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

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with Care and Housing for the Aged program and non-governmentorganisations are sometimes able to forge an initial relationship withthe client and obtain their consent to arrange medical appointments.Assessing capacity. An important question to be addressed fromthe outset is whether or not Mr A. has the capacity to decide whetheror not he needs to receive further medical treatment (e.g.medications, hospitalisation, investigations) and remain in his currentaccommodation. He needs to be able to understand the optionsavailable to him and the potential benefits and risks associated witheach of these.Environmental and public health assessment. Severe domesticsqualor can present the following significant health risks to theoccupant, to neighbours and to the local community: fire from theaccumulation of large quantities of flammable material; rodents andother pests; and the spread of disease associated with lack of runningwater or lack of sewage. If these concerns are apparent in Mr A.’scase, it would be necessary to notify Environmental Health Officers(EHOs) with the local council.Cleaning. Cleaning is often difficult to organise and to pay for. If MrA.’s living conditions are extreme and there are concerns aboutexposure to human waste, body fluids, excretions and an infectionrisk, ‘forensic’ cleaning may be required. The local council may beable to provide contact details for local cleaning services and assistwith removal of property and rubbish. In milder cases, with lessinfectious risk, particularly if Mr A. were voluntarily acceptingassistance, some NGOs (such as Mercy Arms or the Brown Sisters)may undertake some of the cleaning themselves. A small amount offunding is available from the Department of Ageing, Disability andHome Care (DADHC) to broker cleaning services in some cases.What happens if Mr A. persistently resists assessment and/orintervention?Should Mr A. be continually unavailable for assessment and theconcerns in relation to his health and living conditions persist, thereare several ways in which his case could be dealt with. These arelikely to be influenced by which service has had the mostinvolvement. In Mr A.’s case, this would be mental health servicesand the local council. A joint approach (taking as much care tomaintain confidentiality as possible), with one service taking on therole of the ‘lead agency’ and identifying a coordinator or ‘key worker’,is probably the ideal. Continuing efforts should be made to engageMr A. and convince him to accept help voluntarily.If Mr A. continues to resist, legal authorisation to enter his home toconduct an assessment, is required. If there is evidence of a likelymental illness, mental health services could apply to the local court forauthority to conduct an assessment under the Mental Health Act. This54
would permit a psychiatrist to enter his home (in the presence ofPolice and, if necessary, by force) to enable a medical examination,including an assessment of capacity and risk.If Mr A. were determined to be mentally ill and at risk, the psychiatristcould request the police to hospitalise him for further assessmentand/or treatment under the Mental Health Act 1990.If authority to undertake an assessment was not granted to themental health services, then the council could invoke its powersunder the amended Local Government Act 1993 and order a cleanup without Mr. A.’s consent.55
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 and 10: 3.3 Gathering resources for use at
Page 11 and 12: • If the person is from a CALD ba
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: CASE 6Mr A. is a 70-year-old man wh
Page 57 and 58: Non-GovernmentAssistance with Care
Page 59 and 60: APPENDIX 11:Further readingClark AN
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