CHC43415 Certificate IV in Leisure and Health (Release 2)
CHCCCS025 Support relationships with carers and families
CHCHCS001 Provide home and community support services
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Student number: XXXXXX
Assessment number: 35129/02
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CHCCCS025 Support relationships with carers and families (Release 1)
This unit applies to workers who are required to work positively with the carers and families of clients using the service based on an understanding of their support needs.
CHCHCS001 Provide home and community support services
This unit applies to workers who are required to work in a home support environment and community settings with clients, family members, staff, visitors, suppliers and others to meet established work requirements.
This document is Assessment 2 of the three assessments you are required to complete, together with structured workplace learning, for CHCCCS025 Support relationships with carers and families (Release 1) and CHCHCS001 Provide home and community support services.
This assessment is designed to gather evidence of competence, specifically to:
• include carers and family members as part of the support team
• assess and respond to changes in the care relationship
• monitor and promote carer rights, health and wellbeing
• determine requirements of individual plans
• establish relations in the home
• operate respectfully in the home
• complete reporting and documentation.
35129/02 Written assessment
A. When working in the home and community sector, best practice and current approaches to working with clients include:
• using person-centred practice
• working in a consumer-directed care model
• understanding the potential for empowerment versus disempowerment when supporting clients.
The leisure and health worker integrates these contexts into their support work on all levels.
Complete the table below by describing each approach and giving an example of how you might practice this when supporting clients.
Approach Description (20-50 words) An example of how you might practice this when supporting clients (50 words)
Empowerment versus disempowerment
B. Read this case study and then answer the following questions.
You’ll be working with Mrs Brady, to provide her with leisure and health activities. After reviewing her file and meeting with her care support worker, you know now that:
• Mrs Brady is 98 years old and lives with her grandson, Justin. He is her primary carer. Mrs Brady has dementia, high blood pressure and has a carer support worker who assists her with showering, dressing and walking. Mrs Brady currently has a package where support workers visit daily at 8am to assist her with showering and dressing, although Mrs Brady does not usually get out of bed until 10am. Mrs Brady sometimes gets angry at the support workers for getting her out of bed so early.
• Mrs Brady likes to walk in the garden in the afternoons and it seems to calm her. She has a better evening and night when she has had a walk in the garden. Justin needs to be at his office from 2.30pm to 4.30pm, so she often misses out on the walk during the week. Justin feels torn as he would like his grandmother to walk each day to maintain her mobility, but he can’t change his time to be at the office. Currently, the support workers cannot schedule to assist with the afternoon walks.
• Mrs Brady misses going to the hairdresser that she has attended for the last 10 years, but Justin is worried about taking her as she may fall. He is trying to cut Mrs Brady’s hair himself, but this has not been entirely successful as she becomes distracted easily and doesn’t understand why Justin would be cutting her hair.
• Justin has heard about CDC (consumer-directed care) packages now available and he wonders if this type of package may be suitable for his grandmother.
After meeting with Justin and the care support worker, you have developed an individual activity plan to:
• Take Mrs Brady on her daily walks between 2.30pm and 4.30pm each day while Justin is away at work.
• You have arranged for transportation once a month and accompany Mrs Brady to the local hairdresser.
Justin is grateful that you can assist. He now can go to the office, knowing his grandmother is doing something she enjoys.
Complete the table outlining:
• Two areas in CDC where Mrs Brady and Justin could target support for Mrs Brady and Justin in a CDC package.
• Detail what could be arranged for each area of support.
• Explain how each area of support would impact on Mrs Brady’s life.
Area of support What could be arranged? (50-100 words) What difference would this make to Mrs Brady’s life? (50-100 words)
C. As a leisure and health worker in home and community, you may identify that a client is disempowered and may need to act upon this. Read the scenario and then answer the following questions.
You have commenced working with Mr Jones who is a 73-year-old man who has recently started to receive home and community care services. You have noticed that Mr Jones does not have any visitors except for his daughter and his support worker, Julie. Upon asking Mr Jones the reason why his friends are no longer visiting, he became very upset and commenced telling you that his daughter has stopped his friends because she believes they are undesirable characters who frequently borrow money from him without paying it back. He also tells you that his daughter is selling his house and wants him to move into an apartment.
Upon returning to the office, you scheduled a meeting with Mr Jones, Case Manager, Terri, and his support worker, Julie, to report concerns that Mr Jones’ daughter, Michelle, is selling off his house against his wishes and that Michelle is not allowing his friends to visit, as she has accused them of being undesirable characters who frequently borrow money from Mr Jones without paying it back.
You and Julie visit him, and he asserts that he did not want to leave home, but was convinced by Michelle that he should put the home on the market and move to a flat. You and Julie discover that Mr Jones has signed over an enduring power of attorney to his daughter, as she has told him frequently over the last couple of years that he is 'losing his mind' and is not capable of looking after his finances anymore.
Mr Jones tells you and Julie that his friends have borrowed money from him in the past but have always paid it back and says he would like them to be able to visit him.
You, Julie and Mr Jones meet with Terri and Michelle and explain that Mr Jones would like his friends to be able to visit.
Julie reminds Michelle that it is Mr Jones' right to decide who visits him, and not hers. With assistance from Terri, Julie asks you to organise an appointment with a psychogeriatrician, who tests Mr Jones' mental capacity and reports that he shows no signs of mental impairment. The psychogeriatrician says that Mr Jones has decision-making ability and is perfectly capable of managing his own affairs if he wishes to.
You, Julie and Terri discuss Mr Jones’ rights with him, explaining that he does not have to sell his home if he does not want to. You continue by telling Mr Jones about a range of community care services that are available to support him to continue to live at home independently.
He asks if, as he still has decision-making capacity, is he able to revoke the enduring power of attorney that Michelle holds, and you (at his request) assist him to arrange a solicitor’s appointment. You and Julie encourage him to get in contact with other family members to provide support and assistance.
Mr Jones calls his son, James, who lives interstate and tell him what has occurred. James is concerned and horrified. He flies over immediately to assist his father to sort out his affairs. Mr Jones, supported by James, contacts the real estate agent who has been advertising his home and arranges to stop the sale going through. Mr Jones then draws up a new enduring power of attorney naming James as his authorised representative, but only in the event that Mr Jones loses decision-making capacity.
You and Julie explain to Mr Jones that he can report what his daughter has done to the police and press charges if he wishes. Mr Jones decides he does not want to pursue legal action as the sale of the house was stopped in time, and he would like to be able to patch up his relationship with his daughter in the future in order to maintain contact with his grandchildren.
C1. Outline two areas where Mr Jones’ daughter had disempowered him? (100 words)
C2. Identify two actions you, Julie and/or Terri took to address these areas so that Mr Jones was empowered? (50 words for each action taken)
As a leisure and health worker in aged care and home and community, you will be required to establish relationships with clients and other people in their home.
Read the scenario and then answer the questions that follow.
Margaret lives in a unit with Stan, her partner, who is also her enduring guardian and her carer. Sometimes Stan’s children, Ellen (12) and Tony (18), live with them, too. Stan is unemployed but does some mechanical work from home.
Margaret is 59 years old and has younger onset dementia. She becomes upset when she cannot complete tasks and activities that she used to do easily. This frustrates her, and she can become agitated and angry at her inability to do what she sees as simple things.
Margaret likes to do her own washing, but sorting the clothes, putting the washing machine on and hanging out the clothes and then bringing them in off the line is becoming increasingly difficult. She is able to complete the tasks physically but, at times, can’t remember when to do her washing, how to sort the clothes for washing, the sequence of the tasks, or to hang out or take the clothes off the line. She wants to continue to do her own washing and is afraid that if she can’t do this it is a sign of the end of her independence.
Sue, one of CareShore’s leisure and health workers, is assigned to visit Margaret to support her twice a week. She receives a handover from her co-ordinator and before she visits, she reads Margaret’s plan. The purpose of the support visit is to assist Margaret with the washing, folding and putting clothes away. Sue notes she needs to take an RCD protector to use with the washing machine and report in to the office if Margaret is not at home when she calls. She notes that Margaret likes to use a list to prepare to do her laundry and that she requires prompting if she forgets where she is up to in the clothes sorting process. Sue notes on the individual plan that she is to assist Margaret with washing her sheets and her personal clothes and towels only. The rest of the family washing is maintained by Stan. The individual plan also notes that workers are to monitor the condition of Margaret’s clothing as previously she had been wearing stained and torn clothing, and one of Margaret’s support goals is to dress in well-maintained clothing.
Sue calls Margaret on the day before the scheduled visit, introduces herself and confirms the address and time as well as the purpose of the visit with Margaret. Margaret also asks her to speak to Stan about the arrangements on the phone, which Sue does. Sue knocks on Margaret’s door at the scheduled visit time. Tony answers the door and Sue greets him and asks if Margaret is at home. Margaret comes to the door and Sue introduces herself and shows Margaret her photo ID from CareShore. Margaret invites Sue in and says she remembers that the support worker was going to visit. Before commencing the washing, Sue speaks with Margaret asking her how she has been and who is at home with her today. Stan is home, but he and Tony are going out. They say ‘Goodbye’ and leave.
Sue asks Margaret about washing, reminding Margaret that is the purpose of her visit today. She asks if she wishes to start the washing and whether she can assist with gathering the clothes. Margaret pulls a list from her drawer which outlines the steps to preparing for the washing. They go through it together and start the process. During the visit, Sue speaks with Margaret about how the visits are for her and if there is anything else she is having difficulty with. Margaret says she would like to go shopping for underclothes and Stan is too embarrassed to take her, she doesn’t have any close female friends or relatives she can ask. Sue adds this activity on Margaret’s individual plan and schedules a time and transport to go shopping.
Stan and Tony return and Stan says he is worried as Margaret does not seem to be sleeping well at all, and she gets up and down a lot at night. He says he is afraid he is not doing enough to support Margaret and feels ill-prepared for his role as carer.
In your own words, complete the questions below, drawing from the information in the scenario and on the information, you have learned from this module.
A: How does Sue assure Margaret of her identity before entering the house? If Margaret has had another worker, is there another means by which to assure Margaret that Sue is her new support worker? (50 words)
B: How does Sue establish consent from Margaret and provide her information on the purpose of her visit? (40 words)
C: Margaret tells Sue she needs to buy new underwear, but this has nothing to do with the washing task. Should Sue support Margaret to do this? Why or why not? (50-100 words)
D: Stan and Sue talk about his role as carer and how he is feeling about this. Is it appropriate for Sue to talk with Stan about this? Why or why not? (50-100 words)
E: When they go to the laundry area, Sue finds that there is animal faeces over the floor and in a litter box in front of the washing machine. What are the steps that Sue would need to follow to comply with duty of care requirements in this case of infection control for both herself and for Margaret, whilst demonstrating respect and sensitivity towards Margaret and her place of residence? (50-100 words)
F: One of the tasks that Sue has to attend is to support Margaret to wash her sheets. Margaret and Sue go to take the sheets off the bed and Margaret becomes embarrassed as the bedroom is very untidy with personal items, clothes and papers spread all over the floor. How could Sue negotiate the task of the plan (in this case to strip the bed and wash the sheets) while respecting that this is Margaret’s personal space? (50-100 words)
G: While they are hanging out washing, Sue sees that Margaret has bruising on both of her upper underarms and around her elbows. Sue asks Margaret how it occurred, and she tells her that Tony got angry recently as he wanted to watch the TV and he ‘frog-marched’ her out of the room and put her in the garden. Stan wasn’t home, and Margaret said she was scared to tell him as there would be ‘a hell of a fight about it’. Margaret tells Sue not to worry about it. What should Sue do in relation to dealing with ethical dilemmas, behaviours of concern and possible abuse or neglect in accordance with policy and procedure? (50-100 words)
Sue’s actions to ethical dilemmas:
Sue’s actions to behaviours of concern:
Sue’s actions to possible abuse and neglect:
One key aspect of providing support to a client is determining the requirements of the individual client plan (which may also be called the ‘care plan’). Using the individual plan allows the support worker to be prepared to support the client in ways that are unique to them and that provide safety for both the client and the worker. Read the extract from Margaret’s CareShore Individual client plan (attached is Appendix 1 CareShore Lifestyle and Wellbeing: Individual client plan) and answer the following questions.
A: After referring to the Individual client plan, in your own words, describe three pieces of equipment or supplies that Sue needs to take on her scheduled visit to Margaret.
B: Refer to the Individual client plan and in your own words, describe two goals that Margaret has and how Sue can support her with these goals. (20-50 words each)
Margaret’s goal How Sue can support her
C: How can Sue confirm the purpose and time of her visit(s) to Margaret? If Margaret does not seem to understand or remember, what should Sue do? (20-50 words)
You must complete and submit the following.
Case study questions
Part 1 – A - C
Part 2 – A - G
Part 3 – A – C
CareShore Lifestyle and Wellbeing: Individual client plan
Individual program plan
Client name: Margaret Sims DOB: 5 March 1950
Next of kin: Danielle Sims (sister) First day of program: 22 October 2017
Cultural background: English Languages spoken: English, some French
Religion: Catholic Emergency contact: Danielle Sims
(sister) Ph 0414 888 777
Client’s health background:
Margaret has dementia, which she manages with medication. She is prone to self-harm and has agoraphobia.
Client’s cultural background:
Margaret would like to learn more about her English heritage.
Client needs and requirements (including aids and additional support):
Requires assistance with hygiene, dressings, meals, housework.
Needs to have more regular exercise to build confidence and improve health.
Dislikes changes to routines.
Special dietary requirements:
Gluten-free diet, no caffeine.
Margaret has expressed an interest in yoga. This would need to be carried out in her home.
Schedule for yoga practice:
1. Sue to visit on 7 December to meet Margaret and discuss the yoga practice.
She will introduce some basic exercises.
2. Sue to visit every Thursday after that, to conduct a 45-minute yoga session.
3. Review progress after one month – Sue to discuss progress with Margaret and supervisor.
Special ceremonies (Birthday/Christmas/Easter/Other):
Margaret likes to celebrate her birthday with her sister.
She prefers to have a quiet day on Christmas day.
Margaret has never tried yoga before and is a little anxious. The lessons will need to be slow and steady. She will need to be provided with a yoga mat. In addition, a printed chart of yoga poses would help her continue the exercises between visits.
Dated: 1 December 2019