1.4 Independence and Informed Choice

Independence and Informed Choice

1.4

Version 6.1 January 2024

1.4 Independence and Informed Choice Contents Preamble ............................................................................................................................. 3 1.4.1 Individual Choice ..................................................................................................... 3 1.4.2 Dignity of Risk ......................................................................................................... 4 1.4.3 Client Autonomy ...................................................................................................... 4 1.4.4 Seeking Advice........................................................................................................ 5 1.4.5 Advocacy ................................................................................................................. 6 Procedures .......................................................................................................................... 7 Summary ............................................................................................................................. 7 Supporting Documents ........................................................................................................ 8 Policies ............................................................................................................................. 8 Forms ............................................................................................................................... 8 Information Sheets ........................................................................................................... 8 NGO Training ................................................................................................................... 8 Legislation ........................................................................................................................ 8 NDIS Practice Standards and Quality Indicators ................................................................. 9 1.4 Independence and Informed Choice .......................................................................... 9 Human Services Quality Framework ................................................................................. 10 3 Responding to Individual Need ................................................................................... 10 4 Safety, Wellbeing and Rights ...................................................................................... 10 Delegation of Authority....................................................................................................... 10 Version Details ................................................................................................................... 11

1.4 Independence and Informed Choice

2 of 12

Version 6.1 January 2024

Preamble BigDog Support Services Pty Ltd (BigDog) has a range of strategies to ensure communication and decision-making by the individual is respected and reflected in goals set by the person using services and in plans to achieve service delivery outcomes. BigDog has a commitment to individualised planning and goal setting utilising a range of planning tools.

1.4.1 Individual Choice The law presumes that every adult has capacity to make their own decisions. You can’t assume someone has impaired capacity without evidence.

‘Capacity’ is a person’s ability to: Understand the nature and effect of decisions.

Freely and voluntarily make decisions.

Communicate those decisions in some way.

BigDog supports the active decision-making and individual choices of each client, including the timely provision of information using the language, mode of communication and terms that the client is most likely to understand.

On a regular basis, workers of BigDog will find that they are involved in situations that require clients to make decisions that affect their lives. It should always be considered that the client making the decision is competent in the first instance.

Factors that influence the ability of informed decision making are varied as everyone has differing abilities and understandings. It should also be considered whether the person has had the opportunity to explore an appropriate medium in the exchange of information to the person. This aspect of the communication cycle is essential in any determination of the overall understanding and of informed decision making.

BigDog provides clients with information in suitable formats to allow the client to make informed decisions. It is important that the client can understand the information presented to them and any relevant family, friends or carers are involved in the development and review of the information. The information provided to the client is reviewed regularly to ensure it remains accurate, current and relevant.

Achieving individual outcomes requires collaboration between the client and BigDog to ensure active choice and decision-making. This means a joint effort based on mutual respect rather than the service making all the decisions. A focus on individual outcomes includes individuals and services working together to review progress against planned and measurable outcomes.

Workers always need to ratify a client’s decisions by the use of qualifiers. Qualifiers need to be determined through case meetings. They may simply be the use of a person who has a very good rapport with the client speaking with the client and recording the client’s response to the decisions that need to be made. More complex qualifiers may be necessary for clients with more profound levels of intellectual disability. These may be through repeated questioning in a variety of ways to gain a pattern of response over a period.

BigDog ensures that as far as possible, clients are making active decisions in how they are supported and that these decisions are incorporated into the client’s support plans.

1.4 Independence and Informed Choice

3 of 12

Version 6.1 January 2024

1.4.2 Dignity of Risk Dignity of risk is the idea that self-determination and the right to take reasonable risks are essential for dignity and self-esteem and so should not be impeded by excessively cautious caregivers, concerned about their duty of care.

BigDog supports each client’s right to dignity of risk in decision-making. Each client is supported to make informed choices about the benefits and risks on the options under consideration if needed.

BigDog recognises each client’s inherent right to freedom of expression and the right to make decisions about, and exercise control over, their own lives. This reinforces the fundamental right of people with disability to have respect and dignity, including the dignity of risk - the right to choose to take some risk in life.

Instances of overprotection are common for clients as caregivers, parents and friends will often try to shelter their loved one from life’s hazards. Although this generally comes from the best intentions, it can keep people from being who they want to be, which causes a loss of dignity, low self-esteem and underachievement.

To quote the author and disability rights advocate, Robert Perske “Many of our best achievements came the hard way: We took risks, fell flat, suffered, picked ourselves up, and tried again. Sometimes we made it and sometimes we did not.

Even so, we were given the chance to try. Persons with special needs need these chances, too. Of course, we are talking about prudent risks. People should not be expected to blindly face challenges that, without a doubt, will explode in their faces.

Knowing which chances are prudent and which are not – this is a new skill that needs to be acquired. On the other hand, a risk is really only when it is not known beforehand whether a person can succeed. The real world is not always safe, secure, and predictable, it does not always say “please,” “excuse me”, or “I’m sorry”. Every day we face the possibility of being thrown into situations where we will have to risk everything. In the past, we found clever ways to build avoidance of risk into the lives of persons living with disabilities. Now we must work equally hard to help find the proper amount of risk these people have the right to take. We have learned that there can be healthy development in risk taking and there can be crippling indignity in safety.”

BigDog encourages clients to make their own decisions about their life and ensures that as far as possible, clients are provided with potential risks and benefits for each of their options so that the client may make fully informed choices.

1.4.3 Client Autonomy BigDog recognises that each client is entitled to personal autonomy including the right to intimacy and sexual expression.

The opportunity to mix with other people of both sexes, whether socially, at school or at work, is important in developing confidence and social skills. However, some people with intellectual disability may have fewer opportunities to form social and sexual relationships for several reasons.

1.4 Independence and Informed Choice

4 of 12

Version 6.1 January 2024

These may include: a lack of privacy being dependent on others for daily living a lack of confidence about their physical appearance and ability less knowledge of how to negotiate relationships and express their sexuality a limited social circle and a lack of social experience physical or cognitive limitations carers who wrongly think of them as childlike or asexual carers who view their sexuality as something to be feared and controlled.

BigDog respects all client’s rights to form meaningful relationships and to express themselves in a suitable manner, whilst ensuring the protection and safety of all parties. This is achieved through supporting client’s rights to: be recognised as having a sexual nature just like anyone else explore and express their gender and sexuality have relationships based on consent, respect and safety choose when, whether or not to have sexual experiences learn lessons from life’s experience, with support and skill development where required control decisions which affect their sexual and reproductive health and relationships as much as possible

1.4.4 Seeking Advice BigDog ensures each client has enough time to consider and review their options and seek advice if required at any stage during their support, including assessment, planning, provision, review and exit.

BigDog focuses on empowering clients to make decisions and choices about their own lives.

With the consent of the client, BigDog encourages family, friends and carers to be involved with reviewing options so that effective input can be obtained which can allow the client to make informed choices.

It is recommended that arrangements to review planning activities be made: when the goals have been achieved or when there are changes in the person’s life that need to be recognised; or at any other time at the request of the clients.

BigDog workers must always demonstrate responsiveness to the changing needs, aspirations and choices of clients and communicate in a method that will facilitate appropriate decision-making options and choices. This will be supported by annual reviews of planning documents and service goals and by ensuring that attention is paid to the needs of the client to facilitate effective communication. This will include any augmented or alternative communication methods or equipment.

BigDog Directors and coordinators are available to respond to queries from clients and/or their guardians when looking to change or review the support arrangements in a timely manner and to ensure that there is a level of understanding and consensus between all relevant parties at all stages of the support.

1.4 Independence and Informed Choice

5 of 12

Version 6.1 January 2024

1.4.5 Advocacy BigDog supports a client’s right to access an advocate (including an independent advocate) of their choosing, as is their right to have the advocate present.

Advocating is speaking up for people with disability and helping them to get the things that they want and need.

Advocating for people with disability can be part of the work of BigDog. Sometimes when staff advocate for a person with disability there can be a conflict of interest. For example, a staff member must follow the rules of the service but you might want something different. If there is a conflict of interest, it is generally better for you to ask for help from a separate advocacy agency. They will be able to independently advocate on your behalf.

An advocate is a person you choose to speak for you. They make sure that people listen to you. They might help you with talking or writing letters. There are many forms of advocacy.

Self-advocacy is when you speak up for yourself. Advocates from agencies can help you learn about your rights and how to speak up for yourself.

Informal advocacy is when you ask a friend or family member to speak up for you.

Family advocacy is when an advocate works with your parents and family members, so that the family knows how to best help you.

Citizen advocacy is when an advocacy agency matches you with a volunteer. The volunteer gets to know you and finds out what you need. They speak up for you and help you to get the support you need.

Individual advocacy is when an advocate works with a person to sort out bigger problems.

These problems might be neglect, abuse or when your rights are not met.

External Advocacy may be through family, friends, Office of the Public Guardian, the Public Trust (financial matters) Public Advocate, Advocacy groups, Queensland Department of Communities, Legal services, or any other appropriate person.

BigDog should assist in all processes that bring forth appropriate levels of external advocacy and assist the external advocate to the required degree to gain the required information to provide that advocacy, as long as the proper consents have been obtained from the client for BigDog to do so.

The National Disability Advocacy Program NDAP provides people with disability with access to effective disability advocacy that promotes, protects and ensures their full and equal enjoyment of all human rights enabling community participation.

Advocacy for people with disability can be defined as speaking, acting or writing with minimal conflict of interest on behalf of the interests of a disadvantaged person or group, in order to promote, protect and defend the welfare of and justice for either the person or group.

The Disability Advocacy Finder is a web-based application that has been developed to assist people with disabilities, carers and their families, to search for Commonwealth and state and territory government funded disability advocacy agencies. https://disabilityadvocacyfinder.dss.gov.au/disability/ndap/

1.4 Independence and Informed Choice

6 of 12

Version 6.1 January 2024

Procedures The Directors and Management will ensure that: Services are provided by carefully selected, appropriately trained workers and volunteers, emphasising the personal qualities of our workers as much as their formal qualifications or professional skills.

Training, support and supervision aim to cultivate workers and volunteer’s capacity for hope, creativity, compassion, realism and resilience, Recruiting peer support workers where possible including people with disabilities or mental health issues.

Providing services in the least restrictive and most empowering way, in a manner which respects their privacy, dignity and confidentiality.

Respecting and upholding the human rights of clients.

Summary

The UN Convention on the Rights of People with Disability outlines key elements of independence for persons with disabilities: Individual autonomy The opportunity to be actively involved in decision making processes.

The opportunity to access the physical, social, economic and cultural environment.

Promoting independence for people with a disability can be a hard and confronting journey, because our instincts encourage us to protect and nurture.

But if we can embrace the uncertainty and commit to supporting a client on their journey, the result will be a positive and life-changing one for all.

The key areas for promoting independence in adults with a disability: Empower a client to make decisions and actively involve them in decision-making.

Trust others and build a support network in the community.

Be positive and celebrate small improvements.

Make learning a daily habit for all.

Focus on the 1% changes, and don’t get caught up trying to make a “big” difference, it doesn’t have to happen overnight.

1.4 Independence and Informed Choice

7 of 12

Version 6.1 January 2024

Supporting Documents Policies 1.0 Rights and Responsibilities 1.1.2 Communication

Forms Activities Risk Assessment Activity Risk Assessment Dignity of Risk Consent Form Schedule of Supports Service Agreement Supports Cost and Service Booking Calculator

Information Sheets BigDog Monthly Newsletter Human Services Quality Framework October 2021 Version 8 NDIS Practice Standards November 2021 Version 4 Service Information

NGO Training Duty of Care and Dignity of Risk Oral Health Person Centred Active Support Sexuality and Relationships

Legislation Child Protection Reform and other Legislation Act 2022 (QLD) Disability Services Act 2006 (QLD) Disability Services and Inclusion Act 2023 (Cwth) National Disability Insurance Scheme Act 2013 (Cwth) NDIS (Provider Registration and Practice Standards) Amendment Rules 2021

1.4 Independence and Informed Choice

8 of 12

Version 6.1 January 2024

NDIS Practice Standards and Quality Indicators BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.

The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS participants.

The four core modules are: 1.0 Rights and Responsibilities; 2.0 Governance and Operational Management; 3.0 The Provision of Supports; and 4.0 The Support Provision Environment.

1.4 Independence and Informed Choice Each participant is supported by the provider to make informed choices, exercise control and maximise their independence relating to the supports provided.

Active decision-making and individual choice is supported for each participant including the timely provision of information using the language, mode of communication and terms that the participant is most likely to understand.

Each participant’s right to the dignity of risk in decision-making is supported. When needed, each participant is supported to make informed choices about the benefits and risks of the options under consideration.

Each participant’s autonomy is respected, including their right to intimacy and sexual expression.

Each participant has sufficient time to consider and review their options and seek advice if required, at any stage of support provision, including assessment, planning, provision, review and exit.

Each participant’s right to access an advocate (including an independent advocate) of their choosing is supported, as is their right to have the advocate present.

1.4 Independence and Informed Choice

9 of 12

Version 6.1 January 2024

Human Services Quality Framework The Human Services Quality Standards set a benchmark for the quality of service provision.

Each Standard is supported by a set of performance indicators which outline what an organisation is required to demonstrate to meet that standard.

3 Responding to Individual Need The assessed needs of the individual are being appropriately addressed and responded to within resource capacity.

3.5 BigDog has a range of strategies to ensure communication and decision-making by the individual is respected and reflected in goals set by the person using services and in plans to achieve service delivery outcomes.

4 Safety, Wellbeing and Rights The safety, wellbeing and human and legal rights of people using services are protected and promoted.

4.4 People using services are enabled to access appropriate supports and advocacy.

4.5 BigDog has processes that demonstrate the right of the individual to participate and make choices about the services received.

Delegation of Authority Name

Position

Details

Steven Paull

Director

Authorise review and implementation

Courtney Carroll

Director

Authorise review and implementation

David Burrett

Operations Manager

Ensure information dissemination

Monique Paull

HR Lawyer

Ensure compliance by workers

1.4 Independence and Informed Choice

10 of 12

Version 6.1 January 2024

Version Details This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy.

If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0.

The following rules also apply in interpreting this policy: • Headings are for convenience only and do not affect interpretation.

• A singular word includes the plural and vice versa.

• A word that suggests one gender includes the other genders.

Date

V

July 2009

1.0 Valued Status

March 2011

1.1 Updated BDS to BigDog Updated Service User to BigDog

March 2012

1.2 Header includes new logo and page of pages

July 2012

1.3 Training sub-section included

October 2013

2.0 HSQF Standards replace Service Standard Indicators Word converted to Office 2013 DOCX

February 2015

2.1 Updated term ‘Client’ to NDIS term ‘Participant’ LiveBig! Program included in Training

July 2016

2.2 Changed from a policy to a procedure Added information on recovery framework for participants with mental illness Added information on valuing participants

February 2017

3.0 Created an all-inclusive HSQF Policy to address each of the service standards indicators.

January 2019

4.0 Updated to new logo and style guide

January 2020

May 2020

5.0 Removed HSQF Standards Indicators and Policy matched with NDIS Practice Standards and Quality Indicators Front cover updated to Standards colour identification Supporting Policies updated 5.1 Included National Disability Advocacy Program

September 2020

5.2 Included Dignity of Risk Consent Form

January 2021

5.3 Updated Responsible Officers details Changed ‘the director’ to ‘the directors’

Details

1.4 Independence and Informed Choice

11 of 12

Version 6.1 January 2024

Date

V

January 2022

5.4 Updated Responsible Officers details and training modules NDIS Practice Standards November 2021 Version 4

January 2023

6.0 Included Human Services Quality Standards and Child Protection Act and the term “Participant” is returned to “Client” to allow for policies to cover NDIS and Child Safety.

January 2024

6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included.

Details Introduction of BigDog Training Portal and modules

1.4 Independence and Informed Choice

12 of 12

Version 6.1 January 2024