Support, Prompt, Assist, But Do Not Diagnose or Treat

Clear role boundaries help the individual, the worker and the broader support team.

A participant may request that a trusted worker provide health information or a medication change, or a decision that is beyond the scope of the worker's responsibility. Helping is natural, but acting beyond your training is not.

Boundaries are not a lack of care. They allow reliable support to be given and help to ensure clinical, financial, legal and therapeutic decisions are made by the appropriate individual.

Why this matters for support workers

Quality is for the support worker, it's in the hundreds of small things that happen in another person's home and community. Plan is important but consent, language, observation and the discipline to remain within role is also important. Consistency does not need to be rigidity when workers know why a routine is being implemented and they are able to guide the person on how the support is to be delivered.

What better coordination looks like

A professional response recognises the concern, makes the limit clear, discusses the limit with the person and connects with the agreed contact or service.

Know your authorised tasks

Discuss the plan with the person; review your abilities and the specific support you've been trained and delegated to provide.

Use respectful boundary language

Outline what you can do and what you need someone else to do and how you will help this person.

Escalate uncertainty

Where appropriate, if an instruction is in conflict with a plan or is unsafe, stop and follow the documented pathway for guidance.

Make the change last

A helpful change is measurable and manageable. Decide who will take the first step, where the decision is to be documented and when the person will be asked if this helped. If the approach requires multiple services, validate the individual components of the approach individually, not as a group. Keep what works, modify what doesn't and eliminate temporary measures that are not producing the desired results.

Questions for the next review

What would “know your authorised tasks” look like from the person's point of view?

What part of the arrangement is assumed and what part of the arrangement is still a request?

What will happen to the person and the team that will give them an indication if this approach is helping or not?

Keep the boundary clear

Do not change medication, give a diagnosis, use a restrictive practice, or perform any task you are not trained and authorised for. The emergency response should be used during emergencies.

A practical example

A participant asked a worker whether they should double a missed dose. The worker didn't offer guidance. They followed the medication incident pathway and assisted the person to contact the relevant health professional for direction.