CHCCCS015 Provide Individualised Support Learner Resource

LEARNER RESOURCE

UNIT INTRODUCTION

This resource covers the unit CHCCCS015 - Provide individualised support.

This unit describes the skills and knowledge required to organise, provide and monitor support services within the limits established by an individualised plan. The individualised plan refers to the support or service provision plan developed for the individual accessing the service and may have many different names in different organisations.

This unit applies to workers who provide support under direct or indirect supervision in any community services or health context.

The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

ABOUT THIS RESOURCE

This resource brings together information to develop your knowledge about this unit. The information is designed to reflect the requirements of the unit and uses headings to makes it easier to follow.

Read through this resource to develop your knowledge in preparation for your assessment. You will be required to complete the assessment tools that are included in your program. At the back of the resource are a list of references you may find useful to review.

As a student it is important to extend your learning and to search out text books, internet sites, talk to people at work and read newspaper articles and journals which can provide additional learning material.

Your trainer may include additional information and provide activities. Slide presentations and assessments in classNameto support your learning.

ABOUT ASSESSMENT

Throughout your training we arecommitted to your learning by providing a training and assessment framework that ensures the knowledge gained through training is translated into practical on the job improvements.

You are going to be assessed for:

• Your skills and knowledge using written and observation activities that apply to your workplace.

• Your ability to apply your learning.

• Your ability to recognise common principles and actively use these on the job.

You will receive an overall result of Competent or Not Yet Competent for the assessment of this unit. The assessment is a competency based assessment, which has no pass or fail. You are either competent or not yet competent. Not Yet Competent means that you still are in the process of understanding and acquiring the skills and knowledge required to be marked competent. The assessment process is made up of a number of assessment methods. You are required to achieve a satisfactory result in each of these to be deemed competent overall.

All of your assessment and training is provided as a positive learning tool. Your assessor will guide your learning and provide feedback on your responses to the assessment. For valid and reliable assessment of this unit, a range of assessment methods will be used to assess practical skills and knowledge.

Your assessment may be conducted through a combination of the following methods:

• Written Activity

• Case Study

• Observation

• Questions

• Third Party Report

The assessment tool for this unit should be completed within the specified time period following the delivery of the unit. If you feel you are not yet ready for assessment, discuss this with your trainer and assessor.

To be successful in this unit you will need to relate your learning to your workplace. You may be required to demonstrate your skills and be observed by your assessor in your workplace environment. Some units provide for a simulated work environment and your trainer and assessor will outline the requirements in these instances.

You might need to collaborate with other care organisations and specialist services. Specialists are people with qualifications in a particular field that can provide specific assistance to meet the needs of the client. Specialist services can provide the client with assistance in areas of their life such as:

• Medical treatment

• Psychological support and counselling

• Financial management

• Legal advice

• Housing

• Day-to-day living requirements

There may be other services available which can provide your client with valuable assistance beyond the scope of your own organisation, and your own level of expertise. Linking your client with the relevant services will mean that you will have to know the process involved in doing so. Your organisation may have a list or database of the services available. Your supervisor, manager and other staff members might also be able to provide you with information about the range of available services and the required steps in engaging them.

Let’s look in more detail at some of the services that you might use in the care and support of your clients.

Domiciliary Care is designed to support people to continue living independently in their own homes. Through the provision of assistance in the home, the client is able to live in their home for longer, without the need to be admitted to a residential care facility, nursing home or hospital. It also assists in improving people's quality of life by improving their health and well-being outcomes. Being able to live in their own home provides for the emotional well-being of the person by maintaining a sense of independence and empowerment. Some of the types of support offered by domiciliary care include:

• Home support services

• Home assistance

• Respite services

• Physiotherapy

• Occupational therapy

• Social work

• Health advice

• Community care nursing

HOME ASSISTANCE AND SUPPORT PROGRAMS

Home support services can provide the client with valuable assistance by helping them to maintain a clean and comfortable environment in which to live. It may be that the client has difficulty in keeping their house clean, or as they age they are finding it more difficult to prepare meals for themselves. Home assistance makes it easier for the client to live in their home, ensuring that their standards of living are not compromised as a result of their decreasing ability to perform everyday tasks.

Home assistance programs can provide practical assistance and support to clients/ carers by carrying out essential household modifications and maintenance that the client might not otherwise be able to do on their own. Examples might be, helping with the cost of installing bannister and handrails, ramps and the widening of doorways.

RESPITE SERVICES

These provide assistance for the regular carers of the client to ‘take a break’. They include:

• Residential respite

• In-home respite

• Centre-based respite

• Alternative/ shared family care - respite in care provider's homes

• Recreation and community access

• Emergency respite

• Child care

• Holiday programs, preschools, occasional care and out-of-school care

PHYSIOTHERAPY

The purpose of physiotherapy is to restore physical function through exercise, massage and other techniques, thus promote and maintain the client’s quality of life.

The aims of physiotherapy are to:

• Maintain mobility

• Restore function

• Decrease pain

• Promote self-management of joint and postural problems

• Encourage maximum level of independence

Physiotherapists can provide an assessment of the activities of the client such as walking, movement restrictions, postural problems and disabilities. A client's physiotherapy needs are determined via an evaluation of their functional activity.

A physiotherapist can also educate clients and caregivers about injury and prevention, coping with disability and maintaining good health.

OCCUPATIONAL THERAPY

Occupational therapists assess how well a person manages their activities of daily living. Their assessment provides a guide to ways the person’s independence can be enhanced in all aspects of their life.

Occupational therapists can make assessments relating to:

• Home assessment

• Home modifications required

• Activities of daily living that may require assistance such as showering dressing or feeding

• The need for mobility assistance, like the use of wheelchairs, scooters or walking frames

• The need for the client to access domiciliary care

• Assessing the movement of the individual after accident or hospitalisation

SOCIAL WORK

Social workers can be of benefit to your client by ensuring that the social and emotional needs of the individual are properly met. They can provide assistance in counselling issues such as:

• Social isolation

• Grief and loss

• Lifestyle and decision making

• Mental health issues

• Relationships the client has with family and significant others

HEALTH ADVICE

People who are ageing or who have a disability will often require specialist health advice. Specialists can provide education to clients regarding health issues such as diabetes management, nutritional advice, wound care and continence issues, just to name a few. There are often clinic and home-based services available to provide the necessary information. In some communities, special information sessions are held on a regular basis and are open to clients, their carers and families.

COMMUNITY CARE NURSING

Community care nurses are able to provide planned home nursing services to clients there are a wide range of nursing services aimed at assisting people to maintain their health, well- being and independence. This might be short term, for example, if the client requires dressing changes after a surgical procedure, or they may be more extensive if the client is suffering from a chronic illness.

The above are just some of the services that you may use in the care of your clients. Your organisation should be able to provide you with a list of the services that are available

CONFIRM INDIVIDUALISED PLAN DETAILS WITH THE PERSON AND WITH FAMILY AND CARERS WHEN APPROPRIATE

When formulating an individualised plan, the worker needs to identify the client needs, analyse of client needs, match client needs to the appropriate services and resources, develop and implement action plans and monitor and measure outcomes.

The information you gather from the client is the best way to ensure accurate information when developing individualised plans. Workers need to ensure that this is always done within regulatory and legislative guidelines.

Other sources of client information can include:

• The client's advocate or representative

• Family, significant others and carers

• Case documentation

• Information from other professional sources including medical reports Liaison with other service providers

The individualised plan is centred on the goals of the client. The information the client provide in relation to their long and short term goals provides the basis on which the worker focuses on providing them with the possible options that might meet their needs.

MASLOW'S HIERARCHY OF HUMAN NEEDS

Maslow’s hierarchy of needs first designed by a psychologist called Abraham Maslow in the 1960s provides us with a way of examining the types of needs important to most of us. Maslow used to illustrate that some needs are indeed more important to us than others. He showed that each of us will always try to satisfy our more important needs before we concern ourselves with what he called our 'higher order needs'. Maslow's Hierarchy of Human Needs uses a pyramid structure to represent the needs that we all have. He places the more critical and important 'lower order needs' on the bottom and those needs that are less important to preserving our lives higher up in the pyramid.

Maslow's original model had only five levels. It has been revised by many modern psychologists. This model has eight levels.

INDIVIDUALISED PLANS

People who are ageing or those who have a disability have a capacity for physical, emotional, social and intellectual development. They are entitled to the same conditions of everyday living as anyone else in the community.

Clients require an individualised approach to deal with their unique issues, needs, abilities and character traits.

Asking questions to confirm the plans of the client enables you to find the best care options for your client's particular needs.

Questions should delivered in a way that will encourage clients to share relevant information with you, that is, current and past history, including physical, intellectual or psychological health.

Providing the client with open-ended questions enables you to assess the reasons consequences and evidence for their responses. It provides the worker with a perspective on the client’s view of the world.

When gathering information from clients, it is useful to:

• Use simple words and short sentences

• Speak with the client in a manner that is age appropriate

• Be respectful of all their concerns

• Provide a quiet and private environment, free of distractions

• Address the person by their preferred name

• Allow enough time for the client to respond to your questions

• If the client appears to be struggling for words, gently suggest words that may assist them according to the context of the conversation, but do not assume that you know what they want to say

• Try to frame questions and instructions in a positive way

Your organisation should have well-designed systems and procedures for case/ care plans. The types of information you will require from your clients will include:

• Client’s history

• Currents wants

• Preferences

• Expectations

• Future intentions

When working with a client, you must ensure you:

• Are aware of the varying levels of support that clients need at different times

• Take into consideration case histories and family or representative contributions

• Utilise inclusive assessments that are based on client needs, abilities and readiness for care

• Design and implement plans that will enable clients to live in a manner as closely aligned with their previous comfort needs as possible

• Take into consideration the original diagnosis, appropriate and necessary medical treatments, adherence to the treatment plan, and the presence of coexisting conditions

ENSURE THE PERSON IS AWARE OF THEIR RIGHTS AND COMPLAINTS PROCEDURES

It is not only important but essential that you encourage and support the older person and/or their advocate/s to be aware of their rights. A right is an entitlement that every person has in the community. If you support the older person to be aware of their rights, then they are more likely to know when their rights are being breached so that they can take the relevant action to achieve their rights.

Rights may include:

• Privacy

• Confidentiality

• Dignity

• Freedom of association

• Informed choice

• To lodge a complaint

• Right to express ideas and opinions

• To an agreed standard of care

• Right not to be abused

• To use an advocate service

• To receive the care that promotes wellness

• Not to be discriminated against

The rights of the older person are detailed in a number of areas these include:

• Legislation

• Residential Care Manual

• Aged Care Act

• Industry and organisation service standards

• Industry and organisation codes of practice and ethics

• Accreditation standards

• International and national charters

• Organisation policy and procedure

It is also important that you support the older person in understanding their responsibilities, they include:

• To respect the rights and needs of other people within the residential care service, and to respect the needs of the residential care service community as a whole

• To respect the rights of staff and the proprietor to work in an environment free from harassment

• To care for his or her own health and well-being, as far as he or she is capable

• To inform his or her medical practitioner, as far as he or she is able, about his or her relevant medical history and current state of health

• Maintain a safe environment, as far as they are practicable

COMPLAINTS

It is important that you provide information to the older person and/or their advocate/s regarding the mechanisms for lodging complaints. The federal government has a scheme which is designed for the older person to be able to lodge a complaint about the service that they are or are not receiving.

AGED CARE COMPLAINTS SCHEME

The Aged Care Complaints Scheme (the Scheme) provides a free service for anyone to raise their concerns about the quality of care or services being delivered to people receiving aged care services subsidised by the Australian Government, including:

• Residential care

• Home care packages

• HACC services

Most Australian aged care providers do their best to provide quality care and services for older Australians. However, issues can occur, so it is important to have a way for people to raise their concerns in a constructive and safe way.

If they have a concern about the care they or someone else is receiving, it is important that they talk about it. Complaints can help providers improve the services and quality of care they provide to them or their loved one. Resolving one complaint can help other people too. ^[1]

WORK WITH THE PERSON TO IDENTIFY ACTIONS AND ACTIVITIES THAT SUPPORT THE INDIVIDUALISED PLAN AND PROMOTE THE PERSON’S INDEPENDENCE AND RIGHTS TO MAKE INFORMED DECISION-MAKING

Before putting any plans in place to assist your clients, it is important to discuss with the individual what their goals and desires are. After all, it’s their life and their perspective on what they would like to achieve is of primary importance.

People need to set goals. This means you may have to assist them at times to not only set their goals but to create a plan to achieve them. Strategies to meet current and future needs of clients include:

• Conducting changing needs assessments

• Conducting future planning with the person

• Developing individual action plans with the person with a disability that address their changing needs

• Referrals to specialist services appropriate to their needs

Involve significant others as appropriate in helping people identify their options and ways they might be able to achieve their goals. Significant others may include:

• Carers

• Advocates

• Family members

• Case workers

• Friends

PERSON-CENTRED PLANNING

Person Centred planning is a way of enabling people to think about what they want now and in the future. It is about supporting people to plan their lives, work towards their goals and get the right support.

Person Centred Planning is a collection of tools and approaches that can be used to plan with a person- not for them.

Planning should build upon the person’s circle of support and involve all the people who are important in that person’s life.

Person-centred planning is built upon the values of inclusion and looks at what support a person needs to be included and involved in their community. ^[2]

Being person-centred or using person centred approaches means ensuring that everything we do is based upon what is important to a person from their own perspective.

Person Centred planning discovers and acts on what is important to a person. Person Centred planning helps us do this by discovering and acting on what matters to a person. It gives us a structure to help us continually listen and learn about what is important to a person now and in the future and to act on this in alliance with friends and family. It requires a fundamental shift of thinking from a “power over” relationship to a “power with” relationship.

Whilst it is essential to listen to the decisions and preferred options of the person with a disability and treat their wishes as a priority, before those decisions area acted upon, it is wise to also consider and carefully evaluate the input from carers and advocates where applicable.

Carers and advocates are there for a reason. It is quite often that carers and advocates are employed to assist the individual with their decision making process. It may be that the person will confide in their carer or advocate and seek assistance in processing the options available to them before making a final decision. This may be the case particularly if their primary carer is someone they have a strong respect for.

When taking into consideration the input from carers and advocates, it is important to be alert to differences of opinion that might exist between them and the client. It needs to be established that what you are hearing is, in fact, the result of an informed choice and not simply the decision of another who is expressing to you what they think is best for the person.

There are situations when the client may make decisions which are in some way likely to be to their own detriment. In these situations, the input from their advocate may prove to be invaluable.

Depending upon the circumstances of the individual, the decisions and choices they make must be within organisational protocols and procedures. This is yet another way in which they can be assisted by carers and advocates in their decision making process. Before their decisions can be implemented they need to be realistic and within the scope of what can be provided.

Organisational protocols and procedures will be based largely upon current legislation. Whilst there will be variations according to the circumstances of the individual and how appropriately they can make decisions for themselves, there are relevant laws and protocols which must be adhered to by all organisations.

PREPARE FOR SUPPORT ACTIVITIES ACCORDING TO THE PERSON’S INDIVIDUALISED PLAN, PREFERENCES AND ORGANISATION POLICIES, PROTOCOLS AND PROCEDURES

Supporting and assisting the older person to meet their needs, will involve assisting them with their activities of daily living as well as encouraging them to participate in activities provided by your organisation and those provided by other sources. Some of the activities of daily living that you may be required to assist the older client with might include:

• Bathing and showering

• Nail care Dressing

• Continence and toileting

• Shaving

• Oral hygiene

• Provision of meals and feeding if required

• Skin care

• Planning menus

• Handling food

• Physical activity

• Assisting with medication

Of course this is not an exhaustive list and there will be many other roles that you will perform in your care for a client. During assistance, you will need to ensure you make observations so that you can provide reports and further treatment or care as required.

That may include observations of:

• Nutritional status

• Changes in skin

• General condition

• The mouth

• The ears

• Behavioural changes

• Mobility and range of movement

There are many activities that you will need to perform however to do this you will need to prepare well. Your preparation to support the client will involve activities will include tasks such as:

• Ensuring that you have the necessary equipment, tools, personnel and resources required for the task prepared

• Making sure that the environment arranged is safe and accessible

• Preparing and engaging your client

• Prompting the client where necessary

• Conducting personal care tasks

• Cleaning up

• Report according the activities of the client according to organisational procedures and requirements

All of these activities are important in ensuring that you provide the optimal standards of care for the client.

All of the activities that you engage in with your client should be guided by their individualised plan. The plan will provide you with details regarding the client’s abilities and the activities with which they will require assistance in meeting their needs.

The individualised plan should also provide you with valuable information regarding the like and dislikes of the client. This may be the type of foods they like to eat, how they prefer to be addressed, what types of hobbies or activities they like to participate in or other services they wish to use. Encouraging the client to participate in planned activities, assists in keeping them actively engaged and thus promoting their physical, social and emotional well-being.

TOPIC 2 – PROVIDE SUPPORT SERVICES

CONDUCT EXCHANGES WITH THE PERSON IN A MANNER THAT DEVELOPS AND MAINTAINS TRUST AND RESPECT AND INCLUDE THE FAMILY AND/OR CARER AS PART OF THE SUPPORT TEAM

Trust is something that must be earned. Sometimes it can take a long while to earn the trust of the people you are working with. The trust will often be established after a time where the interaction between two people has progressed to a stage where the two parties are comfortable with one another. When caring for your clients, it is important that your interaction with them is based on sound principles that facilitate the generation of trusting relationships. This will allow you to be more effective in the provision of your care.

Trust is based on principles of interaction such as:

• Being courteous to the other person

•

Respecting individual differences

• Listening and responding with empathy non-judgmental interactions Non-judgmental interactions

There are barriers to be aware of in relation to the establishment of a trusting relationship. These are often associated with communication issues, but may also be associated with the personal experiences of the client.

Barriers to generating a trusting relationship can linked to interpersonal interactions and in particular communication such as:

Physical barriers to effective interpersonal communication include:

• Noise

• Insufficient time

• Distance

• Lighting

Communication barriers may also be attributed to:

• Hearing impairments

• Use of language that the client does not understand

• Speech difficulties - it might be difficult to understand what the client is trying to tell you

• Cultural differences

• Differences in language

Where there are communication barriers which inhibit the expression of the needs, interests and requirements of the individual, strategies which you might employ are:

• Listening carefully to what the person is telling you

• Using active listening techniques

• Paying close attention to body language and facial expressions

• Providing ample time for the individual to communicate

• Providing opportunities that facilitate communication e.g. planned times

• Arrange for persons skilled in communication techniques to assist where necessary

• Using communication aids such as signs and symbols if appropriate

By establishing effective communication strategies to interact with your clients them, you are far more likely to establish a trusting relationship.

PROVIDE SUPPORT ACCORDING TO THE INDIVIDUALISED PLAN, THE PERSON’S PREFERENCES AND STRENGTHS, AND ORGANISATION POLICIES, PROTOCOLS AND PROCEDURES

Clients require an individualised approach to deal with their unique issues, needs, abilities and character traits.

When working with a client, you must ensure you:

• Are aware of the varying levels of support that clients need at different times

• Take into consideration case histories and family or representative contributions

• Utilise inclusive assessments that are based on client needs, abilities and readiness for care

• Design and implement plans that will enable clients to live in a manner as closely aligned with their previous comfort needs as possible

• Take into consideration the original diagnosis, appropriate and necessary medical treatments, adherence to the treatment plan, and the presence of coexisting conditions

INDIVIDUALISED PLANS

When formulating an individualised plan, the worker needs to identify the client needs, analyse of client needs, match client needs to the appropriate services and resources, develop and implement action plans and monitor and measure outcomes.

The information you gather from the client is the best way to ensure accurate information when developing individualised plans. Workers need to ensure that this is always done within regulatory and legislative guidelines.

Other sources of client information can include:

• The client’s advocate or representative

• Family, significant others and carers

• Case documentation

• Information from other professional sources including medical reports

• Liaison with other service providers

PLANNING THE SERVICE

Once you have gathered all the data on the needs of your clients, you will need to make a plan to implement the programs to meet those needs.

Planning could include:

• Designing the program/service – you will need to design the program/service that encompasses and the needs, requirements and preferences of your client

• Arranging the venue – you may need to research and arrange the venue that your program/service will run from. You will need to consider the client’s ability to get there (transport arrangements) and the cost for the use of the venue

• Arranging trainers/facilitators/staff – you will need to ensure you have suitably qualified/trained people to run the program or provide the service

• Arranging volunteers – volunteers can be arranged where required to meet the extra needs of the clients

• Arranging resources and equipment – you will need to arrange for resources and equipment to be on-site and set up on time. You will also need to arrange for this equipment to either be picked up or dismantled at the end of the session. In some venues, you may be able to leave equipment in place until the completion of the program

• Designing a timetable – you will need to draw up a timetable that suits all client’s taking into consideration the majority of people. (You may not be able to cater for all people but you must ensure that the program works for the majority). Other arrangements can be made if there are people who are unable to attend some sessions due to prior engagements and appointments

This planning can be tedious as you try to meet the needs of many. If it is and individual plan you will have less trouble, however, if you are trying to incorporate an individual into existing groups you may also have to plan around appointments, current timetables, etc…

There are many types of clients that you need to consider in your allied health/community service. Clients may include:

• Individual members of the public

• Other organisations, community groups, individuals and health providers

• Other work areas of the organisation

• Senior management

• Service users

ASSEMBLE EQUIPMENT AS AND WHEN REQUIRED ACCORDING TO ESTABLISHED PROCEDURES AND THE INDIVIDUALISED PLAN

Activities of daily life refer to tasks of daily life such as eating, drinking, dressing, bathing, hygiene, meal preparation, housekeeping and other personal and/or domestic tasks. ^[3]

Providing the appropriate assistance and equipment can play a significant role in supporting the independence of the older person or a person with a disability. There is a wide range of items available. Some are relatively inexpensive and can be independently purchased from stores or online. Other items of equipment are complex and expensive and require individualised and specialised fitting and instruction. There is a lot of interest and development in new technologies to assist in providing care and support to an ageing and disabled population. To be effective in improving capacity for independent living, equipment and advice about correct use need to suit each individual and their circumstances. Given the range of items available, there is also a range of solutions to getting the correct advice.

Community service workers can facilitate the use of living equipment in a range of ways. For example, by:

• Assembling equipment as required

• Observing and discussing tasks that a person may find difficult

• Identifying tasks for which easy living equipment may be helpful

• Providing information and demonstrating the correct use of easy living equipment

• Assisting with purchase or supply

• Prompting, encouraging, motivating and monitoring the use of easy living equipment

For the older person or person with a disability, everyday tasks, such as opening a jar or tin of food, drying feet, putting on socks or stockings, or performing cleaning tasks may become increasingly challenging. The reduced ability to undertake domestic and household tasks, maintain personal care, or prepare food is often a catalyst for a referral to Home and Community Care (HACC) services. Promoting the use of easy living equipment is about assisting people to overcome challenges and maintain their independence to the greatest extent possible. In some cases, it may also reduce the need for services. ^[4]

Equipment that may be suggested by the support worker in relation to assisting the person in care with their activities of daily living may be in relation to issues such as:

• Domestic and household cleaning

• Bathroom and personal care

• Kitchen and meal preparation

• Recreational and household items

One of the roles of the support worker is to assist in making it easier for the person in care to achieve and maintain their independence as much as possible. When doing so they must ensure that they are doing so within the scope off their work. Apart of the service they provide, they may wish to suggest specialist referrals to the client so to the appropriate support can be provided.

PROVIDE SUPPORT ACCORDING TO DUTY OF CARE AND DIGNITY OF RISK REQUIREMENTS

You will need to ensure you monitor all aspects of your client service delivery to ensure your reputation is upheld, you are meeting the needs of the clients and you are meeting your duty of care requirements.

Your organisation’s reputation is extremely important. Without a good reputation, your service will not operate. You will not receive referrals from others and the clients you have will eventually move on. Therefore, you must ensure that at all times you are addressing the needs of individual clients and the community as a whole. All of this comes under one very important banner. Your duty of care! This means your duty of care to staff, clients, the community as a whole, other organisations and much more.

Duty of care is a difficult term to define as there isn’t a legal definition of the concept (except in occupational health and safety legislation). Duty of care comes under the legal concept of negligence, and negligence belongs to the domain of common law. Common law is also known as judge-made law as the decision about guilt is decided using legal precedence and community attitudes and expectations. That is, there hasn’t been an Act of Parliament passed defining what is legal or illegal but rather the decision is based on what is considered appropriate or not appropriate at a particular time in history. ^[5]

ROLE OF AGENCY POLICY AND PROCEDURE

Organisations should always ensure that there are a clearly written policy and procedure, which enables staff to understand and perform their duty of care. Policy will vary according to the target group and agency context, but should include the following points:

• Encourage consumers, staff and significant others (such as parents and carers) to work together to cooperatively develop strategies and identify solutions for challenging duty of care issues

• Ensure that staff receive appropriate, relevant training and support to perform their duty of care

The following points are an example of what may be incorporated into policy and procedure in relation to the duty of care.

• All employees need access to orientation training and induction that includes information about duty of care

• Employees need to seek advice and support from internal or external professionals to deal with issues that challenge duty of care and dignity of risk

• Appropriate documentation relating to daily duty of care responsibilities should be maintained at all times (e.g. case notes)

• Information should be given to clients, staff, volunteers and significant others about considerations involved in evaluating duty of care issues. This should include information identifying duty of care obligations and the client’s right to experience and learn from risk taking

• Ensure that clients participate in decisions regarding their care arrangements and lifestyle choices

• Issues relating to duty of care must be discussed with a manager or supervisor

As you can see, the thrust of duty of care policy is to collaborate with the relevant people involved and to be mindful of accountability and client rights. ^[6]

Dignity of risk

Dignity of risk is the legal requirement to ensure that all persons with a disability has the legal right to choose their own medical treatments even if the professionals involved feel that this is not the correct choice for them.

PROVIDE ASSISTANCE TO MAINTAIN A SAFE AND HEALTHY ENVIRONMENT

You may need to assist client’s to maintain a healthy and safe environment in which to live.

This assistance may come in many forms but most probably will be:

• Assisting with cleaning duties

• Eating correctly

• Bathing and personal hygiene

• Shopping

In some cases you may have physically assist them in others you may just need to supervise them. Either way your care plan should provide you with both the type of assistance required for each client and the frequency of this assistance.

If you are unsure, please check with your supervisor or the care plan for your client.

RESPECT INDIVIDUAL DIFFERENCES TO ENSURE MAXIMUM DIGNITY AND PRIVACY WHEN PROVIDING SUPPORT

There are a number of benefits of working within the community; one of those benefits would be that you can meet a range of people from different culture, origins, and backgrounds.

It is important that no matter what the background of the individual that you show them the respect that you would want yourself to be shown:

The background could include:

• Age

• Gender

• Sexual orientation

• Political views

• Race

• Religion

• Disability

DIGNITY OF OLDER PEOPLE

Older persons have a right;

• To be treated fairly regardless of age, gender, racial or ethnic background, disability or other status, and to be valued independently of their economic contributions

• To live in dignity and security and to be free of exploitation and physical or mental abuse

• To exercise personal autonomy in health care decision making, including the right to die with dignity by assenting to or rejecting treatment designed solely to prolong life ^[7]

Every client has the right to their privacy and dignity. This includes demonstrating the utmost respect for the client, their belongings, their information and their body. Your organisation will have strict policies the storage of client information and which the case can be discussed with. At times, you may need to share aspects of the client's health status or care needs with others in the health care team. At all times, this must be done in a respectful manner and only the relevant facts revealed.

Where family members or other clients make enquiries about a client be polite but do not reveal personal information. Consider your own position and how you would feel about your personal information being shared with your family and friends without your consent.

If you meet with difficulties in refusing to pass on to a person information about a client in your care, then refer them to a senior member of staff in your organisation to handle the enquiry.

SEEK ASSISTANCE WHEN IT IS NOT POSSIBLE TO PROVIDE APPROPRIATE SUPPORT

Your role as a care worker will involve you dealing with many aspects of client care. Some of these may include:

• Assisting with personal hygiene

• Assisting with eating and drinking and use feeding techniques

• Assisting with oral hygiene and health care

• Assisting with toileting and use of continence aids

• Bed bathing

• Dressing and grooming including assisting with pressure stockings

• Shaving

• Showering

• Elimination

• Hydration and nutrition needs (including addressing dysphagia)

• Maintenance of skin integrity and pressure area prevention

• Mobility and transfer including in and out of vehicles and falls recovery techniques

• Monitoring medication as appropriate to work role

• Nail care

• Pain management

• Rest and sleep

• Respiration

• Technical care activities according to the personal care support plan and organisation policies, protocols and procedures

Be aware that you may be asked by clients to perform tasks for which you have not been trained. As a care worker, you have a legal duty of care to meet the needs of the client by working in a manner that does not cause them harm. Where you are unfamiliar with an aspect of a task or technical procedure, seek the guidance of your supervisor and undertake further training.

In-Home and Community Care (HACC), you will find there are non-transferrable skills where you will be trained in an aspect of personal care with one particular client. Even though other clients require the same procedure, you will require further individualised training to be able to deliver the same service to them. There is nothing in your training that will qualify you to perform invasive or highly technical procedures. These will be performed by a registered nurse.

SPECIALISED CARE

In many cases, when dealing with clients with complex needs there may be a range of specialised professionals that may need to be involved with the assessment of the needs of the client.

It is important the client and any carers or family members that are involved with the assessment are provided with information to on what types of specialist advice may be required; prior to involving any specialists in the assessment of a particular client’s needs it will be necessary to clarify the other parties that may see assessment results. People have a right to privacy and a right to know how their personal information will be used, shared, managed and stored. It is important that the client understands the need for and the reasons that this information will be shared and that they agree to this.

Relevant others that may see the assessment results or be involved in specialised assessment may include:

• Registered Nurses

• Physiotherapists

• Disability specialists

• Mental health professionals

• Counsellors

• Medical Practitioners

• Dieticians

It is important that if any of the needs of the client fall outside the assessment capabilities and qualifications that a specialist will be utilised to identify and collect further information on the clients’ needs.

You must make sure that when you are considering making a referral to one of these specialist services that you follow the correct policies and procedures for your organisation in doing so. You will also need to take into consideration the other agencies procedures regarding referral and guidelines for maintaining client confidentiality.

When making referrals and decisions regarding referrals, it is important that you involve the client in the decision. Clients have the right to be involved in identifying their own needs and making decisions regarding which type of specialised service they feel would be most relevant to their specific needs.

Active participation in selecting the correct specialist for a client’s own needs also contributes to the clients feeling of power over what happens to them and their own process of becoming more independent. This type of relationship building can be beneficial when attempting to collect all required relevant information and commences the start of an effective working relationship between the client and the community services worker.

ASPECTS OF PROCESSES AND AIDS OUTSIDE SKILLS AND KNOWLEDGE AND/OR JOB ROLE

While you may be responsible for some technical aspects of care, there will still be some restriction on your level of involvement.

Some of these may include:

• Catheters - you are responsible for observing for discharge as an indicator of infection, keeping the area and catheter clean by using alcohol wipes to carefully wipe away from where it enters the body, emptying and changing catheter bags and possibly measuring output. You are not responsible for inserting or removing catheters. This will be done by qualified medical staff.

• Suppositories and enemas - these are considered an invasive procedure and will be performed by qualified medical staff. You are required to monitor and record the result.

• Wound dressings - in some instances you are required to apply and tend to simple, superficial wounds. Where more complex wounds exist that require sterile dressings, these will be performed by qualified medical staff. You are responsible for observing the client for any changes that may indicate a possible infection at the wound site, such as spreading redness, pain, heat or offensive odour or discharge.

• Injections - under no circumstance are you to administer an injection. In some HACC situations, a family member may be administering injections without training and seek your assistance. You are to politely refuse and explain that you are not legally permitted to perform the task. This situation should be reported to your supervisor as training or further support may be offered to the family member.

• Blood pressure - you may be required to monitor and record a client's blood pressure. This can be done with an electronic Blood Pressure Monitor. You are not permitted to perform this task with a sphygmomanometer because to use one without proper training can result in serious injury to the client.

• Taking blood and other samples - taking blood samples can only be performed by a person who has undertaken training in venipuncture. You are required to take urine, stool and sputum samples using strict infection control procedures.

• Oxygen administration - you are not permitted to change the flow of oxygen unless authorised by a health professional. You are required to monitor the client for changes in breathing patterns or signs of respiratory distress. You will also be responsible for cleaning and changing any breathing tubes under the direction of a health professional.

• Podiatry and foot care - check your organisation's policy on foot care. Some have guidelines that state nail care can only be performed by a trained professional such as a podiatrist. Others encourage care workers to perform the task but may exclude diabetics from the procedure. Their increased risk of circulatory problems and infections are better monitored by a trained podiatrist.

Always seek the guidance of the supervisor if you are asked to perform procedures you are not familiar with or are uncertain of your level of responsibility.

TOPIC 3 – MONITOR SUPPORT ACTIVITIES

MONITOR OWN WORK TO ENSURE THE REQUIRED STANDARD OF SUPPORT IS MAINTAINED

WHAT IS SELF EVALUATION

A self-evaluation is one’s own opinion of their performance within the workplace, or how well they have dealt with a designated task. It is a thoughtful and considered opinion involving rating oneself in terms of goals competencies and overall performance.

WHY SELF EVALUATE?

When you self- evaluate, you become an active participant in your own evaluation. Your involvement enables you to honestly assess your strengths and also the areas you need to improve. You then can participate more constructively in the evaluation meeting with your supervisor. Self- evaluation also serves to increase the commitment to goal setting/achievement, competency development and career planning.

HOW TO SELF EVALUATE

Conducting a self-evaluation begins with the individual asking themselves a series of questions about their own performance in the workplace.

For example:

• What could I have done better this year?

• What are my strengths?

• What are my weaknesses

• What can I do to improve upon my weaknesses

• Have I made progress compared with my last evaluation

• Where can I take personal initiative and become a stronger employee who contributes more next year?

When asking yourself the hard questions, it is important to be honest and realistic with yourself, but at the same time, don’t be too hard on yourself and recognise your achievements and stay positive.

Whilst the term “self-evaluation “may infer that a person is performing the activity on their own, in reality the process really needs to involve the input of your supervisor and peers in order to be of any real value. After all, the continual interaction you have with your work colleagues will surely assist you in formulating answers to the questions you have asked yourself listed above.

At the time of self-evaluation, you may wish to consider the following tips:

• Don’t be stuffy - Try to write in a conversational style, one that is as natural as the verbal back-and-forth that occurs throughout the year.

• Solicit feedback from co-workers.

• Be objective. Instead of evaluating yourself based on how you wished you’d performed, ask yourself some specific questions: o What difference did my efforts make? o What did I do to contribute to my organisations goals and success? o Did my efforts further the organisations mission?

o Did I take a leadership role when the opportunity arose? ^[9]

Once you have performed this self-evaluation, you will be in the position to determine your quality of support and can then decide on any possible training or education that you need in order to improve.

INVOLVE THE PERSON IN DISCUSSIONS ABOUT HOW SUPPORT SERVICES ARE MEETING THEIR NEEDS AND ANY REQUIREMENT FOR CHANGE

When planning activities and strategies to meet the needs of the client, it is essential to set goals. Without a set of goals, the workers assisting the client have no direction to follow and nothing tangible to aim for. These goals should be set in conjunction with clients.

The goals set should reflect the needs and aspirations of the client, and should be formulated through consultation between the client and the staff.

Before putting any plans in place to assist the client, it is important to discuss with the individual what their goals and desires are. After all, it’s their life and their perspective on what they would like to achieve is of primary importance.

Clients need to set their own goals. However, you may have to assist them at times to not only set their goals but to create a plan to achieve them. Strategies to meet current and future needs of clients include:

• Conducting changing needs assessments

• Conducting future planning with the person

• Developing individual action plans with the person with a disability that address their changing needs

• Referrals to specialist services appropriate to their needs

• Involve significant others as appropriate in helping people identify their options and ways they might be able to achieve their goals. Significant others may include:

o Carers o Advocates o Family members o Case workers o Friends

SMART GOALS

When assisting the client to set goals, it is important to ensure that the goals are:

• Specific - The desired outcome should be stated in specific terms. This enables both the client and the worker to focus on specific achievements and outcomes.

• Measurable - Ideally, the goal should be broken down into smaller steps. This allows for the objectives to be more easily measured. Being able to achieve small steps and measure progress, assists the motivation of the client as they progress toward achieving their ultimate goal.

• Attainable - When setting goals, it needs to be ensured that they are not beyond the reach of the client. If goals are set too high, and the client feels that they will not be able to achieve them, then they are likely to lose motivation. At the same time, the goals need to be set sufficiently high for the client to feel that they have something challenging to work toward.

• Realistic - Goals need to be realistic so that the client feels they have something to work toward. The goal needs to be relevant to the needs of the client so that they see the goal as being worthwhile.

• Timely - Goals should be set with specific timelines in place. Having a timeline in place provides a ‘finish line’ for the client, and motivates them to pursue their goal with a specific date in mind.

If clients identify any aspects of the service that are not meeting their needs, you will need to modify the service and their goals to meet those needs.

GATHERING FEEDBACK FROM CLIENT’S

It will be necessary to collect feedback from clients’ on a regular basis as a standard organisational procedure on the adequacy of the service delivery that they have received. This information will then need to be used to revise and improve service delivery arrangements that are provided to the community.

A range of different methods should be used to collect feedback on the adequacy of services provided; these methods must be systematic and be in line with organisational policy and procedure.

Feedback from clients can be collected using a series of different methods including:

• Discussions

• Focus Groups

• Surveys

• Direct Questioning

• Review documentation

• Feedback reports

There are two main types of feedback data that can be collected, and these are:

• Quantitative feedback: Collects data in the form of numbers. This means that aspects can be measured and expressed in numbers as percentages or ratios. Quantitative Research tells us ‘how many’, ‘how much’, ‘to what extent’ or ‘what size’ something is.

• Qualitative feedback: Collects exploratory data, it asks a variety of carefully planned questions that seek the underlying reasons, opinions and motivation behind different actions and situations.

All the information will need to be compiled into workable sections and measured against the organisations goals and objectives in relation to client service. This information is critical in the design and creation of appropriate policies and actions plans that suit the clients and meets the purpose that they were designed for.

Successful analysis on the feedback that you have gathered will inform on different aspects of the client service delivery platforms and can assist in determining what about the services offered and clients suits the needs of the clients as intended.

It is also important that your target audience understands the purpose of the consultation and feedback process to ensure that information collected during the review is in a manageable and useful format.

It is essential that the results from the feedback collection are used to make positive change and ensure that the community services organisations are continuously improving the services that are supplied to clients in line with the feedback collected.

IDENTIFY ASPECTS OF THE INDIVIDUALISED PLAN THAT MIGHT NEED REVIEW AND DISCUSS WITH SUPERVISOR

When the client has an established individualised plan, centred on meeting their needs, it is important that the plan be continually reviewed in order to determine its effectiveness. The worker needs to monitor the activities of the client to check that they are actually using the services implemented in the original plan.

The needs of the client may change over time. This may be due to the ageing process or it might be that they have simply changed their goals in life. Whatever the reason, it is important for the worker to ensure that the individualised plan is closely aligned with the objectives of the client.

A well-structured individualised plan should incorporate:

• The expected standards of the service

• Staff requirements

• Roles and responsibilities of all parties

• The criteria by which the plan will be monitored

• The reporting process to be followed

• The processes that will be used to obtain feedback

The disability sector, aged care, medical/ clinical services, care, youth work and drug and alcohol services are all have similar standards in terms of organisational requirements, because they are based on standards for community services. Standards are the expectations the organisation holds with regard to the quality of service that will be provided.

While there will be some variation in the standards of each organisation, they are all monitored through government audits and must be compliant with legislative and regulatory requirements. All clients have a right to proper and consistent care and must be treated with respect in all aspects of care.

To ensure that the individualised plan is continually relevant to the needs of the client, organisations need to ensure that:

• The staff they employ are appropriately trained in recognising the ongoing needs of the client

• The necessary resources and support mechanisms are available to both the client and their carers

• Work is continually monitored and measured

• Improvements are made as required

Standards are established to ensure quality and consistency within organisational operations. Likewise, they are put in place to make sure that the performance of the organisations employees is of the required standards. Standards provide operational guidelines for the employees as well as the tools to be used in the measurement of their performance. Monitoring all aspects of care is required to ensure that the relevant standards are being met.

Specialist and external client services need to be monitored according to the agreed procedures, against defined performance indicators. In situations where the service delivery does not meet the required standards, interventions need to be implemented for the necessary improvement to be made.

REPORTING

Part of the role of the community services worker as we have discussed is to assess and monitor the relevance of the individualised plan. When aspects of the plan are identified as not being relevant to the needs of the client, or require review due to their changing needs, it is appropriate for the worker to report this to their supervisor.

The role of the care worker in each individualised plan should be negotiated and agreed between the supervisor and the care workers. So too should reporting procedures and accountability.

For each client, case supervision methods can be implemented to identify any issues that might affect the relevance of the individualised plan. The monitoring of the individualised plan.

The needs and care of the client will often be overseen by a key worker or coordinator. The coordinator generally has a supervisory role and works in close alliance with the other workers of the organisation. Liaising with carers, other organisations, families and other professionals, the coordinator supervises the delivery of services to the client according to their individualised plan.

Coordinators access clinical expertise from service providers, coordinate responsibility for the clinical implementation of a plan, and provide leadership to other staff to better manage people with complex needs. Key coordinators are the people who supervise the case/ care plan and to whom care workers must report. Thus, it is imperative that the coordinator establishes an effective working relationship with the staff with whom they are supervising.

The coordinator or supervisor can provide valuable input relevant to the areas of the individualised plan that may require review. The coordinator is generally a person who is skilled in the delivery of services and recognising the needs of the client. When a worker recognises the need for review of the individualised plan, they should report it to their supervisor, so that a collaborative decision can be made about the possible changes that may be required. This process should take place with the input of other persons involved in the delivery of services to the client, and of course in consultation with the client themselves.

Case meetings might be held to address specific issues relating to the delivery of services, solve problems and provide the client to provide their input regarding the delivery of services.

Case conferences or meetings might be held to address issues, solve problems, eliminate duplication of problems and allow the client opportunities for input into service delivery plan development.

Organisational policies and procedures should ensure that the necessary time and resources are provided to facilitate for regular case consultation meetings. These meetings enable strategies to be implemented and feedback on progress to be provided.

You may find it beneficial to hold a formal meeting with supervisors and experienced personnel to discuss ideas, develop individualised plans, evaluate the outcomes of an individualised plan or to make the appropriate changes.

When monitoring of the individualised plan, you will need to report to your supervisor or coordinator to ensure that the actions you perform as a care worker meet duty of care requirements and fit within the agreed boundaries of the plan.

Making regular reports to your supervisor, you will be able to negotiate and discuss; problem-solving, the rights of the clients, issues relating to family members or representatives, accountability and conflict resolution strategies.

PARTICIPATE IN DISCUSSION WITH THE PERSON AND SUPERVISOR IN A MANNER THAT SUPPORTS THE PERSON’S SELF DETERMINATION

As discussed in topic 2 clients must be allowed to make decisions for themselves. This is vital in providing a client centred service that gives people choices. Clients have the same rights as everybody else to make choices.

The client participates voluntarily when they partake in the provision of the services designed to meet their needs. At no time should the client feel that they are being pressured or forced to participate if they choose not to. Furthermore, they have the right to change their mind, cease an activity or chose an alternative.

It is not enough to simply offer your clients a choice in matters that affect them. Clients have the right to have the services available clearly explained to them. There are times when the information may be unclear. In this instance, workers need to ensure that the appropriate communication strategies are employed in order to assist the client in their understanding of the information.

There are circumstances where the level of understanding of a client prohibits them from making an informed choice even when all reasonable steps have been taken to assist their understanding. For example; a client with an intellectual disability or one who has a cognitive impairment such as dementia, may not be able to interpret information which is complex in nature. When this is the case, an advocate may be used to assist the client in making their choices

ADVOCACY

Advocacy is based upon ensuring the legal rights of clients are upheld and promoted in order for them to have effective input into issues that concern both themselves and the wider community.

Advocacy can be provided by workers to ensure that they have representation and support relating to needs such financial support, legal advice, barriers and discrimination.

DOING FOR THEMSELVES

It needs to be ensured that clients are provided with the opportunity to do as much for themselves as they choose when attending to their needs. Providing people with the opportunity to exercise their skills and rights provides the person with a sense of independence, and self-determination.

Care workers need to set realistic expectations for a person's participation. The expectations should not be set too low for fear of belittling the client, nor should the bar be set so high that the individual is likely to encounter failure. Either of these extremes is likely to result in a decrease in the client’s self-worth. Taking the time to get to know the client and their abilities make it easier for a care worker to help them do as much as they can for themselves and to set realistic expectations.

When you are helping the client to set their goals, it is advisable to do this in conjunction with your supervisor. Your supervisor can provide valuable advice in relation to the goal setting process. Often the supervisor will have a working knowledge of the abilities of the client, particularly if they have worked with them in the past. Supervisors can also help to ensure that the activities of the client are planned and designed within the scope of organisational protocols and procedures.

PROVIDE CHOICES

All clients should be provided with choices in the provision of their care. How care workers respond to the choices the clients make is important. Having choices creates a sense of quality in the life of the client.

Working in the community services sector, you’re likely to encounter situations where the client does not want to make choices about the provision of their care. How you support individual's choices will vary according to the nature of the choice involved and the person's previous experience in making choices.

In situations where people may want to make choices that are obviously not in their best interest it is important that you maintain their self-esteem with your response or so that they will not become withdrawn and stop making choices. Some people with an intellectual disability who are withdrawn or passive have their behaviour incorrectly interpreted as part of their disability, when, in fact, the behaviour is often the direct result of low self-esteem.

In order to maintain the self-esteem of the clients who avoid the decision making process, it is important that you acknowledge their choice to do so and respect their decision. Acknowledging their decisions, can help them to focus upon the things that they feel they can influence.

TOPIC 4 – COMPLETE REPORTING AND DOCUMENTATION

MAINTAIN CONFIDENTIALITY AND PRIVACY OF THE PERSON IN ALL DEALINGS WITHIN ORGANISATION POLICY AND PROTOCOLS

The Australian Medical Association (AMA), Code of Ethics, requires medical practitioners to maintain a patient’s confidentiality and privacy. Your workplace will also have its own policies in place on how you go about doing this.

While the terms ‘privacy’ and ‘confidentiality’ are commonly used interchangeably, they are not identical concepts. Privacy laws regulate the handling of personal information (including health information) through enforceable privacy principles. On the other hand, the legal duty of confidentiality obliges health care practitioners to protect their patients against the inappropriate disclosure of personal information.

WHAT IS CONFIDENTIALITY

Confidentiality means keeping a client’s information between you and the client. You are not to make a client’s information available to anyone else unless they are involved in their care. This includes; family, friends, colleagues and anyone else you may be talking to.

The types of information that is considered confidential can include:

• Name, date of birth, age, sex and address

• Current contact details of family, guardian, etc.

• Bank details

• Medical history or records

• Personal care issues

• File progress notes

• Individual personal plans

• Assessments or reports

Adult clients have the right to decide what information they consider personal and confidential.

There is, however, no such thing as absolute confidentiality in the community services industry. Workers are required to keep notes on all interactions with clients and often to keep statistics about who is seen and what issues are addressed. As a worker, there will be times when you could be faced with some personal difficulties regarding confidentiality. ^[10]

It is desirable for confidentiality to be handled consistently throughout the service, and while the type and extent of the information conveyed by staff will vary according to the situation, certain basic principles are applicable in all instances.

COMPLY WITH THE ORGANISATION’S INFORMAL AND FORMAL REPORTING REQUIREMENTS, INCLUDING REPORTING OBSERVATIONS TO SUPERVISOR

For organisations to function effectively the staff need to know and understand the environment they are working in. information in your workplace provides the guidelines, policies and protocols expected in your work.

Each workplace will have its own guidelines as to what is expected of you, the worker, when reporting and completing documentation. It is your responsibility to know and understand the policies and procedures of your organisation. If you are in doubt as to what your responsibilities are, then you may wish to consult with your supervisor or manager, or manager or check with your procedure manuals.

To function effectively in your role as a community services worker, you need to be aware of what is expected in terms of documentation and develop the necessary skills administrative skills to fulfil those requirements.

The sharing of information between authorised parties is essential in the provision and maintenance of the care of clients. Without the appropriate information being available, the standard of care can be jeopardised. The information needs to have a valid and reliable source, and should be kept up to date at all times.

In relation to the care of the client, some of the documents that you will frequently have to address will be:

• Care plans

• Case and progress notes

• Incident reports

• Individualised plans

• Appointments

• Financial statements and receipts

• Personal documents

Documentation within your workplace will involve other aspects of the job apart from the care of your clients. There are other aspects of your daily work that need to be addressed. Some of these might include:

• Time sheets

• Rosters

• Client contact registers including telephone call meeting registers and records

• Purchase orders and invoices

• Promotional materials

• Organisation's policies and procedures

• Standard operating procedures (sops-policy manuals)

• Relevant legislation

• Food safety information

• A multitude of organisational standard forms

The effectiveness of your communication and documentation will be dependent upon how accurately you relay the information. All documentation should be:

• Relevant

• Legible

• Up to date

• Specific

• Timely

The accuracy of your documentation better facilitates the day to day handling of information in the workplace.

Vigilance should be ensured at all times when sharing the information in your workplace. This is to ensure that the information you are sharing is only available to the appropriate people. Be aware that the information you are sharing can be critical to the effective functioning of your organisation.

IDENTIFY AND RESPOND TO SITUATIONS OF POTENTIAL OR ACTUAL RISK WITHIN SCOPE OF OWN ROLE AND REPORT TO SUPERVISOR AS REQUIRED

Employees also need to ensure they act in a manner that will not put anyone, including themselves, at risk of harm. This duty extends to all the environments where work is carried out.

In each of these workplaces, there will be different workplace hazards that need to be identified and addressed.

A hazard is any source that has the potential to harm life, health, property or the environment. A risk is the chance of something harmful occurring-the likelihood that harm will occur as a result of a hazard. For a hazard to become a risk, a worker or client must be exposed to the hazard.

Safety materials and assessments generally make reference to incidents and near misses. An incident is an unplanned event that has the potential to cause harm. A single distinct occurrence that might cause illness or injury to any degree. This includes property and/or environmental damage. A near miss is an episode in which a dangerous event occurs without actually harming anyone or causing damage. Near miss, episodes should be recorded and assessed as part of the risk assessment process. This enables an evaluation of the likelihood of the danger situation actually causing harm in a future occurrence.

Workplace hazards should, therefore, be subject to:

• Identification

• Assessment and estimation of potential damage

• Evaluation

• Control

• Monitoring and review

TYPES OF HAZARDS

• Obvious hazards - are a visible and likely cause of accident (slippery floors, unguarded machinery, corrosive chemicals, exposed electrical wiring)

• Hidden hazards - are those that can cause illness, either physical or psychological (for example, poorly designed office furniture, carcinogenic substances or long exposure to sunlight, stress, overwork, bullying or intimidation)

A checklist may be developed which may assist you assess your workplace for common hazards. Hazards covered in the checklist include:

• Manual tasks

• Slips, trips and falls

• Occupational Violence/ Aggression

• Psychosocial issues/ stress

• Biological hazards

• Hazardous substances

• Electrical hazards

• External hazards

• Vehicle hazards

• Working alone

There are many risks involved in an organisation that have policies and procedures relating to them. Each one will advise you on the best strategy to minimise the risks. Below are some of the associated risk and reduction strategies.

REPORTING RISKS

Ensuring you report all hazards and risks is an important part of anyone’s role when working with clients. All incidents and hazards must be reported using your organisations Pro-forma for reporting.

You must complete a hazard report and issue this report to the authorised person. This will usually be your supervisor or manager but in the case where you are the supervisor you may have to report to a higher authority, either way the report must be submitted and the process of eliminating or controlling the hazard commenced. All reporting should also include sharing the information with colleagues and co-workers in order to minimise the possibility of further harm or injury.

IDENTIFY AND REPORT SIGNS OF ADDITIONAL OR UNMET NEEDS OF THE PERSON AND REFER IN ACCORDANCE WITH ORGANISATION AND CONFIDENTIALITY REQUIREMENTS

Community service workers need to identify any difficulties they or the service they are associated with might have in meeting the needs of the client. When difficulties are identified, they should consult with their supervisor to develop strategies to meet the client’s needs.

Meeting the needs of the client and the delivery of services involves adhering to several basic principles, such as:

• Maximising client participation

• Providing choices for the client

• Treating the client with kindness and respect

• Ensuring the dignity and privacy of the client are upheld at all times

• Maintaining a positive and professional image

• Making all reasonable attempts to ensure the safety of the client

Clients you will encounter may have a wide variety of support needs. Some of the supports they may require may be associated with:

• Physical and intellectual disabilities

• Psychological problem

• Mental health issues

• Financial problems

• Legal issues

• Drug and alcohol problems

• Social isolation

• Personal care and activities of daily living

• Medical problems

Due to the fact that the needs of the client are often quite specific, it is quite likely that the service that you work for may not be able to cater for the needs of all clients.

As we have discussed previously, this will create the need to refer them to other specialist services which may be able to meet their needs more adequately.

Difficulties in meeting the needs of the client may be associated with:

• Cultural differences

• Language barriers

• Issues of mistrust

• Clients being unable to comprehend information

• Not having the resources to meet their needs

• Client disabilities

When placed in a situation where you cannot meet or satisfy the needs of the client it is important that you consult with your supervisor and act within the protocols of your organisation. Consultation with your supervisor may reveal other options that haven’t been explored, or they may have greater knowledge of services available to meet the needs of the client.

COMPLETE AND MAINTAIN DOCUMENTATION ACCORDING TO ORGANISATION POLICY AND PROTOCOLS

COMPLETE DOCUMENTATION

There will be a requirement of your role to document any observations or concerns about the clients you work with. These may include case notes, care plans, incident reports, family details, personal history, progress reports, financial dealings and other forms of documentation. Where reports are in hard copy handwriting must be legible.

Reports must be written in clear English, in black pen and be objective. This means you should not include personal opinion in what you write. For example, "When I arrived at his house, Bill was drunk" is a subjective statement. You have made the personal decision regarding whether Bill was actually inebriated or not. Written objectively this statement would be, "When I arrived at his house, Bill smelled strongly of alcohol." There may have been many reasons for why Bill smelled of alcohol that have nothing to do with drinking it.

Under The Freedom of Information Act 1982 clients, or their legal representatives, have a right to read anything that you have written about them so be sure to use factual, respectful language at all times.

Incident/accident reports should be completed as close to the time of the incident as possible. These can be used in a court of law so make sure you are clear about the organisation's procedures for reporting an incident.

Many organisations rely on the accurate completion of documentation in order to receive government and other funding. Your induction to an organisation will include guidance on what reports need to be completed on a daily, weekly or at review time basis. Where anything exceptional happens, or you observe changes that impact on the welfare of the client, these should be documented and immediately reported to your supervisor. Always make sure your reports are signed and dated.

Where reports are completed electronically, you will need to sit at the computer in a manner that aligns the spine and complies with workplace health and safety guidelines. Extended periods at the computer can cause physical problems if insufficient breaks are taken or bad posture used

MAINTAIN DOCUMENTATION

Maintaining the security and confidentiality of client information is a key responsibility for your organisation. The Privacy Act 1988 and subsequent amendments (2012) highlight the importance of collecting and recording information about Australian citizens in a manner that upholds the law.

Your clients have the same right as you do to feel confident that personal information is respected and used only for the purpose identified.

Where documentation is completed in a setting other than an office, such as a client's home, you must ensure that the information is kept secure. Avoid leaving client files in your car or where others in the house can access them.

All documentation needs to be current, accurate and reflect how the needs of the client are met on an ongoing basis.

STORE INFORMATION ACCORDING TO ORGANISATION POLICY AND PROTOCOLS

Files and data about your clients are kept in designated offices of the residential or accommodation services and should only be accessible to appropriately authorised staff. Written and computerised data may kept by head office if it is a large organisation, as part of the 'Client Information System' which identifies individual clients and staff that are only to be accessed by personnel maintaining the system and other appropriately authorised staff.

Personal information is defined in section 6 of the Privacy Act 1988 (Cth) (Privacy Act) and means information that identifies or could reasonably identify an individual. There are some obvious examples of personal information, such as a person's name and address.

Personal information can also include medical records, bank account details, photos, videos, and even information about what an individual likes, their opinions and where they work.

The 10 step guide below gives a snapshot of some of the:

• Privacy rights for individuals

• Obligations that organisations and Australian, act and Norfolk island government agencies have under the privacy act

The OAIC website has more information for organisations and agencies. You can also call the Enquiries Line on 1300 363 992.

Don't leave privacy to chance.

TOPIC 5 - ADDITIONAL INFORMATION

DUTY OF CARE

You will need to ensure you monitor all aspects of your client service delivery to ensure your reputation is upheld, you are meeting the needs of the clients and you are meeting your duty of care requirements.

Your organisation’s reputation is extremely important. Without a good reputation, your service will not operate. You will not receive referrals from others and the clients you have will eventually move on. Therefore, you must ensure that at all times you are addressing the needs of individual clients and the community as a whole. All of this comes under one very important banner. Your duty of care! This means your duty of care to staff, clients, the community as a whole, other organisations and much more.

ROLE OF AGENCY POLICY AND PROCEDURE

Organisations should always ensure that there are a clearly written policy and procedure, which enables staff to understand and perform their duty of care. Policy will vary according to the target group and agency context, but should include the following points:

• Encourage consumers, staff and significant others (such as parents and carers) to work together to cooperatively develop strategies and identify solutions for challenging duty of care issues

• Ensure that staff receive appropriate, relevant training and support to perform their duty of care

The following points are an example of what may be incorporated into policy and procedure in relation to the duty of care.

• All employees need access to orientation training and induction that includes information about duty of care

• Employees need to seek advice and support from internal or external professionals to deal with issues that challenge duty of care and dignity of risk

• Appropriate documentation relating to daily duty of care responsibilities should be maintained at all times (e.g. case notes)

• Information should be given to clients, staff, volunteers and significant others about considerations involved in evaluating duty of care issues. This should include information identifying duty of care obligations and the client’s right to experience and learn from risk taking

• Ensure that clients participate in decisions regarding their care arrangements and lifestyle choices

• Issues relating to duty of care must be discussed with a manager or supervisor

As you can see, the thrust of duty of care policy is to collaborate with the relevant people involved and to be mindful of accountability and client rights. ^[13]

DIGNITY OF RISK

Dignity of risk is the legal requirement to ensure that all persons with a disability has the legal right to choose their own medical treatments even if the professionals involved feel that this is not the correct choice for them.

CONFIDENTIALITY, PRIVACY AND DISCLOSURE

The Australian Medical Association (AMA), Code of Ethics, requires medical practitioners to maintain a patient’s confidentiality and privacy. Your workplace will also have its own policies in place on how you go about doing this.

While the terms ‘privacy’ and ‘confidentiality’ are commonly used interchangeably, they are not identical concepts. Privacy laws regulate the handling of personal information (including health information) through enforceable privacy principles. On the other hand, the legal duty of confidentiality obliges health care practitioners to protect their patients against the inappropriate disclosure of personal information.

WHAT IS CONFIDENTIALITY

Confidentiality means keeping a client’s information between you and the client. You are not to make a client’s information available to anyone else unless they are involved in their care. This includes; family, friends, colleagues and anyone else you may be talking to.

The types of information that is considered confidential can include:

• Name, date of birth, age, sex and address

• Current contact details of family, guardian, etc.

• Bank details

• Medical history or records

• Personal care issues

• File progress notes

• Individual personal plans

• Assessments or reports

Adult clients have the right to decide what information they consider personal and confidential.

There is, however, no such thing as absolute confidentiality in the community services industry. Workers are required to keep notes on all interactions with clients and often to keep statistics about who is seen and what issues are addressed. As a worker, there will be times when you could be faced with some personal difficulties regarding confidentiality. ^[14]

It is desirable for confidentiality to be handled consistently throughout the service, and while the type and extent of the information conveyed by staff will vary according to the situation, certain basic principles are applicable in all instances.

DISCRIMINATION

In Australia, employers and their employees are legally obliged to uphold the human rights standards set out in a number of federal laws. Some of these human rights standards are included in the types of Acts listed below.

Some of the types of laws governing human rights include:

• Age Discrimination

• Disability Discrimination

• Human Rights and Equal Opportunity

• Race Discrimination

• Sex Discrimination

It is important for you to familiarise yourself with the relevant human rights legislation. You will be able to access your own copy of relevant legislation at http://www.humanrights.gov.au/our-work/legal/legislation

WORK ROLE BOUNDARIES

Community service workers are often required to make decisions according to the ethics and philosophies of their organisation. Behaving in a way that is ethical and adhering to the policies and procedures of the organisation are a good starting point for providing high standards of care for the client. It is the responsibility of management to develop policies and procedures which reflect the values, objectives, and purpose of the organisation. Whilst management also have the responsibility to introduce staff to the policies and procedures, particularly to the new worker at the time of induction, it is the responsibility of the worker to familiarise themselves with the relevant information and ensure they comply.

Position descriptions are a good way for the worker to establish the scope of their work. These descriptions provide information about the scope of the work and the duties to be performed.

Policies and procedures provide valuable information about how the work should be done.

Community workers should pay particular attention to the boundaries of their work. Not only are they expected to perform to a particular standard outlined by the organisation, but they must ensure that they do not exceed the boundaries of their work role. Attempting to work beyond the level of one's qualifications can be both dangerous to the health and safety of others, as well as to the detriment of the client. For example A person who holds a certificate 4 in community services should not be attempting to provide treatment for a client which would normally be the job of a registered nurse.

All workers need to be aware of their responsibilities and the boundaries of their work role. If at any stage you are unclear about the scope of your work then you should consult with your supervisor or manager, as well as the policy and procedure manual of the organisation.

RELATIONSHIP BETWEEN HUMAN NEEDS AND HUMAN RIGHTS

WHAT ARE HUMAN RIGHTS?

Human rights are rights inherent to all human beings, whatever our nationality, place of residence, sex, national or ethnic origin, colour, religion, language, or any other status. we areall equally entitled to our human rights without discrimination. These rights are all interrelated, interdependent and indivisible.

Universal human rights are often expressed and guaranteed by law, in the forms of treaties, customary international law , general principles and other sources of international law. International human rights law lays down obligations of Governments to act in certain ways or to refrain from certain acts, in order to promote and protect human rights and fundamental freedoms of individuals or groups. ^[15]

HUMAN NEEDS

Maslow's hierarchy of needs is often portrayed in the shape of a pyramid with the largest, most fundamental levels of needs at the bottom and the need for selfactualisation at the top. While the pyramid has become the de facto way to represent the hierarchy, Maslow himself never used a pyramid to describe these levels in any of his writings on the subject.

The most fundamental and basic four layers of the pyramid contain what Maslow called "deficiency needs" or "d-needs": esteem, friendship and love, security, and physical needs. If these "deficiency needs" are not met – with the exception of the most fundamental (physiological) need – there may not be a physical indication, but the individual will feel anxious and tense. Maslow's theory suggests that the most basic level of needs must be met before the individual will strongly desire (or focus motivation upon) the secondary or higher level needs. Maslow also coined the term

"metamotivation" to describe the motivation of people who go beyond the scope of the basic needs and strive for constant betterment.

The human mind and brain are complex and have parallel processes running at the same time, thus many different motivations from various levels of Maslow's hierarchy can occur at the same time. Maslow spoke clearly about these levels and their satisfaction in terms such as "relative," "general," and "primarily." Instead of stating that the individual focuses on a certain need at any given time, Maslow stated that a certain need "dominates" the human organism. Thus Maslow acknowledged the likelihood that the different levels of motivation could occur at any time in the human mind, but he focused on identifying the basic types of motivation and the order in which they should be met.

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¹⁶ https://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs#/media/File:MaslowsHierarchyOfNeeds.svg

HUMAN RIGHTS FRAMEWORKS, APPROACHES, INSTRUMENTS

HUMAN RIGHTS FRAMEWORK

Human rights violations against migrants are often closely linked to discriminatory law and practice, and to deep-seated attitudes of prejudice and xenophobia against them. International human rights instruments and standards provide a broad framework for the protection of fundamental human rights and freedoms of all human beings, including migrants.

HUMAN RIGHTS APPROACH

MANDATORY REPORTING

SUMMARY

Now that you have completed this unit, you should have the skills and knowledge required to organise, provide and monitor support services within the limits established by an individualised plan. The individualised plan refers to the support or service provision plan developed for the individual accessing the service and may have many different names in different organisations.

If you have any questions about this resource, please ask your trainer. They will be only too happy to assist you when required.

REFERENCES

http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/co nfid...

http://www.dhs.vic.gov.au/__data/assets/pdf_file/0006/601098/dsapp_planningpolicy _implementationguide_20071128.pdf .

http://www.health.gov.au/internet/main/publishing.nsf/content/ageing - complaints index.htm

http://www.hr.virginia.edu/uploads/documents/media/Conducting_a_Self_Evaluation. pdf .

http://www.oaic.gov.au/privacy/privacy - resources/privacy - fact - sheets/other/privacy fact - sheet - 7 - ten - steps - to - protect - other - people - s personal information http://www.ohchr.org/EN/Issues/Pages/WhatareHumanRights.aspx

http://www.sa.agedrights.asn.au/residential_care/preventing_elder_abuse/rights_of_ol der_person http://www.unicef.org/crc/index_framework.html http://youthworker.wikispaces.com/file/view/CHCCS502A_reading.doc https://aifs.gov.au/cfca/publications/mandatory reporting child abuse and neglect

https://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs#/media/File:MaslowsHier archyOfNeeds.svg

[3] http://www.mav.asn.au/policy-services/social-community/ageing/home-communitycare/Related%20documents%20%20HACC%20Easy%20Living/HACC%20Easy%20Living%20Equipme nt%20guide.docx.

[7] http://www.sa.agedrights.asn.au/residential_care/preventing_elder_abuse/rights_of_older_person