Chapter 4 CISP service model
4.4 Support systems
The CISP service model is supported by three elements of program infrastructure: a policy and procedures manual, a referral and screening assessment process, and a client records system (the Platypus Systems Case Management Systems – PSCMS). Each of these systems was developed to support the specific features of the CISP program.
Policy and procedures manual
Work commenced on the CISP Policy and Procedures Manual in early 2007, but the
completed manual was not issued to staff in its final form until late 200813. The manual set out the organisational arrangements for the program, eligibility requirements, case management procedures, professional development arrangements and policies on a range of matters including disclosure of information, records management, duty of care and OH&S.
The manual is regarded highly by staff. Experienced staff members view the manual as a source of detailed information that is relevant to the day to day demands of the work. New staff members report that the information in the manual allows them to understand the duties and procedures involved in their work, and get “up to speed” quickly. This situation is contrasted with that before the manual was available when “we were flying by the seat of our pants” and new staff had to be extensively briefed by existing staff on the procedures involved in the program’s operations. A number of staff members suggested additional material for inclusion in the manual, including advice on court procedures and information about the management of blood-borne viruses.
Assessment process
Two assessment instruments were developed for CISP: a referral assessment with basic details of defendants applying for entry to CISP, and a screening assessment to support decisions about program engagement. The Referral Assessment is typically completed by
the defendant or defendant’s solicitor, and the Screening Assessment is completed by the case manager assigned to do the initial assessment. The Screening Assessment was the subject of a detailed review in the first part of 2008 to determine whether it provides an effective basis on which to assess and classify the risks associated with CISP clients. The review was concerned with the following questions:
How well is the Screening Assessment being completed?
How frequently do the specific risks covered in the Screening Assessment occur? Is the distribution of clients across risk categories appropriate?
Do the risk categories derived from the Screening Assessment align with the CISP program levels of clients?
The review was conducted by selecting 40 cases from each of the three CISP program venues and examining the Screening Assessment forms for each case. These cases were selected on the following criteria:
The client was assigned to Level 2 or Level 3 of CISP, and The assessment was completed after 30 June 2007.
The review found that:
The rate of completed data entry on Screening Assessment forms is high. For most data items, information is recorded on around 95% of forms. There were a few data items where recording rates were significantly lower (including
Indigenous status, whether receiving pharmacotherapy and indicators of ABI and intellectual disability). The definitions and recording instructions associated with these items were subsequently reviewed in consultation with CISP staff.
The specific risks in the Risk Assessment section all target risks that occur frequently in the CISP client population and the distribution of the numbers of risks across clients was appropriate. The sub-score sections of this part of the assessment were not always completed, and the risk classification section is completed in less than half of assessments. Where the risk assessment sections of the form were not completed this was frequently in cases where the case manager recommended or the court determined that the client was unsuitable for CISP.
In cases where the risk classification section was competed, higher risk was strongly related to more intensive program involvement, both as a
recommendation and court outcome. Two risk items were identified as having only a weak relationship with case outcome (problems with family relationships and inability to cope with custody). It was recommended that these items be removed from the form.
Following the 2008 review the Screening Assessment form was revised to improve clarity and align the form more closely with the content and screen structure of the PSCMS. In interview with staff during 2009 there was a generally positive view of the Screening Assessment.
I quite like the assessment as it is – it’s quick and works well in the cells, with people who are distressed or upset. It gives you the basics.
It gets the ball rolling, and then you can see where you should go after that, in a more relaxed environment, after they’re on the program.
However, program staff also reported that assessment remains a difficult aspect of their work. Around 60% of assessments are conducted while the defendant is in custody and frequently when the defendant is distressed, anxious, suspicious or otherwise unable to provide accurate information. They noted that assessment is frequently done under considerable time pressure associated with the court process, and that this often takes priority over and interferes with other aspects of their work.
Platypus Systems Case Management System
The Platypus Systems Case Management System (PSCMS) is used to manage client records. The PCSMS records clients’ personal details, contacts with CISP, maintains an assessment and referral history, keeps track of court dates, generates reminders for a variety of events and produces a range of statistical reports on program activity. It is supported by a detailed manual, and new staff members are trained in the use of the system.
Staff members’ views about the system are mixed. While most agree that the system provides ready access to client information and greatly assists in case management, there are concerns about the amount of time required to input data into the system.