The Balancing Act | Duty of Care in Aged Care

We often hear the term Duty of Care casually thrown around in the workplace, especially in the aged care setting, but what does it actually mean and how does it interact with Dignity of Risk?

If you work in the aged or disability sector you have both a legal and moral responsibility to keep the people you support, your clients, participants or residents, safe from harm while they are using your service or in your care.

This responsibility is known as ‘duty of care'.

Duty of care is a legal obligation (that we all have) to take reasonable actions to protect, or at least not cause foreseeable harm, to another person or their property.

Professional Relationships and Duty of Care

Actually, in any professional relationship there exists a duty of care. Your accountant has a duty of care to make sure they are diligent when providing tax advice, likewise, an engineer working on a bridge or building has a duty of care to their employer and the wider community to ensure the projects they design and work on follow accepted standards and are safe for use.

In the aged care or disability support setting, there is a professional relationship between the support worker and the client and therefore staff have a responsibility or obligation to not only provide an expected standard or level of care, but also to uphold the rights of the client.

Expectations in the care industry

Duty of care is a bit of a balancing act in the care industry because you have a duty of care not only to clients or residents, but also to other staff, to your employer and to the general public.

No matter whether you are a support worker, case manager, supervisor or manager of a service, there is also an expectation that your actions or interventions are well thought out and minimise the risk of harm occurring to another person.

The responsibility to prevent harm and to take necessary actions needs to be balanced so that it is respectful of a person’s rights and wishes and reflects community, industry and legislative expectations. For example, there can be a fine line between ensuring the safety of a person and restraint.

If you provide direct care to an individual as a support worker, you have a duty of care to alert your supervisor or perhaps the client and/or their family of any foreseeable dangers that could impact on the client or resident as well as completing all your duties in an effective, efficient and caring manner.

If you are unsure of any actions or interventions, first check with the client or their carer, client plans, or your supervisor.

Examples of Duty of Care

Examples of duty of care might include simple things such as:

• making sure that a client has eaten their meal and sitting with them to help them eat if this support is needed
• ensuring clients have access to sufficient water, especially during hot days
• accompanying a high falls risk person on their walk back to their room
• ensuring a resident gets the correct medication
• making sure wounds are dealt with in a timely manner

Duty of care is also about making sure that issues raised by the client, participant or resident are addressed in a timely and appropriate manner.

Duty of Care can vary between the clients you support

If you are supporting a client with impaired decision making skills, the care worker will need to provide a higher level of supervision and guidance than if they were caring for a frail older person who can make their own decisions and who simply requires assistance with completing daily care tasks.

Volunteers and Duty of Care

When working with older people or younger people with a disability the worker will have a duty of care towards them. This duty of care extends to volunteers who work with clients, such as people who deliver meals on wheels or who assist clients to participate in activities.

It is expected that a person delivering meals would make sure that the client receives their meal within the recommended timeframe for delivery and also to report back to the office any concerns they have about a client.

Likewise, the volunteer helping a client participate in an activity is expected to act in a way that supports the safety and wellbeing of the client and alert the supervisor if they have any concerns about the person.

Balancing Duty of Care and Dignity of Risk

Of course, duty of care needs to be balanced with Dignity of Risk. We want clients and residents to have autonomy, or independence, over their everyday choices, because being able to take reasonable risk is important to a person's self-esteem and dignity. But staff can also demonstrate duty of care by helping a client to do what they want, safely.

For example, a client with mild dementia might want to go shopping, however, they are at risk of becoming disoriented and lost and are therefore vulnerable if they go by themselves. To support the person, a team member could accompany the client so they have a more enjoyable experience without the worry of getting lost. You’ve kept the person safe while supporting their dignity.

Sometimes duty of care and dignity of risk clash

What do you do when duty of care clashes with dignity of risk? For example, a client might decline to take a shower on multiple occasions when offered.

If there is no adverse outcome for not showering, the person might prefer to have a regular wipe down rather than showering. If they are cognisant of their actions, then duty of care and dignity of risk is upheld.

However, if the person has dementia and is also incontinent and at risk of skin irritation if they don't shower, the care staff will need to work more closely with the client or resident to actively encourage them to take the shower. Ignoring the need for a shower in this second scenario would be negligence and a breach of the care staff's duty of care.

Follow the care plan

One of the best ways you can uphold duty of care is to follow a person's care plan and let your supervisor know whenever you feel that it needs to be updated.

The care plan has been designed with the client, participant or the resident, and identifies the care and supports that meet their needs and make the client's life better. By following the care plan, you reduce the chance of breaching duty of care and placing any of your clients at risk.

Complete your documentation professionally and on time

One of your responsibilities as a support worker, case manager or supervisor is to ensure that client progress notes are regularly and accurately completed. Well written notes support and demonstrate good care practices and can back you up if there are ever any questions around your adherence to duty of care.

If you’re interested in improving your progress note writing skills, consider signing up for the CDCS online course ‘Writing Professional Progress Notes'.

Hopefully this post has helped you to understand the concept of Duty of Care better. If you can think of someone else who might benefit from this article, send them a link. We’d appreciate it! And if you’re looking for more helpful resources, why not check out our Total Quality Package resource hub? We have culturally appropriate, tailored resources that are designed to make your job simpler and help you provide quality care to your clients. Click here to find out more.