Intake and Transition Policy and Procedure

Introduction

Decent Care is committed to providing people with a high standard of service aimed at meeting individual needs and promoting dignity, purpose, and security. Decent Care provide a consistent and transparent approach to all people entering or exiting the service.

Principles

The United Nations Convention on the Rights of Persons with Disabilities and the National Disability Insurance Scheme quality standards promote access, inclusion and choice for people with disability with a focus on their individual needs, goals and aspirations. Decent Care aims to promote these principles within all aspects of intake and transition process.

Policy

Decent Care acknowledges all people have the right to accurate, clear and transparent information when enquiring, or accessing or transitioning from the service. This information is provided to inform their decision making. The intake process is undertaken to identify the individuals needs and preferences. This information is utilised to identify the plans required and to identify and manage risks associated with their supports and daily living. Transition planning supports participants who are accessing or leaving the service to do so, in a planned, communicated and risk managed way to minimise any negative impacts that may arise during the process. Decent Care acknowledges that each person has the right to refuse a service or leave Decent Care at any time they choose. Furthermore, it is acknowledged that Decent Care may discontinue a service in consultation with the person, their family and other important members of the person’s support network if the service is no longer sustainable or appropriate to the participant. Decent Care is committed to working with and referring to other community services or organisations to meet the multiple needs of participants. Exit procedures will be fair, transparent, follow due process and uphold the rights of participants.

Procedure

Pre-entry

Entry criteria

Initial Meeting
On entry to the service, an initial meeting will be arranged with the participant, their family/carers and other significant people from their support network This may take place at the person’s home, or other suitable community venue. The initial meeting provides an opportunity to further discuss the participant needs and to review any documentation available, including a transition form from a previous provider, if available. Where a person provides their NDIS Plan, Decent Care will determine if the organisation is able to deliver the specific supports detailed. If the NDIS Plan has not been provided, Decent Care will request the participant’s NDIS Participant Number (for Agency Managed participants). Decent Care acknowledges that participants do not have to provide their NDIS Plan if they do not wish to.

Welcome pack The participant will receive a Welcome Pack explaining their rights while receiving supports from Decent Care. This information is discussed in a format that best meets the participants communication needs.

The service agreement
Service agreements are developed in collaboration with the participant where all components of the agreement are discussed. This includes what services will be provided and how often. All costs associated with the delivery of service are clearly detailed outlining the amount per hour and total budgeted cost for the period The service agreement is signed by both parties, and the participant is provided a copy of the agreement. In the instance where the participant is unable to sign, and a representative is not present, a note will be made outlining the circumstances under why this occurred. A service agreement is created for each program the participant is accessing from Decent Care (e.g. Support Coordination, Support Services, Plan Management), to manage conflict of interest involved in providing multiple support.

About Me and My Supports (Intake and Assessment)
All participants who enter the service will, in collaboration with the relevant Program Manager, complete an About Me and My Supports Form. The information informs and determines the goal planning activities and service provision and ensures that the participant is receiving supports in line with their needs and preferences.

Personal preferences

The About Me and My Support Form identifies the individuals’ personal needs and preferences to ensure a person-centred approach is provided in the delivery of services. This information includes the participants:

Specialised Plans required

The About Me and My Supports Form identifies which plans will be required in order to effectively support the participant. These plans ensure comprehensive supports are provided.

Where identified, this will include:

Vulnerability assessment (My Safety Assessment)
An important feature of the intake process is for a vulnerability assessment to be undertaken. The outcome of this assessment is recorded within the Master Register and determines the frequency of management oversight required in the provision of supports to ensure participant safety and quality of care. This process is informed by the Prevention of Violence, Abuse, Neglect, Exploitation and Discrimination, as well as Emergency Management Planning (See also Prevention of Violence, Abuse, Neglect, Exploitation and Discrimination Policy and Procedure and Emergency Management Policy and Procedure. The My Safety Assessment, additionally outlines individual risks and mitigation strategies for the participant.

Environmental safety checklist

Where supports are provided in the home

Where supports are provided in the participants home, an environmental safety checklist will be undertaken in consultation with the participant. The checklist allows Decent Care to identify any risks to the participant or team member in the provision of supports. Where there are identified risks, risk management strategies will be developed and the appropriate alerting mechanism will be implemented for the team member (See also Work, Health and Safety Policy and Procedure).

Where supports are provided in settings other than the home

Where support is being provided in alternative setting, a risk assessment will be undertaken in consultation with the participant. Where risks are identified, the appropriate management strategies will be developed and recorded within the participants progress notes

Exiting the Service

A person may leave Decent Care for a number of reasons or circumstances including:

Service Transition

Transition

Where a person is transitioning or transferring from another service provider, Decent Care will seek permission from the person and/or their family/carer to contact their ingoing/outgoing provider to obtain information about support requirements to assist support delivery during the transition. This process includes the development of a documented plan to support the transition across services. The process includes undertaking a documented risk assessment and management plan to minimise any negative impact arising from the change.

Temporary transitions

Where a participant undertakes a temporary transition, including to a health care setting or hospitalisation, Decent Care ensures transition planning occurs to support the participant with the process. This includes undertaking a comprehensive risk assessment that is reviewed and communicated throughout the temporary period, to ensure strategies that are developed minimise any negative impacts arising from the arrangement.

Where it is not the person’s choice to exit the service

Information regarding the reasons for being asked to leave the service will be provided and explained to the participant. These reasons will be included in the transition plan if required. The service transition will only be actioned after discussion and consultation with the participant, their family/carer and other important stakeholders, and strategies have been implemented to meet irreconcilable differences.

Exit interview

As part of the transition strategy the participant and their family or carer will be offered the opportunity to participate in an exit interview. Communication methods appropriate for the participant and supporters will be used to assist this process as required. This information will inform the continuous improvement and feedback processes to refine services and identify any training requirements for the service.

Training
All Decent Care team members receive training in relation to intake and transition procedures at induction and through ongoing practice review.

Responsibilities

The Managing Directors are responsible for:

Program Managers are responsible for:

Team members are responsible for:

Related Policies and Documents