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Office of the Senior Practitioner. Asking the right questions: Making life better for people with a disability Lynne Webber Office of the Senior Practitioner Keith McVilly Deakin University. Faculty of Health, Medicine, Nursing & Behavioural Science.
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Office of the Senior Practitioner Asking the right questions: Making life better for people with a disability Lynne Webber Office of the Senior Practitioner Keith McVilly Deakin University Faculty of Health, Medicine, Nursing & Behavioural Science
Role of the Office of the Senior Practitioner • Protect the rights of people with a disability who: • show behaviours of concern and • are subject to restrictive interventions and compulsory treatment orders
Monitor Restrictive Interventions • Restrictive Intervention Data System (RIDS): • Who is restrained and secluded? • What kinds of medicines are used? • practice monitoring for practice improvement, • at an individual client level (e.g., initiating clinical reviews for high-risk clients), • at an organisational level (a tool for service managers) • at a systems level (a tool for those making sector wide decisions) • Any one who has a restrictive interventions must have a Behaviour Support Plan (BSP) • Do BSPs show evidence of best practice in behaviour support?
Other Research questions Some questions addressed: • What do people with a disability think about restrictive interventions? (Paul Ramcharan, RMIT University) • What do support workers think about challenging behaviours? (Stella Koritsas, Monash) • What is the best way to move towards restraint reduction? (Paul Ramcharan) • What do we know about physical restraint? (Keith McVilly, Deakin University) • What things work well in a good disability service? (Tim Clements & Chris Bigby, LaTrobe University)
Promoting dignity grants • What disability support workers did: • Change the skills of disability professionals • Change the skills of people with a disability • Change the environment • What they found: • Change is possible even with small amount of financial support • People are critical to change process • True person centred positive support with respect is the key to promoting dignity
What other questions should we ask? Further questions to be addressed: - What are the barriers to achieving a minimal restraint or restraint free environment - philosophical, educational and practical barriers? - how best to support people with persistent self-injurious behaviours that are highly resistant to environmental and psycho-educational strategies? - how might we re-conceptualise risk assessment, to ensure a focus on enabling people to do things, rather than justifying why they can't do things?
Positive Solutions in Practice Issue 1. Mindfulness Nirbhay Singh and his colleagues: • “Meditation on the Soles of the Feet” • reduce aggression in children and adults with a mild intellectual disability • Mindfulness plus traditional positive behaviour techniques more effective
Positive Solutions in Practice • Issue 2. From Seclusion to Solutions:Alternatives to seclusion • Based on a person centred approach and an assessment of the function/s of behaviour of concern • Removing seclusion rooms and creating Multi-sensory environments that are based on the person’s preferences and reason for behaviour
Positive Solutions in Practice • Issue 3. Getting it Right From the Start: The value of a good functional behaviour assessment (FBA) • 7 steps involved in conducting a functional behaviour assessment • A FBA can be completed by disability support workers, parents and anyone who has received some training. • Most disability support workers have had some training through their disability studies course
Positive Solutions in Practice • Issue 4. What is Chemical restraint • Defining Chemical Restraint • Percentage of people with disability on chemical restraint • Common questions about chemical restraint
Positive Solutions in Practice • Issue 5. Clinical Risk Assessment and Risk Management in People with an Intellectual Disability • Discussion of the importance of Clinical Risk Assessments • Clinical Assessment Tools
Goals of the Office of the Senior Practitioner • Human rights and citizenship • Quality of life and wellbeing • Community Inclusion • Positive lifestyle and behaviour support • Building relationships and collaboration to enable change to occur • Dignity of risk Dignity without restraints
OSP regional contacts: • Rod Carracher (N&WR) (Simon Wardale) • Mandy Donley (EMR and Troy Howard Grampians) • Frank Lambrick (BSW and SMR) • Brent Hayward (Gippsland) • Hellen Tzanakis (Hume) (Karen.M.Williams) • Moira Buchholtz (Loddon-Mallee) (Megan Phillips)