Source: https://practice.orangatamariki.govt.nz/our-work/care/caring-for-tamariki-in-care/all-about-me-plan-to-meet-the-needs-of-tamariki-and-rangatahi/
Timestamp: 2020-07-11 21:15:06
Document Index: 614716789

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All About Me plan to meet the needs of tamariki and rangatahi | Practice Centre | Oranga Tamariki
Page URL: https://practice.orangatamariki.govt.nz/our-work/care/caring-for-tamariki-in-care/all-about-me-plan-to-meet-the-needs-of-tamariki-and-rangatahi/
What is the All About Me plan
How to work with the All About Me plan
The All About Me plan is a living tool for developing, sharing and reviewing a support plan to meet the needs identified in the Tuituia assessment and describes how each need will be met. It involves collective decision-making that identifies who will be responsible for meeting the needs of tamariki and rangatahi who are in care and involved with both youth justice and care and protection.
The All About Me plan must reflect the objectives and goals for tamariki and rangatahi agreed in the family group conference or court plan. The All About Me plan supports those goals and objectives and provides the details of how we will achieve these goals and objectives in a more detailed way. It also allows us to focus on all aspects of wellbeing, healing and maintaining connections at all times with tamariki and rangatahi, and their family/whānau and everyone important to them.
While the family group conference and court plan are set at moments in time, the All About Me plan allows us to be actively responsive to the changing needs of tamariki within the court or family group conference review periods.
If there is not an existing court or family group conference plan in place prior to tamariki and rangatahi coming into care the All About Me plan can be started anyway using existing information and assessment information.
National Care Standards — part 1
Staff resource (Digital Workplace): Who the National Care Standards apply to
Staff resource (non-Digital Workplace): Who the National Care Standards apply to
The All About Me plan reflects the requirements relating to mana tamaiti, whakapapa and whanaungatanga through requiring us to develop quality relationships with the significant people in the lives of tamariki and rangatahi. By consulting with everyone important to tamariki and rangatahi each section is completed over time. By maintaining contact with significant people in the life of te tamaiti or rangatahi the social worker can respond to any changes in te tamaiti or rangatahi needs by adjusting the details of the plan while keeping a focus on the overall objectives.
Explanation about where to find the plan on CYRAS and the functionality of the tool is located in the CYRAS guidelines.
The All About Me plan is divided into 3 parts.
This section contains important introductory information for anyone who is going to care for and support te tamaiti or rangatahi. Even if they are going to stay with family/whānau it is important that we have recorded their information correctly and provided a copy to them. This helps strengthen confidence in our ability to work together.
The information is mostly static and doesn’t necessarily change, such as their name, the date they were born, who their birth parents are and gender. However, as relationships develop we may discover that te tamaiti or rangatahi is known by other names, or doesn’t identify as the gender on their birth certificate. Information will change because the needs of tamariki and rangatahi and their caregivers will change over time.
For tamariki or rangatahi Māori it is important to identify their whānau and hapū. Are they registered with their iwi and what is their marae? If this or any other information is not known this forms part of our assessment or subsequent next steps in the working plan (part 3).
Part 1 also includes practical information such as the name of their lawyer or youth advocate, general practitioner, school, any diagnosed disabilities and Māori, iwi or kaupapa Māori services that may be involved with te tamaiti or rangatahi.
Information stored in CYRAS such as person details, legal status and demographics are auto-populated so ensure they are accurate before opening the plan.
Part 2 – Aspirations and how they are going to be met
This section outlines the aspirations te tamaiti or rangatahi has, including those that are held for and about te tamaiti or rangatahi by others. Completing the section requires good engagement with tamariki and rangatahi, their family/whānau and important people. This will take time and skill, and may require support from Māori specialist cultural advisors such as the kairaranga ā-whānau or an experienced Māori or bicultural practitioner. When working with Pacific children or young people, or tamariki or rangatahi from other cultures, it is important to seek appropriate advice from recognised experienced practitioners.
As well as focusing on day-to-day needs it is also important to think about future aspirations for tamariki and rangatahi and how they can best achieve their full potential. By exploring everyone’s hopes, dreams and wishes for te tamaiti or rangatahi we may be able to establish commonalities about future safety, wellbeing and aspirations. Day-to-day challenges may be better managed when everyone is clear about future hopes and dreams.
Even when family/whānau cannot provide care we must still explore how they can strengthen connection and a sense of belonging. What’s recorded can provide a strong engagement platform which everyone who cares about te tamaiti or rangatahi can strive towards. It also helps us to build a shared view of progress being made for te tamaiti or rangatahi over time.
Part 2 is an opportunity for social workers to:
identify the uniqueness and potential of each tamaiti and rangatahi
promote the strengths, hopes, dreams and wishes of te tamaiti or rangatahi
describe where they belong and come from in relation to their whakapapa
record information about how te tamaiti or rangatahi feels about their identity including their gender, sexuality, disability and culture
record the hopes, dreams and wishes for tamariki and rangatahi that are held by their family/whānau and other important people in their life.
Sections of this part of the plan are auto-populated by the Tuituia report.
See and engage with tamariki — guidance
Part 3 – My working plan
This section covers all our responsibilities under the National Care Standards to meet the needs of tamariki and rangatahi and has both static and dynamic information.
Weave information into the different sections that will help caregivers to understand te tamaiti or rangatahi and their story. Build a picture for the caregiver so they can provide the best care possible. Include significant events and history that impacts on the wellbeing of te tamaiti or rangatahi.
This section is important because tamariki and rangatahi will need to be reminded why they aren’t able to currently live with their mum, dad or primary carer. This becomes a reference point for everyone who is involved so tamariki and rangatahi receives consistent messages and support to make sense of their experiences.
Our assessments and in particular our Tuituia assessment helps us to determine who the right people are to bring together to address identified needs. At different times, the social worker will work with different people to support te tamaiti or rangatahi to achieve the outcomes in the plan. What we agree to do will be flexible and adjusted to ensure we are meeting needs as they change.
For example: Deciding how often to visit tamariki and rangatahi will differ depending on circumstance and need. We may determine that when a tamaiti or rangatahi is first placed away from home we will support them to settle by touching base every day for the first week. This will change based on assessment and in consultation with te tamaiti or rangatahi and their caregiver over time. All plans require testing to see if they are achieving their desired outcome.
National Care Standards — part 2: Support to meet needs
The key care and protection or youth justice social worker for te tamaiti or rangatahi is responsible for the All About Me plan.
Tamariki and rangatahi can have more than one worker. Co-workers can include:
residential case worker.
Key and co-social workers can decide who between them takes responsibility to maintain different sections of the All About Me plan. If required, call a consult and be guided by:
the views of te tamaiti or rangatahi and who has the best working relationship with them.
If the social worker for te tamaiti or rangatahi is unable to actively support and maintain the requirements of the All About Me plan then supervision can identify barriers and create solutions.
Allocating a key worker and co-worder
Ideally, completing the details of the plan can best occur after engaging with and getting agreement from tamariki and rangatahi, key family/whānau, professionals and important people, including caregivers. When working with tamariki and rangatahi Māori or someone from a different culture seek appropriate cultural advice and guidance. Successful engagement requires adjusting your practice approach to meet the needs of who you are working with while maintaining safety, wellbeing and a focus on te tamaiti or rangatahi, in the context of their family/whānau, hapū, iwi and/or their community.
1 Open the plan and complete as much information as you can
Initially, complete as much information that is known. Some information from Part 1 will pre-populate from CYRAS. Some information may be handwritten in consultation with te tamaiti or rangatahi. Consider what the caregiver (or manager of a residence/group home) and te tamaiti or rangatahi needs to know and share to ensure the best care possible can occur. Initially there may be gaps in the plan but it will develop over time as assessments are completed and relationships developed. The Tuituia assessment is used to identify what areas need to be focused on in the plan.
2 Engage with te tamaiti or rangatahi straightaway
Key information is to be completed and shared with te tamaiti or rangatahi from the first day they are brought into care. This feedback loop is maintained over time as the plan is developed and things change. This information needs to be shared in a format that they understand. Our explanation needs to match their age and development and allow time for questions and answers.
3 Tamariki All About Me plan
To engage te tamaiti and rangatahi in conversations to gather and share information for their plan, the Tamariki All About Me plan template can be used as an engagement tool.
This will help them understand what their plan means and allows them to actively engage in the process — they have their own copy of their plan and they can refer back to it whenever they want to.
4 Refer and link to any other plans
Tamariki and rangatahi can have a number of different plans that guide our actions and responsibilities. In youth justice and care and protection the family group conference and/or court plans set the goals and objectives. The All About Me working plan will align with the objectives of the family group conference and/or court plans and provide the details of how needs are being met in a day-to-day way. Other plans focus on specific areas, for example, a safety plan, Supervision with Activity Order, High and Complex Need (HCN) plan. These plans can be hyperlinked to the All About Me plan in the appropriate section and therefore become part of the All About Me plan. Because the All About Me plan covers all our responsibilities under the National Care Standards there is an expectation that when we are being guided by a specific plan the All About Me plan is also maintained.
Example of other plans:
Access orders from the Family Court may describe how often a parent will have contact with their tamaiti or rangatahi. Use the All About Me — My working plan section to describe the details of when, where and how the contact will occur.
There may be a safety plan associated with this access order. Use the All About Me plan to link to this information and ensure the right people have access to it.
The expectation is that information is not duplicated but the All About Me plan provides an up-to-date source document. It will record how we are supporting and responding holistically to tamariki and rangatahi in our care. When someone is new to the case, the All About Me plan provides them with an overview of who and what is important and what everyone has agreed to do. This will ensure that we maintain consistency in our intervention as workers and at times caregivers move out the lives of a tamaiti or rangatahi and their family/whānau.
5 Review and update the plan continuously
The All About Me plan is a living document which is intended to enable live-time reviewing and updating as we go. By maintaining involvement with te tamaiti or rangatahi, their caregiver and family/whānau it will become apparent when the plan, or parts of it, needs to be reviewed. Usually, this is because a plan is not addressing a need, a new or different need has arisen, or there has been a change in circumstances, such as in the circumstances of an allegation of abuse regarding te tamaiti. The care standards require us to update the plan so everyone is always clear about who is responsible for what.
For example: A 16-year-old rangatahi decides not to follow their Transition to Independence family group conference plan and leaves school. Together, the social worker, rangatahi and any other important people determine who can support the rangatahi into employment or alternative education. The objective in the family group conference plan was to engage in either education or employment so no family group conference review is required. Appointments are made, a plan is agreed to and the All About Me plan is updated to reflect the new arrangement.
Keeping the All About Me plan current
The policy requires us to do a more formal review of the plan every 6 months. This more formal review can be combined with the review meetings required for court plans or family group conference plans. Given you will be updating the Tuituia assessment for these meetings it is a good opportunity to test that the All About Me plan continues to align with the goals and objectives of court or family group conference plans.
Decisions about a change in these goals and objectives have to be made through the usual and agreed mechanisms of re-convening an FGC or court review.
We know that on the way to achieving these goals and objectives, things change for tamariki and rangatahi and adjustments need to be made in the intervening weeks and months. The plan is updated whenever there is a change in circumstance or additional information is obtained that indicates the plan isn’t meeting the needs of te tamaiti or rangatahi. This can happen through a hui or individual one-on-one meetings or over the phone depending on the scale of the change and the impact on te tamaiti and those caring for them.
A caregiver social worker is told by the caregiver that their adult son and grandchild are moving back home. This is a change in circumstances, and therefore a review of caregiver is required along with a review of the potential impact on te tamaiti or rangatahi. After assessment and in consultation with key people, one section of the All About Me plan is updated and everyone receives the updated agreement – this might include others, such as family/whānau if appropriate.
6 Share the All About Me plan
CYRAS enables the social worker to select different parts of the All About Me plan to print off and give to different audiences.
Sharing with te tamaiti or rangatahi
The plan has to be developed in consultation with tamariki and rangatahi. The Tamariki All About Me plan is more child friendly to ensure tamariki and rangatahi have a copy of their plan that they can understand. Work with the caregiver and/or residential manager to agree where a safe place would be to store this information to protect the privacy of all tamariki and rangatahi in the home or residence. We can give te tamaiti or rangatahi an information pouch to keep this and other information safe.
When developing a relationship with te tamaiti or rangatahi consider exploring ways they can be consulted about who should or shouldn’t have information about them. Listening to and consulting te tamaiti or rangatahi includes ensuring they participate in decision-making. If we decide to go against their wishes we need to record our rationale, how this decision will affect them and how we have explained our decision to them.
For example: A tamaiti doesn’t want the caregiver to know that they have been sexually abused. Assessment indicates that the impact of the abuse is such that the caregiver needs to know so they are able to support and respond appropriately. Utilising good communication skills explain this to te tamaiti in a way that they can understand. Together work out what information is important to share and what information can remain private. Allow te tamaiti the opportunity to share more detail with the caregiver themselves, when they feel ready.
Explanations need to take into account the age and developmental and communication needs of those we are communicating with. Always check in for understanding and offer opportunities to ask and answer questions. This is not a one-off conversation. Follow up, checking in and explaining what is happening is always ongoing.
National Care Standards — part 4
Sharing with caregivers
It’s important to support caregivers by providing them with information that will help them to understand the needs of tamariki and rangatahi and enable them to understand their role and responsibilities in meeting the needs of te tamaiti or rangatahi in their care. This information should be provided to the caregiver before te tamaiti or rangatahi is placed with them. Where there are gaps, missing information needs to be provided to the caregiver as soon as possible, after it is obtained. The allocated social worker and caregiver social worker should work together to this end.
It is important to acknowledge when the caregiver is whānau and the information may already be known — however, to be sure, check this out with the whānau caregiver.
All About Me plan and caregiver support plan
There is a close relationship between the All About Me plan for te tamaiti and the caregiver support plan, which will reflect the development and support to be provided to the caregiver to enable them to meet the particular needs of te tamaiti. The allocated social worker and caregiver social worker should work together to this end. Where te tamaiti is being cared for by a care provider, the responsibilities of the caregiver social worker will be assumed by the care provider.
Sharing with family, whānau, hapū, iwi
Whānau are entitled to receive all relevant information in the plan to support those areas they will being playing a role in. However we also need to balance the right to privacy with the need to share enough information to ensure the plans succeed in addressing needs and to maintain safety and wellbeing for te tamaiti.
For example: a rangatahi may not want their religion or spirituality shared with certain whānau if they feel it will cause disappointment or conflict, especially if they have decided to break away from the religious tradition of the family/whānau.
Other people may only need to receive some of the information that is recorded in the plan.
For example: a professional focused on helping a rangatahi gain employment may not need medical information especially if it doesn’t impact on the capacity of te rangatahi to work.
Sharing the written plan
Not everyone needs to receive all sections of the written plan. It is important to retain the privacy of tamariki and other individuals when sharing information about them and their whānau, hapū and iwi. It is also important to consider any restrictions of information the Family Court or family group conference have agreed to.
When sharing with tamariki/rangatahi use the Tamariki All About Me version. This will allow social workers to explain the details of the plan in a way that meets their developmental needs. If rangatahi do not want this version and prefer the All About Me plan instead provide them with a copy of this.
In some cases it may be appropriate to share the All About Me plan with Children’s Counsel. This should be managed on a case-by-case basis with a focus on what elements of the plan are appropriate to share. Any sharing of the Tamariki All About Me Plan should be done with the knowledge and agreement of te tamaiti.
All About Me plan — template
Word document with the sections and fields from CYRAS