This Practice Standard aims to ensure that NDIS participants are supported by providers to make informed decisions, exercise control and optimise their independence (NDIS 2020).
NDIS providers must meet the following quality indicators:
Providers should support participants to engage in active decision-making and make individual choices by providing required information in a timely manner. This information should be delivered using the language, mode of communication and terms that participants are able to understand
Providers should support participants’ dignity of risk in decision-making. Participants should be able to make informed decisions by considering the benefits and risks of their options
Informed consent is the ability for a person to voluntarily agree or disagree to different aspects of their care, based on information about the potential benefits, risks and alternative options (RACGP 2018).
It is a key component of person-centred care based on the participant’s right to autonomy (QLD DoH 2017).
People have a legal right to be informed about any proposed healthcare interventions. Using the information given to them, they may accept or decline these interventions. They must also be free to change their decision if they wish to do so (Better Health Channel 2014; QLD DoH 2017).
Participants can only provide valid informed consent if they are given sufficient, clear information and fully understand the nature of what is being proposed. Otherwise, the provider may be held legally liable for breaching the participant’s bodily autonomy (Better Health Channel 2014; ALRC 2014).
Effectively Communicating Information
Effective communication between workers and participants is an essential component of providing high-quality and safe care (ACSQHC 2016).
As well as improving participant outcomes and satisfaction, effective communication is crucial in preventing errors, unnecessary distress and inappropriate interventions (ACSQHC 2016).
It also ensures that participants are adequately positioned to make informed choices about their care.
Every NDIS participant has the right to access clear, timely information about the care they are receiving. You may assume the information you provide is easy to comprehend. Yet, 60% of Australians find it difficult to understand complicated healthcare concepts and information (Ciaglia 2017, OHO 2015).
Furthermore, communication issues are the third most common type of complaint received by the Office of the Health Ombudsman (OHO 2015). These communication complaints often include:
Poor attitude or manners from staff
Incorrect or misleading information
Workers not accommodating the client’s special needs.
This suggests there is significant room for improvement.
What do Participants Need to Know?
The following information should be clearly communicated to NDIS participants:
Care/service options available
Referrals to other providers/services
Health literature and education opportunities
How to access their own health information (e.g. care plan)
(OHO 2015; ACSQHC 2016)
How to Effectively Communicate Information to Participants
The ACSQHC lists the following as the essential components of effectively exchanging information:
Two-way exchanges of information
Engaging care recipients in decision-making and care planning
Every person, including those living with disabilities, has a legal right to dignity of risk - that is, the ability to make life choices and take risks (Interchange 2020).
Having the autonomy to take reasonable risks ensures that participants are able to:
Learn and grow
Enjoy a greater quality of life.
In order to support dignity of risk, NDIS workers should:
Consider the participant’s capacity to make decisions. Are they present of mind? Do they have all the information they require? Should a family member or the resident’s GP be consulted first?
Consider what is a ‘reasonable’ risk, e.g. food choices, daily walks or refusal of recommended care
Keep sufficient documentation. Ensure they have documented every facet of the decision-making process, from who has been consulted, to the information that has been provided to the participant regarding potential risks, and their subsequent acknowledgement of these risks
Familiarise themselves with their providers’ policies. Ensure they are only working within the scope of their role and what processes must be followed to fulfil a resident's request.
(Keast 2016; Woolford 2017)
Supporting Intimacy and Sexual Expression
Ensuring participants’ rights to intimacy and sexual expression is an essential part of respecting their autonomy (NDIS 2020).
Practical ways that NDIS workers can help to support intimacy and sexual expression include:
Providing non-judgmental care
Helping to personalise each participant’s dressing and grooming
Offering privacy when appropriate (e.g. using ‘do not disturb’ signs, always knocking before entering a participant’s room)
Referring participants to the right resources (e.g. sexual health educational material)
Bauer, M, Fetherstonhaugh, D, Tarzia, L, Nay, R & Beattie, E 2014, ‘Supporting Residents’ Expression of Sexuality: The Initial Construction of a Sexuality Assessment Tool for Residential Aged Care Facilities’, BMC Geriatrics, vol. 14, p. 82, viewed 3 September 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4