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Disability (intellectual)

Residential respect

Non-verbal resident gets assaulted

Organising a review plus information about future options

Speaking up gets results

Assistance with move to alternative accommodation

Wanting an ordinary life

Independence in decision-making

Adjusting to life in a residential home

Why go to Court?

The journey to independence

Joining in activities

Respectful language

Sorting the consumer - provider relationship

Being independent

The house meeting

Wanting a reasonable life

 

Residential respect

Residential disability ~ Right 1 ~ respect & privacy ~ Right 3 ~ dignity & independence ~ Right 5 ~ effective communication ~ Right 6 ~ fully informed 

A man living in his own flat at a residential facility made friends with a woman who lived in the residential home. The advocate was known to both through regular visits to the property. The two got together for dinner but as the woman was unable to mobilise without assistance, staff needed to assist with their get-togethers. 

The man was generally a positive person but at an advocate's visit he appeared upset and despondent. After discussing the matter the consumer advised that he and his friend had not been able to get together for their planned dinner. He was unsure why staff had not helped with their get-together. After discussing ways to progress the matter the consumer requested the advocate approach the team leader on his behalf.

When the team leader was approached he advised there had been an incident with another resident which meant staff were not available to take the woman to the man's flat. The team leader advised they were looking at ways in which a similar incident could be handled so others were not affected. The team leader said the woman concerned had requested the advocate visit her as she had other concerns she wished to discuss.

When the advocate visited, the woman told her that a staff member was coming in to her room in the evenings, turning her television off and telling her it was time to go to sleep. The lady was in her late forties and felt she was able to decide what time she wanted to settle for the night.

She also expressed concern about not being able to visit the man and said her visits were dependent upon staff allowing her to go and whether they could be present throughout the visit to ensure no intimacy occurred. As an adult capable of making her own decisions the woman felt that staff being present was an invasion of the couple's privacy. 

The advocate explored with the woman how she could raise her concerns with management.  She was very concerned that her complaint could adversely affect her and asked a couple of times "Will I get in to trouble for complaining about this?". The advocate reassured the woman that she had the right to complain and reminded her how brave she was to make the complaint. After much discussion the woman decided that given the nature of her concerns she would rather the advocate raise them.

The management team consisted of two men. The most senior of the two had only begun work with the organisation two days prior to the woman raising her concerns. The meeting was duly arranged and the woman gave the advocate very clear instructions about the concerns she wanted raised on her behalf. 

At the meeting the management team listened carefully to the issues and were concerned to hear the consumer was fearful of raising her issues - in particular the issue relating to visits to her friend for dinner. A number of options were explored including whether the consumer could use a local bus or taxi service. The manager asked that the woman be advised that he would ensure the dinner dates continued even if it meant he had to go in on his own time to assist her to get there. 

The senior manager explained his philosophy and expectations of how the service would be provided in the future where the focus would be on making the homes consumer focussed. The manager stated he was very happy to have a relationship with the advocacy service and would encourage the advocate to make cold calls to residents and provide education on the Code for staff.

Following the meeting the advocate returned to the woman and advised her of the outcome of the meeting.

The advocate followed up with the woman the following week. She confirmed the dinner had gone ahead as planned. She was very pleased to have had advocacy support and advised she kept the Code handy so when staff questioned her she was able to point out the Right she felt applied in the particular situation. 

The consumer felt happy that she could ensure her rights were enacted and intended to use the Code to make her point about staff walking in to her room uninvited. 

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Non-verbal resident gets assaulted

Residential facility ~ Right 1 ~ respect ~ Right 2 ~ Free from coercion and exploitation ~ Right 3 ~ Dignity and independence ~ Right 5 ~ Effective communication ~ Right 6 ~ Fully informed ~ Non-verbal

A father concerned about his son's care, lack of communication and information from a residential facility contacted the advocacy service. The consumer was non-verbal, but the complainant was advised by another consumer that his son had been hit by a staff member.  

The complainant approached two other residents who are verbal but neither would provide information as they had been told not to. After reporting the assault to the Police, the complainant asked his son, where the staff member hit him. The consumer responded by cupping his eye and ear, and pointed with his hands to his body and looked quite fearful.

When the complainant approached the Residential Facility's Area Manager with information about the assault he was told his son had not been involved in the incident with the staff member. It was at that stage he approached the advocate. 

After considering the support available through advocacy the complainant chose to have help in writing to the Residential Service General Manager requesting an internal investigation. He also expressed concern about the lack of communication and information regarding his son. The complainant received an acknowledgement of his concerns and later a copy of the findings from the investigation along with an invitation to meet, which the complainant accepted. 

The meeting was attended by the Area Manager, Community Service Manager, the complainant and the advocate. At the meeting the providers advised they were unable to substantiate the claim of assault, however, wanted to discuss the recommendations from the report that were being implemented which included: the consumer would be checked daily and the complainant would be emailed if any new injuries were noted, staff were to receive training in positive behaviour support and training in incident report writing, consideration would be given to staff sleeping down stairs to prevent any disruptive behaviour between residents. If any incidents occurred, the complainant would be notified as soon as possible after the event.

The complainant was satisfied that his concerns had been taken seriously and appropriate changes had been made. 

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Organising a review plus information about future options

NASC Review for Intellectually Disabled Consumers ~ Supported Independent Living

An advocate was contacted by a married couple who both had an intellectual disability.

They lived in residential care and wanted to know what the outcome of their previous needs assessment had been as they were unsure of the level of support hours that had been allocated by the NASC.  They also wanted information on the option of Supported Independent Living.

At the request of the consumers the advocate contacted the NASC who arranged a review assessment for both of the consumers.  At the time of the assessment the consumers were both given information on options for support, and were assessed for the number of support hours that they would need.  They were also given information on Supported Independent Living.

The consumers were happy with the outcome of their NASC assessment and getting the information on other options for their future.  

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Organising a review plus information about future options
NASC Review for Intellectually Disabled Consumers ~ Supported Independent Living
An advocate was contacted by a married couple who both have an intellectual disability.  They live in residential care and wanted to know what the outcome of their previous needs assessment had been as they were unsure of the level of support hours that had been allocated by the NASC.  They also wanted information on the option of Supported Independent Living.
At the request of the consumers the advocate contacted the NASC who arranged a review assessment for both of the consumers.  At the time of the assessment the consumers were both given information on options of support and assessed for the number of support hours that they would need.  They were also given information on Supported Independent Living.
The consumers were happy with the outcome of their NASC assessment and getting the information they had requested to look at other options for their future.  
 

 

Speaking up gets results

Residential disability home ~  Right 1 ~ Respect ~ Right 5 ~ Effective communication ~ Right 10 ~ Complaints taken seriously ~ "Tell Someone" DVD

While watching the "Tell Someone" DVD residents raised their concerns about their House Coordinator continuously ignoring their concerns about another resident who had challenging behaviour. The residents informed the advocate that they complained many times to the House Coordinator, but they were not taken seriously. They wanted the advocate to support them so he arranged a time to visit to discuss their concerns.

At that meeting the consumers said they would like their families to be contacted so they would also support them with their complaint. Upon making contact with family members, the advocate discovered they also had concerns about complaints not being taken seriously.

The advocate supported everyone to  put their concerns in writing, and requested a meeting with the   Regional Manager and the House Coordinator.

At the advocacy supported meeting, the Regional Manager acknowledged the delay and explained why it had taken so long to relocate the resident with challenging behaviour to a suitable home. The Manager apologised to the residents and their families for the lack of communication about their complaints and agreed that in future the residents and families would be kept informed about what was being done to address any concerns raised. 

The residents and family members felt that finally their concerns were acknowledged by the Regional Manager. They are also thankful that the advocates were visiting disability homes, especially those in rural areas.

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Assistance with move to alternative accommodation

A woman with an intellectual disability, resident in a disability facility, met with the provider who agreed to assist her to transition from secure care to residential care, as she no longer required secure care. When this did not eventuate, the consumer asked an advocate to assist with arranging another meeting with the provider.

At the meeting the consumer articulated her frustrations. The manager apologised and explained that they had so far been unable to find suitable accommodation, and that finding the right accommodation for the consumer had presented some challenges. They were exploring the possibility of building the consumer a flat with separate access, at the back of her current accommodation.

They agreed to meet six-weekly to discuss progress until alternative accommodation was found. The consumer was happy with the outcome of the meeting.

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Wanting an ordinary life

A 59-year-old man living in a residential disability home was being pressured by both staff and family over his relationship with another resident. The man was unable to speak up and give his own opinion, and was known to say what he knew the family or staff wanted him to say.

The family did not like his choice of girlfriend and were trying to make him choose between them and her. They were also putting pressure on the provider to transfer him to another community home. The staff, on the other hand, were encouraging the couple to sleep together and discuss marriage.

The advocate was able to form a good rapport with the consumer and establish that while his girlfriend was important to him, she was only a friend and that he had difficulty saying no to her and asking her to leave his room. He was adamant that he didn't want to share his bed with her all the time. On the other hand, he wanted his family to respect his girlfriend and not put pressure on him.

He had a week's trial at another community home but was not happy to stay there and returned on the fifth day. With the support of the advocate, he met with staff and members of his family and was able to say exactly what he wanted. The outcome included a notice being put on his door which indicated if he was happy for his girlfriend to enter or not. Staff agreed to support him with monitoring this. The family agreed to include his girlfriend on outings. They all agreed to drop the pressure on him and let the relationship develop on its own. Relationship counselling was another option the provider was encouraged to consider for the couple.

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Independence in decision-making

Having seen the "Tell Someone" DVD, a 27-year-old wheelchair user who lived in a residential home approached her local advocate regarding concerns which had not been resolved by self advocacy.

She was independent in attending day time activities. However, a new policy had been put in place preventing residents from going out in temperatures below 10 degrees Celsius without the use of the mobility van. The woman thought this was unfair, and told the advocate that she was able to decide for herself if the weather was too cold to be out.

The advocate helped her write a letter explaining this. The provider responded to the complaint in a manner which she found to be "a bit rude" and the consumer decided to have an advocate-supported resolution meeting. The providers agreed the woman was competent to decide whether she walked or took a mobility van. They also agreed to review the policy and check that the language used in all of their policies was mindful of residents' right to choose.

Following the meeting the woman advised that she would not have called the meeting nor had the confidence to persevere with her complaint without advocate support. She felt she was in control all the way through the process but having the advocate alongside her had made the difference.

She encourages all of her friends in residential care to speak up, and explains that there are advocates who listen to what you want and support you!

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Adjusting to life in a residential home

The mother of a 44-year-old woman with intellectual disabilities and autism contacted an advocate. She had cared for her daughter all her life but had taken the big step of placing her in residential care as she was unable to continue providing care. Because of the distance to the residential home, the mother was not able to visit very often.

The advocate visited the consumer at the residence. She was unhappy about being away from home and was having difficulty settling. The advocate and the mother visited the needs assessor who had been involved with the family for some time, and the mother outlined her concern that her daughter had being incorrectly placed in this particular residence. She was also concerned were that her daughter had been given incorrect medication by weekend staff, and that staff were not acknowledging the mother's concerns abut her daughter's wellbeing. They had removed the daughter's night light, resulting in her wrecking her room. She had also displayed other uncharacteristic bouts of violent behaviour.

The advocate arranged a meeting with the manager of the home who undertook to investigate these issues. It was decided that regular calls would be set up by the staff to enable the daughter to speak to her mother regularly, that a staff member would be appointed as the main contact person for the mother, and gave the mother the duty manager's cell phone number to contact over weekends if required.

The mother was happy with the actions taken.

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Why go to Court?  

A resident of a secure unit which provided an intellectual disability service under the Regional Intellectual Disability Care Agency (RIDCA) legislation, was alleged to have assaulted a staff member. The staff member made a complaint to the police and charges of assault were laid.

The resident had been assessed as having an intellectual disability and a personality disorder and had had previous contact with an advocate. The other staff felt unable to support the resident because of 'a conflict of interest', so the advocate agreed to take on this role.

As the resident was already in a secure unit, the advocate made contact with the staff member to discuss withdrawal of the charges and also accompanied the resident to the lawyer's office.  Although it was hoped that charges would be dropped, the staff member and the police decided to go ahead, and papers were served. The court date was set quickly.

After meeting his client, the lawyer made the decision that the client should neither make a statement to the police nor appear in court, on the grounds of being unfit to plea. He said that there was nothing the Court could do as a result of the charge that would make any difference to the client's situation as he was already in a secure facility. The lawyer believed the alleged assault was not serious enough to require a more secure facility and noted the purpose of the new RIDCA was to keep people in this situation out of court.

The lawyer was keen to speak with the Advocacy Service Manager who had been involved in a similar situation in another city. In that situation the judge had expressed surprise and regret that time had been wasted by bringing the charge to court, as the person charged was already being cared for in a secure situation, and by definition was in the care of others so there would be no change in the care process following a further conviction.

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The journey to independence

Residential facility ~ Right 3 ~ Independence ~ NASC

A local NASC co-ordinator suggested that a consumer make contact with the local advocate. The consumer was 50 years of age and lived in a self-contained cabin on the property of a residential provider. Although she had a kitchenette and microwave installed, she was told not to cook in her home. She was permitted to prepare breakfast and lunch but required to eat with other consumers in the evening.

When the advocate visited the consumer the microwave had been removed and the consumer banned from using her kitchenette for three months as a penalty for cooking popcorn and rhubarb in her microwave. The consumer wanted to be semi-independent but did not feel the provider was supporting this goal.

After considering her options, the consumer said she would like the advocate to support her at a meeting with the service's residential manager. After hearing the consumer's concerns the manager advised that the consumer's contract was clear in regard to cooking in the cabin, and went on to say there had been ongoing issues in regard to food.

The consumer talked about her goal of being more independent and requested a review of the decision to stop her access to her kitchenette. She believed the decision was too severe. The manager agreed to consult with the general manager and get back to her.

The advocate followed up with the consumer who advised she was being given access to her kitchenette, but not the microwave. In the meantime, she is to receive more daily support and mentoring to enable her to manage her food supplies for the week and counselling is to be arranged to help her with her goal of becoming more independent.

The consumer was very happy with the outcome, particularly being able to use her kitchenette.

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Joining in activities

Education ~ Tell Someone DVD ~ Speaking Up ~ Disability home residents ~ Self advocacy

A number of former residents of Kimberley Hospital now live in smaller homes run by a disability service provider. An advocate was initially engaged to provide training for one group of consumers but residents in two other homes decided they wanted to take part. When the training had been completed the consumers were delighted to receive their Achievement Certificates. They are a treasured item brought out for the advocate to see each time she visits.  

As a result of the training one consumer decided it was time to speak up about her concerns and approached the advocate for support to write a letter to the service provider. For some time the consumer had wanted to take part in an activity at a day centre and had been told she could not attend, but didn't understand why she wasn't allowed to go. She knew of others, both younger and older people who attended.  She had also been told there was no funding but she thought it was because she was too old.

The provider acknowledged her letter and within a week she was attending the vocational service of her choice, and went for coffee with them afterwards.  She was delighted with the outcome.  The consumer is now going every Thursday to the activity and is really enjoying it.

The advocate particularly wanted to write this case study as it demonstrates the success of the 'Tell Someone' DVD and the self advocacy training. It is also a good example of how advocates can encourage people to make choices and speak up for themselves when they know about their rights.

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Respectful language

A 50-year-old consumer with an intellectual disability who lived in a residential flat, reported that one of her support staff had referred to her using belittling language. She felt that this was disrespectful and found it upsetting.

 She asked for advocacy support to speak with the caregiver about how she felt, and request an apology. At their meeting, the caregiver apologised for her comments, and the consumer was happy with the outcome.

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Sorting the consumer - provider relationship

A man in his mid twenties contacted the advocacy services with concerns about being spoken to by his community support worker "as if he was a child". He had lived with a disability all his life and until recently, lived with his parents.

He said the support worker made reference to him making a friend "that may not be suitable" and he felt it sounded "just like his mother". He had lived in supported housing for two years and felt able to pick his own friends.

A meeting was held with the consumer, advocate, support worker and supervisor. The consumer was able to articulate how he felt when he was spoken to like a child. He agreed that he would continue with the same support worker because he "got on most of the time" and the situation would be reviewed in three months time to see if things had improved.

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Supporting Independence

A resident contacted an advocate after moving into a rest home which didn't allow her to use the laundry facilities. She had been used to managing her own laundry and felt her independence was being undermined. The consumer advised she had attempted to address the matter directly with the provider but felt they were not listening to her.

She wanted prompt action and after hearing how the advocate could support her, requested the advocate phone the manager and request a meeting to discuss her concerns. The manager agreed to meet within a few days with the consumer and her advocate. At the meeting, the consumer spoke about the importance of her independence and the concern of others managing her laundry. The manager acknowledged the consumer's concerns, and discussed the need to ensure the consumer's safety and infection control procedures. They discussed a plan for managing the situation that would meet both the consumer's need and the home's needs. This was documented for the consumer who was very happy that she would be able to maintain this aspect of her independence. 

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Being independent

Independence ~ Intellectual disability ~ Residential facility ~Wheelchair ~ Self-empowerment

A man with an intellectual impairment, who was also a wheelchair user, asked an advocate for help because he wanted to be able to go to the chemist by himself to collect his medication. The staff at the residential facility where he lived wouldn't permit him to do this and were supported by authorities higher up. However, after a meeting organised by the advocate, where the man's wishes were discussed, there was a willingness to let him try out his plan. This worked well, and he was able to go to the pharmacy each week (by wheelchair) to collect his own medication.

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The house meeting

Intellectual disability ~ Effective communication ~ Consumer needs ~ Residential facility

A resident in a community house for people with an intellectual disability asked that an advocate be with him at a meeting called by the staff of the house. He had recently been having difficulties in the house, and had been getting angry and frustrated with the staff, calling them names and "being generally out of sorts". The staff complained that he had changed and that they were finding him difficult to manage and had reached the point where they were saying "enough is enough". The staff coming to the meeting were intending to be "really tough" about his behaviour so they could "sort it out".

As the meeting got underway, the advocate posed the question, "Why now?" The advocate also asked the staff to think about whether there might be a reason why the resident had become so unhappy. Was he unwell or in pain, for example? The meeting provided an opportunity for everyone to have their say about their concerns and what they would like to see happen. The resident was pleased to have an opportunity to say how he was feeling and be listened to. The outcome was a specialist assessment to ensure that his pain and anxiety were being helped in the best possible way.

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Wanting a reasonable life

Intellectual disability ~ Residential care ~ Independence ~ Dignity

A man with an intellectual disability living in a residential facility asked an advocate to help him with a problem he was having with another resident. The situation had become so distressing he wanted to move out. He felt bullied because the other resident stopped him watching TV and would come into his room uninvited.

The advocate organised a meeting at the facility so the resident could discuss his concerns with the caregivers.  A plan was agreed to that would allow both residents to have their own quiet space, to respect each other's space, and to be able to make their own choices. Both residents were happy with this arrangement.

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