duty of care and support shifts
So, regarding the duty of care, we saw that this is a topic that not a
lot of support workers understand in depth. At the time of writing and
recording, I am currently in the process of changing support agencies for
community access. We see that people know the term but at the same time do not
understand it since people are unable to define the concept of duty of care and
support and they need to be tightly defined to be able to understand what
people are talking about. As we do hear and see a lot about a lack of duty of
care and it is a legal concept in nursing, childcare, foster care, teaching, and
disability services, just to name a few services that have it embedded into the
model of care as it is a part of the care that is needed for a person.
It is defined as that
a person who is responsible for a child or an adult is responsible for the
other person a child or a vulnerable adult and this means that they have a
legal obligation to protect the person they are caring for or responsible for
from harm, So we also need to be able to
define harm and harm is defined as physical, mental or any preventable mental
or physical danger.
We see that people
need to be very aware of this because even support workers due to the ongoing
crisis of undertraining of support workers and the support workers fundamentally
misunderstanding the role that they are playing in a person’s life that it can
be them that are unintentionally causing harm to a client.
This means that we see that support workers need to be
trained in their role and responsibilities and a much higher level and I see
the need to have a higher qualification than the Certificate 3 individual support
as it covers extraordinarily little of what they need to know when supporting
someone. Especially someone who is higher functioning but at the same time has
complex needs or in other cases someone who has extremely complex needs but is under
less care due to the funding they receive. The skills that someone needs to be
an effective support worker do not come from the current training at all, and to
be able to support someone you need to have active listening skills, privacy,
and the ability to deescalate a potentially dangerous or harmful situation a
good understanding of a client's right to privacy and protection.
However, when this is fundamentally misunderstood or even wilfully
misunderstood, we see that it can cause a massive number of issues that have a domino
effect of consequences that can range from the annoying to the downright
dangerous to the extreme.
Most support workers
are aware of the concept of dignity of risk and will use this to prevent them from
practicing duty of care, but they are the different sides of the same coin and
we see that people need to be aware of this and that support workers need to be
aware of when it is appropriate to use both so to practice duty of care often
seems like common sense but as you would have seen in some of my previous
videos and blog posts we see that a lot of people who do support don’t seem to
have a lot of common sense and that this is a key thing needed if you are interested
in doing support work. That comes from having
life experience and this is complex due to some people having lots of life experience
and a background that comes from working with people such as being a parent of
a disabled child, being an unpaid caregiver, or even having a professional background
in fast food or retail, the last two I know seem surprising but they teach you a
lot about, simply dealing with people who don’t have a lot of education and
being able to keep your cool and to be able to understand what a person is
going through. It also teaches the
needed soft skills so communication, as communication is very different from,
talking to someone as some people’s disabilities will directly affect their communication
and would have barriers in understanding what someone is saying to them and
this is where being able to have effective communication in understanding what
a person needs and being able to take into consideration their abilities, cultural
background, and even simply their background.
In bringing back what skills are needed for a good and
effective support worker we see that duty of care is taking reasonable steps to
prevent harm coming to the client, perceived or otherwise so for example if a client
spends all their money at once this is the dignity of risk to that person but
the flip side is that they spend time
with the clients family, learning about
supported decision making and the possibility of having a trustee or another
trusted person control the person’s finances and have good decisions made.
I am not a fan of having the state control a person’s
finances and this can be sometimes the only option to have the public trustee step
in and control a person’s finances. However, there are now some great alternatives
such as supported decision-making that teaches a person with a disability how
to manage their money, how to stick to a budget, and how to make good decisions
around money and other activities in their lives such as how they spend their
time and what they want to achieve in their lives.
However, this is where a good and effective support worker
needs to be able to step in because a person might not be able to make the decisions
for themselves so they need help this is where both dignities of risk is that everyone
including people with a disability has the right to make mistakes and to take
risks in their lives including risks that might lead to failure. This is how
many people do learn and you learn more from failure than from success on the first
try protecting a person can be just as dangerous because they don’t have the opportunity
to learn and grow.
So this is where the dignity of risk comes in helping a person
to be able to help themselves so taking the risk of cooking a meal, vs using a
meal delivery service you have less risk when using a meal delivery service and
we see that a client might have excellent cooking skills but might not have the
attention span to be able to finish all the steps so this is where it would be appropriate
for a support worker to help the client to cook a meal.
We also see that this is where a person’s dignity is
respected because a person can learn how to cook a basic meal and be able to
understand what is happening, but in other cases, a client might not be able to
use the equipment to be able to cook and therefore a pre-packaged meal delivery
service would be appropriate and they are then just able to heat and eat.
This prevents harm from coming to the clients and the
support workers can give an appropriate level of care that is needed for the
client.
However, the duty of care is a little more complex in that
it is embedded in support and understanding it can be challenging when you don’t
work or have had experience receiving care.
But it is the obligation of the provider to prevent harm perceived or
real from coming to a client under their care but not preventing them from
taking reasonable risks that match their abilities and goals, we see that this working
is very vague as what could be harmful for one client might be beneficial to
another so this is where a support worker needs to use their good judgment and
this is where the rubber hits the road in what is good judgment and good judgment
is learnt behaviours from having diverse life experiences, and being able to work
with a person is a good thing, it makes sense that the wording for duty of care
is vague but this is where having well trained support workers will be able to
understand where it could apply to one client but not apply to another and this
is where we see that people need to be aware that it is a legal requirement in
support and some providers will have it defined clearly and have clear documentation
around skills development and some providers won’t so how a provider interpreters
it can be part of the duty of care and we see that as has played out in the
royal commission that this isn’t a great idea as it can become a restriction of movement due to having blanket rules in
place. Where it might be better for everyone
to have well-trained support workers and one example I can give, is a supported
independent living facility that might have a blanket rule that all trips out
of the house with a support worker need to be pre-approved.
This might impact on
a client that might need to be taken to a doctor late at night or need to be
taken to a grocery store and what happens if the support worker doesn’t have
the ability to contact someone to get them to approve the trip, it also means
that a person who doesn’t have a lot of
family support might be hamstrung in simply getting out of the house even if they
attend activities on the weekend it is a part of normal life to generally go
somewhere on the weekend that could be a place of worship or a friend’s house
and the client might need a support worker to drive them their and if a person
can’t pick them up we see that the person has to miss out and this isn’t fair
to the person so we see where the term duty
of care to me needs to be defined a lot better than it has been and being able
to define it to benefit the client a lot more is where it needs to go so being
able to see a client as more than a client but as a person with wants needs and
desires we see that this is sometimes forgotten about in the mix of caring for
someone and their skills development.
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