Buddy Shift Checklist

Organisation Name:

Organisation Email:

example@example.com

Your Name:

First NameLast Name

Your Email:

A copy of this form will be automatically emailed to you.

Participant Name:

First NameLast Name

Trainer Support Worker Name:

First NameLast Name

Date:

Date

Time From:

Hour Minutes

AM/PM Option

Time To:

Hour Minutes

AM/PM Option

What is the participant’s disability/s and/or diagnosis/s, including any specific medical issues? e.g., diabetes, epilepsy, etc:

Does the participant have any allergies? Please provide details of the allergen, symptoms and assistance needed.

Does the participant have any dietary requirements or intolerances? Please provide details.

Is there any situation throughout the day in the course of your duties where you are required to physically assist the participant? If so, please provide details.

What are the participant’s identified risks and what should you do to best assist them to manage these risks?

What does it look like if the participant appears to be anxious, stressed or mentally unwell and how should you assist them in these circumstances?

Please list the name and numbers of at least 2 people who should be contacted in the event of an emergency:

Please list any formal/informal decision makers if applicable:

Are there any specific considerations/directions for what happens in a medical emergency/natural disaster. Please state all considerations and directions:

What is the process if the participant is not answering the door? Please state if there is a spare key and its location, and/or a lock box and its location and code.

Please describe if the participant has any support requirements regarding their gender, sexuality, culture, diversity, and identity. Please also state how the participant identifies and what pronouns they use.

What form/s of communication does the participant use? (Please list all)

What are the methods for recording your shift notes?

Do DSWs have any role in assisting the participant with their money or finances?

Does the participant have any support plans in place, such as a Behaviour Support Plan (BSP), Individual Support Plan (ISP) or a Transition Plan? If so, please state which ones and where you can access them and what important information can be drawn out of them, restrictive practices, strategies for managing behaviours or situations? Please note: A minimum of one face-to-face buddy shift will need to take place if a participant has any support plans.

Does the participant need assistance with their medication? If so, please state what assistance is required, including medication storage location, as well as medication form location if applicable.

Regardless of how we assist a participant with medication all medication incidents must be reported immediately via an incident form in VisualCare.

Any serious errors or incidents associated with a participant taking medication must be reported to 000, followed by notification to your supervisor or on-call as soon as is practically possible. If the situation is not considered an emergency, advice relating to medication errors and incidents should always be sought in the following order:
The Pharmacist or Healthcare professional (General Practitioner or prescribing doctor or Nurse Practitioner) of the participant. If the Pharmacist or Healthcare professional of the participant are unavailable, then contact any of the following:

Poisons Info centres provide the latest poisons information to the public, and toxicology advice to health professionals on the management of poisoned and envenomed patients. Telephone advice is available 24/7 from anywhere in Australia.

Call if someone has been poisoned or has overdosed, made a mistake with medicines or been bitten or stung (24 hours a day, seven days a week). Situations may include if a participant has taken too much of their own medication, taken the wrong medication or taken a medication via the wrong route. An incident would include but is not limited to:

Medication omitted (not taken)
Incorrect dose taken
Medication taken at the wrong time
Medication incorrectly packaged or supplied
Medication refused by the participant
Medication not available
Suspected abuse of medication
Medication where directions have not been followed accurately by the participant
Any situation where staff have a concern relating to medication

Do you understand what this means in practice?

Does the participant require any personal care assistance? If so, please describe what type of assistance is required.

When assisting with personal care, it is important you maintain the highest level of dignity for the person being supported as well as observing ‘Workplace Health and Safety Requirements’. Do you understand what this means in practice?

Do you feel competent with all aspects of the personal care that you may provide?

Work Health & Safety (WHS): should you identify any potential hazards in the participant’s household, you must complete a WHS Incident form through your shift in VisualCare so hazards can be identified and dealt with in real time by a Supervisor. Do you understand what this means in practice?

Please state and describe (if applicable) if there is any situation throughout the course of your duties where you must wear Personal Protective Equipment (PPE)? Please also state if the participant has any PPE available at their home. Please note: Your Supervisor can supply PPE if required.

Does the participant require assistance during their support for any regular appointments? Please describe what appointments including location, day/frequency, etc

Medical / Healthcare appointments: when assisting a participant with attending any medical or healthcare appointments, even if just transporting them, DSWs must document the appointment in the case notes. Add any important information, such as changes in medication, especially if DSWs assist them with this, and if there is a future appointment in which support from a DSW is required. Please notify your Supervisor asap via SMS or email. Do you understand what this means in practice?

Please provide details of what types of activities you will be supporting this participant with, e.g., cooking, cleaning, shopping, access community, etc.

Are there any specific directions for how to best support them? e,g., needs help cutting vegetables, participant can remove bedding but requires help making it.

What are some of the participant’s likes, interests or hobbies?

Is there any other important information that has not been captured by the above questions?

Please list the participants Current NDIS goals and how you will support the participant to achieve them:

Are you aware of what is required if you are sick or unable to work?Please list the participants Current NDIS goals and how you will support the participant to achieve them:

I am aware that I can and should conduct further self-education to grow my industry knowledge and knowledge of the participant conditions. I am aware that I can ask my supervisor for further training at any time:

I am confident I have been given sufficient information, training, and the opportunity to learn about their support needs and I am competent to begin safely supporting this participant.