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Your G8WAY… To the support worker role

As a support worker, a rewarding part of your role is the opportunity to build meaningful relationships with Participants as well as developing and using your skills and knowledge to support them to achieve their goals and aspirations. These shared relationships give as much to you as they do to the Participants.

Working under the NDIS you will be required to uphold the values of the scheme and adhere to the NDIS National Code of Conduct. As a support worker, you need to understand the NDIS Code of Conduct, expected behaviour, reportable incident requirements, and any additional competencies required for your role. You will be required to complete the on-line Orientation module and print off the Certificate of Completion. Depending on the type of role or job you have, you might need to have an NDIS Worker Screening Check.

In this section you will learn about dignity of risk, duty of care, National Code of Conduct and worker screening check, personal safety and record keeping.

Dignity of risk and duty of care

The balancing act between Dignity of Risk and Duty of Care is challenging. It requires you to think about risk differently. Instead of seeing risk as something to avoid, you need to think about a way to support someone to do what they want, safely.

A great way to understand dignity of risk and duty of care is to watch this video. What is Duty of Care? Duty of Care vs Dignity of Risk

Dignity of Risk

Dignity of Risk is about the right to take risks when engaging in life experiences. Each person’s right to have choice and control is paramount.

Everyone has the right to make informed choices, to experience life, and have the freedom to learn and grow from our mistakes.

Duty of Care

Duty of Care is a legal responsibility. It requires you to take reasonable care to protect another person from foreseeable harm. Duty of Care applies to the person you support, families and carers, other support workers, and may also apply to the general community when working within a community environment.

A duty of care exists when your actions could reasonably be expected to affect other people. If someone is relying on you to be careful, and that reliance is, in the circumstances, reasonable, then it will generally be the case that you owe them a duty of care. As a support worker you need to be clear about the care or support that you are providing and on which the Participant is relying. Failure to exercise care may lead to foreseeable injury (in other words it could have been avoided with due care taken).

In Practice

Breach of duty of care

A breach of duty of care exists when it is proven that the person who is negligent has not provided the appropriate standard of care. That is, the support worker (or agency) has done something that they shouldn’t have done or failed to do something they should have done.

Minimising harm

Safeguards aim to prevent and effectively respond to abuse, violence, neglect, discrimination and exploitation. This applies to Participants, support workers, family and carers.

As a support worker your clear guidelines on harm minimisation based on Workplace Health & Safety and Privacy legislation are part of workplace policies and procedures.

Positive behaviour support

A behaviour support plan is a document prepared in consultation with the person with disability, their family, carers, and other support people that addresses the needs of the person identified as having complex behaviours of concern. The behaviour support plan contains evidence-informed strategies and seeks to improve the person’s quality of life.

A behaviour support plan can only be developed by practitioners who are considered suitable by the Commissioner to undertake functional behaviour assessments and develop behaviour support plans. Behaviour support practitioners (whether a sole provider or employed by a provider) must be registered with the NDIS Commission to provide specialist behaviour support.

Positive behaviour support aims to ensure a better quality of life by reducing harmful incidents. It is a comprehensive approach to assess, plan and intervene to reduce and eliminate a Participant’s perceived behaviours of concern. Positive behaviour support seeks to understand the individual and strategies are developed to be included in the Participant’s plan to guide your actions when necessary.

The aim of positive behaviour support is to reduce and eliminate restrictive practices. There is a primary emphasis on upholding the rights of the person with disability by looking to support the person through evidence-informed, person-centred strategies reflected in a behaviour support plan.

There may be limited circumstances in which a regulated restrictive practice is used. The use of restrictive practices must be:

  • used only in response to a risk of harm to the person with disability or others, as a last resort
  • authorised in accordance with any state or territory legislation and/or policy requirements
  • in proportion to the risk of harm and used only for the shortest possible time.

Use of a regulated restrictive practice must be reported to the NDIS Commission.

Limitation of rights

The use of regulated restrictive practices is one of the most extreme forms of limiting an individual’s human rights. ‘Restrictive practice’ means any practice or intervention that has the effect of restricting the rights or freedom of movement of a person with disability, with the primary purpose of protecting the person or others from harm. Any restrictive practice that has not been formally ordered and is not in a Participant’s plan is illegal. To protect yourself, your organisation and most importantly the Participant, make sure you are adequately trained in restrictive practices before you are expected to administer any.

Restrictive practices represent a serious risk to the human rights of people with disability and there is a need to ensure there will be appropriate reporting and scrutiny of the use of restrictive practices in the NDIS. For this reason, the NDIS Quality and Safeguarding Framework requires that the delivery of specialist behaviour support services and use of restrictive practices should only be undertaken by registered NDIS providers and be managed by the National Disability Insurance Agency (NDIA).

There are five categories of regulated restrictive practices that are monitored by the NDIS Commission. These are:

  • Seclusion – the sole confinement of a person with disability in a room or a physical space at any hour of the day or night where voluntary exit is prevented, or not facilitated, or it is implied that voluntary exit is not permitted.
  • Chemical restraint – the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition.
  • Mechanical restraint – the use of a device to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or non-behavioural purposes.
  • Physical restraint – the use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing their behaviour. Physical restraint does not include the use of a hands-on technique in a reflexive way to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person.
  • Environmental restraint – which restrict a person’s free access to all parts of their environment, including items or activities.

Registration of providers gives the NDIS Commission the necessary level of oversight of behaviour support and restrictive practices. If a regulated restrictive practice is used it must only be as a last resort, a person’s safety or the safety of others is at risk and it is the least restrictive intervention.

Tell me more

The NDIS Quality and Safeguards Commission has determined that both the development and implementation of Participant behaviour support plans that may include restrictive practices are to be done only by service providers approved to do so and registered by the NDIS Commission. Use of a regulated restrictive practice must be reported to the NDIS Commission.

Achieving the balance

Supporting Participants to exercise choice and control means that they may choose to take risks – big and small ones.

Remember:

  • Rights are paramount.
  • Ask: Is the Participant I support in charge? If not, understand why. Is there an opportunity for me to support the Participant to have a more active role in decision making?
  • Duty of care is not meant to create restrictions for Participants.
  • Ask: Is the activity or behaviour or activity something that anyone else in the community could choose to do?
  • Work with Participants to develop their skills so that they can make their own decisions, better communicate their choices and become more independent.
  • Ask: How can I support the Participant to do it safely?
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