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CHCCCS004

Assess co-existing needs

Participant Workbook

Participant Workbook document.docxCHCCCS004 Assess co-existing needs

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PW/CW 12/02/2016

1.0 JST 15/02/2016

03/2013 v1 Initial release

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© BCA National Training Group Pty Ltdv1.0 February 2016. All printed copies are uncontrolled. 3


ContentsIntroduction......................................................................................5

About this unit.................................................................................................5Assessment.....................................................................................................5Icons................................................................................................................ 7

1. Prepare for assessment.................................................................81.1Identify and prepare assessment tools and processes according to

organisation policy and procedures...........................................................81.2Gather existing information about the person..........................................121.3Seek additional information from specialists and other sources as required

to determine the range of issues that may be affecting the person.........141.4Organise practical aspects of assessment in consultation with the person

being assessed.............................................................................................16

1.5Provide information about the assessment process to the person and obtain consent..........................................................................................17

2. Analyse the person’s needs using a collaborative approach...........202.1Work within scope of own role and seek assistance from colleagues and

experts as required..................................................................................202.2Empower the person to identify and prioritise their own needs...............222.3Evaluate needs based on full range of relevant information....................252.4Identify and analyse complex, multiple and interrelated issues...............262.5Evaluate issues of urgency and eligibility.................................................282.6Assess potential risk factors for service delivery......................................30

3. Determine appropriate services....................................................333.1Consider service delivery and referral options from strengths-based

perspective...............................................................................................333.2Evaluate internal capability and other service networks to determine best

fit for the person......................................................................................343.3Provide the person with service information and support their decision

making process........................................................................................393.4Encourage the person to advocate on their own behalf to access services

404. Complete reporting......................................................................42

4.1Document the outcomes of the assessment process according to organisation procedures...........................................................................42

4.2Maintain and store the person’s information according to confidentiality requirements............................................................................................44

4.3Provide the person’s information to other services according to consent and confidentiality requirements.............................................................46

5. Evaluate assessment and referral processes.................................475.1Seek feedback about assessment processes from the person and other

networks...................................................................................................47



5.2Monitor processes and their outcomes in terms of success in meeting the person’s needs.............................................................................................

495.3Routinely seek feedback and reflect on own performance.......................505.4Use feedback and own evaluation as a basis for improving processes....52

Assessment Tasks............................................................................54Assessment Task One: Short Answer Questions............................................54Assessment Task Two: Research...................................................................62Assessment Task Three: Case Study.............................................................69

Assessor Checklist...........................................................................78Useful Links.....................................................................................79



IntroductionAbout this unitCHCCCS004 Assess co-existing needs provides you with the skills and knowledge required to assess the diverse and multi-faceted needs of people and determine both internal and external services required to meet those needs.

Assessment

Why have assessment tasks

A requirement of the qualification you are undertaking is the application of the ideas you have been learning. The assessment activities are an important part of your training program as they provide an opportunity to apply what you have been learning and they give both you and your trainer feedback on your progress.

Assessment evidence

For this unit you are required to complete the following as evidence for your assessment:

1. Assessment Task 1: Short Answer Questions2. Assessment Task 2: Research Task3. Assessment Task 3: Case Study4. Workplace Logbook/Workshop Practical Skills Display

You will also be required to demonstrate your knowledge of and skills in the following:

Performance Evidence

Assessed and appropriately responded to the requirements of at least 3 people presenting with co-existing needs

Used analytical and critical thinking skills in each case: applying a strengths-based approach to assessment analysing information about co-existing issues making evidence-based judgements about the person’s needs

Knowledge Evidence

Different types of assessment and their use in different contexts



Assessment process: roles and responsibilities of different people impact of the setting on the process roles and types of assessment tools ways of collecting information validity and reliability requirements reporting requirements and formats

Nature and impact of diverse and multi-faceted needs and issues affecting client groups, and potential interrelationships between them, including: mental health alcohol and other drugs imprisonment child protection family violence homelessness poverty health age disability behaviours of concern employment culture and religion

Common service requirements and basic features of those services including: employment physical and mental health housing community support social inclusion education and training financial support

Networks and specialist services available Legal and ethical considerations relating to assessment processes, including:

privacy, confidentiality and disclosure duty of care informed consent

Declaration of authenticity

You are required to sign a BCA National cover sheet and attach this to the front of your workbook. Your signature is a declaration that all the work you submit for you assessment tasks is authentic and has been completed by you.

You must keep a copy of all work submitted.

Assessment outcomes

The evidence you submit will be assessed and you will be given written and verbal feedback. Each individual assessment task will have an outcome of either Satisfactory or Not yet satisfactory on the Assessor checklist at the end of this workbook. An outcome of Competent or Not yet competent will also be given for



the whole unit of competency. If you are assessed as Not yet competent you will be supplied feedback and asked to resubmit your revised assessment.

There are time limits for assessment submission and for reassessment, refer to your Student Handbook for further information. If assistance is needed with you assessments please contact your Trainer or Training Coordinator.

IconsEach activity will be clearly marked.

This icon means that the activity must be completed and handed in for assessment.

This icon refers to other incidental activities you may be required to do in smaller groups or as a whole class.

This is the research icon. It indicates where you are to do some research either on the web or from other sources.



1. Prepare for assessmentIn this section you will need to demonstrate that you can:

1. Identify and prepare assessment tools and processes according to organisation policy and procedures.

2. Gather existing information about the person.3. Seek additional information from specialists and other sources as

required to determine the range of issues that may be affecting the person.

4. Organise practical aspects of assessment in consultation with the person being assessed.

5. Provide information about the assessment process to the person and obtain consent.

1.1 Identify and prepare assessment tools and processes according to organisation policy and procedures

Preparation for assessment is critical to ensure the assessment holistically (characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease) assesses the client.

There are many different tools for making assessments. Understanding what is available and choosing the most appropriate is an important skill for the community worker.

The choosing of appropriate tools should be made considering:

What are the assessment requirements of the client? What assessment tools are available, and their purpose and appropriateness

for this client? What is the evidence regarding the reliability and validity of the tool for

assessing these needs? What are the guidelines of your organisation for the use of tools, e.g. budget,

policies and procedures, philosophy, funding? What is the level of training and expertise of the worker using the tools? (It

may be necessary to get a more experienced worker or to make a referral to a specialist.)

Types of assessment

Depending on the service you work for and the needs of your clients there are a great variety of assessments available. You may be required to:



An initial triage assessment where you assess enough to determine if they fit the service criteria. For example, an initial assessment to ensure a client is safe and appropriate for a bed in a homeless shelter.

A comprehensive assessment to determine a service plan. A crisis assessment when dealing with a client in duress e.g. having a mental

health crisis. A reassessment to determine changes in circumstances requiring a change to

the service plan. A referral to a specialist assessment. Client assessments where a client will take responsibility for documenting

their own behaviour over a period of time, for example they might document how often they express anger toward others.

Risk assessments is when a person is assessed as to whether they have behaviours or attitudes which might constitute a risk to themselves or others, for example suicidal ideation.

Assessment domains

Clients may be assessed in a variety of areas such as:

Physical health domain: Physical health history, physical examination and assessment, oral health assessment, health literacy.

Development domain: Developmental history, speech, language and communication, motor development, cognitive development, sensory.

Psychosocial and mental health domain: History of mental health, behavioural, emotional development, social competence, development of identity (including cultural and spiritual identity, particularly for Aboriginal and Torres Strait Islander children and young people).

Some of the methods of assessment are:

Area Assessment method Tools

Mental Health

Normally initial assessment is by a GP with a referral to a Psychiatrist. May result in a mental health plan, medication or psychological support.

Mini-Mental State Examination (MMSE)

Geriatric Depression Scale (GDS)

DMI-10 Self-Report Questionnaire

Edinburgh Depression Scale



Alcohol and other drugs (AOD)

There are tools for initial screening. Drug tests may be used by Detoxification services. Medical and behaviour tools may be administered by workers or medical staff.

Severity of Dependence Screening Instrument (SDS)

Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

Intellectual disabilities

To determine if an individual has an intellectual disability a psychologist is usually involved in assessing both intelligence and adaptive behaviour.

IQ

Severe Language Disorder

Wechsler Intelligence Scale for Children

Physical disabilities

Assessment will be by medical practitioners and physiotherapists to determine levels of functioning and impairment.

Sensory impairment which is when one of your senses; sight, hearing, smell, touch, taste and spatial awareness, is no longer normal will be referred to appropriate specialists for assessment.

Child Disability Assessment Tool

Trauma A psychologist is trained to assess trauma and to help the person to better understand and manage their responses to the trauma by developing effective coping strategies and techniques.

Trauma Symptom Checklist for Children (TSCL)

Indigenous risk impact screen (IRIS)

Mental Health Transcultural Assessment Checklist

Life functions

Life functions might assess a person’s ability to function across a variety of areas such as learning, communication, mobility, self-care and special health care needs, domestic life activities (e.g. preparing meals), interpersonal interactions and relationships, education and training, and employment

National disability insurance scheme assessment tool



Note: Additional information regarding screening and assessment tools can be found at http://ahsri.uow.edu.au/chsd/screening/index.html

Methods of assessment

Depending on the service philosophy and the needs of the client you may need to conduct assessments in different ways such as:

Strength-based assessment: Strength-based assessment is rather than focusing on “what’s wrong” is a focus on the positive resources and abilities that a client has. An example is The Strengths-Based Practice Inventory (SBPI).

Domain-based assessment: Domain-based assessment is also called criterion-referenced assessment, occurs when assessing a person against a predetermined criterion or set standard to see how well they function according to criteria e.g. driving test.

Norm-based assessment: Norm-based assessment is where the client is compared to a sample of others, against what is ‘normal’ for a similar person and indicates whether the person fits into the range of ‘normal’ or is above or below normal functioning. An example is the Wechsler Intelligence Scale for Children.

Competency-based assessment: Competency-based assessment is the process of assessing a person’s competencies in different areas. The person being assessed must demonstrate a skill under a set of conditions, and demonstrate evidence of competency. They are then deemed competent or not yet competent.

Reliability and Validity

A key aspect of assessment is whether the assessment is reliable and valid. Hence, it is important to make use of evidence-based assessment tools to gather appropriate information. For example, most standardised drug and alcohol assessment tools have not been validated for use with people with an intellectual disability.

Reliability relates to the degree to which an assessment tool produces stable and consistent results.

Validity relates to how well an assessment measures what it proposes it measures.

Things you can do to increase the reliability and validity of your assessments are:

Use assessment tools that have been recommended for the type of assessment and client you are assessing from reliable evidence-based sources

Follow service procedures for screening and assessment tools Get training in the use of the assessment tool and follow all assessment

guidelines Don’t use tools for groups or in ways outside of their intended purpose


http://ahsri.uow.edu.au/chsd/screening/index.html


Evidence-based tools

Evidence-based tools are tools that are grounded in well-conducted scientific research to gather evidence that they are both reliable and valid. (Some people prefer the use of the term ‘evidence-informed practice’.)

For a good explanation of the types of evidence that can be gathered for evidence-based practice check out https://aifs.gov.au/cfca/publications/evidence-based-practice-and-service-based-evaluation.

An excellent document on evidence-based is “Evidence-based Psychological Interventions in the Treatment of Mental Disorders: A literature Review” available at https://www.psychology.org.au/Assets/Files/Evidence-Based-Psychological-Interventions.pdf.

Activity 11. What are examples of assessment tools that you have participated in?

(Think of your school or life experience.) Were they strength, domain, norm or competency based?

1.2 Gather existing information about the personWhen completing a client assessment there are a number of steps we need to go through, these are outlined below. In this section and following sections more information will be provided regarding each of the assessment steps.

Assessment Steps:1. Prepare for assessment

Gather previously collected information such as previous assessment results or case notes

Establish positive relationship with clients Identify the need for the assessment Identify and use appropriate assessment tools and processes. Explain polices such as rights and responsibilities (such as privacy

principles, mandatory reporting, etc.) and get informed consent from the client


https://www.psychology.org.au/Assets/Files/Evidence-Based-Psychological-Interventions.pdf


https://aifs.gov.au/cfca/publications/evidence-based-practice-and-service-based-evaluation



Gather and prepare other resources / people required to complete assessment such as interpreters

2. Assess client needs Identify any limitations you have in assessing and addressing client needs.

You may need to refer or get help Identify the client’s range of needs (see previous section on Domains) Explain the assessment process to the clients how the assessment is done Follow procedures to ensure all participants are safe at all times Seek information from specialists and other sources as required to

determine the full range of issues that need to be addressed3. Analyse client needs as a basis for meeting them

Work with the client to determine and prioritise needs Determine if enough information has been gathered and seek additional

assessments if need established for it Report on assessment results in accordance with service procedures

including those outside of the service4. Identify appropriate services to meet client needs and refer as

necessary Identify services inside and outside your service required to meet your

client needs Work with client to access services which may be active or passive

advocacy5. Evaluate assessment and referral processes

Regularly review service to client to identify continuing appropriateness of service plan in light of changing client needs and priorities

Gather client feedback on service plan Gather feedback from colleagues and referral services to assess

continuing suitability of client service plan and eligibility for services

Preparing for assessment

Information for a client can come from a number of sources including:

From the client – do not forget to ask for the clients self-reporting. This information will need to be compared to other information sources to give a fuller picture and to check its reliability. A client suffering from confusion may not be able to self-report accurately. This might be collected from conversations or from questionnaires.

From the client’s family – in some circumstances, and with the consent of the client, you may be able to gather background information from the client’s family, friends or colleagues.

From previous notes – if the client has previously engaged with your service you should have case notes. Review the case notes carefully but be aware that there may have been significant changes in the circumstances or presenting issues of the client.

Health and specialist reports – is their information available from their GP or previous specialist reports that the client is willing to make available.



Observation – you may be able to pick up valuable information from your observation of the client’s appearance, their speech, how they relate to others, and how they have completed a task such as completing an intake form.

From other workers – other workers either from inside or outside the service may have information about the client that has not been recorded in case notes.

Information to be collected

In the process of intake and assessment information should be collected regarding:

Information that is essential to engage with your service. In many cases this might include name, contact details, date of birth, etc. Note that you should only collect information that is necessary and essential. For example, collecting information about their sexual orientation would not be appropriate unless the service you provided dealt directly with that matter.

Information essential to create a service plan such as information about family, medical, mental health, addiction, education, and employment history. Often this information is gathered over-time with a focus in the early assessment on the issues most relevant at this time.

Information regarding their current state such as current financial state, medication regime, emotional well-being.

Information regarding their risk profile such as their risk of homelessness, of suicidal or self-harm behaviours.

Information regarding their future hopes and goals.

Activity 21. You are working as the intake worker in a homeless shelter for men.

A new client arrives at 5pm for a bed that has been arranged for them. What do you believe is the minimal information you would need to collect and why?



1.3 Seek additional information from specialists and other sources as required to determine the range of issues that may be affecting the person

Refer to Section 1.2 for list of other sources of information.

Using Specialists

Community workers engage with clients with a wide range of needs which are more complex than their training will have prepared them for. It is essential that a worker understand the limits of their skills and knowledge and therefore make use of specialists to better serve the needs of their clients.

Just a few of the areas that a worker may consult a specialist are:

Cultural Spiritual Financial/income Disability Homelessness Domestic and family violence Mental health Refugee and migrant issues Legal Education Employment Children/youth Aged care

Specialists may help with an in-depth assessment on a specific issue such as a LLN (Language, Literacy and Numeracy) specialist to assess the reading capacity of a client. Or they may help the worker go broad by helping understand the holistic needs of a client such as when a person experiencing pain from an injured back might have impacts in their social, cognitive, cultural/spiritual and psychological as well as the physical/medical area.

Referral for specialist assessment

When making a referral to a specialist for additional assessment it is important to follow good referral processes.

1. Making the referral: If you believe there is need for a referral ensure you check and then follow your services referral process. Part of this process will



be involving your client in the referral process and providing them with information about a suitable service or services.

2. Contact the service: Before giving your client information about a potential service ensure that the service has the capacity and is appropriate for your client. Gather information about how the service works and any protocols that need to be followed and any costs that might be involved.

3. Get consent from your client and determine who and how the referral will be made. It may be that you provide a referral letter but the client makes the contact.

4. Support your client through the referral process. This may include:

planning an initial visit to the referred agency, or attending the first appointment along with the client

ensuring that the client has the opportunity to provide as much information as they can to the agency

providing the client with as much information as possible to take charge of the process from that point on with your minimal support

encouraging the client to provide feedback on the quality of the service and ways that the service may or may not be meeting their needs

(Additional details in Section 1.4)

5. Follow-up to ensure the specialist report is received and included in your assessment.

Activity 31. What specialist services might be required for a client who is

struggling with alcohol abuse and is the perpetrator of violence in their home?



1.4 Organise practical aspects of assessment in consultation with the person being assessed

As you organise an assessment with a client it is important that you:

Fully explain the reason for the assessment and what the assessment will entail. This may involve giving the client written information or explaining it to a support person.

Explain to the client their rights and responsibilities. For example, in most cases they have a right to a copy of any specialist assessments.

Get the client’s ‘informed consent’ for the assessment letting them know the consequence of any decision not to proceed with any or all parts of the assessment process. Informed consent means the consent is voluntary, and that the person has been given sufficient information to make a decision.

Ensure that you have set aside adequate time for an unhurried assessment. In some cases, additional time might be required if for example they have a disability that will slow down the assessment process.

Arrange a suitable time and location for the assessment. The location should be private and the time appropriate to the needs of the client. For example, if the client works night shifts the time of the appointment might need to be later in the day after the client has slept.

Explain if anyone else will be present or involved in the assessment, for example, an interpreter, a supervisor, or a student placement.

Give the client an option to have a support person during the assessment if that is appropriate.

If the assessment is for a future date, you may need to arrange to remind the client of the coming assessment.

Ensure that the resources needed for the assessment are in place and in good order. For example, if the assessment is a living skills assessment that requires the client to prepare a basic meal, then ensure the ingredients and the cooking tools are available.

Work to make sure that the client is treated with respect and courteously at all times. In some assessments a client may get frustrated and you will need to remain calm. In some assessments it may involve complex assessment by the assessor so ensure that you give enough time between assessments to be well rested and prepared.

After the assessment has taken place check with the client regarding any questions or concerns they may have regarding the assessment process.



Provide the client with the results of the assessment and give them opportunity to ask clarifying questions. In some cases, it may be possible or appropriate to get a second opinion.

Provide results of assessment to other workers or services engaged with the client as per consent of client.

Develop, or alter, service plans in conjunction with the client taking the results of the assessment into consideration. For example, if after seeing a Psychiatrist a client gets a mental health diagnosis, the worker and client may negotiate a reprioritising of goals to deal with mental health concerns before addressing employment goals.

If the client is unhappy with any aspect of the assessment or results explain to them the complaint or review process that is open to them.

Activity 41. Research to find an example a list of Rights and Responsibilities that

you might give to and discuss with a client.

1.5 Provide information about the assessment process to the person and obtain consent

In Section 1.4 we discussed providing results of assessment to client and issues of consent. Here we will explore in more detail the issues of:

privacy, confidentiality and disclosure duty of care informed consent

Privacy, confidentiality and disclosure

The Office of the Australian Information Commissioner (www.oaic.gov.au) provides a plain English summary of the National Privacy Principles (NPPs).

There are ten NPPs that regulate how private sector organisations manage personal information. They cover the collection, use and disclosure, and secure management of personal information. They also allow individuals to access that information and have it corrected if it is wrong.



If you want more detail see the full text of the NPPs at www.oaic.gov.au/ and the NPP Guidelines at www.oaic.gov.au/privacy-law/privacy-archive/privacy-guidelines-archive/guidelines-to-the-national-privacy-principles.

NPP 1: Collection: Describes what an organisation should do when collecting personal information, including what they can collect, collecting from third parties and, generally, what they should tell individuals about the collection.

NPP 2: Use and disclosure: Outlines how organisations may use and disclose individuals' personal information. If certain conditions are met, an organisation does not always need an individual's consent to use and disclose personal information. There are rules about direct marketing.

NPPs 3 & 4: Information quality and security: An organisation must take steps to ensure the personal information it holds is accurate and up-to-date, and is kept secure from unauthorised use or access.

NPP 5: Openness: An organisation must have a policy on how it manages personal information, and make it available to anyone who asks for it.

NPP 6: Access and correction: Gives individuals a general right of access to their personal information, and the right to have that information corrected if it is inaccurate, incomplete or out-of-date.

NPP 7: Identifiers: Generally prevents an organisation from adopting an Australian Government identifier for an individual (e.g. Medicare numbers) as its own.

NPP 8: Anonymity: Where possible, organisations must give individuals the opportunity to do business with them without the individual having to identify themselves.

NPP 9: Trans-border data flows: Outlines how organisations should protect personal information that they transfer outside Australia.

NPP 10: Sensitive information: Sensitive information includes information such as health, racial or ethnic background, or criminal record. Higher standards apply to the handling of sensitive information.

Duty of Care

Duty of care is your legal responsibility to take reasonable care to avoid others being harmed. If for example your work involves children, you have a legal responsibility to respond when you have concern regarding harm to children either through neglect (a child not receiving things such as medical treatment, education, food, etc.) or abuse (a child being physically, sexually or psychologically harmed).

Your duty of care is that you take ‘reasonable care’ which means that you must exercise your duty to a standard that can reasonably be expected from someone in your position with the training and knowledge you should have in your role.

Negligence

A breach of Duty of Care is called Negligence which is the failure to take reasonable care to avoid causing injury or harm to another person.


http://www.oaic.gov.au/privacy-law/privacy-archive/privacy-guidelines-archive/guidelines-to-the-national-privacy-principles

http://www.oaic.gov.au/privacy-law/privacy-archive/privacy-guidelines-archive/guidelines-to-the-national-privacy-principles

http://www.oaic.gov.au/


To prove that a person has been negligent a plaintiff (person making the complaint) must prove four things:

That there is a duty in the circumstances to take duty of care That the behaviour or inaction of the defendant in the circumstances did not

meet the standard of care which a reasonable person would meet in the circumstances (breach of duty)

That the plaintiff has suffered injury or loss which a reasonable person in the circumstances could have been expected to foresee (damage)

That the damage was caused by the breach of duty (causation)

Informed consent

Following is an example of a policy regarding informed consent.

Before any personal information is requested from an individual, informed consent must be obtained. A ‘Statement for Collection of Personal Information’ document will be provided to the client explaining:

What information is to be collected Depending on the type of service you are seeking, some of the following

information may be collected: General, Medical, Health, Family, Legal and Employment History

Where case notes are collected, clients are to be advised that factual information may be recorded as part of holistic service provision

Why information is collected: Information is collected to assist clients to meet their needs and to

allocate resources, meet funding requirements, gather statistics, investigate complaints, and for research purposes.

Who will have access to it Only people directly associated with the support provided to the service

user. This document will be presented in:

Plain English Community languages Large print and/or COMPIC Simple verbal explanations Explanation by accredited interpreter or bilingual employees in the client's

preferred language, where required

After the client has read this document, the client is to sign a declaration indicating that they have done so. This form is to remain in the client’s hard copy file.

Activity 5



1. In what situations have you /or could you be requested to give consent?

2. Have you ever had a situation when you believe your privacy was breached? Which of the privacy principles was breached?



2. Analyse the person’s needs using a collaborative approach

In this section you will need to demonstrate that you can:

1. Work within scope of own role and seek assistance from colleagues and experts as required.

2. Empower the person to identify and prioritise their own needs.3. Evaluate needs based on full range of relevant information.4. Identify and analyse complex, multiple and interrelated issues.5. Evaluate issues of urgency and eligibility.6. Assess potential risk factors for service delivery.

2.1 Work within scope of own role and seek assistance from colleagues and experts as required

Developing a service plan based on a client’s assessment should be a collaborative exercise between the client and worker and may include other key stakeholders such as a specialist or family members when this is beneficial for client outcomes.

As the worker you have a duty of care to provide the best possible care within the constraints of your position description, policies and procedures, level of knowledge and skill, and any relevant legislation. This section explains these in more detail.

Duty of care

Refer to Section 1.5.

Position Description

A position description is a document that outlines the work assigned to a position which the worker is expected to perform and may include specific measureable outcomes of the role. It also outlines who the worker reports to and may include information about how the role relates to other positions in the organisation.

A position description should include:

A job title which will give you a sense of the role you are required to fill Description of the purpose of your role The main duties you are to fulfil



Who you report to Outcomes or Key Performance Indicators (KPI’s) which give specific

measureable about the duties Required education or experience Knowledge, skills and attitudes required to fulfil the role

Your position description helps set some of the boundaries regarding your limitations in assessing needs and helping meet those needs.

Policies and Procedures

Policies are the statements outlining how your organisation intends to operate and meet its legal, funding and mission obligations. Policies provide the skeleton or guiding principles of how things are to be done in this organisation.

Procedures are the detailed steps that explain how the policies are achieved. They normally explain who will do what and how. Procedures help the worker complete tasks in ways that are safe and effective.

Sample policy and procedures are available via your student login.

Examples of model policies and procedures are often provided by government agencies for community service organisations. An example called ‘Sample Policy and Procedures – Manual for SAAP Services’ is available from www.dcp.wa.govv.au.

Your knowledge, skills, qualifications

As discussed in Section 1.5 your duty of care “is that you take ‘reasonable care’, which means that you must exercise your duty to a standard that can reasonably be expected from someone in your position with the training and knowledge you should have in your role.”

This means that:

If you don’t have the training or experience, you should not complete an assessment.

If you have the training and experience required for the assessment you still must have currency in your training, for example a First Aid certificate must be up-to-date.

You should not complete an assessment outside of the scope of your position. Some assessments can only be completed by those with particular

qualifications as outlined in their assessment guidelines.

In cases where you feel that an assessment is outside of your training and knowledge you should make a referral to a specialist or seek help from a colleague or supervisor who has the appropriate knowledge, skills and qualifications.


http://www.dcp.wa.govv.au/


Activity 61. What types of client assessments do you feel you are able / not able

to complete and why?

2. Explain in your own words what is meant by ‘duty of care’.

2.2 Empower the person to identify and prioritise their own needs

Empowerment

When working with a client it is essential to maximise the autonomy and self-determination of that client within the constraints of their capacity which is referred to as empowerment.

“Empowerment refers to working with others in a way that increases their autonomy and self-determination so they increasingly make decisions and take actions in line with their self-interest.”

Service practices that encourage empowerment are the overlapping principles of strength-based practice, person-centred practice and consumer-directed care. Service approaches that support clients to maximise their capacities are the wellness, ‘reablement’ and restorative approaches.

Strength-based practice emphasises people's self-determination and strengths. It views clients as resourceful and resilient in the face of adversity. It assumes and seeks to discover the strengths such as the capacity, knowledge, skills and connections that a client brings to the situation.

Person-centred practice is when we place the client and their rights as central to the decision making process. The focus is not on what the service brings but what the client needs.

Consumer-directed care is about providing the types of care and support services that the client determines they need.



Wellness approach: Is a focus on minimising functional loss and seeking to avoid dependency. Where the client is able to do something they are encouraged to take action and responsibility to maintain maximum autonomy. This approach may require a gradual increase in action and responsibility over time due to the need to teach new skills or to practice old skills.

‘Reablement’ approach works toward developing the client’s ability to care for themselves building on their strengths. It may require short-term interventions and/or the use of aids.

Restorative care approach is an approach that makes use of a multi-disciplinary team to support the client to regain function and may include physiotherapists, speech therapists, etc.

As the worker you will provide the client with the results of assessments, help the client have insight into their issues, give information and ideas, suggest services and ways forward, but in the end the worker must help the client identify and prioritise their own needs.

Dignity of risk

Dignity of Risk is a term used to describe the right of individuals to choose to take some risk in engaging in life experiences. It is important not to overprotect clients in a way that unnecessarily restricts opportunities to enjoy life.

Following are some guidelines to staff that may be included in a procedure regarding ‘dignity of risk’ within the context of ‘duty of care’.

Staff are provided information on duty of care, the law relating to negligence and how to deal with situations where a client is at risk of exploitation, abuse or personal loss.

Staff must ensure that the highest level of care is taken to minimise the risk of harm, illness, injury or death to clients, balanced with the right of the client to take risks.

Staff will assist clients in making informed choice by providing them with information about the benefits and risks involved in activities.

Where a client chooses to undertake an activity that could harm them, and understands the risks involved, this should be noted in the clients file notes.

Potential risks and hazards are reported and managed as per the organisations policies and procedures.

7 traits of effective workers

Workers who are most effective at empowering clients are skilled in the following behaviours.

1. Acceptance: The ability to make people feel welcome and safe so that they are able to open up and honestly share their experiences and the things they need help with.



2. Attitude: The ability to bring a positive and hopeful attitude so that clients or fellow workers feel a sense of hope and optimism about the future, that things can get better.

3. Aspiration: The ability to get clarity around what a person is hoping to achieve, to help a person be clear and specific about their current and future hopes and dreams.

4. Actuality: The ability to get a clear and accurate picture of how things currently are, the reality as it really is.

5. Agreement: The ability to get a clear and specific commitment to what actions each stakeholder is going to do to help move from the current situation (actuality) towards the hoped for future (aspiration).

6. Action: The ability to support, help and motivate stakeholders to do what they have committed to do in their agreements, to overcome procrastination and other blockages.

7. Accountability: The ability to clearly and respectfully hold people accountable for what they said they were going to do by when they said they were going to do it. Accountability involves celebrating effort (not just success) for when actions have happened, and holding a person accountable for when they did not take action as they agreed.

Source: 7a disciplines by Impact Facilitation, Peter Watson, www.impactfacilitation.com.au

Activity 71. What decisions might a client make which would fall into the

category of ‘dignity of risk’?

2. Consider the 7 traits of effective workers. Which of these are you best / worst at? How could you improve?


http://www.impactfacilitation.com.au/


2.3 Evaluate needs based on full range of relevant information

A comprehensive and holistic assessment process will have gathered a range of information that now needs to be evaluated.

The evaluation of the information gathered will be a result of:

discussion with the client and their reflections on the assessment information

the worker’s insight due to their knowledge and experience

the expert recommendations by any specialists

and any advice or insight the worker may gain from colleagues and supervisors



A good evaluation will be seen as a ‘hypothesis’ that is open to variation with additional information. A hypothesis evaluation is simply an acknowledgement that we don’t have every piece of information and our perception of information may not be 100% correct, so based on what we know we will move forward but always be open to new information.

As we make the evaluation we need to consider where the ‘client’s strengths and capacities’, ‘desired outcomes’ and ‘available resources’ intercept, this will be where we are most likely to get engagement and change.

Motivational Interviewing

At this point the use of Motivational Interviewing can be extremely helpful.

Motivational Interviewing is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behaviour. MI is a goal-oriented, client-centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence.

An excellent video outlining motivational interviewing is “Motivational Interviewing with Bill Matulich, Ph.D., The Decisional Balance Technique” which is available on YouTube.

Activity 81. Watch the Motivational Interviewing video (details above) and

outline the four stages of the interview.

2. In what situations do you think using the Decisional Balance technique would be helpful?



2.4 Identify and analyse complex, multiple and interrelated issues

Co-existing conditions

Clients may be dealing with co-existing needs which make their care much more complex; evidence suggests this makes them much more vulnerable.

Co-existing conditions might include those related to:

Mental health Alcohol and other drugs Imprisonment Child protection Family violence Homelessness Poverty Health Age Disability Behaviours of concern Employment Culture and religion

Comorbidity

When a client has multiple disorders or illnesses this is referred to as ‘comorbidity’. Some conditions have high rates of comorbidity, for example compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true.

In Australia the main approaches to dealing with comorbidity are:

holistic care client empowerment individualised, client-driven treatment being comorbidity-prepared ‘no wrong door’ approach

An excellent document looking at comorbidity approaches in Australia is ‘Effective Models of care for comorbid mental illnesses and illicit substance use’ available at www.health.nsw.gov.au/mhdao/publications/Publications/comorbid-


http://www.health.nsw.gov.au/mhdao/publications/Publications/comorbid-mental-care-review.pdf


mental-care-review.pdf.

Responding to complex and comorbidity issues

Steps to dealing with complex and comorbidity issues should include:

Getting training and colleague support to deal with complex issues. In your assessment always assess for Mental Health and Physical health

conditions which could impact on the client. When risk conditions have been identified complete a thorough risk

assessment. Use assertive follow-up to encourage a multi-disciplinary response. Provide or access supportive therapies that are known to help with

comorbidity such motivational interviewing, CBT, withdrawal management, medications, prevention and psycho-education regarding substance use, and involving alcohol and other drug (AOD) services/GPs where appropriate.

Activity 91. Research and explain what the ‘no wrong door’ approach is.


http://www.health.nsw.gov.au/mhdao/publications/Publications/comorbid-mental-care-review.pdf


2.5 Evaluate issues of urgency and eligibility

Evaluating risk

It is essential at all times to keep in mind issues of risk so that you respond to the most urgent issues in a timely manner. Things that would indicate that a client is at risk are:

Suicidal behaviour or repeated threats to suicide Sexual and physical abuse In some situations, homelessness Consistent taking of harmful legal and illegal substances Repeated serious criminal offences

If you identify high risks, these should take precedent over all other matters. If you are unsure about identifying or categorising risk you should immediately seek advice from your supervisor.

Eligibility

Not everyone is eligible for every service and so one of your roles is to assess what services a client will be eligible for in light of the comprehensive assessment and prioritisation you have completed in conjunction with your client.

It is critical that you do not suggest a service that the client will not be eligible for.

Criteria that might determine eligibility are:

Residency: Some services require you to live in a defined area such as in a particular state or suburb. At times there will be a time-frame for residency where you must have lived in the area for a minimum amount of time before you become eligible.

Age: Services may only cater to particular ages such as birth to 8 years, or over 65.

Diagnosis: Services may only be available to clients with a particular diagnosis such as schizophrenia.

Time frame: Services may only be available for a fixed period or for a number of engagements and may not be able to be accessed until a set period has elapsed since the last time the service was accessed. For example, you can get three emergency support payments in any twelve-month period, or six counselling appointments within two years.

Capacity: The service may have a limit of for example 50 clients and cannot be accessed until a space becomes available.

Income: Service may only be available for those on benefits or below an income threshold.



Cost: Service may only be available on a fee-for-service basis, so unless you are able to pay the service cost you can’t access the service.

Categories: Service may only be available to set categories of people such as refugees or the unemployed.

Priority status: Services may only be available for those who have reached a threshold on some priority status rating scale. For example, you might require to meet the criteria of at least three of the five categories of unemployed, mental health diagnosis, residency, age over 55.

Urgency: Services may only be available for clients with high risk needs, for example, only available for clients who rate a high risk of suicide.

Activity 101. Research a Community Service program and find out their eligibility

criteria. List who and who isn’t eligible to engage in that program.



2.6 Assess potential risk factors for service delivery

Risk Assessment

As previously discussed, duty of care is your legal obligation to protect the wellbeing of those being assessed as far as is reasonably practicable. If you identify risk to the client, or another person, you are legally required to take steps to minimise risk. You must at all times uphold your duty of care when conducting complex assessments. If you are uncertain about how to best minimise risk you should immediately consult with colleagues, supervisors or emergency response services.

As part of your risk assessment you should use your services Work, Health and Safety procedures which will include a risk assessment document.

Risk assessments will seek to measure the consequence of an event happening (in the following Hazard Rating Matrix this scale goes from Insignificant to Catastrophic) and the likelihood of that event happening (Rare to Almost Certain) and then giving a score to the risk in the table section.

It is important that you as a worker understand how to make an assessment of risk and know the procedures you are to follow to minimise the risk to an acceptable level.



Sources of Risk

Risk to and from clients can come from many sources such as:

Client violence Domestic and family violence Environmental risks such as fire, tripping, car accidents Self-harm & suicide Trauma

When assessing risk for clients the following list of questions could be asked to make a risk assessment.

Risk to self Do you have any medical conditions, including allergies?

Have you ever been hospitalised? If so when? How do you manage your condition/s?

Do you take any medications? Details? Have you ever thought about or attempted to commit suicide?

Have you ever been hospitalised after an attempt? When did you last think about/attempt suicide?

Have you ever intentionally caused harm to yourself? What kind of ways do you harm yourself? What causes you to want to harm yourself?

Have you ever had a problem with drug or alcohol abuse?



What kind of substances? Have you ever been to detox?

Risk to others Have you made verbal threats of intent to harm another person?

Has this occurred in the last three months? Have you ever been arrested?

Why were you arrested? When were you arrested?

Have you ever been charged with committing an offence? What were you charged with? When did this occur?

Have you ever been jailed for committing an offence? What offence were you jailed with? When did this occur? How long did you spend in prison? When were you released?

Have you ever had an AVO served on you? When were you given an AVO? Who took the AVO out against you?

Have you ever used anything as a weapon to assault or injure anybody? What kind of weapon did you use? What did you use the weapon for? When did this happen?

Have you ever been excluded from other services because of your behaviour? What service were you excluded from? Why were you excluded? When did this happen?

Risk from others Is there anyone wanting to cause you harm who might know where you are?

Who is this person? Why would they want to cause you harm?

Activity 111. Make a list of five hazards your might experience when working with

a client and then use the Hazards Matrix above to score the risk level of each hazard.



2. For each of the hazards what is one thing you could do to minimise that risk?



3. Determine appropriate services


1. Consider service delivery and referral options from strengths-based perspective.

2. Evaluate internal capability and other service networks to determine best fit for the person.

3. Provide the person with service information and support their decision making process.

4. Encourage the person to advocate on their own behalf to access services

3.1 Consider service delivery and referral options from strengths-based perspective

Referring clients

The development of a client service plan will require assessing which needs can be meet from within the service and which will need to be referred to outside specialists and services.

Issues regarding referral have already been discussed in Sections 1.1 – 1.3, with a focus on how to make referrals in Section 1.3.

The issue of strengths-based practice was discussed in Section 1.1.

When making a referral you should consider the following factors:

Criteria for eligibility – does the client qualify? Capacity of the service – does the service have capacity to receive this

referral in the immediate or near future? Cost of service – are there any costs to the client or referring service and can

these be met? Location of the service – can the client get to the service in a reasonable time

at a reasonable cost? Referral procedure – what is the procedure for referring to this service? Limitations – are there any restrictions that make the client unable to attend?

Case Conference

If a client has a complex service plan with multiple services involved it can be helpful to have a case conference. A case conference is a formal, planned, and



structured event separate from regular contacts. The goal of case conferencing is to provide holistic, coordinated, and integrated services across providers, and to reduce duplication. Case conferences are usually interdisciplinary, and include one or multiple internal and external providers and, if possible and appropriate, the client and family members/close supports.

Activity 121. You are working with a client who is homeless, is not registered for

any benefits, and who appears to have an undiagnosed mental health condition. You decide to have a case conference regarding this case. Who would you invite to attend?

3.2 Evaluate internal capability and other service networks to determine best fit for the person

Internal capability

Community services range from one person teams to services that have thousands of staff across multiple sights. Therefore, understanding your internal capacity can range from very simple to very complex.

When assessing whether you have internal capacity to meet the needs of a client you should:

Discuss with your colleagues and supervisor what resources exist that you might be unaware of.

Consider the scope of experience and training of the staff. Consider the mission of the organisation. Understand the funding requirements of your service programs. For example,

if your service is funded under the Brighter Futures program the requirements are described as: “Brighter Futures delivers targeted early intervention services to families with children aged under 9 years, or who are expecting a child, where the child/ren are at high risk of entering the statutory child protection system.” (www.community.nsw.gov.au/for-agencies-that-work-with-us/our-funding-programs)


http://www.community.nsw.gov.au/for-agencies-that-work-with-us/our-funding-programs

http://www.community.nsw.gov.au/for-agencies-that-work-with-us/our-funding-programs


What is your current capacity to undertake the service to meet the client’s needs? You might have the internal skill and experience but not the capacity.

When your service cannot meet the needs of the client internally you need to draw upon other services as discussed earlier in sections on referral.

External services

You need to become familiar with the wide range of services that are available to meet the needs of your client. Increasing your knowledge of other services and building relationships across networks will greatly enhance your capacity to work with and help your client gain the services they require.

Types of services available: (The following list comes from www.dhs.vic.gov.au/for-individuals)

Type of Service What they deal with

Housing and Accommodation Homelessness Home Owner Support Community Housing Private Renter Assistance Supported Accommodation Public Housing

Children, Families & Young People

Child Protection Family and Early Parenting Support Young People Family Violence Youth Justice Adoption and Permanent Care Kinship, Foster & Other Care Care Leavers Sexual Assault

Disability Self-Directed Support Help Living at Home Accommodation Specialist Services National Disability Insurance Scheme Individual Support Packages Community Life and Jobs Aids & Equipment Carer and Family Support

Financial Support Concessions Home Owner and Rental Support Funding and Grants – Disability MoneyHelp Disability Financial Support Carer Support Scholarships



Crisis & Emergency Crisis Accommodation Sexual Assault Emergency Assistance Financial Crisis Support Domestic and Family Violence Reporting Child Abuse Preparing for Emergencies

Aboriginal & Torres Straight Islanders

Housing & Accommodation Children, families and young people Disability Financial Support Applying for Documents and Records Crisis & Emergency

Culturally & Linguistically Diverse Women

Housing & Accommodation Children, families and young people Disability Financial Support Applying for Documents and Records Crisis & Emergency

Networking

Networking is the ability to build relationships within and across organisations that lead to better exchange of information, better sharing of resources and increase the ability to collaborate for the benefit of clients.

Networking can be developed through informal relationships or using more formal structured networks such as interagency meetings or formal collaboration agreements.

Some networking avenues are:

Attending regional, specialist and peak associations Join and engage in professional/occupation associations Connect with others in your sector on LinkedIn Connect with trainers, teachers and academics and ask them for who they

recommend to network with Build up your contacts in policy and funding bodies Attend and actively engage in your local inter-agency networks Join local community interest and support groups Connect with other DFV workers in your area Make use of networking support services. In Queensland you can find

networks at http://networks.communitydoor.org.au/. In ACT check out http://www.actcoss.org.au/about/networks.html.


http://www.actcoss.org.au/about/networks.html

http://networks.communitydoor.org.au/


Building and maintaining your professional network

To build and maintain your professional network you need to actively and methodically work to develop positive and mutually beneficial relationships with those inside and outside of your organisation. As you meet with people you should be:

Actively asking people about their job and challenges to learn about their knowledge, skills and abilities

Ask people if they would mind if you called them if you have a question which they might have expertise in

Ask to connect with them on networking tools such as LinkedIn Ask them for their advice about which networking activities they recommend As you come across useful information and resources distribute it to people in

your network to whom you feel it would be valuable

You should also be participating in professional networks and associations where you can:

Learn about the role, services and resources of other organisations Learn about the roles and resources of other workers Provide advice and information about own service and organisations Get peer support and review Learning about professional development opportunities Maintain coordination among organisations and workers Support joint programs or activities Provide information for policy development Support the interests of specific groups within the community

Networking hints

The following ideas are adapted from www.businessballs.com which contains lots of useful information on a variety of organisational and professional development tools.

When participating in these networking opportunities what should you look for?

Conferences: Conferences are full of people with common interests. Coffee breaks are an ideal time to make introductions

Exhibitions: Exhibitions are obviously full of people with a common interest. Most exhibitions rightly do not like visitors to canvass the exhibitors, but there are plenty of other situations to meet people and network.

Seminars: Seminars attract people of all sorts. Again there are usually coffee breaks which are ideal for making introductions and getting to know people.

Training courses: Open training courses are excellent for meeting people. Many will encourage informal networking among delegates because this adds value to the quality of the event; certain types of training bring people together in work teams, making it extremely easy to get to know all attendees very well.


http://www.businessballs.com/


Chambers of Trade or Commerce: All towns have at least one 'chamber of commerce', specifically to bring local business-people together. Many run networking events and/or other meetings and activities which are ideal for networking.

Website forums: Website forums exist for every subject you can think of. Each offers a networking opportunity for the subject matter concerned.

Website user groups: User groups are a further variation of groups found online. User groups are typically within the websites of major internet corporations such as Google and Yahoo. Many user groups are highly specialised, and by implication, internet networking is second-nature to most of these people.

Professional body websites: Every profession and trade is represented and connected by at least one official body, which tends to act on behalf of its members, and also offers various opportunities for outsiders to get involved and make helpful connections.

Local networking events: Anyone can set up a networking event, so you can find isolated or more permanent networking operations cropping up at a town near you.

Societies and associations: Every specialist subject has its own society or association. These organizations offer various ways to meet their members.

Lectures and talks: Lectures and talks occur widely, held or promoted by various organizations for all sorts of purposes. Obviously a lecture/talk will attract a common grouping of people interested in the subject concerned.

Annual General Meetings: AGMs are by their nature a regular occasion offered by corporations and membership organisations to engage with its members. Some are very formal and tightly run with few networking opportunities, but others are more sociable affairs, in which case if a group is relevant to your aims and you can become a member, it can be worth consideration.

Conventions: Conventions are organized for all sorts of special interest groups. If the group is relevant to your aims in any way, then their convention could offer excellent networking opportunities.

Pressure groups: Pressure group meetings are strongly connected and usually attended by very active and energized people. If the subject is relevant to your aims there will be opportunities to meet some interesting people at this sort of event. These situations often also have scope for volunteering and becoming involved at a strategic level.

Public meetings: Public meetings are held for all sorts of reasons, for example local planning consultations; presentation of local development plans. These events attract business people, especially if the subject relates to commerce, as many will do. At meetings like these, most attendees sit and listen for quite a while, and consequently are ready for conversation during breaks and at the close of the meeting.

Opening ceremonies: Opening ceremonies, especially for notable new buildings, attract many local business people and dignitaries. If the community concerned is relevant to your aims this sort of event can provide useful networking opportunities. The same applies to unveiling ceremonies, especially where there is a reception afterwards.



Activity 131. Who do your already have in your Community Services network?

2. What actions could you take in the next month to extend your network?

3.3 Provide the person with service information and support their decision making process

Make arrangements

When referring your client to other services it is important that you work to make the process as simple, transparent and positive as possible. The movement between services is a point where clients may drop out of contact as it can be a very stressful time for the client.

It is preferable to provide the client with options of possible services. Provide the client with information about each of the options, and then discuss the pros and cons of each option so the client can make their own choice. (Note: Normally don’t provide more than three options as too many options can lead to a paralysis in decision making.)

When making the referral you need to be clear regarding the documentation, appointment, costs and travel. Consider the following:

What referral documentation needs to be provided and in what format. Agree with the referral service, and your client, about what information

you will receive and how you will continue to support them during the referral process.

Confirm with the referral service all arrangements and necessary information to ensure the referral goes smoothly.



If possible, ensure your client and referral service has access to you around the time of the referral in case something goes wrong or additional information is required. Ensure you have all necessary information easily available in case you get contacted.

If appropriate personally contact the worker in the referral service to brief them on the client.

Check with the client before the appointment to ensure all details are in place and you answer any last minute questions or concerns.

Some clients may require you to actively support them at the first or first few appointments.

Ensure any funding or cost arrangements have been clearly understood and explained to the client.

Confirm with the client how they intend to travel to and from the appointment.

Communicate realistic expectations to the client regarding the benefits of the referral.

Contact the client after the referral appointment to debrief and reassure them.

Provide ongoing advocacy for the client if they require or request it. (Extra effort supporting the client may save additional work at a later date.)

Keep accurate and up-to-date records in case notes for your own benefit and for the benefit of any other worker who may take over the case in the future.

Activity 141. Imagine you are a client being referred to another service. What

feelings or fears might you experience during the transition process?

3.4 Encourage the person to advocate on their own behalf to access services

What is Advocacy?

Advocacy can be defined as ‘being a voice for (by speaking, acting or writing) your or the interests of others (either an individual or group) to promote, protect or defend rights’.

When advocating for others it involves:

Standing with that person or group Being concerned for their rights Being empathetic to their requests Being active on their behalf© BCA National Training Group Pty Ltdv1.0 February 2016. All printed copies are uncontrolled. 45


Advocacy services seek to increase the power and control that individuals or groups have over their lives.

Types of Advocacy

There are a variety of forms of advocacy.

Self-advocacy: This is when a person stands up and speaks for themselves. Self-advocacy requires the ability to make informed decisions and then taking responsibility for taking the steps to get the resources and help they require to achieve their goals. (See below for more detail.)

Peer-advocacy: Takes place when a person who has been through the advocacy process helps someone else through the process. For example, a person who has successfully advocated for their children at school helps another parent to advocate for their children.

Crisis-advocacy: This is when someone is used to advocate for a client in a one-off emergency situation, for example, to get into emergency shelter.

Professional-advocacy: Is when a person whose role it is to advocate provides advocacy on behalf of a client. Most often this person will work in or with an advocacy organisation. A list of these types of services in NSW is available at www.adhc.nsw.gov.au/individuals/support/directing_my_own_life/advocacy_and_information_services.

Self-Advocacy Skills

To facilitate self-determination and autonomy clients should be encouraged to either self-advocate or be moving towards self-advocacy whenever practical.

When helping a client to advocate on their own behalf you should help the client to:

Gain a good understanding of their strengths and weakness to understand what they can or can’t do and where they might need help or development.

Get a clear understanding of their needs and wants. What exactly are they hoping to get?

Have a clear understanding of their legal and moral rights, Know who they will need to contact and how to make that contact. Be clear about the steps in the process and how long it is likely to take. Have all their documentation in order. Practice speaking up for themselves so that they are assertive, not passive or

aggressive. Be aware of what resources are available to them and how to access those

resources. Understand that they can come back to you for support and help at any

stage.


http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life/advocacy_and_information_services

http://www.adhc.nsw.gov.au/individuals/support/directing_my_own_life/advocacy_and_information_services


Activity 151. When have you had to advocate for yourself? What steps did you take

and what was the result?



4. Complete reportingIn this section you will need to demonstrate that you can:

1. Document the outcomes of the assessment process according to organisation procedures.

2. Maintain and store the person’s information according to confidentiality requirements.

3. Provide the person’s information to other services according to consent and confidentiality requirements.

4.1 Document the outcomes of the assessment process according to organisation procedures

Recording

Organisations must adhere to legislation, standards and their own policies and procedures when documenting, maintaining and storing client’s information.

To ensure that you adhere to these requirements you should:

Always keep your case-notes up-to-date: The best way to do this is to have a schedule which allows you to write up

notes either during client appointments or immediately after client appointments. Some services will provide a monitor so that the client can see what is being written in their case notes.

If this is not possible, then have a time during each day to keep client notes up-to-date within 24 hours. Research indicates any extended delay in recording records will result in less accurate records.

Case-notes should include: Notes about appointments Notes regarding conversations or communication with other services Records of assessments Actions taken to support the client such as phone calls, emails, referral

letters Client case plans Details about the client gathered in the assessments or ongoing

appointments

Reporting assessment outcomes

As a result of internal or external assessments you may be required to report assessment outcomes. There are several instances where total confidentiality is either impossible, undesirable or illegal. These include:

Cases where the law requires disclosure of information which will be



if the health and/or welfare of a child or young person is at risk. (See Mandatory Reporting section below.)

if your client tells you he/she has committed a serious crime. You are required to notify your supervisor or the police directly.

if a worker is subpoenaed to present information in a court of law When the client needs to be protected from harming themselves (e.g. If

suicidal) Where others may need to be protected (if the client has threatened to harm

others or will do so inadvertently) The need to keep records When working in conjunction with other professionals in caring for a client The requirements of professional supervision, training, workshops or seminars

Child abuse and neglect

In all states and territories, many professionals in contact with children are required by law to report child abuse. This is known as ‘mandatory reporting’ or ‘mandatory notification’. Typically, the requirement applies to people working in health, legal, childcare and educational services.

Details about Mandatory Reporting are covered in other units.

Elder Abuse

No older person should be subjected to any form of abuse, often referred to as ‘Elder abuse’. Elder abuse can take various forms such as physical, psychological or emotional, sexual or financial abuse. It can also be the result of intentional or unintentional neglect.

Elder abuse can be defined as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” (World Health Organization).

If you are concerned about elder abuse you may want information about the issue, or the opportunity to talk to someone independently about your concerns and the options for getting help. Each state and territory provides information about abuse, abuse prevention and useful contacts.

(Source: www.myagedcare.gov.au/financial-and-legal/elder-abuse-concerns)

Infectious Diseases

Staff may be required to report on assessments regarding infectious diseases for the welfare and safety of other service users. Notification of infectious diseases to the local Public Health Units is normally required by medical practitioners, hospitals, pathology laboratories, primary schools and child care centres. Staff are not to diagnose suspected Infectious Diseases rather, help is to be sought by a qualified medical professional. Staff should be familiar with information for each infectious disease outlined at http://www.health.nsw.gov.au/PublicHealth/Infectious/a-z.asp


http://www.health.nsw.gov.au/PublicHealth/Infectious/a-z.asp

http://www.myagedcare.gov.au/financial-and-legal/elder-abuse-concerns


WHS Risks

Everyone is responsible for Work, Health and Safety. Your service will have guidelines for reporting risks and hazards which you need to follow. If you are unsure about how to access or use the reporting documents you should contact your supervisor.

Activity 161. Research and note down to whom you would report Child Abuse or

Elder Abuse in your state?

4.2 Maintain and store the person’s information according to confidentiality requirements

Guidelines relating to parameters of confidentiality/client consent

Clients have a right to have their confidentiality respected and observed and are be informed of situations where that confidentiality may be limited. Confidence in confidentiality is an extremely important issue for clients disclosing issues of domestic and family violence. A breach of trust in this area may put clients in danger and affect their willingness to disclose in the future. Services must:

Clearly outline when confidentiality limits apply. (Refer to Section 4.1) Have a system in place for the safe storage and retrieval of records and

client data. Report breaches of confidentiality.

The confidentiality statement to the client should state:



Limits of confidentially such as the need to report suspected child abuse or neglect (in line with the services policy on suspected child abuse or neglect);

When there is the existence of coordinated services where information is shared across agencies;

The issue of duty of care e.g. a security threat or a situation where the woman, the children or any other person is at risk of serious harm;

Information may be shared in discussion of the case in supervision or team meetings.

Information may be shared due to a subpoena of information for Court proceedings

Confidentiality and security

Maintaining confidentiality requires keeping information and documents in a place that can’t be easily accessed by non-authorised people.

To ensure this:

Rooms that hold confidential information should be locked. Filing cabinets should have locked drawers. Computers should have passwords and screensavers that quickly lock an

unattended computer. Case notes should not be left where they can be read.

Ways of maintaining confidentiality are to:

Talk with clients in private rooms where you cannot be overheard. Only discuss cases with relevant people. De-identify records by using case numbers when discussing cases

Most records are kept for as long as they are in use by the organisation or for the length of time that the client receives a service. In some cases legislation requires the archiving of client files for 7 years and each organisation needs to be familiar with the legislation as it applies to their service and client group. Any confidential information must be shredded before it is sent for recycling.

Breaches of confidentiality

Breaches of security or confidentiality need to be reported immediately. Examples of how breaches can occur are:

Sharing of personal information without legitimate purpose. Carelessness with documents or information. Providing passwords to unauthorised persons

Your organisation will have specific procedures for reporting breaches. These often provide penalties for staff that will vary depending on the seriousness of the breach and whether it is a repeat occurrence. These could include:

official warnings notes on file disciplinary record referral to mediation or board suspension



dismissal

If a person believes their privacy or confidentiality has been breached, then they are able to make a complaint with the Office of Australian Information Commissioner at www.oaic.gov.au

Privacy Principles

Refer to Section 1.5 for information on Privacy Principles.

Activity 171. What actions have you seen that could have resulted in a breach of

confidentiality? What happened and what was the result?

4.3 Provide the person’s information to other services according to consent and confidentiality requirements

Consent and Confidentiality & Referrals

When providing client information to other services it is essential that you comply with consent and confidentiality requirements.

Consent has been discussed throughout this document. Refer to Section 1.5 for a detailed discussion about informed consent.

Confidentiality was discussed in Section 4.2. How to make a referral was discussed in Sections 1.3, 3.1 and 3.3.

Process for sharing information

Your service will have a policy and procedure regarding how information is to be shared with other services so that you comply with consent and confidentiality requirements.

Activity 18




1. If you had a client who was unhappy with how their information had been shared they could make a complaint at www.oaic.gov.au. Research what steps they would have to take to make a complaint and the potential outcomes.




5. Evaluate assessment and referral processes


1. Seek feedback about assessment processes from the person and other networks.

2. Monitor processes and their outcomes in terms of success in meeting the person’s needs.

3. Routinely seek feedback and reflect on own performance.4. Use feedback and own evaluation as a basis for improving processes.

5.1 Seek feedback about assessment processes from the person and other networks

Good governance

Good governance standards require client participation and feedback. Following is an example from governance guidelines for Community Service organisations in the ACT.

Standard 4.2.3 Client participation and feedback: Participation of clients in the decision-making processes of the service is valued and actively encouraged. Features of good practice are: A range of strategies and processes are used to gain regular and ongoing

client feedback about the overall running of the service. Processes used are flexible and take account of the individual and cultural

attributes and preferences of clients. Written information for clients includes information about how clients can

be involved in the decision-making processes of the service. Clients have the opportunity and support to have input and influence

decisions about services provided to them and to provide feedback about their experience of the service.

Information from clients is used in planning and evaluation and the service can demonstrate improvements that have resulted from input from clients.

The way clients are encouraged to be involved assists them develop skills and interest to take up opportunities for participation in the wider community.

Client feedbackHaving an unbiased appraisal of your own work performance is difficult, we tend to either be over or under critical of our own performance. So along with self-evaluation we need to get feedback from others including clients, their family, and our work colleagues.



Getting feedback from a range of sources can be done using systems like a 360-degree feedback system, or using methods such as feedback forms.

360 Degree Feedback is a system or process in which employees receive confidential, anonymous feedback from the people who work around them. This typically includes the employee's manager, peers, and direct reports. A mixture of about eight to twelve people fill out an anonymous online feedback form that asks questions covering a broad range of workplace competencies. The feedback forms include questions that are measured on a rating scale and also ask raters to provide written comments. The person receiving feedback also fills out a self-rating survey that includes the same survey questions that others receive in their forms. (http://www.custominsight.com.au/360-degree-feedback/what-is-360-degree-feedback.asp)

Once you have gained feedback you need to integrate the feedback into your professional development plan so that you overcome those areas of weakness and improve your ability to provide excellent client care.

Client feedback can come from other sources such as:

Client compliments, suggestions or complaints. Surveys (written or online). Focus groups. Feedback can also come from statistics where client outcomes are measured

against standards. An example could be the number of client contact hours you have compared to the industry standard or from the average of contact hours of your colleagues.

Feedback from other services can come from: Interagency meetings where you request feedback from other services. Case conferences in which you review how each service has been

contributing to the assessment, service planning, and service implementation.

Funding agencies who can provide details about how your service functions compared to other similar services.

When asking for feedback from other services you should seek information regarding their experience of your service to do with:

Your capacity to effectively deliver services to meet the needs of your clients.

The referral processes between agencies. The appropriateness of the roles you have fulfilled. How supportive you have been to other services in the network. Whether together your services are extensive and comprehensive enough

to meet the needs in the community.

Activity 19



1. You have been asked to get feedback from a client regarding how well your service has met their needs and provided appropriate referral services. Create a list of at least five questions you would ask.

5.2 Monitor processes and their outcomes in terms of success in meeting the person’s needs

Monitoring and measuring outcomes

In Section 5.1 we discussed that organisations must meet standards. We looked at the example of good governance which requires getting feedback from clients.

Assessing how we have met the needs of the client includes but is not limited to the feedback from the client. Feedback from the client, although critical, may not give the full accurate picture of how well the service is performing.

Other methods of measuring outcomes include:

Benchmarking: Is the process of comparing your services process and outcomes to those services who are considered the best in your sector. For example, you might be a Rehab Service who has 72% of clients complete the program. Unless you know the results of others it is hard to assess whether you are doing a good or poor job. If the average in the sector was 65% and the top performers were at 78% you could then rate your service.

Satisfaction surveys: Is getting feedback to measure how satisfied a client or other service is with the service you have provided. You can measure satisfaction over time to compare your current performance with previous performance, or compare with industry benchmarks.

Audits: An external audit is a methodical and systematic review by an outside agency of how well your systems operate. For example, it might assess your complaints system to see if it is being used and how complaints have been dealt with. An internal audit might use checklists to check that processes are being followed or have been completed in appropriate timeframes. Examples of audit checklists can be found at http://communitydoor.org.au/organisational-resources/administration/policies-procedures-and-templates/governance-and

Key Performance Indicators: KPI’s are a measureable value used to assess how well workers or services are performing. For example, a KPI could be to


http://communitydoor.org.au/organisational-resources/administration/policies-procedures-and-templates/governance-and

http://communitydoor.org.au/organisational-resources/administration/policies-procedures-and-templates/governance-and


return all enquiries within 24 hours. You would then keep a record of how quickly your service returns inquiries and assess it against your KPI.

Dashboards: Are a way of displaying key statistics relating to service to measure effectiveness. NSW Family & Community Services presents its results in this way at http://www.facs.nsw.gov.au/facs-statistics

Results based accountability: Results-Based Accountability, also known as Outcomes-Based Accountability, is a disciplined way of thinking and taking action that communities can use to improve the lives of children, youth, families, adults and the community as a whole. RBA is also used by organisations to improve the performance of their programs or services. More information available at http://resultsaccountability.com/

Activity 201. Which measures of client outcome are you familiar with? Research

one you are not familiar with and explain how you would integrate it into your work.

5.3 Routinely seek feedback and reflect on own performance

Seeking feedback

Getting feedback has been discussed in Section 5.1 and 5.2

Reflecting on the feedback you have received is discussed below in reflective practice.

Reflective practice

Reflective practice is a way of thinking about your own experiences to improve the way you work. It is very useful for those who want to carry on learning throughout their lives. The act of reflection is a great way to increase confidence and become a more proactive and qualified professional.

Neil Thompson, in his book People Skills, suggests that there are six things you can do to increase your skill in reflection:


http://resultsaccountability.com/

http://www.facs.nsw.gov.au/facs-statistics


Read - around the issues you work in and want to develop Ask - others about the way they do things and why Watch - what is going on around you Feel - pay attention to your emotions, what prompts them, and how you deal

with negative ones Talk - share your views and experiences with others in your organisation Think - learn to value time spent thinking about your work

One way of describing the Reflective Practice process is the following Reflective Learning Process:

Step 1 : Identify a situation you encountered in your work or personal life that you believe could have been dealt with more effectively.

Step 2 : Describe the experience: What happened? When and where did the situation occur? Any other thoughts you have about the situation?

Step 3 : Reflection: How did you behave? What thoughts did you have? How did it make you feel? Were there other factors that influenced the situation? What have you learned from the experience?

Step 4 : Theorising: How did the experience match with your preconceived ideas, i.e. was the outcome expected or unexpected? How does it relate to any formal theories that you know? What behaviours do you think might have changed the outcome?

Step 5 : Experimentation: Is there anything you could do or say now to change the outcome? What action(s) can you take to change similar reactions in the future? What behaviours might you try out?

Another way of practicing reflective practice is to use the stages described in the table below:

Reflective Practice Stages

Questions Example

Description What happened? A client yelled at me and I yelled back at them

Feelings What were you thinking and feeling during the event?

I was feeling threatened and felt angry that they were treating me this way after trying to help them. I was thinking they should be grateful not angry at me.

Evaluation What was good and bad about the experience?

I responded in anger and yelled at them. I modelled a bad response. I increased the aggression in the situation.



Analysis What sense can you make of the situation?

Did any previous experiences or beliefs negatively impact this interaction?

When I allowed myself to raise my voice.

I had previously been assaulted by a person who looked and sounded very similar to this client and so I went in with heightened emotions.

Conclusion What else could you have done?

I could have told them that I would leave the room if they continued to yell, and then could have left the room. I could have sat down instead of standing up. I could have taken a break before this appointment as I knew it was a stressful client.

Action plan If it arose again what would you do?

If a client begins to yell at me I will:

Consciously take a few deep breaths

Inform them that I will leave the room if they continue to yell

Only return to the room with another worker

Debrief with another worker afterwards so that I have time to calm down before seeing another client.

Activity 211. Think about a time you did not act in a way that you were happy with.

Complete a Reflective Practice exercise using one of the examples from above



5.4 Use feedback and own evaluation as a basis for improving processes

As a result of personal and organisational feedback, reflective practice and comparison to best practice of the sector, we are able to move towards improving our processes to better meet the needs of our clients.

One of the ways of thinking about this is the PDSA model for improvement which is discussed below.

The Plan Do Study Act model for improvement

The Plan Do Study Act (PDSA) model is a simple but powerful tool for improvement. The model provides the opportunity to develop, test, and implement change so as to continuously improve.

The PDSA model two stages:

Ask the three questions to set the context of the improvement. (1) What are we trying to accomplish? (2) How will we know that a change is an improvement? (3) What changes can we make that will result in the improvement?

With the answer to the above questions we then complete the PDSA cycle as described below.

Step Description

Plan Plan the test or observation, including a plan for collecting data:

State the objective of the test Make predictions about what will happen and why Develop a plan to test the change: who? What?

When? Where? What data needs to be collected?

Do Try out the test on a small scale:

Carry out the test Document problems and unexpected observations Begin analysis of the data

Study Set aside time to analyse the data and study the results:



Complete the analysis of the data Compare the data to your predictions Summarise and reflect on what was learned

Act Refine the change, based on what was learned from the test:

Determine what modifications should be made Prepare a plan for the next test Implement improvements on wider scale, if

appropriate

Activity 221. Consider an aspect of your life that you would like to improve.

Complete the PDSA model to plan a test to improve.



Assessment Tasks Answer the following assessment questions and complete the assessment activities. If you receive an outcome of Not yet satisfactory for any part of the assessment you will be supplied feedback and have the opportunity to resubmit your revised assessment.

To receive an outcome of Competent you will need to be assessed as Satisfactory in the following tasks and signed off as Satisfactory.

Assessment Task One: Short Answer Questions1. You are conducting an informal assessment with a client who has

come to see you for help with alcohol dependence. Give one example of something you might say to the client that would empower them to identify and prioritise their own needs, and one example of something you might say that would inhibit their ability to do this.

2. You will need to draw on a range of information in order to evaluate the needs of a client. List five potentially helpful sources of information.



3. The assessment method that you use for a client will depend largely on context and on the individual being assessed. For each of the following, describe the function of the assessment method, and name a context in which the method would be useful.

a) Informal assessment

b) Formal assessment

c) Domain-based assessment

d) Norm-based assessment



e) Strengths-based assessment

f) Competency-based assessment

4. An IQ test is an example of an assessment tool that may be used for Norm-based assessment. Select two other assessment tools and describe what they are, and which type(s) of assessment(s) they are used for.



5. Describe the impact that setting (e.g. home, community centre) may have on the assessment process.

6. Explain how requirements related to validity and reliability may direct your work in assessing a client’s needs.

7. Explain the basic process of documenting, maintaining and storing information about the assessment process (bearing in mind that these practices may vary according to organisation and role, and should always be in line with confidentiality requirements).



8. Briefly outline under what circumstances you would need to report a client’s issues, and describe what you would need to include in a report.

9. You may conclude that your client needs to be referred to another service. Explain your responsibilities and boundaries when it comes to sharing the person’s information with other services, according to consent and confidentiality requirements.

10. Explain why it is important to seek feedback from the person (and others if necessary) about the assessment process, and describe how you would go about doing this.



11. Explain how often you will seek feedback and reflect on your own performance, and indicate how you will respond to feedback so as to improve your performance.

12. Apart from seeking feedback, give two examples of ways in which you might monitor your process and its success in meeting the client’s needs.



13. Research a service that provides community assistance in each of the following areas. Briefly describe the features of the service, and outline what a client may expect from it.

a) Employment

b) Physical and mental health

c) Housing

d) Community support

e) Social inclusion



f) Education and training

g) Financial support

14. Explain why it is important for clients to advocate on their own behalf to access other services. How will you encourage a client to do this?



Assessment Task Two: Research1. Research the following areas, and write approximately two

paragraphs on each, outlining the nature of the area and its potential impact on a person, as well as any needs or issues that might be associated with it.

a) Mental health

b) Alcohol and other drugs



c) Imprisonment

d) Child protection



e) Family violence

f) Homelessness



g) Poverty

h) Health

.



i) Age

j) Disability



k) Behaviours of concern

l) Employment



2. Select three of the above issues, and write a paragraph explaining how these issues might be interrelated.



Assessment Task Three: Case StudyThe following task will be based on a case study scenario. You will need to answer the following questions based on this scenario and how it applies to your role within the community services context.

Ramzi, Mena and Ahlia

Mena (32 years) has recently been referred to your organisation for assessment by her GP, who is concerned about her mental health. Her husband, Ramzi (42 years), migrated to Australia from Egypt 10 years ago. Ramzi had been working as a draughtsman in an engineering office until six months ago, when on his way to work, he was hit by a car and suffered significant brain injuries. He is in the local rehabilitation hospital but is unlikely to regain many of his capacities. The long-term prognosis is that he will require high level care for the rest of his life. Mena has only been in Australia for five years (she is also from Egypt) and speaks very little English. Her parents, as well as Ramzi’s, are still in Egypt.

Their four year old daughter, Ahlia, was diagnosed with autism a couple of years ago and is showing signs of significant behavioural issues. Ramzi was better able to care for Ahlia as he had the physical strength to control her when she had tantrums and the patience to settle her. He was also able to communicate with the therapist working with Ahlia and was able to follow through on any exercises she set for them.

Since Ramzi’s accident, Mena’s own health has deteriorated and she has recently started taking anti-depressants. Ahlia’s therapist has contacted the child protection agency stating that Mena appears to not be coping with Ahlia. She reports that there is bruising on Ahlia’s arms and that Ahlia’s condition has regressed, making her very difficult for Mena to manage her.

1. You are preparing to assess Mena, in order to decide on what treatment and services will be most useful for her. (When answering the following questions, you will need to bear in mind the role that your organisation’s policies and procedures will play in assessing clients.)

a) Identify which type of assessment you think will be most helpful for Mena, and explain the benefits of using this method.



b) Briefly outline which assessment tools and processes you will need to prepare prior to assessing her.

c) Mena’s issues are complex and interrelated. Summarise in dot points the existing information that you have regarding Mena’s case, and explain what you believe her main issues and needs might be.



d) Who might you speak to in order to obtain more information regarding the potential issues that may be affecting Mena?

2. You are conducting your initial assessment of Mena. Compose a dialogue between you and Mena in which you explain the assessment process to her and obtain her consent, as well as organise and establish the practical aspects of the assessment that is about to occur. (Note: a translator would likely be present in this situation. Assume that the dialogue between you and Mena is being translated, and write your response in English.)

3. List and describe three strengths-based tools or services that you might incorporate into this assessment, or consider when referring Mena to other services.



4. Outline the roles and responsibilities of each of the following in Mena’s assessment: a) The community worker

b) Mena

c) Mena’s family



d) Mena’s GP

e) Ahlia’s therapist and any other health practitioners

5. List at least three indications that Mena’s situation is or has become urgent.



6. Based on the information you have about Mena, what services do you believe she may be eligible for? Research and describe three to five services or networks (internal and/or external) that might be appropriate for Mena.



7. For each of the services described above, give an example of information you might supply Mena in order to assist her decision-making process.

8. Explain how you will respond if Mena refuses any of the services you have suggested, or makes a decision regarding her needs that you do not agree with.

9. Outline your legal and ethical responsibilities relating to the assessment, referral and reporting process for Mena, in the following areas: a) Privacy, confidentiality and disclosure



b) Duty of care

c) Informed Consent

10. In a case as complex as Mena’s, explain why it will be important for you to be aware of and work within the limits of your role, and seek assistance from others as necessary.



11. Outline at least three risks that might be associated with Mena’s case and the delivery of services to her.



Assessor ChecklistUnit of competency CHCCCS004 - Assess co-existing needs

Student name

Assessment Task 1: Short Answers

Satisfactory Not yet satisfactory

Assessment Task 2: Research Satisfactory Not yet satisfactory

Assessment Task 3: Case Study Satisfactory Not yet satisfactory

Workplace Logbook/Workshop Practical Skills Display

Satisfactory Not yet satisfactory

Comments:

Assessment decision Competent Not yet competent

Signature Date



Appeals process: For information regarding BCA National’s appeals process please refer to the Student Handbook.



Useful LinksAustralian Institute of Family Studies: Evidence Based Practice

https://aifs.gov.au/cfca/publications/evidence-based-practice-and-service- based-evaluation

Australian Psychological Society: Evidence Based Interventions

https://www.psychology.org.au/Assets/Files/Evidence-Based-Psychological- Interventions.pdf

ACT Council of Social Services: Networking

http://www.actcoss.org.au/about/networks.html

Net Spaces: Networking

http://networks.communitydoor.org.au

The Office of the Australian Information Commissioner: Privacy

www.oaic.gov.au

University of Wollongong: Screening and Assessment tools





http://networks.communitydoor.org.au/



