CASE STUDY

You work for CITEnable in its community outreach program. In this program you support people with a disability and people who are older citizens to access community settings.

The client you support on Wednesdays is Sharon Welsh (at 54 year old women who have an acquired brain injury). Sharon has some physical impairment - minor muscle contracture and balance issues. She also has difficulty with memory and problem solving. Sharon lives in her parents in their house. Her Mother is Mrs Wallace (aged 89 years old), and has some mobility difficulties. Her father is Mr Wallace (aged 90 years old) and also has some mobility difficulties. Also living in the house are Sharon's daughter (Vanessa) and grandson (Stephen aged 10 years old). You are employed to provide Sharon and no one else in the home.

You often support Sharon to access the community by meeting her at her residence and taking her out. At times this may also require you to provide support to the individual in their own home. For example you regularly take Sharon out to do some grocery shopping and then return to her home and support her to cook a meal for her family.

One evening when you are supporting Sharon to cook an evening meal. Her parents are out of the house, but her daughter (Vanessa) and grandson (Stephen) are present.

While you are helping Sharon cut up the vegetables, Vanessa comes into the kitchen and tells you "I have to go to the shops and get some medicine from the pharmacy, because he has a flu". She asks you "would you please look after Stephen while I'm at the shops and make sure he is okay?"

Sharon says that she would be happy to but Vanessa tells Sharon "You memory isn't very good Mum, it would be better if the worker does it".

The next time you are supporting Sharon she tells you that she would like to be able to help Vanessa more with Stephen. She says that she would like to be able babysit Stephen so that Vanessa can go out more.

Sharon asks if you would be able to support her to babysit Stephen next week.

You consider that, as this is a request for support from the client, it may fall into your scope of practice.

Vanessa usually supports Sharon to do some arm and leg stretching. This is an important part of Sharon's therapy supports and helps to improve her movement. Vanessa has received training from a physiotherapist to do the stretching exercises for her mother.

Vanessa asks you if it would be okay for her to show you how to do the exercises, so that Sharon could have some extra stretching because it is "really improving her movement".

CITEnable have a new documentation system. All Home and Community Care staff now have access to "Electronic Tablets". These tablets are updated each week with all relevant client information, schedules and plans.Incident forms and case notes are also included on the tablets.

Staff pick up a tablet from the office before they start work for the week, and return them to the office at the end of the work week. Staff are then to take the tablets to each client's home and/or community activity, so staff can read appropriate information and keep progress notes.

As different staff get a different tablet each week there cannot be any codes on the tablets to lock them. Staff are expected to take the tablets home with them between shifts and charge the tablets. Staff are told to keep the tablets "safe".

A fellow worker has told you that they don't like using the tablets because they keep making mistakes and feel they "Aren't very good with technology". They say that they are just going to use the old paper documents instead.

QUESTIONS

1)Consider your scope of practice; is it appropriate for you to look after Stephen? Why or Why not?

2) How would you confirm that it would be appropriate for you to help Sharon support Stephen?

3) What sort of changes would this new activity have on your role in supporting Sharon? Consider training, checks, reporting, policy and duties.

4)Can you agree to let Vanessa show you how to do the exercises? Why or Why not?

5) To effectively provide this physiotherapy to what sort of supports, information, education and approval do you need?

6) : Does this new system meet the requirements of good documentation management? Why or why not?

7) : Does the policy contain information and procedures that meet the needs of the new technology? What are some of the ways you should you raise the need for this policy to be reviewed?

8) Given what your colleague has told you, consider what could be done to improve the effectiveness and use of this new technology for the organisation?