We all hope that we never encounter any serious issues whilst working with our customers, but incidents do happen. They can be minor, major, or catastrophic.
Let’s look into the area a little bit more closely and what your responsibilities are within the NDIS framework.
Whether registered or unregistered, every provider has a responsibility to keep, maintain and provide a safe environment for your customers and staff.
Incident Management System:
Registered providers are required to keep track, maintain, and manage whilst providing support or services to people living with disabilities.
Under the NDIS (Incident Management and reportable incidents rules 2018) the structure of your system should include: *
(a) Acts, omissions, events, or circumstances that occur in connection with providing NDIS supports or services to a person with disability and have, or could have, caused harm to the person with disability
(b) Acts by a person with disability that occur in connection with providing NDIS supports or services to the person with disability and which have caused serious harm, or a risk of serious harm, to another person
(c) Reportable incidents that have or are alleged to have occurred in connection with providing NDIS supports or services to a person with disability.
Providers should maintain thorough records of all incidents - not limited solely to those required by the NDIS. It is key to respond appropriately to each incident and take preventive measures to avoid their return. The management system implemented should align with your organisation's size and the services you offer.
Clearly outline processes for identifying and addressing incidents - These procedures must be documented and easily accessible to both customers and staff. The management system should incorporate written protocols covering the identification, recording, and reporting of incidents. Additionally, it should detail the impact on customers and the support provided post-incident.
Designate a staff member specifically responsible for incident reporting - including notifying the NDIS of reportable incidents. In cases where an incident requires investigation, establish guidelines for corrective actions. Lastly, define how customers will be involved in managing and resolving incidents and specify the timeframe for resolution.
Ensure that staff undergo training on risk identification and management - understand their responsibilities, and are familiar with compliance measures related to the incident management system. This thorough approach will contribute to effective incident response and risk mitigation within your organisation.
Example One:
Jack, a 46-year-old living with intellectual disability residing in his own home, he faces various medical challenges, including diabetes. His daily support involves personal care, including reminders for medication and community engagement. However, over the past two weeks, support workers have noted and reported to their team leader that Jack has been neglecting to take his prescribed medications. Previously, Jack struggled to adhere to the specific times for medication (morning, noon, and night). To address this, he received support by having his medications organised in a Webster pack and setting alarms on his phone and tablet, which had proven helpful until recently. In response to Jack's sudden reluctance to take his medications, the team leader instructed the support worker to investigate the root cause. When asked, Jack could only express that he "doesn't want to take them." His support worker suggested consulting Jack's doctor, and an appointment was scheduled, with Jack agreeing to have the support worker accompany him. During the appointment, the support worker briefed the doctor on Jack's recent reluctance to take his medications. The doctor, reviewing the list of prescribed medications and inquired about how the medications made Jack feel. Jack communicated feeling sick and pointed to his stomach. With this information, the doctor concluded that one of the drugs had latent side effects, which, although previously tolerated by Jack, were now causing discomfort, and likely contributing to his medication refusal. In response, the doctor prescribed an alternative medication with fewer side effects, expressing hope that this adjustment would ease Jack's discomfort. The doctor also encouraged Jack to talk openly with his support worker if he ever felt unwell after taking his medications. Jack acknowledged that he understood, and the doctor reassured him that the new tablets would not make him feel sick. However, if they did, the doctor insisted that Jack should promptly tell his support worker. Fast forward a few weeks and Jack successfully resumed taking his medications without reporting any bad effects. The team leader updated their management system, marking the issue from pending to resolved, and discussed with the support worker the importance of regular check-ins with Jack to prevent a repetition of the problem. |
In this example, the incident was minor, but also had the potential to be catastrophic. With a coordinated effort of reporting and solution-based thinking, the issue was settled.
Example 2
Petra is 34 and lives with a range of complex mental health issues, an intellectual disability and is nonverbal. Petra lives in a SIL (Supported Independent Living) home with two other people. This is a new living arrangement. Recently, there have been concerning reports from support staff regarding Petra's nighttime activities. Over the past four weeks, Petra has been waking during the night, entering other residents' rooms, attempting to wake them with pinches, slaps, and loud gestures, she has also taken items from her housemates rooms. While Petra has exhibited some similar behaviours during the day, the nighttime occurrences are a new development. Despite the efforts of night staff to redirect Petra back to bed, these attempts have proven unsuccessful. The House Manager diligently records these incidents in the management system and engages with staff to identify any unusual patterns in terms of time or day that may provide insights into the causes of Petra's nocturnal adventures. Reports from day staff highlight that Petra has been lethargic during the daytime, often sleeping extensively. This has resulted in Petra not attending community engagement activities during the day. Recognisng the need for a comprehensive approach, Petra's behaviour practitioner collaborates with the staff to investigate the potential influence of her medications. Upon careful examination, they identify a medication prescribed to Petra for her mental health conditions that carries a notable side effect of drowsiness, this was recently increased by the psychiatrist. The practitioner tried to communicate with Petra's psychiatrist to discuss the medication and its effects. This was met with refusal. The house team leader and Petra’s family collectively decide to explore alternative strategies to address the situation. They diligently recorded all incidents and found that the behaviours were escalating and without 1:1 supervision, Petra was hurting other residents. After discussions, the home provider decided that they could no longer house Petra as her behaviours were having a detrimental affect on the other residents. An agreement was reached that Petra might benefit from alternative accommodation, preferably in a 1:1 setting. This would provide Petra with the personalised attention she requires, alleviating the incidents that have been affecting the well-being of other household members. The decision reflects a collaborative effort to find a more suitable living arrangement for Petra. |
This example shows that sometimes the best solution for a customer is not always what appears positive, but rather a solution that takes into account the well-being of everyone involved. It's important to keep records as it can reveal patterns that can be investigated and solutions found.
There are many different scenarios that can arise, some more serious than others. If you're interested, you can find more information on the NDIS website, as it's crucial to know your role, even as a sole trader, providing Support Coordination services.
REPORTABLE INCIDENTS:
Lastly, let's go over what a reportable incident is. If you're providing support or services and any of the following occur, you must contact the NDIS commission to report it.
Death | 24 hours |
Serious Injury | 24 hours |
Use of restrictive practice if not used in accordance with your state or territory or the support plan. | 5 business days |
Sexual misconduct including grooming | 24 hours |
Unlawful Sexual or physical contact | 24 hours |
Abuse or neglect | 24 hours |
If you are a registered provider, you should use the NDIS Portal and go to the “my reportable incidents” page.
For further information and reading, please visit the link below.
You have a few options for recording and managing incidents. Many management systems, including Lama Care, have a built-in feature for recording and administering incidents, which is accessible through their staff app. Alternatively, you can use an Excel spreadsheet. Regardless of the method you choose for recording incidents, it is important to regularly review your procedures. This benefits both your business and the well-being of your customers.
*NDIS website
We wish you well, as always
The Lama Care Team
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