Self directing, personal boundaries and the ndis

One of the many choices participants can now make under the National Disability Insurance Scheme is to self-direct their own supports team.  This can occur under a number of different models.

1. Some support services offer self-directive services.  This is where support workers are employed by the service to work with a specific participant.  The service I use offers several different ways to self-direct.  Having strong professional boundaries is important to me so I wanted policies and procedures to protect both my workers and myself.
2. There are new types of support services emerging as participants are encouraged and empowered to direct more of their supports.  Participants can completely self-direct through becoming a sole-trader with an ABN  (Australian Business Number) or they may contract workers who have an ABN. 
3. In addition to the staff I engage through the support service provider, I have been engaging staff through online platforms like Mable and Hire Up.  These companies offer the legal protections under their policies and procedures.  Participants agree to follow these when they sign their service agreements.  
4. If you are engaging your own support workers through their ABN or your own then I would recommend there be a written agreement of what happens if either party is injured, hurt or abused in anyway.  As an employer I want to ensure my staff feel valued and protected at work or they waver their right to compensation if they are injured.  These are some of the issues participants are not considering when they engage support staff.

When you're thinking about engaging your own worker, you need to be clear on:

1. The personal qualities of the worker.
2. The types of activities you will be doing together.
3. Will the worker be required to drive.
4. What hours are available and what is the pay rate.

Traditional providers have a screening process to ensure workers are trustworthy and will treat clients well.  As an individual you too can request your workers have police checks and road worthy certificates if you are traveling in their cars. It's all well and good to say your working partnership is based on trust and honesty, however when things go wrong, people become bitter and self protective. Sometimes things end up in court.  Policies and procedures of services are there to protect participants and support workers. 

What does a support worker do?

Under the ndis the support workers role is to empower participants to achieve their ndis goals. Historically Lifestyle Support Workers were carers or personal care attendants, depending on what the needs of the person with a disability were.  These workers had a 'care roll' and a sense of responsibility for their clients.  Today a 'carer' refers to an unpaid person who plays a caring role in the participants life. In most cases this is a parent or family member. A common community misconception is that all people with disabilities have carers. 

Carers are often legal guardians of adults over the age of 18 that need protection in some aspects of their life.  Usually in matters regarding money and the law.  Some people with disabilities for whatever reason prefer to use the public trust.  It doesn't matter who I am out and about with: a family member, friend or worker the general public assume it is a carer.  Over the years I have had all sorts of questions, including Do I need to call someone to check it's OK to spend $20?

Umm! They could try my cat!  However even if I did have a guardian I would not need to check for such a small amount. This poses a good question on what are the responsibilities of a support worker.

Every worker engaged to support a person with a disability has a responsibility and duty of care at all times. However, this is not a decision making role. Most support services are moving towards a participant centered approach, where the participant directs how a support shift is structured, not the worker.  In some cases this will be guided by a parent or carer. And a support plan will direct the areas in which the participant needs more guidance such as handling money, behavioural support or medication.  In these cases workers must follow the support plan or they are legally responsible.  

Support plans are not guidelines or suggestions the are legal documents that are part of service agreements.  If workers do not follow plans and things go wrong, they will be held legally responsible.  As representatives of an organisation they must carry out directives in the support plan.  Platforms such as Hire Up and Mable do have support plans for all participants, part of their agreement in using the platform is agreeing to activate the participants support plan. 

Even if you are directly employing your own workers you can attach a support plan to a contract or working agreement. Support always works best when expectations are clear. No matter who is the employer, the participant is paying them under the ndis. They are directing. 

Boundaries are the things in our lives that protect us and those we are with from harm. A fence is a good example of a boundary, if a fence is locked then people can not enter a property. If it is a pool fence this keeps children from drowning.  So all boundaries whether they are seen or unseen provide protection.  However, not all people have good boundaries, people still try to break into houses. If we are working with people who have poor boundaries we need to ensure out personal boundaries are strong .  I do not allow people to smoke on my property, not even my family.  That is a personal boundary I have that I may not share with others.

If a worker is employed through an organisation there will be a policy around this and in Queensland there is generally a no smoking in the work place rule. As a participants house is a work place you can not legally smoke in their home.  There is also a professional code of practice a support worker must follow, these are referred to as professional boundaries. When support staff work in a community setting organisations and individual employers rely on staff to do the right thing. 

For me boundaries all come down to one thing, respect.  I like to remind people that respect is a two way street.  If you want to be respected and trusted you need to be respectful.  'Trust of a participant is not a given, it must be earned.' Under self-direction agreements where trust is broken a participant is entitled to end the agreement. Ultimately this may be the protection they need to take. 

In my home I have three very simple rules:

1. Respect for self (Worker) - own your own values and beliefs, know what they are and do not use them to influence others. (participants or team members).
2. Respect for participants, their family and their homes - Think how you would feel having to let people into your home, your personal space and bedroom.  People with disabilities who need support have no choice. You need to respect their space. You do not need to interact every part of the shift, that is an invasion of privacy.  Participants don't want to hear your suggestions all the time, they want to be supported to live their own lives. 
3. Respect for other support workers or professionals in the participants lives, this may include family members. Your way of doing things is not the only way.  There is only really one right way,  the way you are directed.

To break any of my simple three rules means you will be asked to leave my house.  Likewise if you feel disrespected I would expect you to terminate a work agreement. In a ndis environment more and more we need to insist on good personal boundaries. 

In self-directing there should be not be an increased threat of harm to participants. My workers role is to empower me to achieve my ndis goals.