Checklist of Guardian S Responsibilities

GUARDIANSHIP PLAN

A guardian is appointed by the Queensland Civil and Administrative Tribunal (QCAT)
to make some or all personal decisions on behalf of an adult with impaired decision-making capacity.
You are asked to respect the privacy of the persons to whom this information may apply.

Checklist of Guardian’s responsibilities:

act as required by terms of Order;

apply General Principles;

act honestly and with reasonable diligence;

give the Tribunal a guardianship plan when requested;

keep records of guardianship decisions, with whom I consulted, or attempted to consult, and the reasons for my decisions;

consult with other stakeholders, guardians and administrators;

if I am not available for decision-making, inform the relevant people/provide emergency contact details;

advise Tribunal if changes to appropriateness or competence;

complete the Tribunal’s form “Guardian’s Report to the Tribunal” within two (2) weeks of it being sent to me when my appointment comes up for review, and sent to Tribunal with copies of completed Record of Decisions.

PRELIMINARY MATTERS

Surname of Adult:
Given Names:
Name of Guardian/s:
Tribunal Client No.
Date of Order: / / / / Length of Order:

Matters for which Guardian/s is appointed:

all personal matters

the following personal matters:

Accommodation

With whom ______has contact and/or visits

Health care

Provision of services

Day-to-day issues, including, for example, diet and dress

Legal matters not relating to the adult’s financial or property matters

Whether ______works and, if so, the kind and place of work and the employer

What education or training ______undertakes

Whether ______applies for a licence or permit

Seeking help for, or making representations to ______

A restrictive practice matter

Approving behaviour management plans

including the use of restrictive practices, if necessary

Directions Given to Guardian:

Adult’s current address:

Adult’s general practitioner:

Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:

Adult’s support agency/carers:

Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:

1.What difficulties do you see in doing the job as guardian and how will you solve these?

2.I plan to change the adult’s:YesNo

Health Provider

Support Agency

Carer

Accommodation

Contact with family/friends

Lawyer

Employment/training

Day to day issues e.g., diet/dress

Medical treatment

Other (Please specify other planned changes)

3.If yes to any of the above, please provide reasons and outline your proposed actions:

4.People in adult’s life (family, friends, attorney/administrator) with whom I intend to consult when making decisions:

Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Relationship to Adult: / Relationship to Adult:
Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Relationship to Adult: / Relationship to Adult:

5.In making decisions, I do not plan to consult with the following people:

Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Relationship to Adult: / Relationship to Adult:
Reasons for not consulting this person: / Reasons for not consulting this person:
Name: / Name:
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Relationship to Adult: / Relationship to Adult:
Reasons for not consulting this person: / Reasons for not consulting this person:

6.Individuals, health professionals and service providers, I plan to advise about my appointment as guardian and my duties and responsibilities:

Name: / Name:
Organisation / Organisation
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:
Name: / Name:
Organisation / Organisation
Address: / Address:
Phone: / Phone:
Fax: / Fax:
Email: / Email:

7.I plan to advocate for the adult so that he/she:

8.How will you involve the adult in your decision-making or take into account previously expressed wishes:

9.How often do you intend to visit or contact the adult and/or make contact with his/her service providers/other supports?

10.I plan to maintain the adult’s existing supportive relationships by doing the following:

11.If there is an appointed administrator or attorney for financial matters, how do you plan to involve them in your decision-making?

12.If I am temporarily not available for decision-making, I will inform the following people and give them emergency contact details:

13.I plan the following to ensure the adult’s best interests are met and he/she is protected from neglect, abuse or exploitation:

14.I plan to record my guardianship decisions, with whom I consulted, or attempted to consult, and the reasons for my decisions in the following manner:

15.Since being appointed as guardian, I have already resolved the following:

Only complete question 16 if you have been appointed as a guardian for a restrictive practice

16.I will consult with the following parties in the development of a Positive Behaviour Support Plan, and will only consent to the use of restrictive practices in compliance with that plan.

17.I agree to complete the Tribunal’s form “Guardian’s Report to the Tribunal” within two (2) weeks of it being sent to me when my appointment comes up for review.

Name of person completing this form:
Relationship to adult:
(If you are not a relative, please indicate how long you have known the adult)
Your address:
Your telephone contact details: / Home: / ( )
Work: / ( )
Mobile:
Your email address:
Signed:
Date: / / /

Guardianship plan

Version 2.0 – 22 November 2015