Screening, identification and triage

Screening, identification and triage involves identifying and prioritising the needs of people accessing The Orange Door.

The Orange Door determines whether:

• the enquiry is about something that The Orange Door can help with (screening)
• there are immediate safety issues, wellbeing issues or risks that need to be addressed, and the priority or urgency of the action required (triage)

The Orange Door uses a consistent process, and practitioners are skilled in identifying family violence and child safety and wellbeing issues. They quickly determine the priority and urgency of people’s risks and needs.

The purpose of screening, identification and triage is to:

• quickly identify whether an emergency response is needed and make sure emergency services are activated or Child Protection is notified
• identify any affected adults and children connected to the initial referral or client to enable early identification of risk and needs
• determine whether The Orange Door is the most appropriate service to work with the person and their family, or whether another service is better placed to support them
• prioritise the response required from The Orange Door or another service
• provide people and families with information, resources and advice
• make sure people and families who are referred to another service are well informed and supported to the extent necessary in making contact
• identify whether there could be underlying issues behind the ‘presenting need’
• seize the opportunity to engage a person or family by making sure first contact is a safe and comfortable experience that encourages people to continue using The Orange Door
• reaffirm that violence is not tolerated

What this looks like within The Orange Door

Screening, identification and triage is the first step undertaken to work out the most appropriate type of response for the person or family accessing The Orange Door.

This function requires that:

• The risks and needs of all people in the family, including children, are considered individually and in the context of their family.
• People have choice and control through the process (unless this is not possible or appropriate).
• Aboriginal people and families can exercise self-determination.
• The Family Violence Multi Agency Risk Assessment and Management (MARAM) framework is applied, including use of the Tools for Risk Assessment and Management (TRAM). The safety and wellbeing of children is also assessed in line with the ‘Best interests case practice model’ (BICPM).
• The capacity and capability of the person, and each person in a family, informs all decisions.
• Barriers to and willingness to engage are considered at each interaction or decision, considering whether failure by The Orange Door/service to engage the person or family increases their level of risk or vulnerability

Screening and identification

Screening and identification determine whether an immediate emergency response is required and/or if The Orange Door can provide the most appropriate service response, by considering:

• Is there an immediate risk to safety for any individual family member?
• Is there or has there been family violence?
• Are there concerns about a child’s safety, wellbeing or development?

In addition, the screening process identifies family members and associated people to the case or referral, with particular emphasis on discovering whether there are any children or young people involved (especially for L17 referrals). Where associated people are identified, the screening questions are applied to them to consider their needs individually.

Clients are redirected to another service where there are no family violence or child safety and wellbeing concerns. This includes:

• adults experiencing issues relating to their health, safety and wellbeing where family violence is not present (for example, people who are homeless or have a mental health issue) or family violence has not directly contributed to the presenting issue or need
• victims of non-familial sexual assault
• victims of other crime

In these instances, The Orange Door supports the person to access the appropriate service response or redirects the referral.

In addition, where there are family violence or child safety and wellbeing concerns, in the following instances, The Orange Door supports the person to access the appropriate service response or redirects the referral:

• where there is an immediate risk to safety which warrants the involvement of emergency services (triple zero - 000)
• where the matter concerns a mandatory report or it is believed that a child has suffered or is suffering significant harm and where a report to Child Protection is required
• where the client is a male victim of family violence; the client is offered the support to contact the Community Operations and Victim Support Agency (COVSA)

In these instances, The Orange Door ensures that the person receives the appropriate response and may continue to provide follow-up or have continued involvement (for example, where The Orange Door provides follow-up support post-emergency, or where they are involved with an associated party, such as a perpetrator of violence towards a male victim).

When screening, The Orange Door practitioners draw on their professional expertise and judgement to consider and explore any possible underlying reasons for the person’s presenting needs. For example, a woman may be seeking housing assistance, but this may be because she has experienced family violence. The Orange Door practitioners undertaking screening and triage are able to identify underlying issues and determine whether The Orange Door is the right service to respond.

Triage

Triage determines the priority and urgency of The Orange Door’s response to the person.

• What is their presenting concern? Why have they come to The Orange Door or been referred for?
• Is the person or family in crisis? (for example, are they facing imminent issues that threaten their ability to manage self-care, access shelter or maintain their safety?)
• What is the level of risk?
• Are there children’s developmental needs that are not being addressed? How urgent are these?
• Are there any upcoming relevant events or activities that impact on the person’s risks or needs? (for example, court attendance)
• Are there additional or intersecting factors that may increase the level of risk and need or increase complexity?
• What services have been previously or are currently involved and what are they providing?
• What is the person’s expectation or awareness of the referral made, or of The Orange Door and how would they prefer this service to be provided?
• Are there any issues or potential barriers to The Orange Door or the service system making effective contact and engaging with the person of family that The Orange Door needs to address? (including any legal orders that could impact the service response).

This information is used to determine the urgency, priority and the next action required. This could include providing information and advice, undertaking further assessment or providing a crisis response.

Information and advice is provided for all cases, but specifically where:

• it fully addresses the presenting concerns and there is no indication of any serious risks or issues
• it supports the capability and capacity of the person to determine and manage their needs and promotes their agency
• a referrer or third party has not confirmed that the person has consented to be referred (where consent is required)
• the person does not wish to take up any further service offering or is unwilling to engage in assessment.

The screening, identification and triage process helps the practitioner determine if:

• The Orange Door can connect them to the appropriate service response, such as in cases where the screening and triage process identifies relatively discrete, immediately apparent needs, or that the person or family is or has been recently connected to an effective service response (in these instances, further assessment is undertaken as part of the service response)
• a targeted intervention, including use of brokerage, would be an appropriate service response at this stage (in these cases, this intervention is provided by The Orange Door, alongside determination of whether further assessment is needed (for example, to assess and plan interventions for other or associated needs)
• further assessment by The Orange Door is needed – this is likely for clients where there is greater complexity or multiple risk factors, higher risk and/or for families where there are a range of risks and needs of each individual to be addressed.

If further assessment is needed, triage indicates:

• whether the assessment and response is needed as a priority (there is an indication the client or family is in crisis, there is a high risk of harm or there are significant issues and complexity)
• any specific skills and knowledge needed to undertake the assessment to support assigning each case to the most appropriate practitioner within The Orange Door.
• Prioritised assessments are expedited (commencing within 24 hours). The mode of assessment (for example, via phone, outreach or at the primary physical premises) is determined based on the preferences and circumstances of the person or family and the optimal mode to achieve effective assessment and planning.

Gathering further information

The Orange Door has a critical role to play in collecting and analysing information from different sources to better understand the risks and needs for an individual or all members of a family.

Information may be gathered through:

• direct enquiries with the individual or affected family members (with consent where appropriate)
• information provided through a referral (L17 or professional referral)
• a history of previous contact with The Orange Door (from the CRM)
• a discussion with another worker or professional (both within and external to The Orange Door)
• a direct request for information from another agency (for example, maternal and child health)
• the CIP.

Information is gathered in line with the requirements of the relevant privacy and information-sharing legislative requirements.

Gathering further information is a critical step to inform prioritisation and to help clarify or verify critical information. This assists with recognising and understanding:

• family violence risk (including assessing for the misidentification of primary aggressor)
• cumulative harm and impacts of risk factors on children’s development
• impacts of previous service involvement and strategies or opportunities to support engagement.

The approach to screening, identification and triage varies slightly depending on the client context and access pathway of each individual case. The likely approaches to screening and triage are outlined below.

People accessing The Orange Door directly

Screening, identification and triage is undertaken by practitioners over the telephone or in person for people who self-refer to The Orange Door. People are provided with information to ensure they have a clear understanding of:

• how to make contact again if circumstances change, if the person does not presently have any needs or risks that warrant involvement from The Orange Door
• the process and next steps, including whether a practitioner gathers information from other sources (with the person’s consent where required), whether there is a further assessment undertaken by The Orange Door or a core service and when this takes place, as well as information about what to do if a crisis situation emerges or the person or family’s needs or risk changes
• how their information is collected, stored, used and shared.

Where screening identifies the need for an assessment or further service response, practitioners undertake supplementary information gathering to inform prioritisation. This may involve consulting with other members of The Orange Door team, including practice leaders, to inform and update the initial screening and prioritisation.

People referred to The Orange Door

The Orange Door practitioners screen and triage referrals received. This involves checking existing information sources, details provided by the referrer and confirming whether the person is aware of the referral and has consented to it (as appropriate).

Where a referral is received and there is insufficient information, contact is made with the referrer to obtain or clarify information.

The Orange Door considers who may be best placed to make initial contact with the person. In many cases this is The Orange Door practitioner; however, there may be instances where another agency or service makes initial contact with the person. This may be because:

• the service or professional has a pre-existing relationship with the person
• the screening and triage process identifies that a specific service or professional is likely to provide the service response, and rapport is facilitated by that service making initial contact

Initial contact with the person referred is a prioritised activity, and multiple attempts are made to contact people who are referred, using a range of methods including telephone, text message, in writing and in person. At screening, identification and triage, The Orange Door practitioners determine which method is safe and effective for engagement. This may be informed by previous contact with services or professionals.

Cohorts

A range of people contact The Orange Door, including people who need help for themselves and their family, professionals who have concerns for people they are working with, or people seeking advice on how to help their friends, family members, colleagues or members of their community.

Screening and triage is provided for all people who are referred to or contact The Orange Door.

• The Orange Door provides screening, identification and triage in relation to all forms of family violence as defined in the Family Violence Protection Act (2008).
• The Orange Door provides screening, identification and triage in relation to all child safety and wellbeing concerns in accordance with the Children, Youth and Families Act (2005).

Screening determines which contacts or referrals to The Orange Door receive a further assessment or response – that is, those people who become ‘clients’ of The Orange Door and which ones are redirected to another service or are only provided with information and advice.

Workforce

The Orange Door practitioners undertake screening, identification and triage for all people who come to The Orange Door (directly or are referred). Practitioners have the necessary skills and capabilities to undertake screening and triage.

Practitioners have a well-developed understanding of family violence risk assessment, child safety, wellbeing and developmental needs and perpetrator dangerousness. They are also highly skilled, capable of building rapport with clients and able to make quick decisions relating to prioritisation.

Practice tools, frameworks and guidelines

The Orange Door applies the Family Violence Multi-Agency Risk Assessment and Management (MARAM) Framework.

The Orange Door also applies the BICPM in relation to children, young people and families.

When working with clients, practitioners use a strengths-based practice approach that focuses on what’s working well for an individual or family, as well as identifying risks, issues or difficulties.

Timing and duration

Screening and triage is the highest priority function within The Orange Door. This ensures that high-risk cases do not go unnoticed, and provides The Orange Door team visibility of the relative priority for cases so resources can be planned and shifted to respond.

The time taken for screening and triage ranges from just a few minutes to several hours.

Screening and triage are delivered on the same day the referral is received. For direct contacts, this begins immediately.