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Issues

In Ontario, there are currently no legislated pre-service educational qualifications for residential staff in group care settings (other than in directly operated youth justice secure custody settings) or foster care settings. Residential services (other than youth justice custody services) can hire any person, regardless of educational credentials, who can pass the police record check for the vulnerable sector (only required at time of hire), and who has the capacity to complete a series of mandatory orientation and training requirements.

The orientation period and on-going in-service training of residential staff in group care settings (other than directly operated secure custody settings) are largely unregulated, with the exception of the following mandatory annual or triennial certification requirements:

The quality of staffing, both with respect to pre-service education and in-service training, has been cited consistently by reviews, reports, inquests, and other studies of residential services in Ontario as inadequate. In 2006, the Bay Consulting report noted:

The presence of appropriately trained staff was seen as a key element in service quality and an area where there were inconsistencies across programs and services…. Training was continually mentioned as an area that required attention and upgrading to ensure staff were able to deal with the complex needs of the residents. … Some service providers (including Outside Paid Resources (OPRs) and Transfer Payment Agencies (TPAs) have a role in setting expectations and standards for residential providers in on-going staff training.

The report went on to recommend that MCYS should “clearly define quality requirements to help shape staffing considerations such as competencies and training. This might require financial support, particularly in regard to levels of compensation.” (p.83).

Also in 2006, MCYS released A Shared Responsibility: Ontario’s Policy Framework for Children and youth mental health. The framework identified the strengthening of human resources in children and youth mental health and addictions across service settings as a core priority. Ontario’s comprehensive mental health and addictions strategy, Open Minds, Healthy Minds, released in 2011 as a follow up to A Shared Responsibility, again cited training, and also the “building of attractive career choices and pathways for people who work in mental health and addictions” as important strategic directions.

The Blue Print for Fundamental Change to Ontario’s Child Welfare System, released in 2013 in response to My Real Life Book produced by youth in collaboration with the Provincial Advocate for Children and Youth, repeatedly cites the skills, competencies and related education and training as priorities. The Blueprint outlines the competencies required for caregivers (and other professionals) (p.10), and specifically with respect to residential care, cites the proper training and qualifications of staff as an essential priority (p.18).

The Ontario Centre for Excellence in children and youth mental health (2013) conducted a review of evidence related to best practices in residential care settings, and identified a range of approaches that are supported by research evidence, all of which place great emphasis on staff qualifications and on-going training in complex contexts, including trauma-informed care, developmentally-focused programming, comprehensive and integrated programming, and relationship-based programming. Evidence-informed approaches include Positive Peer Culture, Sanctuary Model, Stop-Gap-Model and Teaching Family Model (pp.7-8).

The Foster Parents Society of Ontario (2015), children and youth mental health Ontario (2016) and major TPAs such as Kinark Child and Family Services (2015), Robert Smart Centre (2015) and Youth Services Bureau (2015) all have emphasized the increasing use of evidence-based practices in residential services, and the significant complexity of the everyday work. As a result, they all have cited staff development, training and education as core priorities.

Research literature and various reports and documents are replete with emphases on the importance of pre­service and in-service professional development. Whenan, Oxlad and Lushington (2009) demonstrated that training caregivers before and during care is one of the most important indicators of a caregiver’s well-being. According to several studies, group care workers must create an intricate balance of moderate control, therapy and community involvement to achieve the best outcomes for child and youth behavioural development. In order to achieve this balance, workers must possess the adequate training and skills as well as supports (Knorth, Zandberg, Harder, & Kendrick, 2008). Gharabaghi (2009) points out that there is enormous variation in training amongst private residential service providers in Ontario, and that much of the training in children and youth mental health and child welfare is not focused on the life-space context of residential care service provision.

While Children and youth mental health Centres and Children’s Aid Societies invest significantly more money in training than do OPRs, much of it is focused on clinical pathologies and system issues rather than skills required to work with the day to day reality and experiences of children and youth in residential care (p.175).

In another study, Gharabaghi (2010) reviewed training events at 130 discreet residential group programs in Children and youth mental health (CMH), Child Welfare and Private Residential Services in Ontario, and found continuous training related to specific disorders or pathologies, as well as safety-related procedures, but very infrequent training opportunities related to therapeutic alliances, team work, residential milieu work and family dynamics and parenting, amongst other themes (p.99).

The Panel raised questions about human resources through the consultation process, and received feedback in this respect from all levels of the residential service system, including young people, front line staff, supervisors and middle management, and executive management. Overwhelmingly there is concern in all sectors about the capacity to attract well qualified staff due to comparative employment conditions in non-residential services such as schools and hospitals, and to retain such staff given limited training and professional development opportunities and ad hoc career mobility processes. Residential group programs in the North and in rural areas in particular are challenged to attract qualified staff.

The Panel heard repeatedly about the inequities in the compensation of residential staff working in directly operated, transfer payment funded and private per diem operated programs. Public sector (children and youth mental health and child welfare) hourly compensation is sometimes as much as three times higher than in the private sector, where such compensation is near, and sometimes at, minimum wage. Benefits are scarce in the private sector, with some service providers not covering sick leave, providing minimum vacation allotments, and no extended health coverage. In many settings front-line residential care positions can be described as precarious employment, generally characterised as poorly paid, insecure, unprotected and with insufficient income to support a household. In the public sector, residential staff members are generally covered for extended health care, receive well above (between three and six weeks) minimum legislated vacation allotments and are covered for sick leave. As one front line residential staff in the near North put it, “if I wanted to make money, I would work at Tim Horton’s”.

Training in residential services appears to vary significantly. Some service providers are very focused on staff development and provide a range of in-house and external training opportunities, often focused on current client profiles. Others, however, cannot afford to pay for training, whereby the cost of training is primarily related to the replacement cost of the staff who are unable to work their shifts while in training. In general, there is a great emphasis on in-house training, with much less external training provided across all sectors. We heard from the management groups of several service providers that evidence-based practices were in place, but then were unable to confirm this with staff groups, who seemed unaware of what such practices might be. In several instances, the representation on human resource development given by management groups did not match the responses of front line staff.

This was also true in the context of supervision. Many front line staff described supervision as infrequent, and when it took place, as not very organized or targeted toward any particular goal. Many supervisors and even senior managers across all sectors were unable to describe a ‘supervision model’, nor were they able to describe the skills or attributes of an effective supervisor. In Child Welfare, Children and youth mental health, and Privately Operated Residential Services, no agency we spoke to identified a well-defined process for promotion to the supervisory level other than frontline experience, and no agency required qualifications for supervisor positions that exceeded those for front line positions. Training for supervisors, across systems, is limited and we did not hear about initiatives to develop or find training related to providing supervision to staff.

Of particular concern to the Panel is what we heard about relief and casual staff as well as one-to-one staff hired under Special Rate Agreements (SRA). These staff are often exempt from the same level of agency-specific qualification required of regular staff, and are almost always excluded from agency training programs, clinical staff meetings, and the supervision process. Even in settings where SRAs are common and several young people are subject to one-to-one workers at the same time, these workers often appear to not be part of any development or oversight regimen of any kind.

In the context of foster care, the Panel heard from foster parents that support provided by most CASs to their foster parents is minimal, and in the case of several CASs, such support is decreasing due to budgetary pressures. Foster parents in private per diem operations had more positive assessments of the supports they receive and also of the responsiveness of their agencies in the context of special circumstances that might arise from time to time. While we heard many compelling stories from foster parents in both public and private organizations that speak to the level of commitment and dedication to young people, we also heard clearly a very high level of frustration on the part of foster parents with respect to their feelings of disempowerment, peripheral roles in decision-making about the young people they care for, and institutional processes and requirements that make it impossible to care for young people in ways that reflect family contexts.

During the Panel’s consultations, foster parents regularly stated that rules for “parenting” are agency-dependent and therefore vary. For example, some foster parents claimed that their foster children were unable to participate in class photos at school and others claimed this was not an issue. In addition, some foster parents were allowed to take their foster children boating or let them drive a golf cart and other foster parents were not permitted to do the same. Foster parents indicated that such rules sometimes come from their agency (either a private per diem operator or a CAS) and sometimes from the Children’s Services Worker from the placing CAS. The inconsistency of rules and regulations across agencies in relation to the responsibilities of foster care parents is of concern to the Panel.

From management groups, we heard that foster parents are aging, and the recruitment of foster parents continues to present major challenges. Eligibility criteria for who can foster, and in particular criteria related to the capacity to provide foster children with their own bedrooms, results in challenges for some cultural communities, in particular Aboriginal communities. This is also the case in regions where real estate costs are very high, and therefore extra bedrooms are scarce.

With respect to training requirements, the Panel heard that while CAS-based foster caregivers must complete the PRIDE training modules, OPR-based foster caregivers are not required to complete this training, and may in fact be denied access to this training if they chose to complete it. While some OPRs provide an alternative, typically in-house developed training schedule, others do not. There is no consistency across OPRs or between OPRs and CASs in terms of the training required of foster parents. In-service training opportunities appear to be more available and better attended in OPR foster care than in CAS foster care.

Compensation for foster caregivers also varies significantly across CASs, amongst OPRs, and between OPRs and CASs. Typically, OPRs provide higher per diem compensation to foster parents than CASs, and furthermore often provide additional funds for foster parents who can then purchase supports as needed, usually with the assistance, and sometimes through the resources, of the home agency.