Fostering Human Rights

What are rights of people that need community services or aide?

The Convention on the Rights of Persons with Disabilities (CRPD) recognises the barriers that people with a disability may face in realising their rights. The rights under all human rights treaties apply to everyone, including people with disability. However, the CRPD applies human rights specifically to the context of people with disability.

Where do the rights of people who need support come from?

Australia is a party to seven core international human rights treaties. The rights of people with disability are contained in the Convention on the Rights of Persons with Disabilities (CRPD). Some of the more significant rights that are particular to people with disability are extracted in the section 'Articles from relevant Conventions' and are discussed below. These include articles 4(3), 5, 9(1), 19, 26(1) and 33.

You will need to consider the rights accorded to people when you are working on legislation, a policy, or a program that:

• information, communications, and other services, including electronic services like the Internet and emergency services
• buildings, roads, transport and public facilities like schools, housing, hospitals, clinics, and workplaces
• public services such as education and healthcare, public institutions such as the justice system and courts and other public activities such as voting and advocacy
• employment
• an adequate standard of living, including adequate food, clothing, and housing
• in-home, residential, and other community support services, or
• mobility aids, assistive devices and technologies designed for people with disabilities.
• sets standards and guidelines for access to facilities and services to ensure that private businesses that provide facilities or services to the public consider access for people with disability, and/or
• relates to capacity to make decisions or legal rights and recognition before the law.

Code of conduct

Codes of conduct are a set of documents that provide guidance to staff on appropriate ethical standards for work-related behaviour and is generally based on the values of the organisation. For instance, integrity, accountability, and transparency.

Discrimination

Discrimination happens when a person or group of people actively treat a person differently because of a factor that is irrelevant. For example, it is discrimination to refuse to give a person employment simply because of the support or assistance they require, if the person can do the job in the same way that a younger, non- disabled person can do. People who belong to certain groups, such as people with disabilities, mental health conditions, people from certain races and ethnicities, people who identify as LGBTIQ and people from low socio-economic backgrounds can find that they are not able to access the same opportunities as other people in society. This can lead to further disadvantage, including cycles of poverty, poor health, social exclusion, and increased incidence of mental health issues. Discrimination, both direct and indirect, still contributes to this cycle in Australia. Direct discrimination is illegal. It refers to treating a person differently or unfairly in their access to services or venues in society based on a protected and irrelevant trait, including gender, sexuality, cultural background, religious beliefs, English-speaking status, age, race, and disability. People with mental health conditions frequently find themselves the victim of direct discrimination. This means that the person has been directly refused fair access because of traits that are not relevant to the situation. This can affect their ability to obtain work because they have disclosed a mental illness; their ability to access rental accommodation; and their access to the full recreational, creative, spiritual, sporting, and other opportunities in society that most of us enjoy. Other people are victims of indirect discrimination. This means that the person is not able to fully access public and private services because of rules that make it more difficult for them to pass through.

Dignity of risk

Dignity of risk means the person has the right to take some risks in their everyday life, even if others do not approve, and even if it is not the best or safest thing for the person. Dignity of risk allows the person to make choices, even if we do not agree that they are the right ones. The person should be allowed the dignity of risk when the following three things are considered:

1. You have helped them to learn about the consequences of their decision if they were not aware of the risk
2. They can understand the consequences of their decision
3. The choice they are making does not have the potential to harm anyone else.

Duty of care

Community and health facilities have a legal obligation to provide a duty of care to their clients. Failing to act potentially places the client and others in danger. You should discuss duty of care requirements with your supervisor, so you understand fully the expectations of your workplace. You may be required to use tools or assessments to help you decide the duty of care which you owe to a person, and how you should exercise your duty.

Model WHS Act health and safety legislation states a person conducting a business or undertaking (PCBU) has a duty of care to maintain a healthy and safe workplace. Employers are generally regarded as PCBUs and are legally obliged to ensure workers can carry out their work safely and without risk to their health. The ethical consideration here would be to always follow principles of respect for all persons you are caring for. In day-to-day work duty of care is the legal duty to take reasonable care so that others aren't harmed and involves identifying risks and taking reasonable care in your response to these risks. It is the employer's responsibility to ensure that all reasonably practicable measures have been taken to control risks against all possible injuries arising from the workplace. The employer's duty of care applies to all people in the workplace, including visitors, contractors etc. Legal liabilities may arise if facility or workers are in breach of their duty of care and if client care is sub-standard. Failure at audit – rectifications, fines, cancellation of registration.

Human rights

Human rights lie at the heart of ethical decision making. Human rights are fundamental to the way we interact with other people and the value we see in their ability to survive and thrive in our society. Human rights recognise that each person, regardless of their backgrounds have the right to be treated fairly, with dignity and mutual respect and can make their own daily life choices. The Universal Declaration of Human Rights was adopted by the United Nations General Assembly in 1948. The declaration is not legally binding for the countries who have signed it, but it does set out an important set of agreements and understandings about what human rights mean for the world.

The declaration begins by acknowledging that ‘the inherent dignity of all members of the human family is the foundation of freedom, justice and peace in the world.’ When we are working within the aged care and disability sectors it is very important to be mindful of workplace policies, procedures, legislation, and regulations that we need to adhere to when we are supporting clients.

Some of these include the following:

• Aged Care Act 1997
• Aged Care Guidelines
• Aged Care Diversity Frameworks
• The Aged Care Quality Standards
• The Charter of Aged Care Rights
• User Rights Principles
• Disability Discrimination Act (1992)
• Racial Discrimination Act 1975
• Sexual Discrimination Act 1984
• National Disability Insurance Scheme Act (2013)
• Informed consent
• Mandatory reporting

It is worth remembering that this information is not exhaustive but contains examples of the types of information relating to the different frameworks in which support work is undertaken.

Mandatory reporting

The laws related to mandatory reporting vary across the states and territories. Mandatory reporting sets out the requirements for making a report about known or suspected child abuse, neglect, harm, or risk because of circumstances which exist within their current living arrangement. There are differences about who must make a report and the types of abuse which must be reported. In some locations, any adult with a reasonable belief is required to make a report, while in other locations, only particular groups of people must report.

Privacy, confidentiality, and disclosure

Maintaining privacy and confidentiality is a law that protects people's privacy and confidentiality and is part of respecting a person's individual rights. In practice, confidentiality means not discussing an individual's personal information unless they have given their consent for this to happen. There are exceptional circumstances that enable you to disclose private information, but this is generally only when you become aware that someone may be harmed or is enforced by the law.

Work role boundaries, responsibilities, and limitations

As a community worker in Australia, it is important to understand and operate within certain work role boundaries, responsibilities, and limitations. These may vary depending on the specific job role, employer, and relevant laws and regulations.

Work role boundaries refer to the limits of what is expected and permitted within your job role. It is important to understand and respect these boundaries to ensure that you are working within your scope of practice and not exceeding your qualifications, skills, and legal authority. Boundaries may include not providing services or interventions that are outside your training or expertise, not engaging in activities that are unethical or illegal, and not overstepping professional boundaries with clients or colleagues.

Let’s take a look at a few examples:

1. A community worker who is not trained or authorised to administer medications should not attempt to administer medication to a client, even if asked by the client or their family. This is beyond the worker's scope of practice and exceeds their qualifications and legal authority.
   Work responsibilities refer to the tasks, duties, and obligations that are associated with your job role. As a community worker, your responsibilities may include providing care and support to clients in accordance with their individual care plans, promoting their health and well-being, ensuring their safety and dignity, maintaining accurate documentation, adhering to relevant policies and procedures, communicating effectively with clients, families, and colleagues, and seeking appropriate guidance or assistance when needed.
2. A community worker is responsible for helping with daily living activities, such as bathing, dressing, and meal preparation, as outlined in the individual care plan of a client that requires additional support. The worker should ensure that these responsibilities are carried out in a safe and appropriate manner, following relevant policies, procedures, and guidelines.
   Work limitations refer to the constraints and restrictions that may be in place due to legal, organisational, or professional factors. It is important to be aware of these limitations and not exceed them in your job role. Limitations may include not providing services or interventions that are prohibited by law, not disclosing confidential information without proper consent or legal authority, not making decisions, or taking actions that are beyond your level of authority, and not engaging in practices that are considered discriminatory, abusive, or unethical.
3. A community worker is not allowed to disclose a client's personal health information to anyone without proper consent, unless required by law or in case of an emergency. The worker should respect the confidentiality and privacy of the client's information and only share it with authorised individuals or entities as per the organisation's policies and procedures.

Work Health and Safety

Health and safety are the concerns of every person who enters a workplace. Legislation outlines the roles and responsibilities of every Australian employer and worker to protect yourself and others from harm. In the community services workplace, this includes the safety of clients or residents, family members, visitors, and volunteers. These laws are made and enforced by different levels of government.

Here are some examples of National Laws and Regulations in Australia:

• The Commonwealth (Australian Government) National work health and safety laws, such as the Workplace Health and Safety Act 2011 (Cwth)
• State and territory governments, State and territory legislation and regulations regarding workplace safety, such as codes of practice
• Local councils and shires Local council bylaws, such as building codes and food safety

Legislated, statutory, professional, and ethical standards play a critical role in ensuring the well-being and protection of individuals who are ageing or living with disabilities. These standards provide guidelines, regulations, and expectations for various stakeholders involved in the care and support of older adults and individuals with disabilities, including caregivers, service providers, policymakers, and organisations.

The following information are examples of various principles that relate to legislated statutory, professional, and ethical standards:

Empowerment

Empowerment means ‘giving the person power’. This is an especially important principle in support work. It is a basic human right to have control over our own life and decisions. When the person feels confident about feeling in control of themselves and their own choices, we give them power. There are many ways to help the people you support to express their own preferences and to gain confidence in speaking up about their own wishes. You hand over this power to the person when you:

• Talk to them as someone who is providing a service, rather than as someone who is in charge
• Tell them about their rights and how to use them. Remind the person often that they are their own expert, and that they have the right to express their own wishes.
• Do not just say it, do it—Treat the person as an expert about their own needs and preferences whenever you can
• Help them practice making choices, such as exploring options together, rather than simply telling them what you think they should do. Try to practice using open-ended questions like ‘What would you like to do today?’ rather than providing your own options.
• Help the person practice saying ‘No’ to what they do not want
• Respect the person’s reasonable final decisions without question unless it is not safe for them to do so.
• Be conscious of your facial expressions and how you respond to the person’s own choices.
• Avoid showing displeasure or annoyance, even in subtle ways, when you do not agree with the person’s choices. Different choices are what make us unique.

Rights-based approaches

In the context of aged care and disability services in Australia, a rights-based approach is grounded in several key principles, including:
Human rights	Recognising that older Australians and people with disabilities have fundamental human rights, including the right to life, liberty, security, equality, and non-discrimination. It also acknowledges their right to participate in decision-making processes that affect their lives, and to have their choices and preferences respected.
Person-centredness	Prioritises the unique needs, preferences, and goals of older Australians and people with disabilities, and emphasises the importance of tailoring care and support services to meet their individual needs. It promotes a holistic and inclusive approach that considers the physical, emotional, social, and cultural well-being of individuals.
Empowerment	Seeks to empower older Australians and people with disabilities by promoting their autonomy, independence, and self-determination. It recognises their right to be active and engaged members of their communities, and promotes opportunities for participation, inclusion, and social connection.
Accessibility	Emphasises It emphasises the need for physical, communication, and information accessibility to ensure that older Australians and people with disabilities can access services, facilities, and information without discrimination or barriers. It promotes the use of inclusive design principles and reasonable accommodations to facilitate full and equal participation.
Accountability	It holds service providers, policymakers, and other stakeholders accountable for upholding the rights of older Australians and people with disabilities. It encourages transparency, accountability, and continuous improvement in the provision of aged care and disability services, and promotes mechanisms for complaints, feedback, and redress.

A rights-based approach in aged care and disability in Australia is aligned with international human rights frameworks, such as the United Nations Convention on the Rights of Persons with Disabilities (CRPD) and the Universal Declaration of Human Rights (UDHR), and is aimed at promoting dignity, inclusion, and well-being for older Australians and people with disabilities.

Person-centred practices

Person-centred practices in Australia refer to an approach to care and support that prioritises the individual's needs, preferences, and goals, and involves them as an active partner in their care and decision-making. Person-centred care aims to respect the person's autonomy, dignity, and cultural background, and to provide care that is responsive, inclusive, and empowering. For example:

• Consumer-Directed Care (CDC) in Aged Care: CDC is an approach to care that gives adults more choice and control over their care and services. It allows consumers to make decisions about their care plan, service providers, and the type of services they receive, based on their individual needs and preferences. CDC promotes person-centred care by involving older adults in decision-making, supporting their autonomy, and tailoring care plans to their unique needs and preferences.
• Shared Decision-Making: Shared decision-making is an approach that involves individuals as active partners in their healthcare decisions. It involves healthcare professionals and individuals working collaboratively to develop a care plan that aligns with the individual's values, preferences, and goals. Shared decision-making respects the autonomy and choices of the individual and encourages their active participation in their care.
• Culturally Sensitive Care: Culturally sensitive care is an important aspect of person-centred care that recognises and respects the cultural background, beliefs, and practices of individuals. It involves understanding and valuing the diversity of cultures and providing care that is inclusive, respectful, and responsive to the cultural needs and preferences of individuals.
• Strengths-Based Approach: The strengths-based approach focuses on identifying and building upon the strengths, abilities, and resources of individuals, rather than focusing solely on their deficits and limitations. It encourages individuals to participate in decision-making, set goals based on their strengths and abilities, and be active partners in their care and support.
• Person-Centred Planning: Person-centred planning is a process that involves individuals, their families, and their support networks in developing a plan that reflects the individual's needs, preferences, and goals. It involves listening to the individual's voice, respecting their choices, and tailoring the care and support plan to their unique needs and preferences.

Self-advocacy

Self-advocacy refers to individuals with aged care or disabilities advocating for their own needs, rights, and preferences. It involves empowering individuals to express their opinions, make choices, and participate in decision-making about their own care and support.

Active support

Active support is an approach that focuses on providing the necessary support to individuals that need additional support to enable them to participate in meaningful activities and fully engage in their community if possible. It involves working alongside individuals, rather than doing things for them, and promoting independence, choice, and skill development.

Active listening

Active listening is a communication technique that involves fully focusing on the person speaking, and seeking to understand their thoughts, feelings, and perspectives without interrupting or passing judgment. It is an important skill for caregivers and support providers in aged care and disability settings to effectively understand and respond to the needs and preferences of individuals they are supporting.

Social justice

Social justice is the concept of promoting fairness, equality, and inclusiveness in society. In the context of aged care and disability, it involves advocating for the rights, dignity, and well-being of individuals who require additional support, and working towards creating an inclusive and equitable environment that respects and values diversity.

Strengths-based approaches

Strengths-based approaches focus on identifying and building on the strengths, abilities, and capabilities of individuals, rather than solely focusing on their limitations or deficits. It involves recognising and utilising the skills, talents, and resources of individuals that require additional support, to empower them and enhance their well-being and quality of life.

Restrictive practices

A restrictive practice is any practice or intervention that has the effect of restricting the rights or freedom of movement of an aged care consumer.

Under the legislation, there are five (5) types of restrictive practices:

• Chemical restraint
• Environmental restraint
• Mechanical restraint
• Physical restraint
• Seclusion.

The definitions of restrictive practice and the five types of restrictive practices were implemented to provide clarity to providers on what constitutes a restrictive practice and the circumstances for the use of a restrictive practice. These definitions are aligned with those applied under the National Disability Insurance Scheme.

Aged Care

The Aged Care Act 1997 and the Quality-of-Care Principles 2014 have been updated to clarify and strengthen approved provider requirements in relation to the use of restrictive practices in aged care. These changes protect senior Australians receiving aged care and services and ensure that providers understand and meet their obligations in this regard (Aged Care Quality and Safety Commission, 2021).

Disability

The Disability Act 2006 protects the rights of people who require additional support who submit to the use of restrictive practices or compulsory treatment. A small number of people with a disability are subject to restrictive practices or compulsory treatment, which are used to protect the person from causing harm to themselves or others. The use of regulated restrictive practices by disability service providers must be included in a behaviour support plan and reported to the Victorian Senior Practitioner. The use of regulated restrictive practices by registered NDIS providers must be included in a NDIS behaviour support plan prepared by a NDIS behaviour support practitioner and reported to the NDIS Quality and Safeguards Commission.

When can restrictive practices be used?

Everybody has a right to move freely, but sometimes people might hurt themselves or hurt other people. Providers can use restrictive practices to stop harm to self or to others.

Physical restrictive practices

Some common restrictive practices in residential aged care that are physical can include:

• clasping a person's hands or feet to stop them from moving
• applying restraints such as leg, wrist, ankle, or vest restraints
• seating residents in chairs with deeper seats, recliners, or rockers where they are unable to stand up from, or moving their mobility aids
• It may also include confiding a person in a residential facility or specialised unit

Pharmacological restrictive practices

Some medications prescribed can have the effect of restricting a person's movements or their ability to make decisions. Some medications may cause sedation and can be prescribed for pain relief, whilst others such as psychotropic medication can include stimulants, antidepressants, anti-psychotics, mood stabilisers and anti-anxiety agents.

Physical restraint effects

The use of restrictive practice can present with serious human rights breaches therefore it is crucial that ethical consideration is considered. While in certain circumstances, physical restraint may be necessary to mitigate risks to a resident or others in an emergency, the impacts on a person receiving physical restraint can include:

• shame
• fear
• anxiety
• loss of dignity
• agitation
• lower cognitive performance; and
• depression

Documentation Requirements

Under the NDIS Rules 2018, all regulated restrictive practices must be thoroughly detailed in a Behaviour Support Plan. This document includes information about triggering behaviours and what causes them and how to reduce or stop the behaviours from happening.

The following points are helpful to consider in a behaviour support plan:

• What is the description of the restrictive practice to be considered
• Why is it being used? What strategies were tried before restrictive practice was considered?
• Process - What detailed instructions about how, where, when the restrictive practice will be used and for how long?
• Recording - How will you make sure that all incidents are recorded or reviewed? How will you monitor the effectiveness of the restrictive practice and how will you monitor any side effects?
• What strategies do you have in place to reduce or eliminate the restrictive practice?
• Training - How will training occur with key staff about restrictive practices?

When a Behaviour Support Plan is being written, consider the following suggestions:

• Keep it simple
• Use simple language.
• Simplify your font, layout, and design
• Keep to short sentences
• Use visual images if required
• Highlight what is important
• Read and review - Check your work. Does it make sense? Is it easy to read? Have you captured all relevant information?
• Get it checked! - Have your work colleagues, supervisor or carer review the information. Is it clear? Does anything need amending

Positive Behaviour Support

Positive behaviour support is about creating individualised strategies for those that are responsive to the person's needs, that reduces and eliminates the need for the use of regulated restrictive practices. It focuses on evidence-based strategies and person-centred supports that address the needs of the person and underlying causes of behaviours or concerns, whilst protecting their quality of life and dignity. It helps people live better lives, with less behaviours of concern through changing things that help a person feel better.

Positive Behaviour Strategies

Strategies that reflect positive behaviour support include:

• Respecting a person
• Upholding a person's human rights
• Complying with legislative requirements
• Supporting a person by doing tasks and activities they like
• Going to places that a person likes
• Stopping things that a person does not like
• Policies and Procedures

Policies and procedures must be implemented in your workplace if using regulated restrictive practices, which may include processes and policies relating to:

• Behaviour Support Plans and Implementation
• Informed Consent
• Privacy and Confidentiality
• Client Rights and Responsibilities
• Authorisation of Regulated Restrictive Practices
• Record Keeping and Reporting
• Professional Development
• Reportable Incidences
• Legislation and Frameworks

The following information provides various legislative frameworks and Standards that relate to restrictive practices in Aged Care and Disability:

• NDIS Practice Standards
• NDIS Act 2013 (Section 9)
• Aged Care Quality Standards
• Quality of Care Principles 2014
• Aged Care Act 1997
• Convention of the Right of People with Disabilities
• NDIS Restrictive Practices and Behaviour Rules 2018
• NDIS Provider Registration and Practice Standards Rules 2018
• NDIS Incident Management and Reportable Incident Rules 2018
• Framework for reducing restrictive interventions - VIC
• Regulated Restrictive Practice Guide
• The Positive Behaviour Support Capability Framework

Ethical considerations

When we think about ethical considerations, the fundamental human rights of a person must be assured according to relevant legislation. Before any assessment is carried out, the rights of a person exhibiting challenging behaviours are being met (Australian Human Rights Commission, n.d.). This may include making sure that the person has:

• a safe environment to live in
• access to social and community support and regular activities
• the respect of staff and service providers
• The United Nations Convention on the Rights of People with Disabilities (2006) states that a person should be "guaranteed freeform from torture and from cruel, inhumane or degrading treatment or punishment" (Article 15). Further, it states that states should "protect the physical and mental integrity of persons with disabilities, just as for everyone else" (Article 17).

Professional, ethical guidelines must be complied with by all practitioners. Practices that are condoned include:

• degrading or demeaning a person
• involve intimidation or aversive outcomes
• involve denial or access to basic supports or prevent people from fulfilling their basic needs
• involve wrongful imprisonment
• give rise to assault or abuse or act in any way that causes physical pain or serious psychological distress; or
• involve the unauthorised use of medication

Individual, emotional, and environmental barriers

Individual, emotional, and environmental barriers to empowerment refer to factors or challenges that can hinder an individual's ability to make choices, assert their rights, and exercise control over their own lives.

The following table provides examples of potential barriers that may be experienced and ways they can be addressed:

	Barrier	Ways to address
Physical	Limited mobility, sensory impairments, chronic pain, health conditions that affect physical abilities.	Modify the physical environment to make it accessible and accommodating to the individual's physical abilities. Provide assistive devices or technologies that can enhance the individual's physical abilities and independence.
Social	Social isolation, lack of social support, communication difficulties, discrimination, or stigma.	Encourage social participation and engagement through group activities, social events, and community connections. Foster inclusive and supportive social environments that promote acceptance, diversity, and mutual respect.
Cognitive	Cognitive impairments, memory loss, decision-making difficulties, challenges with abstract thinking or problem-solving.	Use person-centered approaches that consider the individual's cognitive abilities, preferences, and strengths. Provide cognitive aids or tools, such as memory aids, visual cues, or written instructions, to support decision-making and problem-solving.

Supportive Practices

Supported practice refers to a person-centred approach to providing care, support, and services to individuals, particularly those that need additional help. It involves tailoring care and support to the unique needs, preferences, and goals of each person, while fostering their independence, dignity, and well-being. Supported practice recognises that individuals should be active participants in their own care and decision-making process, and that caregivers and support workers should aid in a respectful, empowering, and collaborative manner.

• genetic factors
• physical trauma
• psychological trauma
• chronic lifestyle conditions
• acquired brain injury

Condition	Ideal supportive practices
Genetic tactors	Personalised Treatment Plans: In cases where genetic factors influence disease risk or response to treatment, healthcare providers can develop personalised treatment plans. This may involve tailoring medication dosages, treatment approaches, or lifestyle recommendations based on an individual's genetic profile. Family Support and Education: Genetic conditions often run in families. Offering support and education to family members about the implications of genetic factors and the importance of genetic testing can help them make informed decisions about their health.
Physical trauma	Pain Management: For individuals experiencing chronic pain or discomfort due to physical factors, support practices may include pain management techniques, medications, and therapies to improve their quality of life. Nutritional Guidance: Nutrition plays a significant role in managing physical health conditions. Support practices include providing dietary guidance and counselling to individuals with specific dietary needs, such as those with diabetes or food allergies. Exercise and Physical Activity: Encouraging regular exercise and physical activity, adapted to an individual's capabilities, can improve physical health and well-being. Support practices may involve developing exercise routines and ensuring access to appropriate facilities.
Psychological trauma	Trauma-Informed Care: Create an environment that is sensitive to trauma by training professionals, caregivers, and support workers to understand the impact of trauma on individuals and how to provide care with empathy and respect. Psychoeducation: Educate individuals and their families about the effects of trauma, common symptoms, and available treatment options. Knowledge can reduce stigma and empower individuals to seek help. Mindfulness and Relaxation Techniques: Teach relaxation techniques, mindfulness, and stress-reduction methods to help individuals manage anxiety and hyperarousal symptoms associated with trauma.
Chronic lifestyle conditions	Nutrition Counselling: Offer personalized nutrition counselling and dietary planning. Dietitians or nutritionists can help individuals make healthier food choices, manage portion sizes, and develop meal plans that align with their specific dietary needs and health goals. Physical Activity Promotion: Encourage regular physical activity tailored to an individual’s fitness level and abilities. Support practices may include designing exercise plans, offering fitness classes, or recommending suitable physical activities. Behavioral Modification: Utilize behavioural change strategies, such as motivational interviewing and goal setting, to help individuals make sustainable lifestyle changes. Emphasize the importance of setting achievable goals and tracking progress.
Acquired brain injury	Rehabilitation Programs: Provide access to comprehensive rehabilitation programs that address physical, cognitive, and emotional aspects of recovery. This may include physical therapy, occupational therapy, speech therapy, and neuropsychological therapy. Cognitive Rehabilitation: Assist individuals in regaining cognitive skills, such as memory, attention, problem-solving, and communication. Cognitive rehabilitation strategies are tailored to the specific cognitive deficits caused by the brain injury. Physical Rehabilitation: Support individuals in regaining physical abilities and motor skills through physical therapy. Rehabilitation may focus on improving mobility, strength, balance, and coordination. Speech and Language Therapy: For individuals with communication difficulties resulting from the brain injury, speech and language therapy can help improve speech, language comprehension, and communication skills.

It is worth remembering that restrictive practices should only be used as a last resort and under specific circumstances where they are deemed necessary to prevent harm to the individual or others. The use of restrictive practices should be guided by a strict set of principles and regulations to ensure the safety and well-being of all involved. Here are some situations in which restrictive practices might be considered as a last resort:

• Imminent danger: Restrictive practices may be used when there is an imminent risk of serious harm to the individual or others, and no less intrusive interventions are effective in preventing this harm. This should be based on a thorough risk assessment conducted by qualified professionals.
• Exhaustion of alternatives: All less restrictive interventions and positive behavior support strategies should have been exhausted and proven ineffective before considering restrictive practices.
• Informed consent: When it is determined that restrictive practices are necessary, informed consent should be obtained from the individual or their legal guardian, if applicable. The person's wishes and preferences should be taken into account to the greatest extent possible.
• Monitoring and oversight: When restrictive practices are used, there should be continuous monitoring, data collection, and oversight by qualified professionals to ensure that the practices are implemented safely and effectively.
• Time-limited: The use of restrictive practices should be time-limited, with regular reviews and assessments to determine if they can be reduced or eliminated as soon as the risk decreases.
• Legal and ethical compliance: The use of restrictive practices must comply with all relevant laws, regulations, and ethical guidelines. This includes respecting the individual's human rights and dignity.
• Training and certification: Staff members responsible for implementing restrictive practices should be properly trained and certified in their use to ensure safety and minimize harm.

It is essential to emphasize that the use of restrictive practices should always be a measure of last resort and should be accompanied by a comprehensive plan to transition to less restrictive strategies as soon as possible. The primary goal should be to provide effective support that respects the individual's rights, dignity, and quality of life while minimizing the need for restrictive interventions.

Working with a person-centred approach to deliver services that ensure the rights and needs of individuals are upheld in aged care and disability involves several key strategies to consider. These can include:

• Establishing a trusting and respectful relationship with the individual based on empathy, active listening, and mutual respect. Recognising and valuing their unique qualities, preferences, and perspectives.
• Taking the time to understand the individual's rights, needs, and desires through thorough assessment, observation, and communication. Being aware of their legal and human rights, including the right to autonomy, dignity, privacy, and choice.
• Actively involving the individual in the development of their care plan, treatment decisions, and goal setting. Encouraging them to express their preferences, desires, and concerns, and actively involving them in decisions that affect their care and support.
• Tailoring services and support to meet the individual's unique needs, interests, and abilities. Taking into consideration their preferences, cultural background, language, and communication style, and making reasonable accommodations to ensure their comfort and well-being.
• Collaborating with the individual, their family, friends, and other members of their support network in decision-making and care planning. Recognising and respecting the role of the individual and their support network in making choices and decisions about their care and support.
• Providing the individual with clear, accurate, and accessible information about their care, rights, and options. Using communication methods that are appropriate for their cognitive, sensory, and linguistic abilities, and ensuring that they have the information they need to make informed decisions.

Consulting with the person to confirm cultural needs and prioritising these in service delivery is important because it shows a respect for their individual autonomy, it allows care providers and workers to gain cultural competence and cultural sensitivity. It enhances communication and trust with the person, improves positive outcomes and respects, values and prioritises their human rights, encourages inclusiveness, diversity and avoids discrimination, stigma, and marginalisation.

Some strategies to ensure we respect and prioritise services when working with people from cultural linguistic diverse backgrounds include:

• Acknowledging and appreciating the cultural diversity of the person and their background. Understand that culture encompasses various aspects such as language, customs, beliefs, values, traditions, and social norms, and that it plays a significant role in shaping an individual's identity and preferences.
• Initiating open and respectful communication by creating a safe and supportive environment where the person feels comfortable expressing their cultural needs and expectations. Use open-ended questions and active listening skills to understand their cultural background, preferences, and any specific requirements they may have in terms of service delivery.
• Collaborating with the person and their support network, including family, friends, and community members, in the care planning process. Seek their input and perspectives on how cultural needs can be respected and prioritised in service delivery. Respect their role as the experts on their own culture and involve them in decision-making.
• Tailoring services to align with the person's cultural needs and preferences, as much as possible. This may include accommodating dietary preferences, providing language interpretation or translation services, observing cultural practices, and creating a culturally inclusive environment.

The human rights framework for service delivery is primarily based on the principles and provisions of the Universal Declaration of Human Rights (UDHR) and other international human rights instruments, as well as national and state/territory laws, policies, and guidelines.

When consulting with an individual to identify any form of breach of their human rights it is critical to familiarise yourself with your organisation's policies, procedures and workplace practices that govern the identification and reporting of breaches of human rights. Understanding the steps, roles, and responsibilities outlined in these policies, ensure that you comply with them in your actions and communications.

You may utilise the following skills and expertise when eliciting information to identify a breach:

Engage in active listening

Listen to their concerns, experiences, and perspectives without interruption or judgment. Show empathy and respect for their feelings and opinions and create a safe and non-judgmental environment for open communication.

Consent

Obtain explicit consent from the person before discussing their concerns with others, and explain the purpose, process, and potential outcomes of the consultation. Ensure that the person understands their rights and has the autonomy to make informed decisions.

Open-ended questions

Use open-ended questions to encourage the person to express their thoughts and experiences in their own words. Avoid leading questions or assumptions that may bias their responses. Take notes to document their input accurately.

Stay within the scope of your job role

Recognise and respect the boundaries of your job role and responsibilities. Refrain from making promises or commitments that are outside the scope of your role. Seek guidance or involve appropriate personnel, such as managers, supervisors, or designated human rights officers, when necessary.

Respond appropriately

Based on the information gathered from the person, respond in an appropriate and timely manner. Address their concerns within the scope of your job role and organizational policies. Offer support, provide information, and collaborate with relevant personnel to identify and implement solutions to breaches of human rights.

Report according to organisational procedures

Follow the organisational procedures for reporting breaches of human rights. Complete required documentation accurately and promptly, and report to designated personnel or authorities as per the policies and procedures. Maintain confidentiality and protect the person's privacy, unless required by law or organizational policies.

Follow-up and review

Follow up with the person to ensure that their concerns are addressed satisfactorily and monitor the situation for any changes. Review the outcomes of the response and reporting process and identify opportunities for improvement in the future.

Consulting with the person, particularly if they have a disability or are ageing, is a crucial step in identifying indications of abuse and neglect. It is essential to follow organisational policies and procedures, as well as legislative requirements, when responding to suspected abuse or neglect.

Some examples to support an individual are to:

• Create an environment where the person feels comfortable and safe to disclose any concerns. Build rapport and trust by actively listening, showing empathy, and respecting their autonomy and choices.
• Ask open-ended questions that encourage the person to share their experiences and observations without leading them to a particular response. Avoid using leading or suggestive language that may influence their answers.
• Look for physical, emotional, and behavioural indicators of abuse or neglect, such as unexplained bruises or injuries, changes in behaviour or mood, withdrawal from social activities, fear or anxiety, and changes in personal hygiene or living conditions.

Pay attention to the person’s verbal and non-verbal cues, as they may provide important clues about their well-being. Respect their boundaries and do not press for information they are not comfortable sharing. Refer to your organisation’s policies and procedures for reporting suspected abuse or neglect. This may involve notifying a supervisor, designated safeguarding officer, or another appropriate authority within the organisation. Familiarise yourself with the relevant laws and regulations in your jurisdiction regarding reporting of abuse or neglect. Follow the legal requirements for reporting, which may include notifying law enforcement, adult protective services, or other relevant agencies.

Respect the person’s privacy and confidentiality throughout the process, while also adhering to legal requirements for reporting. Share information only with authorised personnel who are involved in the investigation or intervention. Keep accurate and detailed records of your observations, conversations, and actions taken, following your organisation’s documentation procedures. This information may be used as evidence in investigations or legal proceedings.

Indicators of abuse exploitation and neglect

Indicators of abuse, exploitation, and neglect can vary depending on the type of abuse and the individual’s age, ability, and circumstances. However, here are some general indicators that may raise concerns:

1. Physical Abuse

• Unexplained bruises, cuts, burns, or injuries.
• Broken bones or fractures.
• Signs of restraint, such as rope marks or bruising.
• Inconsistent or implausible explanations about injuries.
• Fear or avoidance of specific individuals or situations.
• Changes in behaviour, such as aggression or withdrawal.

2. Emotional or Psychological Abuse

• Verbal or non-verbal threats, insults, or humiliation.
• Intimidation, belittling, or ridiculing.
• Social isolation or withdrawal from activities.
• Emotional distress, depression, or anxiety.
• Unusual changes in behaviour or mood.

3. Loss of interest in previously enjoyed activities

• Financial Exploitation
• Unexplained or sudden changes in financial situation, such as missing money or valuables.
• Unusual or unauthorised use of the individual’s funds or assets.
• Forged signatures on financial documents.
• Coercion, deception, or manipulation to gain control over the individual’s financial resources.
• Sudden changes in estate planning or wills.

4. Neglect

• Poor personal hygiene, dirty clothing, or unkempt appearance.
• Malnutrition, dehydration, or unexplained weight loss.
• Inadequate medical care or untreated health conditions.
• Unsafe or unsanitary living conditions.
• Lack of appropriate clothing, shelter, or necessities.
• Social isolation or abandonment.

Sexual Abuse

• Unexplained injuries to the genital or anal area.
• Torn or stained underclothing.
• Bruising or bleeding in the genital or breast areas.
• Unexplained sexually transmitted infections (STIs).
• Changes in behaviour or mood, particularly related to sexual matters.
• Fear or avoidance of specific individuals or situations.

How and when to seek support from more experienced and qualified staff

As a support worker, seeking support from more experienced and qualified staff is an important part of professional practice. Here are some guidelines on how and when to seek support from more experienced and qualified staff in Australia:

Recognise your own limitations

It’s important to acknowledge that everyone has limitations in their knowledge, skills, and experience. Be honest with yourself about your own limitations and understand that it’s okay to seek help when needed. This may include situations where you encounter complex or unfamiliar situations, or when you feel unsure about how to best support a person with specific needs.

Establish clear lines of communication

Build open and trusting communication channels with your colleagues and supervisors. Know who the more experienced and qualified staff are in your workplace and be familiar with their areas of expertise. Establish a supportive and collaborative working relationship with them, so that you feel comfortable reaching out for help when necessary.

Seek guidance proactively

Don’t wait until a situation becomes unmanageable before seeking help. If you have questions or concerns, seek guidance proactively. This may involve discussing the situation with your supervisor, team leader, or other experienced staff members. Be specific about your concerns and ask for their advice, input, or assistance.

Be willing to learn and receive feedback

Embrace a growth mindset and be open to learning from others. Be receptive to feedback and constructive criticism, as it can help you improve your skills and knowledge. Recognise that seeking support is not a sign of weakness, but rather a proactive approach to ensuring the best possible care for the people you support.

Follow policies and procedures

Familiarise yourself with the policies and procedures of your workplace, including those related to seeking support from more experienced and qualified staff. Follow the established protocols and guidelines for seeking assistance and be aware of any reporting requirements or documentation that may be necessary.

Reflect and debrief

After seeking support from more experienced and qualified staff, take the time to reflect on the experience and debrief with your colleagues. Discuss what you learned, how the situation was resolved, and what you can do differently in the future. This can help you further develop your skills and build your confidence as a support worker.

This section of the module outlined the possibilities and means of obtaining a patient’s health status through the understanding of a few of the major body systems – its basic structure and functions to support the healthy functioning of the body. Another important aspect learnt in this section was the interrelationships between major components within each of these body systems and other structures. For example, the lungs and the respiratory system or the human reproductive organs and fertilisation. Subsequently, we paid more attention to the process of homeostasis and how an imbalance in this process can cause certain diseases.

Additionally, to make sure the patient under your care is healthy we looked at the specific normal values for certain health protocols such as temperature, pulse rate, respiration rate, blood pressure and blood glucose levels. Lastly, you were introduced to the anatomical terms of location on where all of these body systems and components are situated.

In the next section, we will look at how we can confirm the person’s health status and bring about any concerning or rising issues, whilst discussing the healthy functioning of the body. We will also look at common conditions and illnesses that have an impact on the healthy functioning of the body system.

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