Maybe it’s the combination of having both ‘Personal Care’ and ‘Clinical Care’ in the one standard that makes this a tricky Standard to unpack. I know some of you don’t provide clinical care, but stick with me here.
Both types of ‘care’ are really important in helping maintain a person’s sense of wellbeing, good health, and to maximise their comfort and dignity if they are nearing their end of life.
In reviewing this Standard I have swayed between ol’ blue eyes (Frank Sinatra) and his classic ‘My Way’, to Bon Jovi’s ‘It’s My Life’, and finally ‘I’ll Stand By You’, by Chrissie Hynde.
Standard 3 covers a lot – from showering, personal hygiene, and assistance with dressing, to nursing and specialised therapy services, including helping people with cognitive impairment and dementia.
The key for home care providers is in understanding your responsibility and scope when providing personal care and the role your service has in supporting a client to access timely clinical support.
We need to remember the importance of the ‘person’ in ‘personal and clinical care’.
When I listen to Frank Sinatra, the message is about recognising how someone has lived their life, their travels, their regrets, the people they have loved, and what they have laughed and cried over.
This Standard also ties in with the first two, Dignity and Choice and Ongoing Assessment and Care Planning. Standard #7 (Human Resources), and having staff interactions with clients that are ‘kind, caring and respectful’ is related, as is Standard #8, where risk management is a focus. Remember all these standards are interlinked.
“Safe and right for me.”
This phrase is the second and key aspect of the consumer outcome for Standard 3, so what does it mean? Below is an example:
Showering can pose a challenge, in terms of access to appropriate facilities that are safe, e.g. handrails, shower chairs, non-slip flooring and sufficient space for assistance where this is required. Some people may also have a preference to only shower a 2-3 times a week, so you may need to look at other ways to support safe hygiene and skin integrity, especially if continence is an issue or their living environment (cleanliness and carer support) is lacking.
Are staff appropriately trained in how to shower someone properly? Sometimes, if they have had limited practical experience and not shown properly how to correctly shower and dry someone, they can exacerbate someone’s condition or put them at risk from infection.
As a provider, we often need to balance safety with personal preferences and choice. So how is balance found?
I recently sat in on a presentation from a disability workforce agency where their spokesperson gave a great example of a ‘person-centred’ approach to an issue they were addressing with a client who had a disability.
The client loved to have a bath but was at high risk of drowning. The solution involved working with the person, reviewing the equipment and designing processes that worked for the person. The approach taken focused on the desired outcome and worked back from there. The client and their family were actively involved in the process, making choices about how care could and would be delivered.
You may have also encountered similar conflicts in your workplace where you are attempting to support choice and decision making whilst managing risk.
The Standard specifies the need to manage ‘high impact or high prevalence risks’. What are they?
Some of the more common risks that are mentioned include:
You might experience other common risks within your organisation. How are you going to manage them? This is what the Standard asks of you.
Another issue that this standard covers is ‘minimisation of infection related risks’. In brief this means your service needs to have good hygiene and infection control practices and ensure staff are trained in these.
For example, how does your service manage someone’s personal care where they have a known infection which may adversely impact on staff or other clients? And what about appropriate laundry management practices to prevent cross contamination?
And now for that strange phrase that we have been asked about: ‘antimicrobial stewardship’ – what does this mean?
If you know that a client is taking a course of antibiotics, it is really important that they are supported to finish the course. This helps to reduce the risks of microbes becoming resistant to antibiotics in the general population, protecting your clients even further.
Of course personal and clinical care becomes more complex in a residential setting and antimicrobial stewardship even more important.
But how do we ‘stand by’ our consumers in a rural and remote context?
Being alert to changes in the person’s health status is a great start and a critical part of supporting clients and managing risk.
Ensuring that staff have had training in ‘signs and symptoms’ and know how to escalate a concern is really important as it’s the support workers who are the eyes and ears on the ground.
Daily team briefings or a handover back to the Coordinator when staff return from delivering meals on wheels can be good ways of monitoring and being alert to someone’s personal health status.
Developing good working relationships with other agencies who can or also support a client is important, as are sound referral processes.
So how are you going to ‘stand by your clients’ and support them to live life their way?
We hope you enjoyed this article on the third Standard. This blog post is part of a series on the New Aged Care Standards, where we investigate how and why they were developed and take an in depth look at each of the Standards to give you ideas for implementing these effectively within your organisation. If this is of relevance to you and you’re not signed up for our short email alerts, fill in the quick form at the bottom of the page and we will let you know when the next post is released. We also send a monthly round up of blog posts and videos.
Other posts in this series
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