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Evaluation of the NT MOS projects

4. Analysis & recommendations

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An evolving service model
NT service sector context
Community engagement
Service focus
Service scope
Staffing
Data management

An evolving service model

The MOS Plus service is a relatively new and evolving service model. It requires time to engage with the sector and with communities, and to adapt and respond to service and community need.

Based on all the evidence considered for this evaluation, it is clear that there is support for the key principles and characteristics of the MOS Plus services, albeit there are some areas requiring further development and improvement. These principles are also supported by research literature, which finds that most clinicians working with children believe that therapeutic counselling needs to be ecologically based (i.e. in the local context) and involve family or carers where possible. It is also noted that O'Brien (2010) and Purdie et al (2010)³⁵ suggest that children and young people can be traumatised if support services are withdrawn suddenly.

Recommendation 1

The MOS Plus service is a new and evolving service model that should continue, to enable further development and refinement responsive to community and service need and the changing primary health and community care environment in the Northern Territory.

NT service sector context

MOS Plus is operating in an environment of change, including: the NT implementation of the "Growing them strong, together: Promoting the Safety and Wellbeing of the Northern Territory's Children" Report³⁶ recommendations; and primary health care reforms, including regionalisation.

The further development of the MOS Plus service should align with service planning and development recommendations of the Growing them strong, together Report, where appropriate. Such recommendations include, but are not limited to:Top of page

• that government and non-government organisations work jointly to develop cross-sector operational guidelines around collaborative practice and information sharing
  
  
• development of a 'dual pathway' process for the referral and assessment of vulnerable children and families
  
  
• enhancement of the child safety and wellbeing roles of other government agencies and personnel
  
  
• that the planning processes around the development of integrated children and family centres in remote areas specifically address the service delivery needs of vulnerable and at-risk children and families and promote collaborative practice amongst government and non-government service providers relating to these target groups
  
  
• that the NT Government seeks the co-operation of the Commonwealth in undertaking a strategic review of the child and family wellbeing services in the NT. The review should inform the development and implementation of a joint strategic plan around service planning and funding in order to overcome fragmentation, inefficiencies and duplication and to target services where they are most needed
  
  
• that the suite of service options should include: intensive maternal and child support; therapeutic services for children, youth and families; substance abuse treatment; parenting skills development; intensive family preservation; targeted family support; and community development and healing (around issues such as sexual abuse, alcohol abuse, neglect, domestic violence and gambling)
  
  
• development of a workforce strategy based on principles that:
  
  
  • involve the employment and continued training of well qualified, culturally aware and competent child safety and protective personnel who can identify risk...as well as being able to utilise community development approaches for early intervention and preventative services
    
    
  • promotes an Aboriginal workforce employment and engagement strategy developed in partnership with Aboriginal advisers and agencies that creates 'on country' employment, education, training and employment development pathways for Aboriginal people working in family support and protective services from volunteer through to post graduate level
    
    
  • is characterised by a strong partnership engagement with the non-government sector in planning and implementation.

Recommendation 2

That further development of the MOS Plus services align with service planning and development in response to both the recommendations of the Growing them stronger, together Report and the primary health care reforms, to ensure an integrated family and children's services response in remote communities.

Community engagement

Cultural competence and respectful engagement in remote communities was considered by all stakeholders interviewed to be of equal or even greater importance than the provision of specialist counselling and support services.

Many outreach and local service providers highlighted the importance of staff not only having appropriate clinical qualifications and specialist skills, but also experience in working with Aboriginal communities, particularly in remote communities. The staffing profile of the MOS Plus service, and appropriate links within community, were considered key factors in ensuring this experience is gained within a culturally safe approach.

The complexity of communities, and the need to understand the local and regional context of each community, was highlighted. Most stakeholders noted that if a service was not culturally safe, there was a risk of doing harm and of negatively impacting upon other services in the local community. The potential to jeopardise the integrity of the roles of local organisations' Aboriginal Liaison Workers, who live and work in community, as well as those of Aboriginal staff in outreach services [such as the MOS Plus ATROs], was raised by many people interviewed in community.

Adding to this complexity is the multiple number of services (many of them outreach services) currently involved in remote communities, as part of the NTER.
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The overarching challenge for a new and outreach service is to leave a 'service imprint' in community, between visits. Currently the MOS Plus service is not well known in community, and there are differing levels of knowledge of the service amongst local service providers.

Concerns were raised by many stakeholders about the feasibility and capacity of the service to go to all NT communities, however the data shows that this service reach has been achievable. There were also mixed views about the appropriateness of an outreach service as opposed to a locally based service.

However, in community the focus was more on service continuity, consistency and regularity. These were highlighted by those interviewed as the key to successful service engagement in community. This was raised both in terms of the NT service provision history of services 'starting and stopping', and that it requires service continuity for people in the sector and in community to gain a knowledge and understanding of the support available.

Regularity of service visits was considered to be one key factor in ensuring this occurred, along with strengthening capacity in communities - supported by a range of practice tools to ameliorate the impacts of changing and transient staffing in services in the NT, both within MOS Plus and in other local organisations.

Enhancing the MOS Plus service imprint could be achieved by:

• making contact with all key local organisations, community groups, meeting places (such as the shop) on each community visit to reinforce the availability of the service and to regularly leave promotional materials such as posters and brochures
  
  
• regular visits to organisations (which also have changing personnel) to provide clarity around referral protocols and to encourage service collaboration
  
  
• exploring opportunities for a service community link/liaison person in community.

(See recommendation 3 and recommendation 4)

There are differing views in relation to an outreach service model, particularly for a counselling and support service in the sensitive area of trauma related to child abuse and neglect.

Literature reviewed, too, revealed mixed views about the 'fly in/fly out' model, because the service it provides is often unreliable (due to difficulties in attracting and retaining workers, the large areas serviced and transport issues, particularly in the wet season).

The literature further suggests that the effectiveness of an outreach model can be increased where service providers work collaboratively, and as a means to improve service provision by establishing multi-entry point approaches both for the service providers into the community, and for the community in being able to access services. This also caused less disruption to communities and enhanced privacy around which services were being accessed, particularly in relation to sensitive issues such as child abuse and neglect.

A number of stakeholders were not supportive of a service outreach model, particularly one delivered centrally across such a high number of communities. The concerns mainly related to the capacity of the service to visit regularly to enable timely, safe therapeutic interventions.

Others acknowledged the 'realities' of the infrastructure in the NT, and of employing and retaining qualified, specialist staff living in community, and spoke of the characteristics of a successful fly in/fly out service model. These included developing a rapport with the community through consistent contact, not just in times of crisis or referral, and gaining an understanding of how the community works in terms of the 'multi layers' of with whom to speak, about what, in community.

Others interviewed spoke of some of the benefits of an 'outside' visiting service in remote communities, which can be so isolated that it is entirely kinship groups, and of enhancing the capacity for confidential referrals for intervention and support by an 'external', objective specialist. The potential for the service to create trusted relationships outside the family group was seen as a way to build resilience and capacity within the child and his/her networks.

Many interviewed spoke of the need for an outreach service to work collaboratively and to be locally supported. This was identified as a means of ensuring a MOS Plus 'service imprint', and building capacity within communities through linking more closely with local Aboriginal community workers, existing services and service developments such as regionally focused primary health care. This was also suggested as a strategy to ensure (regionally appropriate) cultural safety in service engagement and provision.

Such an approach is also supported by the literature reviewed. Santhanam (2005) notes that having an Aboriginal worker as part of the 'fly in/fly out' team [such as the MOS Plus ATRO] was seen as a critical factor for providing a user friendly practice, and helped to engage the community. Further, that the 'fly in/fly out' model works most effectively if it is supported by a locally based Aboriginal support worker (such as an Aboriginal Liaison Worker, as discussed) in the community who can provide appropriate ongoing support to clients, some community development work, as well as providing support to the [MOS Plus] specialist flying in and out. ³⁷

(See recommendation 5 and recommendation 6)

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Recommendation 3

That the MOS Plus service model strengthen culturally safe practices by expanding service links with existing regional and community networks and groups to enhance both knowledge of the MOS Plus suite of services and to build upon established services and strategies.

Recommendation 4

That the MOS Plus service model strengthens its focus on strategic planning and targeting service engagement and intervention responsive to regional, community and service need through the collaborative efforts of the respective Regional Team Manager and the Clinical Practice and Cultural Competence Advisers.

Recommendation 5

That the MOS Plus service model further develops culturally safe engagement approaches and continues as an outreach counselling and support service within community.

Recommendation 6

That a regular, consistent service schedule that is informed by strengthened strategic planning and targeting of the MOS Plus service at the regional and community level, is further developed with each community to maximise opportunities to align with key community and regional events such as Council and network meetings.

Service focus

Most importantly for MOS Plus service development, there is support from outreach and local organisations and community members interviewed, for counselling and support service engagement with children in communities. This was with the stipulation that the child needs to be engaged and supported within the context of the family. The value of group work with children and young people was also a consistent theme.

There are mixed views about the service focus, and the expansion of service scope from MOS to MOS Plus. Concerns were expressed by many stakeholders that the specialist area of child sexual assault counselling would be 'lost' in the expanded service scope. However, the 'initial assessment' data of MOS Projects' casework cases shows sexual assault as by far the most commonly identified underlying cause of trauma for clients referred to the service, over the period of the evaluation. The number of cases citing sexual assault has continued to grow in the period following the service scope expansion to MOS Plus.

From a clinical perspective, recognising the effects of abuse and neglect as occurring along a continuum of the trauma experience was highlighted. The importance of gaining trust in the therapeutic relationship was also highlighted in this context, in terms of potential disclosure of traumas other than the original 'presenting issue', once trust and confidentiality was assured.

As an evolving service, stakeholders (and the literature reviewed) stressed the importance of service continuity to ensure an understanding and acceptance of the MOS Plus suite of services.

As the service develops further, there is the capacity to review the service in more depth, particularly in terms of the effectiveness of counselling interventions with children, adolescents and their families in community in relation to all forms of abuse and neglect, including sexual assault.

The capacity to undertake such a review in the future should be enhanced by the recommended further development of the MOD data management system - in terms of both recording all categories of abuse identified during the counselling intervention (not just the presenting issue at the point of referral) and more expansive descriptors as to the outcomes of casework.

A future review could also assess the effectiveness of the recommendations to further develop links within service networks and in community (such as the creation of 'MOS Plus Community Link' positions), to enhance community and family friendly referral points in community. This would be especially relevant to the sensitive area of child sexual assault.

Reservations were raised by many stakeholders about the use of terminology such as abuse, sexual assault and neglect, as there are differing perspectives and understandings in community of what these terms may mean. Trauma as a concept was more clearly understood and recognised in community.

In community, the feedback indicated a need for a broader support service approach, encompassing trauma from any form of abuse or 'community life' experience. The nature and level of intervention could then be tailored to the child and family's needs, from the suite of MOS Plus services.
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Recommendation 7

That the MOS Plus service focus (inclusive of child sexual assault) is retained, and consideration is given to community-friendly terminology to promote the suite of support services available.

Recommendation 8

That as the MOS Plus service develops further, a review is undertaken to assess the effectiveness of counselling and support interventions with children, adolescents and their families in community in relation to all forms of abuse and neglect, including sexual assault. The scope of the review should be enhanced by further development of the MOD system in terms of both recording all categories of abuse identified during the counselling intervention and more expansive descriptors as to the outcomes of casework.

Service scope

The service is beginning to gain traction in community, with services and new cases increasing over the period of the evaluation. In the time that the MOS Projects have been operating, all communities in the NT have been visited at least once. While the number of communities visited varies on a quarterly basis, each year of the service has seen a net increase in the number of communities visited overall.

Non-case related services account for approximately two-thirds of services delivered, with community meetings comprising over half of total services.

The larger proportion of casework service events occurred in the Top End (57.3%) and approximately one-quarter of casework services events were delivered in Central Australia (20.8%). With the exception of Barkly, which has remained stable, the number of new cases in each Region has increased over the MOS Projects service period, with the most substantial increase in the Top End. This is consistent with the fact that Top End accounts for by far the greatest proportion of Aboriginal and Torres Strait Islander people living in the NT (49.4%), while Barkly accounts for the smallest (8.6%).

The most common referral sources for casework are Child Protection services (21.4%) and SARCs (18.6%). These are followed by health services (15.9%) and schools (15%). This may reflect the initial MOS sexual abuse service focus, and the referral protocols in place with Child Protection services.

Slightly fewer than half MOS Projects' cases were closed as a result of the casework being concluded (41.8%). The next most commonly recorded reason for closing a case was that there had been no activity in the case for three months (21.3%). Overall, the outcomes recorded for closed cases are positive.

The suggested review of elements of the MOD database should enable improvements which better capture data relating to all activities and service outcomes, to better inform service development, resource allocation and efficiency measures.

Staffing

Alongside the importance of service regularity, the relationship established with the outreach staff providing the service was emphasised by those interviewed. Trust established with the MOS Plus service staff, alongside knowledge and understanding of the services they provided, were considered the essential ingredients for a successful service intervention.

There is support by both service organisations and community members for key aspects and principles of the MOS Plus service model, particularly in relation to the staffing model. Maintaining the alignment of Aboriginal and non-Aboriginal staff in the outreach team was considered crucial. Maintaining an appropriate gender mix in the staffing profile was also highlighted to ensure cultural safety in both service engagement and capacity strengthening in community, particularly given the sensitivities of the service focus on child trauma, abuse and neglect.

(See recommendation 9)

The current staffing model profile comprises a central management team providing leadership and professional guidance to outreach teams (see Diagram 1). The current management team comprises: a Project Manager; Principal Clinical Practice Advisor; Information Manager; two Regional Team Managers (RTMs) - Top End/Katherine, and Central Australia/Barkly; two Problem Sexual Behaviour Advisors (PSBs) and administration support. All are based in Darwin with the exception of the Central Australia/Barkly RTM who, with some administration support, is based in Alice Springs.
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Given the diversity, number and geographic spread of communities across the NT, and complexity of service development and provision, an overall Project Manager is required. The role of the Principal Clinical Practice Advisor is also considered essential, given the highly specialist nature of the therapeutic counselling service and of engaging in this professional relationship in remote Aboriginal communities. The evolving nature of both the service and of the database systems, requires an information manager to ensure data appropriately records outputs and outcomes to inform service development and provision, and resource allocation.

The current model also provides for two Problem Sexual Behaviour (PSB) Advisor roles, however recruitment to these positions has not been successful to-date. The MOS Plus management team is exploring strategies to support PSB capacity within the service, including creating short term Territory Internships for post graduate level practitioners from Institutes nationally.

Another strategy may be to recruit broader 'Challenging Behaviour Advisors' in response to stakeholder feedback that the effects of abuse and neglect occur along a continuum of the trauma experience. For example, such advisor roles could provide specialist advice in relation to a range of behaviours including: anxiety and withdrawal; difficulties with emotional regulation; complex family issues; experience of trauma; and sexualised behaviours.

Currently there are two Regional Team Managers (RTMs) - Top End & Katherine; and Central Australia & Barkly. For a range of factors including, but not limited to the: geographic spread of communities; diversity of communities; need for 'local' cultural competence; need for fieldwork supervision and mentoring, and tailored professional development, there is clear requirement to increase the number of RTMs to enable this all to occur effectively.

The roles may still outreach from Darwin and Alice Springs respectively, but would have a clear region and specific communities focus. Co-locating RTMs in Darwin and Alice Springs would also strengthen the ability to work together strategically, in terms of both service planning and development, and service provision management. This would enhance the targeting of specialist staff resources, and increase service and cost efficiencies.

Increasing the number of RTMs would enable the role to both undertake professional fieldwork supervision of staff and to have involvement with local organisations and community leaders at a more strategic and service development level. It would also offer greater support and guidance to outreach staff, enhancing the potential for staff retention and for further development of professional skills and experience.

(See recommendation 10)

A principal advisor role in the critical area of cultural competence could provide leadership, expertise and mentoring for the ATROs in particular, and for all outreach staff. The expanded and defined role of ATROs suggested above could be supported and further developed by a senior Aboriginal or cultural competency advisor role. This would also offer a career path for Aboriginal staff in the MOS Plus service.

(See recommendation 11)

The difficulties of recruitment and retention of staff in the NT is well documented. This impacts upon the location of the regional teams and the complexity of needing to balance employing highly skilled staff in the specialist area of child abuse and neglect, and staff who have experience in working with Indigenous people in remote communities.

The appropriate number of outreach staff would be further informed by the suggested expansion in the leadership and management team. The new and additional roles offer opportunities in terms of: staff retention and professional development; linking in with initiatives underway in community; and tailoring the service response to each community to maximise effectiveness and strengthen capacity in community.

Phasing in the establishment of the recommended additional positions would enable a more strategic, targeted and responsive service with commensurate cost savings and benefits. It is suggested the new management and leadership positions (additional RTMs and the Principal Cultural Competence Advisor) are established first to undertake the strategic planning and networking within regions and communities, and to develop greater clarity around the roles of counsellors and ATROs in the outreach teams. This planning and development work would then flow on to the appropriate establishment of MOS Plus community contact/link positions in each region, area or community level.
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Establishment of these leadership and management, and then community-based, roles should also enhance the targeting of specialist staff resources, and increase service and cost efficiencies.

Further development of the MOS Plus service model focusing on strategic planning and targeting of the suite of services at the respective regional and community level, should enable a more responsive staffing profile in terms of number and location of staff in the outreach team. For example outreach staff may be located and managed in a way which both more effectively targets regional, cross-regional and community needs and maximises staff specialist skills and experiences - potentially requiring fewer total outreach staff. (See Diagram 2)

The staffing profile is sound, and the service has the potential to develop and grow, supported by key people in community. Further developing the service spread and bedding down service regularity is challenging, however there are existing networks which can be engaged with more effectively to support this, and to act as a catalyst for strengthening capacity.

There is also an imperative to engage more effectively with Aboriginal Liaison Workers in the respective local organisations, and with Aboriginal Community Controlled Health Services (where they exist) to ascertain more clearly the strategies and strengths of networks and interventions already in place, and to add specialist value to supporting and strengthening those strategies.

Value was seen in having a network of cultural safety advocates that are community based, as well as relationships with a broad range of local organisations such as Councils, clinics, local government, shops and schools, as not all services have the same level of connection with the community.

In terms of strengthening capacity in community, and enhancing the MOS Plus service imprint, an important element of the ATRO role should be to engage with the Aboriginal Liaison Workers in community and to facilitate the establishment of this relationship with the counsellors.

To strengthen this further, it is suggested the MOS Plus service creates an identified service link with the Aboriginal Liaison Worker from the most appropriate local or regional organisation for each community. Part of this person's role would then become the MOS Plus key point of community contact, between scheduled visits of the outreach team. It is suggested this is a paid function, albeit most likely for a few hours per week or fortnight within the person's substantive role in the community agency. This would strengthen recognition of this function as a designated MOS Plus community-based role and of the rights and responsibilities that come with being a member of the MOS Plus outreach staff team.

This would: promote continuity of service; enhance understanding of the service supports available; provide a community friendly point of referral; strengthen capacity within the existing service networks in community; and encourage community ownership of both the issues contributing to trauma in community - and of the services.

(See recommendation 12)

Ensuring knowledge and understanding of the MOS Plus services in community, requires greater clarity in relation to the distinct roles of the counsellors and the ATROs. Counselling in this service requires significant work to engage with local organisations and the community, and to gain trust, to enable the therapeutic relationship to develop. That is, community engagement is not solely the role of the ATRO.

The role of the ATRO requires greater clarity to reflect the important elements of the role in terms of: the cultural competence of the outreach staff team; cultural safety in all aspects of engagement with community; knowledge and understanding of the local community and the context for community engagement and service intervention approaches; and imparting knowledge and understanding of the MOS Plus services in community. That is, promoting understanding and acceptance in community of the MOS Plus counselling and support services is not solely the role of the Counsellor.

The position may require a different title to more accurately describe this function, in community-friendly terminology such as MOS Plus 'Community Liaison Worker'.

(See recommendation 13)

The ATRO also has an important function in ensuring the MOS Plus service is known and understood in community, and in working together with the counsellor to ensure appropriate service engagement with community. An opportunity for the ATRO role to gain (further) qualifications or accreditation recognising and acknowledging their skill, experience and pivotal role in the service, was raised by a number of stakeholders.

(See recommendation 14)
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Recommendation 9

That efforts are maintained to ensure a mix of Aboriginal and non-Aboriginal staff are retained in the outreach service team, along with an appropriate gender mix, to enhance the cultural safety of service establishment and provision in community.

Recommendation 10

That the Regional Team Manager role is reviewed to enhance the focus on: strategic regional service networking, planning and development; and professional development and fieldwork supervision of outreach staff; and that the number of positions is increased.

Recommendation 11

That a Principal Cultural Competence Advisor role is established within the MOS Plus service management and leadership team to enhance culturally safe approaches and provide leadership, expertise and mentoring for all MOS Plus outreach staff in the critical area of cultural competence, strengthen strategic planning and targeting of the service in regions and communities, and to provide a career path for Aboriginal staff.

Recommendation 12

That a MOS Plus community link/contact role is established within the most appropriate existing Aboriginal Liaison Worker position in the respective communities, to both strengthen the MOS Plus service imprint within community and to provide a community and family friendly point of referral.

Recommendation 13

That the role of the ATRO is reviewed to enhance the focus on imparting knowledge, understanding and acceptance of the MOS Plus suite of services in community along with strengthening general community engagement and culturally safe approaches, and that consideration is given to a more community-friendly title for this position to more accurately describe the role.

Recommendation 14

That opportunities are explored to enable ATROs within the MOS Plus service to gain (further) qualifications or accreditation recognising their skill, experience and pivotal role in the service. This should align with the recommendations in the Growing them stronger, together Report in relation to the development of workforce strategy.

Diagram 1: Current staffing model

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Text version of Diagram 1

This diagram illustrates the current staffing model, with all staff either reporting directly to the Project Manager, or in the case of operational outreach staff (counsellors and Aboriginal Therapeutic Resource Officers), through one of two Regional Team Managers. Each Regional Team Manager is responsible for two of the four MOS Plus regions of Top End, Katherine, Barkly and Central Australia. There are a minimum of seven staff positions reporting directly to the Project Manager: the Principal Clinical Practice Advisor; two Problem Sexual Behaviour Advisors; the Information Manager; the two Regional Team Managers and the Administration Support staff.

Diagram 2: Proposed staffing model

Text version of Diagram 2

This diagram illustrates the proposed staffing model, with all staff either reporting directly to the Project Manager, or in the case of operational outreach staff (counsellors and Aboriginal Therapeutic Resource Officers), through one of four Regional Team Managers. Each Regional Team Manager is responsible for one of the four MOS Plus regions of Top End, Katherine, Barkly and Central Australia. There are a minimum of ten staff positions reporting directly to the Project Manager: the Principal Clinical Practice Advisor; the Principal Cultural Competence Advisor; two Challenging Behaviour Advisors; the Information Manager; the four Regional Team Managers and the Administration Support staff.

Data management

The effectiveness of the MOD data base system in capturing outputs and appropriate outcome measures in an evolving and responsive service model, will be critical. It is timely to review elements of the MOD database to ensure that the MOD captures service outputs and outcome measures, in an efficient and accessible way, to inform service development and provision on a Regional and community basis. These include, but are not limited to, the following seven recommendations.

There is currently a lack of data collected for 'community meetings' which currently comprise over 50% of MOS service activities.

(See recommendation 15)

MOD currently only records data instances where a case is opened. This means that activity following up referrals that does not result in a case being opened is not measured.

(See recommendation 16)

Currently information relating to the reason for referral (category of abuse) is recorded at the time of referral, and this information can only be extracted manually from case files. To further inform service development and strategic focus, it would be helpful if all categories of abuse addressed during the therapeutic counselling intervention were recorded.

(See recommendation 17)
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The current descriptive categories for the outcome of closed cases provide limited information about the impacts and outcomes of the service intervention, to inform further development and refinement.

(See recommendation 18)

MOS Plus currently operates under a data collection rule whereby a case is recorded as 'closed' if there has been no activity for 90 days. Discussions with NT MOS Plus staff indicated this is similar to the standard applied in urban areas, and may not be appropriate for remote settings where it may not be possible to access or visit a community for longer periods of time.

(See recommendation 19)

Feedback indicates that the process for completing data collection forms which input into the MOD database are onerous, as each visit with a client requires separate documentation resulting in duplication of the same information such as name, client number, community. For example, if outreach staff have been working with 10 children over 3 days in community, 30 forms are required to be completed.

(See recommendation 20)

The following communities are included in the MOD schedule but do not receive discrete visits from MOS outreach staff due to their very small populations and proximity to other centres: Jabiru Town Camps; Adelaide River Town Camps; Borroloola Town Camps.

(See recommendation 21)

Recommendation 15

That MOD (or any subsequent data collection tool) records the following with regard to community meetings:

• purpose of the meeting (pre-coded response options)
• whether the meeting is formal (pre-arranged) or informal
• with groups or individuals
• number of attendees
• outcome of the meeting (pre-coded response options).

Recommendation 16

That MOD (or any subsequent data collection tool) be revised to capture:

• all referrals to the service
• all referral sources
• the nature of the referral follow up (pre-coded response options. (eg telephone, meeting)
• groups of individuals with whom follow up is conducted
• whether the referral resulted in a case being opened
• the reason for a case not being opened (pre-coded response options).

Recommendation 17

That all categories of 'abuse and neglect' addressed during the casework intervention are recorded, and that this information can be accessed in an efficient way.
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Recommendation 18

That the reasons for closing a case and the outcomes of casework are recorded by more expansive descriptors (pre-coded response options).

Recommendation 19

That the 90 day data rule is reviewed to determine its suitability for remote settings.

Recommendation 20

That the data collection forms are simplified to remove unnecessary duplication.

Recommendation 21

That Jabiru, Adelaide River and Borroloola Town Camps are removed from the MOD Schedule.

Footnotes

³⁵ Appendix D: Literature Review
³⁶ Report of the Board of Inquiry into the Child protection System in the Northern Territory 2010
³⁷ Appendix D: Literature Review

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