Text OnlyPrint View

Questions and Answers - Secure Care Facilities and Services

Secure Care Services Updates

The below fact sheet provides stakeholders with a broad summary of key achievements and developments pertaining to the development of the secure care service system. The accompanying Plan depicts the proposed facility's floor plan.

Download:

Secure care consultation feedback

Download:

The consultation paper seeks to provide background information to service providers and interested community members on the development of new secure care and professional support services for young people and adults with high risk behaviours. 

The paper provides information about the commitment for the new services and raises a number of questions about how the services might operate.

The consultation paper feedback period has now closed. The Department would like to thank all organisations and individuals who submitted feedback.

Download: Secure Care Facilities Consultation Summary (Adobe PDF document - 55KB)

Frequently Asked Questions

What is a Secure Care Facility?

A Secure Care Facility provides one option in a range of therapeutic, treatment and accommodation responses for members of our community who from time to time, require additional supports and closely monitored treatments that are provided in an environment that is safe for the client, the staff providing the service, and the broader community.

For as long as they reside in the secure care facility, clients will not be able to leave the premises except with staff as part of their treatment plan.

Who will be living there?

Clients will have been assessed as requiring intensive therapy within a controlled environment to learn activities of daily living (such as cooking, cleaning, taking care of themselves) and to modify high risk behaviours so that they are able to live in a less restrictive environment in the future. While clients are at the facility, it will be their home and normal patterns of daily living will occur.

The design of the building will house the children at one end of the building the adults at the other. The design is intended to ensure that there is no mixing of the child and adult clients together.

Up to 8 children/young people will live at the facility at any given time. They are likely to have experienced significant trauma in their lives. The facility will also support 8 adults, likely to have an intellectual disability, and who are exhibiting high risk behaviour (described below).

Individuals whose behaviour involves a level of unpredictability (ie who are unstable) will be cared for in the assessment and stabilisation units that are part of the overall secure care initiative but are sited in hospitals.

What does High Risk Behaviour mean?

High risk behaviour for clients varies broadly. For some it may be self harm. For some, the behaviour will be a result of their disability, or due to infrequent medications and/or lack of discipline, there may be inappropriate behaviour such as anger exhibited to others.

Clients who require secure care have complex behaviours which may have become more intense over time and require a level of intensive therapy not able to be accessed in their usual homes.  An individual may not always have the cognitive ability to make decisions to protect their own safety. In these circumstances they can place themselves at risk in the community. Placement into a secure care setting reduces the level of imminent harm the client can present to themselves and others, by removing the person from the triggers known to escalate their behaviours. 

The secure care setting is created for the delivery of intensive therapeutic assessment and interventions. The clients require a safe and structured environment in which to learn new skills, and manage their reaction to triggers for their behaviour. A secure care setting eliminates competing demands (e.g. concerns for their accommodation and meals) so they can focus on learning and acquiring new skills in a stable environment.  

Examples:

An example of an adult with an intellectual disability and high risk behaviours is "Sammy" (not his real name).

Sammy is aged 28 years. Sammy was identified as having low cognitive capacity when his family identified that he had trouble learning and was not achieving at school.

As he got older Sammy started having aggressive outbursts and was referred to a paediatrician who prescribed medication to assist with the behaviour. Sammy did not have a mental illness. Sammy's family was no longer able to support him at home and so he was provided with a placement in a community supported accommodation service. Sammy lived with one other person and a behaviour management plan was put in place with the aim of helping Sammy manage his own behaviour.

There were major changes in the supported accommodation service and Sammy's medication was not provided consistently. This really disturbed Sammy and his behaviour became uncontrollable. When Sammy was disturbed he became physically and verbally aggressive to support workers; he was also agitated and irritable. The supported accommodation service was unable to continue to support Sammy in his house.

Sammy would then have greatly benefited from referral into the secure care facility, with intensive and consistent therapy and support from highly trained professionals in the support and management of people with cognitive impairments.

A typical example of a young person entering into secure care is "Zoe" (not her real name):

Zoe is a teenager from a family that has experienced a wide range of personal and social dysfunction. Zoe has witnessed several tragic events in her extended family, including the death of close family members.

Zoe's childhood has been characterised by chaos and trauma. As a young child she did not learn appropriate skills to manage or moderate her emotional responses to the significant events that have occurred in her life. Consequently she has turned to alcohol and sniffing as a coping strategy.  When Zoe drinks or sniffs she places herself in vulnerable positions, which have included engaging in sexual activity with significantly older men taking advantage of her vulnerability. Zoe's capacity to make informed safe decisions is not only hindered by her youth, but also her levels of intoxication. 

Multiple efforts have been made to engage Zoe in services to meet her personal needs. Repeated efforts to stabilise Zoe have been unsuccessful as she often fails to present for appointments and absconds from workers attempting to establish contact with her. Zoe's weight has dropped below a healthy range for a child of her age. She needs to be placed in a safe environment where she can receive urgent medical attention and appropriate treatment. In secure care, Zoe can stabilise both mentally and physically. It is an environment that immediately removes her contact with the things that make her most vulnerable.

Secure care allows professionals to undertake a thorough assessment of her needs and plan for her immediate and long-term interventions, as she can not continue to avoid engagement. Staying in the secure care facility will ensure Zoe has the safest, most constant environment in which she can make successful changes to her behaviours. This will be the pathway to make lasting change in her behaviours which will give her the optimum chance to lead a safer, healthier lifestyle in her adult years.



Will children and adults be cared for separately?

While the child and adult services are physically co-located on the same site, the buildings have been designed to ensure client separation. The buildings have separate accommodation and living areas for children and for adult clients. This is replicated with separate outdoors areas for both groups. The design reflects the intent for the child and adult services to operate independently from one another. Adults and children will not mix together.

Co-location of the child and adult services together is however intended to maximise the use of the various professionals who will be providing therapies, as well as minimise building costs.   

How long might a client stay in the secure care facility?

A client would stay in the facility for as long as they continue to gain therapeutic benefit from the programs and care they are accessing, and while they are learning to integrate back into the community. Some clients will take several months to achieve significant therapeutic benefits, and some disabled adults may require a longer term stay, given the nature of their cognitive disability. The young people in secure care are expected to benefit more quickly from the intensive programs provided and move more quickly back into community or family settings.

How will the residents be 'transitioned' into less restrictive environments?

Residents will be assessed by a multidisciplinary professional team following a period of behavioural compliances and treatment. An example of transitional processes includes connecting with family members in their own home or on an outing e.g. a shopping trip to reward appropriate behaviour. Staff would accompany the resident at all outings.

Transition into a less restrictive environment also could be connecting with other residents in a group home within a community that may be suitable for the particular client.