Support Planning Policy
| Policy area | Support Planning |
| Document type | Policy |
| Applicable to | Beyondlimits Care & Support Services |
| Version | 001 |
| Date approved | 19/08/2024 |
| Approved by | Managing Director |
| Next review date | Every 12 Months |
| Related policies | Service Delivery Policy Service Access and Exit Policy Safeguarding Against Violence, Abuse, Neglect, Exploitation and Discrimination Policy Client Health and Wellbeing Policy Risk Management Policy Emergency and Disaster Management Policy Covid-19 Response Policy Duty of Care Policy Diversity Policy Transition of Care Between Different Environments Policy Client Living Alone and Receiving Personal Care from a Sole Worker Policy Human Resources Management Policy Work Health and Safety Policy Consent Policy Client Advocacy Policy Conflict of Interest Policy Manual Handling Policy Continuous Improvement and Quality Management Policy Client Feedback and Complaints Management Policy Medication Management Policy Mealtime Management Policy Privacy Policy |
| Authority | NDIS Act 2013 NDIS Practice Standards and Quality Indicators NDIS Code of Conduct UN Convention on the Rights of Persons with Disabilities UN Convention on the Rights of the Child Aged Care Act 1997 Aged Care Quality and Safety Standards Aged Care Code of Conduct |
PURPOSE
The purpose of this policy is to explain our organisation’s commitment and approach to planning client services and supports
SCOPE
This policy applies to all our workers (employees, contractors and volunteers).
DEFINITIONS
| Term | Definition |
|---|---|
| Dignity of Risk | A person’s right to make an informed choice - even if the choice involves some risk. |
| Reablement | Maintaining a person’s functional ability. It refers to the process of rehabilitating a person to enable them to learn, or re-learn new skills to gain or regain some or all of their independence. It involves developing strategies to work towards achieving personal goals. |
| Wellness | A philosophy underpinned by an emphasis on preventative health measures, optimising physical and emotional function, independence and encouraging active participation and engagement. |
CONTEXT
Our organisation is committed to collaborating with the client, their family/alternate decisionmaker/advocate and other stakeholders to plan client services and supports that achieve the best outcomes for the client. We will do this in a way that:
- encourages and supports them to adopt and maintain good nutrition and healthy lifestyle habits;
- best suits their individual needs, abilities, circumstances, preferences and goals;
- safeguards them against violence, abuse, neglect and exploitation;
- escalates health-related issues, concerns and risks promptly and appropriately;
- provides choice, control and self-determination;
- is culturally safe;
- upholds their privacy and dignity;
- promotes community participation and engagement;
- enables independence and capacity-building where possible; and
- empowers them to live their best life.
POLICY STATEMENT
#1
Collaborative Approach to Support Planning
- We will adopt a collaborative approach to support planning and work in partnership with the client and stakeholders to develop a Support Plan that:
- identifies and documents the client’s needs, preferences and strategies to achieve their personal goals;
- identifies others involved in the client’s care and ensure coordination;
- is current and complete;
- reflects outcomes of all applicable assessments;
- includes information about risks associated with care and services and how to manage these risks;
- is accessible to the client and others involved in their care with their consent;
- is used and understood by workers to guide the delivery of care and services
- We will involve other service providers and health practitioners in the assessment and planning process, with the client’s consent, as required.
- We will involve the client in selecting their support worker(s), including the preferred gender, language spoken and/or cultural background, and maximise continuity of support.
- We will support the client to exercise choice and control, including to make decisions about when family, friends, carers or any other person of their choice should be involved in their care.
- We will foster an ongoing partnership with other people that the client chooses to have involved in their care.
- We will gather information and partner with the client and other stakeholders to design the supports in a way that:
- maximises their independence and skills;
- promotes wellness, reablement and maintenance of function;
- suits their age, abilities and circumstances;
- includes preventative health care measures (vaccinations, dental check-ups, comprehensive health assessments and allied health services);
- maintains their human rights and safeguards them against violence, abuse, neglect, exploitation and discrimination;
- is culturally safe and communicated in a language, mode and method that they are most likely to understand;
- recognises and supports the right of self-determination and informed decision-making;
- fosters social connections and relationships of choice (including intimate relationships);
- meets their needs in the least intrusive and restrictive manner possible;
- is ethical and legal; and
- optimises quality of life.
- Where appropriate, we will collaborate with the client and/or their family/alternate decision-maker/advocate to identify and address advance care, palliative care and/or end of life planning needs and preferences, as requested.
#2
Supporting Client Decision-making
- We will implement and maintain a system:
- to identify clients who require support with decision-making and provide access to the support necessary to make, communicate and participate in decisions that affect their lives;
- that involves family and carers in supporting decision-making where possible; and
- that uses substitute decision-makers only after all options to support the client to make decisions themselves have been exhausted.
#3
Building a Trust Relationship
- We will seek to ‘know our client’ and build a relationship based on trust, to enable us to work with them to assist in developing strategies to support achievement of personal goals.
#4
Dignity of Risk and Achieving Personal Goals
- We will support the client’s right to take informed risks and build resilience and independence (dignity of risk).
- We will encourage and support the client to be creative and ‘think outside the box’ to identify and develop strategies to achieve personal goals.
- We will seek and provide information to assist with planning and discuss opportunities for the client to explore and expand their vision for the future.
- We will review client progress towards achievement of goals and revise the Support Plan accordingly.
#5
Risk Management and Continuity of Support
- We will seek input from the client and/or their family/alternate decisionmaker/advocate to identify risks to the client’s health, safety and wellbeing, and strategies for managing these risks.
- We will collaborate with the client to develop strategies and plans that facilitate continuity of support in the event of:
- an emergency or disaster; and
- a transition to a different environment (hospital, hospital, respite, residential facility).
- We will conduct ongoing risk assessments, including environmental risks in the client’s home, to make sure the client’s risks continue to be identified and managed and revise the Support Plan accordingly.
- We will implement strategies to support our workers to recognise, identify, respond to and escalate in a timely manner client risks, concerns and deterioration or changes in their ability to perform activities of daily living, mental health, cognitive or physical function, capacity or condition.
#6
Reviewing Support Plans
- We will review each client’s Support Plan (and other care plans if applicable) at least annually and also if:
- there is a change in the client’s needs, preferences and goals;
- if new risks are identified;
- if there has been an incident or change that adversely impacts the client;
- there is a change in availability of others involved in the client’s care.
#7
Information and Record-keeping
- We will ensure information and records are accurate and up to date.
- We will ensure the client has provided us with all required written consents.
- We will store the information securely to ensure privacy, dignity and confidentiality and make sure it is accessible to the client and only other stakeholders authorised to access it.
#8
Worker Training and Supervision
- We will maintain a skilled and trained workforce which is aware of clients’ right to freedom of expression, self-determination and decision-making and to be involved in their own support planning.
- We will maintain processes to adequately monitor and supervise workers.
SUPPORTING DOCUMENTS
Related procedures and forms include:
- Support Plan
- Support Plan — Easy Read
- Service Agreement
- Personal Emergency Preparation Plan
- Emergency and Disaster Management Procedure
- Participant Information Consent Form
- Participant Safe Environment Risk Assessment
- Continuity of Care Backup Support Form
- Support Planning Procedure
- Service Access and Exit Procedure
- Service Delivery Procedure
- Safeguarding Against Violence, Abuse, Neglect, Exploitation and Discrimination Procedure
- Risk Management Procedure
- Emergency and Disaster Management Procedure
- Covid-19 Response Procedure
- Client Advocacy Procedure
- Diversity Procedure
- Client Living Alone and Receiving Personal Care from a Sole Worker Procedure
- Transition of Care Between Different Environments Procedure
- Infection Management Procedure
- Manual Handling Procedure
RESPONSIBILITIES
Managing Director is responsible for:
- maintaining this policy, its related procedures and associated documents;
- ensuring the policy is effectively implemented across the service;
- monitoring workers compliance with the requirements of this policy; and
- ensuring training and information is provided to workers to carry out this policy.
All workers are responsible for complying with the requirements of this policy.
COMPLIANCE
Deliberate breaches of this policy will be dealt with under our misconduct provisions, as stated in the Code of Conduct Agreement.
Download
