Experiences of Care in Aotearoa 2022/2023

Agency Compliance with the National Care Standards and Related Matters Regulations

EOCR22 23 FullCover

Summary

The National Care Standards (NCS) Regulations came into effect in 2019, and set out the minimum standard of care that must be provided when the state has custody of a child.

We report annually on whether agencies with custody and care responsibilities are complying with the NCS Regulations
(National Care Standards and Related Matters) Regulations 2018 View the full glossary
and whether it is making a difference for tamariki
Children (plural) aged 0-13 yearsView the full glossary
(children) and rangatahi
Young person aged 14 – 21 years of ageView the full glossary
(young people) in care. We do this by looking at what the data shows and what people tell us they are experiencing.

Experiences of Care in Aotearoa
New ZealandView the full glossary
2022/2023 is our third full report on compliance with the NCS Regulations. We found that while some things have improved for tamariki and rangatahi in care, they are still not seeing their social worker often enough, their caregivers continue to need more support and there needs to be better prioritisation across government agencies of tamariki and rangatahi in care.

Oranga Tamariki, Open Home Foundation and Barnardos have custody and care responsibilities. Oranga Tamariki had custody of almost 99 percent of the 6,054 children in care during the 2022/2023 reporting period.

Download the PDF version (PDF 4.99MB)
Download the Tamariki version (PDF 2.38MB)
Read the foreword and key findings in te reo Māori
Read the agency responses
Read the media release

This is our third report on experiences of care, agency compliance with the National Care Standards and Related Matters Regulations (NCS Regulations
(National Care Standards and Related Matters) Regulations 2018 View the full glossary
). We have now visited every region in Aotearoa
New ZealandView the full glossary
New Zealand, and have a comprehensive view of how tamariki
Children (plural) aged 0-13 yearsView the full glossary
(children) and rangatahi
Young person aged 14 – 21 years of ageView the full glossary
(young people) experience care.

Over the last three years, there has been some improvement in Oranga Tamariki compliance with the NCS Regulations. For Open Home Foundation, there has been continued improvement in its compliance and care practice.

Many tamariki and rangatahi we met with told us they feel safe, supported and cared for. They talked positively about having someone in their lives they could turn to. This could be their caregiver, social worker, sibling or parent.

However, overall, the voices of tamariki, rangatahi, caregivers, whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
(extended family) and professionals, as well as Oranga Tamariki data, tell us the NCS Regulations have not been implemented well enough. Not all tamariki and rangatahi are having their basic needs met, including fundamental requirements such as being seen by their social worker, proper support for their caregivers, and access to health, education and other services.

Despite a decrease in the number of tamariki and rangatahi in the custody of Oranga Tamariki, an increased number are being abused or neglected.

Oranga Tamariki kaimahi (staff) told us that they want to support tamariki and rangatahi, but things such as resources, funding and lack of supervision make this a challenge. Good support requires other government agencies to be there, but collaboration and information sharing remain a barrier. Whānau also need support, so that tamariki and rangatahi can return home safely.

Where we hear about good practice, it is often because of the strength of a trusted relationship or because caregivers or kaimahi do what is best for tamariki and rangatahi despite, not because of, the system.

Agencies with custody of tamariki and rangatahi, Oranga Tamariki, Open Home Foundation and Barnardos, have responded to our previous reports, and will respond to this one, stating what they will do to better meet the needs of those in care. For tamariki and rangatahi in the custody of Oranga Tamariki, progress has not been fast enough.

Several commitments have been made, but we are yet to see positive impact.

Tamariki and rangatahi mostly come in to care because they are unsafe and/or are not having their needs met by those who are supposed to care for them. Once tamariki and rangatahi are in care, agencies need to do more. The NCS Regulations were put in place to ensure agencies meet their needs and give them the same opportunities as every other child. They deserve nothing less.

We will continue to look at whether things are improving. We are now returning to communities we visited previously, and looking to see what has changed.

Our heartfelt thanks to those who met with our monitoring teams over the past year. You welcomed us into your communities, homes, and offices, and trusted us to tell your stories in order to improve outcomes for tamariki and rangatahi in care. Our people are dedicated to improving outcomes for tamariki and rangatahi, and their whānau. This report is the result of their mahi
WorkView the full glossary
(work).

Arran Jones
Chief Executive

Nova Banaghan
Chief Monitor

Foreword

Key Findings

What has changed for tamariki and rangatahi in care since the NCS Regulations came into effect?

Our Context

Our Methodology

Gathering data and information

Analysing data and information

Analysing information

Analysing data

Equity analysis

Preparing for publication

Agency self-monitoring

Oranga Tamariki

Independent statistician's review of sampling methodology

Oranga Tamariki surveys

Open Home Foundation and Barnardos and compliance with the NCS Regulations

Open Home Foundation

Barnardos

Outcomes for tamariki and rangatahi

Introduction

Manaakitanga

Summary

What the Oranga Tamariki data tells us

Commitments and changes in response to our 2020/2021 and 2021/2022 reports

Manaakitanga in detail

What the Open Home Foundation data tells us

Key insights from our community visits

Whanaungatanga

Summary

What the Oranga Tamariki data tells us

Commitments and changes in response to our 2020/21 and 2021/22 reports

Whanaungatanga in detail

What the Open Home Foundation data tells us

Key insights from our community visits

Rangatiratanga

Summary

What the Oranga Tamariki data tells us

Transition to adulthood measures

Commitments and changes in response to our 2020/2021 and 2021/2022 reports

Rangatiratanga in detail

What the Open Home Foundation data tells us

Key insights from our community visits

Aroha

Summary

Commitments and changes in response to our 2020/2021 and 2021/2022 reports

Aroha in detail

Allegations of harm and abuse

Social Worker visits with tamariki and rangatahi

Assessing caregivers and the safety needs of tamariki when they come into care

Stability of care

What the Open Home Foundation data tells us:

Kaitiakitanga

Summary

What the Oranga Tamariki data tells

Prevalence of disability

Commitments and changes in response to our 2021/2022 report

Kaitiakitanga in detail

What the Open Home Foundation data tells

Key insights from our community visits

Mātauranga

Summary

What the Oranga Tamariki data tells us

Commitments and changes in response to our 2021/2022 report

Key insights from our community visits

What the Open Home Foundation data tells us

Key insights from our community visits

Barnardos Outcomes

Glossary

Appendices

Appendix One: Agency commitments from 2021/2022 and 2020/2021

Oranga Tamariki

Open Home Foundation

Barnardos

Appendix two: Oranga Tamariki compliance tables

Appendix three: Open Home Foundation compliance tables

The National Care Standards and Related Matters Regulations (NCS Regulations
(National Care Standards and Related Matters) Regulations 2018 View the full glossary
) came into effect in 2019 and set out the minimum standard of care that must be provided when tamariki
Children (plural) aged 0-13 yearsView the full glossary
(children) or rangatahi
Young person aged 14 – 21 years of ageView the full glossary
(young people) are in care. The NCS Regulations were developed by Oranga Tamariki and informed by what tamariki and rangatahi with experience of care said they need – such as supporting them to express their views, keeping them connected to their family and whānau
Whānau refers to people who are biologically linked or share whakapapa. For the Monitor’s monitoring purposes, whānau includes parents, whānau members living with tamariki at the point they have come into care View the full glossary
(extended family), giving them opportunities to participate in their culture and ensuring their health and education needs are met.

The agencies that have custody of tamariki and rangatahi are Oranga Tamariki, Open Home Foundation and Barnardos, and we have been monitoring them for over three years.

We started monitoring compliance with the regulations in 2019, with our first full report covering the period 2020/2021. Over the past three years we have visited tamariki and rangatahi, and those who support them, right across the motu (country).

What has changed for tamariki and rangatahi in care since the NCS Regulations came into effect?

For tamariki and rangatahi in care:
  • ■ most of us have important people in our lives who make us feel loved and cared for

  • ■ we are more likely to have an assessment and a plan in place

  • ■ we are likely to have had fewer moves between homes

  • ■ we are more likely to have contact with close whānau

  • ■ our caregivers are more likely to be visited by a social worker, and plans are more likely to be in place for them.

However:

  • ■ our social workers aren’t seeing us as often as we need

  • ■ findings of abuse and neglect have not reduced

  • ■ our caregivers are still not seeing their social worker as often as agreed and some caregivers need more support. They also aren’t always getting the information they need about us

  • ■ agencies are finding it hard to share information about us

  • ■ we struggle to get education support and mental health services

  • ■ if we have a disability, it’s still not well understood and we’re less likely to have a say in our plan

  • ■ our whānau don’t always feel heard, and a lack of cultural competence means social workers struggle to build relationships with them

  • ■ fewer of us have had an assessment of our life skills as we transition to adulthood. More of us are offered a referral to transition support services but referrals are often made too late for us to build a relationship with the service.

What we found

Three years of reporting has shown that the minimum standards set out in the NCS Regulations are not consistently being met. There has been some improvement in compliance, and we heard about pockets of good practice where agencies worked together to support tamariki and rangatahi. However, we are still hearing from tamariki, rangatahi, whānau and professionals that there is more to be done and crucially, findings of abuse and neglect have increased.

The key findings in this report are similar to those of previous years.

Social workers are not able to see tamariki and rangatahi as often as they need

The frequency of social worker visits was a key finding in our previous reports, and there has been no improvement in this area. Only 61 percent of tamariki and rangatahi are being seen by social workers to the frequency set out in plans, or at least once every eight weeks.

“I haven’t seen my social worker [OT] in ages probably two months at least … in person. I don’t think I’ve ever seen my social worker to be honest … there’s been a few changes.”

“[Social worker name] she’s cool, she does heaps for me. She sorts out my clothes – like when I first came here, I didn’t have time to pack my bag or get my clothes cos they had to fly me straight up. I just had what I was wearing. She sorted out clothes and stuff. I wish I could have filled my drawers you know. She asked if I needed blankets, but we’ve got heaps here so that was fine. If I want to get into boxing, she will organise that. She sorts out school stuff. She just got me a new computer, I’m pretty sure that was her.”

Changes in social worker are common, with tamariki and rangatahi having had on average ten social workers during their time in care. This has increased from nine over the last three years. The majority (61 percent) of tamariki under the age of five have had between two and five social workers. The majority (51 percent) of rangatahi aged 15 and above had have had between ten and twenty social workers during their time in care.

Tamariki and rangatahi are more involved in decisions about them

Oranga Tamariki data shows an improvement in tamariki and rangatahi involvement in plans and decisions, but we’ve also heard from tamariki, rangatahi and whānau that they don’t feel listened to. It is one thing to ask tamariki and rangatahi what they would like to happen, it is another to listen and act upon it.

“They [OT social worker] says it doesn’t matter what I want because I’m the child and they’re the adult. It doesn’t matter because I’m only 14.”

“Not only is she the first social worker that’s listened to [rangatahi]’s wants and needs, she’s also the first to listen to me and acted on it.”

“I have a voice in the plan! You can see it and hear it – I just received the first plan and it was great – I broke down, like is this really happening? I actually have a plan that recognises me. I have built a relationship with her and she is the only one in Oranga Tamariki that has earned my trust.”

Tamariki and rangatahi don’t always know their rights or how to make a complaint. Data from Oranga Tamariki shows low levels of complaints compared to an increasing number of tamariki and rangatahi making complaints directly to the Ombudsman.

Tamariki and rangatahi are less likely to move between homes

When we talked to tamariki and rangatahi about their experiences in care, we heard that changes in placement feel difficult and unfair.

“Make sure you know what you’re doing before bringing a kid to your care, before a kid is brought into so many houses. Make sure you know that. We are kids, we hate to be moved to different people. It’s hard and not fair.”

Three quarters of tamariki and rangatahi have had more than one caregiver, and on average, tamariki and rangatahi will have approximately four caregivers while in care. Positively, Oranga Tamariki data shows that transitions within and out of care are reducing, from 48 percent in 2020/2021 to 25 percent this year.

However, availability of suitable homes, poor information sharing with caregivers and the availability of respite care remain barriers to further improvement.

We often heard from kaimahi (staff) that changes in placement hamper what can be achieved, particularly in education and health services. We also heard that some mental health professionals are reluctant to treat tamariki and rangatahi who are not in stable placements because they believe that mental distress may be caused by their lack of stable care. Conversely, Oranga Tamariki has told us that a lack of mental health services for the caregivers and their tamariki may lead to placement instability.

“It’s like having been wet and miserable all day, but it’s like coming home and there’s a fire there and its warm”. [explanation of life before and after being with a whānau caregiver]

Fewer rangatahi leaving care are being supported

A decreasing number of rangatahi had an assessment of their life skills as part of their move to independence, down to 38 percent this year. This assessment is a requirement of the NCS Regulations.

Transition support services were set up to ensure rangatahi leaving care and custody have the same opportunities in life as any other New Zealander. Oranga Tamariki expected the service would grow as more rangatahi become eligible and are referred to it for support.1

While more rangatahi were offered a referral to transition services (up to 71 percent), we’re hearing that referrals are often too late. Fewer rangatahi had a transition plan developed, down from 54 percent in 2021/2022 to 48 percent this year.

“I think it’s crazy that we spend so much money to build them [rangatahi] up and then just pull it away [when they age out]. [Oranga Tamariki] can’t wait to get them out the door fast enough. They [Oranga Tamariki] are just waiting for them to turn 18… One of the [young people] we were [working with] we were told to just put him on a bus. We asked if we could support him by going with him, but they said he has to get used to it [being independent].”

Caregivers continue to need more support

This year we saw a marked improvement in both recorded visits and plans to provide support to caregivers. Despite the improvement, fewer than half of caregivers are being visited to the frequency in their plans, and caregivers told us they need greater support.

“Trust your caregivers and bring them on board, you’re a team, a unit together, not on different sides. And listen. That would solve a multitude of problems. I almost feel like they’re too scared to do anything, there is a lot of red tape.”

This is consistent with findings from the Oranga Tamariki caregiver survey. The survey showed 45 percent of caregivers are satisfied with the support Oranga Tamariki provided. Forty-seven percent of caregivers felt valued. Open Home Foundation’s caregiver survey showed foster parents had high levels of satisfaction with the support they received from Open Home Foundation.

Collaboration and information sharing between government agencies remains a barrier

Our monitoring over the last three years has shown that government agencies do not always work effectively together to support tamariki and rangatahi in care. Particularly in education and health, individual government agency policy settings can sometimes delay or prevent access to services and supports. A lack of information sharing from Oranga Tamariki means that education and health agencies don’t always know whether tamariki and rangatahi they are engaged with are in care. We've also heard there are differing views among agencies about who funds services and supports. Teacher aide funding is one example that we heard a lot about during the 2022/2023 reporting period.

However, this year we have started to hear positive examples of inter-agency collaboration, including that dedicated liaison roles have made a real difference in bringing agencies together and ensuring that the needs of tamariki and rangatahi are met.

Access to health services continues to be a challenge

There is a lack of clarity about enrolments with primary health organisations, and annual health and dental checks, including when parental/whānau consent is required.

As outlined in our report on access to primary health services and dental care, an annual health check is a requirement of the NCS regulations yet there is no guidance for those caring for tamariki and rangatahi, or for the health professionals who would be carrying out the checks, on what an annual health check should cover.

The number of plans that include needs assessments and identify the support required has improved, but we do not know if that support was provided.

“It is the fight between the services in the background. He has disability, mental health. Instead of all working together, the services want [the other] one to take it, so they don’t work together.”

“In terms of the mental health, I have whānau who have schizophrenia, it is in our family. When we talk about my son, it feels like I am talking about my brother. You can imagine how it feels when the doctor says he is tracking on that. We need the right label so that we get the right help. Because mental health have fallen, poor disability have to pick it up. If they both worked together side by side, we wouldn’t be in this situation.”

For secondary health care, we continue to hear about challenges accessing services. Mental health services are an area of particular concern, given the high prevalence of mental distress experienced by tamariki and rangatahi in the general population2. Despite providing data on the use of Substance and Choices, Kessler and Suicide (SKS) screens and information on the number of tamariki and rangatahi who may have needed these screens in 2020/2021, and a more limited set of data on this in 2021/2022, Oranga Tamariki was unable to provide any data on the level of SKS screening for 2022/2023.

Access to education support continues to be a challenge

There have been improvements in the completion of individual assessments of educational need for tamariki and rangatahi in the care of Oranga Tamariki over the last three years. However, Oranga Tamariki does not have assurance that these needs are being met or that services and supports are being delivered. In particular, Oranga Tamariki is not able to provide data on school attendance.

Tamariki and rangatahi in care often have high or very high educational needs, but we continue to hear about difficulties for this group securing educational placements or accessing educational supports. There is a lack of clarity about who is responsible for funding. There is also a lack of oversight in areas such as school attendance and achievement.

“Whānau found he was six years behind – how did this happen when he’s been in care? Don’t the school try to get kids up to speed?”

“... Just wish I came [into care] earlier and learning needs supported earlier especially at high school. Would have been lot more settled if [it] came three years ago.” 

Oranga Tamariki is starting to improve data collection and monitoring

The NCS Regulations require self-monitoring of compliance. By 2021/2022, Open Home Foundation had implemented systems to provide data on all areas of compliance with the regulations (for all tamariki and rangatahi in its custody) and identify areas for improvement.

Oranga Tamariki has continued to make improvements in self-monitoring and reporting. It has been able to provide additional data this year and has started to develop a self-monitoring framework. However, as we said last year, gaps in that self-monitoring mean that its leadership team are hampered in their ability to understand the quality of care, what areas of practice are working well, and where best to focus effort to ensure Oranga Tamariki is adequately supporting tamariki and rangatahi in its care.

1 https://www.orangatamariki.govt.nz/support-for-families/how-we-support-whanau/from-care-to-adulthood/

2 As reported in the 2021/22 Annual Report on the Child and Youth Wellbeing Strategy, there has been a trend of
sharply increasing rates of youth psychological distress and associated measures over the last decade in Aotearoa
New ZealandView the full glossary

New Zealand and internationally. https://www.childyouthwellbeing.govt.nz/sites/default/files/2023-04/Final-202122-
CYWS-Annual-Report.pdf