Guidelines for field staff to assist people living in ... - Housing NSW

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SECTION 4: The Initial Visit4.1 PurposeThe purpose of conducting a home visit to the person is to:1. assess whether the person lives in squalor and to rate the extent of the squalor2. assess whether the person hoards excessively and/or self-neglects, i.e., doesnot adequately look after his/her bodily requirements and hygiene3. assess the nature and severity of any associated health and lifestyle issues4. make a preliminary identification of strategies required to address the issuesidentified.If a home assessment is not initially possible, information available to the agencymay permit identification of the issues to be addressed. Case management plansshould include eventual entry to the home, preferably with the consent andinvolvement of the occupant.The issue of consent in relation to decision-making capacity is complex and is dealtwith in more detail in Section 8. Field staff should also refer to their own agency’sconsent procedures.4.2 Approaches to engaging the personPeople living in severe domestic squalor vary markedly in their nature, personality style,acceptance, cooperation, insight and perception of their circumstances. As aconsequence, there is a need for flexibility in the approach taken by caseworkers. Somepeople may respond to a series of initial, brief, casual meetings. Others may be morelikely to respond to a visit by someone perceived to be in authority, such as a fire officeror the Police. However, cultural sensitivity and appropriateness is important here, assome people may feel uncomfortable with authority figures, which may intensify feelingsof fear and suspicion.Generally, the person is more likely to be successfully engaged if an interest is shown inthem and their particular reason for needing help. If the person agrees to accept help,the likelihood of achieving significant change and improving conditions for the individualand others is considerably greater.Options that could be considered include:• If the person is too fearful to open the door, try leaving a note in the mailbox orunder the door, asking them to make contact. Keeping privacy concerns in mind,discrete enquiries with neighbours might be of assistance.• Repeat visits by a key worker. Sometimes calling after hours, varying the hours orvisiting on several occasions may assist to engage the person.• If the person is of Aboriginal or Torres Strait Islander or CALD background,arranging to visit with a worker from the particular background or with anaccredited interpreter may be appropriate. Check with the client as to theirpreference and consent prior to making any arrangements.10
• If the person is from a CALD background, encourage them to use their preferredlanguage.• If the person requests an interpreter or has inadequate language skills, aprofessional interpreter should be used. Refer to your organisation’s proceduresregarding the engagement and use of interpreters. Cultural and linguistic factorscan impact on the success of engagement with the person.• Ask the person how he/she feels that they could benefit from help, and identify theperceived needs.• Be persistent, sensitive to the person’s needs and careful not to overwhelm them.Even if their initial reaction is negative and they reject any intervention, it is stillimportant to continue to try to establish a relationship.• Avoid imposing your own values and judgement. Many people living in squaloroften do not even perceive that their home is dirty.• Take time. An immediate focus on a need for cleaning can cause distress, andsabotage chances of achieving a successful alliance.• Reframe the need for cleaning in terms of the person’s perceived needs andpreferences. The person might agree to tidy up as a staged process. Wherepossible, establish an inventory of possessions, identify valuables and arrange forthem to be placed securely.• Ensure that the person has the capacity 3 to make decisions about giving awayproperty, and that service staff do not accept gifts or directly benefit from the cleanup.It is important to note that in situations of extreme squalor, the assessment of ‘risk’ islikely to vary between the relevant authorities. The evaluation of a field staff may notcorrespond with that of the local council’s environmental health officer . Situationsshould be avoided where one course of action is advised by a field staff but another ispursued by the local council (as the council does not need the consent of the resident toinvoke its clean up powers). It would be useful, therefore for field staff to liaise with therelevant local council before making an assessment on intervention and advising theperson on what will happen. This would also allow the field staff to determine whetherthe residential premises are subject to an existing order (which may be in effect for aperiod of up to five years).When sharing information with other agencies, be sure that disclosure of information isdirectly related to the purpose for which it was given and collected.4.3 Ensure OH&S requirements can be metThe Occupational Health and Safety (OH&S) of persons entering premises wheresqualor is evident, and the safety of the person/s living in these conditions is asignificant issue. Workers that provide services to people living in squalor mustcomply with their organisation’s OH&S policy and procedures.3 The issue of ‘capacity’ is complex and is discussed further in Section 8.1 and Appendix 7.11
Page 1 and 2: Guidelines for field staff toassist
Page 3 and 4: Section 7: Strategies to help peopl
Page 5 and 6: SECTION 2: Explaining severe domest
Page 7 and 8: If such persons do agree to speak,
Page 9: 3.3 Gathering resources for use at
Page 13 and 14: availability of essential services,
Page 15 and 16: 4.6 Initiate referrals to address c
Page 17 and 18: SECTION 5: Interagency cooperationF
Page 19 and 20: 5.3 FLOWCHART 1: ASSESSMENT & SUPPO
Page 21 and 22: • placing a lien on the property,
Page 23 and 24: SECTION 7: Strategies to help peopl
Page 25 and 26: SECTION 8: Strategies to assist peo
Page 27 and 28: SECTION 9: ConclusionsThe key point
Page 29 and 30: ENVIRONMENTAL CLEANLINESS AND CLUTT
Page 31 and 32: J.SLEEPING AREA:0 1 2 3Reasonablycl
Page 33 and 34: APPENDIX 3: Impact of Squalor Check
Page 35 and 36: APPENDIX 5:living in severe domesti
Page 37 and 38: Aged Care Assessment Teams (ACATs)A
Page 39 and 40: Department of Ageing, Disability an
Page 41 and 42: Department of Community Services (D
Page 43 and 44: APPENDIX 6:Organisations that can a
Page 45 and 46: NSW PoliceThe Police are often the
Page 47 and 48: • must have a disability within t
Page 49 and 50: APPENDIX 8: Case studiesCASE 1An el
Page 51 and 52: CASE 3Ms D, who had been living in
Page 53 and 54: CASE 6Mr A. is a 70-year-old man wh
Page 55 and 56: would permit a psychiatrist to ente
Page 57 and 58: Non-GovernmentAssistance with Care
Page 59 and 60: APPENDIX 11:Further readingClark AN

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