Reading G

Reviewing is a component of case management that is integrated throughout the process. It is about monitoring and checking that everything is on track with the case plan and that the current support is still relevant. It also ensures the client understands the process and is developing their capacity to help themselves. Further still, reviewing is about the caseworker reflecting on their practice.

Reviewing involves ensuring that there are formal processes in place to check and celebrate progress in the case plan. It evaluates if the organisation is operating effectively and efficiently to meet the needs of the target group. Reviewing or monitoring therefore involves a combination of formal and informal processes to ensure the ongoing provision of high quality and relevant services to clients.

When to Review

Reviewing should occur at regular points throughout the support period. It should happen between caseworker and client; caseworker to caseworker; manager to caseworker; and organisation to funding provider (for service review). Each will have a different purpose and consider different factors.

Reviews need to happen informally and formally. They are completed using individual feedback and data analysis. For example, a caseworker and client will need to review the progress against a case plan but a funding provider will want to review service outputs and how funds were spent to achieve agreed outcomes. Formal case management reviews should ideally occur at least every three months and annually for all clients, in terms of service outputs in relation to effectiveness. This may include reviewing the number of clients:

• Who got what they needed from the service
• Successfully transitioned into long-term housing
• Satisfied with the level of case management support

A review will also be needed when a client’s circumstances change and or when new issues emerge.

Strengths-Based Rather Than Deficit-Based

A strengths-based approach to reviewing requires caseworkers to keep a focus on achievement and skills development rather than failure. Even if a client makes little progress, there may be evidence of increased insight and new lessons learnt about life, that they can now use in the next phase of support.

Reviews are an opportunity to point out success and identify the skills that were used or developed. Most clients will be used to being told about their problems and failures. This contributes to a lack of motivation and feeling overwhelmed by these issues. A strengths-based approach, in contrast, helps motivate clients by reinforcing their abilities and developing their self-belief. It also sends clear messages of hope.

The strengths-based assessment tool in Appendix 12 may help when reviewing a client’s progress and identifying new goals.

Case Review/Case Conference Meetings

A case review is a meeting to check the client’s progress towards their case plan goals. The recommended guideline for case reviews is that they occur within the first six months of the support period and then ideally at least every three months to ensure everything is on track. In some cases, a review will occur more regularly due to the service type and client needs.

A case review meeting will generally involve all of the key stakeholders. These include:

• Support workers
• Significant family members
• Other professionals such as a school principal or psychiatrist.

Who comes will depend on who is involved in the case plan and can make a valuable contribution to it.

Before inviting anyone to a case review the caseworker must first discuss it with the client. The review is about them and they should have a direct say over who takes part. Those who do not attend the review may provide a comment in writing or over the phone, which can then be raised at the meeting. If there are too many people at the meeting it can be overwhelming for the client and make the process difficult. Therefore try to keep the number of people to a minimum.

It is important to prepare the client for the case review meeting by helping them understand what to expect and how they can contribute. The review is about the client and enables them to get feedback and stay in the loop about who is doing what. It is therefore important to ensure there is a focus on the client’s strengths and that any achievements in the case plan are acknowledged and emphasised rather than the failures.

The caseworker may like to use a self-review tool to help the client consider their progress and any changes that may be needed. A sample client self-reflection form is included as a guide in Appendix 13. The caseworker should use this tool to explore the thoughts and feelings of the client. This process helps the caseworker to start reassessing the client’s needs, so they can update the case plan.

During the Case Review

The lead caseworker will generally chair the meeting and guide those present through the agenda items. It is important that the caseworker ensures the client understands each step of the meeting. The caseworker should also spend time with the client after the meeting to ensure they understood everything and see if they have any questions or comments about the meeting and the discussions.

Caseworkers must also take a role of challenging negative concepts about the client and reinforcing their strengths rather than deficits. In some cases, a caseworker will need to be the voice for their client.

Someone should be nominated to write notes during the meeting. These minutes should be typed up as soon as possible after the meeting and given to each person present, including the client.

Information from the case review meeting should then be used to adjust the case plan. Once it is updated the caseworker should discuss it again with the client and make any changes as needed. Once finalised, a copy must be given to each person who is part of the case plan.

Client Feedback

Client feedback gives important information about what works and what doesn’t work in the casework support and other services your organisation provides. Client feedback, if done well, also empowers clients to have a say in how the organisation delivers support. Client feedback should therefore be used to guide service development and measure effectiveness.

Good client feedback processes show that the organisation is willing to receive feedback and improve services as a result. If not done well, client feedback will be seen as tokenistic and not taken seriously; therefore practice changes cannot occur.

A service can get formal feedback as part of the case review process and at the end of the support period. This can be done using client feedback or client-self reflection forms during the case review process.

Samples of these forms are included in this resource kit. See Appendix 13 for the client self-reflection form and Appendix 14 for the client feedback form.

It is also useful to consider collecting a mix of personal and anonymous feedback. Anonymous feedback can be done at the end of a support period by asking the client to fill out a form without their name and place it in a box that will be collected by the service manager. This helps to get more genuine and honest feedback on service delivery.

Client feedback should be collated and used in quarterly and annual service reports to management and funding providers. This data should also be used in annual planning days to see if a change in service delivery or a new type of service is needed as part of continual quality improvement.

For example, client feedback data may highlight the need for a new partnership to fill a service gap or it may suggest the need to change referral and intake procedures.

Client Complaints

Client complaints may arise during casework and clients may need support when making a complaint. This is an important part of client empowerment. The caseworker should ensure they stay impartial and maintain strict confidentiality. Complaints can also come from external community members or other workers.

Caseworkers must follow their service’s client complaints procedures. They often include the need to record complaints and the actions taken to investigate them. All complaints should be investigated no matter how insignificant they seem to be. Information about complaints involving staff should be kept in a separate confidential file and not placed on the client’s file.

Clients also have a right to get feedback about their complaint. The caseworker or manager should give them a summary of the investigation’s findings without breaching the confidentiality of other informants. A person who is subject to a complaint also has a right to get similar feedback. More information about complaints can be found at:

NSW Ombudsman Office Phone: Telephone 02 9286 1093
If you are outside the Sydney metropolitan area you can call 1800 451 524.
Website: http://www.ombo.nsw.gov.au/.

NSW Commission for Children and Young People
The Commission for Children and Young People reports directly to the NSW Parliament.
Address: Level 2, 407 Elizabeth Street, Surry Hills NSW 2010
Phone: 02 9286 7276
Fax: 02 9286 7267
Email: kids@kids.nsw.gov.au
Website: www.kids.nsw.gov.au.

Reflective Practice

Reflective practice is a key part of case management and essentially what reviewing is all about. It involves taking the time to think critically about and analyse your practice and then adapt and improve casework practice. Without reflective practice caseworkers will become ineffective over time.

A more comprehensive set of reflective factors is shown in the following diagram. It offers some prompts to help caseworkers reflect on their practice and find alternate issues and practice options. This diagram is adapted from this document.

Diagram 7: Reflective Practice

The following is a brief summary of each element in the above diagram:

• View things from a different perspective: Consider things from other people’s points of view (especially the client’s) as a way of trying to identify things you may have missed or different explanations for issues. For example, what appears as oppositional behaviour may actually be a cultural way of responding to authority.
• Think about consequences: Think about how changing practice might affect your work with the client or that of other support workers or colleagues. Will any changes to your practice impact on anyone else?
• Keep an open mind: Avoid assuming that a different way of working will not work and be ready to have a go at changing. Remain open minded and teachable in your work.
• Test ideas: Try out new practices or visit other caseworkers who may do things in different ways. For example, select one client and try doing things a bit differently.
• Ask ‘what if?’: Be confident enough to try out new ideas and think about things in different ways. Encourage innovation in your team. Research current literature on best practice with your client group and try to implement something from it and review the results.
• Synthesise ideas: Be ready to investigate new ideas and then try to adapt them to practices in your workplace. Use team meetings to review new ideas that have been tested or training that someone has attended.
• Identify and resolve problems: Be proactive in making things work and taking a problem-solving approach to any difficulties. Deal with problems directly and creatively rather than avoiding them.
• Question the way that you do things: Are some things done in a certain way simply because that is how they have always been done? Question the way things are done and encourage others to do that also.
• Seek alternatives: Explore and research different ways of working. Attending training is a good way of exploring alternate ways of working. There is no single best way to support SHS clients and always something new to learn. Make time for training.

A self-reflection tool for caseworkers is included in Appendix 15. It is adapted from a reflective-practice guide developed by Human Systems and Outcomes Inc (2001). This tool has a series of questions caseworkers can use to reflect on their casework practice in more detail.

Monitoring Casework Service Delivery

Monitoring involves an ongoing process of checking that things are happening the way they should be. Monitoring is normally the responsibility of a supervisor/manager and involves:

• Checking that records are up to date
• Reviewing client data
• Checking service outputs
• Reviewing client complaints and client feedback
• Checking that policy and procedures are being implemented.

A caseworker must also be involved in monitoring as part of reflective practice and continuous improvement.

Service Evaluations and Continuous Quality Improvement

Evaluation is about asking the question ‘Given the nature of the change processes we are evaluating, have we sufficient evaluation strategies in place to convince a reasonable person about the worth of what we are doing?’ Evaluation helps organisations to know whether they are achieving what they set out to do and to work out improvements that can improve the quality of service provided. It involves looking at the four elements in the following diagram:

Diagram 8: Evaluation questions

Casework Evaluation
Effectiveness (Are we making a difference?)	Efficiency (Can we achieve more with less?)	Adequacy (Are we adequately meeting the needs of the client/community?)	Appropriateness (Is what we do appropriate in relation to funding guidelines and organisational mission?

Effective caseworkers are plan driven rather than event driven (i.e. proactive). Caseworkers benefit from decisions and actions that are based on facts and data (evidence-based practice). Continual improvement relies on continuous learning and investing in the ongoing improvement of casework service to clients.

Evaluation requires taking time out to reflect on practice and identify personal and professional development goals that can be followed up in supervision.

Samples of some self-evaluation questions for caseworkers are included as a guide in Appendix 12 and Appendix 15. Caseworkers should use these questions to self-evaluate and then discuss them in supervision.