CHCCCOM005 - Communicate and work in health or community services

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CHCCOM005 CHCCOM005

Communicate and work in health or community services

Learner Guide

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Housekeeping Items Your trainer will inform you of the following:

➢ Where the toilets and fire exits are located, what the emergency procedures are

and where the breakout and refreshment areas are.

➢ Any rules, for example asking that all mobile phones are set to silent and of any

security issues they need to be aware of.

➢ What times the breaks will be held and what the smoking policy is.

➢ That this is an interactive course and you should ask questions.

➢ That to get the most out of this workshop, we must all work together, listen to each

other, explore new ideas, and make mistakes. After all, that’s how we learn.

➢ Ground rules for participation:

o Smile

o Support and encourage other participants

o When someone is contributing everyone else is quiet

o Be patient with others who may not be grasping the ideas

o Be on time

o Focus discussion on the topic

o Speak to the trainer if you have any concerns

Objectives

➢ Discover how to communicate effectively with people

➢ Know how to collaborate with colleagues

➢ Learn how to address constraints to communication

➢ Understand how to report problems to supervisor

➢ Ascertain how to complete workplace correspondence and documentation

➢ Identify how to contribute to continuous improvement

➢ Gain skills and knowledge required for this unit

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1. Communicate effectively with people

1.1. Use verbal and non-verbal communication to enhance understanding and

demonstrate respect

1.2. Communicate service information in a manner that is clear and easily understood

1.3. Confirm the person’s understanding 1.4. Listen to requests, clarify meaning and respond appropriately 1.5. Exchange information clearly in a timely manner and within confidentiality

procedures

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1.1 – Use verbal and non-verbal communication to enhance understanding and demonstrate respect

Your communication skills

You will need to have a good understanding of the various ways that people communicate in order to work effectively in health and community work. Not only will you need to have very clear communication skills with colleagues and managers regarding work requirements, you will also need to have a developed sense and ability to adapt your communication skills for the different clients, patients and individuals you will meet on a regular basis. This will require development and review and revision of your personal communication skills in line with your organisation's standards.

Establish rapport

Establishing rapport is usually the initial phase of any communication, so can be largely established through body language and other non-verbal communication. Being friendly and approachable by smiling and welcoming new members of staff and/or patients/clients will help them to feel comfortable around you. Establishing rapport with staff and patients/clients is very important, as it will be the basis for any working relationship you have with them, so it is important that you are willing to listen and get to know the individual, so that a level of trust and respect are also established.

Verbal or non-verbal communication skills

Your communication strategies will vary depending on the situation, and you will need to consider the requirements and desired outcome before choosing the most appropriate strategy. Consider whether you need to use verbal or non-verbal communication, or both, as this will aid in an effective outcome. Verbal communication includes:

➢ Spoken words (face-to-face, via telephone or internet)

➢ Formal or informal speech

➢ Differences in tone, for example:

o softly spoken

o a loud authorative voice

o low tone to show a commanding presence

➢ Volume:

o quiet or loud (this should be considered for the specific situation)

➢ Speed:

o fast (if too fast communications will be misheard)

o slow (this will ensure that information can be heard and understood).

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Non-verbal communication can include:

➢ Body language, intended or non-intended, this can be used to portray qualities such

as authority, seriousness and joy

➢ Gestures/sign language to converse without words

➢ Facial expressions can show feelings and can connect with

individuals

➢ Written words, such as a letter or email communication

➢ Using images or graphics to aid understanding of information.

For example, if you are communicating with a colleague your communication will most likely be a verbal communication of a less formal nature. This will therefore dictate that the tone is softer, the volume to be as sufficient for discourse and understanding, and at a medium speed to ensure information is passed and understood. If you are speaking with a patient, you will need to determine if the person can participate in verbal communications (e.g. can understand English, or does not have a hearing impediment). If so, it will depend upon the need for communication as to which tone, volume and speed you may use. If checking on their wellbeing, you may have an informal tone and be slightly louder as the communication will be more conversational. If the person is not able to communicate verbally, you may need to use gestures or sign language; you may even need to use the sense of touch (such as passing a glass of water, or when using sensory equipment with a patient or client). However you need to communicate, always ensure that this is done with respect and is appropriate to the circumstances. Choose a strategy that advocate clear communication to the benefit of all persons. You should also develop good listening skills to make your communication a two-way process. By showing that you are listening you are showing a respect for the person’s thoughts and concerns. Reflective listening

This is where you seek to understand a contribution that has been made verbally, by restating back the contribution to confirm the understanding of this. It looks to reconstruct what the person is thinking and feeling as well as the overall understanding of the information. This is very similar to active listening but it goes the step further in attempting to understand the other person’s feelings as opposed to just the correct meaning.

Exchange information

When exchanging information, you should have open body language and use clear, accurate language. Staff and patients/clients need to know that they can trust the information you are providing them with and they also need to be clear and understand what they are being told. Exchanging information is best done face-to-face so that any misunderstandings can be dealt with and any questions can be asked but you may find that your organisation uses

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email, for example, as its established channel of communication, so ensure any written information is clear and concise.

Models of communication

Lasswell’s model of communication

Harold Lasswell (1902 – 1978) developed a model of communication to show the process in its simplest form as it applies to everyday interactions. This follows as:

➢ Who (the communication)

➢ Says what (the message)

➢ In which channel (the medium)

➢ To whom (the receiver)

➢ With what effect (the effect).

This linear model (similar to Aristotle’s communication model) is straightforward and includes the concept of effect but it does not go as far to include feedback within the communication or noise. The Shannon and Weaver model of communication

A further model of communication was developed by Claude Shannon and Warren Weaver in the late 1940s. This model goes further than Lasswell’s model as it includes feedback and noise. This model follows the following process:

➢ The sender/originator of the information delivers the message

➢ The encoder/transmitter is the means by which the message is sent via

signals/sound waves/binary data

➢ The channel is the method used for delivery

➢ The decoder is where the signal/sound wave/binary data is converted back into the

information

➢ The receiver is the intended destination of the sender

➢ The receiver will then provide feedback to the sender in response to the

information.

Receiver Sender Encoder Decoder Channel

Noise

Feedback

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Note: noise is the element of distraction that may occur through the sending and receiving process, such as crowd noise or sound distortion.

1.2 – Communicate service information in a manner that is clear and easily understood

Service information

The information that you need to communicate will be of importance and may have influence on the wellbeing of those under the care of your organisation, as such it is vital that information is not misinterpreted and it is communicated clearly to the recipient(s). Service information may be a simple communication of appointment times or directing people through the service, or you may handle patient/client information that is confidential and vital to the care they may be receiving. Information should be:

➢ Written or spoken in words that accurately describe the situation/circumstance

➢ Clear and concise in the use of language, grammar and spelling

➢ Clarified with those involved – use and encourage active listening skills (where the

other party/parties repeat back information to show they have understood this)

➢ Provided in a manner whereby the individual(s) are able to understand, such as use

of sign language, an interpreter or use of Braille communication.

Knowledge of values, beliefs and perspectives

It will be beneficial to know of the values, beliefs and perspectives of all individuals you communicate with, as this will ensure effective and smooth communication between all involved. This may include:

➢ Cultural sensitivity

➢ Religious beliefs

➢ How they wish to be addressed

➢ Potentially offensive subjects

➢ Respecting values and beliefs.

Communication is key and you should ensure that you are aware of, and respect individual beliefs and values. You should never discuss any topics that you know could cause offence but if you have to due to workplace issues, you should do so in the most sensitive manner possible. You should also never dismiss the views of another due to different values and beliefs, as you may find their perspective will be beneficial to the situation you require support and information for.

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Improve your communications

As well as considering how you perform your communications the following can help you to improve your effectiveness and aid understanding. These include:

➢ Listening skills, such as active and reflective listening

➢ Being mindful of other people’s emotions

➢ Showing empathy for others’ situations

➢ Use encouragement to help the speaker to relay their communication/message.

Using affirmations

If you want to improve your communication skills, as well as attending courses and workshops to develop your skills, you can also try using positive affirmations to help change your mindset and approach to how you communicate. This is specifically useful if you are aware of the areas that you may want to develop. Affirmations are short phrases spoken in the present tense and are chosen for their positive outlook. They can be anything that accurately describes the skills that you wish to display. Positive affirmations can include:

➢ I am an excellent communicator

➢ I am assertive and able to influence people

➢ I can remain calm when speaking with others.

They act as positive reinforcement of a specific area/skill/habit that a person would like to have. It is a simple technique and uses the laws of attraction – if you believe you are not good at communicating, you won’t be, but if you repeat that you are good at this, then your mind takes on the positive reinforcement and you automatically take on the positive characteristics of the attribute you want.

The need for networking

In your day-to-day work there may be instances where information is needed to enhance the service that you provide. One way of opening up regular communication channels is through business networking. Networking allows you to exchange information, to gather the most current information available and also allows you to consult with other professionals who are in the same or a related field of work. In order to do this, you may find that there are a number of principles you must adhere to, to ensure you contribute appropriately in networking.

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These may vary between organisations and industries but generally include the following;

➢ Networking can happen anywhere, don’t wait for a reason to network, you may find

that you are networking without even realising it, when working with other workers

or outside organisations.

➢ Treat everyone you network with equally, don’t treat the manager of a large

organisation any different from how you treat a co-worker or vice versa. Treat

everyone with respect and do not abuse the opportunities you are given through

networking.

➢ Networking is the same as building a working relationship, it will take time, trust

and effort. You may find that people network with you because you can help them

and don’t reject this opportunity as you may find you need their help in return one

day.

➢ Show respect and an interest in the people you are networking with.

➢ Learn to listen as well as talk, do not dominate the conversation with your needs.

➢ Show what you have to offer before you expect something in return.

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1.3 – Confirm the person’s understanding

Check that understanding has been made

Always check that the persons involved in the communication understand what is being said to them. Ensure that you allow for any disturbances or background noise and take time to explain/relay your information clearly. If the person does not speak English very well, use simple, clear sentence structures, write important information down clearly for them, or seek the help of an interpreter. Equally, be aware of any persons who have difficulty in hearing or in communicating and seek further assistance as may be needed. If information is of a sensitive nature, allow time for the other person to absorb what is being communicated. You should be aware of how another person may feel in response to the information they are receiving. Assess the situation and approach and confirm their understanding accordingly. You can:

➢ Ask if the information has been understood

➢ Check if further information is required

➢ Repeat key points/information

➢ Encourage a discussion to confirm that

understanding has been made

➢ Provide supporting written information.

Open-ended questions

An open-ended question is essentially an unstructured question that allows the recipient to answer in their own way and with their own words. They should lead others to think analytically and to reflect. For example, ‘How have you been feeling since using the treatment/medicine?’ This will require a longer answer which is specific to the individual. This can help you determine how fully another person has understood the communication. Note: a closed question can be answered with a ‘yes’, ‘no’ or other single word, (or short phrase). They are designed to gather facts and assess a situation quickly. For example, ‘Have you visited the client?’ the answer will be either ‘yes’ or ‘no’.

Summaries

In your communications, the use of a summary can greatly assist in relaying important information and facts to required individuals (in a short space of time). It can also help you relay concise information to help another person to understand what is important. You can also ask the person to summarise back the information that you have just spoken. A summary should contain the essential points that are required for an understanding to be made. This can be helpful when actions need to be taken quickly, or to consolidate information that has been given to you. You can summarise verbally or in writing, it will depend upon the situation as to which way will be best. Writing down information in a summary is essential for health and care requirements such as treatment and medical needs.

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1.4 – Listen to requests, clarify meaning and respond appropriately

Listening to others

When you are engaged in communications you should ensure that any requests made to you are listened to and receive your acknowledgement in response. Acting upon the request, will depend upon the nature and feasibility of this. Reflection skills/reflective listening

As briefly mentioned in section 1.1, reflecting in communication is the ability to literally reflect back what you have heard spoken to you by the speaker. It can also include reflecting back the feelings or emotions to clarify additional meaning and understanding. Reflecting can be performed through:

➢ Mirroring – this is reflecting back in its simplest form. Repeat

back the key phrase or words to show your listening skills and

to clarify meaning.

➢ Paraphrasing – using your own words to repeat back the

meaning of what has been spoken to you. As well as showing

your listening skills, it also shows that you have made an

understanding and are clarifying this through your own words

with the speaker. This can also help the speaker to confirm

that they have correctly relayed their message to you.

Use this to reflect back the words of the speaker to ensure you have heard information correctly, have interpreted the intended feelings and have made the correct understanding.

Interacting with others

In your interactions with others, be aware that you may need to resolve situations or agree on courses of action in your working day. Look to finding suitable ways to meet the needs of your work and those that are in your service.

Motivational interviewing and a coercive approach

Motivational interviewing was developed by William R Miller Ph.D in 1983 as a technique in behavioural therapy to help people to change their behaviour to improve their wellbeing. In 1991, Stephen Rollnick Ph.D assisted Miller in progressing this further into a detailed clinical procedure. Although not clearly defined, this technique can be described as the technique of facilitating motivation to improve and raise a person’s mood/behaviour. This technique also can be used to help a patient/client explore and resolve issues or negative feelings. This can be helpful for treating patients/clients, for example:

➢ Addictions, such as alcohol

➢ Depression

➢ Obsessive, compulsive behaviour.

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This touches on recognising and encouraging the motivation to change from the patient/client and emphasises that the change needs to come from the patient/client. It works on partnership to resolve difficulties. A coercive approach is where a person is influenced or forced into taking a direction or making a decision. The person is not able, or not allowed, to come to a decision in their own time or way. This is not a recommended way for anyone to make a decision however in a medical or health emergency, a person may need to be guided into making a decision for the benefit of another. Motivational interviewing is working with someone to help them come to their own decisions, coercion is influencing another in making a decision.

The difference between collaboration and confrontation

Collaboration is the coming together of two or more persons to work together for the mutual benefit of all involved. There is emphasis on cooperation and combining strengths and qualities to produce the end result. Confrontation is where two or more persons who come together in a work or other situation, clash and disagree over a subject. This circumstance is a negative aspect to working together and does not produce mutual agreement. The parties involved are not able to work together or find compromises in choosing a solution.

Respond appropriately and professionally

In your work you should always be professional and appropriate to the needs of the situation. Feelings, such as frustration or upset, may be felt in different work situations that you encounter. These will reflect a certain moment and can help to indicate that communications may need to be clarified or explained further. Ensure that you determine what you require to carry out your work tasks and to dissipate uncertainties.

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1.5 – Exchange information clearly in a timely manner and within confidentiality procedures

Potential sources of information

Information can come from a variety of sources and may be passed to you in very different ways. When communicating with colleagues, staff or other professionals, information will be specific to the health and care needs carried out within your job role. Information from patients/clients and family members may be given less formally and will need more careful understanding. You may need to seek out particular information or support or you may be aware of a particular network your organisation has access to, in which case you will need to identify the information and support they can offer your organisation and/or your client.

Participate in information exchange

Once information has been given, or obtained, make sure you pass this to the correct person(s) as required by your organisational procedures. This should be assessed and correctly identified for the intended recipient and passed to them in a time-efficient manner. Always assess the security and confidential nature of the information and use the correct channels for relaying the information. Optimise client service delivery

Once you identify the information and support provided by network(s), you can use this to optimise the client service delivery that your organisation provides. You will need to work out appropriate ways for the people within the network(s) and the workers within your organisation to work together effectively to improve and sustain a high standard of client services. Essentially colleagues, service providers and other relevant parties need to work together to make client service delivery the best it can possibly be.

Confidentiality of communication

Communicating records may be required from time to time, either in a written format or verbally. This may involve discussing conditions or test results with the families of clients or their doctors. There are specifications in place for whom information can be shared with, which will depend upon the nature of the information, the reason for the request and to whom you are communicating it to. These should be followed at all times and are often specified by law; there are also other measures you should take, which will be explained below. Verbal communication:

➢ Be aware of who is present when communicating personal information

➢ Use a private room to discuss information

➢ Ensure that you won’t be disturbed or overheard

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➢ Explain to the recipient the sensitive nature of the information

➢ Ensure that the recipient is cleared to receive the information

➢ Only disclose the necessary information

➢ Not using the real names of patients when discussing them in a public environment

➢ Don't release confidential information to unauthorised personnel without client

consent.

Written communication:

➢ Documents should be given in a sealed envelope

➢ Documents should be signed for

➢ Documents should be stored securely and not left around

➢ Encrypt all electronic information

➢ Keep all confidential written information stored in a secure location

➢ Postal communication should be sent securely and marked ‘private and

confidential’

➢ Papers should be received by the correct person

➢ Papers should be distributed by authorised personnel.

Sensitive information may not always be about a client; company information may also be shared amongst staff. Similar restrictions apply when communicating this type of information, insofar as it should be discussed in private and paper documents controlled. Information about any organisation or business should be kept private, which includes the exclusion of customers and clients. Any sensitive information, whether it is about the organisation or a client, should always be treated appropriately; if in doubt, err on the side of caution – you can never be too careful!

Confidentiality

Confidentiality is required by law in certain respects; the privacy of patient and client records is the most important aspect of confidentiality in the care industry. Failure to maintain privacy of customer records is punishable by law and organisations can be sued by the patient. This would mean not sharing certain information in your communications, such as networking. Information cannot be disclosed to those not directly involved in the patient’s/client's case. Measure should be implemented within your workplace and you will probably find that your organisation already has certain policies and procedures in place.

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The only situation where this private information can be disclosed is when there is a serious threat or risk of injury to the client or others. Other than that, the patient/client may choose to disclose their information – but it is their choice only. Clients will need to give permission (normally in writing) for their information to be released to others; if they are unable to do this through disability or death, advocates can grant permission. Client records

Clients also have a right to view their records – this information should be supplied only by authorised personnel in that field. If access is denied the client should be informed why and given details of when the decision can be reviewed. Any comments they make should be attached to their notes in an addendum. There should be policies in place to deal with workers who breach confidentiality – these will depend on your specific industry. Breaching confidentiality can, however, give clients a right to open legal action against you and if the individual or organisation is found responsible, accreditation and awards could be removed from the culprit. Staff must be versed in all confidentiality legislation, organisational policies and which information should be treated as confidential. They need to know the policies and procedures for every possible situation, so regular training is essential. Confidentiality covers:

➢ Physical privacy of patients in facilities, such as surgeries, hospitals and residential

care homes

➢ Controlling/not sharing records

➢ Monitoring access to records

➢ Disclosure to third parties, such as employers, other patients, family members,

insurance companies

➢ Use of audit trails to monitor who has accessed records and when

➢ Encrypting electronic records

➢ Protection of Personally Controlled Electronic Health

Records (PCEHR)

➢ Not selling or communicating data to other companies.

These are examples; as a rule, any information relating to the patient/client, in terms of:

➢ Medical records

➢ Financial information

➢ Personal details.

These should all be treated as sensitive information and be treated accordingly. Organisations usually have their own measures and control procedures in place regarding confidentiality, which will operate within the requirements of the law.

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Acceptable procedures may be in place regarding:

➢ Access to records:

o who can access what

o how information may be accessed, such as by permission or a record kept

o permissions

➢ Destruction of records:

o records should be suitably destroyed in a prescribed manner

o correct procedure followed

➢ Release of information:

o who information can be communicated to

o how information can be communicated

➢ Storage of records:

o electronic encryption

o password protection

o locked rooms, safes and secure filing systems

➢ Verbal and written communication:

o protocol for written communication, such as sealed envelopes and to whom they are given

o procedure for verbal communication, such as a private room to discuss information.

All matters relating to confidentiality are very important and should be taken seriously by all involved. All staff should be morally and ethically motivated to abide by patient/client confidentiality, not just because it is the law.

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2. Collaborate with colleagues

2.1. Listen to, clarify and agree timeframes for carrying out workplace instructions

2.2. Identify lines of communication between organisation and other services 2.3. Use industry terminology correctly in verbal, written and digital communications

2.4. Follow communication protocols that apply to interactions with different people and

lines of authority

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2.1 – Listen to, clarify and agree timeframes for carrying out workplace instructions

Apply workplace protocols and procedures in all workplace communication

When you are given work instructions to follow, you should listen carefully and take note of the specific information relayed to you. Your work may be varied, depending on the environment and the different needs of your patients or clients, and each situation will require a different set of instructions. Clarify any parts that you need with the relevant persons/your supervisor and ensure that you understand what is required from you. Clarify the following points:

➢ What tasks you need to complete

➢ Deadlines for these tasks

➢ Sequential order of these tasks

➢ Expected length of these tasks

➢ Documentation requirements

➢ Required equipment

➢ Required safety precautions.

You must only take orders from management/designated personnel and you should regard their input as the authority. You should also determine and agree acceptable timeframes with them. Some tasks, such as administering medication or checking the wellbeing of the patient/client, will be of priority and should be carried out to the specific timeframes stipulated for fulfilling their health and care requirements. Ask questions

Use questions to clarify information and show the speaker you have understood what they have said. This is also a method for finding out about any areas you truly don't understand. Repeat back what you have heard to the speaker, so they can correct you if you've misheard. Take notes

This may help you to remember information at a later date. They may only need to be triggers to help you remember the full scope of the information. This may be a better method for you than simply trying to memorise speech. Instructions

Whenever you are given instructions, you will need to ensure you understand certain aspects of them, such as those given in the bullet list above. If instructions are written ones, look for key information such as headings, deadlines, required equipment etc. You may find written instructions in the following places:

➢ On product labels

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➢ In instruction booklets for equipment

➢ In procedure manuals

➢ On notices.

Take messages

If you are in the situation where you are required to take a message for someone, ensure it is accurate. Don't allow yourself to be distracted while you are writing it down and clarify the message with the sender. Ensure you take the following information:

➢ Who the message is for

➢ Who the message is from

➢ Contact details of the sender

➢ The message content

➢ The time and date of the message

➢ Your details (if the receiver needs to

contact you for clarification).

Communicating with clients

There will be times when you need to give clients information – these may be instructions or directions within the healthcare facility. This sort of knowledge will need to be obtained through experience and is essential in your ability to service patients/clients efficiently. If you ever don't know the answer to a client enquiry (e.g. you have just started in your department), you should refer them to someone with the appropriate knowledge, rather than just guess. Keep a record of any regulations, forms, procedures and products that are relevant to your job role, so you have access to this information should you need to answer queries.

Scope of practice

Your ‘scope of practice’ refers to the actions and procedures that you are permitted to undertake and usually refers to licensed individuals, such as nurses and paramedics. It generally refers to what you are licensed to do, though unlicensed workers also have restrictions placed on the actions they can do. By attributing professionals with a scope of practice, you are providing them with a framework of guidelines that state what they are and are not allowed to do. This gives the individual the confidence to know their limitations and also the knowledge to avoid overstepping any boundaries. These boundaries are particularly important in the care and medical professions, as they prevent individuals attempting to tackle jobs that they are not qualified to do, which can be dangerous for all parties involved and can also mean that the individual is not insured if something goes wrong, which can leave all parties at a disadvantage.

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Staff should be fully aware of their expectations and limitations and should apply this to all the work that they do; they should be ready and willing to step up to the mark and prepared to draw the line where their authority ends. If, for some reason, anyone is unsure, they should refer to their licensing and qualifications or ask a supervisor, as they will usually be informed of specific job roles and who is qualified to do what.

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2.2 – Identify lines of communication between organisation and other services

Working with other sectors of the industry

The care industry consists of many different types of sector, some of which are unrelated to others and some of which work together to contribute to a particular purpose. Some examples of different sectors may be:

➢ Aged care

➢ Alcohol and other drugs

➢ Child protection

➢ Children's services

➢ Community development

➢ Community work

➢ Disability services

➢ Employment services

➢ Family and domestic violence

➢ Funding/administrative

➢ Home and community care

➢ Housing

➢ Mental health

➢ Youth work and juvenile justice.

In terms of aged care, several of these could apply, such as:

➢ Alcohol and drugs: to help service users manage these dependencies and enable them to receive treatment and help where desired or required.

➢ Community development: development of community projects to benefit the elderly.

➢ Community work: such as youth or charity groups maintaining gardens or doing basic decoration jobs for the elderly.

➢ Disability services: for any aspects of disability.

➢ Home and community care: support for those wishing to remain in their own homes.

➢ Housing: help with finding suitable housing for the elderly, such as ground-floor flats, adapted housing or retirement complexes.

➢ Mental health: for help managing any mental health issues users may have.

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(Whereas, child protective services and juvenile justice systems are not likely to be anything to do with aged care.) Providing aged care may entail securing use of these services where required and/or working alongside them to meet the needs of the client. Knowledge of other sectors can allow you to recommend and arrange services that could benefit a client, such as applying your knowledge of housing services to help a client who needs to move home. Clients often have access to a range of these services, which they will use for different purposes. For example, the housing services organisation may make arrangements with community groups to plant flowers in a retirement complex or gather volunteers to maintain gardens. A user may have a carer who visits him daily, but also a mental health advisor who works with him weekly or monthly. It can be useful and beneficial for staff to be aware of and understand how other services interact with your own, in order to see the complete picture and to do the very best for each client.

Roles of other organisations

Knowledge and understanding of other aspects of care industry sectors can enable you to put together a service package for the client and to ensure that they receive all the help that they need and want. Other organisations offering services can provide great additional services or required services to clients; if you are aware of these and understand what they provide and how they operate, then you can use this to your advantage to arrange things for your clients. Additional services may include:

➢ Volunteer gardening services

➢ Coffee and cake mornings

➢ House cleaning services

➢ Charities that provide services for the elderly

➢ Organisations who arrange and provide days out for clients

➢ Entertainment, such as bingo

➢ Shopping services

➢ Meals-on-wheels services.

There are many organisations and charities who operate to provide services; using them can provide a benefit for the service users, who will have their experiences enhanced and the companies, who will be able to grow and provide a better service.

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Organisations in the health care system in Australia

The Australian health care system is a mix of public and private sector health services. There are also a variety of funding sources and regulations that govern how services should be carried out. Service providers include:

➢ Public hospitals

➢ Private hospitals

➢ Health professionals

➢ Private practitioners

➢ Clinics

➢ Government agencies

➢ Non-government agencies.

The funding is provided by the Federal Government, State, Territory and Local governments, health insurers and individual investors. This money comes from tax and, Medicare Levy and private financing/insurance (for private health care). Around 70 per cent of health care is funded by the government. There are three national subsidy strategies:

➢ Medicare

➢ Pharmaceutical Benefits Scheme (PBS)

➢ Private Health Insurance rebate.

Networking needs

Your networking needs will depend on your position and the organisation you work for. Networking is undertaken by most organisations at some point and will often be to gain and share information and make contacts with groups etc., who can help with the organisation’s goals or their client’s needs. You may find that you have networks for various aspects of your work life; these may be relevant to your work role, the organisation’s priorities or the target groups. More specifically, the purposes of networks and networking may include:

➢ Learning about the role, services and resources of other organisation

➢ Learning about the roles and resources of other workers

➢ Providing advice and information about own service and organisation

➢ Peer support and review

➢ Professional development

➢ Maintaining coordination among organisations and workers

➢ Supporting joint programs or activities

➢ Providing information for policy development

➢ Supporting the interests of young people.

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Identify networks

What is the most appropriate network?

This will depend on your organisational, individual and/or client goals.

In most cases you’ll need to communicate with and establish the effectiveness of several potential or existing networks to achieve your goals.

➢ It is generally regarded as prudent to keep your personal networks personal.

➢ Instead, make use of your existing and professional networks.

Personal networks should be used to further your social life not your work life. Networks will vary and will be grouped as either informal or formal, which ones you use will depend on the needs of you, your organisation or target groups. How you interact and deal with various networks will depend on the informality/formality of each. Networks may be informal and include:

➢ Other workers, particularly those in the community services industry

➢ Trainers, teachers and academics

➢ Contacts in policy and funding bodies.

Networks may be formal and include:

➢ Local interagency networks

➢ Interest and support groups

➢ Regional, specialist and peak associations

➢ Professional/occupation associations.

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2.3 – Use industry terminology correctly in verbal, written and digital communications

Organisational requirements for communication

Where protocols and procedures are in place regarding workplace communication, all staff should endeavour to adhere to these. This usually refers to the communication of information between staff, concerning a patient, an event, an issue or any other workplace information. To support accuracy and understanding, many organisations provide guidelines for staff to follow, especially regarding the use of acronyms and abbreviations. These protocols are not necessarily enforced, but are there as a recommendation or suggestive framework. Where staff have worked together a long time or are all of a similar level of experience, they will usually be able to communicate effectively amongst themselves without the need for guidance. This, of course, can become an issue where new staff are employed; in these instances, the workplace protocol may be to introduce the existing framework to the new employee, so that they can understand what is being said. Aside from professional terms, workplaces may use slang or other sociolect to refer to places, objects or people, such as the ‘med room’ for the pharmacy, ‘wet room’ for showers and ‘gaffer’ for the boss. These will vary from building to building and form part of the workplace culture. Where communication is required between the staff and the management, or staff and a partner company, such as a supplier, it is generally required for staff to use the correct terminology or standard accepted abbreviations, to minimise the event of a mistake or failure to understand. As with any type of communication, if you are unsure or do not understand, you should always ask for clarification; this will minimise the likelihood of orders being misunderstood or clients given the wrong care.

Industry terminology

Always familiarise yourself with the correct industry terminology in use at your organisation and for the services that you provide to others. There are many standard terms, such as ancillary service (to describe supporting services within the medical field such as laboratory, radiology or physical therapy work) and these will be well-used within your service. Others may be specific to your area or type of work, such as home and community care which may be used for the care of the aged.

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2.4 – Follow communication protocols that apply to interactions with different people and lines of authority

Friendly communication

Communication should be inclusive and clear for all concerned, especially in the care profession. Communication that is person-centred or community-centred can have a positive effect upon the person or group involved and adds a feeling of personality to communication, as opposed to impersonal communication. A person-centred approach could involve:

➢ Putting people and carers at the centre of

service delivery

➢ Including people in decision-making relating

to their care

➢ Involving people in discussions about service

delivery options and issues

➢ Obtaining the person's consent to examine,

treat or work with them

➢ Effective customer service

➢ Listening to and addressing complaints

within scope of own work role.

The duty of care is in place to ensure that clients receive the care that they are entitled to; this care can be enhanced through the application of person-centred communication approaches, which contribute to the happiness and wellbeing of service users. Encouraging and allowing the above points, such as enabling users to contribute to decisions around their own care can make a big difference and can be very positive for service users, as this shows that they are cared for and that their input has weight and value. Individual work roles will limit the extent to which you can implement these points; good staff should endeavour to meet these as far as possible, within the scope of their role and organisational requirements.

Client-centred approach to health care

It is important that the client's (or patient’s) needs are at the forefront of your mind when you are making decisions and communicating with them. Listen to what they have to say when you are communicating with them; if they indicate a preference for something, take this into account when providing their care. Always respond to patients/clients in a calm manner and avoid blaming them for things they may have done. Even if they do not behave in the same manner towards you, you shouldn't lose your cool and react badly. Be attentive to patients/clients and communicate with them in a courteous manner – this helps them to feel comfortable and that they are getting the care they deserve. It will

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remove any communication barriers before they arise, minimising problems that may occur later on. A client-centred approach to health includes:

➢ Putting patients/clients and carers at the centre of service delivery

➢ When the patient/client is a child or young person, service delivery strategies may

need to be modified to ensure child safety and provide a child friendly, supportive

environment

➢ Including patients/clients in decision-making relating to their health care

➢ Involving patients/clients in discussions about service delivery options and issues

➢ Obtaining patient/client consent to examine, treat or work with them

➢ Effective customer service

➢ Listening to and addressing patient/client complaints within scope of own work

role.

Demonstrate respect for others

Health and care professionals are likely to come into contact with many different types of healthcare provider or co-workers in their working lives, such as:

➢ Supplier services:

o stairlift installers

o caterers

o pharmaceutical distributors

➢ Other service providers:

o drugs and alcohol advisers

o housing officers

o community volunteers

o entertainers, such as bingo

callers

o social services

o laundry services

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➢ New staff

➢ Student staff

➢ Other care companies

➢ Internal staff:

o medicine distributors

o kitchen staff

o laundry department

o housekeeping

o nurses

o managers and supervisors

➢ Inspectors

Both internal and external staff, as well as organisational and agency staff may work alongside you in your mission to provide are to the aged. This will naturally mean that there are many different hierarchies and skill levels involved. It is not acceptable for care providers to be rude or demeaning to those they perceive as below them, such as laundry operators, food servers or students. People should also not be judged on their organisation, such as a business perceived as an inferior catering company or a sub-standard entertainments provider, though where these services fail to meet basic requirements, they may be replaced, in the interests of the clients. As you are all working together towards a common goal, you should foster a feeling of teamwork, as opposed to rivalry or snobbery.

Correct protocols

You should always ensure you follow the correct protocols for your communications. Each group or type of persons will have their own set of protocols for performing workplace communications. For example, a manager will be there to assist you and support your work and you may have a less formal approach in your communications. If communicating with an outside contact, you will need to be professional and follow strict codes for communications; this will ensure that confidentiality and ethics are maintained. You will end up communicating and working with people from different sectors and levels of your industry. Therefore, it is essential that you make them feel respected and valued. You need to make people feel as if they are part of a wider team and that you trust them. Cooperation is generally very important when completing a task – you will need to rely on others to do their job effectively, so the resources you need are available. This will require effective communication skills, to enable you to pass on messages and respect their cultural and personal differences, as well as their diversity.

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You will need to know the roles and responsibilities of the people you work with, in order to recognise their expertise and skills. When you have this knowledge, you can utilise these people better and have more reasonable expectations of their capabilities.

Culturally sensitive communication

In order to show respect for those from different cultures that we may work with, we need to display culturally sensitive communication. For example think about the differing meanings between cultures of:

➢ Gestures

➢ Words

➢ Body language

➢ Pauses

➢ Eye contact

➢ Terms of address.

You need to also learn about the following of your colleagues:

➢ Knowledge

➢ Skills

➢ Feelings

➢ Needs

➢ Interests.

Another aspect of respecting other workers is to perform up to expectations yourself. Remember that these people are relying on you, just as you are them. If you fail to perform your duties you are letting the team down and making it harder for everyone else to carry out their roles. Other aspects of your co-workers that you'll need to take into account include:

➢ Gender

➢ Age

➢ Lifestyle

➢ Abilities

➢ Qualifications

➢ Socio-economic status

➢ Beliefs

➢ Values

➢ Family background.

Embrace diversity, as it allows you to exploit strengths of different people to mutual advantage and provides an opportunity to learn from one another.

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3. Address constraints to communication

3.1. Identify early signs of potentially complicated or difficult situations and report

according to organisation procedures 3.2. Identify actual constraints to effective communication and resolve using appropriate

communication strategies and techniques

3.3. Use communication skills to avoid, defuse and resolve conflict situations

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3.1 – Identify early signs of potentially complicated or difficult situations and report according to organisation procedures

Identifying the problems in your area

If you encounter a complicated or difficult situation that you need assistance with, report this to your supervisor/manager and/or to the requirements of your organisation. The source of this may come from those that you are working with or for, or may come from another area such as a change to legislation. The difficulties that you may encounter will largely depend upon your role and the service that you provide to others.

Current issues influencing health care

You must keep abreast of all of the current issues affecting health care in Australia. For example, some of the challenges include:

➢ Changing demographics

➢ An ageing population

➢ Increasing costs of medical advances

➢ Health workforce supply is low

➢ The quality and safety of health services

➢ The balance of public and private health care

➢ Creating healthy communicates

➢ Investing in health of children

➢ Providing equal health care opportunities to all citizens.

Aged care

Communication skills are vital in many roles and industries and they are particularly important in the care industry. Where aged people are involved, many different communication issues can arise, which staff must be capable of dealing with efficiently. These may include:

➢ Deafness

➢ Hard of hearing

➢ Poor eyesight

➢ Unfamiliarity with slang and modern words

➢ Use of old fashioned terminology

➢ Difficulty understanding complex terminology

➢ Memory problems

➢ Language barriers

➢ Learning to speak to clients in the way they prefer or insist upon.

Health and care providers should have an all-round knowledge of communication requirements and how to meet them, which can be gained and developed through normal working practices in the care industry.

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New skills, methods or techniques can be learned as requirements change or a new client is introduced with new needs. Care professionals should seek to constantly develop their communication skills, in the interests of performing their jobs the best they can.

Health issues for Indigenous Australians

One of the major issues of health surrounds Indigenous Australians. People within the Aboriginal and Torres Strait Islander community view health from a wholesome point i.e. not only the physical, but also the social, emotional and spiritual health of the whole community. Another aspect is their strong bond with the land, especially that of their people. As such, they prefer to use the term "social and emotional wellbeing" to "mental health", as this presents a more holistic approach to health (Australian Health Ministers, 2003). As their perception of health is different to the rest of the population, they may only utilise health services/hospitals when their condition is severe, or their local area has limited facilities. They may doing so otherwise is unhelpful, due to cultural and gender differences. They may view things such as hallucinations, negative feelings or pain as a personal/spiritual issues, rather than health ones. Their beliefs mean that many people in their community may have undiagnosed conditions. As part of an overall goal of cultural inclusiveness, you should look at increasing the participation of Aboriginal and Torres Strait Islander people in health service delivery. This means giving them active roles in decision making and employing more of them within in health service industry. Factors contributing to Aboriginal and Torres Strait Islander people's ill health include:

➢ History of European/Aboriginal contact

➢ Loss of culture, land, identity and Indigenous law

➢ Loss of family links

➢ Geographical remoteness

➢ Lack of relevant and culturally appropriate education

➢ Lack of meaningful employment or occupation

➢ Lack of relevant health knowledge

➢ Food and nutrition

➢ Smoking

➢ Alcohol and substance abuse

➢ Mental stress

➢ Poor maternal health

➢ Feelings of isolation and vulnerability and being culturally unsafe

➢ Violence

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➢ Environmental health factors (housing, sewerage, water supply, hygiene)

➢ Late presentation, diagnosis and treatment.

These things can be attributed to a wide range of external factors, which include:

➢ Low income

➢ Lack of education

➢ Unemployment

➢ High stress

➢ Poor social networks and support

➢ Poor working and living conditions

➢ Gender inequalities

➢ Behavioural problems (mental conditions).

Using interpreters

You will need to use Aboriginal and Torres Strait Islander interpreters, health workers and colleagues as cultural brokers, in order to meet duty of care requirements. A cultural broker is someone who facilitates people form one culture crossing over to another. In other words they act as a mediator between people/groups of different cultures, to enable effective communication and reduce conflict. They act as more than just an interpreter – in colloquial terms, they would be known as a "middle man". Interpreters may be:

➢ Registered – these are professional people whose work involves travelling and

mediating for multiple people/groups.

➢ Other multilingual people not related to the person – these may be people on your

staff who have multilingual abilities, but this is not their main duty at work.

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Availability of interpreter resources

You will need to know the available interpreter resources available to your organisation and its needs, so you can employ them as necessary. Government agencies are required to provide and pay for professional interpreters when people are seeking government-related services that have difficulties speaking English. The Translating and Interpreting Service (TIS) National provides free interpretation services to non-English speaking Australian citizens or permanent residents who need to communicate with approved groups and individuals, such as medical professionals. Interpreters can be accredited and unaccredited – you should aim to provide a 'Professional Interpreter' level worker accredited by the National Accreditation Authority for Translators and Interpreters (NAATI). If this is not possible/available, a 'Paraprofessional Interpreter' should be your second choice. Useful resources for finding interpreters include:

➢ Australian Institute of Interpreters and Translators Incorporated (AUSIT):

www.ausit.org

➢ Translating and Interpreting Service (TIS): www.tisnational.gov.au

➢ National Accreditation Authority for Translators and Interpreters (NAATI):

www.naati.com.au

All websites accessed 21.09.2015.

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3.2 – Identify actual constraints to effective communication and resolve using appropriate communication strategies and techniques

Personalised communication

Communication requirements can vary greatly from one individual to another and from one cultural group to another. This can be more pronounced and significant in the care industry, where clients’ needs and wellbeing is at the forefront of every action; this means that their needs and wants need to be communicated properly, and the service user should also have relevant information communicated to them in a manner which is understandable and friendly. There can be many different communicative issues encountered by people requiring care, which can range from hearing issues to memory problems. Adjustments should not just be made on the basis of need, but should also meet the clients’ ‘wants,’ in order to show respect and make people as comfortable as possible. Individual differences may include:

➢ Hearing difficulties

➢ Memory issues

➢ Language barriers

➢ Accent/regional speech differences.

Cultural differences may include:

➢ Religion

➢ Lifestyle

➢ Different values

➢ Different views about personal space

➢ Hierarchy

➢ Conversational preferences.

Aspects that cause difficulty in communication, such as hearing problems need to be worked around to a satisfactory level. Cultural issues should also be met wherever possible, as failure to do this, or disregarding requests can fall under cultural discrimination. Where patients/clients have specific personal preferences, they will usually make them known. These wishes should be met wherever possible, though staff are protected from having to do anything demeaning, dangerous or preferential for single patients/clients. Requests can involve anything from asking to be called a preferred name, having someone knock before they come in the room or making sure you smile.

Cultural differences

In a health care situation, you will come across people from a variety of cultures. It is important that you recognise these and don't discriminate against them.

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Culture refers to values, beliefs and common behaviours of a certain group. These groups can be determined by a variety of factors, such as location, age, upbringing, religion, interests etc. An individual's culture is often determined by many of these factors, rather than one thing. You can also be part of more than one culture (or subculture). Cultural misunderstandings

Because of the variety of cultures that you will encounter, it is likely that cultural misunderstands will occur. This can happen when you are communicating with someone who has a different culture (or language) to yourself. You will need to be patient and recognise that meanings of words, gestures and other non- verbal communication will differ. You may have to clarify things more often than you are used to. To minimise the chance of cultural misunderstandings:

➢ Avoid using jargon

➢ Ask the other person if they understand what you are saying

➢ Practice listening to accents

➢ Listen carefully to what is said.

Communication strategies

If you experience constraints in your communications, you should adopt a strategy to ensure that you can still perform your work and any communications that are required. From a chosen strategy, you can look at the best techniques to convey your message. For example, if your strategy is to ensure your message is received clearly, you may decide that sending your message by written word, i.e. in a letter or email/electronic communication is better. Each situation will determine its own needs and will require a specific approach. Your strategies may include:

➢ Respect of others and their differences

➢ Clear understanding in communications

➢ Appropriate forms of communication

➢ Attending to the needs of the client

➢ Working for the benefit of client and service.

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3.3 – Use communication skills to avoid, defuse and resolve conflict situations

Facilitate resolution of issues and defuse potentially difficult situations

There are a number of things you should consider when dealing with any issues or defusing potentially difficult situations. These will include:

➢ Use open body language

➢ Do not fold arms or put hands on hips

➢ Remain calm and patient

➢ Use clear language

➢ Keep tone of voice calm

➢ Do not shout or raise voice

➢ Give accurate information.

Communicating effectively under any circumstance can include:

➢ Effective use of questioning, speaking, and listening and non-verbal communication

techniques

➢ Identifying and evaluating what is occurring within an interaction in a non-

judgemental way

➢ Making decisions about appropriate words, behaviour, posture

➢ Using clarifying, summarising questions

➢ Putting together a response that is culturally appropriate

➢ Expressing an individual perspective

➢ Expressing own philosophy, ideology and background and exploring the impact of

this on the communication

➢ Exploring and unpacking problems

➢ Using active and reflective listening appropriately

➢ Providing sufficient time to enable stories to be told

➢ Providing summarising and reflective responses in conflict situations

➢ Confirming that required information is accessed or message communicated.

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Conflicts of interest

Conflicts of interest can occur in any workplace or business and should always be handled properly. Organisational policy will have a big impact on the occurrence of conflicts of interest and the action to be taken; ethical issues may also be relevant. This is any situation where you have the ability to make a decision that could potentially benefit the client, but could also impact on yourself. It is a situation where there is potential to take advantage of a client or be influenced by your interests and personal opinions. Any situation where your influences impact on the ability to perform your job to a professional standard/objectively is a conflict of interest. Even if you do not act under the influence of these things, if they have the potential to impact on your work, a conflict of interest still exists – this can lead to doubt over your ability to perform your job well. Therefore, it is important to refrain from situations where your personal life affects your professional conduct. This is part of your duty of care (as an individual and organisation). The aspects that can cause conflicts of interest include:

➢ Personal relationships

➢ Political views

➢ Financial interests

➢ Cultural activities

➢ Private activities.

If you believe there is a conflict of interest (for yourself or others, you should inform management/your supervisor as soon as possible – you may need to request that you be reassigned to another case or granted permission to seek additional work to compensate for the loss caused by conflict of interest. Another key way of avoiding conflicts of interest is to not accept any money/gifts from clients or others – as this may affect your ability to make objective decisions and create a vested interest.

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Negotiation

In order to negotiate a resolution, consider the following:

➢ Assess alternatives

➢ Determine the underlying issue

➢ Be constructive

➢ Create solutions

➢ Be objective

➢ Empathise with their situation

➢ Listen actively.

Problem-solving

The following steps will help you solve any problems:

1. Identify the problem

2. Investigate the problem

3. Specify what you want to achieve

4. Create solutions

5. Implement the most appropriate solution.

Generating solutions

When creating solutions, you should ensure that only the best solution is chosen. Don't allow criticism or judgement to sway your decision. You need to create a deadline for the solution and continuously monitor its effectiveness. Ensure that patients/clients are happy with the resolution and carry out a follow up to determine that they are satisfied with the outcome.

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4. Report problems to supervisor

4.1. Comply with legal and ethical responsibilities and discuss difficulties with supervisor

4.2. Refer any breach or non adherence to standard procedures or adverse event to

appropriate people 4.3. Refer issues impacting on achievement of employee, employer and/or client rights

and responsibilities 4.4. Refer unresolved conflict situations to supervisor

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4.1 – Comply with legal and ethical responsibilities and discuss difficulties with supervisor

Duty of care

Duty of care is a legal duty to take all reasonable care to avoid others being harmed and to ensure that all health and community workers provide a good standard of care, with due attention. This involves the application of and adherence to ethical standards and acknowledges that people have a right to be cared for in safe environments which are free from neglect and abuse. It also involves identifying risks and responding in the most appropriate way. It does not require perfection; moreover, it is the effort to ensure that the person is protected. It acknowledges that you may lack resources and abilities that would enable said perfection.

Reasonable care includes considering the safety, privacy, confidentiality and needs of clients and others. In the aged care industry, other responsibilities may include management of the client’s benefits and always the prevention of age discrimination. In instances where the health and care of children are concerned, all children should be protected against risk factors to their health and wellbeing. Be aware of any circumstances that may cause concern and seek advice.

Everyone has a duty of care responsibility – for example, the employer and employees are both responsible for safety in the workplace. When working with disabled people, this applies in potentially risky situations, where duty of care will need to be exercised to ensure hazard prevention.

You must ensure that all of your work meets the duty of care requirements. Policies and procedures which take into account things like WHS and legal responsibilities should be followed. A WHS officer should be appointed to ensure all workers and people in the vicinity of work comply with these requirements.

Employers have a duty of care to provide a safe work place and systems of work in consultation with their team and to keep their team informed about changes in WHS legislation. To assist you in ensuring that your organisation is compliant with WHS legislation, you can download a copy of the WHS Compliance Self-Assessment from the Safety at Work process. You should also check the specific legislation, codes of practice and standards that apply in your location to ensure compliance at work.

The objective of the WHS Act is to ensure that a safe workplace is created free form risk or illness or injury. For that end, compliance must be demonstrated in regards to:

➢ A safety management system

➢ Responsibilities and Accountabilities

➢ Consultation

➢ Risk management

➢ Information, instructions and training

➢ Managing injuries

➢ Record keeping

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➢ Monitoring, review and improvement

➢ Resource management

➢ Corporate risk.

If you are able to work through the document and tick yes the whole way through, then you are complying with current legislation. Care should be taken; this is not a one off process. Managers are required to ensure the continuous compliance with the legislative system.

Duty of care in law

Duty of care comes under the ruling of tort law i.e. a civil wrong as opposed to a breach of contract. It requires an individual to provide a standard of reasonable care while carrying out any activity that could potentially harm others. Breaching duty of care means that you, as an individual, are liable to legal action from the claimant. Duty of care has been developed through common law i.e. it exists based on past related court rulings – therefore, there is no exact legal definition of things like duty of care and negligence. Negligence is when damage/harm occurs to another person as a result of someone else not exercising reasonable care. Duty of care requires that an acceptable standard of care is exercised, where it is reasonably practicable, to ensure the health and safety of yourself and others. Duty of care also means that everyone has a responsibility to ensure a safe and healthy working environment. This can include the following people:

➢ Community and disability service workers

➢ Doctors

➢ Solicitors

➢ Financial advisors

➢ Drivers

➢ Local governments.

Duty of care is written legally into the Workplace Health and Safety Act 1995 – it is a moral duty to anticipate possible hazards and causes of injury and do everything reasonably practicable to prevent/remove/minimise these causes. This means that duty of care cannot be delegated – all adults in the workplace are responsible for health and safety. Courts will determine breaches of duty of care based on the following criteria:

➢ What is typically expected of another person in the same situation

➢ The person's roles and responsibilities within their organisation

➢ The experience/level of training for the individual

➢ The practicalities of the situation

➢ What is deemed acceptable practice within the community

➢ Generally acceptable standards in the situation

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➢ Relevant laws e.g. the Workplace Health and Safety Acts, Regulations and Codes of

Practice.

For negligence to be successful, the following must be proven:

➢ A duty of care is owed by the plaintiff to the defendant

➢ In exercising the duty of care, the defendant failed to

function according to a reasonable standard of care

➢ The failure to function according to a reasonable standard of

care (breach) caused the damage suffered by the plaintiff

➢ The loss or damage suffered by the plaintiff was reasonably

foreseeable.

Negligence laws

In order to restrict the number of negligence claims, there are laws in place; in Queensland laws related to professional liability for damages related to negligence:

➢ Personal Injuries Proceedings Act 2002 (Qld)

➢ Civil Liability Act 2003 (Qld).

The following principles apply to negligence:

➢ It does not apply if the risk of the activity was obvious/made clear

➢ What is expected is dependent on the skill level/experience of the worker

➢ People are given a reasonable amount of information to make informed decisions

on optional actions (e.g. medical treatment)

➢ Apologies/expressions of regret do not amount to admitting liability/fault and will

hold no weight in court

➢ First aid personnel have no liability in emergency situations, as long as their actions

are in good faith and without reckless disregard for safety.

Maintaining competence

As an employer/worker, it is your responsibility to maintain competence in your given field and retain a skill level that can be described as reasonably competent. This can be reviewed and monitored through:

➢ Supervision

➢ Co-worker/peer support and review

➢ Professional development

➢ Reading up on current literature

➢ Providing advice and services based on current evidence/facts

➢ Membership of professional associations

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➢ Participating in research programs.

Ethical guidelines in decision making

Working within the field of health, it is important to follow ethical guidelines when making decisions. This is because you will deal with a number of sensitive issues, where you will need to be careful not to breach the trust and confidentiality of clients, but are still required to perform your work role effectively. Often, these two requirements can contradict each other i.e. in order to do your job properly, you may have to go against the wishes of the client and breach confidentiality or perform procedures that are contrary to their beliefs. For instance, if you have a Jehovah's Witness who may die without a blood transfusion, what would you do? (Their religion forbids blood transfusions). As a worker in the health industry, your primary responsibility is to the wellbeing of clients. However, this does not eliminate the fact that you will need to make decisions of your own that your will be directly liable for – this is where ethics fits in.

Code of ethics

This is a set of moral principles and standards that you use to guide practice in a particular profession. It is not a legal document but more of a voluntary set of controls that regulate your industry. It defines the obligations and responsibilities you have to clients and colleagues. An example of a code of ethics is the NSW Code of Conduct for Health. It can be found at: http://www0.health.nsw.gov.au/policies/PD/2015/PD2015_035.html (access date: 20.09.2015). The code outlines the following:

➢ Personal and professional behaviour towards others

➢ Bribes, gifts and benefits – what you can and cannot accept

➢ Professional standards – maintaining skills, knowledge and

all-round competence

➢ Fairness in decision making – being consistent and objective

➢ Performance of duties – what is expected

➢ Ethical dilemmas – how to respond.

Ethical dilemmas

Every decision you make should be based on doing the best for the client and what is ethically and morally correct. Persons qualified to provide care on a professional level should be sufficiently aware of how ethical guidelines affect them and the work they do in the provision of service. When there is an ethical dilemma, it is because at least two sets of values are involved, with a decision to make on which set is most important. You will have to decide which the most important point in the particular situation is.

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Of course, the client's rights should always be a priority; however, how to actually protect these is not always obvious, as there can be conflicting opinions from family, co-workers and others involved. Working ethically at all times ensures the best for the client, the best for you and the best for the community:

➢ Clients receive the correct care

➢ Clients and their families can rest assured that they

are being cared for properly

➢ Personnel have a framework of guidelines from

which to make their decisions

➢ Personnel are protected somewhat if they always

make decisions based on the best ethical solution

➢ The organisation is less likely to come under fire for malpractice.

The ethical expectations of your work role will depend upon your level of authority and the type of care you provide; where you are required to make direct decisions regarding the provision of care for someone, you will have to make more ethical decisions, though staff who are required to implement a prescribed routine or action, such as the administration of medication of the maintenance of a room, will be required to do this to a lesser extent.

Categories of ethical dilemmas

Competing values

This is when your responsibility for another conflicts with their ability to make independent decisions. For example, take an alcoholic – they have the right to self-determination (make their own decisions) but you have a duty to protect human life and intervene. Multiple client system

This is when, in addition to the client, there are other parties involved who have opposing views to the client. You have to decide who you have an obligation to – usually, it is the client but, if the other parties are advocates, a dilemma arises. For example, imagine a client wants to refuse life support but their family is insisting that they remain on it. Value dilemma

This is where your personal values conflict with the action you need to take in regards to your work role. This can arise when you have a legal obligation to report something like abuse, but where you personally get on with the person accused of said abuse (and perhaps understand the causes of it). Discussion of ethical dilemmas

As previously outlined, ethical dilemmas should be discussed with those who are at least one level above your role and they should provide an objective opinion of the situation. You need to collectively decide the best course of action in the interests of the client and remove your personal feelings from the situation.

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Child protection

Australian legislation for child protection differs between states and territories. Australia signed the United Nations Convention on the Rights of the Child (1989) and uses many of the principles in this to guide its own child protection legislation. Generally, decisions are made based upon the "best interests of the child". If your health or care work involves working with children, always ensure that you adhere to the legislation in your state/territory and maintain the safety of any minor at all times. Notices of disclosure should be listened to and assessed to ensure the safety of the child. The other principles that make up child protection legislation include:

➢ Early intervention

➢ Participation in decision making

➢ Out-of-home care

➢ Culturally specific responses to Aboriginal and Torres Strait Islander people

➢ “After care” support

➢ Permanency planning and stability of care.

Further information on child protection laws can be found at: https://aifs.gov.au/cfca/publications/australian-child-protection-legislation (access date: 24.09.2015).

Mandatory notification

It important that you are able to identify and report any issues that require mandatory notification. You should ass these on to your supervisor and/or the appropriate authority. 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.

Discuss problems as needed

If you need to raise any issues relating to the work that you carry out, make sure you discuss this in the appropriate manner with your supervisor/manager. You will need to ensure that you have a full understanding of the situation, that you have gathered all relevant information and facts and that you treat the matter with discretion. Your supervisor/manager will be able to help and assist in deciding and taking the correct course of action. Always report any difficulties that you may experience to your superior

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immediately; this will ensure that actions can be decided appropriated and to your organisational requirements.

4.2 – Refer any breach or non adherence to standard procedures or adverse event to appropriate people

Identify issues

While you are working there will be several opportunities for you to identify breaches in the duty of care, non adherence to standard procedures and adverse events; it is the responsibility of every care provider to be vigilant in identifying issues and is often a legal requirement for you to report serious issues. These include:

➢ Breaches in the duty of care:

o providing inadequate care

o allowing abuse

o allowing or causing neglect

➢ Non adherence to standard procedures:

o doing something in an unacceptable way

o cutting corners

o skipping parts of a procedure

➢ Adverse events:

o falls

o accidents

o other incidents.

These types of events should always be reported to the appropriate personnel, which will usually be a designated manager, team, WHS officer and/or regulators/authorities.

Mandatory notification requirements

As briefly mentioned in section 4.1, mandatory notifications are important and situations of urgency and concern that fit into this category should be reported. Different issues will require different action to be taken, but action must be taken in all instances. Clarify with your supervisor which situations are classed as mandatory in your workplace. Where you are unsure, ask your supervisor/manager, it is likely that they will be your first port of call anyway. For example, assaults, both physical and sexual, must be reported to the most senior supervisor, then the police and social services. This includes suspicions and signs of assault; you should never wait to witness an actual attack before you report. Where there are missing residents, you need to tell the senior supervisor on duty and then the police and social services within 24 hours.

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Examples of such issues may be:

➢ Someone working whilst intoxicated through drink or drugs

➢ Sexual misconduct

➢ Risking public health:

o through impairment

o through deviation from standards

➢ Concerns about a worker’s performance

➢ Concerns about a worker’s conduct

➢ Assaults or use of unreasonable force against a client

➢ Inappropriate relationships with a mentally-impaired client

➢ Missing residents.

Report issues

Reporting incidents and issues can:

➢ Support the constant provision of quality service

➢ Enhance quality of service

➢ Promote diligence

➢ Promote duty of care

➢ Promote consistency

➢ Encourage a culture of openness

➢ Prevent issues getting out of control or worsening.

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Reporting and resolving issues can provide those involved with the opportunity to learn from the event and understand how to prevent a reoccurrence. Reporting issues or concerns should be encouraged as far as possible in the care profession; the duty of care obliges care providers to adhere to guidelines and expectations for providing a good quality level of care for all clients; where this care is not being provided, it is important that the issue is tackled. Some staff may occasionally make mistakes or forget to do things and other staff may be cutting corners and skipping tasks; these errors, whether deliberate or accidental should be referred by another member of staff who may discover them; this will ensure that the client receives the proper care and service and hasn’t missed a meal or their medication or not had their room cleaned. When staff begin to cut corners or make frequent mistakes, their colleagues should help them recognise where they are going wrong, such as “you forgot to replace Mr Watson’s water jug this morning. I did it for you” or “hey, did you know that you’re supposed to change the water every morning with breakfast?” casually mentioning these issues to the person responsible will either remind them of a genuine error or will point out to them that they are not getting away will being lazy. When staff begin to watch each other’s’ backs and help each other cover up issues, this can breed a culture of deceit and disrespect for the job. These instances can encourage and allow deep issues to become established and can result in establishments and organisations being investigated and shut down, as well as the negative effects on the lives of dependent clients. Different levels of problem and types of issues will require different procedures for reporting; minor issues or discrepancies may be highlighted to the relevant staff member so they can rectify the issue, whereas repeated or serious breaches should be reported to either a senior manager or relevant authority. Reporting to a relevant authority may mean emergency situations requiring an ambulance, fire engine or police team or poison control. Where there are failings within the organisation, a higher authority, such as an inspection authority or similar, depending on the type and size of the organisation, could be reported to, in order to investigate issues and failings.

Unethical conduct

Unethical conduct can potentially lead to breaches of standards. If someone engages in it they may be putting clients at risk. It can include:

➢ Gossiping about clients or co-workers (inside or outside of the workplace)

➢ Disclosing official information to people without the authority to access it

➢ Misusing equipment and facilities

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➢ Arguing with co-workers in front of clients

➢ Going against lawful requirements/orders

➢ Behaving irresponsibly/unprofessionally

➢ Being intolerant of other cultures/religions and making this apparent

➢ Segregating/discriminating against others different to yourself

(race/religion/beliefs/sexual preferences etc.).

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Workplace standards

In order to maintain an ethical and functional workplace, you will need to have and adhere to certain workplace standards. These will vary between industries, but the following generally apply to all workplaces:

➢ Confidentiality – only discuss clients with co-workers involved in their care who

have the correct level of authority; discuss only what needs to be discussed; don't

discuss clients' personal matters with friends, family or members of the public

➢ Honesty – tell the truth and admit your own mistakes

➢ Punctuality – be on time for client appointments whenever possible; inform clients

if you are running late

➢ Courtesy – treat others how you'd like to be treated yourself

➢ Discretion and tact – be discreet about workplace matters and keep your cool when

responding to negative comments; remain objective

➢ Dependability – finish jobs you start and do what you promise to do

➢ Loyalty –don't criticise other staff members to clients; share the responsibility for

mistakes across the organisation.

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4.3 – Refer issues impacting on achievement of employee, employer and/or client rights and responsibilities

Working alongside others

As a care professional, most of your working life will be shared with others, as you work as a team and amongst each other. All workers should show respect and consideration for others in the workplace, which allows everyone to do their jobs with minimum disruption and inconvenience.

This may mean that you either modify your existing practice or establish your patterns and systems with others in mind. Always refer issues that impact on work achievements to your manager/supervisor to make sure that all work requirements can be carried out safely and to the wellbeing of all.

People your work may affect can include:

➢ Clients

➢ Community organisations

➢ Families

➢ Care givers

➢ Friends, peers and target group

➢ Government representatives

➢ Service providers

➢ Local community

➢ Management

➢ Other colleagues

➢ Supervisors

➢ Team members

➢ Medical specialists and experts

➢ Health/community specialist and experts.

Different types and models of work that may be done by you or your colleagues may be:

➢ Advocacy

➢ Case management

➢ Community development

➢ Community education

➢ Developmental

➢ Health care

➢ Inter-agency

➢ Medical/nursing care

➢ Participatory

➢ Person-centred

➢ Service delivery

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➢ Working with families.

You must remember that you are working as part of a chain and the actions you do will be affected by the people before you in the process and will affect the people after you in the process, as you work together to provide care to a patient or a client. For example, you can’t change the client’s bedding if your colleague has not come and dressed the client for breakfast. Similarly, if you cannot change the bedding for whatever reason, it will mean that the next person will have to take time out of their schedule to do your job for you. This will disrupt the other staff and the client as they will not be able to have a nap or go to bed until their sheets have been changed. If you fail to dress the client and make sure they have eaten their breakfast, then they will be delayed when their family comes to visit or to take them out for the day. Everyone’s job is an important part of care provision; in order for the service to run effectively, everyone must do their jobs and do them in a way that contributes to the system, as opposed to disrupting it. This can be easily achieved when workers have respect for one another and are aware of the impact their actions have on others.

Rights and responsibilities

As explained in the previous section, all workers have rights and responsibilities at work and should tailor their working schedule and methods to complement and meet the rights and responsibilities of their co-workers. Employee rights and responsibilities may include:

➢ Adherence to Work Health and Safety (WHS)

➢ Attendance requirements

➢ Confidentiality and privacy of:

o organisational information

o client information

o colleague information

➢ Duty of care responsibilities

➢ Leave entitlements

➢ Obeying lawful orders

➢ Organisational policies and procedures

➢ Protection from discrimination and

sexual harassment in the workplace

➢ The right to union representation.

All employees are subject to these rights and responsibilities, insofar as they are all entitled to have these rights met while they are working. It is, however, also the collective responsibility of the employees to ensure that these rights and expectations are met, by

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following codes of conduct and the laws; for example, it is the responsibility of employees not to engage in discrimination or to leak confidential information; if this does happen, then these rights and responsibilities will be used to punish the offender in line with the law and organisational policy. Employer responsibilities may include:

➢ Enterprise workplace agreements

➢ Legislative requirements for employee

dismissal, such as the Workplace

Relations Act

➢ Legislative requirements to provide a

safe work environment free from

discrimination and sexual harassment;

this will vary for different states and

the Commonwealth- check your local

requirements

➢ Relevant State and Territory

employment legislation:

o wage rates

o employment conditions

o working conditions.

These rights and responsibilities are designed and implemented to contribute to the creation and maintenance of a healthy, harmonious and compliant working environment, which will benefit the staff, the clients and the organisation overall. As explained in the previous section, a culture of respect between employees and their work will help to encourage mutual understanding and willingness to help each other and forgive mistakes. Legislation is put in place to protect both employees and employers; for example, the Workplace Relations Act that concerns employee dismissal determines a procedure and criteria that should be followed and met in order to properly dismiss an employee; this means that employees are not unfairly dismissed and that organisations are less likely to face legal repercussions from terminating an employee’s contract. All work undertaken will be subject to the application of employer and employee rights and responsibilities; workers should be aware of their expectations and requirements at all times and should understand why these specifications are in place. Ignorance is no excuse in the eye of the law and in ethical terms; having all staff be aware of their requirements can contribute to the reduction of incidents and issues in the workplace.

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Rights and responsibilities of client

All clients have certain statutory rights that must be awarded to them regardless of your personal opinion of them. Rights may include:

➢ To be treated in a professional and courteous manner

➢ To have differences respected, in relation to:

o Race

o Ethnicity

o Gender

o Nationality

o Sexual orientation

o Religion

o Age

o Disability

o Economic situation

o Personal values

➢ Respect for personal privacy and confidentiality

➢ A right to a safe environment

➢ A right to choice of services

➢ Participation in decisions concerning their care

➢ A right to complain

➢ A right to view information held about them

➢ Consultation on any changes to the services they receive.

In terms of client responsibilities, they have a duty to:

➢ Be respectful of others, including staff and others involved in their care

➢ Be respectful of any equipment that isn't their own

➢ Refrain from being under the influence of drugs/alcohol when receiving services

➢ Attempt to maximise the benefit of the services provided

➢ Provide accurate information in regard to their health and the services provided.

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4.4 – Refer unresolved conflict situations to supervisor

Resolving conflict

All conflicts and issues in the workplace should be tackled and resolved as a matter of great importance; disagreements or misunderstandings between staff or staff and clients can very quickly make life hard for those involved and have a detrimental effect upon the happiness and security of the individuals, as well as those around them. Some issues may need to be referred to a supervisor, manager or personnel relations worker for resolution, though many can be worked out between the people involved. If an issue cannot be resolved without assistance of your supervisor/manager, always remember to refer the issue in a clear, concise and equitable manner (there will always be valid points from both sides that will need to be listened to and considered). Where the duty of care has been breached in relation to a client, serious action may need to be taken, which can include the involvement of outside parties, such as standards authorities or authorities where discrimination, abuse or neglect has occurred. Your contribution to the resolution of conflict and interpersonal differences could involve:

➢ Working out an issue you are having

➢ Helping to mediate an issue someone else is having

➢ Reporting issues witnessed or known about

➢ Mentoring another staff member

➢ Giving staff and clients the opportunity to confide in

you

➢ Being respectful and courteous towards others

➢ Following standard procedure and protocol

➢ Helping to defuse situations.

An ideal workplace is one where everyone gets along and is happy, though workplace disputes are very common. The best thing to do, aside from avoiding issues where possible, is to be aware of action and procedures that can be taken to resolve issues once they have begun. Building strong relationship with co-workers and supervisors can contribute to both of these measures. In order to resolve any conflicts, you will need good communication skills; display empathy, respect and warmth towards the other person. Issues should never be left to fester and worsen and should be tackled as soon as is reasonable practicable, in order to secure a happy and harmonious working environment for all. Client conflict

Clients can often be hostile, disgruntled or distressed, particularly if they are feeling anxious. These feelings may arise from having to wait to see another member of staff, an impending serious meeting/operation, lack of communication or confusion around an issue. The best way to deal with this kind of situation is:

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➢ Listen to them

➢ Remain calm

➢ Don't interrupt them while they are speaking

➢ Clarify the problem

➢ Acknowledge their point of view

➢ Ask what you can do to help

➢ Suggest solutions

➢ Inform them of the likelihood of/timeframe for resolving the issue.

Conflict with colleagues

To prevent conflict with colleagues:

➢ Treat them as you wish to be treated yourself

➢ Have regular communication with them

➢ Assist them if they are busy and you are not

➢ Don't gossip about them behind their back

➢ Communicate any issues openly before they escalate

➢ Listen to any issues they have and try to solve them

➢ Avoid mixing personal problems with work

➢ Use feedback to assist with issue resolution.

Conflict prevention

Obviously, it is better to prevent conflicts in the first place, rather than have to deal with them when they arise. To prevent conflict, try the following:

➢ Remain mobile and maintain a positive posture

➢ Support other staff present

➢ Avoid turning your back on the client

➢ Keep an eye on the client

➢ Explain documents and instructions to clients clearly

➢ Contact assistance, if required.

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5. Complete workplace correspondence and documentation

5.1. Complete documentation according to legal requirement and organisation

procedures

5.2. Read workplace documents relating to role and clarify understanding with supervisor 5.3. Complete written and electronic workplace documents to organisation standards 5.4. Follow organisation communication policies and procedures for using digital media

5.5. Use clear, accurate and objective language when documenting events

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5.1 – Complete documentation according to legal requirement and organisation procedures

Completing required documentation

In your role at work you will need to complete documentation to ensure that work is recorded and can be evidenced. Documenting work carried out is essential for any business industry, not only for legal requirements but also to accurately relay processes, procedures and all work tasks that have been carried out. Documentation allows others to know which services have been performed and what actions may need to be taken. In the health and community services, records are required to maintain accounts of patient/client services, to record treatments and medications prescribed and taken, and to ensure referrals take place. There are many more reasons why records need to be made and kept. It forms the back bone for a client service and enables others to know what work task have been performed, how they were performed and by whom. It enables accountability for actions that have been taken. Documentation may include:

➢ Health care records, including:

o patient/client information

o test requests/results

o medical diagnosis

o treatments

o admission notes

o progress notes

o discharge notes

➢ Appointment bookings

➢ Service documentation/forms

➢ Reports on services

➢ Records for transferring

➢ Outpatient/clinic records

➢ Care records, including visits made

➢ Patient/client details:

o in the care of the service

o previously in the care of the service

o awaiting care from the service

➢ Staff records/rotas.

➢ Staff schedules.

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Ensure documentation is performed

Many records and work documentation are created and accessed on computers and database systems. You may need to update appointment details via computer records or notify a specialist that a client has arrived for their appointment. Ensure that you follow your organisation’s procedures for maintaining records and all documentation. For example, by completing one section on a record/document, it may then enable the record to ascend to the next part of the database system to notify/enable a client to move through a course of treatment. If you need to provide completed documentation for other personnel or departments, make sure this is done to time and to the requirements of your work role. You may also create reports or produce spreadsheets to show performance figures or records of visits. There may be records required on paper; if you need to print information or patient/client record, ensure that this is done securely and confidentially. Never leave paper copies in public areas, always ensure paper copies and records are stored and filed appropriately. If you are required to initial or sign records or documentation that you have completed, make sure this is clearly done. At the end of the day, make sure all confidential information is stored and locked securely away and that the key is located safely on site for the next working shift. If working electronically, ensure all programs and applications are closed and all files are saved and stored securely to your organisational requirements.

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5.2 – Read workplace documents relating to role and clarify understanding with supervisor

5.3 – Complete written and electronic workplace documents to organisation standards

Read and understand documentation

You will need to well-versed in the types of workplace documents that you may see or need to handle in your working day. Your organisation should ensure that training is given to fully cover your work requirements, and this should include workplace documents. If there are technical terms that are unfamiliar to you, or words that are not clearly written (or printed), check this with your supervisor/relevant person. Never guess or surmise any parts, always ensure you have a full understanding of the document. As often happens, workplace documentation can adapt, evolve or change over time. If you need to check on any document you receive, make sure you ask your supervisor to clarify or explain the parts that are unfamiliar to you. Types of documentation

There is a wide range of documentation that may pass through your service; some may be standard and familiar to the running of the service, such as a referral document, while others may be less used. Most will include medical terminology regarding conditions, diagnosis and treatments. Documentation may include:

➢ Applications for services

➢ Claim forms

➢ Patient/client records

➢ Medical/health cards

➢ Supply/medical stores documentation

➢ Information on services for clients

➢ Certificates

➢ Medical reports

➢ Care reports

➢ Staff documentation.

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Completing workplace documentation

Your role will include documentation and you will need to ensure that you complete these as necessary. You may need to sign and confirm that procedures have occurred, or you may need to complete lengthy documentation such as a report on services provided. The type of documentation that you may need to complete will depend upon your role and organisation. Many types of documentation are crucial to the day-to-day running of a health and care environment; they log vital patient/client information, provide details of events and requirements and ensure that activities are tracked and monitored. Some services will rely on correct documentation before they can take place, as such you should always be aware of the time factors in your documentation requirements and the expectations of those in the service. Always follow your organisational standards and procedures for completing documentation, and store or file as necessary. Documentation may be created as an electronic record/document, or for use as a printed paper copy. You may use electronic systems to create central records and documentation which can be used by different departments or relevant personnel. Patient/client records may be printed so that medical or health care staff can write additional notes by hand, such as medications given, health monitoring requirements or information to other health or care workers that may visit. Your documentation provides evidence of your service activities and creates a pathway for the patient/client in the service. If you need to refer records or treatment needs to other services, this helps to provide a history of events for the patient/client and can help determine any future needs. Report outcomes from networking groups

You may also need to report any outcomes from your networks, as used by yourself and your organisation. Outcomes will vary and so will the need to report them and to whom. Chances are, you will need to report any outcomes to members of management, who will then be able to decide on any next steps to be taken or to evaluate the outcomes for future use etc. You may find you will also need to report outcomes to internal or external stakeholders, it will either be your responsibility to do this or you may find this is something that management will deal with.

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Reporting outcomes can include:

➢ During a meeting

➢ Via email

➢ Via teleconference

➢ Newsletter

➢ Written report.

You will need to follow your organisation’s policies and procedures regarding reporting.

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5.4 – Follow organisation communication policies and procedures for using digital media

Using digital media

Digital media is used in many ways in work and at home; it has enabled us to instantly access information, send information and contact others, and has provided us with tools to aid us in our needs. Digital media in community services and the health sector will include the devices that we use to keep and make records, i.e. use of tablets and relevant applications, emails and website/intranet. For example, if you are a health or care visitor, a tablet will provide the means to record and log the details of your visits when off-site. With Wi- Fi/internet access this can then be accessed quickly afterwards in your place of work by other personnel. This provides a more efficient and faster method to record and process information. You can instantly make appointments to your device which can then synchronise and update all systems that you are connected to; this will show others in your workplace your availability and diary. Not only do devices give us the flexibility and immediacy of carrying out our work requirements, they also provide us with a large resource bank and also an online community that can offer advice and support for the health and community care professional. Digital media may include:

➢ Web

➢ Email

➢ Social media

➢ Podcast and videos

➢ Tablets and applications

➢ Newsletters and broadcasts

➢ Intranet.

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Check your organisational policy and procedures

If using digital media, you should check your organisation’s policies and procedures to ensure that you follow the correct guidelines for digital media usage. Always respect confidentiality and be aware that the information you may pass through digital media will be immediately viewed by others and privacy settings should be applied correctly. If in any doubt check this with your manager/supervisor or appropriate technical expert. If you update records/events remotely, check that this has loaded correctly and that if any details change that the system is amended accordingly. If you are involved in an online community or belong to a service that receives industry- specific information, always be sure of the validity of the source. This will help ensure that your information is from a reliable contact. Always check that any information you may wish to submit in a professional capacity has been allowed/cleared for usage. HISA online health community

HISA is an online digital health care community and provides opportunities to network, attend events and find out information on career paths. For more information, visit their website: http://www.hisa.org.au/ (access date: 23.09.2015).

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5.5 – Use clear, accurate and objective language when documenting events

Choose your words carefully

When writing up notes, filling out forms and providing information, ensure that you are clear with your use of words and meaning. Take the time to write the details required and check that spelling and grammar are correct, as this could change the understanding of the information. Be mindful that other personnel may need to read and refer to this. Meanings and intonations

Be sure to check through your documentation so that the meaning is accurate and clearly shows events as they happen, or document requirements as needed. Check that your punctuation reads correctly and that any emphasis in the document is intended. Make sure your meaning is as required; do not influence another reader to assume other factors that did not happen. Objective language

Make sure that you choose objective writing over subjective commentary when documenting events. Being equitable and impartial is essential to recording the facts and situations as they occur and it allows the reader to make their own understanding. If you are subjective you may unintentionally leave out a small but important detail or add an emotional bias that can change the perspective of the event for another person. Be sequential in your documentation to show how events transpired and be sure to give accurate timings to help you (and others) gain a clear picture. Check your work

Always check your documentation after you have completed it. Perform a final check on spelling and grammar and ensure the information is factually correct and is clear to understand.

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6. Contribute to continuous improvement

6.1. Contribute to identifying and voicing improvements in work practices

6.2. Promote and model changes to improved work practices and procedures in

accordance with organisation requirements 6.3. Seek feedback and advice from appropriate people on areas for skill and knowledge

development 6.4. Consult with manager regarding options for accessing skill development

opportunities and initiate action

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6.1 – Contribute to identifying and voicing improvements in work practices

Values and philosophies

The health and care industries rely upon a standardised set of values and philosophy to function in its goal to provide good care for all of its clients. The duty of care reinforces these collective values and provides a structural framework for all employees to follow. Values and philosophy may relate to:

➢ A holistic and person-centred approach

➢ Promotion of the wellbeing of staff, patients/clients and communities

➢ Early identification of problems

➢ Delivery of appropriate services

➢ Commitment to meeting the needs and upholding the

rights of people

➢ Commitment to empowering the person and/or the

community

➢ Ethical behaviour

➢ Preventative strategies

➢ Exercise of responsibilities and accountabilities within

the context of duty of care for patients/clients.

These values should form the basis of care provision and should be invested in by all staff. The best way to demonstrate consideration and understanding of these is to make it the foundation of your work ideology and to make the values your own; if you invest in these values and philosophies, your belief will be visible in your work, as you put the client first and genuinely try your best for them. Always contribute to improvements and make suggestions that could improve the service you work within.

Access and equity

‘Access and equity’ refers to action taken to ensure that people have a fair and equal opportunity to access resources and services that they require. This means that people cannot be disadvantaged or denied access to resources and/or services on the basis of:

➢ Cultural background

➢ Linguistic background

➢ Religious and spiritual beliefs

➢ Socio-economic status

➢ Gender

➢ Age.

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Access and equity is most commonly applied to the following groups:

➢ Disabled people

➢ Indigenous Australians

➢ Aged people

➢ Marginalised people:

o social isolation

o socio-economic disadvantage

➢ Different cultural backgrounds

➢ Different linguistic abilities.

A commitment to access and equity principles must be demonstrated by the use of a non- discriminatory approach to all people using a service, including their family and friends, the general public and co-workers. In short, access and equity rules are in place to ensure that everyone can access opportunities, without fear of exclusion of discrimination.

Improved work practices

In order to improve work practices, you should subscribe to the principles of continuous improvement. Improved work practices may relate, for example to:

➢ Enhancing outcomes for clients

➢ Enhancing sustainability of work, such as efficient and effective work practices in relation to:

o use of power

o use of resources, including for administration purposes

o waste management and recycling practices

➢ Enhancing safety of staff and clients.

Identifying and implementing improved work practices may include:

➢ Application of safety practices, including for work in a range of contexts, such the person's home

➢ Assessing/observing/measuring environmental factors

➢ Checking equipment

➢ Monitoring tasks

➢ Reporting and implementing suggested improvements

➢ Responding to surveys and questionnaires

➢ Seeking and addressing customer feedback

➢ Developing and implementing child safe, child friendly resources, environment and work tools to support staff and volunteers working with people under 18 years of age.

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Common areas you could look to improve include:

➢ Infection control:

o Hand washing methods

o Preparation for operations

o Disposal of waste

o Handling sharps

o Contamination areas

o Exposure to bodily fluids

➢ Client service:

o Responding to concerns

o Meeting and greeting

o Confidentiality and privacy

o Cultural sensitivity

o Telephone manner

➢ WHS:

o Safety data sheets (SDS)

o Waste disposal

o Environmental responsibility

➢ Workplace culture:

o Quality control

o Security

o Ethical behaviour

o Conflict resolution/prevention

o Computer programs

o Equipment maintenance

o harassment

➢ Emergencies:

o Fire safety

o Emergency procedures.

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Wherever the prompt to improve work practices comes from, it should always be seized as an opportunity for development. With no development there can be no progression.

If you find a better way of doing things or believe you have identified an area for improvement, you should always discuss this with other personnel, such as colleagues and supervisors. If your new practice can help others, sharing it can benefit everyone involved. If you believe something needs to be worked on, you should discuss it with your colleagues or supervisors, who should be able to make recommendations and propose ideas for resolution; where issues run deep, it may mean that an entire process or task needs overhauling.

Accreditation schemes

Where the organisation is part of an accreditation scheme, all staff are required to work to the standards laid out by this; the organisation can’t claim a level of quality that not all staff provide.

For example, the Better Practice in Aged Care Award is awarded to residential care homes that visibly strive for continuous improvements and to better the lives of their clients. Organisations that achieve this are awarded with a certificate, a Better Practice profile on relevant websites and can participate in Better Practice events. Furthermore, achievement of this award can be used as a focal point for advertisement, as it demonstrates to potential clients that higher standards have been consistently met and acknowledged by the accreditation authority.

There are many different types of award and accreditation schemes available and they are generally self-explanatory; for example, the ‘Better Practice’ award obviously means that this care home is recognised for providing ‘better service.’

Many awards and accreditation schemes are reviewed by the awarding bodies to ensure that the standards required are still being met; a decline in standards can mean that the organisation has their status removed or is told to get back up to standard immediately.

In order to maintain high standards, all staff must work together to provide great care; if some staff are not invested in the achievement of the organisation and the welfare of the patients/clients, then the overall performance of the company will drop.

Make suggestions to improve work practices

If you are aware of an area that could be improved upon and have suggestions on how this can be done, speak with your supervisor/manager. Be confident in your approach and be open to discuss your suggestions. There may be counter reasons that you are not aware of, or there may be other implications that need to be considered first.

You should speak:

➢ Clearly and confidently

➢ Be open in your discussion and look to collaboration

➢ Be objective

➢ Be prepared to listen to other opinions.

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You may attend work meetings or staff sessions where the forum for suggestions and feedback are sought. Seek to participate and contribute as appropriate and with valid and considered suggestions.

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6.2 – Promote and model changes to improved work practices and procedures in accordance with organisation requirements

Enhancing work performance

Adapting and upgrading your work skills is an important aspect of development in any role and should be a constant point of focus for anyone in any role. Improving your work practices can make your daily tasks easier and more efficient. You can identify opportunities for development in several ways:

➢ New tasks are added

➢ New methods are introduced

➢ Your experience and competence allows you to develop new methods

➢ New training may become available

➢ Old methods may become obsolete

➢ New elements of a task may need to be addressed

➢ Someone may point out inefficient methods that should be rethought

➢ Old practices are no longer suitable or sufficient.

Organisational goals

Your organisation will have specific goals – these are usually underpinned by a mission statement. This should let both the employees and clients know what is expected of the service and all decisions should comply with its ethos. A good mission statement and clear and concise goals will ultimately offer a better service, as it is clear what is expected for all parties involved. You need to have a thorough understanding of your organisation's mission statement, as well as the goals and objectives it has set to achieve this. Organisational goals are in place to help move the organisation forward; this could be in terms of:

➢ Quality

➢ Success

➢ Growth

➢ Expansion

➢ Profitability

➢ Sustainability

➢ Coverage/provision of service.

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The organisation will likely make its staff aware of its objectives and goals; this is so everyone can combine their efforts and focus on achieving these objectives as a team. Achievement of goals should provide benefits to staff, as well as the business; if the business is able to expand, increase profitability and become more sustainable, for example, the jobs of the staff may become more secure or they may gain benefits, such as a pay rise or an increased workforce. This gives the staff more motivation to work hard and rewards them for their efforts towards the success of the business. Ideally, all work undertaken should be in support of the organisation’s goals, either directly or indirectly. Goals may be ongoing and can be reached through no direct action, such as continuing to provide a level of quality, whereas other may be specifically introduced to reach a desired result, such as a drive to attract new business or an effort to increase the quality of a certain aspect of work before an inspection. Staff should be able to understand the implications of particular targets and goals, in terms of how this will affect the business and their jobs. If staff can be shown what a particular objective will achieve and change, then they will likely be more motivated to contribute. When targets and goals are met, this should be fed back to the staff and they should be thanked and congratulated for their involvement. Everyone appreciates being given a job well done and this will make them feel valued and involved.

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6.3 – Seek feedback and advice from appropriate people on areas for skill and knowledge development

Personal values and philosophy

Health and care providers should endeavour to invest in the generalised values and philosophies of the industry. The personal values of each employee can also play a significant part is care provision. These values are wide-ranging and can concern:

➢ Ambition

➢ Balance

➢ Carefulness

➢ Diligence

➢ Efficiency

➢ Focus

➢ Generosity

➢ Honesty

➢ Independence

➢ Justice

➢ Leadership

➢ Reliability

➢ Professionalism

➢ Teamwork

➢ Timeliness.

These values are somewhat desirable and beneficial and can aid you greatly in your work, as well as having a positive effect on the organisation, the patients/clients and other colleagues. Having strong and beneficial values can make the difference between an acceptable employee and an excellent one. Where staff can recognise these values, they should incorporate them into their working lives and make the most of them where possible, by playing to their strengths. Seek feedback from your supervisor/appropriate persons on the skills and knowledge that you may need to develop to improve your work performance and prospects.

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There are also less desirable and advantageous traits, such as:

➢ Laziness

➢ Apathy

➢ Tardiness

➢ Impatience

➢ Intolerance

➢ Selfishness

➢ Superiority

➢ Lack of respect

➢ Frustration

➢ Lack of care.

Where staff members identify that they have an issue with an above point or similar, they should attempt to resolve it, either by helping themselves or discussing this with a colleague, mentor or manager. These issues can arise because they are unhappy at work, perhaps because they are disillusioned with their job or experiencing a problem with other colleagues. Where this may be the case, steps should be taken to resolve issues.

Self-evaluation and performance reviews

Self-evaluation is an important tool for self-improvement and managing yourself at work; being able to identify your own strengths and weaknesses can enable you to adapt your working processes somewhat to play to your strengths and downplay your weaknesses, wherever possible. Many companies hold a yearly review with each employee, where the employee discusses their performance and goals with a supervisor or manager. These meetings give the employee a chance to discuss their strengths and weaknesses, including any goals and concerns, with a supervisor, who can help them to alter their course to accommodate these desires, where possible. The supervisor will also usually discuss their perception of the employee’s performance, highlighting areas for development or areas of strength and making relevant suggestions. Where records are kept of employee evaluations, new tasks or opportunities can be offered to the right people; for example, an employee who works 2PM-10PM because they can’t get up in the morning would likely not appreciate being moved to a 6AM-2PM shift, whereas another employee on the later shift may love this opportunity. Self-evaluation would reveal the fact that an employee doesn’t handle mornings very well; you would do this automatically without thinking about it. Evaluation can also come from colleagues, usually in a casual way, such as ‘Sophie is the best at making the beds!’ or ‘Tom’s so organised, he will know who’s going on the trip today.’

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Seek feedback

You will likely not be offered feedback and compliments on everything you do, so you should ask. You can seek workplace feedback on things like:

➢ Method used

➢ Quality of job

➢ Time taken

➢ Resources used

➢ Ideas pitched

➢ Competence

➢ Efficiency

➢ Teamwork.

Whether you ask for the feedback or not, you should accept it in a professional manner; this means not becoming big-headed, angry or disappointed. Good feedback can be very encouraging to receive; you should take it as a compliment, but not get complacent. Bad feedback can make you feel disappointed or deflated, but you should use this as an opportunity for development. You can ask for general feedback from your co-workers and specific feedback from team- members who may work with you on a task or a project; there would be no point asking a random colleague what they think of your bed-bathing skills if they only ever see you in the break room. Whether you like the feedback or not, you should always thank the person that took the time to give you it, even if they were a little too honest!

Developing skills and knowledge

Skills and knowledge are required by all people in all professions and usually require constant updating and development. Skills need refining, revising and adapting, whilst knowledge needs to be updated and revised where required. Skills and knowledge training and revision can be done:

➢ In group sessions

➢ In courses

➢ Through factsheets

➢ Through notices

➢ With colleagues

➢ Independently

➢ Online

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➢ Through experience.

Your organisation may have designated people elected for training or particular people who have access to all information required, so staff can approach them for advice or clarification. You may identify your own need for development or this may be specified by the organisation, for example, if you are being trained in a new role or information such as legislation changes.

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6.4 – Consult with manager regarding options for accessing skill development opportunities and initiate action

Skill development opportunities

As explained in the previous section, there will usually be several opportunities to access training and advancement opportunities in your workplace. These may be formal scheduled sessions, or they may be on an ad-hoc one-on-one basis. You can also go through your supervisor or manager and explore the opportunities available to enhance your skills and knowledge for your job role, or refer to your HR department. Skill development opportunities may be:

➢ Training sessions

➢ Group sessions

➢ One-on-one sessions

➢ Formal or informal

➢ Role playing opportunities

➢ Workshops

➢ Distance learning courses

➢ On-the-job training

➢ Shadowing

➢ College training courses (to obtain relevant qualifications)

➢ Conferences.

If you want to develop your skills, you should speak to your manager; they will be able to tell you what is available and book and organise any sessions there might be. Optional training sessions may be advertised in your workplace; you should sign your name up for any that appeal to you and may be useful. Designated skills and knowledge can refer to:

➢ Cardiopulmonary resuscitation emergency response and notification protocols

➢ Child protection

➢ Communication, conflict resolution

➢ Cultural awareness

➢ Customer service, including the provision of a child friendly environment that

values, respects and welcomes children and young people

➢ Discrimination, harassment and bullying in the workplace

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➢ Fire emergency response procedures for notification and containment of fire, use of

fire-fighting equipment and fire safety procedures

➢ First aid

➢ Formal and informal resolution of grievances

➢ Hazard control

➢ Manual handling

➢ Quality improvement policy and practice

➢ Security procedures

➢ WHS

➢ Waste management.

These skills and knowledge may be required to work competently and legally in the care profession; in these instances, training and schedules should be provided to staff. You should aim to participate in all courses and training that are required and as many voluntary ones as you can, in order to gain the best grasp of skills and knowledge, as well as wide-ranging understanding and application.

Personal work goals

You should generally encounter two types of goals in the workplace- the organisation’s goals and objectives and your own work-related goals. The organisation’s goals will be designed with particular goals in mind, usually expansion and/or sustainability or perhaps to overcome a particular issue. Personal work goals may relate to your desire to progress or to reach a particular skill level. Personal work goals are more likely to succeed if they correlate with those of the organisation; for example, if you want to be a manager or a team leader, this will depend on the growth targets of the organisation. If the organisation is expanding, you are more likely to have the opportunity to become a manager, but if the organisation is downsizing or remaining static, achieving this goal will be considerably more difficult, as you would typically have to wait for the existing manager to leave and hope to get the job. If you have several work goals, you should try to align them with the organisation in terms of priority and aim for the ones that are currently more compatible.

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References

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

Websites

Australian Council on Healthcare Standards (ACHS): http://www.achs.org.au/ Australian Commission on Safety and Quality in Health Care: www.safetyandquality.gov.au Australian Medical Council Limited (AMC): http://www.amc.org.au/ Australian Health Practitioner Regulation Agency: http://www.ahpra.gov.au/About- AHPRA.aspx Child Family Community Australia: https://aifs.gov.au/cfca/publications Standards Australia: http://www.standards.org.au/Pages/default.aspx

All references accessed on and correct as of 24.09.2015, unless other otherwise stated.