5 THE GROUNDWORK: LAYING THE PROGRAMME FOUNDATION

5.1 Programme Snapshot

Description

The CPCM programme involves two parallel processes that will need to be put in place for a child to be safe and protected. The two processes are the case management process and the community placement process. Both processes, although somewhat independent, will converge at a point as demonstrated in the diagram on page 17.

5.1.1 The Case Management Process

The case management process endeavours to be a client-centred, goal-oriented process, which assesses the needs of clients for particular services and assists them in obtaining these services. This process continues until a durable solution or case resolution is achieved based on outcomes that are in the best interest of the child, or upon a child turning 18 and ageing out of the programme.

Case referrals may include referrals from government, non-governmental, community based organizations, and UN agencies. Case management services in relation to protection and case resolution may differ based on the immigration status of the child, the specific country context and available resources.

The Case Management Process will include the following:

Referral Process
Screening Process
Rapport Building and Intake Process
Assessment Process
Rapport Building and Care Planning Process
Implementation of Care Plan or Intervention Process
Monitoring and Reassessment Process
Termination and Case Resolution Process

5.1.2 The Community Placement Process

The community placement process works towards finding permanency and stability in terms of a child’s home environment. There are various options for community placement, including foster care placement, kinship care or informal foster care, independent group homes for older UASC, and in certain circumstances, residential care when it is in the best interest of the child. Community placement options for a child must be carefully assessed to ensure it is in the best interest of the child. Community placement options should also meet basic minimum standards of care, and have adequate monitoring and follow up assessments.

Below is a suggested flow chart for the CPCM Programme with a foster care community placement model and case management model. Note that these processes may differ based on the specific circumstances or variables of a child’s situation. The foster care community placement model provides processes that a foster parent will need to go through while the case management model provides processes applied to a child. The following processes will be further explained in the Manual.

5.2 Getting the Right People

5.2.1 Description

A key step in setting up the programme is ensuring that the right people are hired to implement the programme. Depending on the country context and resources, it is recommended that a 1:18 Case Manager to client or case ratio be adopted. It is recommended that there are male and female Case Managers to address the different needs of male and female clients accordingly. It is also recommended that there are no more than five Case Managers per supervisor to manage. Below is a list of recommended key personnel roles and responsibilities, as well as the supervision and reporting frameworks.

5.2.2 Personnel

5.2.2.1 a) The Case Manager

5.2.2.1.0.1 Roles and Responsibilities

The effectiveness of a case management system is very much dependent on its Case Managers. As a Case Manager, he/she will have direct contact with the client and will be expected to empower clients and ensure that their best interests are always upheld. A Case Manager will be expected to conduct all home visits, oversee coordination of services, ensure the protection and promotion of the client’s best interest until a durable solution or case resolution is achieved, complete all relevant reporting mechanisms, and consult the Case Supervisors, and/or other colleagues when necessary.

As clients are children and come from traumatic backgrounds, all Case Managers will be expected to read, comprehend, sign and strictly adhere to the organization’s Child Protection Policy (Annex 1) and Confidentiality Agreement (Annex 2). Contravention of these policies can result in the termination of employment. The working relationship with each child should be a partnership based on mutual respect and trust. As much as possible, the Case Manager will jointly problem solve and work together with the client to develop a care plan to empower and address the needs of the client.

SUKA context: Casework hours To develop recommended casework hours for Case Managers, casework practices were tracked over a 6 month period using a time sheet. Data from the time sheet was then coded and analyzed. A recommended distribution of casework was then developed in line with the maximum number of work hours required by staff per month. A proposed Case Manager to client ratio was also developed based on the work hours.

Casework hours are distributed based on non client contact hours (for example coordination work and other SUKA related work) and individual client contact hours based on the type of case and interventions. It is recommended that Case Managers have 78% of their time allocated to individual client contact hours. Of this 78%, it is recommended that 50% of that time is apportioned to new cases as time is needed to stabilize a case.

Although it is not an exact science, developing recommended casework hours for your Case Managers will ensure more efficient use of time, assist with fair distribution of work, and may prevent staff burnout.

Case management responsibility may entail all or some of the following in any given case:

Establish a positive rapport and working relationship with clients and referral agencies.
Ensure the protection of clients’ privacy and confidentiality at all times. All case notes are to be stored in an appropriate manner.
Provide an environment where the client can feel safe when confronting difficult issues, attitudes and behaviours.
Carry out home visits as required, based on the suggested timeframes and frequencies.
Conduct safety assessment of community placement on each home visit to ensure that the placement continues to be safe and is nurturing for the child.
Complete all relevant intake forms and assessments as required, paying attention to the needs and particular vulnerabilities of the clients.
Work with, guide, facilitate and empower clients to problem solve - identifying strengths and barriers, developing goals and an individualized care plan to reduce non-compliance and ensure the needs of the clients are addressed.
Assist each child and their care providers to make a safety plan in the event of an emergency.
Monitor and document individual progress towards goals within the care plan.
Reassess goals and care plans on a regular basis. Provide monthly reports to the Case Supervisor on this monitoring and reassessment exercise.
Identify community and other resources to meet needs of clients. Utilize mapping database of services that are publicly available.
Refer clients to the appropriate service providers based on their needs and/for follow up assessments as needed.
Coordinate case management with other non-governmental service providers, government and UNHCR or ICRC teams through regular personal contact and the exchange of written information with these agencies.
Participate in regular monthly and/or bi-weekly meetings with other Case Managers and Case Supervisors to discuss issues and to report on progress of clients.
Maintain case files and ensure individual softcopy and hardcopy files are organized, detailed, and up to date with relevant information on the client’s progress.
Provide reports as required to funders and/or any other implementing agency.
Any other responsibility deemed reasonably necessary to carry out the case management process.

In addition to the above, a Case Manager may have additional responsibilities when a child is placed in a foster family. This will include the following:

Conduct regularly scheduled and unscheduled visits to the foster home and check with the child to ensure that the child is safe and that the Minimum Standards of Care prescribed by the Foster Care Agency are met.
Work closely with the foster parents and the child in developing the care plan and putting it into practice.
Encourage the child to develop and maintain a healthy and positive relationship with his or her foster parents and other family members in the household.
Keep the foster parents updated regarding the implementation of the care plan, the child’s status in the foster care programme, progress of case resolution, and any other issues raised during the Case Manager’s contact with the child.
Work with the foster parents when the Case Manager is unable to work directly with the child because of the child’s limited maturity or his/her diminished capacity.
Work with the Foster Parents Support Worker by providing necessary feedback from the child’s perspective in plugging gaps in delivery of care by the foster parents.
Regularly conduct care plan reviews with the child and the foster parents.
Support foster parents during emergencies or whenever the child is ill and requires medical intervention.

5.2.2.1.0.2 Selection

Case Managers must possess the following criteria:

Minimum diploma level qualifications in Social Sciences or its equivalent, or some experience working with children from refugee, asylum seeking, migrant, and/or stateless communities.
Have a basic understanding and able to work with children, particularly children from immigration detention and at-risk children from marginalized communities.
Able to adapt to diverse cultural and social situations or backgrounds.
Experienced or able to work on community placement, case management process and long term follow up.
Able to network, communicate and develop referral processes with clients, other service providers and agencies.
Have a basic understanding of child protection, children’s rights, and child development.
A willingness to adhere to ethical guidelines, child protection policies, and respect confidentiality agreements with the client and partners.
Able to work in a team.
Able to adhere to periodic reporting timelines and home visits, as needed.
Able to cope with challenging behaviours and situations.
Demonstrates a willingness to be proactive and to be self-directed.
Experience in communication and conflict negotiation skills is an added advantage.
Able to speak and write adequately in English.
Have basic computer skills for case management reporting and documentation.
Ability to speak any other languages specific to the population is an added advantage.

5.2.2.2 b) Case Supervisor

5.2.2.2.0.1 Roles and Responsibilities

The Case Supervisor has similar responsibilities as the Case Managers above but with the additional responsibility of supervising and monitoring Case Managers, the client intervention progress, and directly reporting to funders or implementing agencies. More specifically, a Case Supervisor’s responsibility will entail all/some of the following:

Providing supervision for the Case Managers to ensure Case Managers follow acceptable standards, including those prescribed in this Manual, and relevant standard operating procedures prescribed by the organization.
Ensuring that the overall case load for Case Managers is within reasonable limits so that Case Managers are able to meet expected roles in an efficient and effective manner.
Developing the overall direction for the programme to ensure activities are carried out in the best interest of the child.
Monitoring and evaluating the programme to ensure the programme meets the standards prescribed in the Manual.
Problem solving and resolving conflicts, challenges and issues that come up with regards to the cases.
Monitoring of the budget and grant reporting on the programme, where needed.
Reviewing case reports and assessments carried out by the Case Managers.
Coordinating Case Conferences and Case Committee meetings with relevant stakeholders.
Engaging and networking with relevant stakeholders to create opportunities for the Case Managers to coordinate interventions.
Coordinating capacity building for Case Managers and other relevant persons involved in the case, including the foster parents.

5.2.2.3 c) Project Director

5.2.2.3.0.1 Roles and Responsibilities

The Project Director’s responsibilities may entail the following:

Provide supervision of the Case Supervisor to ensure the programme is implemented in an efficient and effective manner, and according to acceptable standards.
Evaluate overall progress of the programme in meeting the objectives and intended impact.
Overall strategic planning and development of the programme, along with organization planning and development.
Problem solving and resolving conflicts, challenges and issues that come up with regards to the programme and staff.
Provide guidance, direction and mentorship for the Case Supervisor.
Participate as a member of the Case Committee and actively engage in the decision making process.

5.2.2.4 d) Case Committee

5.2.2.4.0.1 Roles and Responsibilities

A Case Committee will be established to discuss individual cases via a Case Conference. Decisions will be made in the best interest of the child. Representatives of the Case Committee will include Case Managers, the Case Supervisor, the Project Director, an external consultant or expert, and where possible, relevant representatives from the referring agency. The Case Committee may call the following types of Case Conferences:

Admission Case Conference – to decide on new referred cases for admission into the programme, the suitability of community placement, and other relevant interventions needed.
Case Review Case Conference – to review care plans and progress of existing and transitioning out cases.
Emergency Case Conference – to review a case following an incident and to determine what follow up action is required.

5.2.3 Case Management Supervision and Reporting

Each Case Manager will be assigned to a Case Supervisor and will report directly to the said Case Supervisor who will supervise the Case Manager’s cases. In the absence of the allocated Case Supervisor, or when urgent consultations are needed, the Project Director will assist in managing the process. All reports by Case Managers should be provided to the Case Supervisor, as necessary.

The Case Supervisor will schedule monthly meetings with all Case Managers to debrief and discuss case progress. Individual meetings between an individual Case Manager and the Case Supervisor must also be scheduled once a month, or following a specific incident or emergency situation with a case. The Case Supervisor will, in turn, provide monthly updates to the Project Director.

As a check and balance, Case Managers may use the supervision tool in Annex 3 as a checklist to assess if they are carrying out their functions and responsibilities adequately. The Case Supervisor or Project Director may also use the supervision tool to provide constructive feedback on the work of their Case Managers, and assist them in addressing any gaps or challenges in service provision. Hardcopies of this assessment and feedback, regarded as confidential, will be stored by the relevant administrative staff.

5.2.4 Handover or Case Manager Transition

Before a Case Manager leaves, a transition process will be initiated. All documentation and client folders must be up to date and accurate. A handover document must be prepared and everyone in the team, including the Case Supervisor, must be briefed before a Case Manager’s departure from the organization. To ensure continuity in the Case Manager-client relationship, a new Case Manager will be assigned to the client and will shadow the exiting Case Manager on home and referral visits with the client for at least three months. The Case Manager will also need to clearly brief the client on the change of circumstances.

5.3 Capacity Building

Continuous training is an important aspect for all personnel working on community placement and case management. All relevant personnel should receive training to build key skills and knowledge in one or more of the following areas:

People Skills
Working with children
Interviewing skills
Working with partners and stakeholders
Rapport building
Working with interpreters
Case Work Specific Skills
Understanding case management and essentials of being a Case Manager
Case management standard operating procedures and guidelines
Basic understanding of international refugee law, national immigration laws, UNHCR guidelines and processes, migration related processes, and other refugee issues
Mitigating risks and handling crisis
Time management and planning
Ethics and minimum care standards
Child protection and children’s rights
Child centric decision making
Child development and issues related to UASC
Dealing with trauma
Data collection for monitoring and evaluation
Working with survivors of torture and trauma
Mental health first aid/working with clients at risk of self harm
Case Manager Personal Skills
Self-care
Boundaries and personal safeguards
Being a leader
Working in a team.

5.4 Personnel Self-care: Debriefing and Reflecting on Practice

Self-care is an important aspect of the work. It ensures that personnel are able to manage stressors on the job and have a clear mind to make effective decisions. As Case Managers will be faced with clients who have experienced some form of trauma or exploitation, it is recommended that organizations put in place a self-care and debriefing process to avoid the occurrence of burnout and to be able to effectively manage Case Manager capacity.

It is also important that the Case Supervisor and Project Director are able to identify signs of burnout and the inability to cope among Case Managers. On identification of these signs, strategies to mitigate these problems should be put in place - including changing a Case Manager’s role in the interim, giving opportunities for a break from work for rest or leisure, and getting external mental health assistance, where necessary.

It is recommended that an independent third party facilitate a self-care or debriefing process with individual Case Managers and Case Managers in a group on a bi-monthly basis and/or after a case discussion of a critical incident. Debriefing should also happen during monthly team review meetings with the Case Supervisor and Project Director. The debriefing exercise will provide Case Managers the avenue to share learned experiences, evaluate critical incidents and develop strategies accordingly, and to reflect on emotions, personal development or personal stressors. Suggested debriefing frameworks are provided in Annex 4a and Annex 4b.

5.5 Storage of Information

Case Managers are required to document all interviews, home visits, emails and/or telephone conversations with clients where relevant in the case management process. All information in relevant forms and assessments, including intake reports or assessments, needs assessments, progress reports, referral reports, intervention plans, monitoring and evaluation forms, consent and confidentiality forms, amongst others, should be stored in soft and hard copy formats.

All forms, assessments or reports should have the following information:

Full date
Full case number and status of the case
Name of the report
Case Manager and Case Supervisor’s name

Hard copies of these forms, assessments or reports must be stored in a client folder that is kept in the office at all times in a secured or locked cabinet, and only accessible to authorized individuals. All client folders must be labelled with the case category, year of admission, assigned client number, and the status of the case. Cases may be categorized as per the following:

Open Case (O)– for active clients still within contact and currently accessing services
Inactive Case (IA) – for instances where contact is lost with the client due to some unexplainable circumstances. In these instances, the case may become active once communication or contact is resumed, or closed once the child is no longer in the country or remains untraceable.
Aged-out Case (on a transition plan) (AO) - cases when the child turns 18 and is on a transition plan. Transition cases will be automatically closed six months later, unless otherwise agreed.
Closed Case (C) – upon case termination under specified circumstances, depending on the case at hand, usually upon a durable solution being achieved.

All softcopies of the forms, assessments or reports must contain a header with the case number and the status of the case. All softcopies must be stored securely on a cloud server, accessible only to authorised individuals. All confidential documents must be stored with a password protect known only to the Case Manager and Case Supervisor. Photographs may be stored as softcopies on the cloud server and identifying photos must be password protected. Where there are hardcopies of pictures, these must be stored in the respective client folders.

5.6 Accountability and Continuous Improvement

5.6.1 Monitoring and Evaluation

To ensure accountability, the programme should have in place a monitoring and evaluation framework to ensure goals and outcomes are being met. A suggested internal monitoring and evaluation framework of the programme has been developed. The framework evaluates the programme across case management goals (see Annex 43).

Reporting from the monitoring and evaluation should be provided to funders, board members and other implementing agencies, where necessary. Reporting may be provided in quarterly, half-yearly and/or yearly reports.

5.6.2 Continuous Improvement

It is important that time and effort be invested in continuous improvement of programme procedures and processes. This is done through the periodic review and revision of procedures and forms contained in this Manual, and review of staff performance and any other relevant documentation conducted regularly. Continuous review will ensure procedures and processes are in line with the current needs and the country context.

5.6.3 Complaints Mechanism

In a dynamic environment working with marginalized populations, grievances and the occurrence of misconduct by Case Managers may arise. All staff, volunteers and clients will be able to access a confidential complaints mechanism to raise any allegations or observations of misconduct, violation of child protection polices, or dissatisfaction of services by the organization or its staff.

In general, all allegations, grievances and problems will be treated confidentially. Furthermore, all allegations, grievances and problems will be investigated fairly and without judgment or prejudice to all parties involved.

External grievance process

Complaints by clients, partners or implementing agencies: All clients, partners or implementing agencies must make a formal complaint of any staff misconduct or service provision via a formal complaint form (Annex 5) and can submit this confidentially to the Case Supervisor, Project Director or Administrator of the organization. The complainant may be called for further information during the investigation process. The Case Supervisor or Project Director will undertake investigations impartially and will communicate in writing on the follow up actions within 15 days of receiving the complaint. Requests may be made to change Case Managers or for cessation of services.

Internal grievance process

Internal grievances may arise under two main circumstances:

Interpersonal conflict among Case Managers: It is recommended that for cases of dissatisfaction or interpersonal conflicts between staff, attempts are first made to resolve the problem through informal means and with open communication. When this fails, the staff must make a formal complaint, (using Annex 5) which must be submitted to the Case Supervisor. The Case Supervisor must undertake all relevant investigation, which may include a request for further information from the complainant. All parties will be given the opportunity to refute any allegations. The Case Supervisor must carry out all investigations and respond in writing with a solution or course of action within 15 days of receiving the complaint, unless otherwise stated.

Serious violation of agency policies, ethical standards or misconduct: All staff members must formally report incidents of serious violation of policies and ethical standards to the Project Director as soon as possible (using Annex 5). The Project Director will undertake all relevant investigation, which may include a request for further information from the complainant. Investigations will refer to the agency Child Protection Policy in Annex 1 All parties will be given the opportunity to refute any allegations. The Project Director must carry out all investigations and respond in writing with a solution or course of action within 15 days of receiving the complaint, unless otherwise stated.

Where misconduct by staff is found to be criminal or in serious breach of organization’s policies, an independent investigation should be undertaken by an independent expert, and/or law enforcement agencies, where necessary. All parties will be given reasonable opportunity to challenge any findings from this investigation and will be briefed on any legal and administrative action that will be taken.