Support organization's and office culture part three
So this is a continuation of my series on disability support services and office culture and ethics and I am hoping in this post to answer some of the questions I asked in the previous posts about the services and support people how do you manage this to make sure they are effective, well-trained and right for the person using the service and how do you spot if the company has a good ethical framework that is apart from the thinking about disability as a moral failing.
As if the disability is thought about as a form of morality does this then give the service providers the right to take a medical model approach to disability what type of framework is this mindset working from and how is it a good framework to work with who does it help the service provider or the person they are supposed to support?
This is a dangerously outdated model of care and it states
at its core that disability is something to be ashamed of and therefore you
need to be cured to be of worth to society.
However, we see that thankfully most disability providers do work within
a person-centered framework but at times do slip back into a medical model of
care that states that the person needs to be supported but doesn’t get a say in
who supports them and is told that they get what they get and that they should
be blessed that they get any support at all.
The Client has rights and responsibilities but what about
the service provider who doesn’t listen to the client’s needs and doesn’t want
to work to fix their long-term issues it will be costly to turn around and fix as it means admitting their mistakes and this is
in direct breach of the national framework and code of ethics for support
providers. [i]
I do believe that there is a line here to
provide privacy to a person but when a person does have complex needs they need
to be supported to be able to not be a risk to others or themselves but this doesn’t
mean having a massive amount of restriction’s it more means having people who
are aware and able to work with this person and having a behavior support
specialist come and work with the person. As well as their care team as this is a whole
other blog post on having their care team all on the same page.
I am very aware that this is very dependent on the person's funding and the level of advocacy they have in their lives but some people need this
support to have a dignified life and to not have people see them as “less” than others but to see them
as needing complex support and to lead to understanding.
What level of disability training do the office staff
have some will have very highly trained support workers but the office staff is more trained in office skills and they need a combination of both to be
able to work as a team. So are they able to respond to incidents quickly or is
there a lack of accountability why is this the case. Often there is internalized ableism and this is
quite ironic because the person is working directly with people
with a disability and often support organizations will have people with a disability
working for them in a paid or unpaid capacity, and this internalized ableism often is shown in surprising ways as it comes out not as overt discrimination
but more subtle ways like not fully explaining to a person what they are signing
and signing a service agreement are signing a legal document, and not giving
them a copy of the document and time to review it because the person forgets
things due to the office being behind in their paperwork and accounting.
This shows a lack of fundamental respect for there clients and for the growth of
their support organization because this can cause major issues
down the line in a person's funding budget. It also shows that the office is
understaffed because often people will do both support and the
office to keep “ one foot on the ground.” I see that this is a great idea
however it does have some risks if they don’t have enough full-time staff in
the office we see that people will leave both support workers and support organizations
because they don’t have the support, and back up that they need,
and this is why it’s so important to have a good office culture that
understands disability, disability law and the best practices around disability
frameworks.
I have lost count of the times I have been having casual
conversations and that it has led to people stating that “ the office is playing god with
people’s lives” when the support organization on its website states that its
core values is person centred care, and this is where this disconnect comes
into play due to the fact that one support office from the same organization might
have a great culture and understanding of disability and disability support but
another in a different area might have a very different leadership style and
this is something that we also see time and time again that a support organization
doesn’t have the management needed to keep it person centred and due to the organization
ballooning and getting big very quickly there might be a need for people to
take on several roles in the short term but in the long term if this continues
it is the clients that suffer and those who are able to move services will do
so, and they will be vocal about it and as much as a person is told to keep information
private there is a fundamental difference between gossip and information sharing,
and in the digital age it only takes a few quick google searches to find many
message boards on both Facebook and reddit around NDIS and on reddit they have
a screening process that shows if it is a provider or if it’s a client and this
needs to be declared, or they are kicked off the subreddit.
This is also a link to a post I did on disability and privacy.
https://annieswonderlanda.blogspot.com/2022/11/when-to-breach-privacy-and-how-to-do-it.html
and this is the other
thing that we need to be aware of does the office have in their continuation of
best practices, do they have a privacy policy and where is it kept when a
client comes into this service do they provide a copy of this policy and do
they have consequences if a clients privacy is breached, I am not talking about
necessary information sharing for reports such as shift notes and incident reporting
I am talking about personal details and details that could present a significant risk
to the person if they where to be exposed, as there seems to be a fundamental miss
understanding of what necessary and reasonable information sharing is vs gossip
and there is a fine line between the two and that support workers do have a duty
of care to report harm or any foreseeable risk of harm to a person or to
clarify if a person is just venting.
We need to be aware that gossip can happen both
intentionally and unintentionally and it is the unintentionally that is difficult
to control, due to clients that might have a psychosocial disability or a
mental illness that makes them manipulative and gossip is one way to manipulate
the situation to what they what and it is often difficult to redirect.
This is very different from a person who is perceived to be
manipulative and difficult because they can self-advocate and can
see through a provider’s self-marketing to see the truth, and is advocating for
change in the way that support is provided to a person with a disability, and
manipulation can be a difficult thing to define as often this behavior was the
only way to get any level of support for a person as well, but maladaptive behavior’s need to be
redirected in much more positive ways and into much more positive behaviors as
well. [ii]
[iii][iii][iii]
Comparison
of the Moral, Medical, and Social Models of Disability | Download Table
(researchgate.net)
Disability
Tropes 101: Manipulative Sympathy | Spoonie Authors Network
The
Core Principles of Leadership Accountability (knowledgewave.com)
Person-centered
care - Wikipedia
Psychosocial
disability support - Mental health - AIHW
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