CHCCCS015 Provide individualised support

CHCCCS015 Learner Guide 1.3 Page 0 of 66

CHCCCS015 Provide individualised

support Learner Guide

CHCCCS015 Learner Guide 1.3 Page 1 of 66

Table of Contents

Unit of Competency .......................................................................................................................... 5

Application ........................................................................................................................................... 5

Performance Criteria ............................................................................................................................ 6

Foundation Skills .................................................................................................................................. 8

Assessment Requirements ................................................................................................................... 9

1. Determine support needs ............................................................................................................ 11

1.1 – Interpret and clarify own role in implementing individualised plan and seek appropriate support

for aspects outside scope of own knowledge, skills or job role ............................................................ 12

What is your role in implementing an individualised plan? .............................................................. 12

Using the individualised plan to interpret and clarify role ................................................................ 13

Seeking support ................................................................................................................................. 13

Example Individual Care Plan ............................................................................................................. 14

Activity 1A .............................................................................................. Error! Bookmark not defined.

1.2 – Confirm individualised plan details with the person and with family and carers when appropriate

............................................................................................................................................................... 15

What is an individualised plan? ......................................................................................................... 15

Confirming individualised plan details ............................................................................................... 16

Person-centred, strengths-based and active care and support ......................................................... 16

Activity 1B .............................................................................................. Error! Bookmark not defined.

1.3 – Ensure the person is aware of their rights and complaints procedures ....................................... 18

Client rights ........................................................................................................................................ 18

Complaints procedures ...................................................................................................................... 19

Activity 1C .............................................................................................. Error! Bookmark not defined.

1.4 – Work with the person to identify actions and activities that support the individualised plan and

promote the person’s independence and rights to make informed decision-making .......................... 21

Supporting the plan ........................................................................................................................... 21

Promoting independence .................................................................................................................. 23

Activity 1D .............................................................................................. Error! Bookmark not defined.

1.5 – Prepare for support activities according to the person’s individualised plan, preferences and

organisation policies, protocols and procedures ................................................................................... 25

Preparing for support activities ......................................................................................................... 25

Activity 1E............................................................................................... Error! Bookmark not defined.

2. Provide support services ............................................................................................................. 26

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2.1 – Conduct exchanges with the person in a manner that develops and maintains trust ................. 27

Trust and interactions ........................................................................................................................ 27

Activity 2A .............................................................................................. Error! Bookmark not defined.

2.2 – Provide support according to the individualised plan, the person’s preferences and strengths,

and organisation policies, protocols and procedures ............................................................................ 29

Implementing the plan ....................................................................................................................... 29

Activity 2B .............................................................................................. Error! Bookmark not defined.

2.3 – Assemble equipment as and when required according to established procedures and the

individualised plan ................................................................................................................................. 31

Assembling equipment ...................................................................................................................... 31

Activity 2C .............................................................................................. Error! Bookmark not defined.

2.4 – Respect and include the family and/or carer as part of the support team .................................. 32

Support team ..................................................................................................................................... 32

Activity 2D .............................................................................................. Error! Bookmark not defined.

2.5 – Provide support according to duty of care and dignity of risk requirements ............................... 33

Duty of care requirements ................................................................................................................. 33

Human rights ...................................................................................................................................... 34

Dignity of risk requirements .............................................................................................................. 35

Activity 2E............................................................................................... Error! Bookmark not defined.

2.6 – Provide assistance to maintain a safe and healthy environment ................................................. 36

Workplace safety ............................................................................................................................... 36

Activity 2F ............................................................................................... Error! Bookmark not defined.

2.7 – Provide assistance to maintain a clean and comfortable environment ....................................... 38

Maintaining a clean environment ...................................................................................................... 38

Maintaining a comfortable environment........................................................................................... 39

Activity 2G .............................................................................................. Error! Bookmark not defined.

2.8 – Respect individual differences to ensure maximum dignity and privacy when providing support

............................................................................................................................................................... 41

Ensuring maximum dignity and privacy ............................................................................................. 41

Activity 2H .............................................................................................. Error! Bookmark not defined.

2.9 – Seek assistance when it is not possible to provide appropriate support ..................................... 43

Seeking assistance .............................................................................................................................. 43

Roles and responsibilities of those involved in the individualised plan ............................................ 44

Activity 2I ............................................................................................... Error! Bookmark not defined.

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3. Monitor support activities ........................................................................................................... 46

3.1 – Monitor own work to ensure the required standard of support is maintained ........................... 47

3.2 – Involve the person in discussions about how support services are meeting their needs and any

requirement for change ......................................................................................................................... 47

Monitoring own work ........................................................................................................................ 47

Activity 3A .............................................................................................. Error! Bookmark not defined.

3.3 – Identify aspects of the individualised plan that might need review and discuss with supervisor 50

Reviewing the individualised plan ..................................................................................................... 50

Indications that an aspect of the plan requires further discussion ................................................... 51

Activity 3B .............................................................................................. Error! Bookmark not defined.

3.4 – Participate in discussion with the person and supervisor in a manner that supports the person’s

self determination.................................................................................................................................. 52

Discussing with client and supervisor ................................................................................................ 52

Activity 3C .............................................................................................. Error! Bookmark not defined.

4. Complete reporting and documentation ...................................................................................... 53

4.1 – Maintain confidentiality and privacy of the person in all dealings within organisation policy and

protocols ................................................................................................................................................ 54

Confidentiality .................................................................................................................................... 54

Privacy ................................................................................................................................................ 54

Activity 4A .............................................................................................. Error! Bookmark not defined.

4.2 – Comply with the organisation’s informal and formal reporting requirements, including reporting

observations to supervisor .................................................................................................................... 57

Reporting requirements ..................................................................................................................... 57

Mandatory reporting ......................................................................................................................... 59

Activity 4B .............................................................................................. Error! Bookmark not defined.

4.3 – Identify and respond to situations of potential or actual risk within scope of own role and report

to supervisor as required ....................................................................................................................... 60

Situations of risk ................................................................................................................................. 60

Reporting to supervisor ..................................................................................................................... 61

Activity 4C .............................................................................................. Error! Bookmark not defined.

4.4 – Identify and report signs of additional or unmet needs of the person and refer in accordance

with organisation and confidentiality requirements ............................................................................. 62

Additional and unmet needs .............................................................................................................. 62

Activity 4D .............................................................................................. Error! Bookmark not defined.

4.5 – Complete and maintain documentation according to organisation policy and protocols ........... 63

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4.6 – Store information according to organisation policy and protocols .............................................. 63

Completing and maintaining documentation .................................................................................... 63

Storing information ............................................................................................................................ 63

Activity 4E............................................................................................... Error! Bookmark not defined.

Summative Assessments ............................................................................ Error! Bookmark not defined.

References ............................................................................................................................................. 65

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Unit of Competency Application This unit describes the skills and knowledge required to organise, provide and monitor support services within the limits established by an individualised plan. The individualised plan refers to the support or service provision plan developed for the individual accessing the service and may have many different names in different organisations. This unit applies to workers who provide support under direct or indirect supervision in any community services or health context. The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.

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Performance Criteria Element Elements describe the essential outcomes.

Performance Criteria Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Determine support

needs 1.1 Interpret and clarify own role in implementing individualised

plan and seek appropriate support for aspects outside scope of own knowledge, skills or job role

1.2 Confirm individualised plan details with the person and with family and carers when appropriate

1.3 Ensure the person is aware of their rights and complaints procedures

1.4 Work with the person to identify actions and activities that support the individualised plan and promote the person’s independence and rights to make informed decision-making

1.5 Prepare for support activities according to the person’s individualised plan, preferences and organisation policies, protocols and procedures

2. Provide support

services 2.1 Conduct exchanges with the person in a manner that

develops and maintains trust 2.2 Provide support according to the individualised plan, the

person’s preferences and strengths, and organisation policies, protocols and procedures

2.3 Assemble equipment as and when required according to established procedures and the individualised plan

2.4 Respect and include the family and/or carer as part of the support team

2.5 Provide support according to duty of care and dignity of risk requirements

2.6 Provide assistance to maintain a safe and healthy environment

2.7 Provide assistance to maintain a clean and comfortable environment

2.8 Respect individual differences to ensure maximum dignity and privacy when providing support

2.9 Seek assistance when it is not possible to provide appropriate support

3. Monitor support

activities 3.1 Monitor own work to ensure the required standard of

support is maintained 3.2 Involve the person in discussions about how support services

are meeting their needs and any requirement for change 3.3 Identify aspects of the individualised plan that might need

review and discuss with supervisor 3.4 Participate in discussion with the person and supervisor in a

manner that supports the person’s self determination

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Element Elements describe the essential outcomes.

Performance Criteria Performance criteria describe the performance needed to demonstrate achievement of the element.

4. Complete reporting

and documentation 4.1 Maintain confidentiality and privacy of the person in all

dealings within organisation policy and protocols 4.2 Comply with the organisation’s informal and formal

reporting requirements, including reporting observations to supervisor

4.3 Identify and respond to situations of potential or actual risk within scope of own role and report to supervisor as required

4.4 Identify and report signs of additional or unmet needs of the person and refer in accordance with organisation and confidentiality requirements

4.5 Complete and maintain documentation according to organisation policy and protocols

4.6 Store information according to organisation policy and protocols

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Foundation Skills The Foundation Skills describe those required skills (such as language, literacy, numeracy and employment skills) that are essential to performance.

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

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Assessment Requirements 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 evidence that the candidate has:

➢ Used individualised plans as the basis for the support of 3 individuals.

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:

➢ Rationale and processes underpinning individualised support planning and delivery: o basic principles of person-centred practice, strengths-based practice and active support o documentation and reporting requirements

➢ Roles and responsibilities of different people and the communication between them: o carers and family o person being supported o health professionals o individual workers o supervisors

➢ Service delivery models in the relevant sector ➢ Legal and ethical requirements and how these are applied in an organisation and individual

practice, including: o privacy, confidentiality and disclosure o duty of care o dignity of risk o human rights o discrimination o mandatory reporting o work role boundaries – responsibilities and limitations

➢ Factors that affect people requiring support ➢ Practices that support skill maintenance and development ➢ Indicators of unmet needs and ways of responding ➢ Risk management considerations and ways to respond to identified risks.

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Assessment Conditions Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. The following conditions must be met for this unit:

➢ Use of suitable facilities, equipment and resources, including: o individualised plans and equipment outlined in the plan o infection control policies and procedures

➢ Modelling of standard industry operating conditions and contingencies, including involvement of real people when using relevant equipment

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors. Links Companion volumes from the CS&HISC website - http://www.cshisc.com.au Companion Volume implementation guides are found in VETNet - https://vetnet.education.gov.au/Pages/TrainingDocs.aspx?q=5e0c25cc-3d9d-4b43-80d3- bd22cc4f1e53

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1. Determine support needs

1.1. Interpret and clarify own role in implementing individualised plan and seek appropriate

support for aspects outside scope of own knowledge, skills or job role

1.2. Confirm individualised plan details with the person and with family and carers when

appropriate

1.3. Ensure the person is aware of their rights and complaints procedures 1.4. Work with the person to identify actions and activities that support the individualised

plan and promote the person’s independence and rights to make informed decision- making

1.5. Prepare for support activities according to the person’s individualised plan, preferences

and organisation policies, protocols and procedures

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1.1 – Interpret and clarify own role in implementing individualised plan and seek appropriate support for aspects outside scope of own knowledge, skills or job role

By the end of this chapter, the learner should be able to:

➢ Identify five tasks required in your work role in implementing individualised plans

➢ Recognise five tasks they are not trained or permitted to do within their work role

➢ Identify the persons permitted to perform the five tasks they are not trained or

permitted to do.

What is your role in implementing an individualised plan? It is very unlikely that one person will responsible for all aspects of a client’s care. Different people will provide different services and complete different tasks. You need to be able to interpret and clarify your own role in implementing an individualised plan. Different aspects and elements of a client’s individualised plan will be applicable to different types and levels of staff. What is your role in relation to implementing an individualised plan? What are your responsibilities? Your role and responsibilities will depend on your qualifications, authority, experience or training. You should find your specific role and responsibilities within your job description. It is important to never attempt something that isn’t considered as part of your role. If administering medication is not your responsibility – don’t ever attempt it. If there is any uncertainty surrounding your role in implementing an individualised plan you should clarify this with your manager or supervisor to ensure you are aware of what is and isn’t included within your role. It is essential that you are confident with what your role entails and the expectations and limitations that are associated with it. By being aware of the expectations and limitations of your particular role, you can avoid overstepping any boundaries and ensure you don’t fail to meet expectations. Overstepping boundaries

If you overstep your boundaries, you risk breaking codes of conduct and other laws and regulations. Many tasks require specific training and qualifications, such as catheter care or administering injections. If you attempt to do things you are not specifically trained to do, it can have serious repercussions for the client, for yourself and for the organisation. For example, if you incorrectly inserted the catheter or failed in some other aspect of its care, the client could become very uncomfortable or gain a serious infection. This would make the client very ill and you would be accountable for your actions. When injecting clients with insulin or any other drug, there is a chance of death or brain damage if an air bubble enters the bloodstream; if this was caused by an untrained person giving the shot, then they would not be protected by any insurances or workplace cover and if the patient died, could be convicted of manslaughter and gross negligence.

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Failing to meet expectations

Failing to carry out and complete your tasks can have negative effects for the clients, your colleagues, yourself and the organisation. There will be repercussions for all failures, from forgetting to change a client’s sheets, to forgetting their medication. As tasks are assigned to particular teams or individuals, an oversight or deliberate omission could go unnoticed for any period of time. Care plans work when teams work in harmony and can be visualised as a chain or a circuit; if the chain or circuit is broken, for whatever reason, then proper care is not being provided.

Using the individualised plan to interpret and clarify role Your job description and training and practice will, to an extent, determine your role in implementing an individualised plan. However, the client’s personal needs, wants and abilities will help to determine the extent of the support you provide. An individualised care plan may indicate who is responsible for implementing strategies outlined in the plan, as shown in the highlighted section in the example care plan overpage.

Seeking support If you face something that is outside the scope of your own knowledge, skills or job role, you should seek the appropriate support. Don’t ever ignore something – if something needs doing but you are not adequately qualified, find someone who is. Feeling able to seek support when you need it is a good quality to have and it can lead to all-round better care for your clients. For example, you are helping a client to get dressed in the morning and you notice a wound on their elbow that looks inflamed and you think it could become infected. You know that you have a basic understanding about dressing wounds but your specific role, in this case, is to assist the client in their daily activities (like getting dressed). Rather than ignoring the wound and allowing it to become infected, you should report it to someone appropriate. The appropriate person should be a worker whose role involves dressing wounds, particularly infected ones. This will ensure that the client still receives the necessary care.

P a g e | 14

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Example Individual Care Plan

Adult Services

INDIVIDUAL CARE PLAN

Facility:_____

Complete by: ___________

Authorised by: _________ Client identification

URN:

Family name:

Given names:

Date of birth:

Sex:

Signature:___________ ___

Date of authorisation___________

Client signature: Client has been given copy of the care plan? Y N

Carer’s signature: Please indicate which tools and sources have been used to create this care plan:

Date Issue Objective Strategy/Intervention Person(s) responsible Review date

13/06/17 Isolation Seek social opportunities

Sign up to the local coffee morning Client with help from support worker

20/06/17

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1.2 – Confirm individualised plan details with the person and with family and carers when appropriate

By the end of this chapter, the learner should be able to:

➢ Identify the purpose of an individualised plan

➢ Recognise what is meant by person-centred practice, strengths-based practice and

active support

➢ Determine the importance of developing and confirming an individualised plan with

the client.

What is an individualised plan? Individualised plans are personalised plans of care that are created for each client and are specific to the client and their needs. They can be either formal or informal and can be used in a variety of settings. For example, individualised plans are often used in the client’s home, in residential settings or in a range of community services. Individualised plans may be useful in the care of every type of client; including children, young clients, older clients and clients with a disability. Individualised plans should include all the information that is relevant to the care of that client, for example:

➢ General care requirements

➢ Care goals

➢ Records of health and wellbeing of clients

➢ Issues, problems and emergencies that arise

➢ Client’s wishes

➢ Daily needs

➢ Treatments given and needed

➢ Details of medication

➢ Steps and directions for future care.

These plans will be reviewed by the people involved with the client’s care (e.g. doctors and specialists). It is important to keep them up-to-date and refer to them regularly throughout the delivery of care.

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Confirming individualised plan details You may find that your particular role involves having to develop a client’s individualised care plan. You should do this with your client; it is their plan, after all. They should be treated as a person, not just a client and their opinions and thoughts should be taken into consideration. They should be able to contribute to their care plan and give details of what they want their care to include. This will ensure that the client feels important and like their wishes are being taken into consideration. It also means that you will have a full understanding of what the client wants, needs and expects in terms of care. Once a plan has been developed for a client, the specific details within it should be confirmed with the client. They should review the details and assess whether they are accurate and suitable. They may need to amend the requirements or conditions related to their care. By confirming the details with the client, you can be confident that the details are accurate and you can go ahead with delivering the care in the particular way that the client wishes. This process of confirming the details also gives the client chance to query or amend anything that they are not particularly happy about and will reduce the chance of any problems or issues occurring. You will find that, in some instances, it is necessary to confirm the details of an individualised plan with the family and carers of your client. Sometimes, a client will want their family or carers to be involved with the creation and maintenance of their individualised plan. This is completely fine and you should ensure that you grant their wishes. In other situations, a client may not be able to contribute to their care plan or confirm the details of it. For example, if a client is suffering with Dementia they may not be able to fully contribute to their plan, if at all. Therefore, it would be necessary to seek confirmation from family members or carers. An effective measure when confirming is to get your client, or their family member or carer, to sign their name to accept that they happy with the details. Whether signing the whole document or just sections that have been changed, asking for a signature is a good way of ensuring they are satisfied with the plan.

Person-centred, strengths-based and active care and support So, why is it so important to involve your clients in the development and confirmation of their individualised care plan? You will find that, nowadays, the approach to care is focused on ensuring that it is person-centred, strengths-based and active. Person-centred practice involves caring for your clients in the way that they want you to. It relies on your getting to know them as an individual and finding out what they need from their care, their goals and any preferences related to care. Basically, how do they want to be cared for? Strengths-based practice involves viewing clients as resourceful and emphasising their self- determination. Clients aren’t just clients – they’re people and they are often capable of contributing to their care in one way or another. It relies on client-led care and doesn’t focus on the weaknesses of that client (although they shouldn’t be completely forgotten). Instead, this practice builds on the client’s existing characteristics and strengths to encourage them to address their own care and develop their own plans.

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Active support involves giving clients some level of control over their care. It encourages them to get involved, engaging and participating in their own care. Together, these approaches to care ensure that a client is considered as a resource and that they can be valuable to their own care. By including your client in the development of their care plan, you have started this at the very beginning of the process. You may find the details of the types of service you should be delivering will be detailed in the relevant service delivery model. Service delivery models

These are the specific frameworks that are developed and followed; they define the approach taken with providing services to clients and are recognised as being effective ways to deliver care. They are developed to target specific groups and needs, and may vary between the states and territories. For example, service delivery models exist for:

➢ Rural and remote areas of Australia

➢ Individuals with mental health issues

➢ Aged-care

➢ Individuals with disability needs.

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1.3 – Ensure the person is aware of their rights and complaints procedures

By the end of this chapter, the learner should be able to:

➢ Identify ten or more rights of the client

➢ Summarise what is included in a complaints procedure

➢ Recognise the importance of having a complaints procedure.

Client rights Your clients will have rights, regardless of the situation in which they are receiving their care. It is your responsibility to ensure that your clients are aware of these rights whilst supporting their rights whilst delivering care to them. You will be able to find the relevant information within your workplace and you, and the other members of staff, should be trained to develop an understanding. This chapter will explore different examples of client rights. Clients have the rights to receive the appropriate care relevant to their specific needs whilst being treated with respect and dignity. They have the right to live with privacy, free from abuse and/or neglect and not be victimised, discriminated against or exploited. Your clients also have the right to a safe and secure environment in which they should be able to move around freely. Most importantly, your clients have the right to make their own decisions and have these decisions, along with their preferences, considered and respected. Other rights that your clients have include:

➢ Access information about their own medical details

➢ A choice of suitable treatments

➢ To be treated as an individual

➢ Maintain religious practices

➢ Use their preferred language

➢ Maintain social and personal relationships with others

➢ Freedom of speech

➢ Control their own finances

➢ Retain their own possessions

➢ Choose which activities and similar they participate in

➢ To have access to generally-available community services and activities

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➢ Have a say over their living arrangements

➢ Access to information about their rights

➢ The right to complain

➢ Not be afraid of reprisals arising and a result of

complaint or query

➢ To withdraw from the service at any time.

Although this list is not exhaustive, it does provide you with a brief overview.

Complaints procedures As you can see from the bullet points above, your clients have the right to complain and shouldn’t be afraid to do so, should they think it is necessary. As well as ensuring they are aware of this right, you need to ensure that they are aware of the complaints procedures too. You may find that your complaints procedure depends on your own organisation; this chapter will look at the general aspects of a typical complaints procedure. The nature of complaints may differ, but most commonly complaints are an expression of dissatisfaction with the care being delivered, disappointment with the behaviour of a member of staff or frustration with the complete failure of their care. Generally, a complaints procedure will include the following steps:

➢ Acknowledgement

o any complaint made by a client should be acknowledged as quickly as

possible

➢ Assessment

o complaint should be investigated and evaluated in order to determine the

direction needed for resolution

➢ Response

o refer back to client with a clear response/decision

➢ Follow up

o any concerns expressed by client should be followed up.

By ensuring that your client is aware of the complaints procedure that is in place, they will know how to approach the situation in order to get the outcome that they require. So, what should they do if they want to make a complaint? Any client wishing to make a complaint should be able to do so in a safe and constructive way. Whether it’s made in person, in writing, over the telephone or through email, they should feel confident that it will be taken seriously and acted on accordingly. Once a complaint is made, the client should be informed on the specific plan. What are the steps involved in the process? How

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will it be investigated? How soon can they expect a response? What can they do if they are not happy with the outcome? It is extremely important to have an effective complaints procedure in place when delivering care to clients. It can ensure that any issues or problems highlighted by clients are dealt with quickly and efficiently. When dealt with correctly, complaints can contribute to the continuous improvement of the care that you are delivering. If you are able to deal with complaints appropriately, your relationships with the clients, their family and their carer can be enhanced, leading to an overall improved standard of care. When dealing with complaints, it is important to take any relevant legislation into consideration.

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1.4 – Work with the person to identify actions and activities that support the individualised plan and promote the person’s independence and rights to make informed decision-making

By the end of this chapter, the learner should be able to:

➢ Identify eight or more actions and/or activities that can support a client’s

individualised plan

➢ Determine the importance of promoting and encouraging client independence

➢ Provide six examples of the different decisions a client has the right to make.

Supporting the plan The client’s requirements for daily care and enrichment can be met and supported with the provision of additional services and assistance that addresses their wider needs. It is your responsibility to work with your clients to identify the specific actions and activities that can support their individualised plan. This support can refer to:

➢ Accommodation support

➢ Community access

➢ Employment support

➢ Lifestyle support

➢ Personal care

➢ Social support

➢ Support involving simple technical skills, such as:

o active assistive exercises

o application of anti-thrombotic stockings

o application of prostheses

o assistance with breathing tubes (under direct supervision of a health professional)

o catheter care (not including insertion or removal of tubes)

o deep breathing/coughing exercises

o simple dressing

o simple eye care

➢ Cleaning services

➢ Garden maintenance services

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➢ Home maintenance/modification services

➢ Laundry services

➢ Meal preparation and/or delivery services

➢ Shopping services

➢ Transport services.

These can support all elements of the client’s life, either by addressing their basic day-to- day medical and health needs, enriching their lives or by enabling them to retain their independence. Clients may enquire or request supportive services, or you may be able to identify an appropriate service to recommend to them. For example:

➢ You know that Mrs Anderson struggles with her laundry. She tells you that her

washing machine has broken. Instead of helping her arrange to buy a new machine,

you could ask her whether she has considered using a home-delivery laundry

service. This would address her issues with the laundry and allow her to avoid a

large one-off payment.

➢ Mr Richards tells you that he is unhappy in his flat, as it is up a flight of stairs and he

is concerned about youths congregating outside. He asks you to research and

recommend a retirement complex, ideally with a warden. You could source

appropriate accommodation and work with him to find an ideal home.

➢ You know that Mr Jacobs does not cook or eat hot meals

since his wife passed away and he lives off basic snack

items and bread. He is losing weight and it is affecting

several aspects of his general wellbeing; with his

agreement, you could refer him to a meals-provision

service, which will deliver hot meals at a designated time

each day or provide him with ready-made meals that he

could simply microwave on the plate.

You should always consult the client before making any decisions on their behalf; you also need to adhere to confidentiality laws. This means that you cannot pass on a client’s details, especially financial and medical information, to a third party without the client’s express consent.

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Promoting independence Independence is often considered one of the most important attributes that a person can possess. Following the principles of person-centred, strengths-based and active support and care, it is essential that you promote the independence of your clients. Your clients should be encouraged to do as much as possible for themselves. Your role is to promote this independence; get your clients to do what they feel comfortable with doing. You should strive to help your clients improve their quality of life whilst maintaining their pride and keeping their dignity. Just because an individual needs care and support, it doesn’t mean their life should stop. You should do what you can, and what they feel comfortable with, to promote their independence. The level of independence a client has will obviously depend on the individual client and their particular situation; everyone is different and likes their own things. For example, for one client, making their own cup of tea in the morning is something that they may not be ready to lose. How can you ensure they keep this little bit of independence? Think about the different activities that can promote a client’s independence. These can involve teaching new skills or working on existing skills, such as:

➢ Cooking skills

➢ Cleaning skills

➢ Shopping skills

➢ Exercise advice

➢ Gardening skills

➢ Technology skills:

o using the internet

o using the DVD player

o using the television

➢ Housekeeping skills.

Along with a client’s independence, you should also strive to promote their right to make informed decisions. Clients have the right to make decisions about their care and daily lives. Clients should also be encouraged and given the opportunity to make smaller decisions on a day-to-day basis. For example, a client should be encouraged to make decisions about:

➢ What to wear

➢ What to eat

➢ Who to talk to

➢ What activities to participate in

➢ What to watch on television

➢ Whether to go out into the garden or not

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➢ If they want to call their friends or families

➢ Whether to read the paper

➢ Which paper to read.

No matter how trivial or insignificant these choices may seem, clients tend to appreciate every one of them and each contributes to their self-worth, autonomy, independence and confidence. Imagine how your quality of life and self-esteem would suffer if these kinds of decisions were made for you. Time, patience and convenience should not be a factor in implementing clients’ decisions; they should be given time to think about their choices and then their elected choice should be met. Clients’ independence and their rights to make decisions should always be promoted; this is an essential part of care provision.

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1.5 – Prepare for support activities according to the person’s individualised plan, preferences and organisation policies, protocols and procedures

By the end of this chapter, the learner should be able to:

➢ Determine how organisational policies, protocols and procedures will affect the

provision of support activities and services for clients.

Preparing for support activities As explained in the previous section, support activities and services can be arranged and recommended to improve the quality of life of clients. Support can be determined based upon:

➢ The client’s individualised plan: the plan will include information on the client’s

medical and social needs; these needs can usually be easily matched to a relevant

supportive service. Many plans will also detail the lifestyle and preferences of the

client, including hobbies and such.

➢ Client preferences: the client may make their preferences known through general

conversation, requests or when reviewing their care plan. This may be their desires

or dislikes; if a client doesn’t like craft of any kind, then you should avoid referring

them to art classes, knitting groups and similar. Client preferences may refer to

more important aspects of their care, such as their eating preferences or the fact

that they do not like strangers coming into their

house.

➢ Organisational policies and procedures: these

may stipulate that certain types of support

should or should not be offered. For example,

medical and health services must be provided

where required. The organisation may specify

that staff should encourage the clients to join

some sort of social club, but may prohibit them

from arranging any financial services.

In general, you should follow the policies set out by the organisation and work within these parameters to recommend and arrange services that the client requires or could benefit from. For popular services, the company may have selected a favoured suitable service, such as a particular laundry service or particular social club.

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2. Provide support services

2.1. Conduct exchanges with the person in a manner that develops and maintains trust

2.2. Provide support according to the individualised plan, the person’s preferences and

strengths, and organisation policies, protocols and procedures 2.3. Assemble equipment as and when required according to established procedures and

the individualised plan

2.4. Respect and include the family and/or carer as part of the support team

2.5. Provide support according to duty of care and dignity of risk requirements 2.6. Provide assistance to maintain a safe and healthy environment 2.7. Provide assistance to maintain a clean and comfortable environment 2.8. Respect individual differences to ensure maximum dignity and privacy when

providing support 2.9 Seek assistance when it is not possible to provide appropriate support

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2.1 – Conduct exchanges with the person in a manner that develops and maintains trust

By the end of this chapter, the learner should be able to:

➢ Demonstrate their ability to interact effectively with others in a way that develops

and maintains trust. This may involve:

o implementing a range of polite, friendly and respectful interactions, such as

acknowledgements, greetings and conversations

o being truthful, respectful and honest with the client

o being patient

o avoiding letting bad feelings or bad moods show in front of the client

o showing an interest in making a personal connection with the client, e.g.

asking about their hobbies, families, etc.

Trust and interactions Every interaction you have with a client should be friendly, polite and respectful. Interactions may include:

➢ Acknowledging them as you pass

➢ Greeting them in the morning

➢ Conversations with them

➢ Working with them.

The following will help to ensure that exchanges develop and maintain trust:

➢ Be truthful; don’t lie or hide things from the client

➢ Give straight answers, not vague generalities

➢ Be respectful

➢ Don’t let your bad mood show

➢ And certainly don’t take it out on the client

➢ Be patient, don’t show that you’re itching to get away for lunch

➢ Follow through with your promises

➢ Take the time to ask them how they are and whether you can get them anything

➢ Have conversations with them as your work with them

➢ Enquire about their hobbies.

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Remember that a single bad encounter or mistake can have a big impact on the client; you can be polite and lovely to them for weeks on end, but if you snap at them once or are rude, you can seriously damage the relationship and their trust and respect of you. Bear in mind that you may also inadvertently upset a client; a particular thing may offend them, such as not knocking before you come in their room or mentioning something they feel strongly about. The client may not necessarily tell you that you have upset them, they may suddenly go quiet and withdrawn, or even complain about you. Where you become aware that an issue has arisen, take the time to apologise and explain yourself, saying you’re very sorry about bad-mouthing their favourite sports team/television program/hobby or that you didn’t mean to ignore them in the corridor on Tuesday, but you were in a rush to deal with an emergency with another client. Many clients will appreciate you taking this time out and apologising. If they are more stubborn than this, you may just have to focus on building your relationship back up, using the methods you already use.

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2.2 – Provide support according to the individualised plan, the person’s preferences and strengths, and organisation policies, protocols and procedures

By the end of this chapter, the learner should be able to:

➢ Identify an aspect of a client’s individualised care plan and determine the client’s

preferences and/or strengths regarding this and the supports required for this.

Implementing the plan The purpose of the individualised care plan is to act as a guide for the personalised care that a specific client requires, as well as their individual preferences, strengths and organisation policies, protocols and procedures. As explained throughout this Learner Guide so far, the individualised plan may contain information on the provision of:

➢ Medical needs

➢ Medical preferences

➢ Personal preferences

➢ Support activities

➢ Support services

➢ Concerns

➢ Future goals

➢ Next steps

➢ Any other relevant information.

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Your job, as a care provider, is to provide support according to the specifications of this individualised plan. This should be carried out in line with the client’s preferences and the policies and procedures established by the organisation.

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2.3 – Assemble equipment as and when required according to established procedures and the individualised plan

By the end of this chapter, the learner should be able to:

➢ Identify how to assemble equipment in accordance with proper procedure and

manufacturers’ guidelines.

Assembling equipment You will find that on many occasions when you are providing a support service you will need to assemble equipment to assist the client in their day-to-day life. This equipment could include:

➢ Shower and bath seats, bath lifts and grab rails (to help client wash themselves)

➢ Commodes (to help client maintain continence and personal dignity)

➢ Adapted kitchen tools (to help client continue to participate in cooking/cleaning)

➢ Adapted cutlery or non-spill cups (to help client eat and drink by themselves)

➢ Bed sticks, hoists and transfer turntables (to help client move from bed to chair)

➢ Labelled pill boxes (to help client control their own medication)

➢ Stair lifts (to help client get up and down the stairs)

➢ Walking frames or wheelchairs (to help client move around independently)

➢ Chair raisers (to help client get in and out of their chair easily).

Regardless of the equipment that your client requires, you need to ensure that is assembled according to established procedures and your client’s individualised plan. If your client’s plan stipulates that they don’t want to be confined to a wheelchair until absolutely necessary, you should find another solution. For example, a walking frame or walking stick could be suitable. The equipment that you choose should be easy for your client to use; this will depend on the specific condition of your client and can vary drastically between your clients. Assembling equipment is a very important task and it needs to be done 100% correctly. You need to ensure that it is fit for purpose and it can be used safely by your client. Always refer to the manufacturer’s guidelines.

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2.4 – Respect and include the family and/or carer as part of the support team

By the end of this chapter, the learner should be able to:

➢ Recognise the important role of family and/or carer as part of the support team

➢ Identify four ways that a client’s family and/or carer can help provide support.

Support team It is important to respect and include your client’s family and/or client as part of the support team. The family members and carer of a client will have an exceptional and unique knowledge about your client – specifically their needs and preferences. This knowledge can be much better than yours. You should use this to your, and your client’s, advantage and ensure that you listen to what their family and carer have to say, respect this and include them in the design and delivery of your client’s individualised plan. Working collaboratively with the client’s family and/or carer to provide support is a vital component of ensuring that support is of high quality. By working together, you can better respond to the needs and preferences of your client, leading to positive results and better outcomes for your client. We have already discussed why a client’s family and carer should be involved in the development of a client’s individualised plan. To recap, they may be involved simply because the client wants them to be. They may also be involved because the client is not able to contribute. This is mirrored in the need to involve families and carers in the delivery of that very plan. The whole point of providing support to a client is to ensure they can live their life as normally as possible. Think about the different ways that their family and carer could be included in the support team. For example:

➢ They could be consulted before any decisions about the care and support of your

client are made (e.g. they may be able to help with choosing the most appropriate

equipment)

➢ They could inform you about any changing preferences of your client (e.g. they may

not like their peas putting in a separate bowl like they used to)

➢ They could contribute to the care so the client can

continue living at home (e.g. they may be able to

go round every evening to ensure the client has

dinner and a shower before bed)

➢ They could demonstrate how your client likes

something doing (e.g. they may like to be helped

out of bed in a certain way).

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2.5 – Provide support according to duty of care and dignity of risk requirements

By the end of this chapter, the learner should be able to:

➢ Identify what is meant by duty of care and dignity of risk

➢ Apply duty of care and dignity of risk in decisions for client requirements.

Duty of care requirements It is essential that the support that you are providing is done so according to duty of care requirements. Duty of care comes under the legal concept of negligence and refers to your obligation to take responsible care of your client. Your level of support must meet the duty of care requirements. This may apply to:

➢ Provision of:

o nutrition

o clothing

o bathing and personal hygiene

o toileting

o safety

➢ Administration of:

o medicines

o treatments

o medical care

➢ Protection of:

o rights

o confidentiality

o physical wellbeing

o mental wellbeing.

This means that you must ensure that clients are receiving adequate care in these departments, as well as others. This includes tasks that you complete yourself, tasks completed by colleagues and tasks completed by the clients.

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For example: proper nutrition.

➢ If you feed the client, you must ensure that they eat enough quality food, including

fruit and vegetables. If you notice that the client is not eating, you must determine

the reason and provide a solution.

➢ If your colleagues feed the client and they tell you that the client is not eating

properly, you need to report this to the appropriate person and sort a solution out.

➢ If the client feeds themselves and you become aware of the fact that they are not

eating properly, you will need to take steps to rectify this. Knowing that a client only

eats two slices of toast all day or binges on junk food and failing to address and

rectify this can mean that you fail in your duty of care, as you are not ensuring that

the client receives proper nutrition that is healthy.

Whatever care you provide to the client, you must always ensure that you meet the requirements of the duty of care; this is a moral obligation and may be a legal requirement.

Human rights It is important to understand human rights and how people should be treated, regardless of whom they are and what their situation may be. Human rights are the fundamental rights that all individuals should have as a human being; these include respect, dignity, freedom of speech and a right to be safe. It is treating people fairly without discrimination or cruelty, and understanding that all people should have access to the same rights and opportunities. All people should have a right to:

➢ Life

➢ Liberty

➢ Freedom

➢ Recognition as a person/equal before the law

➢ Protection against:

o slavery

o torture

o cruelty

o discrimination.

Modified from source, and for more in-depth information on the Universal Declaration of Human Rights, visit ‘Universal Declaration of Human Rights’ at the United Nations website: http://www.un.org/en/universal-declaration-human-rights/index.html (access date: 17.03.2017). Discrimination against clients should not be made in any circumstance. All clients and their families have a right to be treated with respect and dignity, and should be given access to receive appropriate health and wellbeing services.

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Dignity of risk requirements As well as meeting duty of care requirements, you will need to ensure that you provide support according to the dignity of risk requirements too. All life experiences come with some level of risk; your clients have the right to choose to take some risk when engaging in their own life experiences. Your role is to support your client in experiencing these things, regardless of whether they lead to success or failure. It is important that you don’t overprotect your client whilst providing them with support. You should never tell them what to do. How would you feel if all your decisions were made for you? Dignity of risk emphasises personal choice and self-determination and your client should be able to decide what level of risk they are comfortable with. Even if you disagree with a client’s decision or think it is unwise, you must respect their right to make it, offering them reasonable support and assistance in making it and following it through. Therefore, when providing support for your client you need to ensure that you are not hindering their right to make their own decisions, even if they are associated with risk. For example, an elderly client is adamant they want to remain living in their own home rather than a care facility. They are unsteady on their feet and are prone to trips and falls. You know that is unsafe for them to be alone all the time but need to respect their wishes despite the risk associated with them. What should you do? You need to figure out a way that will enable your client to continue living independently in his own home. This may involve arranging daily visits from a family member, a carer or another support worker to ensure that the client is okay. It may also involve installing equipment around their house to provide them with assistance (e.g. hand rails, ramps or even a stair lift). You could assess their house for hazards and deal with them accordingly. For example, if they like to save their old newspapers for a family member who uses them to make papier-mâché with their children but the pile is on the floor, getting out of control and is a trip hazard, you could source a container of some sort to store them in safely and reduce the chance of trips and falls. You could also assess their need for a 24-hour emergency alarm system (e.g. a pendant or wristband with a button). This alarm system can give your client the freedom to remain living in their own home, safe in the knowledge that if they trip or fall they can call for help quickly. It’s about finding a balance between duty of care and dignity of risk. In order to support someone to be independent, you will need to let them make their own decisions and take risks. It’s about figuring out how you can do this whilst still keeping them safe and meeting your duty of care.

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2.6 – Provide assistance to maintain a safe and healthy environment

By the end of this chapter, the learner should be able to:

➢ Identify three potential workplace hazards

➢ Recognise the impact of these hazards

➢ Assess how these hazards can be rectified.

Workplace safety Workplace safety is the responsibility of everyone who works in it and is designed to benefit all those who work in it. There are several laws regarding Work Health and Safety (WHS); these are covered extensively in other units and should be explained to you at your workplace. You can contribute extensively to the maintenance of a safe working environment by being generally considerate and applying common sense. You will identify hazards as you go about your work, such as:

➢ Loose carpets

➢ Wet floors

➢ Broken equipment.

These examples, as well as many others, can be potentially very dangerous:

➢ Loose carpet: staff or clients could trip and fall; this is especially hazardous near

sharp or hot objects and stairs.

➢ Wet floors: anyone passing through can slip and seriously hurt themselves. It is

possible to suffer sprains, broken bones and concussions through slips and falls.

This could be especially dangerous in the kitchen areas or busy corridors.

➢ Broken equipment: this can cause serious harm to staff and clients using the

machine; for example, a bath hoist. If this fails, the client could be dropped onto or

into the bath or onto the floor. Serious injuries can be gained through slipping or

falling on or against tiles and porcelain.

The initial hazards seem quite insignificant and trivial, but they can have serious consequences. Aside from injuries and associated pain and suffering, accidents can cause:

➢ Client loss of confidence

➢ Staff off sick

➢ Compensation claims

➢ Negligence claims against the company

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➢ Loss of clients

➢ Loss of staff

➢ Much more.

Many of these issues and similar can be resolved fairly easily, through the application of common sense and consideration:

➢ Loose carpets: can be glued or stapled down or cordoned off until professional

maintenance is arranged.

➢ Wet floors: can simply be mopped up or cordoned off until professional

maintenance can be secured.

➢ Broken equipment: should be labelled as broken and stored until a person qualified

to repair it can do so.

A problem arises when a staff member is too lazy or inconsiderate to address issues and chooses to ignore them or leave them for the next person. This type of behaviour is bad practice and can have serious consequences. The workplace should aim to establish a team culture where everyone pulls their weight and looks out for one another. General steps to maintaining workplace safety:

➢ Be considerate: don’t ignore hazards or

leave them for the next person

➢ Use common sense: easy fixes can be

applied to many hazards

➢ Always be on the lookout: many hazards

can be identified without specifically

looking for them

➢ Report it:

o report any accidents or injuries you sustain

o report any hazards, risks or issues you identify

➢ Follow procedures: procedures in place for infection control and manual handling

are there for your own safety!

➢ Take training seriously: any training you are offered or given is there to help

➢ Maintain safety culture: promote a team approach to safety by encouraging others

and demonstrating your contribution.

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2.7 – Provide assistance to maintain a clean and comfortable environment

By the end of this chapter, the learner should be able to:

➢ Identify what a clean environment should include

➢ Determine different ways to maintain a clean environment

➢ Recognise how a comfortable environment may differ between clients.

Maintaining a clean environment A clean environment is critical in a care and support setting; it is essential to the health of both the workers and the clients. A clean environment can reduce the risks to health and improve client safety too. Your clients have a right to a clean environment and you need to ensure that you take all the necessary precautions to ensure the risks associated with an unclean environment are at an absolute minimum. The standards of the cleanliness of an environment can often be seen to reflect the quality of care and support that is provided. If the environment is unacceptably dirty, people may assume the level of care and support offered is of low standard (although this is not necessarily true). A clean environment should include:

➢ Physical cleanliness of surfaces and tools used

➢ Low risks to health from microorganisms

➢ Access to safe, clean water

➢ Access to basic sanitation

➢ Low risks of cross-contamination

➢ Low risks of infection

➢ Safe disposal of waste (particularly high-risk wastes such as needles).

Think about the ways in which you can create a clean environment that promotes an atmosphere of competent caring and offers a sense of comfort for your clients. How can you maintain a clean environment? For example, you can maintain a clean environment by:

➢ Practising good hand hygiene (e.g. washing hands between clients)

➢ Maintaining good personal hygiene (e.g. keeping fingernails short and uniform

clean)

➢ Keeping up-to-date with the relevant training

➢ Cleaning spills of bodily fluids (e.g. blood or urine) correctly

➢ Making yourself familiar with the relevant guidelines, policies and procedures

➢ Wearing the correct Personal Protective Equipment (PPE)

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➢ Following the rules in regards to hygiene (e.g. there may be a colour-coded system

in place)

➢ Cleaning equipment and tools according to instructions and guidelines.

Maintaining a comfortable environment A comfortable environment, on the other hand, is about providing your clients with physical comfort, ease and relaxation. Although this will involve an environment being clean, a comfortable environment is more focused on being free from stress or anxiety. As well as providing clients with physical comfort, ease and relaxation a comfortable environment should:

➢ Be free from stress or anxiety

➢ Be homely

➢ Create a welcoming atmosphere

➢ Be clean and safe

➢ Allow clients to feel secure

➢ Be pleasant and enjoyable.

The important thing to remember when maintaining a comfortable environment is that ‘comfort’ will be considered differently by the variety of clients you work with. You can maintain a comfortable environment for your clients by listening to and understanding their specific needs in relation to ‘comfort’. For example:

➢ One of your clients feels comfortable in a warm environment; another feels

comfortable in a cooler environment

➢ One client may feel comfortable in a smaller, cosy living environment; another may

feel comfortable in a larger, open living environment

➢ One client may feel comfortable in structured environment with routine and order;

another client may feel comfortable in an unstructured environment with more

freedom and spontaneity

➢ One client may feel comfortable in a brightly-lit environment; another may feel

comfortable in a dimly-lit environment.

As you can see, it’s about addressing the individual client and their definition of a comfortable environment. You are caring for a client with Dementia. How can you ensure that their environment is comfortable for them? This may involve using signs and labels to help them remember where and what things are. This would put them at ease with their environment and reduce the level of stress and anxiety when they can’t get their bearings or find what they are looking for. What about clients that can’t see very well? How can you ensure that they feel comfortable within their environment? This could involve making simple, minor adjustments to ensure

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they don’t get stressed and anxious when needing to read things. For example, how can you make the process of ordering their lunch easier? It can be as simple as providing them will a visual menu that includes pictures of the different options available. This way, they can order their meals stress-free.

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2.8 – Respect individual differences to ensure maximum dignity and privacy when providing support

By the end of this chapter, the learner should be able to:

➢ Determine what is meant by dignity and privacy of clients

➢ Identify ten or more ways that a client’s dignity and privacy can be maintained.

Ensuring maximum dignity and privacy When providing a client with support, it is essential to respect their individual differences; each client will be different. It is essential to get to know your clients in order to develop an understanding of their background, their ideas, their wishes, their likes and their dislikes. You could always refer to their individualised plan to decipher the way that they would like to be cared for. Demonstrating respect for your clients’ individual differences will mean you are able to ensure that their dignity and privacy is maintained. Although difficult to define, dignity is considered to be the result of being treated with respect. It is associated with a sense of well-being, worth, having a sense of purpose and being valued. The support that you provide to your clients should support and promote, and not undermine their self-respect. It involves respecting their choices and decisions whilst not making assumptions about how they may want to be treated. Privacy is closely related to dignity and clients need privacy in order to maintain their dignity. Privacy is related to ‘peace and quiet’ and involves giving your clients space when they need it. For example, by not disturbing, interrupting or observing your client you will maintain their privacy. Dignity and privacy can often be ensured and maintained by the little things in life; the support you provide for your clients should be as personalised as possible and should put them at the centre of it. Examples of ways to maintain a client’s dignity and privacy include:

➢ Implementing and adhering to a confidentiality policy

➢ Not discussing personal or sensitive information where

others might overhear

➢ Ensuring that they receive their mail unopened

➢ Knocking before you enter their personal space

➢ Asking them if it is okay to touch them before doing so

➢ Ensuring facilities are single-sex

➢ Providing clients with their own facilities when possible

➢ Allowing them to go to the toilet and close the door

➢ Washing them without poking fun at their body

➢ Closing the curtains or doors if you are assisting them wash or get dressed

➢ Giving them a ‘do-not-disturb’ sign to use

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➢ Giving them personal space when they have visitors

➢ Being sensitive when undertaking personal care tasks (e.g. matters of

culture/religion)

➢ Ensuring your clients never feel embarrassed.

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2.9 – Seek assistance when it is not possible to provide appropriate support

By the end of this chapter, the learner should be able to:

➢ Recognise when tasks are beyond the scope of their own responsibility, skills or

expertise

➢ Identify the correct persons to seek assistance from.

Seeking assistance It will not always be possible for you to provide your client with the appropriate support that they need. This may be because you are not adequately qualified, you don’t have the correct experience or you lack the relevant skill. It could also be because you simply cannot provide that support alone. You may find that you need assistance in some instances – the help from another individual. By seeking assistance, you are ensuring your client receives the appropriate support, even though you cannot do this yourself. You shouldn’t be afraid to ask for help. At the end of the day, it’s about ensuring your client receives the support that they need. Consider the following examples:

➢ One of your clients has recently deteriorated and can no longer get in and out of

bed by themselves. Unfortunately, their room is not big enough to use a hoist and

they therefore need to be assisted manually. You are not able to do this alone so

may need to seek the assistance of a colleague to ensure that the client gets the

support that they need.

➢ A client has recently been prescribed daily medication and is not capable of

administering it themselves. You are not yet trained to administer medication so

may need to seek the assistance of someone who can.

➢ A client has started to become increasingly depressed. So far, you have managed to

encourage them to get out of bed and get dressed daily. Your past two attempts

have not been as successful and the client ended up staying in bed all day which is

not really acceptable. In order to ensure they get the support they need, you may

need to seek assistance from a professional. Alternatively, you could seek the

assistance from the client’s friend or family member; they may be able to

encourage them in a way you would never be able to. This would ensure that you

could continue supporting your client in an appropriate way.

➢ One of your clients has asked you to take control of their

finances and after a closer look you realise that it is way

beyond your capability. You may need to seek help from

someone, maybe an accountant, to ensure that you can

support your client in the way that they need you to.

➢ One of your clients can no longer tend to their beloved

garden. They have asked if you would maintain it for

them – something that is beyond your skills. You may

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seek assistance from a local gardener who can mow the lawn and weed the

pavement for your client.

All of the above examples give you an idea of when you may need to seek assistance in order to ensure your client receives the appropriate support. Think about your own experiences – when have you had to seek assistance because you were not able to provide the appropriate support?

Roles and responsibilities of those involved in the individualised plan The persons whom you work with in your delivery of care to the client may be varied and will be influenced by the client and their own specific set of circumstances. For example, an aged-care client at home may have home care help to perform shopping and housework, while a young person with mental health issues may work with a counsellor and have a support worker to help with their self-recovery. Each person involved in the plan will have defined roles and responsibilities; each providing a set of skills and expertise to assist in the provision of care and services, as agreed in the client’s individualised plan. All professional workers and services will need to work within their stipulated work boundaries and role requirements; they should provide a duty of care and work ethically to support the client. For example, the roles below will have the following responsibilities:

➢ The client (or person being supported) – the client should be actively involved in

making decisions concerning their care and agree to their individualised plan; they

should fully participate in receipt of care and take responsibility for their own health

(as far as practicable)

➢ Carers and/or family – they should support the client in their situation of

health/need, as agreed and as far as possible; they may also need to be involved in

making decisions with or for the client (depending on the degree of client

independence) and work with care services on behalf of the client (e.g. driving the

client to an appointment)

➢ Health professionals – they should provide medical expertise on a health concern;

this may include providing treatments and medications, health checks and diagnosis

➢ Individual workers – these persons can be varied and all should have a defined role

that provides a specific service, such as a support worker or meals on wheels

service provider

➢ Supervisors – they should oversee the workers involved in the delivery of services,

as identified in the individualised plan; they are responsible for ensuring services

are being provided at the required standard and that the client’s wellbeing is

maintained. They may be required to provide guidance and assistance to workers,

and to resolve issues or difficulties in the delivery of care.

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All service providers should follow set communication protocols and procedures with each other and with the client and their family/carer. A support worker or healthcare professional can operate as the main source of contact for the client and their family/carer, acting as a conduit for other professionals and service providers but this will depend on the situation. The client may need to have direct contact with service providers to arrange specific needs, such as housing or a social support group. You will need to be clear on the communication requirements between services and professionals and inform the client of how they need to interact with others for the provision of their care.

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3. Monitor support activities

3.1. Monitor own work to ensure the required standard of support is maintained 3.2. Involve the person in discussions about how support services are meeting their

needs and any requirement for change

3.3. Identify aspects of the individualised plan that might need review and discuss with

supervisor 3.4. Participate in discussion with the person and supervisor in a manner that supports

the person’s self determination

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3.1 – Monitor own work to ensure the required standard of support is maintained

3.2 – Involve the person in discussions about how support services are meeting their needs and any requirement for change

By the end of these chapters, the learner should be able to:

➢ Identify how they can monitor their work to ensure the required standard of

support is maintained

➢ Engage in discussions to determine if support services are meeting the client’s

needs or whether changes are needed.

Monitoring own work In order to maintain the required standard of support, you will need to continuously monitor your own work. This involves reflecting on the way that you work and evaluating it honestly. By identifying your strengths and weaknesses, you can discover ways in which you can improve the way that you work. When considering your own work, you may think about many things. For example:

➢ Time management

➢ Self-confidence

➢ Motivation

➢ Morale

➢ Attitude.

Take the time to think about what your specific role and responsibilities include. What’s in your job description? Are you currently fulfilling this? The methods that you use to monitor your own work may include:

➢ Self-monitoring

➢ Supervisor assessment

➢ Client feedback.

Self-monitoring

Self-monitoring involves observing and assessing the way that you work and the standard of support that you provide, using your own judgement. This self-monitoring should be an ongoing, conscious effort that you undertake whilst you are going about your day-to-day work. By assessing your day-to-day work, you will be able to identify any particular skills that you may need to learn. You can also discover areas that need improving. This unit is about providing individualised support and care:

➢ Are you doing this in your work?

➢ Is there any way you can make the standard of support and care even higher?

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➢ Are your skills and knowledge sufficient for your role and responsibilities?

Remember that self-evaluation shouldn’t just focus on what you could be improving – you should acknowledge the things that you are already doing well. Consider the following questions:

➢ Do you provide a high standard of support to your clients?

➢ Do you address their specific needs?

➢ Do you take their preferences into consideration?

➢ Do you value their choices and decisions?

➢ Do you respect their individual differences?

➢ Do ensure their dignity and privacy is maintained?

➢ Do you always refer to their individualised plan?

➢ Do you provide a safe, clean and comfortable environment?

➢ Do you communicate well with your clients, their family and their carer?

By answering these questions, you will be able to assess whether the support that you provide is of a high standard. Supervisor assessment

An assessment conducted by your supervisor can also help you to evaluate your work; they will have a more objective outlook and can provide you will valuable information. By seeking a supervisor assessment, you can see yourself from their perspective. They can help you to identify both positives and negatives about the way that you work. They may use the following in order to conduct an assessment:

➢ Observation of you in your role

➢ Feedback from the people using your service and their families

➢ Feedback from other workers.

Client feedback

Often, the feedback from your client, their families or their carers can be essential in identifying the effectiveness of your work. This feedback can also help you to identify any gaps in your knowledge or skills related to providing support. Think about the different ways that you can gain this feedback. For example, you could involve them in a discussion and ask them how your support services are meeting their needs. This also gives you the chance to find out if they see any requirement for change. You may find that your client is able to tell when you’ve had a bad morning because you tend to snap at them. You don’t realise that you are doing it, but it is something that your client has picked up on. You can take any points that your client highlights and work on them, ensuring that your clients are receiving a high standard of support.

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3.3 – Identify aspects of the individualised plan that might need review and discuss with supervisor

By the end of this chapter, the learner should be able to:

➢ Identify aspects within an individualised plan

➢ Determine which aspects may need to be reviewed.

Reviewing the individualised plan Some aspects of the individualised plan are subject to evaluation and change. Your task is to identify these aspects. These can be related to a client’s:

➢ Fitness: for example, if measures are made to increase a client’s fitness, then these

would need to be adapted to match the client’s improving fitness, either by

increasing the difficulty or by switching to a maintenance regime.

➢ Medical needs: medical needs increase and decrease often. Conditions might

improve which would warrant a lesser dose of medicines and treatments or may

change their nature, requiring a different type of treatment.

➢ Social: clients’ social needs are subject to change and should be reviewed regularly

with the co-operation of the client.

➢ Diet: dietary needs can change; for example, a client may need to gain or lose

weight, or may be advised by the doctor to avoid certain foods permanently or on a

temporary basis. The client may also need to start eating more of a particular food.

➢ General care: general care needs are subject to change; a client may gain more

independence and mobility and be able to dress or bathe themselves, whereas they

could also suffer a setback and need to be dressed and bathed when they weren’t

previously.

This is why reviews and evaluations should be carried out regularly and the individualised plan altered to reflect these changes. This ensures that the care provided is more in line with the client’s needs. When you identify a need for change within a client’s individualised plan, you may need to discuss it with your supervisor. You can do this verbally (e.g. face-to-face or over the telephone) or through written methods (e.g. reports, notes in plan or case notes). Monitoring the plan and instigating evaluations is part of your duty of care and should be done in line with client needs and organisational policies.

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Indications that an aspect of the plan requires further discussion You may feel that aspects of the individualised plan warrant further discussion with your supervisor, if:

➢ It is uncertain whether they are suitable for the client’s specific needs

➢ There are health and safety concerns

➢ There are practical issues

➢ There are inconsistencies with on-record information or previous plans

➢ You are unsure about a client’s eligibility for a service, scheme or form of support

➢ A relative or carer has a concern

➢ Details are missing (e.g. doctor information, etc., key contacts, etc.)

➢ It is uncertain whether aspects of the care plan comply with organisation policy,

procedure and protocol

➢ You feel that any part of the individualised plan is not in the best interests of the

client.

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3.4 – Participate in discussion with the person and supervisor in a manner that supports the person’s self determination

By the end of this chapter, the learner should be able to:

➢ Consult with others to determine how to make changes to client individualised

plans

➢ Define self-determination

➢ Identify how you can support client self-determination.

Discussing with client and supervisor As explained in the previous chapter, it is important to implement regular reviews and evaluations of the individualised care plans and discuss them with your supervisor. It is essential that you and your supervisor participate together in a discussion with the client too. Consulting with the client is effective, as they are aware of their current condition and preferences. The client should be able to identify areas they feel should be reviewed and changed, as well as being able to suggest solutions and changes themselves. Supervisors, on the other hand, can apply company policies and procedures, which may stipulate a requirement for reviews and alterations to be done in specific timeframes. Any reviews and changes should need to be cleared with the supervisor and the client, so it is always worth getting them involved anyway. Discussions with different people involved in the provision of care for a client can help you to discover more areas that may need attention; this is because when different people work in different areas, they are more likely to notice a need for revision or change. These discussions can be done as a group, such as you, the supervisor and the client, or could be part of a tiered system, in which you talk to the client and other colleagues, where applicable, then take the results of these discussions to the supervisor and decide on a course of action. It is important that the manner in which you participate in the discussion supports client self-determination. Self-determination is when a person is free to make their own decisions regarding aspects of their life. To a client, this could mean being able to choose:

➢ How they would like to receive care and support

➢ What they would like to eat

➢ What they would like to wear

➢ What they would like to do

➢ Where they want their care and support to lead.

When working with or discussing with a client, you should always promote the fact that they have self-determination and are free to make many, if not all, of their own choices; this will remind them that they are in control of their own lives and the direction they are going in and will reinforce notions of independence and autonomy.

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4. Complete reporting and documentation

4.1. Maintain confidentiality and privacy of the person in all dealings within organisation

policy and protocols

4.2. Comply with the organisation’s informal and formal reporting requirements,

including reporting observations to supervisor 4.3. Identify and respond to situations of potential or actual risk within scope of own role

and report to supervisor as required 4.4. Identify and report signs of additional or unmet needs of the person and refer in

accordance with organisation and confidentiality requirements

4.5. Complete and maintain documentation according to organisation policy and

protocols 4.6. Store information according to organisation policy and protocols

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4.1 – Maintain confidentiality and privacy of the person in all dealings within organisation policy and protocols

By the end of this chapter, the learner should be able to:

➢ Locate organisational guidance on client confidentiality and privacy

➢ Recognise the requirements for maintaining client confidentiality and privacy.

Confidentiality Confidentiality and privacy are important aspects of care. Confidentiality must be applied to clients’ personal information, including financial and medical details. You must not disclose information to any other persons who are not authorised to have access to this unless permission has been sought and obtained from the client (or relevant acting authority of the client). There are cases where confidentiality can be broken:

➢ If the person is at serious risk of harm

➢ Where there is an imminent, serious threat to the public or a

specific person

➢ Where there is a police request for information under the Police

Powers and Responsibilities Act 2000

➢ For use by a healthcare professional (as long as a recognised

standard of treatment is being delivered).

Confidentiality is required by law and serious consequences are applicable to any individual or organisation found to be in breach of confidentiality laws and requirements. You should be trained in these laws and procedures in relation to your role. Maintaining confidentiality requires you to:

➢ Protect sensitive information

➢ Monitor who can access information

➢ Store information properly

➢ Dispose of information properly.

Privacy Privacy is applicable to many aspects of a client’s life and care and a person’s personal information is protected by the Privacy Act 1988. Privacy policy

Every organisation should have a privacy policy in place that is in accordance with Australian Privacy Principles. In the context of community services and healthcare, a privacy policy may include policies and procedures which cover:

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➢ How the confidentiality of patient records is ensured and maintained

➢ How clients can access their personal information

➢ How and when clients should be informed about their privacy rights and the

organisation’s privacy policy

➢ The transfer of patient information between service providers and to other relevant

personnel and/or institutions

➢ Patient consent for the sharing of personal information for research or service

improvement.

Examples of how privacy should be maintained and promoted include:

➢ Training all staff properly about privacy

➢ Restricting access to records and information about the client to appropriate

personnel

➢ Respect clients’ personal relationships with others

➢ Respect clients’ sexual relationships and give them relevant privacy

➢ Give the client a choice in interpreters, where required

➢ Ask their permission before entering their personal space

➢ Ask their permission before touching their possessions

➢ Ask their permission before going through their drawers

➢ Allow clients privacy for conversations and phone calls, such as by having

designated rooms or areas

➢ Do not open mail addressed to clients

➢ Provide single-sex bathrooms and toilets

➢ Allow and encourage personalisation of personal spaces, such as bedrooms

➢ Only gather and collect relevant and required information.

Providing clients with as much privacy as possible will have a significant impact on their happiness and self-worth and make life in a residential home much more agreeable and attractive; having the privacy and opportunity to do things also encourages and provides levels of independence that clients may not necessarily expect.

➢ A care provider asking permission to go through their wardrobe can grant clients a

degree of autonomy, self-worth and independence, even if they are being dressed.

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➢ Knocking before you enter a room and awaiting an invitation inside will show clients

that they have much more autonomy and respect than having them walked in on

with no warning.

➢ Providing clients with a private room where they can take or make phone calls will

show them how much privacy they have and allow them to retain some of their

identity and independence.

Many of these actions are common sense; think how you would feel in the client’s shoes, if people were coming in and out of your room all day, listening in on your conversations and opening your mail. As a general rule, if it would upset you, it could upset them, so allow as much privacy as possible. Your organisation will likely have a policy in place regarding these elements and more, such as:

➢ Never open mail

➢ Always knock before entering

➢ Ask clients if they would like to decorate their room (e.g. with ornaments or

pictures).

These policies are in place for the welfare and wellbeing of the clients and you should always adhere to them, unless a client gives you express permission, such as by asking you to open their mail and read it to them. Bear in mind, that just because a client asked you to open their mail today, that does not necessarily mean that they want you to open it tomorrow. Ensure that you maintain confidentiality and privacy of client in all dealings with them.

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4.2 – Comply with the organisation’s informal and formal reporting requirements, including reporting observations to supervisor

By the end of this chapter, the learner should be able to:

➢ Identify organisational reporting requirements for both informal and formal

situations

➢ Determine the differences between different types of reporting.

Reporting requirements There are certain things that need to be reported in the care industry, such as:

➢ Accidents and injuries

➢ Clients’ progress

➢ Medical care and medication

➢ Mandatory notification

➢ Observations.

These examples, and similar, are likely to have information and evidence gathered by a care provider, which is communicated to a supervisor, for record-keeping or for action to be taken. Where you are required to do this, whether they are formal or informal reports, it is important to follow organisational procedures. By following organisational procedures, you can ensure that:

➢ Reports are received correctly

➢ Reports are sent to the right person

➢ All required reports are gathered

➢ Reports are in the appropriate format and include all required information

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➢ Reports are handled correctly.

You will have the company’s expectations made clear to you before you complete any reports or have to report something. If in doubt or unsure, double-check with a supervisor or colleague.

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Mandatory reporting This is the requirement to report to (or notify) your supervisor (or the relevant authority) of a serious concern with regards to any individual who may be at risk. This risk may be in relation to the client’s health or treatment of the client by others. It may also be concerned with the conduct of another worker or health professional that is not following appropriate protocols and conduct in their work. Issues requiring mandatory notification may include:

➢ Protection of children and others identified to be at risk

➢ Issues defined by jurisdictional legislation and/or

regulatory requirements

➢ Issues specifically identified under organisation policies.

It is a legal requirement that these issues are reported; if you fail to do so, the consequences can be quite severe and you may be putting clients and colleagues at risk. Your organisation may have developed a specific procedure to perform mandatory reporting/notification and this should be followed in any situation where this may be required. If not, you should seek guidance from your supervisor or manager. It is important to determine whether a situation does require this and you should speak with your supervisor to assess the circumstances if in any doubt. Always ensure confidentiality is maintained with mandatory reporting and that only the persons who should be informed are done so. Information on mandatory reporting can be found at ‘What is a mandatory report?’ at the Australian Health Practitioner Regulation Agency website: http://www.ahpra.gov.au/Notifications/Make-a-complaint/Mandatory-notifications.aspx (access date: 17.03.2017).

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4.3 – Identify and respond to situations of potential or actual risk within scope of own role and report to supervisor as required

By the end of this chapter, the learner should be able to:

➢ Recognise potential or actual risk

➢ Identify how to follow reporting procedure for reporting potential or actual risks.

Situations of risk Risk in the workplace goes further than identifying physical hazards, especially in the care industry. It is your job to identify and respond to situations of potential or actual risk. When responding to these risks, you should ensure that it is within the scope of your own role. Situations of risk or potential risk may include:

➢ Environmental hazards

o slippery or uneven floor surfaces

o physical obstructions (e.g. furniture and equipment)

o poor home maintenance

o poor or inappropriate lighting

o inadequate heating and cooling devices

o inadequate security

➢ Evidence of abuse

➢ Evidence of self-harm

➢ Evidence of self-neglect

➢ Impaired cognitive functioning

➢ Impaired judgement and problem solving abilities

➢ Social rights infringements

➢ Sudden or unexpected change in health status, including sensory loss

➢ Uncharacteristic or behaviours of concern.

The items on this list should be well-known and understood by care providers, who should be trained to recognise signs and know the appropriate action to take.

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Reporting to supervisor Your duty of care means that you need to report any concerns, especially where abuse and neglect may be involved. Even suspicions or reasons for suspicion should be reported and investigated; you should never wait for an incident to occur or evidence of suspicions before reporting to the supervisor. You should always report potential or actual risks to your supervisor promptly. The delay between you discovering a hazard and the supervisor implementing a solution should be covered by:

➢ Cordoning off the area

➢ Verbally warning others

➢ Leaving a sign or notice clearly stating the danger

➢ Preventing accident and injury as a result

➢ Implementing a temporary fix.

Supervisors can be contacted in several ways. A particular method may be favoured by the supervisor or the organisation, such as:

➢ Notes

➢ Memos

➢ Phone calls

➢ Face-to-face

➢ Paper report

➢ Email.

Due to the nature of the contact, instant methods would be more appropriate; a supervisor may not get a memo, email or report until the next day or even later. Remember: anything that can potentially cause accident, injury or other harm can be classed as a hazard and should be properly addressed.

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4.4 – Identify and report signs of additional or unmet needs of the person and refer in accordance with organisation and confidentiality requirements

By the end of this chapter, the learner should be able to:

➢ Determine what actions to take to address the additional or unmet needs of clients.

Additional and unmet needs You may find that there are instances when your clients are left with unmet needs or the requirement for additional needs. Unmet needs are the needs that are specified in a client’s individualised plan that are not being met by the support they are receiving. Additional needs are new needs that didn’t originally apply to your client and were not initially outlined within their individualised plan but have recently surfaced. Unmet needs are often associated with increased depression, anxiety and challenging behaviours. It is your job to identify the signs of these additional or unmet needs so that you can ensure that they are dealt with accordingly and your clients receive the level of care and support that they require. You have a client that is usually able to dress themselves. In their care plan, it specifies that they wish to do this alone and without your assistance. Recently, their health has deteriorated and they can’t bend to put their socks on. You have noticed that they are struggling each morning and raise the issue with your supervisor. Although it was not originally stipulated in their care plan, you think that providing them with extra help so that they can put their socks on (whether this is help from yourself or a gadget/device) is an additional need that should be incorporated into their plan. A client needs assistance when bathing – this is outlined in their individualised care plan and you do this when you are on shift. You have picked up on the fact that they are being left to bath themselves when ‘Helen’ is on shift. This is an unmet need and should be referred to the appropriate person and addressed as quickly as possible. Once identified, these needs should be reported and referred in accordance with organisation and confidentiality requirements. Think about the procedure for reporting and referring incidents of additional or unmet needs. These will be specific to your particular organisation. For example, you may need to report and refer them to your shift leader, your supervisor or your manager. You should also consider the relevant confidentiality requirements when reporting and referring signs of additional or unmet needs.

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4.5 – Complete and maintain documentation according to organisation policy and protocols

4.6 – Store information according to organisation policy and protocols

By the end of these chapters, the learner should be able to:

➢ Complete a piece of paperwork for your organisation

➢ Identify different types of filing systems used in the workplace.

Completing and maintaining documentation Any documentation used within your workplace will need to be completed and maintained according to your organisation’s policy and protocols. Your documents should look exactly how the organisation needs them to look once completed and when you update them. This includes:

➢ The formatting of the documents

➢ The way that you present the documents

➢ The way that you submit the documents.

Think about the documentation that you complete within your role. How should you do it? Should you hand-write it? Should you type it on a computer? Should you use a particular font type and size? Should you sign it off once completed? Should you hand it in to your supervisor? Should you file it in the correct folder? Should you email your completed documents to your manager? The answers to these questions will vary depending on your own organisation’s policy and protocols. Ensure that you are aware of these before attempting to complete documentation.

Storing information When documents and reports have been completed and submitted, they need to be filed and stored properly, ensuring that organisational and confidentiality requirements are met. These standards should be specified and implemented by the organisation and the supervisors that are responsible for this. Storage methods may include:

➢ Electronic folders

➢ Physical folders

➢ Filing systems.

You should also be aware of legislation that may apply. For example, in some areas, reports and documents regarding client accidents, injuries and treatments are required to be stored for a certain amount of time before it can be destroyed, so that it can be referred to or used as evidence. Conversely, there may be a time limit on how long you can store certain pieces of information, such as financial information, before it must be destroyed. These requirements, where applicable, should be made clear to anyone with these responsibilities.

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As explained in the previous section, there are particular specifications made about the storage of reports, documents and information. These may be made by the law or the organisation; both should be adhered to and organisational specifications should meet legislative requirements and stipulations. Anyone working in this department should be sufficiently trained on all areas to do with data storage, including time frames, confidentiality and data protection. A uniform approach to completing documentation ensures that all documentation can be easily accessed and read by everyone. Organisational policies and protocols are implemented to ensure that this is the case for as much paperwork as possible and can benefit everyone involved.

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References

These suggested references are for further reading and do not necessarily represent the contents of this unit.

Websites

Information on human rights has been modified from source, and for more in-depth information on the Universal Declaration of Human Rights, visit ‘Universal Declaration of Human Rights’ at the United Nations website: http://www.un.org/en/universal-declaration- human-rights/index.html Information on mandatory reporting can be found at ‘What is a mandatory report?’ at the Australian Health Practitioner Regulation Agency website: http://www.ahpra.gov.au/Notifications/Make-a-complaint/Mandatory-notifications.aspx

All references accessed on and correct as of 17.03.2017, unless other otherwise stated.