Preamble
BigDog Support Services Pty Ltd (BigDog) ensures that each client requiring high intensity daily personal activities receives appropriate support relevant (proportionate) to their individual needs.
Each client is involved in the assessment and development of the plan for their high intensity daily personal activity and management. With their consent, the client's health status is subject to regular and timely review by an appropriately qualified health practitioner.
Health practitioners may include; a Registered Nurse, Dietitian, Speech Pathologist, Pharmacist, Medical Specialist, General Practitioner and Stomal therapist deemed competent by training.
The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each client who has enteral feeding needs.
The requirements of this role will be clearly documented in a care management plan that has been developed and is overseen by an external health practitioner.
Both the training plan and the management support plan will include the identification of risks including actions and escalations.
BigDog will ensure that the support worker has the relevant knowledge and has received client specific training in order to safely support the client in the community.
All client specific training will be delivered by an appropriately qualified RTO.
Modules
5.1.1 Complex Bowel Care
BigDog ensures that each client requiring complex bowel care receives appropriate support relevant (proportionate) to their individual needs.
Each client is involved in the assessment and development of the plan for their complex bowel care management. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
5.1.2 PEG Feeding and Management
Percutaneous Endoscopic Gastrostomy (PEG)
Naso-Gastric Tube – Jejunum or Duodenum
PEG feeding tubes have been in use since the early 1980's. They are used increasingly for long term enteral nutrition where people cannot maintain adequate nutrition with oral intake. BigDog ensures that each client requiring enteral feeding and management receives appropriate nutrition, fluids and medication, relevant and proportionate to their individual needs.
Each client is involved in the assessment and development of the plan for their enteral feeding and management. With their consent, the client’s health status is subject to regular
and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
5.1.3 Severe Dysphagia Management
BigDog ensures that each client requiring severe dysphagia management receives appropriate support that is relevant and proportionate to their individual needs and preferences.
With their consent, their individual severe dysphagia management needs are assessed by appropriately qualified health practitioners, including by practitioners conducting regular and timely reviews if needs change or difficulty is observed.
Each client requiring severe dysphagia management is involved in the assessment and development of their severe dysphagia management plan which will identify their individual needs and preferences (such as for food, fluids, preparation techniques and feeding equipment); and how risks, incidents and emergencies will be managed to ensure their wellbeing and safety, including by setting out any required actions and plans for escalation.
5.1.4 Tracheostomy Management
BigDog ensures that each client with a tracheostomy receives appropriate suctioning and management of their tracheostomy relevant and proportionate to their individual needs. Each client is involved in the assessment and development of the plan for their tracheostomy suctioning and management. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
5.1.5 Urinary Catheter Management
In-dwelling Urinary Catheter, In-out Catheter, Suprapubic Catheter
BigDog ensures that each client with a catheter receives appropriate catheter management relevant and proportionate to their individual needs.
Each client is involved in the assessment and development of the plan for management of their catheter. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
5.1.6 Ventilator Management
BigDog ensures that each client requiring ventilator management receives appropriate support relevant and proportionate to their individual needs and the specific ventilator used.
Each client is involved in the assessment and development of the plan for their ventilator management. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
5.1.7 Subcutaneous Injections
BigDog ensures that each client requiring subcutaneous injections receives appropriate support relevant and proportionate to their individual needs and specific subcutaneous injections and medication administered.
Each client is involved in the assessment and development of the plan for their subcutaneous injections which includes dosage measurement and calculation. With their consent, each client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
There are documented written orders by the health practitioner prescribing the medication that trained workers may administer by subcutaneous injection.
5.1.8 Complex Wound Management
BigDog ensures that each client requiring complex wound management receives appropriate support relevant and proportionate to their individual needs.
Each client is involved in the assessment and development of the plan for their complex wound management. With their consent, the client’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure client wellbeing.
Additional Modules Hoist Transfer
BigDog ensures that each client requiring hoist transfer and management receives appropriate support proportionate to their individual needs and that support workers are provided suitable and adequate training in the use of hoist equipment.
Prevention of Respiratory Infections
BigDog complies with the NDIS Code of Conduct and the NDIS Practice Standards when supporting clients at risk of respiratory infection.
Respiratory infections and diseases are a leading cause of ill health and death in people with a disability worldwide. In Australia, respiratory infections and diseases contribute to up to half of deaths of people using disability services.
Summary
Any high intensity daily personal activity and management forms part of the formal training program and must be signed off by a Registered Training Organisation (RTO). Supporting Documents
NGO Training
Complex Bowel Care
Comprehensive Health Assessments (PA03)
Dysphagia (PA04)
Subcutaneous Injections
Tracheostomy Support
Transitions of Care (PA02)
Urinary Catheter Care Part 1
Urinary Catheter Care Part 2
Ventilator Support Part 1
Ventilator Support Part 2
Wound Care and Pressure Injury Management Part 1
Wound Care and Pressure Injury Management Part 2
Legislation
Disability Discrimination Act 1992 (Cwth)
Disability Services and Inclusion Act 2023 (Cwth)
Disability Services Act 2006 (QLD)
Health Act 1937 (QLD)
Health Regulation Act 1996 (QLD)
National Disability Insurance Scheme Act 2013
NDIS (Provider Registration and Practice Standards) Amendment Rules 2021
Queensland Guardianship and Administration Act 2000 (QLD)
Queensland Human Rights Act 2019 (QLD)
Queensland Mental Health Act 2016 (QLD)
NDIS Practice Standards and Quality Indicators
BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.
The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS participants.
The four core modules are:
1.0 Rights and Responsibilities;
2.0 Governance and Operational Management;
3.0 The Provision of Supports; and
4.0 The Support Provision Environment.
The supplementary modules cover:
5.0 High intensity daily personal activities
5.1 Specialist behaviour support
5.2 Implementing behaviour support plans
5.0 High Intensity Daily Personal Activities
These NDIS Practice Standards set out the responsibilities of BigDog when providing supports and services to clients that require the following.
5.1.1 Complex Bowel Care
5.1.2 PEG Feeding and Management
5.1.3 Severe Dysphagia Management
5.1.4 Tracheostomy Management
5.1.5 Urinary Catheter Management
5.1.6 Ventilator Management
5.1.7 Subcutaneous Injections
5.1.8 Complex Wound Management
Human Services Quality Standards
The Standards set a benchmark for the quality of service provision. Each Standard is supported by a set of performance indicators which outline what BigDog is required to demonstrate to meet that standard.
3 Responding to Individual Need
The assessed needs of the individual are being appropriately addressed and responded to within resource capacity.
3.3 BigDog ensures that services to the individual/s are delivered, monitored, reviewed and reassessed in a timely manner.
6 Human Resources
Effective human resource management systems, including recruitment, induction and supervisory processes, result in quality service provision.
6.3 BigDog provides people working in BigDog with induction, training and development opportunities relevant to their roles.
Delegation of Authority
Name Position Details
Steven Paull Director
Courtney Carroll Director
David Burrett Operations Manager
Monique Paull HR Manager Lawyer
Authorise review and implementation
Authorise review and implementation
Ensure information dissemination
Ensure compliance by employees
Version Details
This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy. If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0. The following rules also apply in interpreting this policy:
• Headings are for convenience only and do not affect interpretation.
• A singular word includes the plural and vice versa.
• A word that suggests one gender includes the other genders.
January 2023 6 0 Included Human Services Quality Framework (HSQF) and Child Protection Act and the term “Participant” is returned to “Client” to allow for policies to cover NDIS and HSQF.
March 2024
6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included. Included 5.1.3 Severe Dysphagia Management.