NSW Ombudsman inquiry finds Intensive Therapeutic Care program is not achieving its key objectives

A new report by the NSW Ombudsman has concluded that the state’s Intensive Therapeutic Care (ITC) program for children in Out-of-Home Care (OOHC) with high and complex needs is not operating as intended and is not achieving its key objectives.

The Inquiry into Intensive Therapeutic Care Report has revealed a range of service gaps and systemic issues. Factors undermining the efficiency and effectiveness of the program, and children’s access to needed services, include: inefficient systems and processes, variable participation by children and young people in decisions affecting them, housing insecurity and workforce shortages, and limited placement options. 

“The Department of Communities and Justice (DCJ) set the objectives for this program as being to provide children with stability, safety, and access to therapeutic care” said NSW Ombudsman, Paul Miller. “DCJ’s fourth stated objective is to transition children away from ITC into permanent or less intensive placements.”  

“The evidence we obtained through our Inquiry indicates that these objectives are systemically not being met.”  

DCJ introduced the ITC program in 2018–2019 as a new model of residential care for children in statutory OOHC replacing former models of residential care. The program is intended to provide flexible, individualised supports to children over 12 years with high and complex needs in a home-like environment where family-based placements are not possible or available to them. These services are provided by non-government organisations and funded by DCJ. 

“Our report acknowledges the inherent challenges and rewards of this work, and the impact of issues such as workforce challenges and housing insecurity on providers. We appreciate that some providers gave us information about positive outcomes for particular children.” said Mr Miller. “However, at a system level, the program is not working as it should, and outcomes are not being demonstrated across the four objectives.”   

The key findings of the Ombudsman’s Report showed that: 

• DCJ’s referral processes for children to ITC providers for a placement in ITC are inefficient.  

• Placing children in ITC is hampered by ITC providers often receiving insufficient, outdated or incorrect information. 

• Stability measurements do not include children’s experiences of stability (such as changing schools or caseworkers) and their continuity of relationships when in ITC. 

• Multi-agency agreements and collaborative protocols (across health, education, police, youth justice) do not consistently deliver coordinated or timely services for children in ITC. 

• There is a lack of independent advocacy for children in both initial and subsequent placement decisions in ITC. 

• Current safeguard mechanisms intended to respond to risks to children in residential care do not always trigger timely intervention. For example, in 2023-24, 65% of children in ITC were subject to at least one risk of significant harm (ROSH) report, but only 37% of children reported received a completed assessment from DCJ. 

• The required specialised support services for children in ITC are not always available where and when they are needed. 

• There continues to be significant barriers to educational engagement for children in ITC, including delays in enrolment, behavioural issues, frequent suspensions, lack of trauma-informed responses from schools and a lack of alternative or flexible educational options. 

• Many children are placed in ITC homes that are a long way from their familial and community support networks due to local placement scarcity. 

• While explicitly intended to be a temporary measure focused on securing permanency and promoting ‘step-downs’ through its service continuum, only 5% of all children in ITC ‘stepped down’ in 2023–2024. 

The report makes 12 recommendations that seek to inform, enhance and strengthen future reforms related to therapeutic residential OOHC in NSW. These recommendations were developed with awareness of the DCJ’s plans to release a detailed OOHC Strategy by the end of 2025, in addition to the Department’s advice that an evaluation of ITC will be conducted and completed by June 2027. The NSW Ombudsman also recommended that DCJ implement the Inquiry’s recommendations in consultation with providers, children, families and others with a lived experience of OOHC. 

Read the full report

Read the summary report