DHHS Reference:
The Quality of Support Review process is a mechanism to identify areas for improvement and to implement strategies that will serve to support the safety, health and wellbeing of people with a disability. As part of the Quality of Support Review process, the department is required to request and collate information from the disability service provider.
Please complete all parts of this Quality of Support Review template and return to <name, email, phone> by <date>. You may attach documentation/evidence to support your response if you wish. The information you provide will be used for the purpose of conducting the Quality of Support Review and may be sent to the Disability Services Commissioner if requested.
The report will provide evidence to be assessed as part of the Quality of Support Review.
The Quality of Support Review template must be signed by the person completing it and endorsed by a senior manager of your organisation (chief executive officer, senior divisional manager or appropriate delegate).
Additional information or documentation may be sought as part of the Quality of Support Review process. (Please refer to the Quality of Support Review guideline further information).
Incident report details
Client incident report number (IRD) / Date incident occurred / dd/mm/yyyyDate incident first told / dd/mm/yyyy / Date incident registered by department / dd/mm/yyyy
Incident Type: Physical Assault – Staff to Client Sexual Assault – Staff to Client Unexplained Injury (highlight one)
Service Provider
Name of service provider:Address:
Person with a disability details
Surname / First nameMale / Female/ Other (highlight one) / Date of birth / dd/mm/yyyy
Profile of person with a disability / Provide a summary of the person’s disabilities, mobility, support needs and communication requirements.
Summary of incident/allegation
Summary of incident/ allegation / Provide a brief summary of the alleged incident and/or allegationHow to complete this template
1.1 Question
/ Action taken / Opportunities for improvementAnswer each question and provide a detailed response in the “Action Taken” and “Opportunities for improvement” columns.
Please refer to the following documents for guidance:
· Quality of Support Review guideline
· Critical client incident management instruction Technical update 2014
· Responding to allegations of physical or sexual assault Technical update 2014 / Provide more information about your response including:
· dates
· times
· location
· who was involved
· description of circumstances
· reasons for response
· influencing factors
· impact on the person with a disability. / What opportunities for improvement have you identified?
What would you do differently in the future?
How could you improve your response?
Identified opportunities for improvement are to be summarised in the Part 4: Improvement Action Plan
Definitions
‘Key support person’ / A ‘key support person’ for a person with a disability may include a family member, friend, advocate, ‘circles of support’ and significant others.
The role of the key support person is to provide support and advocacy, and ensure client’s rights are respected in relation to any subsequent investigation or action taken. A key support person should be someone who preferably knows the client well and has their trust.
Fully substantiated / partly substantiated / not substantiated / Following an investigation the alleged incident may be:
Fully substantiated: the evidence establishes on the balance of probabilities the alleged incident of assault is proven.
Partially substantiated: the evidence establishes on the balance of probabilities that some of the alleged incident of assault is proven.
Not Substantiated: the evidence establishes on the balance of probabilities that some of the alleged incident of assault is not proven.
Part 1: Person with a disability health, safety and wellbeing
Has the person with a disability’s health, safety and wellbeing needs been met?
Please use a person-centred perspective to consider the adequacy of the Action Taken with regard to the following:
1.1 Immediate response
/ Action Taken / Opportunities for improvement /1.1.1 What steps were taken to address the person with a disability’s immediate safety, health and wellbeing? / Provide a brief description of the actions taken to support the person’s health safety and wellbeing immediately following the incident.
How was the person with a disability:
· reassured?
· concerns acknowledged?
· supported to feel safe?
1.2 Medical attention
/ Action Taken / Opportunities for improvement /1.2.1 Was the person with a disability injured? / How was the person assessed for injury?
How was the client involved in the assessment?
1.2.2 Was the client offered medical attention?
1.2.3 Was medical attention required?
If yes, was medical attention sought and when (date and time)?
If no, why not?
1.2.4 How was the person with a disability supported to communicate directly with medical staff?
1.2.5 Was a forensic examination undertaken?
If yes, by whom? What was the outcome? / In some instances, the police may suggest that the Victorian Institute of Forensic Medicine is contacted to provide a forensic medical officer, free of charge, to examine the victim.
The Victorian Institute of Forensic Medicine provides clinical services and medical advice in the investigation of violent crimes and other offences.
1.2.6 Was a medical opinion provided regarding the cause of the injury/whether an assault occurred?
Provide details
1.2.7 What was the medical recommendation/s about the cause of injury?
1.2.8 Have the medical recommendation/s been acted upon? If not, why?
1.2.9 Are there ongoing concerns for the health or wellbeing of person with a disability as the result of the injury/alleged incident?
How have those concerns been addressed? / Has the person recovered from their injuries as the result of the alleged incident?
1.3 Supports
/ Action Taken / Opportunities for improvement /1.3.1 What and how were supports have been offered to the person with a disability following the incident?
For example counselling, CASA, access to advocate., other supports / What supports were offered?
How were they offered?
How often were they offered?
How were they explained to the client?
How was the person supported to access supports?
1.3.2 Did the person with a disability accept the offered supports?
If not why not?
1.3.3 Has the person with a disability’s support plan/s (including communication plan) been reviewed as the result of the incident?
Provide details
1.4 Secondary consultation
/ Action Taken / Opportunities for improvement /1.4.1 How were other professionals consulted following the incident including professionals with regular involvement with the person with a disability? / i.e. Office of Professional Practice, case manager, psychological or psychiatric services, physiotherapy, occupational therapy etc
1.4.2 How did you consult with the Office of Professional Practice?
1.4.3 Were restrictive interventions used in this incident?
(physical, chemical, mechanical)
1.4.4 Was the use of restrictive intervention reported to Restrictive Interventions Data System(RIDS) if required? / If yes, please provide date
1.5 Police involvement
/ Action Taken / Opportunities for improvement /1.5.1 Was/were the alleged incident/s reported to police? On what date was the report made?
If police contact has not been made, why not? / Name of Police Station, by whom?
1.5.2 Who did the police interview and on what date did the interview occur?
(i.e. the person with a disability, staff, or other witnesses?)
1.5.3 Was the person with a disability supported to report the incident to police? How?
1.5.4 What was the outcome of the police response/investigation? / What was the Police response?
1.5.5 Was an Independent Third Party (ITP) offered to the person with a disability upon being interviewed? If not, why not? / Independent Third Persons (ITPs) attend police interviews for adults and young people with disability to ensure that they are not disadvantaged during the interview process.
Victoria Police members are responsible for contacting an ITP to attend an interview.
1.6 Other people with a disability
/ Action Taken / Opportunities for improvement /1.6.1 Following the incident, what supports have been offered to other people with a disability who were involved in, impacted by or witness to the incident? / For example counselling, CASA, access to advocate, and/or family.
1.6.2 Did other people with a disability accept the offered supports?
If not why not?
1.6.3 Are there ongoing concerns for the safety, health or wellbeing of other people with a disability using the service following this incident?
1.6.4 How have those concerns been addressed?
Part 2: Person with a disability rights
Have the person with a disability’s rights been protected and promoted?
Please use a person-centred perspective to consider the adequacy of the Action Taken with regard to the following:
2.1 Engagement and communication
/ Action Taken / Opportunities for improvement /2.1.1 Given the person with a disability’s communication preferences, how did you engage with them following the incident?
2.1.2 What did the person with a disability want to happen following the incident?
2.1.3 Was the person with a disability’s wishes acted upon? If not, why?
2.1.4 How has the person with a disability been provided with information about the actions taken in response to the incident?
2.1.5 What was the person with a disability’s feedback regarding the actions taken response to the incident?
2.1 6 If appropriate, has the person with a disability and/or support person received an apology?
2.2 Support person (family/advocate)
/ Action Taken / Opportunities for improvement /2.2.1 When did you communicate about the incident with the person with a disability’s support person (if appropriate)?
2.2.2 If the support person was not informed of the incident and the investigation/review findings, why? / Provide details
2.2.3 What was the support person’s feedback regarding the actions taken response to the incident? (if applicable)
2.3 Rights and privacy
/ Action Taken / Opportunities for improvement /2.3.1 How was the person with a disability made aware of their right to seek the support from an advocate following the incident?
2.3.2 How was the person with a disability made aware of their right to seek further advice and support or lodge a complaint through your organisations’ internal complaints process, with the Disability Services Commissioner or the Victorian Ombudsman following the incident?
2.3.3 How was the person with a disability’s privacy maintained following the incident?
2.4 Other people with a disability
/ Action Taken / Opportunities for improvement /2.4.1 How were the rights and privacy of other people with a disability, who were involved in or witness to the incident, upheld and protected?
PART 3: Incident management, reporting and investigation
Has the service provider reported, investigated and taken action with staff appropriately?
3.1 Reporting the alleged incident
/ Action Taken / Opportunities for improvement /3.1.1 Was the alleged incident reported to management immediately? When?
3.1.2 If not, what action have you taken to ensure staff report alleged incidents to management immediately?
3.2 Reporting timelines
/ Action Taken / Opportunities for improvement3.2.1 If the Client Incident Report was not provided to the Department of Health and Human Services within the timelines, what action have you taken?
3.3 Investigation by the service
/ Action Taken / Opportunities for improvement /3.3.1 Was an investigation undertaken? If yes, on what date/s did the investigation occur?
3.3.2 Who undertook the investigation? (Name of investigator/agency, internal investigator/external investigator)
3.3.3 What was the scope and methodology of the investigation?
(What was the investigation’s focus? Who was interviewed? What files were reviewed?)
3.3.4 What were the findings, outcomes and/or recommendations of the investigation?
3.3.5 Were the investigation findings and recommendations accepted and actioned?
You may attach documentation if you wish.
3.3.6 How was the person with a disability involved in the investigation process?
If they were not involved, why not?
3.3.7 Were the findings, outcomes and/or recommendations communicated to the person with a disability?
3.3.8 What was the response of the person with a disability to the investigation findings?
3.3.9 How was the support person involved in the investigation process?
If they were not involved, why not?
3.3.10 Were the findings, outcomes and recommendations communicated to support person and what was their response?
For incidents involving unexplained injuries also consider:
3.3.10 Was there a cause identified for the unexplained injury?
(such as assault or failure to provide appropriate support to the person with a disability)
3.3.11 What actions have been taken to reduce the likelihood of further injury occurring?
3.4 Actions taken with staff member
/ Action Taken / Opportunities for improvement /3.4.1 Was there a staff member identified as a perpetrator/having contributed to the alleged incident?
3.4.2 Was the staff member removed or stood down pending investigation following the alleged incident? What date did this occur? If not, why not? / Provide details
If the staff member was removed to another position, what duties are they completing? Are they being supervised?
3.4.3 Was the alleged incident substantiated against the staff member?
(Fully substantiated / partly substantiated / not substantiated)?
3.4.4 What action has been taken with the staff member following the investigation outcome? Provide details
3.4.5 What risk assessment was undertaken prior to the staff member returning to work (including where the alleged incident was not substantiated)?
How has the staff member’s performance and conduct been supervised and monitored following the alleged incident? / Provide details of the assessment undertaken to mitigate the risk prior to the staff member returning to work?
What measures/strategies did you put in place to manage the risk?
3.4.6 How was the person with a disability consulted regarding the staff member returning to normal work duties?
3.4.7 Was the support person consulted regarding the staff member returning to normal work duties? If not, why?
3.5 Pre-employment and post placement safety checks
/ Action Taken / Opportunities for improvement /3.5.1 What is/was the work tenure and employment status of the staff member at the time of the alleged incident?
(casual permanent, agency labour hire, part time)
3.5.2 Was a Criminal Record Check undertaken pre-employment for the staff member? Is it current?
3.5.3 For residential services only
Was there a Disability Worker Exclusion Scheme (DWES):
· pre- employment screening check undertaken for new staff
· preliminary notification and final notification to DWES?
· Was this preliminary notification within the 5 day timeline requirement?
If not, what were the reasons?
3.6 Staff support