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An Action Plan

Introduction

Over the past year, the Ministry of Children and Youth Services (MCYS) has been working with its partners – other ministries, community agencies and other stakeholders – to develop a plan to establish a more integrated system of residential services for children, youth and families. The ministry has made it a priority to build a system that helps:

• Give children the best possible start in life
• Prepare youth to become productive adults
• Make it easier for families to access services appropriate to their child’s needs at all stages of development.

This Action Plan outlines four priority areas for residential services that will lay a strong foundation for long-term improvements that will benefit children, youth and their families:

1. Improving standards
2. Improving training and tools for licensing staff
3. Improving access to information on residential services
4. Supporting greater accountability for agencies and organizations serving children and youth.

This Action Plan is based on valuable input received over the past year from a wide range of stakeholders including providers, families, front-line agencies, staff and children and youth.

A review of the current state of residential services was completed in April 2006. The review identified a number of issues, including: unaligned accountabilities, regional inconsistencies, limitations of information and monitoring systems, lack of credible information to assist families and placing agencies, out-of-region placements, under-funding, and low occupancies in some services while wait lists exist. The 2006 Auditor General’s report on Child Welfare reinforced the findings of the residential services review and the Action Plan is consistent with the Auditor’s recommendations in this area.

The review included: focus groups with external stakeholders, including three focus groups with youth; field visits in a number of communities across the province; as well as a scan of the literature and selected jurisdictions.
An External Reference Committee comprised of representatives from placing agencies, residential service providers, child and youth mental health agencies, families, child and youth counsellors, developmental services agencies and youth justice service providers, provided input at various stages of the review. The participation and commitment of stakeholders and other key partners has been invaluable in the identification of priorities and will continue to be needed as the ministry seeks to achieve its long range goals for residential services. MCYS will continue to be sensitive to the significant challenges faced by Aboriginal children and youth and the unique history of Aboriginal peoples with respect to residential services.

The Ministry of Children and Youth Services’ Action Plan is a starting point for system change. This plan lays a solid foundation for the ministry’s long-term goal of helping to establish a quality, integrated residential service system for children, youth and families. We will focus first on two key directions – increasing consistency and improving transparency. These are stepping stones towards long term quality improvement initiatives that will ultimately provide more measurable benefits for Ontario’s children and youth who need residential services. Our work will be guided by the following child and youth focused objectives:

Residential settings that are

• Safe, secure and provide quality care and accommodations
• Matched to the needs of the child
• Provided as close to home and community as possible
• Supportive of greater stability in the lives of children and youth.

1. Improving Standards

   Consistent, transparent standards that clearly address both basic requirements and quality expectations will help serve the best interests of children and youth. To increase accountability, transparency, quality and consistency, the ministry will review and enhance existing standards and policies. Residential homes and facilities will be provided with clear direction on areas such as:

   Sensitivity to Diverse Needs of Children and Youth

   • Emphasizing and reinforcing personal choice and dignity
   • Revisiting existing provisions related to ethnic, religious and cultural identity and the means for communicating with children and youth
   • Supporting the development of more comprehensive and child-centred plans of care that are consistent between agencies serving the child, particularly with respect to family, medical and psychiatric involvement.

   Quality, Safety and Security of Residents

   • Promoting quality, safety and security of residents by looking at residential staff training and orientation in areas such as physical safety, medication management and accountability between multiple agencies serving the same child or youth
   • Clarifying the range and nature of conditions that can be attached to licences and the compliance and enforcement measures that may be taken to meet licensing requirements and standards
   • Establishing an independent panel of experts to examine issues around the administration of psychotropic medication and associated standards of care in all licensed residential settings serving children and youth.

   Residential services take many shapes and forms

   Some children are placed in foster care homes – home-like settings in which they are cared for by a foster parent or parents. Others are cared for by staff and live in group homes. In general, these are larger homes which can accommodate three or more unrelated children or youth. The largest proportion of children and youth in foster care or group homes have been placed there through Children’s Aid Societies (CASs) because of child protection concerns. Some come into these residential settings through other agencies or avenues such as mental health agencies. Some residential services offer specialized treatments and therapeutic programs; others provide care, support and safety to children and youth at risk. Youth in conflict with the law may be placed in custody or detention facilities, with differing levels of security depending on the direction of the courts. All of the above are subject to licensing in accordance with the Child and Family Services Act and accompanying regulations, which set out requirements to be met for operating a children’s residence or foster home.

   Living Environments

   • Emphasizing that residential settings are homes, and places for children and youth to grow and learn
   • Providing further direction on areas such as: furnishings, equipment, nutrition and privacy matters, so that the settings are as appropriate as possible for the needs of the children and youth living there.

   Support for Transitions

   • Examining ways to provide for smoother transitions when children or youth are required to move – either to another residential setting, back into the community or to a more independent living situation
   • Looking at strategies to support youth who remain in a residential setting upon reaching adulthood and how to maintain sufficient capacity for children requiring residential care.

   A phased approach will be taken, one that will begin by addressing what can be done within the current legislative and regulatory context. In the longer term, the ministry will look at further evidencebased measures that could be put in place to support and promote quality care.

   Next Steps

   The review of standards is targeted for completion in early 2007. The results of the review will provide a foundation for improved standards in residential settings provincewide.

2. Improving Training and Tools for Licensing Staff

   Ontario’s licensing staff are the people who license children’s residences and residential operators. It is the responsibility of licensing staff to assess whether basic care and safety requirements, set out in legislation, regulations and policies, are being met and to take action when these requirements are not being met.

   The ministry will provide additional supports to these key staff through the development of necessary tools, training and instruments so that the enhanced licensing and decision-making process is as consistent and transparent as possible across Ontario. The goal is to have a common understanding and set clear expectations through:

   • Ongoing orientation and training on revised and refreshed standards, policies and guidelines as they are developed
   • Specific, provincewide direction on enforcement, accountability and reporting requirements
   • An enhanced toolkit, including updated check lists for decision-making
   • Clarification of roles, responsibilities and expectations for service providers, ministry staff and placing agencies, including sanctions for non-compliance.
   
   Next Steps

   The enhanced training of licensing staff will be an ongoing process so that licensing staff are provided with up-to-date information on improved standards and processes. The first phase of this training is scheduled for early 2007. The ministry will also implement an automated licensing tool that will support greater consistency in the licensing process. This will also be implemented in early 2007.

3. Improving Access to Information on Residential Services

   The ministry is working to develop a public website that will be designed to provide agencies, families and ministry staff with a single, integrated database of reliable information. The site will start by providing basic information and will incorporate additional data as permitted. The ministry will provide one-stop access to information about specific residential programs, such as:

   • Location/Area
   • Number of licensed beds
   • Date of last inspection
   • Licensed status and terms and conditions
     (if any)
   • Rates
   • How to contact the service.

   Providing families and placing agencies with better information on available services can contribute to more informed placement decisions. The goal of the public website is to help them assess options to facilitate a better fit between children and their placement. Greater transparency and information on a geographic basis is also intended to support local placements so that fewer children may need to be placed far from their homes and communities. This measure is also aimed at decreasing waiting time for an appropriate placement and the number of moves a child or youth makes while in residential care.

   Next Steps

   The first phase of information will be available online to the public by Spring 2007.

4. Supporting Greater Accountability for Agencies and Organizations Serving Children and Youth

   Following the release of the Auditor General’s 2006 Report, the ministry has introduced a number of changes to support greater accountability in the child welfare sector. These include: a new strengthbased risk assessment model, introduction of a strengthened and standardized process for addressing client complaints, new regulations to strengthen requirements for places of safety and licensing of foster and group homes and implementation of a new regulation that will require children’s aid societies to complete a thorough assessment.

   Next Steps

   As part of strengthening accountability for all residential programs, the ministry will examine how services are funded, including the way per diem rates are set. Public funds must be used efficiently and effectively, and must be directed towards making sure that children and youth receive the services they need.

Conclusion

Residential services are an integral component of the range of services for children and youth at risk, and an important resource for children, youth and families. The high standards of care that we must provide for children and youth require the ongoing commitment of all service providers and ministry partners.

MCYS is committed to working with its partners, families and providers to develop an integrated, consistent, evidence-based approach to residential services – services that emphasize safety, quality and responsiveness, with particular consideration given to the needs of Aboriginal children and youth.

The ministry will continue to streamline principles, objectives and funding to support these priorities. It will continue to build its capacity to report on performance and trends across the sector by addressing information gaps and the limitations of existing data. Relationships will be established between programs within the ministry, between ministries and with external stakeholders to make services as seamless as possible from the perspective of children, youth and their families.

For more information, please contact:

Ministry of Children and Youth Services
Children and Youth at Risk Branch
800 Bay Street, 6th Floor
Toronto, ON M5S 3A9
416-327-4865

Email: residential@ontario.ca