What is duity of care in a disablity perspective?



Disclaimer – That these are my own lived experiences and understanding from the research that  I do around the NDIS and health-related topics please be aware that it is informational only and not to be used as a substitute for professional advice or working with a Planner, Disability Advocacy service or talking to your Medical and Allied Health team.  

So I am taking the time to do a deeper dive into what is duty of care and in doing this we need to look at what the words are before we even look at where the phrase is applied and how it works in a practical sense, and I will be focusing on a disability perspective.

Duty as defined by [i] the Merriam- Webster dictionary is defined as

: : obligatory tasks, conduct, service, or functions that arise from one's position (as in life or in a group)

 CHARGESUPERVISION left the house in his care especially responsibility for or attention to health, well-being, and safety under a doctor's care

 

So these come together to make the phrase that we all know but don’t know the potential legal ramifications being that  the phrase duty of care  becomes, and it is a legal term in a disability, aged care and hospital setting and it is part of a harm mitigation and a reduction of risk in disability care however we see that in a disability settings it is used in a very different way as it needs to be balanced with dignity of risk and I will do a blog post on dignity of risk as well.

So the legal definitions of duty of care, and this will vary from country to country we see that this taken from Wikipedia[ii], is a general overview,  however, In a disability setting it’s not that simple as we need to know several things about the client that the care worker is supporting and this is where another phrase around NDIS comes into play being Dignity of risk and I have a post coming on this but it is the other side of the same coin with Duty of care, so in simple terms we see that  duty of care is the duty towards the person that the person is caring or supporting we see that they have a responsibility to support and care for this person and this means helping or supporting them to meet their daily basic needs if required, or to support them in more complex ways. 

In the more complex ways we see that this is where the duty of care comes into play so does a person have all the information about what they want to do to make an informed decision around the risk.? 

Are they likely to harm themselves or others a his is where duty of care and restrictive practices comes into play so I do have a post planned around restrictive practices however we see that  sometimes it is actually the support worker doing the harm and so we need to be aware of this as well, so it is up to other support workers and the persons informal support network to be able to spot abuse, neglect and exploitation, and this is where things get tricky as what a provider is able to  for a person varies from person to person and this makes things tricky but reflects person cantered practice at the same time, and even the best support workers can get held back by company culture, and if a companies culture isn’t great or the administration staff in the offices aren’t communicating with the support and care staff on the ground we see that this becomes an issue in that a person can leave an organization due to the stress caused by the office. I know that I have kept with one of my care organizations due to having some great support workers but have had to be on the offices tail due to them being understaffed.

So this could potentially become a duty of care issue do to not being able to communicate with clients in a timely manner or having to roster supports in advance but having to constantly change rosters, and have support workers check rosters vs being asked to do the shift and when there is this constant changing it is stressful for both the client and the support worker due to the fact that the need to explain their needs and often this leads to them not being able to receive good quality supports and this is where duty of care in a company culture and all the staff understanding person cantered care is really important in what you are trying to achieve.

 

In a support worker it is important to have formal training around this as a support worker is put in a position of power over a person and some people unfortunately will abuse this power. 

So the duty of care is the responsibility of all providers to protect their clients from harm, and from harming others.   

When we say harm in a physical sense is providing a safe home or day centre environment, so this might be prompting with cleaning, and other activities of daily living to maintain a house, and in Sil houses ( supported independent living) it might mean having a house meeting and talking through any issues that need to be resolved. 

It might also be meal planning a preparation as well as medication management. 

In harm to others it might be that the client doesn’t understand some things about boundaries and personal space so that the client might need to be taught about these things.

If the persons behaviours are triggered by foods or beverages it might be that a restrictive practice needs to be in place around food and not having foods that are highly processed.

In a housing sense you need to understand what is called a ratio of support so this is how many clients to support workers in a house and what their support needs are, as some providers do offer varying levels of support depending on skill level and this is a tricky one that goes into dignity of risk.

However this is a very basic beginning towards duty of care and I hope to do a series on it, into the future. 


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