NDIS Quality and Safeguards Commission
The NDIS Quality and Safeguards Commission (sometimes referred to as the NDIS Commission) is an independent government agency established to improve the quality and safety of NDIS supports and services.
Incidents and Reporting
Incidents
All staff must have a good understanding of what an incident is and their obligations to report this to the office.
An Incident is something that happens that:
- is unplanned or unexpected.
- occurs in connection with our services to a person with disability.
- potentially could or does cause harm to either the participant, support worker or another person.
- could be reported to us as having occurred prior to the service.
Examples -
- a client falls or almost falls (near miss)
- medication error
- wound
- dangerous behaviour
- suffers a medical episode (choking, seizure, stroke etc.)
- change in health
- client is absent/missing
- a client notifies you of an injury or fall prior to shift start
- abuse (verbal, physical, psychological, financial, neglect)
- damage to property (even if accidental) by participant or support worker or another person
Note - worker injuries or pain associated with work that occurs during shift are also examples of incidents. Please report immediately if you are injured during a shift.
Important Reminder - if a client has a fall or almost falls (near miss), you must offer for the client to see a GP (which the client can refuse, but you must offer and note that in your incident report).
If unsure whether a situation should be classified as an incident, always contact the office to confirm.
Reportable Incidents
Some incidents are classified as severe, potentially creating a risk of serious harm or death, therefore there are additional reporting obligations by both the support worker and the organisation. These are known as Reportable Incidents.
Examples -
- The death of a person with disability.
- Serious injury of a person with disability.
- Abuse or neglect of a person with disability.
- Unlawful sexual or physical contact with, or assault of, a person with disability.
- Sexual misconduct, committed against, or in the presence of, a person with disability, including grooming of the person with disability for sexual activity.
- Unauthorised use of restrictive practices in relation to a person with disability.
All incidents need to be reported to the office immediately and a written incident report completed within 24 hours of the incident: (https://onlycare.com.au/incident/)
Only Care is required to additionally urgently report all Reportable Incidents to the NDIS Quality & Safeguards Commission.
More details on Incident management and Reportable Incidents from the NDIS Quality and Safeguards Commission
Flyer on Reportable Incidents
Duty of Care vs Dignity of Risk
Clients have 'choice and control' (dignity of risk) - the freedom to make their own decisions and choices about what is important to them and to decide how they would like to receive their supports and who from. Sometimes these choices may expose them to a level of risk that they might choose to take.
However, we (service provider/management/support workers) have a responsibility (duty of care) to take reasonable care to ensure our actions or inactions do not result in serious injury or worse to the client.
In certain circumstances, we might be called upon to override the client's choice and control if we believe the client is at serious risk.
Example of duty of care - client has sudden chest pain and they have known cardiac concerns. Support worker wishes to call 000, but client refuses. In this example the support worker should advise client that they have a duty of care to call the ambulance because it is a possible life threatening situation and the client can then exercise their choice and control with the paramedics who are better qualified to make a judgement on situations like these. Immediately also call the office to notify and for guidance.
Example of choice and control - client asks support worker to take them to McDonalds to order fast food for lunch. The support worker feels this is an unhealthy choice for lunch, especially given the client's health conditions, so offers to cook something healthier but the client refuses. Ultimately the client has choice and control over what they would like to eat, so the support worker should take the client to McDonalds. Support worker should write in their progress notes that the client requested McDonalds. If it becomes a regular request that may cause long-term negative health impacts, the client manager would need to discuss and investigate further with the key shakeholders involved.
We can have client sign the "Dignity of Risk Acknowledgement Form" if we believe the client wishes to participate in an activity that may pose a reasonable risk. However, we can override this decision if we have concerns about their safety or if there are life-threatening issues at stake.
Please notify Client Manager or RN if you have any concerns that a client might be taking a significant health or activity risk.