support independence and well being
CHCCCS023
SUPPORT INDEPENDENCE AND WELLBEING
LEARNER RESOURCE
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T A B L E O F C O N T E N T S
TABLE OF CONTENTS ………………………………………………………………………………………………………………………. 2
COURSE INTRODUCTION …………………………………………………………………………………………………………………. 5
ABOUT THIS GUIDE ……………………………………………………………………………………….. ERROR! BOOKMARK NOT DEFINED. ABOUT THIS RESOURCE …………………………………………………………………………………………………………………….. 5 ABOUT ASSESSMENT ………………………………………………………………………………………………………………………… 6
ELEMENTS AND PERFORMANCE CRITERIA …………………………………………………………………………………………. 8
PERFORMANCE EVIDENCE AND KNOWLEDGE EVIDENCE ……………………………………………………………………. 10
PERFORMANCE EVIDENCE ……………………………………………………………………………………………………………………… 10 KNOWLEDGE EVIDENCE ………………………………………………………………………………………………………………………… 10
ASSESSMENT CONDITIONS ……………………………………………………………………………………………………………. 13
PRE-REQUISITES …………………………………………………………………………………………………………………………… 13
TOPIC 1 – RECOGNISE AND SUPPORT INDIVIDUAL DIFFERENCES …………………………………………………………. 14
RECOGNISE AND RESPECT THE PERSON’S SOCIAL, CULTURAL AND SPIRITUAL DIFFERENCES ……………………. 14
COMMUNICATE INFORMATION IN WAYS THAT ARE UNDERSTANDABLE AND RELEVANT TO DIVERSE GROUPS ……………………….. 15 ENSURE WORK PRACTICES ACCOMMODATE A CLIENT’S MODESTY AND PRIVACY ACCORDING TO CULTURAL REQUIREMENTS ……… 16 OTHER ACTIONS …………………………………………………………………………………………………………………………………. 17
AVOID IMPOSING OWN VALUES AND ATTITUDES ON OTHERS AND SUPPORT THE PERSON TO EXPRESS THEIR
OWN IDENTITY AND PREFERENCES …………………………………………………………………………………………………. 18
CONSIDER THE PERSON’S INDIVIDUAL NEEDS, STAGE OF LIFE, DEVELOPMENT AND STRENGTHS WHEN
ENGAGING IN SUPPORT ACTIVITIES ………………………………………………………………………………………………… 19
RECOGNISE, RESPECT AND ACCOMMODATE THE PERSON’S EXPRESSIONS OF IDENTITY AND SEXUALITY AS
APPROPRIATE IN THE CONTEXT OF THEIR AGE OR STAGE OF LIFE ………………………………………………………… 20
SUPPORT THE PERSON TO EXPRESS THEIR SEXUALITY ……………………………………………………………………………………….. 21
PROMOTE AND FACILITATE OPPORTUNITIES FOR PARTICIPATION IN ACTIVITIES THAT REFLECT THE PERSON’S
INDIVIDUAL PHYSICAL, SOCIAL, CULTURAL AND SPIRITUAL NEEDS ………………………………………………………. 23
TOPIC 2 – PROMOTE INDEPENDENCE ………………………………………………………………………………………………. 24
SUPPORT THE PERSON TO IDENTIFY AND ACKNOWLEDGE THEIR OWN STRENGTHS AND SELF-CARE CAPACITY
…………………………………………………………………………………………………………………………………………………. 24
Advocacy services ………………………………………………………………………………………………………………………. 24
ASSIST THE PERSON TO IDENTIFY OPPORTUNITIES TO UTILISE THEIR STRENGTHS, WHILE COMMUNICATING
THE IMPORTANCE OF USING AVAILABLE SUPPORT WHEN REQUIRED ………………………………………………….. 26
PROVIDE INFORMATION AND ASSISTANCE TO THE PERSON IN ORDER TO FACILITATE ACCESS TO SUPPORT
SERVICES AND RESOURCES WHEN NEEDED ……………………………………………………………………………………… 27
PROVIDE SUPPORT THAT ALLOWS THE PERSON TO SELF-MANAGE THEIR OWN SERVICE DELIVERY AS
APPROPRIATE ……………………………………………………………………………………………………………………………… 28
ENCOURAGE THE PERSON TO BUILD, STRENGTHEN AND MAINTAIN INDEPENDENCE ……………………………… 30
TOPIC 3 – SUPPORT PHYSICAL WELLBEING ………………………………………………………………………………………. 32
PROMOTE AND ENCOURAGE DAILY LIVING HABITS THAT CONTRIBUTE TO HEALTHY LIFESTYLE ……………….. 32
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SUPPORT AND ASSIST THE PERSON TO MAINTAIN A SAFE AND HEALTHY ENVIRONMENT ………………………. 34
SECURITY SYSTEMS ……………………………………………………………………………………………………………………. 35 SHELTER AND PROTECTION ……………………………………………………………………………………………………….. 35 COMFORT AND SELF EXPRESSION …………………………………………………………………………………………….. 35 SAFETY AND ADAPTATIONS……………………………………………………………………………………………………….. 36
IDENTIFY HAZARDS AND REPORT ACCORDING TO ORGANISATION PROCEDURES ………………………………….. 38
ASSESSING HAZARDS …………………………………………………………………………………………………………………. 38 SEVERITY ………………………………………………………………………………………………………………………………….. 38
ANALYSING THE LIKELIHOOD AND CONSEQUENCES OF RISK ………………………………………………….. 39 HAZARD RATING MATRIX CHART ………………………………………………………………………………………………. 39 REPORTING RISKS AND HAZARDS ……………………………………………………………………………………………… 40
IDENTIFY VARIATIONS IN A PERSON’S PHYSICAL CONDITION AND REPORT ACCORDING TO ORGANISATION
PROCEDURES ………………………………………………………………………………………………………………………………. 41
RECOGNISE INDICATIONS THAT THE PERSON’S PHYSICAL SITUATION IS AFFECTING THEIR WELLBEING AND
REPORT ACCORDING TO ORGANISATION PROCEDURES AND IDENTIFY PHYSICAL HEALTH SITUATIONS
BEYOND SCOPE OF OWN ROLE AND REPORT TO RELEVANT PERSON ……………………………………………………. 42
TOPIC 4 – SUPPORT SOCIAL, EMOTIONAL AND PSYCHOLOGICAL WELLBEING ………………………………………… 45
PROMOTE SELF-ESTEEM AND CONFIDENCE THROUGH USE OF POSITIVE AND SUPPORTIVE COMMUNICATION
…………………………………………………………………………………………………………………………………………………. 45
COMMUNICATION ………………………………………………………………………………………………………………………………. 45 RECOGNISE AREAS WHERE THE PERSON REQUIRES ASSISTANCE …………………………………………………………………………… 46
CONTRIBUTE TO THE PERSON’S SENSE OF SECURITY THROUGH USE OF SAFE AND PREDICTABLE ROUTINES . 47
ENCOURAGE AND FACILITATE PARTICIPATION IN SOCIAL, CULTURAL, SPIRITUAL ACTIVITIES, USING EXISTING
AND POTENTIAL NEW NETWORKS AND AS PER THE PERSON’S PREFERENCES ……………………………………….. 48
IDENTIFY ASPECTS OF SUPPORTING A PERSON’S WELLBEING OUTSIDE SCOPE OF KNOWLEDGE, SKILLS
AND/OR JOB ROLE AND SEEK APPROPRIATE SUPPORT AND IDENTIFY VARIATIONS TO A PERSON’S
WELLBEING AND REPORT ACCORDING TO ORGANISATION PROCEDURES …………………………………………….. 49
VARIATIONS ……………………………………………………………………………………………………………………………………… 49
IDENTIFY ANY CULTURAL OR FINANCIAL ISSUES IMPACTING ON THE PERSON’S WELLBEING …………………… 51
FINANCIAL ISSUES ………………………………………………………………………………………………………………………………. 51 CULTURAL ISSUES ……………………………………………………………………………………………………………………………….. 51
IDENTIFY THE PERSON’S RISK AND PROTECTIVE FACTORS IN RELATION TO MENTAL HEALTH ………………….. 53
RECOGNISE AND REPORT POSSIBLE INDICATORS OF ABUSE OR NEGLECT AND REPORT ACCORDING TO
ORGANISATION PROCEDURES ……………………………………………………………………………………………………….. 55
IDENTIFY SITUATIONS BEYOND SCOPE OF OWN ROLE AND REPORT TO RELEVANT PERSON ……………………. 58
ASPECTS OF PROCESSES AND AIDS OUTSIDE SKILLS AND KNOWLEDGE AND/OR JOB ROLE ………………………………………………. 59
TOPIC 5 – ADDITIONAL KNOWLEDGE ……………………………………………………………………………………………….. 61
SELF-ACTUALISATION……………………………………………………………………………………………………………………. 61
THE TWELVE STAGES OF THE HUMAN LIFE CYCLE ……………………………………………………………………………… 62
SERVICE DELIVERY APPROACHES ……………………………………………………………………………………………………. 64
WHAT IS INTEGRATED SERVICE DELIVERY? …………………………………………………………………………………………………… 64 SERVICE STANDARDS ……………………………………………………………………………………………………………………………. 65
FUNDING MODELS ……………………………………………………………………………………………………………………….. 66
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DEPARTMENT OF HUMAN SERVICES FLEXIBLE FUNDING MODEL (2011 – 2012) …………………………………………………….. 66 DEPARTMENT OF HEALTH BLOCK FUNDING MODEL ……………………………………………………………………………………….. 66 ACTIVITY BASED FINDING ………………………………………………………………………………………………………………………. 67
DUTY OF CARE …………………………………………………………………………………………………………………………….. 68
ROLE OF AGENCY POLICY AND PROCEDURE …………………………………………………………………………….. 68
DIGNITY OF RISK ………………………………………………………………………………………………………………………….. 69
CONFIDENTIALITY, PRIVACY AND DISCLOSURE …………………………………………………………………………………. 70
WHAT IS CONFIDENTIALITY ……………………………………………………………………………………………………….. 70
DISCRIMINATION …………………………………………………………………………………………………………………………. 72
WORK ROLE BOUNDARIES …………………………………………………………………………………………………………….. 73
RELATIONSHIP BETWEEN HUMAN NEEDS AND HUMAN RIGHTS………………………………………………………….. 74
WHAT ARE HUMAN RIGHTS? ……………………………………………………………………………………………………………….. 74 HUMAN NEEDS ………………………………………………………………………………………………………………………………….. 74
HUMAN RIGHTS FRAMEWORKS, APPROACHES, INSTRUMENTS…………………………………………………………… 76
HUMAN RIGHTS FRAMEWORK ………………………………………………………………………………………………………………… 76 HUMAN RIGHTS APPROACH ……………………………………………………………………………………………………………………. 76
MANDATORY REPORTING ……………………………………………………………………………………………………………… 77
SUMMARY ………………………………………………………………………………………………………………………………….. 86
REFERENCES ………………………………………………………………………………………………………………………………… 87
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U N I T I N T R O D U C T I O N
This resource covers the unit CHCCCS023 – Support independence and wellbeing.
This unit describes the skills and knowledge required to provide individualised services in ways that support independence, as well as, physical and emotional wellbeing.
This unit applies to workers in a range of community services contexts who provide frontline support services within the context of an established individualised plan.
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 class to support your learning.
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ABOUT ASSESSMENT
Throughout your training we are committed 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.
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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.
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E L E M E N T S A N D P E R F O R M A NC E C R I T E R I A
1. Recognise and support individual differences
1.1 Recognise and respect the person’s social, cultural and spiritual differences
1.2 Avoid imposing own values and attitudes on others and support the person to express their own identity and preferences
1.3 Consider the person’s individual needs, stage of life, development and strengths when engaging in support activities
1.4 Recognise, respect and accommodate the person’s expressions of identity and sexuality as appropriate in the context of their age or stage of life
1.5 Promote and facilitate opportunities for participation in activities that reflect the person’s individual physical, social, cultural and spiritual needs
2. Promote independence 2.1 Support the person to identify and acknowledge their own strengths and self-care capacity
2.2 Assist the person to identify opportunities to utilise their strengths, while communicating the importance of using available support when required
2.3 Provide information and assistance to the person in order to facilitate access to support services and resources when needed
2.4 Provide support that allows the person to self- manage their own service delivery as appropriate
2.5 Encourage the person to build, strengthen and maintain independence
3. Support physical wellbeing 3.1 Promote and encourage daily living habits that contribute to healthy lifestyle
3.2 Support and assist the person to maintain a safe and healthy environment
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3.3 Identify hazards and report according to organisation procedures
3.4 Identify variations in a person’s physical condition and report according to organisation procedures
3.5 Recognise indications that the person’s physical situation is affecting their wellbeing and report according to organisation procedures
3.6 Identify physical health situations beyond scope of own role and report to relevant person
4. Support social, emotional and psychological wellbeing
4.1 Promote self-esteem and confidence through use of positive and supportive communication
4.2 Contribute to the person’s sense of security through use of safe and predictable routines
4.3 Encourage and facilitate participation in social, cultural, spiritual activities, using existing and potential new networks and as per the person’s preferences
4.4 Identify aspects of supporting a person’s wellbeing outside scope of knowledge, skills and/or job role and seek appropriate support
4.5 Identify variations to a person’s wellbeing and report according to organisation procedures
4.6 Identify any cultural or financial issues impacting on the person’s wellbeing
4.7 Identify the person’s risk and protective factors in relation to mental health
4.8 Recognise and report possible indicators of abuse or neglect and report according to organisation procedures
4.9 Identify situations beyond scope of own role and report to relevant person
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P E R F O R M A N C E E V I D E N C E A N D K N O W L E D G E E V I D E N C E
This describes the essential knowledge and skills and their level required for this unit.
PERFORMANCE EVIDENCE
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be demonstrated evidence that the candidate has:
Safely supported at least 3 people to enhance independence and wellbeing
Performed the activities outlined in the performance criteria of this unit
during a period of at least 120 hours of direct support work in at least one
aged care, home and community, disability or community service
organisation
KNOWLEDGE EVIDENCE
The candidate must be able to demonstrate essential knowledge required to effectively
complete tasks outlined in elements and performance criteria of this unit, manage tasks and
manage contingencies in the context of the work role. This includes knowledge of:
Basic human needs:
o Physical
o Psychological
o Spiritual
o Cultural
o Sexual
Concept of self-actualisation
Human development across the lifespan
Wellbeing, including:
o Physical
o Psychological
o Social
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o Spiritual
o Cultural
o Financial
o Career/occupation
Individual differences, how these may be interrelated and impact on support
provided
Basic requirements for good health for the person, including:
o Mental health
o Nutrition and hydration
o Exercise
o Hygiene
o Lifestyle
o Oral health
Mental health issues and risk and protective factors
Indications of neglect or abuse:
o Physical
o Sexual
o Psychological
o Financial
Reporting requirements for suspected abuse situations
Service delivery models and standards
Relevant funding models
Issues that impact health and well-being
Impacts of community values and attitudes, including myths and stereotypes
Issues surrounding sexuality and sexual expression
Indicators of emotional concerns and issues
Support strategies, resources and networks
Legal and ethical requirements and how these are applied in an organisation
and individual practice, including:
o Duty of care
o Dignity of risk
o Human rights
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o Discrimination
o Mandatory reporting
o Privacy, confidentiality and disclosure
o Work role boundaries – responsibilities and limitations
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A S S E S S M E N T C O N D I T I O N S
Skills must have been demonstrated in a relevant workplace with the addition of simulations and scenarios where the full range of contexts and situations have not been provided in the workplace. Where simulation is used it must reflect real working conditions and contingencies by modeling industry operating conditions and contingencies, as well as using suitable facilities, equipment and resources, including:
Individualised plans and any relevant equipment outlined in the plan
Modelling of industry operating conditions including real interactions with
the person and their carers
Overall, assessment must involve some real interactions with the person and their families/carers.
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
P R E – R E Q U I S I T E S
This unit must be assessed after the following pre-requisite unit:
There are no pre-requisites for this unit.
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T O P I C 1 – R E C O G N I SE A N D S U P P O R T I N D I V I D U A L D I F F E R E N C E S
RECOGNISE AND RESPECT THE PERSON’S SOCIAL, CULTURAL AND SPIRITUAL DIFFERENCES
In all cases when working in a community service or health environment you will need to consider and respect a person’s social, cultural and spiritual differences if you are going to work with them effectively.
A client’s cultural preferences may include:
Ceremonial and festive observances
Dress and dietary observance
Need for continued interaction with cultural community
A client’s spiritual preferences may include:
Ceremonial observances
Formal and informal religious observance
Need for privacy
Need for an appropriate environment to reflect and / or participate in
spiritual activities
It is essential that you demonstrate acceptance of a client’s cultural and spiritual preferences. Consider the following information on how you can demonstrate acceptance of a client’s cultural and spiritual preferences:
Community and disability services workers need to be alert to the possible differences in religious ritual and the impact of a person’s religious practice on their beliefs and value system. Dominant religion may regard other religions as cults rather than official religions however people of any religion have a right to respect.
The following points may assist you to become sensitive to different religious practices:
Clarify the client’s… religious practice. Consult others who know or follow the same religious practice to gain further
understanding.
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Read the complete article here: http://legacy.communitydoor.org.au/resources/etraining/units/chccs405a/section1/section1topic06.ht
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Demonstrating acceptance of a client’s cultural and spiritual preferences also involves supporting the client to worship when and how they choose. It also requires you to support the client to access appropriate equipment and resources to allow them to participate meaningfully in festive and ceremonial observances. Additionally, demonstrating acceptance of a client’s cultural and spiritual preferences involves enabling the client to maintain links with their cultural and spiritual communities.
It is important that you are able to demonstrate cultural sensitivity in communication practices. This means recognising and responding effectively to cultural differences when you communicate with others. There are a number of strategies you may use to demonstrate cultural sensitivity in communication practices:
COMMUNICATE INFORMATION IN WAYS THAT ARE UNDERSTANDABLE AND RELEVANT TO DIVERSE GROUPS
This may involve providing multi-lingual brochures or, for people who have low levels of literacy, producing DVDs or using other media, or other visual / iconic strategies (e.g. diagrams, tables, graphs, pictures), etc. This ensures that health services deliver their messages in ways which are most likely to have a positive impact on the client groups they service.
Understanding and utilising appropriate methods of cross-cultural
communication – for example, avoiding eye contact when discussing certain
topics. This increases the client’s comfort with the communication process,
and improves the likelihood that they will communicate openly with you.
Respecting that people may be uncomfortable communicating with people
outside their cultural group and / or of a different gender, and wherever
possible responding to this. This demonstrates respect for the client’s cultural
preferences, and again increases their comfort in engaging with the service.
Avoiding patronising communication, such as mimicking accents / patterns of
speech, etc. This not only has a negative effect on communication (often
resulting in complete communication breakdowns), but it also further
disempowers vulnerable groups of people.
Taking responsibility for the on-going development of your own cross-
cultural communication skills.
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Monitoring and reflecting on your own actions in the workplace to ensure your cultural values are not imposed on others during communication and interaction.
ENSURE WORK PRACTICES ACCOMMODATE A CLIENT’S MODESTY AND PRIVACY ACCORDING TO CULTURAL REQUIREMENTS
Modesty and privacy are fundamental rights of all people. Privacy, in particular, is a legal obligation outlined in The Privacy Act (1998) (Commonwealth) and related state / territory legislation. Modesty is just as important – particularly for clients who require assistance with activities of daily living.
It is important that you ensure your work practices accommodate a client’s modesty and privacy according to cultural requirements. Consider the following information on ensuring work practices accommodate a client’s privacy and modesty:
Privacy is a basic right for all humans. We like to have our privacy, and so do our residents and clients. Each person is different and what might be ‘personal’ to one person may not be to another. For example a resident or client may be trying to do something they have trouble with, like eating, and prefer to be in a private place, so they feel they are not being watched by everyone in the room. Whereas another resident or client may feel encouraged by seeing others struggle with the same tasks, and feel that being with a group makes things more fun.
Therefore, it is important to know our individual resident or client’s personal needs and wishes. This information should be outlined in their individualised care plan. It is then the care workers role to ensure that dignity is respected by giving them the privacy they require.
In a residential facility or a client’s home it is important to consider the following:
1. Keep doors closed, draw curtains or screens when the resident or client is undressing, showering/bathing or using the toilet/commode.
2. Maintain the personal dignity of the resident or client. Do not discuss issues that may cause distress and embarrassment in front of other residents/clients or staff. If the person is overcome with emotion, do all you can to retain their privacy and dignity.
3. Do not touch a resident’s or client’s personal property without permission. Some people may see this breach of their space as touching them without permission.
4. Ask the resident or client for permission before you open their drawers, cupboards or wardrobes.
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Read the complete article here: https://nationalvetcontent.edu.au/alfresco/d/d/workspace/SpacesStore/3973a53f-00c9-4d22-9a84-
4844a817f302/602/shared/resources/director/induction/personal_care/privacy_and_dignity.htm
Cultural requirements have a significant impact on a client’s perception of appropriate modesty and privacy. For example, clients of certain cultures may require that parts of their body remain covered or that they are only bathed by same-sex carers, for example. It is important that you ensure your work practices take into account a client’s cultural requirements for modesty and privacy.
OTHER ACTIONS
Below are some other things that you might think about to support people from other cultures:
Accept cultural and religious ceremonies and link in to them
Celebrate different cultures by sharing food from that culture or having
cultural days
Get guest speakers to talk about different cultures
Learn a language (even a few words) to make people feel more welcome
The most important thing is that everyone feels accepted and welcome and that no-one is discriminated against or made to feel insecure when in your care.
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AVOID IMPOSING OWN VALUES AND ATTITUDES ON OTHERS AND SUPPORT THE PERSON TO EXPRESS THEIR OWN IDENTITY
AND PREFERENCES
From the discussion above, it is clear that you should avoid imposing your own values and attitudes regarding sexuality on others, including your clients. Your own values may not be consistent with those of your client, and if you impose these conflicting values on your client this can cause them problems – including psychological harm. Reflect on the following information:
As human beings, we all have our own values, beliefs and attitudes that we have developed throughout the course of our lives. Our family, friends, community and the experiences we have had all contribute to our sense of who we are and how we view the world. As community services workers, we are often working with people who are vulnerable and/or who may live a lifestyle that mainstream society views as being different or unacceptable. If, as community services workers, we are to provide a service that meets the needs of our target groups and helps them to feel empowered, we need to be aware of our own personal values, beliefs and attitudes and be prepared to adopt the professional values of our industry—and not impose our own ideas on our clients.
Read the complete article here:
https://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/values/values.htm
In some cases, you may find you have strong values and attitudes regarding sexuality which conflict with your capacity to provide the best care and support to a particular client. If this is the case, you must raise this issue promptly with your manager. You can then work with your manager to develop a plan of action to enable you to respond effectively to this problem; this might involve you seeking supportive counselling or being rostered so that you do not work with the client in question, etc.
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CONSIDER THE PERSON’S INDIVIDUAL NEEDS, STAGE OF LIFE, DEVELOPMENT AND STRENGTHS WHEN ENGAGING IN SUPPORT
ACTIVITIES
Social and recreational activities should “support, challenge and enhance the psychological, spiritual, social, emotional and physical well-being of individuals”, in addition to promoting confidence, empowerment and fulfillment (Diversional Therapy Association of Australia 2012). As such, you must recognise that some recreational activities may need to be modified or adapted to meet clients’ specific needs. Taking the time to consider your clients’ specific needs and modify or adapt activities to better suit these needs is important; this ensures that the activities you provide will be more meaningful and beneficial to your clients.
How you modify or adapt activities ultimately depends on the types of activities you provide and the specific needs of the clients with whom you work. For example, an activity such as bowling may need to involve smaller and / or lighter balls to enable the participation of physically disabled clients. Similarly, when delivering an arts-and-crafts activity you may need to provide non-toxic paints and glues to protect the safety of intellectually impaired clients who may inadvertently consume these items. If you are running a sing-along for elderly clients, you may need to consider the volume of the music for those who are hearing impaired. These are just some of many thousands of different examples!
Whenever you modify or adapt an activity, it is important that you report this to an appropriate person. Doing so ensures that the modifications or adaptations you implement are appropriate and consistent with your organisation’s expectations. Examples of appropriate people to whom you may report include your direct supervisors and managers, colleagues who also provide care to the client, the client’s family members (providing the client’s confidentiality is maintained), external agencies (such as advocacy services), health professionals, law enforcement officers and legal guardians, etc.
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RECOGNISE, RESPECT AND ACCOMMODATE THE PERSON’S EXPRESSIONS OF IDENTITY AND SEXUALITY AS APPROPRIATE
IN THE CONTEXT OF THEIR AGE OR STAGE OF LIFE
A client’s circumstances may have a significant impact on their expression of identity and sexuality. Expression of identity and sexuality may include:
Access to assistive / protective devices
Love and affection
Need for privacy and discretion
Physical appearance
Touch
Read the following about the importance of sexuality to people – including, in this example, people with an intellectual disability:
Sexuality is a key part of human nature. People with intellectual disability experience the same range of sexual thoughts, attitudes, feelings, desires, fantasies and activities as everyone else… Sexuality has psychological, biological and social aspects and is influenced by individual values and attitudes…. Healthy self-esteem and respect for self and others are important factors in developing positive sexuality.
Most people with intellectual disability can have rewarding personal relationships. However, some may need additional support to develop relationships, explore and express their sexuality and access sexual health information and services.
Read the complete article here:
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Intellectual_disability_and_sexuality?o pen
The expression of identity – that is, ‘who’ the individual perceives themselves to be – is also important for people, including your clients, regardless of their circumstances. However, a client’s circumstances may restrict their individual expression of identity and sexuality in a number of ways. Read through the following examples relating to a client with an intellectual disability:
A lack of privacy
Being dependent on others for daily living
A lack of confidence about their physical appearance and ability
Less knowledge of how to negotiate relationships and express their sexuality
A limited social circle and a lack of social experience
Physical or cognitive limitations
Carers who wrongly think of them as childlike or asexual
Carers who view their sexuality as something to be feared and controlled
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Read the complete article here:
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Intellectual_disability_and_sexuality?o pen
The impact a client’s circumstances may have on their expression of identity and sexuality are complex. However, it is important that you are able to demonstrate a basic understanding of the impact a client’s circumstances may have on their expression of identity and sexuality. As discussed, this is important because it enables you to provide services which are more reflexive to a client’s needs, and, therefore, more effective at supporting a client to achieve desired outcomes.
SUPPORT THE PERSON TO EXPRESS THEIR SEXUALITY
Supporting a client to express their sexuality is an important aspect of your role. But how can you do so in ways that are both legal and meaningful? Consider the following information from Victoria’s “Personal relationships, sexuality and sexual health policy and guidelines” for disability workers in the state about how you can support clients to express their sexuality:
All people access a wide variety of support and materials to meet their individual needs. Sexuality is just one of many life areas where people may seek such support. The role of support workers is to provide assistance, where needed, so people with a disability can experience the same life opportunities as other people. As part of their role, support workers are expected to be able to respond to sexuality and sexual health issues by:
Answering simple questions. Supporting people with a disability to understand their rights and
responsibilities in this area. Supporting people in accessing services where needed. This may include helping
people access information and services or attend appointments. Being aware of, and able to respond appropriately to, duty of care issues. Ensuring sexuality and sexual health are considered in individual planning for
people with an intellectual or cognitive disability
Read the complete article here:
http://www.dhs.vic.gov.au/__data/assets/pdf_file/0008/604583/dsd_personal_relationships_sexual_heal th_policy_250506.pdf
It is essential that you find a suitable balance between supporting a person to express their sexuality and remaining within the boundaries of your legal obligations to your client. Read the following:
…There are still many barriers that stand in the way for people like David [who have physical and intellectual impairments]. One problem is that third or fourth parties may have to be involved if people cannot even undress themselves or get into bed without assistance. And that is where barriers like official policies can come into play.
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White said while the Spastic Centre supported clients’ rights to sexual expression, it had a policy that staff could not help them overcome the physical limitations that could make this possible. ‘‘Some people may need assistance in order to express their sexuality due to their disability but our policy is that staff can’t assist people in any sexual activity,’’ he [Spastic Centre CEO Rob White] said…
This interpretation of the law means staff could not even phone on a client’s behalf to make an appointment with a sex worker, let alone provide the further help that may be needed in cases of severe disability to position a couple for sex. That means options are extremely limited. …Unless they had an understanding family member or friend prepared to help, one who wasn’t constrained by the same duty of care, they had no chance of being able to have sex.
Read the complete article here: http://www.touchingbase.org/resources/library/sexual-liberation
As noted above, it is essential that you find a suitable balance between supporting a person to express their sexuality and remaining within the boundaries of your legal obligations to your client. Ensure you seek support from your supervisor or manager where required.
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PROMOTE AND FACILITATE OPPORTUNITIES FOR PARTICIPATION IN ACTIVITIES THAT REFLECT THE PERSON’S
INDIVIDUAL PHYSICAL, SOCIAL, CULTURAL AND SPIRITUAL NEEDS
As noted above, an important aspect of demonstrating acceptance of – and respect for –a client’s cultural and spiritual preferences involves supporting the client to worship when and how they choose. Facilitating a client’s participation in cultural and spiritual practices and celebrations is an essential aspect of your role. Read the following section on ways to facilitate a client’s participation in cultural and spiritual practices and celebrations:
Culturally appropriate spiritual support assists care recipients to express their unique spirituality in an open and non-judgemental environment by helping them to maintain important practices, beliefs and networks. Identifying current and desired practices and beliefs will assist you to meet the needs of your care recipients from culturally and linguistically diverse backgrounds; simply asking to which religion a person belongs does not adequately determine spiritual needs.
The religious beliefs of some of your care recipients may require strict adherence to ritual and influence all aspects of their daily life. The needs of your care recipients may also change over time; some people may become more aware of and interested in spiritual matters, perhaps for the first time in their lives. Regular reviews of your care recipients’ spiritual needs will ensure the support you provide is relevant to their needs.
Read the complete article here: http://www.culturaldiversity.com.au/resources/practice-
guides/spiritual-support
Facilitating a client’s participation in cultural and spiritual practices and celebrations may also involve more practical aspects of support – such as providing transport, ensuring the availability of required resources and arranging access to relevant spiritual advisors, etc. Also, you may research suitable opportunities online and in local newspapers / magazines or religious organisation bulletins, etc.
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T O P I C 2 – P R O M O T E I N D E P E N D E N C E
SUPPORT THE PERSON TO IDENTIFY AND ACKNOWLEDGE THEIR OWN STRENGTHS AND SELF-CARE CAPACITY
In order for the client to make appropriate decisions about the care and services, they require, workers should assist them to identify their own strengths, and realise what their capacity might be.
By supporting the individual in this way, it is possible for them to assess what their level of independence may be. However, if the client is already accessing a service, it is pertinent that an assessment be performed to determine their capabilities. Identification of strengths and capacity may include:
The activities of daily living
The capacity for employment
The capacity to live independently
In order to exercise choice and maximise independence, people require access to accurate information that will help them manage their own lives, understand their options and engage with and actively participate in their community.1
ADVOCACY SERVICES
Advocacy services are designed to actively assist people in the decision-making process. Advocates listen to the goals of the client, and aim to help them to identify ways they can maintain and increase their independence, and confidence to represent their own best interests.
By assisting the client to recognise their strengths and capacities, you will be assisting them to establish goals that are realistic and attainable.
The strengths capacities of the client should be clearly documented in the client’s care plan so that all relevant staff are aware of their capabilities.
1 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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As part of your role within your organisation, you may be involved both the designing of their individualised plan, along with accessing and linking the client with the services they require according to their plan.
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ASSIST THE PERSON TO IDENTIFY OPPORTUNITIES TO UTILISE THEIR STRENGTHS, WHILE COMMUNICATING THE IMPORTANCE
OF USING AVAILABLE SUPPORT WHEN REQUIRED
Each of us has areas of ability and other areas of function that we find difficult. The way that a person functions in their life will depend on many factors. Factors that may influence the strengths and capabilities of the client may include:
The ability to effectively communicate
Personality
Social circumstances
Psychological problems
Mental health issues
Disabilities
Available support mechanisms such as o Family o Friends o Support workers o Advocates
Workers need to be able to effectively assess and interpret the strengths and abilities of the clients they are supporting. Strength may be defined as the ability to cope with difficulties, to effectively function under stressful conditions, the ability to bounce back from stressful situations, to accept challenging situations as an opportunity for personal growth as and to use social supports as a source of resilience.
The Strength, however, is more complex than just how the individual reacts to vulnerable situations. It is also important to note that a person who is vulnerable is not necessarily weak.
For example, a person who is experiencing a significant crisis in their life such as the death of a loved one may be vulnerable, particularly in the period closely following the event. This does not imply that they are weak, but may require some assistance in developing the necessary coping mechanisms.
Part of the role of the community services worker is to assist the client in recognising their strengths and capabilities so that they may be better equipped to face the challenges of life.
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PROVIDE INFORMATION AND ASSISTANCE TO THE PERSON IN ORDER TO FACILITATE ACCESS TO SUPPORT SERVICES AND
RESOURCES WHEN NEEDED
As discussed above, an important part of enabling your clients to access and engage with social networks is to provide them with information on the networks and activities available to them. The types of networks available to your clients may include:
Clubs
Community centres
Community welfare groups
Ethno-specific organisations
Sport and recreational groups
Support groups
Veterans / war widows organisations
Voluntary organisations
To be able to provide information to your clients on the activities available to them, it is important that you are aware of the activities available in your local community (including both existing and new activities, as they occur). Networking – that is, engaging – with other professionals in the community services and in related fields – is important in this respect, as this will provide you with valuable information on events and services which might be suitable for your clients. Also, you may research suitable opportunities online and in local newspapers / magazines, etc.
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PROVIDE SUPPORT THAT ALLOWS THE PERSON TO SELF- MANAGE THEIR OWN SERVICE DELIVERY AS APPROPRIATE
The older person’s willingness and ability to direct the processes relating to the provision of their care may be attributed to both how well informed they are and a recognition that they have the right to refuse services.
In order to exercise choice and maximise independence, people require access to accurate information that will help them manage their own lives, understand their options and engage with and actively participate in their community.2
The client has the power to determine the direction that their care takes. Those providing support services should not presume what direction their care will take. As it is the older person who makes the ultimate decision regarding the provision of their care and services, they are the person who is providing direction to the support worker.
Whilst the support person can provide the client with information and suggestions which they feel may be beneficial to their care, the older person has the right to refuse these suggestions and choose the path they wish to take. They may wish to determine their ongoing care on a daily basis or institute planning for their needs in the future. In the case where the support worker identifies potential issues in the way the care in being planned or instituted then they may wish to raise this with the client, but ultimately they need to respect the client’s decision.
Providing information to the older client, may assist them in making decisions about how they may improve their lifestyle. The information needs to be relevant to their needs and lifestyle, how improvements might be made, and should identify the services which could be of assistance to them in meeting their needs. This information may be in relation to issues such as the provision of health care services, equipment which might be beneficial to them, financial services or perhaps referrals that might provide them with the further information they need. Providing this information enable the individual to gain a better sense of control over their life.
If the older person is not given the responsibility of directing their care then there is a risk that they will become compliant with the direction of the person or organisation providing the services. Subsequently, this can negatively impact upon their independence. In this situation the provision of care and services is directed by the
2 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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provider and the older person risks losing their sense of empowerment. Whilst the support worker may be compliant with respect to the provision of care and services, the overall effect may be detrimental to the older person in that they can become reliant on others making decisions for them.
There may be compliance issues arise when the support worker who is in a position of influence promotes what they see as being beneficial to the client. If the worker promotes their ideas in such a way that they are perceived to be insistent of intimidating to the older person, then this may result in the older person feeling disempowered and having to do what they are told.
A more appropriate way of approaching the client regarding the way in which they utilise a particular service would be to explain not only what services are available to them but how they might be beneficial. I.e. there should be reasoning behind the suggestions given.
If the support worker identifies the need for an intervention which will be of benefit to the client, and the client subsequently refuses, then there should be supporting documentation outlining the refusal as well as the reasoning behind the refusal. Instances of non-compliance without the appropriate supporting reasoning can sometimes be viewed as the client being merely obstinate or irrational. Providing the reasoning behind their choice to refuse the implementation of services can assist in validating their decision.
The older person may wish to consult with an advocate before making a decision based on the suggestions of a support worker.
Advocacy services support people to actively participate in decision-making processes and conversations that impact on their lives.
Advocates will listen and act in the best interests of the individual and support people with the aim to increase independence and confidence to represent their own interests, and help them to be aware of the different ways they can have a say.3
3 http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
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ENCOURAGE THE PERSON TO BUILD, STRENGTHEN AND MAINTAIN INDEPENDENCE
Whilst an older person may still be able to attend to most or all of their activities of daily living, as they age, they may find it necessary to adapt their lifestyle and perform the tasks with which they are familiar differently to what they have been used to.
The client may indeed experience difficulties in adapting to the changes both physically and psychologically, and the support worker can be instrumental in helping them to make the necessary modifications and adaptations necessary to maintain their independence.
The type of modifications and adaptations that they might encounter may be associated with the use of new or replacement of old equipment, changes in their behaviour related to the state of their health, learning new ways to do things, or possibly engaging I the use of extra support services in order to meet their needs.
Once the changing needs of the client have been identified, the next step is to seek out the relevant sources that might be able to provide the required assistance. If the assistance seems to be relevant to the needs of the client, then they can then be presented with the information that may address their needs and then make an informed decision about the changes that they might need to make.
Let’s take for example a situation where an older client is experiencing difficulties in accessing part of their home because it is upstairs, and they are now, due to health issues, experiencing difficulties in climbing the stairs each day. After being assessed the support worker might suggest to the client that there are mechanisms available such as stairlifts to assist them, or possibly they might consider transferring to different premises, where movement around their environment would require considerably less exertion. The client in this situation may choose one of the possible alternatives that have been suggested, or elect to reject them entirely. It is important to note, that such changes are significant in the life of the individual, both from a financial perspective, as well as having to deal with a major change in their environment.
Regardless of the scenario, support workers need to assist the client in making the changes they need to maintain their independence. When doing so, it is necessary for the worker to us the communication techniques necessary for the older person to understand the information provided.
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Once the information has been provided, it is important to follow up with the client, particularly if no changes have been instituted. The client may have the need for further information before making a decision, or they may well decide to take no action. Whatever decisions they make, it is important that they receive the appropriate information they need
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T O P I C 3 – S U P P O R T P H Y S I C A L W E L L B E I N G
PROMOTE AND ENCOURAGE DAILY LIVING HABITS THAT CONTRIBUTE TO HEALTHY LIFESTYLE
The extent to which the older person is able to maintain their environment is largely dependent on the state of their physical well-being. However, consideration should also be given to their psychological and emotional state.
Whilst there may come a time in their life when the older person is no longer able to manage their environment by themselves, they may still have the capacity to live at home if they are provided with assistance to deal with the tasks that they find more challenging.
In order to maintain their independence as much as possible, and remain in the home environment, providing them with information about the services available to them enables the client to seek out the necessary services they need. This process in itself is empowering for the older person. Not only are they making decisions about their lifestyle, but they are also engaging with other members of the community when they seek assistance, thus showing that they are still capable of exercising their communication and negotiating skills.
Try to identify the areas that the client is able to manage without assistance. Communicating this to the client is likely to boost their self-esteem, particularly if they are feeling emotionally vulnerable as a result of realising that they may require assistance in other aspects of their lives. Another way that the client can elevate their self-esteem is knowing that they have the capacity and ability to delegate tasks to others who are providing them with assistance.
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Recognise areas where the older person requires assistance. By communicating appropriately with the person, you can help them to identify areas in which they feel that they might need assistance. Reinforce to the client that they still have the power to make the decision about what services they see as being as beneficial to them. This too will help them maintain a sense of empowerment. It may be that the assistance required is only minimal, or that the support services they engage will be infrequent, thus not encroaching excessively on their privacy. This enables the older person to see that whilst they are receiving some assistance; they are still able to function independently in many other areas of their life.
It is important to develop a plan that identifies how the maintenance of the environment is to happen. Throughout the establishment of the plan, the older person should be continuously consulted so that they have a sense of involvement, and that they have the ultimate control over their environment.
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SUPPORT AND ASSIST THE PERSON TO MAINTAIN A SAFE AND HEALTHY ENVIRONMENT
Regardless of the environment in which they live, the older person needs to feel that they are secure and safe in their living situation. They should feel secure in the knowledge that they are able to move around in their surroundings without feeling that they are vulnerable to harm. Older people, particularly those who live at home alone, may sometimes feel that they are easy targets for criminal activity such as violence and robbery.
When working with older people it is important to try and establish a sense of security and confidence so that they may maintain their sense of confidence and empowerment. The client needs to feel that they have a sense of control over their security and that they have the ability to use strategies to protect their well-being. Whilst the older person may not able to defend themselves well from physical violence, there are other measures they can take to improve their security.
Security does not just mean being able to ward off offenders. It incorporates other issues such as ensuring their own personal safety when they are moving around in their environment, having shelter and protection, feeling comfortable in their environment and knowing that they are free to express themselves as they desire.
Some of the requirements of the older person in relation the establishment and maintenance of their security are:
Security systems and how they work
Support staff that recognise the need for the older person to feel secure in
their environment
To have the information relative to security issues close at hand, easy access
to security and emergency contacts
That the environment is suitably adapted to ensure the security and safety of
the older person
The support worker is able to link the client with the appropriate mechanisms so that they will be able to maintain their safety and security in the following ways:
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SECURITY SYSTEMS
There are numerous ways that the support worker in conjunction with the client can promote and ensure that security is established and improved. Examples are:
Installing alarm and emergency systems
Security patrols
Regular visits from support workers to ‘check -up’ n the client
Ensuring that entrance doors have adequate locking mechanisms including
dead bolt locks.
Having emergency numbers close by to every telephone in the house and
where appropriate stored in mobile phones
Ensuring that safety mechanisms such as thermostats, smoke alarms and
electrical protection devices are in place and are regularly serviced and
maintained
Having adequate and emergency lighting available at all times
Ensuring that all mobility assistance devices e.g. handrails are securely fitted,
fastened and appropriately placed according to the needs of the client
SHELTER AND PROTECTION
Older people need to know that they are able to live in an environment that provides them with shelter, where they are sheltered from the outside environment when they need to be and that they are protected from the elements. Likewise, they should feel that they are assured in the knowledge that there are others to protect them should they require assistance. This might include having access emergency services if necessary, and the support of friends, family, and support services to assist them in times of need.
COMFORT AND SELF EXPRESSION
Not only should the environment of the older person reflect their physical comfort, but the person should also feel emotionally comfortable in their environment. The support worker can help the older person to be surrounded by the things that they enjoy in life. For example; an important aspect of the older person’s life might be the ability to have regular interaction with others. The support worker can assist by helping to organise a
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carer to visit the client on a regular basis so that they have someone with whom they a have regular, meaningful conversations.
SAFETY AND ADAPTATIONS
The older person’s safety is of paramount concern in relation to their well-being. The client should feel that they are not at risk from harming themselves as a result of the very environment in which they live. Accidents in the home can be a prime source of injuries, possibly even result in death if the appropriate measures are not taken to eliminate or minimise potential hazards.
As a person ages, their bones become more brittle, their sense of sight, smell and touch tend to deteriorate, as does their sense of judgement and reaction time. For these reasons, they are more prone to injuring themselves in any environment. The following is a list of measures and modifications that can be implemented to minimise the risk of harm in their living environment:
Inside and outside door handles and locks are easy to operate
Door handles are lever-action instead of round knobs
Carpeting and rugs are not a trip hazard
Appliances, lamps and cords are clean and in good condition.
Electrical overload protection is provided by circuit breakers, fuses
Electrical cords are placed out of the traffic flow and are not underneath rugs
and furniture
Ensuring the kitchen area is well lit
Making sure that there is adequate ventilation, particularly near heating and
cooking areas
Cabinets and shelving should be easily accessible to the client
Non-slip flooring is in place
Temperature limiters for the hot water system
Smoke detectors are fitted and working
Telephones are easily accessible in the event of an emergency
Light switches should be easily accessible
Emergency lighting such as torches are available
Handrails and handles are appropriately placed and securely fastened
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Garden areas and aces paths are kept clear of obstructions
People working with older clients need to be aware of their role in ensuring that the security of the older person is maintained wherever possible. This will, of course, be dependent upon the person being willing and able to implement the suggested changes and adaptations to their environment.
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IDENTIFY HAZARDS AND REPORT ACCORDING TO ORGANISATION PROCEDURES
When working in any organisation, it is imperative that the staff comply with Work Health and Safety legislation and adhere to organisational policies and procedures at all times.
As part of your role when working in the community services sector, you are responsible for the identification and prevention of potential hazards which might adversely affect the health and well-being of your clients, co-workers and yourself.
When working in your organisation, you should:
Be aware of the procedure for reporting hazards
Know who to report hazards to so that they will be actioned appropriately
Know your role if the hazard is not addressed
Know the legislative requirements and your role where these are concerned
Know your role in addressing hazards when you find them; can you resolve
the hazard or does it need to be someone else
ASSESSING HAZARDS
There are a number of factors that play a part in the probability and degree of injury or illness for a particular hazard. For example, contact with blood & body fluids exposure.
The significance of the risk of injury or illness may be influenced by the level of a worker’s exposure to a hazard. For example, the hazard posed by exposure to a solvent increases with the frequency and duration of exposure.
SEVERITY
Severity refers to the extent of the injury or degree of harm which might be caused by a hazard. Death, permanent disability or an illness such as cancer or hepatitis are all classed as severe. Some examples are electrical hazards and machinery; chemicals such as acids, and dust particles such as asbestos.
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ANALYSING THE LIKELIHOOD AND CONSEQUENCES OF RISK
Let’s now look at the likelihood of the risk happening. We need to assess how likely it is that the risk will happen and what the consequences of this could be.
Consequence is measuring the consequences of being exposed to a hazard. As a risk assessor you are asking whether the hazard is so:
Severe = E.g. Death, extreme injury or permanent disability
Major = E.g. Long-term injury or illness
Medium = E.g. Medical attention required with time off work
Minor = E.g. First aid required/hazard or near miss report completed with
follow-up action
Insignificant = E.g. No Injury or near miss follow-up action required
The likelihood is assessing how likely it is that a hazard will harm someone. This likelihood will range from:
Rare
Unlikely
Possible
Likely
Almost certain
HAZARD RATING MATRIX CHART
If you line up the likelihood and consequences on this chart, you will see that it will guide you to the type of risk i.e. low, medium, high or extreme.
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REPORTING RISKS AND HAZARDS
Ensuring you report all hazards and risks is an important part of anyone’s role when working with children. All incidents and hazards must be reported using your centres 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 centre manager 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.
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IDENTIFY VARIATIONS IN A PERSON’S PHYSICAL CONDITION AND REPORT ACCORDING TO ORGANISATION PROCEDURES
One of the most important aspects of your job role is to identify variations in a client’s physical condition – particularly when the client is unable to do so. Variations in a client’s physical condition may include changes in:
Aches,
Pain
Nail status
Oral health anomalies
Skin tone and colour
Weight gain
Weight loss
Or, perhaps the client might just report or appear to be feeling ‘unwell’.
You are able to identify variations in a clients’ physical condition by getting to know your clients’ normal physical condition well, and carefully observing changes in their physical condition. Documentation (e.g. written records of weight or temperature, or photographs of skin conditions, etc.) may also assist you in identifying variations in clients’ physical condition.
When you identify variations in a client’s physical condition, it is essential that you report these to your supervisor. This is a key aspect of your duty of care – that is, your legal and ethical responsibility to ensure, to the greatest possible extent, the health and safety of your clients. It is also important in terms of ensuring the client’s wellbeing – and this is the most fundamental aspect of your job.
It is likely that your report of variations in a client’s physical condition will be made to your supervisor verbally in the first instance. However, your supervisor may also require you to complete additional written documentation and, depending on the circumstances surrounding the variation in the clients’ physical condition, you may also be required to make reports to others.
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RECOGNISE INDICATIONS THAT THE PERSON’S PHYSICAL SITUATION IS AFFECTING THEIR WELLBEING AND REPORT
ACCORDING TO ORGANISATION PROCEDURES AND IDENTIFY PHYSICAL HEALTH SITUATIONS BEYOND SCOPE OF OWN ROLE
AND REPORT TO RELEVANT PERSON
This unit has previously discussed that it is essential for you to have a basic understanding of the impact a client’s circumstances may have on their health. It is also important for you to consider the impact the client’s circumstances may have on their emotional and psychological wellbeing. The client’s circumstances may result in a range of emotional and psychological needs.
A client’s emotional needs may include: A sense of security and contentment
Acceptance of loss
Dealing with degenerative issues
Dealing with pain, grief, bereavement, acceptance of death
Freedom from anger, anxiety, fear, guilt loneliness
Love and affection
Veterans’ / war widows’ issues
A client’s psychological needs may include:
A sense of control
Acceptance of disability
Freedom from undue stress
Life stage acceptance
Personal identity
Self-determination
Self-esteem
Sense of belonging
Veterans’ / war widows’ issues
How a client’s circumstances impact on their emotional and psychological needs is often complex. For example, an elderly client may be grieving the loss of their former lifestyle
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as a result of a degenerative disease, a client with a newly-acquired spinal injury might be feeling anger at the cause of their injury and subsequent loss of control, and a person with a chronic disability might by experiencing a lack of self-determination and self- esteem.
You should demonstrate a basic understanding of the impact a client’s circumstances may have on their emotional and psychological wellbeing. Again, this is important because it enables you to provide services which are more reflexive to a client’s needs, and, therefore, more effective at supporting a client to achieve desired outcomes.
The experience of pain can have a significant negative effect on a clients’ wellbeing. Consider the following case study:
Mandy Nielsen understands how chronic pain drives some people to the point of desperation. On maternity leave from her job as a social worker and plagued by chronic back pain, Nielsen used to stand in the shower each morning and think, “How many more months can I do this?”
With painkillers providing no relief and doctors unable to offer a solution, Nielsen was unable either to care for her baby son or to return to work. The scepticism she sometimes encountered from others and the attitude that it was “just psychological” also took their toll… Struck down by this disabling and often stigmatised condition, people lose their jobs, suffer family breakdown and end up watching in bewilderment as their lives fall apart. Some even reach the point of suicide.
Read the complete article here:
http://www.abc.net.au/health/features/stories/2010/03/11/2842912.htm
It is important that you recognise indications that a client’s experience of pain is affecting their wellbeing. Indicators that a client’s experience of pain is affecting their wellbeing are provided following:
Be less able to function Feel tired and lethargic Lose [their] appetite or have nausea Not be able to sleep, or have [their]sleep interrupted by pain Experience less enjoyment and more anxiety Become depressed, anxious, or unable to concentrate on anything except pain Feel a loss of control Have less interaction with friends; be less able to enjoy sex or affection Have a change in appearance Feel that [they] are more of a burden on family or other caregivers
Adapted from “Management of Cancer Pain” by the Agency for Health Care Policy and Research.
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When you recognise indications that a client’s experience of pain is affecting their well- being, it is essential that you report this according to organisation policy and protocol. This may involve formal reports, both in written and verbal format, to your supervisor and other senior persons in your organisations, as well as your clients’ other caregivers (such as their doctor or chronic pain specialist, etc.). You should familiarise yourself with your organisations policies and protocols for reporting instances which negatively impact a clients’ wellbeing.
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T O P I C 4 – S U P P O R T S O C I A L , E M O T I O N A L A N D P S Y C H O L O G I C A L
W E L L B E I N G
PROMOTE SELF-ESTEEM AND CONFIDENCE THROUGH USE OF POSITIVE AND SUPPORTIVE COMMUNICATION
It is a fundamental aspect of your role that you provide support in a manner that promotes the client’s self-esteem and confidence. How you do so ultimately depends on your unique clients and the context in which you work (including the types of services provided by your organisation). Consider the following list of ways you can promote the self-esteem and confidence of a client with a physical disability:
• Assert her right to make choices about her body • Feel ownership of her body • Restrict the limitations resulting from her disability to physical functioning
only and not impose those limitations on her sexual self • Be accepting, not ashamed of her body • Take action to enhance her attractiveness
Read the complete article here: http://www.spinalcord.org/pdf/body-image-self-esteem-webinar.pdf
Depending on your unique clients and the context in which you work (including the types of services provided by your organisation), you may be able to think of many other ways of providing support in a manner that promotes the client’s self-esteem and confidence.
COMMUNICATION
The extent to which the person is able to maintain their environment is largely dependent on the state of their physical well-being. However, consideration should also be given to their psychological and emotional state.
Whilst there may come a time in their life when the person is no longer able to manage their environment by themselves, they may still have the capacity to live at home if they are provided with assistance to deal with the tasks that they find more challenging.
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In order to maintain their independence as much as possible, and remain in the home environment, providing them with information about the services available to them enables the client to seek out the necessary services they need. This process in itself is empowering for the person. Not only are they making decisions about their lifestyle, but they are also engaging with other members of the community when they seek assistance, thus showing that they are still capable of exercising their communication and negotiating skills.
Try to identify the areas that the client is able to manage without assistance. Communicating this to the client is likely to boost their self-esteem, particularly if they are feeling emotionally vulnerable as a result of realising that they may require assistance in other aspects of their lives. Another way that the client can elevate their self-esteem is knowing that they have the capacity and ability to delegate tasks to others who are providing them with assistance.
RECOGNISE AREAS WHERE THE PERSON REQUIRES ASSISTANCE
By communicating appropriately with the person, you can help them to identify areas in which they feel that they might need assistance. Reinforce to the client that they still have the power to make the decision about what services they see as being as beneficial to them. This too will help them maintain a sense of empowerment. It may be that the assistance required is only minimal, or that the support services they engage will be infrequent, thus not encroaching excessively on their privacy. This enables the person to see that whilst they are receiving some assistance; they are still able to function independently in many other areas of their life.
It is important to develop a plan that identifies how the maintenance of the environment is to happen. Throughout the establishment of the plan, the person should be continuously consulted so that they have a sense of involvement, and that they have the ultimate control over their environment.
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CONTRIBUTE TO THE PERSON’S SENSE OF SECURITY THROUGH USE OF SAFE AND PREDICTABLE ROUTINES
Throughout their lives, people develop a set of routines. They learn to recognise what it is they find enjoyable in their lives and become accustomed to doing things their own particular way. In order for older people to maintain their sense of independence, it is important that they be able to maintain their routines and have the freedom to think the way they are used to, according to their abilities.
To assist the older person in maintaining their independence, this may involve bringing other people into their lives to maintain the objectives and goals of their service delivery plan. Those providing the required services need to take into consideration the routines of the client prior to the commencement of the services. This way the services can be provided at a time which is not intrusive to the client. Whilst the client may need to exercise some degree of flexibility, they are the person who really decides how and when the services are best provided.
Service delivery should be provided in accordance with the service plan. The service plan should indicate both how and when the services are to be provided. It should clearly identify areas of significant importance to the client such as their cultural, social and religious values, significant others in their lives, events of importance, and other interests and activities in their lives. These factors are important determinants of the style in which the services are provided and the way they are timed.
Regardless of whether the services are provided in the home or another environment such as an aged care facility, they should be provided in a timely manner. I.e. they need to accommodate for the routine of the older person. When the workers can identify he established routines, they can effectively design a time schedule which is not disrupting for the client. Having discussions regarding the time the service will take place are important before the services are implemented. This helps to avoid conflict that may arise as a result of disruption to routines.
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ENCOURAGE AND FACILITATE PARTICIPATION IN SOCIAL, CULTURAL, SPIRITUAL ACTIVITIES, USING EXISTING AND POTENTIAL NEW NETWORKS AND AS PER THE PERSON’S
PREFERENCES
An important part of respecting cultural and spiritual preferences is to provide your clients with information on the cultural and spiritual networks available to them.
Networks may include:
Advocates
Carers
Clergy / pastoral care providers
Family members
Friends
Veteran’s / war widow organisations
To be able to provide information to your clients on the cultural and spiritual networks available to them, it is important that you are aware of the cultural and spiritual networks available in your local community (including both existing and new, as they occur). As noted above, networking – that is, engaging – with other professionals in the community services and in related fields is important in this respect, as these networks will be able to provide you with valuable information on events and services which might be suitable for your clients. Also, as discussed, you may research suitable opportunities online and in local newspapers / magazines, etc.
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IDENTIFY ASPECTS OF SUPPORTING A PERSON’S WELLBEING OUTSIDE SCOPE OF KNOWLEDGE, SKILLS AND/OR JOB ROLE
AND SEEK APPROPRIATE SUPPORT AND IDENTIFY VARIATIONS TO A PERSON’S WELLBEING AND REPORT ACCORDING TO
ORGANISATION PROCEDURES
As noted above, regardless of the specific strategies you use to support your clients’ emotional wellbeing, you must ensure you actions are within your scope of knowledge and skills and/or the scope of your job role. Working within your scope means working within the bounds of what you have learned in your training course and have become qualified to provide. This is both a legal and ethical requirement for professionals in all fields.
Where a client requires support for their emotional wellbeing which is beyond your scope of knowledge and skills and/or the scope of your job role, you should seek alternative forms of appropriate support. For example, if a client appears to be experiencing an episode of depression or anxiety you should seek the support of a medical doctor, a counsellor and / or a psychiatrist or psychologist, etc. Again, seeking appropriate support for issues outside your scope of practice is both a legal and ethical requirement of your job role.
VARIATIONS
One of the most important aspects of your job role is to identify variations in a client’s physical condition – particularly when the client themselves is unable to do so – however it is just as important to identify variations in a client’s emotional well-being. Variations in a client’s emotional well-being may include:
As with variations in a client’s physical condition, you are able to identify variations in a client’s emotional wellbeing by getting to know your clients’ normal demeanour well, and carefully observing changes in their psychological state. Documentation (e.g. written records of a client’s mental state, etc.) may also assist you in identifying variations in clients’ emotional wellbeing.
When you identify variations in a client’s emotional well-being, it is essential that you report these to your supervisor in much the same way as you would variations to a client’s physical wellbeing. Remember, this is a key aspect of your duty of care – that is, your legal and ethical responsibility to ensure, to the greatest possible extent, the health and safety of your clients. Again, it is also important in terms of ensuring the client’s wellbeing – and this is the most fundamental aspect of your job.
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It is likely that your report of variations in a client’s emotional well-being will be made to your supervisor verbally in the first instance. However, your supervisor may also require you to complete additional written documentation and, depending on the circumstances surrounding the variation in the clients’ emotional wellbeing, you may also be required to make reports to others.
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IDENTIFY ANY CULTURAL OR FINANCIAL ISSUES IMPACTING ON THE PERSON’S WELLBEING
Whilst working in a HACC environment you are going to come across hundreds of issues that can or could possibly impact on a person in your care. None the least of financial and cultural.
FINANCIAL ISSUES
It is a well-known fact that people who are struggling financially have a higher rate of illness than those who are not.
You may often find that the well-being of your client’s is affected by the financial struggles they face. People who need home care do not work, perhaps live on disability income or aged pensions, where their disposable income is limited. People often isolate themselves because they do not have the finances to be socially active. This can increase depression and physical illness in your clients.
If you recognise signs of mental illness, depression or other signs that might be negatively impacting your client, consider their financial state as at least one aspect that could be impacting their well-being.
CULTURAL ISSUES
Cultural issues may also be affecting your client’s ability to socialise and therefore may be impacting on their well-being. People in care often have limited ability to socialise due to illness or incapacitation but in some cases there may be language barriers that can affect people. English may not be their first language and it is possible that they are isolated because of this.
Others may have had a lifetime of going to church for example. Due to their illness or incapacity, they are now limited to where they can go and what times they can go. This could be impacting on their well-being. If their church was not only a spiritual action but a social interaction then this could be impacting on their lives and well-being.
Of course these two issues are not the only ones that can impact of mental and physical well-being. You should consider all aspects of the person if you notice a deterioration in
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mental and physical health in your clients and record and report them to your supervisor.
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IDENTIFY THE PERSON’S RISK AND PROTECTIVE FACTORS IN RELATION TO MENTAL HEALTH
There are a range of approved screening tools, parameters, assessments, checklists, observations, activities and other measurement tools that can be used in order to ensure that all signs of developmental delay or mental health issues can be identified.
The identification of these factors is essential for ensuring that the services and referrals that are offered are appropriate to the clients’ needs. A lot of information can be gathered from the client using these types of standards assessments and tools.
The Australian Psychological Society creates a range of different tools that can be used in conjunction with tools that are created by specialists and provided and approved by the organisation that you are working for.
These tools have been created for use when a client is presenting with any of the commonly known signs of mental health or developmental delay issues. It is important to ensure that the correct tools are being used. If you are unsure you may contact a range of specialists within their network to consult and ensure the correct tool is being used.
Instructions on the tools will explain the appropriate times to use the tools and it is important that you conduct research and familiarise yourself with the range of tools and protocols that they can use in order to ensure that all developmental and mental health needs of clients will be appropriately assessed. You must be aware of the signs that may indicate that a client is dealing with either mental health or developmental issues. Signs of developmental delay may include but are not limited to the below categories.
Behavioural signs:
Attention span or ability to focus is markedly less than others of same age
Rare use of or avoidance of eye contact with others
Violent behaviour
Stares into space, rocks body or talks to self, more often than others of same
age
Disinterest in seeking love or approval from a caregiver or parent
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Gross motor signs:
Has a markedly clumsy manner when compared with others of same age
Vision signs:
Has difficulty following objects (or people) with eyes
Hearing signs:
Fails to develop sounds or words that would be appropriate for their age
Signs of mental health issues may include but are not limited to:
Changes in cognition:
o Hallucinations or delusions
o Excessive fears or suspiciousness (paranoia)
o Confused thinking
Changes in mood:
o Loss of interest in once pleasurable activities
o Thinking or talking about suicide
Changes in behaviour:
o Bizarre behaviour (strange posturing, ritualistic behaviour)
o Intention harming or killing of animals (especially in children)
o Hyperactivity
o Physical changes:
o Deterioration in hygiene or personal care
o Unexplained weight gains or loss
o Sleeping too much or being unable to sleep
Consultation and questioning of the client should be conducted in an exploratory and clinically professional manner at all times, if you feel that a client is presenting with issues that are outside your scope of responsibility or expertise then appropriate referrals must be made in line with organisational, legal and ethical guidelines.
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RECOGNISE AND REPORT POSSIBLE INDICATORS OF ABUSE OR NEGLECT AND REPORT ACCORDING TO ORGANISATION
PROCEDURES
Client abuse and/or neglect are fortunately rare in Australia. However it does occur. Consider the following report on an investigation conducted in 2014 by the Australian Broadcasting Corporation and Fairfax:
When it comes to people with disabilities, caregivers are supposed to be exactly that – carers, protecting the most vulnerable in our community. But what if managers in a major institution ignored warning signs that staff may have been abusing people in their care, effectively allowing the abuse, including sexual assault, to continue?
This week, in a joint Four Corners/Fairfax investigation, reporter Nick McKenzie lifts the lid on a major scandal involving one of the country’s biggest disability providers. How did a respected provider fail in its duty to the people it has sworn to protect and nurture?
Despite their horrific experiences, a number of disabled people and former staff speak about their treatment. The allegations they make are deeply disturbing.
They detail shocking sexual assaults repeatedly inflicted upon numerous disabled clients… with the victims left to fend for themselves, scarred and terrified. They tell how complaints were ignored and whistleblowers targeted, their warnings not acted upon. As a result, two men employed by the organisation – and now allegedly a third – went on to rape and sexually abused disabled clients.
Read the complete article here: http://www.abc.net.au/4corners/stories/2014/11/24/4132812.htm
It is important that you recognise possible indicators of client abuse and/or neglect. Consider the following examples of indicators of different types of abuse and neglect (bearing in mind that these are general examples):
(1) Physical Abuse
Signs in the Client
Physical harm (e.g.,. lacerations, burns, bruises, scratches, broken bones, etc.) Pain internally (especially abdomen), vomiting, drowsiness, etc. Frozen watchfulness. Regression, over-compliance, lack of communication. Avoidance of physical contact. Extremities covered by clothing, even in warm weather.
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(2) Emotional abuse
Signs in the Client
Depiction of violence in artworks. Regression, self-harming. Fearfulness when approached by strangers, or in new situations. Expresses feelings of worthlessness. Low tolerance to frustration. Delayed emotional, social, intellectual development; learning difficulties. Behavioural extremes; attention-seeking; lack of demonstration of love.
(3) Sexual abuse
Signs in the Client
Pain / itching in genital or anal areas. Disrupted toileting patterns; enuresis (wetting) or encopresis (soiling). Inappropriate sexualised behaviour; inappropriate sexual knowledge. Depiction of sexual acts in artworks. Behavioural extremes (regression, acting out, etc.). Inappropriate expressions of affection. Anxiety associated with removing clothes for normal daily activities.
(4) Neglect
Signs in the Client
Poor personal hygiene, including lack of skin ‘bloom’, hair loss, etc. Dirty clothing. Constantly hungry; failure to thrive; possibly obese. Lack of medical / dental care. Untreated sores / nappy rash. Frequent illness / low-grade infections. Delays in all developmental domains; erratic attendance at respite care. Lack of adequate supervision; extended stays at services. Inadequate sleep cycles; fatigue. Anxiety about abandonment. Self-comforting behaviours. Attention-seeking, often extreme.
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When you recognise and report possible indicators of client abuse and/or neglect, it is essential that you report these according to organisation policy and protocol. As discussed above, this may involve formal reports, both in written and verbal format, to your supervisor and other senior persons in your organisations, as well as your clients’ other caregivers (such as their adult guardian and medical doctor, etc.). You should familiarise yourself with your organisations policies and protocols for reporting indicators of client abuse and/or neglect.
It is important to note that you are likely to be subject to a legal requirement to report indicators of client abuse and/or neglect under your state / territory legislation. Your organisation’s policies and protocols for reporting indicators of client abuse and/or neglect will reflect your legal requirements.
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IDENTIFY SITUATIONS BEYOND SCOPE OF OWN ROLE AND REPORT TO RELEVANT PERSON
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.
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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.
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.
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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.
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T O P I C 5 – A D D I T I O N A L K N O W L E D G E
SELF-ACTUALISATION
“Self-actualization” represents a concept derived from Humanistic psychological theory and, specifically, from the theory created by Abraham Maslow. Self-actualization, according to Maslow, represents growth of an individual toward fulfillment of the highest needs; those for meaning in life, in particular. Carl Rogers also created a theory implicating a “growth potential” whose aim was to integrate congruently the “real self” and the “ideal self” thereby cultivating the emergence of the “fully functioning person”. It was Maslow, however, who created a psychological hierarchy of needs, the fulfillment of which theoretically leads to a culmination of fulfillment of “being values”, or the needs that are on the highest level of this hierarchy, representing meaning.
Maslow’s hierarchy reflects a linear pattern of growth depicted in a direct pyramidal order of ascension. Moreover, he states that self-actualizing individuals are able to resolve dichotomies such as that reflected in the ultimate contrary of free-will and determinism. He also contends that self-actualizers are highly creative, psychologically robust individuals. It is argued herein that a dialectical transcendence of ascension toward self-actualization better describes this type of self-actualization, and even the mentally ill, whose psychopathology correlates with creativity, have the capacity to self-actualize.
Maslow’s hierarchy is described as follows:
1. Physiological needs, such as needs for food, sleep and air.
2. Safety, or the needs for security and protection, especially those that emerge from social or political instability.
3. Belonging and love including, the needs of deficiency and selfish taking instead of giving, and unselfish love that is based upon growth rather than deficiency.
4. Needs for self-esteem, self-respect, and healthy, positive feelings derived from admiration.
5. And “being” needs concerning creative self-growth, engendered from fulfillment of potential and meaning in life.4
4 https://www.psychologytoday.com/blog/theory-and-psychopathology/201308/the-theory-self- actualization
https://www.psychologytoday.com/basics/creativity
https://www.psychologytoday.com/basics/sleep
https://www.psychologytoday.com/basics/relationships
https://www.psychologytoday.com/basics/self-esteem
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THE TWELVE STAGES OF THE HUMAN LIFE CYCLE
Which stage of life is the most important? Some might claim that infancy is the key stage, when a baby’s brain is wide open to new experiences that will influence all the rest of its later life. Others might argue that it’s adolescence or young adulthood, when physical health is at its peak. Many cultures around the world value late adulthood more than any other, arguing that it is at this stage that the human being has finally acquired the wisdom necessary to guide others. Who is right? The truth of the matter is that every stage of life is equally significant and necessary for the welfare of humanity. In my book The Human Odyssey: Navigating the Twelve Stages of Life, I’ve written that each stage of life has its own unique “gift” to contribute to the world. We need to value each one of these gifts if we are to truly support the deepest needs of human life. Here are what I call the twelve gifts of the human life cycle:
1. Prebirth: Potential – The child who has not yet been born could become anything – a Michaelangelo, a Shakespeare, a Martin Luther King – and thus holds for all of humanity the principle of what we all may yet become in our lives.
2. Birth: Hope – When a child is born, it instills in its parents and other caregivers a sense of optimism; a sense that this new life may bring something new and special into the world. Hence, the newborn represents the sense of hope that we all nourish inside of ourselves to make the world a better place.
3. Infancy (Ages 0-3): Vitality – The infant is a vibrant and seemingly unlimited source of energy. Babies thus represent the inner dynamo of humanity, ever fueling the fires of the human life cycle with new channels of psychic power.
4. Early Childhood (Ages 3-6): Playfulness – When young children play, they recreate the world anew. They take what is and combine it with the what is possible to fashion events that have never been seen before in the history of the world. As such, they embody the principle of innovation and transformation that underlies every single creative act that has occurred in the course of civilization.
5. Middle Childhood (Ages 6-8): Imagination – In middle childhoood, the sense of an inner subjective self develops for the first time, and this self is alive with images taken in from the outer world, and brought up from the depths of the unconscious. This imagination serves as a source of creative inspiration in later life for artists, writers, scientists, and anyone else who finds their days and nights enriched for having nurtured a deep inner life.
6. Late Childhood (Ages 9-11): Ingenuity – Older children have acquired a wide range of social and technical skills that enable them to come up with marvelous strategies and inventive solutions for dealing with the increasing pressures that society places on them. This principle of ingenuity lives on in that part of ourselves that ever seeks new ways to solve practical problems and cope with everyday responsibilities.
7. Adolescence (Ages 12-20): Passion – The biological event of puberty unleashes a powerful set of changes in the adolescent body that reflect themselves in a teenager’s sexual, emotional, cultural, and/or spiritual passion. Adolescence passion thus represents a significant touchstone for anyone who is seeking to reconnect with their deepest inner zeal for life.
8. Early Adulthood (Ages 20-35): Enterprise – It takes enterprise for young adults to accomplish their many responsibilities, including finding a home and mate, establishing a family or circle of friends, and/or getting a good job. This principle of enterprise thus serves us at any stage of life when we need to go out into the world and make our mark.
9. Midlife (Ages 35-50): Contemplation – After many years in young adulthood of following society’s scripts for creating a life, people in midlife often take a break from worldly responsibilities to reflect upon the deeper meaning of their lives, the better to forge ahead with new understanding. This element of contemplation represents an important resource that we can all draw upon to deepen and enrich our lives at any age.
http://www.institute4learning.com/books_videos.php#The_Human_Odyssey
http://www.institute4learning.com/books_videos.php#The_Human_Odyssey
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10. Mature Adulthood (Ages 50-80): Benevolence – Those in mature adulthood have raised families, established themselves in their work life, and become contributors to the betterment of society through volunteerism, mentorships, and other forms of philanthropy. All of humanity benefits from their benevolence. Moreover, we all can learn from their example to give more of ourselves to others.
11. Late Adulthood (Age 80+): Wisdom – Those with long lives have acquired a rich repository of experiences that they can use to help guide others. Elders thus represent the source of wisdom that exists in each of us, helping us to avoid the mistakes of the past while reaping the benefits of life’s lessons.
12. Death & Dying: Life – Those in our lives who are dying, or who have died, teach us about the value of living. They remind us not to take our lives for granted, but to live each moment of life to its fullest, and to remember that our own small lives form of a part of a greater whole. 5
6
5 http://www.institute4learning.com/stages_of_life.php 6 https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&im gil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.e nergistics.org%25252Fstandards-development%25252Fstandards-development-life- cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXa ke9v19zzUBqLFB-
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SERVICE DELIVERY APPROACHES
WHAT IS INTEGRATED SERVICE DELIVERY?
Integrated service delivery refers to a number of service agencies working together to collaborate and coordinate their support, services and interventions to clients. The focus is generally on clients, or client target groups, who have complex needs that require services from a number of agencies. Some efforts may be one-off, but more typically, there will be a system developed that enables agencies to meet or communicate and possibly streamline processes, to provide ongoing coordination.
The primary purpose of integrated service delivery approaches is to improve
outcomes for our clients. How this is achieved, and the factors that are
important, will vary according to the service settings, agency capabilities and
specific needs of the clients. They may include:
Improving communication between agencies to monitor client progress and
changes and be more responsive to these.
Identifying areas of duplication, working at cross-purposes, or what is
creating confusion for clients about who is doing what.
Developing one plan for the client which includes the work being done
by/with all agencies. This plan may also include actions and responsibilities
the client agrees to do.
Building understanding and capacity between the agencies – such as sharing
practice frameworks and legal and funding limitations – so they can work
together more effectively and generally support each other in their service
delivery.
Identifying systematic issues that create problems for clients, and for services
in their efforts to meet client needs. This may include identification of client
groups or needs that “fall between the gaps”. Ideally, there will be a process
whereby these issues can be brought to the attention of decision-makers.
Development of streamlined processes which can provide more seamless
services to clients, such as a common referral or assessment process.7
cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#img rc=jjg9MmoUrJV0iM%3A 7 http://communitydoor.org.au/sites/default/files/A_GUIDE_TO_INTEGRATED_SERVICE_DELIVERY_TO_CL IENTS.pdf.
http://communitydoor.org.au/sites/default/files/A_GUIDE_TO_INTEGRATED_SERVICE_DELIVERY_TO_CLIENTS.pdf
http://communitydoor.org.au/sites/default/files/A_GUIDE_TO_INTEGRATED_SERVICE_DELIVERY_TO_CLIENTS.pdf
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SERVICE STANDARDS
There are standards that are developed for the community services that outline basic good practice when providing a service to clients. There are basically 4 service delivery rules including:
Empowerment – this basically means that clients have the right to choose.
Every person must be treated in the same way.
Access and engagement – this basically means that everyone has access to the
service, there are no exclusions and clients can engage with the service as
part of the service.
Wellbeing – client’s must feel safe and happy. Clients must be supported to
think about what they want and how they can access it.
Participation – this means that clients can join in at any time whether at home,
work or in the community. Clients must be given information on other
services if they can assist.
There are also governance and management rules that apply to community service organisations. For access to all the current standards please go to:
http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,- guidelines-and-legislation/human-services-standards-evidence-guide-and-resource- tool
http://www.communityservices.act.gov.au/home/about_us/client_service_standards.
https://www.qld.gov.au/community/community-organisations- volunteering/community-care-standards/
http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-guidelines-and-legislation/human-services-standards-evidence-guide-and-resource-tool
http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-guidelines-and-legislation/human-services-standards-evidence-guide-and-resource-tool
http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-guidelines-and-legislation/human-services-standards-evidence-guide-and-resource-tool
http://www.communityservices.act.gov.au/home/about_us/client_service_standards
https://www.qld.gov.au/community/community-organisations-volunteering/community-care-standards/
https://www.qld.gov.au/community/community-organisations-volunteering/community-care-standards/
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FUNDING MODELS
DEPARTMENT OF HUMAN SERVICES FLEXIBLE FUNDING MODEL (2011 – 2012)
Flexible Funding models have been created to provide a new flexible way to fund many of the nation’s health priorities.
The creation of the Funds will, over time, reduce red tape, increase flexibility and more efficiently provide evidence based funding for the delivery of better health outcomes in the community.
For further information on flexible funding models go to: http://www.dhs.vic.gov.au/funded-agency-channel/about-service- agreements/simplifying-funding-and-reporting/flexible-funding
DEPARTMENT OF HEALTH BLOCK FUNDING MODEL
A fundamental principle of the new block funding arrangements is that changes to the service mix will be determined at the local level and negotiated between organisations and the Department of Health.
Changes should focus on the local community’s needs but also take into account broader health objectives, along with the capacity of the ACCHO.
Each ‘ACCO Services’ activity or ‘bucket’ includes sub activities that describe the programs or ‘jam jars’.
In a block funding model, ACCHOs will have the flexibility to move funds from one ‘bucket’ to another, as well as have one ‘jam jar’ to another, to address local priorities.
The service standards and guidelines for each program area will still apply.
For a full description of block funding arrangements go to: http://www.dhs.vic.gov.au/funded-agency-channel/about-service- agreements/simplifying-funding-and-reporting/flexible-funding
http://www.dhs.vic.gov.au/funded-agency-channel/about-service-agreements/simplifying-funding-and-reporting/flexible-funding
http://www.dhs.vic.gov.au/funded-agency-channel/about-service-agreements/simplifying-funding-and-reporting/flexible-funding
http://www.dhs.vic.gov.au/funded-agency-channel/about-service-agreements/simplifying-funding-and-reporting/flexible-funding
http://www.dhs.vic.gov.au/funded-agency-channel/about-service-agreements/simplifying-funding-and-reporting/flexible-funding
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ACTIVITY BASED FINDING
The key principles of ABF are the accurate and transparent allocation of funding to health services based on the activity they perform. This requires an ability to define, classify, count, cost and fund activity in a consistent manner.
Three key elements form the building blocks of ABF.
Classification – grouping activity that uses a similar amount of resources into
clinical meaningful classes
Counting – applying the same rules and units to measure the amount of
activity that occurs
Costing – measuring in dollars the amount of resources used to provide each
output in the classified group
For a full outline on activity based funding models go to:
https://www2.health.vic.gov.au/hospitals-and-health-services/funding-performance- accountability/activity-based-funding
https://www2.health.vic.gov.au/hospitals-and-health-services/funding-performance-accountability/activity-based-funding
https://www2.health.vic.gov.au/hospitals-and-health-services/funding-performance-accountability/activity-based-funding
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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.
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.8
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.
8 http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/duty_o…
http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/duty_of_care/duty_of_care.htm
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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.9
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.
9 http://youthworker.wikispaces.com/file/view/CHCCS502A_reading.doc
http://youthworker.wikispaces.com/file/view/CHCCS502A_reading.doc
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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
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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.
10 http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/confid…
http://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/confidentiality/confidentiality.htm
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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
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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.
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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 are all 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. 11
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 self- actualisation 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
11 http://www.ohchr.org/EN/Issues/Pages/WhatareHumanRights.aspx
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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.
12
12 https://en.wikipedia.org/wiki/Maslow’s_hierarchy_of_needs#/media/File:MaslowsHierarchyOfNeeds.svg
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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
Human rights are those rights which are essential to live as human beings – basic standards without which people cannot survive and develop in dignity. Human rights are inherent to the human person, inalienable and universal. The United Nations set a common standard on human rights with the adoption of the Universal Declaration of Human Rights in 1948. Although this Declaration is not part of binding international law, its acceptance by all countries around the world gives great moral weight to the fundamental principle that all human beings, rich and poor, strong and weak, male and female, of all races and religions, are to be treated equally and with respect. The United Nations has since adopted many legally binding international human rights treaties and agreements. These treaties are used as a framework for discussing and applying human rights. Through these instruments, the principles and rights they outline become legal obligations on those States choosing to be bound by them. The framework also establishes legal and other mechanisms to hold governments accountable in the event they violate human rights. The instruments of the international human rights framework are the Universal Declaration of Human Rights and the six core human rights treaties: the International Covenant on Civil and Political Rights; the International Covenant on Economic, Social and Cultural Rights; the Convention on the Rights of the Child; the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment; the International Convention on the Elimination of All Forms of Racial Discrimination; and the Convention on the Elimination of All Forms of Discrimination against Women. Every country in the world has ratified at least one of these, and many have ratified most of them. These treaties are important tools for holding governments accountable for the respect for, protection of and realization of the rights of individuals in their country. As part of the framework of human rights law, all human rights are indivisible, interrelated and interdependent. Understanding this framework is important to promoting, protecting and realizing children’s rights because the CRC—and the rights and duties contained in it—are part of the framework.13
13 http://www.unicef.org/crc/index_framework.html
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MANDATORY REPORTING
What is mandatory reporting? Mandatory reporting is a term used to describe the legislative requirement imposed on selected classes of people to report suspected cases of child abuse and neglect to government authorities. Parliaments in all Australian states and territories have enacted mandatory reporting laws of some description. However, the laws are not the same across all jurisdictions. The main differences concern who has to report, and what types of abuse and neglect have to be reported. There are also other differences, such as the state of mind that activates the reporting duty (i.e., having a concern, suspicion or belief on reasonable grounds – see Table 1) and the destination of the report. This sheet focuses on the major differences features of state and territory laws regarding who must report and what must be reported.
Table 1: Key features of legislative reporting duties: “state of mind” that activates reporting duty and extent of harm.
Jurisdiction State of mind Extent of harm
ACT Belief on reasonable grounds
Not specified: “sexual abuse … or non-accidental physical injury”
NSW
Suspects on reasonable grounds that a child is at risk of significant harm
A child or young person “is at risk of significant harm if current concerns exist for the safety, welfare or wellbeing of the child or young person because of the presence, to a significant extent, of … basic physical or psychological needs are not being met … physical or sexual abuse or ill- treatment … serious psychological harm”
NT Belief on reasonable grounds
Any significant detrimental effect caused by any act, omission or circumstance on the physical, psychological or emotional wellbeing or development of the child
QLD Becomes aware, or reasonably suspects
Significant detrimental effect on the child’s physical, psychological or emotional wellbeing
SA Suspects on reasonable grounds
Any sexual abuse; physical or psychological abuse or neglect to extent that the child “has suffered, or is likely to suffer, physical or psychological injury detrimental to the child’s wellbeing; or the child’s physical or psychological development is in jeopardy”
TAS
Believes, or suspects, on reasonable grounds, or knows
Any sexual abuse; physical or emotional injury or other abuse, or neglect, to extent that the child has suffered, or is likely to suffer, physical or psychological harm detrimental to the child’s wellbeing; or the child’s physical or psychological development is in jeopardy
https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect#table-1
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VIC Belief on reasonable grounds
Child has suffered, or is likely to suffer, significant harm as a result of physical injury or sexual abuse and the child’s parents have not protected, or are unlikely to protect, the child from harm of that type
WA Belief on reasonable grounds
Not specified: any sexual abuse
Australia Suspects on reasonable grounds
Not specified: any assault or sexual assault; serious psychological harm; serious neglect
Adapted from relevant state and territory legislation.
Who is mandated to make a notification? The legislation generally contains lists of particular occupations that are mandated to report. The groups of people mandated to notify cases of suspected child abuse and neglect range from persons in a limited number of occupations (e.g., Qld), to a more extensive list (Vic.), to a very extensive list (ACT, NSW, SA, Tas.), through to every adult (NT). The occupations most commonly named as mandated reporters are those who deal frequently with children in the course of their work: teachers, doctors, nurses, and police. What types of abuse are mandated reporters required to report? In addition to differences describing who is a mandated reporter across jurisdictions, there are differences in the types of abuse and neglect which must be reported. In some jurisdictions it is mandatory to report suspicions of each of the four classical types of abuse and neglect abuse (i.e., physical abuse, sexual abuse, emotional abuse, and neglect). In other jurisdictions it is mandatory to report only some of the abuse types (e.g., Vic., WA). Some jurisdictions also require reports of exposure of children to domestic violence. It is important to note that the legislation generally specifies that except for sexual abuse (where all suspicions must be reported), it is only cases of SIGNIFICANT abuse and neglect that must be reported. Reflecting the original intention of the laws, the duty does not apply to any and all “abuse” or “neglect”, but only to cases which are of sufficiently significant harm to the child’s health or wellbeing to warrant intervention or service provision. However, reflecting the qualitative differences presented by sexual abuse as opposed to other forms of abuse and neglect, five jurisdictions apply the reporting duty to all suspected cases of sexual abuse without requiring the reporter to exercise any discretion about the extent of harm which may have been caused or which may be likely (ACT, NT, SA, Tas., WA). In the other three jurisdictions, the practical application of the duty to report sexual abuse would still result in reports of all suspected sexual abuse being required, as sexual abuse should always create a suspicion of significant harm. Suspicions of more minor child abuse and neglect may be referred to child and family welfare agencies, especially where jurisdictions have made more extensive provision for this (e.g., Vic., NSW, Tas.). It is also important to note that the duty to report also applies to suspicions that significant abuse or neglect is likely to occur in future, not only suspected cases of significant abuse or neglect that have already happened. Table 2 provides an overview of the key features of the legislation in each state and territory: who must report, and what must be reported.
https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect#table-2
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Table 2: Mandatory reporting requirements across Australia
Who is mandated to
report? What must be
reported? Abuse and neglect types which must be reported
Legal provisions
ACT
A person who is: a doctor; a dentist; a nurse; an enrolled nurse; a midwife; a teacher at a school; a person providing education to a child or young person who is registered, or provisionally registered, for home education under the EDUCATION ACT 2004; a police officer; a person employed to counsel children or young people at a school; a person caring for a child at a child care centre; a person coordinating or monitoring home- based care for a family day care scheme proprietor; a public servant who, in the course of employment as a public servant, works with, or provides services personally to, children and young people or families; the public advocate; an official visitor; a person who, in the course of the person’s employment, has contact with or provides services to children, young people and their families and is prescribed by regulation
A belief, on reasonable grounds, that a child or young person has experienced or is experiencing sexual abuse or non- accidental physical injury; and
the belief arises from information obtained by the person during the course of, or because of, the person’s work (whether paid or unpaid)
Physical abuse Sexual abuse
Section 356 of the CHILDREN AND YOUNG PEOPLE ACT 2008 (ACT)
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NS W
A person who, in the course of his or her professional work or other paid employment delivers health care, welfare, education, children’s services, residential services or law enforcement, wholly or partly, to children; and
A person who holds a management position in an organisation, the duties of which include direct responsibility for, or direct supervision of, the provision of health care, welfare, education, children’s services, residential services or law enforcement, wholly or partly, to children
Reasonable grounds to suspect that a child is at risk of significant harm; and
those grounds arise during the course of or from the person’s work
Physical abuse Sexual abuse Emotional/psychologica
l abuse Neglect Exposure to
domestic violence
Sections 23 and 27 of the CHILDREN AND YOUNG PERSONS (CARE AND PROTECTION ) ACT 1998 (NSW)
NT
Any person
A belief on reasonable grounds that a child has suffered or is likely to suffer harm or exploitation
Physical abuse Sexual abuse Emotional/psychologica
l abuse Neglect Exposure to physical
violence (e.g., a child witnessing violence between parents at home)
Sections 15, 16 and 26 of the CARE AND PROTECTION OF CHILDREN ACT 2007 (NT)
Registered health professionals
Reasonable grounds to believe a child aged 14 or 15 years has been or is likely to be a victim of a sexual offence and the age difference between the child and offender is
Sexual abuse
Section 26(2) of the CARE AND PROTECTION OF CHILDREN ACT 2007 (NT)
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greater than 2 years
QLD
An authorised officer, a public service employee employed in the department, a person employed in a departmental care service or licensed care service
Awareness or reasonable suspicion of harm caused to a child placed in the care of an entity conducting a departmental care service or a licensee
Physical abuse Sexual abuse
Sections 9, 148 of the CHILD PROTECTION ACT 1999 (Qld)
Relevant persons: doctors; registered nurses; teachers; police officers; child advocates
Has a reasonable suspicion that a child has suffered, is suffering or is at an unacceptable risk of suffering significant harm
Physical abuse Sexual abuse
Part 1AA, Section 13a and 13b of the CHILD PROTECTION ACT 1999 (Qld)*
School staff
Awareness or reasonable suspicion that a child has been or is likely to be sexually abused; and the suspicion is formed in the course of the person’s employment
Sexual abuse
Sections 364, 365, 365A, 366, 366A of the EDUCATION (GENERAL PROVISIONS) ACT 2006 (Qld)
SA
Doctors; pharmacists; registered or enrolled nurses; dentists; psychologists; police officers; community corrections officers; social workers; teachers in
Reasonable grounds to suspect that a child has been or is being abused or neglected; and
Physical abuse Sexual abuse Emotional/psychologica
l abuse Neglect
Sections 6, 10 and 11 of the CHILDREN’S PROTECTION ACT 1993 (SA)
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educational institutions including kindergartens; family day care providers; employees/volunteer s in a government department, agency or instrumentality, or a local government or non-government agency that provides health, welfare, education, sporting or recreational, child care or residential services wholly or partly for children; ministers of religion (with the exception of disclosures made in the confessional); employees or volunteers in a religious or spiritual organisations
the suspicion is formed in the course of the person’s work (whether paid or voluntary) or carrying out official duties
Tas.
Registered medical practitioners; nurses; midwives; dentists, dental therapists or dental hygienists; registered psychologists; police officers; probation officers; principals and teachers in any educational institution including kindergartens; persons who provide child care or a child care service for fee or reward; persons concerned in the management of a child care service licensed under the CHILD CARE ACT 2001; any other person who is employed or engaged
A belief, suspicion, reasonable grounds or knowledge that:
a child has been or is being abused or neglected or is an affected child within the meaning of the FAMILY VIOLENCE ACT 2004
Physical abuse Sexual abuse Emotional/psychologica
l abuse Neglect Exposure to family
violence
Sections 3, 4 and 14 of the CHILDREN, YOUNG PERSONS AND THEIR FAMILIES ACT 1997 (Tas.)
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as an employee for, of, or in, or who is a volunteer in, a government agency that provides health, welfare, education, child care or residential services wholly or partly for children, and an organisation that receives any funding from the Crown for the provision of such services; and any other person of a class determined by the Minister by notice in the Gazette to be prescribed persons
Vic.
Registered medical practitioners, midwives, registered nurses; a person registered as a teacher under the EDUCATION, TRAINING AND REFORM ACT 2006 or teachers granted permission to teach under that Act; principals of government or non- government schools; and members of the police force
Belief on reasonable grounds that a child is in need of protection on a ground referred to in Section 162(c) or 162(d), formed in the course of practising his or her office, position or employment
Physical abuse Sexual abuse
Sections 182(1)(a)-(e), 184 and 162(c)-(d) of the CHILDREN, YOUTH AND FAMILIES ACT 2005 (Vic.)
WA
Doctors; nurses and midwives; teachers; and police officers
Belief on reasonable grounds that child sexual abuse has occurred or is occurring
Sexual abuse
Sections 124A and 124B of the CHILDREN AND COMMUNITY SERVICES ACT 2004
Court personnel; family counsellors; family dispute resolution
Reasonable grounds for suspecting that a child has
Physical abuse Sexual abuse
Sections 5, 160 of the FAMILY COURT ACT 1997 (WA);
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practitioners, arbitrators or legal practitioners representing the child’s interests
been: abused, or is at risk of being abused; ill treated, or is at risk of being ill treated; or exposed or subjected to behaviour that psychologicall y harms the child.
* This section has not yet been proclaimed and is likely to occur early in 2015 due to other legislative changes required as a result.
Commonwealth law
In addition to state and territory laws, the FAMILY LAW ACT 1975 (Cth) creates a mandatory reporting duty for personnel from the Family Court of Australia, the Federal Magistrates Court and the Family Court of Western Australia. This includes registrars, family counsellors, family dispute resolution practitioners or arbitrators, and lawyers independently representing children’s interests. Section 67ZA states that when in the course of performing duties or functions, or exercising powers, these court personnel have reasonable grounds for suspecting that a child has been abused, or is at risk of being abused, the person must, as soon as practicable, notify a prescribed child welfare authority of his or her suspicion and the basis for the suspicion.
What protections are given to reporters?
In all jurisdictions, the legislation protects the reporter’s identity from disclosure. In addition, the legislation provides that as long as the report is made in good faith, the reporter cannot be liable in any civil, criminal or administrative proceeding.
About whom can notifications be made?
Legislation in all jurisdictions except New South Wales requires mandatory reporting in relation to all young people up to the age of 18 (whether they use the terms “children” or “children and young people”). In New South Wales, the legislative grounds for intervention cover young people up to 18 years of age, but it is not mandatory to report suspicions of risk of harm in relation to young people aged 16 and 17.
What type of concerns must be reported, and what may be reported?
Mandatory reporting laws specify those conditions under which an individual is legally required to make a report to the relevant government agency in their jurisdiction. This does not preclude an individual from making a report to the statutory child protection service if they have concerns for the safety and wellbeing of a child that do not fall within mandatory reporting requirements. All statutes enable people to report concerns for a child’s welfare
Developed by Enhance Your Future Pty Ltd 85 CHCCCS023 – Support independence and wellbeing Version 2
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even if they do not compel such reports. Any voluntary non-mandated reports will receive the legal protections referred to above regarding confidentiality and immunity from legal liability.
Although particular professional groups (such as psychologists) or government agencies (such as education departments in some states) may have protocols outlining the moral, ethical or professional responsibility or indeed the organisational requirement to report, they may not be officially mandated under their jurisdiction’s child protection legislation. For example, in Queensland, teachers are required to report all forms of suspected significant abuse and neglect under school policy, but are only mandated to report sexual abuse under the legislation.
In what cases can child protection and welfare agencies respond?
A common assumption is that mandatory reporting requirements, the legislative grounds for intervention, and research classifications of abusive and neglectful behaviour are the same. In fact, mandatory reporting laws define the types of situations that must be reported to statutory child protection services. Legislative grounds for government intervention define the circumstances and, importantly, the threshold at which the statutory child protection service is legally able to intervene to protect a child. Researchers typically focus on defining behaviours and circumstances that can be categorised as abuse and neglect. These differences arise because each description serves a different purpose; the lack of commonality does not mean that the system is failing to work as policy-makers had intended.14
For further information on mandatory reporting please go to: https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
14 https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
Developed by Enhance Your Future Pty Ltd 86 CHCCCS023 – Support independence and wellbeing Version 2
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S U M M A R Y
Now that you have completed this unit, you should have the skills and knowledge required to provide individualised services in ways that support independence, as well as, physical and emotional wellbeing.
If you have any questions about this resource, please ask your trainer. They will be only too happy to assist you when required.
Developed by Enhance Your Future Pty Ltd 87 CHCCCS023 – Support independence and wellbeing Version 2
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R E F E R E N C E S
“Management of Cancer Pain” by the Agency for Health Care Policy and Research.
http://etraining.communitydoor.org.au/mod/page/view.php?id=286
http://www.abc.net.au/4corners/stories/2014/11/24/4132812.htm
http://www.abc.net.au/health/features/stories/2010/03/11/2842912.htm
http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Intellectual_disability_and_sexuality?o pen
http://www.culturaldiversity.com.au/resources/practice-guides/spiritual-support
http://www.dhs.vic.gov.au/__data/assets/pdf_file/0008/604583/dsd_personal_relationships_sexual_heal th_policy_250506.pdf
http://www.edac.org.au/letmespeak/html/rights.html
http://www.institute4learning.com/stages_of_life.php
http://www.spinalcord.org/pdf/body-image-self-esteem-webinar.pdf
http://www.unicef.org/crc/index_framework.html
https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
https://en.wikipedia.org/wiki/Maslow’s_hierarchy_of_needs#/media/File:MaslowsHierarchyOfNeeds.sv g
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https://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/values/values.htm
https://www.chf.org.au/files/Client-complaints-procedure-Nov-2010.pdf
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&im gil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.e nergistics.org%25252Fstandards-development%25252Fstandards-development-life- cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXa ke9v19zzUBqLFB- cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#img rc=jjg9MmoUrJV0iM%3A
https://www.psychologytoday.com/blog/theory-and-psychopathology/201308/the-theory-self- actualization
http://etraining.communitydoor.org.au/mod/page/view.php?id=286
http://www.abc.net.au/4corners/stories/2014/11/24/4132812.htm
http://www.abc.net.au/health/features/stories/2010/03/11/2842912.htm
http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Intellectual_disability_and_sexuality?open
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Intellectual_disability_and_sexuality?open
http://www.culturaldiversity.com.au/resources/practice-guides/spiritual-support
http://www.dhs.vic.gov.au/__data/assets/pdf_file/0008/604583/dsd_personal_relationships_sexual_health_policy_250506.pdf
http://www.dhs.vic.gov.au/__data/assets/pdf_file/0008/604583/dsd_personal_relationships_sexual_health_policy_250506.pdf
http://www.edac.org.au/letmespeak/html/rights.html
http://www.institute4learning.com/stages_of_life.php
http://www.spinalcord.org/pdf/body-image-self-esteem-webinar.pdf
http://www.unicef.org/crc/index_framework.html
https://aifs.gov.au/cfca/publications/mandatory-reporting-child-abuse-and-neglect
https://en.wikipedia.org/wiki/Maslow’s_hierarchy_of_needs#/media/File:MaslowsHierarchyOfNeeds.svg
https://en.wikipedia.org/wiki/Maslow’s_hierarchy_of_needs#/media/File:MaslowsHierarchyOfNeeds.svg
https://nationalvetcontent.edu.au/alfresco/d/d/workspace/SpacesStore/3973a53f-00c9-4d22-9a84-4844a817f302/602/shared/resources/director/induction/personal_care/privacy_and_dignity.htm
https://nationalvetcontent.edu.au/alfresco/d/d/workspace/SpacesStore/3973a53f-00c9-4d22-9a84-4844a817f302/602/shared/resources/director/induction/personal_care/privacy_and_dignity.htm
https://sielearning.tafensw.edu.au/MCS/CHCAOD402A/chcaod402a_csw/knowledge/values/values.htm
https://www.chf.org.au/files/Client-complaints-procedure-Nov-2010.pdf
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.google.com.au/search?q=stages+of+life+development&biw=1129&bih=710&tbm=isch&imgil=4zG8ETapEKR4LM%253A%253BHDNacUbpQ35C1M%253Bhttp%25253A%25252F%25252Fwww.energistics.org%25252Fstandards-development%25252Fstandards-development-life-cycle&source=iu&pf=m&fir=4zG8ETapEKR4LM%253A%252CHDNacUbpQ35C1M%252C_&usg=__A96cXake9v19zzUBqLFB-cO7f8E%3D&ved=0ahUKEwiFh_je2KPLAhUJFZQKHbcJCygQyjcIOA&ei=X7_XVsXbGomq0AS3k6zAAg#imgrc=jjg9MmoUrJV0iM%3A
https://www.psychologytoday.com/blog/theory-and-psychopathology/201308/the-theory-self-actualization
https://www.psychologytoday.com/blog/theory-and-psychopathology/201308/the-theory-self-actualization
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