go about caring for children and young people and the main challenges they face in doing so. The core category of "being a parent, but not" demonstrates tensions that carers experience in trying to establish a sense of belonging and connectedness with a child, within the limits of the Victorian home‐based care system. Conclusion: Home‐based carers view their role through a parental lens, but with various limitations that restrict their sense of being a parent. Implications: The current research acknowledges the role tensions inherent within the Victorian home‐based care system and emphasizes the importance of raising the status of foster and kinship carers to provide more recognition of the expertise they hold in the care of children and young people within this complex context. [ABSTRACT FROM AUTHOR]

The Healthy Eating, Active Living Matters (HEALing Matters) program is being scaled up across residential out‐of‐home care (OOHC) in Victoria, Australia and is providing young people with the knowledge, skills and resources to promote better health through healthy eating and activity. HEALing Matters was piloted as the HEAL program, a dual‐intervention program that aimed to provide young people living in residential care with education and opportunities to improve their eating and physical activity habits, while simultaneously building the capacity of their carers to promote, encourage and role model healthy lifestyle behaviours. Qualitative findings indicated that HEAL resulted in increased participation in community sport, increased availability of sports equipment, healthy meal preparation and healthy food availability and improvements in perceived young person self‐esteem and independent living skills. Findings also revealed some limitations of the program. Following the pilot, a participatory methodological approach was used to better understand how to align the HEAL program with individual and community needs. This approach engaged diverse stakeholders to better understand the barriers and enablers, address limitations, identify key intervention points and build trust and a shared vision to co‐design the HEALing Matters program. HEALing Matters is now delivered within a framework that is informed by attachment, trauma and resilience theories. This paper outlines the HEALing Matters journey from what matters, to what works, to what translates in relation to a healthy eating and active living intervention in OOHC. [ABSTRACT FROM AUTHOR]

Young people in residential out-of-home care are universally over-represented in the criminal justice system. This study presents an evaluation of Community around the Child, an early-intervention initiative designed to reduce contact with the criminal justice system among young people living in residential care in Victoria, Australia. Interviews and focus groups with professionals (n=44) produced data that were analysed using inductive thematic analysis. The study found the program promoted positive relationships between young people in care and police and between police and residential carers. Increased knowledge on the part of both carers and police about the impact of trauma on young people's behaviour and methods for supporting young people to regulate their behaviour contributed to these positive relationships. The study calls for a holistic, therapeutic response to the individual needs of young people who have experienced and continue to experience trauma. Essential to this is the provision of training in trauma informed care for police and other stakeholders. [ABSTRACT FROM AUTHOR]

For children in out-of-home care (OOHC) and adults who experienced OOHC as children, the records compiled by care workers, social workers and other relevant personnel present multiple ongoing problems. The records often embody deeply contested narratives that may include distortions and misinterpretations of facts, judgemental inferences, moralistic attitudes and other problematic aspects that can leave the care leaver at best ill-served and at worst profoundly distressed and traumatised. This article, an auto-ethnographic collaboration between a social work professional and two care leavers, aims to address these issues by constructing a 'virtual archive' consisting of several hypothetical records compiled in the style typically employed by caseworkers, which are then critiqued by the care leavers. In each case, the record is found to have significant shortcomings in terms of what is included or omitted, the tone, and implied judgements. The article concludes with a discussion that identifies a number of thematic issues and pitfalls intrinsic to the task of record-keeping in the OOHC context and makes recommendations aimed at achieving inclusive, rights-based processes and procedures in the creation and maintenance of records. [ABSTRACT FROM AUTHOR]

Researchers have examined sub-groups that may exist among young people transitioning from out-of-home care (OHC) using various theoretical models. However, this population group has not been examined for trajectories of homelessness risk. To examine whether different subtypes of homelessness risk exist among young people transitioning from care and whether these trajectories of homelessness are associated with mental health and substance use disorders. A retrospective population-based cohort study was conducted from a population of 1018 young people (aged 15–18 years) who transitioned from out-of-home in 2013 to 2014 in the state of Victoria, Australia, with follow-up to 2018. Latent Class Growth Analysis was conducted using linked data from homelessness data collections, child protection, mental health information systems, alcohol and drug use, and youth justice information systems. Three sub-groups of young people were identified. The 'moving on' group (88 %) had the lowest levels of homelessness, with the slope of this trajectory remaining almost stable. The ' survivors' (7 %) group started off with a high risk of homelessness, followed by a sharp decrease in homelessness risk over time. The ' complex' (5 %) group started off with a low risk of homelessness but faced sharp increases in the risk of homelessness over time. Our study demonstrates that subgroups of young people transitioning from care exist with distinct longitudinal trajectories of homelessness, and these classes are associated with different risk factors. Early intervention and different approaches to tackling homelessness should be considered for these three distinct groups before transitioning from care and during the first few years after leaving care. [ABSTRACT FROM AUTHOR]

Young people transitioning from out-of-home care are globally regarded as a vulnerable group due to traumatic experiences pre-care and within the out-of-home care system, stigmatisation by the wider community, and limited and ineffective support beyond 18 years of age. Yet, many care leavers overcome this adversity to achieve positive life outcomes post-care. This exploratory qualitative study examines the views of a small group of care leavers and foster carers within Victoria on the key factors that influenced positive transition outcomes. Particular attention is drawn to the importance of ongoing support from a close relationship with a trusted adult, a sense of belonging within a placement or extended family or community, the value of advocacy by care leavers and their key support persons, and a connected autonomy beyond 18 years which allowed care leavers to assert their independence without losing their "safety net" of support. These findings are highly relevant to policy makers given the recent introduction of extended care until 21 years for care leavers in Victoria. [ABSTRACT FROM AUTHOR]

Aim: To describe the health needs identified in children attending a comprehensive health assessment at a tertiary hospital, multidisciplinary clinic for children following entry to out-of-home care and timeliness of referral and assessment compared with national recommendations.Methods: This was a retrospective audit of all the children who attended the Pathway to Good Health clinic at The Royal Children's Hospital, Melbourne from May 2013 until 31 August 2016.Results: A total of 119 children aged 0-12 years attended the clinic during the audit period. Of these children, 17% (including more than 30% of 0-2-year-olds) were not up-to-date with immunisations, and 87% had physical health concerns that were addressed on the day or needed further management. Over 50% had mental health concerns identified (76% of 7-12-year-olds). In children aged 3-6 years, 64% had behavioural problems and 77% had developmental problems identified. Only a third of the children was referred to the Pathway to Good Health clinic within the national standard of 30 days post-entry to care, and 24% of children attended within 3 months of entry to care.Conclusion: Children in out-of-home care within Victoria have high rates of physical, mental and developmental health concerns, consistent with previous studies. Timeliness of attendance at the clinic was low compared with national recommendations, even within a programme designed to facilitate timely health checks. This is the second and largest Australian study exploring timeliness of health checks. Further research would establish whether these results are more systemic. [ABSTRACT FROM AUTHOR]

Seeking permanency for children is a central concern of Western child protection and out-of-home care systems, with approaches differing between and within countries. Historically, Australia has not prioritised adoption as a permanency pathway. In the state of Victoria there has been a preference for the use of Permanent Care Orders (PCOs), which have been positioned highly in the permanency hierarchy. Despite their significance, little research has been undertaken in relation to the implementation of PCOs. This article reports on a study that explored themes associated with the implementation of PCOs through an analysis of submissions to an inquiry into the early outcomes from Victoria's 2014 permanency amendments. Four key themes emerged: the power of government; the assumption of a perfect system; disproportionate impact on the most disadvantaged; and the impact of the permanency hierarchy. These themes are discussed with respect to their implications for practice and policy development. Systemic resource deficits and poor quality professional decision-making can significantly hinder timely and effective implementation of permanent placements for children in child protection and out-of-home care systems. Reducing timeframes for family reunification and promoting adoption of children in out-of-home care without first addressing resourcing and practice issues risks unintended consequences, as well as undermining the rights and best interests of vulnerable children and their families. [ABSTRACT FROM AUTHOR]

The adoption of children from out-of-home care is uncommon in Australia and rarely occurs in the state of Victoria. This paper reports on how professionals involved in making decisions about the permanent placement of children explain the current rates of adoption from out-of-home care in Victoria. Interviews were conducted with eight child welfare specialists, eight adoption and permanent care specialists and five judicial officers. The current low rates of adoption were attributed to the effect of current legislation, the impact of past adoption practices and the establishment of a culture in Victoria in which adoption is now rarely considered an option for children in out-of-home care. [ABSTRACT FROM AUTHOR]

Internationally, there are few interventions that promote healthy lifestyles in the out-of-home care (OOHC) sector. The aim of this quantitative study was to measure the efficacy of the Healthy Eating, Active Living (HEAL) programme for young people who live in residential OOHC and their carers. Seventy young people and 177 carers were recruited between August 2012 and October 2014 from 48 residential care units across metropolitan Melbourne and regional Victoria, Australia. The HEAL programme included educational sessions for young people, and professional development for carers to foster healthy eating and physical activity. Young people and carers completed questionnaires measuring behavioural, psychosocial and motivational outcomes. Objective measures of height and weight were collected for young people and self-reported by carers. The findings revealed no evidence for the efficacy of the HEAL intervention for either young people or carers. The most likely explanation for the null result was difficulties associated with: (1) collecting quantitative data for evaluative purposes in vulnerable populations (particularly the impact of attrition on statistical power); and (2) implementing interventions in complex environments. We conclude with a summary of lessons learnt and recommendations for future research in this unique setting. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages There are a number of challenges inherent to collecting longitudinal data and/or employing a randomised trial design in this setting. Researchers working in this area need to acknowledge the critical need for this type of research but also consider alternative approaches to data collection., It is integral that organisational practices and/or policies are in place so that a HEAL philosophy is embedded in the residential OOHC culture; in other words, HEAL becomes a part of each organisation's values, goals and shared expectations. [ABSTRACT FROM AUTHOR]

Indigenous children and young people are over-represented at all stages of the Australian child protection system. Policy and legislative initiatives exist in the state of Victoria, Australia aiming to support the connection between Indigenous children and young people in state care and their culture and community. This exploratory research involved focus group consultations with seven child and family welfare agencies to investigate the impacts, barriers, benefits and limitations of cultural support planning for Indigenous young people in, and leaving care in, Victoria. Findings indicated that cultural planning was of value when it could be completed. However, various shortcomings of current systems were identified including limited resourcing of Aboriginal Community Controlled Organisations to generate plans and provide direct and secondary consultation services to implement plans, difficulty gathering information for plans and some Indigenous young people expressing disinterest in connecting to their culture and community. Complexities in the relationships between the Indigenous and non-Indigenous agencies that aimed to support Indigenous young people in care were also acknowledged. Participants identified a number of strategies to improve outcomes, such as facilitating better relationships between agencies, promoting opportunities for ongoing cultural training for staff in mainstream agencies and improving the resourcing of Aboriginal Community Controlled Organisations to deliver planning and to support cultural connections. [ABSTRACT FROM AUTHOR]

Many care leavers with disabilities face difficulties as they transition from out-of-home care (OoHC), and suffer multiple, ongoing forms of disadvantage after they leave care. This paper is drawn from a study comprising six focus groups, involving 21 participants employed in disability and OoHC services in Victoria, Australia. The findings suggest that care leavers with disabilities do not receive the transitional and postcare support and housing they need. Many are transitioned into housing options that are unsuitable for their needs, or unsafe. The argument of this paper is that care leavers with disabilities may benefit from adult guardianship legislation. When appropriate an application for a guardianship order should be made prior to the young person exiting care, to enable a smooth transition between the child and adult systems. Adult protection services with an advocacy function should be given the opportunity to advocate for care leavers with disabilities. [ABSTRACT FROM PUBLISHER]

Senate Inquiries into the lives of people who grew up in care, highly critical Ombudsman reports, and advocacy groups for recent and past “care leavers” draw attention to the significance of the records for children growing up in out-of-home care. This article reports on a project in which an interdisciplinary team of social workers, archivists, and historians worked together with 12 community-sector (nongovernment) organisations to look at the question of how to improve the management of the records for people with experience of out-of-home care. A Self Assessment Tool was developed and deployed at two points in time to provide feedback to organisations about the quality of their record-keeping practices. Clear improvements could be documented over a 2-year period in all 12 of the organisations involved. [ABSTRACT FROM PUBLISHER]

In Australia, there is no binding protocol that proscribes the processes by which the release of personal records of adults who grew up in care occurs. Individual agencies that hold the records - both government and non-government organizations - have their own policy and practice guidelines. While not specific to care-leavers, the existence of freedom of information and privacy legislation means that the subject of the records is entitled to access information about themselves, but this is not unproblematic. Drawing on qualitative in-depth interviews with a group of Australian care-leavers, this paper discusses their experiences of accessing personal records. Accessing these records was often highly significant to identity formation, but could produce both positive and negative effects. The negative aspects of the records were that, typically, at least in part, they were incomplete, insulting, incorrect and/or incomprehensible. Currently, the range of support provided to those accessing their records varies significantly across agencies. The findings of this research suggest the need for the greater provision of supported release and the implications for social work practice are discussed. [ABSTRACT FROM AUTHOR]

A significant proportion of young people leaving out-of-home care make their transition to independence via the youth justice system, exposing them to further risks and reducing their likelihood of full social and economic engagement in mainstream society. This article presents the initial findings of a research project based on a partnership between Monash University and seven nongovernment child and youth welfare agencies in Victoria, Australia. Seventy-seven key stakeholders participated in interviews and focus groups with a view to identifying practices and policies that could reduce the over-representation of young people leaving out-of-home care in the youth justice system. Factors that contributed to offending included varied responses by the child protection and youth justice systems, limited utility of leaving care plans, and the availability of a range of preventative and diversionary programs. The findings point to a need for more formalised interagency collaboration, and intensification of the interventions and supports offered both in custodial settings and post discharge from custody or care. [ABSTRACT FROM AUTHOR]

Abstract: Young people transitioning from out-of-home care are one of the most vulnerable and disadvantaged groups in society. Those with disabilities have particular and complex needs, and face additional barriers compared to other care leavers in terms of accessing assistance. As a result, they are a high risk group for poor outcomes. This qualitative study involved consultations with 19 workers from six key agencies involved in out-of-home care and leaving care practice and policy to examine the current experience of, and support services available, to young people with a disability transitioning from out-of-home care in the Australian State of Victoria. Our findings suggest that care leavers with a disability do not currently receive the transition and post-care supports they need particularly in the area of housing and mental health, and that further holistic support is required until at least the age of 21years. [Copyright &y& Elsevier]

• This is the first Australian health service utilisation data for children in out-of-home care (OOHC). • Very few children attended all recommended services for routine and timely health assessment. • Most children entering OOHC saw a General Practitioner within one year of entering care. • One in three children saw a GP within the recommended one month of entering OOHC. • This study provides benchmarking data for monitoring of future system improvements and research. Children in out-of-home care (OOHC) have high rates of health needs; consequently, many countries (including Australia) have policies and/or statutory requirements for health assessment upon OOHC entry. However, Australia has no data on health service utilisation or timeliness. We aimed to describe timing and extent of health service utilisation by children in the state of Victoria upon entry to OOHC, exploring demographic and specific service exposure variations. Population-based retrospective cohort study. Data from Victoria's Child Protection dataset (2010–2015) were linked to federal (Medicare Billing Schedule (MBS)) and state (Community Health, Mental Health, Community Dental and outpatient clinic) health datasets. Victorian first-time entrants to OOHC (April 2010 – December 2015): 6,201 0 – 12 year old children. Proportion visiting health services within 12 months of entering care; proportion visiting within recommended timeframes. Descriptive statistics, multivariable logistic regression, and Kaplan-Meier survival curves. Pre-post health service use following the limited introduction of health assessment clinics was compared with trends elsewhere in Victoria. 5,676 (92%) children were successfully linked to the MBS dataset. 41 children (<1%) had attended all recommended health services within 12 months of OOHC entry. While most (90%) within the linked cohort visited a General Practitioner, only 37% attended within the recommended 30 days. Around a third visited a paediatrician; fewer than 20% visited a community dentist, optometrist, or audiologist. Children in foster care had higher odds of attending services than those in kinship care. The pre-post trends in health service use in areas where a dedicated assessment clinic commenced were more positive than for areas without the clinic. A minority of Victorian children in OOHC accessed health services according to national or state (Victorian) standards, very few in a timely manner. Children in kinship care were less likely to meet guidelines. [ABSTRACT FROM AUTHOR]

Young people leaving state out-of-home care are arguably one of the most vulnerable and disadvantaged groups in society. Many have been found to experience significant health, social and educational deficits. In recent years, most Australian States and Territories have introduced specialist leaving care and after care programs and supports, but there has been only limited examination of the effectiveness of these programs. This paper examines the experiences of a group of young people involved in the leaving care and after care support program introduced by St. Luke's Anglicare in the Victorian town of Bendigo. Particular attention is drawn to some of the practical needs identified by the young people including re-establishing relationships with family, acquiring a driving licence and/or managing public transport, dealing with legal issues, and coping with the particular challenges of living in rural communities. [ABSTRACT FROM AUTHOR]

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care. [ABSTRACT FROM PUBLISHER]

• Summary: This article reports on a study funded by the Criminology Research Council, Australia, investigating the intersection between the child protection and criminal justice systems and the extent to which children before the Melbourne Children’s Court on child protection matters, during the study period June to December 2006, had a parent currently in prison, awaiting sentencing or previously in prison. This article focuses on what associations there might be between parental imprisonment and its impact on family life and the care of children.• Findings: Magistrates identified 156 children as meeting these criteria during the study period for whom there were concerns about physical and emotional harm, child development, or the parent’s incapacity to provide care for the child; concerns about parental substance abuse, mental health, family violence and transience. The instability in these children’s lives was linked to the parents’ offending and was reflected in the reasons why the children came to the attention of the court, and the child protection concerns expressed about them. Yet, there was no co-ordinated response by the child protection and justice systems to managing these children’s situations.• Application: Early intervention for children affected by parental offending, and the development of child protection service protocols with the corrections system about children when their parents enter prison is essential, to better address the instability and disruption in care these children experience, their vulnerability as adults to mental health and relationship problems, and their reduced education and employment outcomes. [ABSTRACT FROM PUBLISHER]