How to manage risks during the transition of support from one provider to another
This fact sheet may assist disability and health care support providers such as hospitals, allied health professionals, supported living accommodation, out of home support, aged support and other disability service providers when a person in their care is transitioned to another service provider.
When is a transition of support needed?
A transition of support may be required for many reasons, such as when changes occur in someone’s health or medical or behavioural support needs and the current service provider is no longer able to meet that person’s needs. Or the person may have chosen to use a different provider.
Transitions may be planned or unplanned
Planned transitions could include:
- normal discharge planning activities (e.g. from a hospital to home/residential care facility) or
- a person with a disability commences a school leaver support program (SLES) to transition from school into employment.
Unplanned transitions of support occur in emergency or escalating situations.
These are typically when the person’s medical needs or behaviours change in such a way that a different service provider can better meet that person’s needs (e.g. where aggressive behaviour cannot be appropriately managed through current behaviour supports or the person's health deteriorates suddenly).
How can I manage the risks?
If you are a business or other ‘person conducting a business or undertaking' (PCBU), you have a duty to ensure your health and safety, that of your workers and others, under the Work Health and Safety Act 2011.
If you cannot eliminate all risks to health and safety, you need to minimise risks so far as is reasonably practical.
The best way to manage risks associated with a transition of support is to talk to the current service providers, your workers and the person (where possible) about their support needs.
Then you should follow these steps:
- Identify all hazards associated with supporting the person (e.g. what are the hazards with equipment, behaviour, support tasks and environmental needs?)
- Assess any risks (likelihood) of injury to workers and the person from these identified hazards.
- Put in place control measures (actions/activities to prevent, eliminate or reduce the hazard).
- Regularly review how effective your control measures were.
Information sharing is critical to the management of risk during transition. When sharing information you must meet privacy and other laws.
You will need to have a systematic process to document risks to worker safety, and how those risks will be eliminated or reduced during and after the transition of support.
Identify all hazards and assess any risks
You need to consider potential hazards that could increase health and safety risks to both workers and the person being supported.
Risks increase during transitions of support when:
- transitions are done in an emergency or are poorly planned
- the new service provider does not have enough information to understand the person’s needs or behaviours (for example discharge summaries or behaviour support plans)
- plant and equipment are not provided or maintained (for example mobility support equipment)
- people with specific needs are placed with organisations who are not ready to manage those needs (such as behaviour or mobility support)
- workers are not familiar with the person and/or have not been adequately trained in support tasks needed to safely care for the person.
Put in place control measures
If you are transitioning support to another service provider, consider how you will share information about the person's support needs with the new service provider. Where possible this should be before, or at the time of transition in the case of an emergency situation.
You might consider:
- sharing detailed discharge summaries and behaviour support plans
- holding a case conference before the hand-over
- mentoring workers about care needs and suitable controls.
If you are the receiving service provider, consider how you will obtain information about the person's needs so you can assess risks and have controls in place when you start supporting the person.
You might consider:
- how you will obtain information about the person’s support needs
- who will do the risk assessment and when (preferably before support starts). Include workers in this process
- risk factors
- how to decide on risk controls and if they can be implemented (considering access to equipment, resources or workers)
- implement high level controls to reduce risks first. These could include changing the environment using equipment. Then consider controls like staffing ratios, training and supervision
- how to tell workers (especially new starters) about the person's needs and risk controls. Information needs to be easily available to workers doing the support work in a way that can be shared between shifts if the support period extends over multiple shifts. Ideally, this information should be written rather than verbally passed on.
- escalation procedures if a person's needs are higher than anticipated
- contingency plans to support unplanned or unexpected transitions.
Control measures must be maintained to be fit for purpose and effective.
You must review and update control measures when:
- the measure no longer controls the risk
- a new relevant hazard or risk is identified
- consultation identifies the need for a review, or
- a health and safety representative requests a review under clause 38(4) of the Work Health and Safety Regulation 2017.