Self - Directing and Support Worker Role (ndis)

The National Disability Insurance Scheme gives participants and their families and/or their carers choices around how they want to be supported; the support agencies they want to access and the times they would like support.  On my blog we have explored many choices on how you can ask for your ndis plan to be administrated. 

One of these options is to self manage, if you are self-managing your plan or someone you care for, you are the person responsible for spending the funds as set out in your plan.  You might remember I shared information on some of the supports you can access to enable you to do this effectively.  For example you can ask the ndis for a plan manager, this is a person or organisation who can advise you on budget choices and usually pays your invoices on your behalf.  What services and supplies you access is up to you.

Self-managing gives you the greatest flexibility under the ndis, as you are not restricted to using a ndis provider.  For example you can use any registered physiotherapist, if physio is included in your ndis plan.  If you struggle with housework you may prefer to hire a cleaner rather than a support worker, so you can use that money on other things.  If you are self-managing you can use your plan to pay anyone with an Australian Business Number to provide you with support.  However, there are some things you will need to be mindful of. 

There are a number of ways you can engage support workers.  

1. Self - directing support staff services.
2. Agency support staff
3. Support staff with their own ABN
4. Setting up your own personal support services. 

Every employer has a duty of care to their employees and their clients, to do this they develop policies and procedures along with general guidelines on how to support clients.  Different organisations will require different levels of training.  If you are self-directing you can decide the level of training you want for your staff.  However there are industry requirements around training for some types of support. e.g. peg feeding and manual handling.  An employer has a duty of care to provide the correct training to protect their staff and clients.

So what happens when support is provided under an agreement of two parties ie you the participant and the support worker.  If the worker has their own ABN then they are responsible for their insurances and payroll.  You have the right to ask for any documentation that will ensure your safety.  This is not a friend doing you a favour and thus you need to check their qualifications. I recommend that you put together an agreement, something in writing and print a copy as digital files can be altered after things go wrong. 

So you want to spell out what happens in an event of an emergency. Is the worker and participant covered for injury and how? What is the paid rate and are you guaranteeing a set number of hours?  What happens if there is a disagreement between the two parties, how will workplace disagreements be resolved? Do you have someone who can play a mediator role?  There are advocacy services you can access if things get off track, but a written agreement that sets out how things will be resolved if any party involved is not happy is required.

So if your are directly employing a support worker you have the sole responsibility to provide working conditions under the employment act, and you can read this online or contact employer services.  In this post I am only discussing what you might term human service not the financial responsibilities.  So that is things around duty of care, insurance and work place practices; professional and personal boundaries.  In any work agreement of this nature both parties have a legal obligation to show due care for the other.  This covers accident and income protection; physical, emotional and psychological harm.

I know participants not considering these things fully when engaging workers, but I personally do not want to go down that track.  I want to care for my workers workplace needs so hopefully they will also do the right thing by me.  So what happens in the absence of polices and procedure?

Many organisational policies are developed around different legislation such as work, health and safety.  This applies to all workplaces and if you are engaging staff to support you, you must provide safe working conditions. This is something that falls under due care.  If you require someone to work more than 10 hours than that could be seen as not taking due care for a worker.

Regardless of how a support worker is engaged, there is an industry standard of practice and this too can be found online.  I would be wary if any worker, that dismissed any legal responsibilities and workplace safety.  e.g I do not have to follow PPE.  I got this a lot when I accessed traditional support providers,  Nah, we can wear thongs.

As an ex-member on a Board of Management of a Service Provider, I know under workplace and safety laws closed-in shoes must be worn.  I like to say if my health and well-being is at risk I have a right to feel safe and I don't feel safe if you are pushing my manual wheelchair in thongs and if I am hurt that will come up in a court of law.  So if I have trouble asking for professional boundaries when people are employed by an organisation what hope do you or I have with only a working agreement?  I have tried it once and for a long-term working relationship I would not do it again. 

Support workers are very forward about their personal comfort, and their perceived duty of care, that they often overlook the obvious. Like coming to work with an injury or when they are emotionally unfit because they need the money.  

People will do anything they think they can get away with. Which is why I think participants who self-direct need good personal boundaries as well as ensuring professional boundaries are followed. 

PROFESSIONAL BOUNDARIES

Professional boundaries apply when there is a working agreement between two parties, this can be either paid work or unpaid work and does not apply to friendship where a person might be 'just doing a good deed'.  This is why you want a working agreement in place, so you have a clear line defining the person is 'at work' not just hanging out with you.  In most industries when care and support is given there is a code of practice among privacy, confidentiality and respect.  In my opinion the code of practice stands regardless of who a support worker is engaged with.   That includes being contracted under their ABN.  Using an ABN does not make the support worker the boss.  This is referred to as self-directing support for a reason and that needs to be made clear at the start of the working relationship.

For me, whether we're talking about privacy or confidentiality, respect for the person is involved.  Participants due to the nature of their disability need to allow workers into their private lives and homes.  For some participants who require high personal care, that will require contact with private areas of the body.  The participant has a right to feel respected at all times.  I am unsure if some workers are fully aware how much trust we are required to put in them.

What is private and what should be kept confidential? So obviously as a epileptic I want my workers to pass on some private information to people who are providing medical care.  Things like Deb is allergic to . . . . . while I am not going to give you that information, I want the paramedics and hospital staff to have it.  I also access a medical on-call service so I also want them to have that information.  However, anyone outside the call center should be told nothing of the emergency situation.  So a support worker should not be saying anything about a medical incident that occurs at work.  Personally, I don't mind my workers saying Deb had a seizure today, a partner is a good person to give a debrief.  Any details of the incident are private, unless an incident report needs to be written for a workplace.  Unless my seizures are out of the ordinary or my seizure response plan is not followed my  providers are not required to write a report.


As incidents occur, I realised bending rules like support workers family members knowing where I live is not fair.  I had a worker whose partner dropped her at work.  When the two broke up and she took out a Apprehension Order against him, he knew where she worked and the time of her shift and he would wait for her to leave. What seem like a harmless breech in client confidentiality put my personal safety at risk.  Most policies and professional boundaries are there for a reason. 

This why service providers discourage friendships. Friendships blur the professional boundaries. I also think my definition of 'friendship' is different to most people.  I have a wide circle of friends and an even wider circle of colleagues.  I do not consider even artists in Ipswich as my friends, but there are a small number I have a very close relationship with.  While I am to a certain extent very open, there are some things I only share with people I trust. 

While self-directing has certainly changed the dynamics between myself and my team we regularly discuss our work boundaries and we check in with each other.  Is there anything I am doing that you are uncomfortable with?  Of course this is much easier to do in a team where we all have strong personal boundaries, it is much more difficult when people don't respect my personal boundaries. 

I engage some of my workers through a self-directing service, these staff are hired and trained by me, but are employed by a service provider and I don't share them with other clients.  However, as my readers know I engage staff through online platforms such as Hire-Up and Mable.  While both these companies do have duty of care to me as a client, some of the agreements are much more causal. So even though both I and the worker are aware of workplace health and safety laws,  workers still turn up in thongs and want to debate PPE policies.  

You can only imagine if workers are challenging policies enforcing laws what other boundaries a blur are bent or broken.  Everything is fine while all parties remain respectful,  but when trust is broken or one party feels taken advantage of, what seems harmless at the time can lead to repercussions.  Recently, I have experienced this with workers, who talk freely about other clients they work with and who may be expecting I might want a similar working relationship as other clients.

Like I say I am abundantly blessed in the friendship department and I do not pay any of my friends to give me a lift to a function we're all attending, or to pick up a few things at the shops.  When workers discuss other clients as if they are friends, what are they saying about me to other clients?  When workers share mutual clients and I have a fallout with one worker, how does that affect other workers on my team and any clients they may share? 

Clients should never be discussed with other clients or in front of them even if it is not private information.  As far as I am concerned what happens on shift or in my home stays on shift, if I am being told personal information about another client, I am sure my personal information is being shared also.  I, like every other Australian have a right to know who knows what about me in the event we might one day meet.  What workers share with other workers could be classed as gossip and hear say. Likewise, if workers talk to me about other team members about anything unrelated to me, then I have no yard stick to know if it's the truth or not.  Not to respect someones privacy is just bad work practice.

These are gifts to offer as friends and do not expect anything in return.  When workers give me gifts and do favours, I get worried.  I don't mean when they bring me produce from their garden because they know I will return the favour.  I mean things like buying me hair accessories so they can put them in my hair.  This means a worker is making choices on my behalf and I feel obligated to accept these and be grateful.  This too is harmless and things can and have previously spiraled out of control.  Maybe for some I am too black and white. 

Communicating with workers on social media seems harmless especially when you have an open and honest relationship.  However when boundaries are already blurred, i.e. I am told things about other clients, then what seems like a very safe post about enjoying a night out, can hurt a client who you lied to and cancelled their shift.  If you are cancelling to catch-up with friends, just be honest. Something just popped up would you mind. . . .  I now need to consider if I would be friends on social media with workers I engage in the future. 

I do believe participants who have strong personal boundaries and work with workers who have good professional boundaries even if a participant is self directing, as long as both parties respect each others boundaries even friendship on some level is possible.  I am also aware as an artist and public figure, boundaries are already blurred, so I like to discuss this up front at the beginning of working agreement.