• Table of Contents
• Parliamentary Secretary Foreword
• Purpose of this toolkit
• 1. Background
• 2. Introduction to quality improvement
• 3. Getting started
• 4. Management systems
• 5. Staff recruitment, retention, training and development
• 6. Advocacy access
• 7. Tailoring advocacy to individual needs
• 8. Decision making and choice
• 9. Complaints and disputes
• 10. Privacy, dignity and confidentiality
• 11. Participation and integration
• 12. Valued status
• 13. Protection of human rights and freedom from abuse
• Appendix 1: Concepts related to quality
• Appendix 2: Disability Services Standards and Supporting Standards
• Appendix 3: Draft Disability Advocacy Standards

National Disability Advocacy Program Quality Improvement Toolkit

• Previous: 12. Valued status
• Next: Appendix 1: Concepts related to quality

13. Protection of human rights and freedom from abuse

13.1 Getting started

Use this section of the Toolkit to help your agency assess your practices and implement quality improvement actions related to protection of human rights and freedom from abuse.

Work through the four step process:

1. develop a checklist
2. conduct a self-assessment
3. plan quality improvement actions
4. review your progress.

Your agency is not expected to adopt all policies or practices or use all resources provided in this section.  You will find that some of the resources will be relevant to all agencies, while others will only apply depending on your agency’s approach to advocacy.  Where you already have your own quality management practices in place, you may use the resources as a way of gauging how your own practice is going.

Remember, your agency does not have to complete all sections of the Toolkit so start with the sections that are most relevant for your agency.

13.2 Advocacy agency's approach to protection of human rights and freedom from abuse

Villamanta Disability Rights Legal Service Inc.

The necessity to protect human rights is one of Villamanta Disability Rights Legal Service Inc.’s foundation beliefs.  It underlies everything that Villamanta does.  Our whole service is built on the belief that people’s human rights are paramount. The reason our service exists is to help people with disability, in particular people who have an intellectual disability, to get to know their rights and the relevant law and to learn how to use the law to protect those rights.

The protection of human rights informs all of our policies and procedures.  We believe that having clear, well thought out policies and procedures about how we manage our service is vital to ensuring we consistently recognise and protect our clients’ human rights.  The Management Committee would not sign off on a policy, procedure or document without consideration of human rights.  We recently reviewed all of our policies and procedures as a whole, drawing on a range of resources for guidance.

When we are writing policies and procedures we do not just make them up, we go to respected sources.  We have drawn on resources from the Eastern Community Legal Centre (Victoria), which received a grant for a consultant to develop a policies and procedures manual; the Federation of Community Legal Centres; VCOSS whose website has some example policies and procedures; and the Law Institute of Victoria.  In Victoria, we also have a Disability Advocacy Resource Unit (DARU), which is in the process of developing, and setting up, a library of resources which advocacy agencies can draw on.

We also believe that it is extremely important that we ensure our staff members and volunteers always treat clients (and others) with the utmost respect and dignity.  One of the questions we ask people who want to work or volunteer for Villamanta is “what, if any, are your views on human rights?”  We also ask whether they have experience working with people with disability.  That is not to say that people who do not have that experience cannot work for Villamanta, but they may need training in that regard before they are able to do a good job for our clients. Workers and volunteers need to understand where our agency is coming from.  We are not providing a charitable service for the “down and out”.  Our clients have human and legal rights and dignity.  Our job is to stand up for the rights of people with disability – and support them to stand up for their own rights - and to redress the imbalance in society, so that people with disability have the same rights and opportunities as other people in the general community.

A number of our service’s activities promote the human rights of people with disability.  We provide community legal education (CLE) for people with disability and their carers.  We also provide training on disability related issues for service agencies as well as the general community.  At the CLE sessions we hold for people who have an intellectual disability, we provide participants with a free copy of our booklet ‘Your Rights Your Choices’, produced in plain English, so that they are aware of, and understand, their rights.  The sessions we run for others in the community aim to teach them about the rights of people with disability and what they need to do to avoid infringing those rights.

We also work on systemic advocacy issues.  For example, in response to the over-representation of people who have an intellectual disability in the criminal justice system, we recently got funding to research and produce a publication to be read by people working in the criminal justice system (police, courts, judiciary, lawyers and corrections) to ensure better understanding and treatment of those people who have an intellectual disability.

Much of our work is done on individual legal cases where the human rights of a person with disability are not being upheld.  It is Villamanta’s view (and that of many other people) that the rights of a person with disability cannot be met if that person is placed in an institution.  There is an extensive history of abuse of people living in institutions which clearly illustrates that people’s human rights cannot be protected in such a setting.  For those rights to be fully met the person should be living in the community with appropriate levels of support.  Today there are many community residential units (CRUs) dotted throughout the community which have gradually been replacing the large institutions.

We are frequently involved in cases where a CRU placement of a client who has a disability is failing, often including physical abuse.  In these cases it is sometimes suggested that the best option is to place either our client, or another resident of the CRU, in an institution.  In such cases we strongly oppose this suggestion.  We have found that when a residential placement is not working it is often because there has been an inappropriate placement.  For example, one person in the residence may be abusing others who are more vulnerable and unable to defend themselves.  In some cases the abuse comes from a direct care worker.  In some cases, increased and better trained staffing can solve the problem.  In other cases, where this is not so, we lobby the Department of Human Services, or other relevant service provider organisations, to arrange an alternative and more appropriately supported CRU placement for the person whose behaviours are causing the problem.  We would always oppose the placement of any of the residents of the CRU in an institution.  We also consider issues of negligence and victims of crime in these matters.

As a legal advocacy agency, we are different from many other advocacy agencies that advocate in the ‘best interests’ of people with disability.  We are client directed and act on the client’s instructions and wishes.  Our service considers that there will always be someone there, such as a parent/ relative or a public advocate, to indicate what would be in the client’s ‘best interests’; we are there at a tribunal or talking to a service agency to indicate the wishes of the person with disability.  It is about ensuring their voice is heard and they have their human and legal rights recognised and acted upon.  We always aim to communicate with our client in person using whatever means of communication works best for them.  In cases where it is impossible for us to communicate with the person with disability, or they have limited capacity, we find families often know how best to communicate with the person and what their wishes would be.  In some cases a guardian is appointed to make decisions on the person’s behalf and we may receive instructions from them.  We are always careful to check out whether families might have an ulterior motive for trying to ensure a certain outcome.

If we did not protect the human rights of people with disability, we would be failing in our work both morally and ethically and we would be doing our clients a grave disservice.

Queensland Advocacy Incorporated

The definition of advocacy is to protect, promote and defend people’s human rights. This comes through in the key elements of advocacy (functioning by speaking out, acting or writing; minimal conflict of interest; sincerely perceived interests; promotion of person’s welfare, well being and justice; vigour of action; and costs).

Considering quality practice in this area involves unpacking what things mean.  For example, acting in ‘best interests’ is not about taking away a person’s rights; and there are differences between expressed need, perceived need and fundamental need.

Where an action is not considered in someone’s ‘best interests’, a paternalistic approach would be to block or deny that action; but, as advocates, we work with the person, discuss the issues and the possible consequences of the actions.  It is the person’s right to be involved in decision making.  Also, it’s important to recognise that the way we perceive a need does not necessarily make it right.  As advocates we must stop and ask ourselves if we’re really pursuing an action in a person’s ‘best interests’?

There are a range of tools we can use in considering our practice in relation to human rights – the Convention on the rights of persons with disability (CRPD) social justice principles; community development principles; and social role valorisation theory.

Personally I find the vulnerability schema, developed by David Massy, a useful tool in planning advocacy strategies that recognise, from a systems point of view, how society is affecting the life situation of the person with disability (eg how they are portrayed by people in power).  Other people might not relate to this or certain tools I’ve mentioned – what is important is finding a tool that best articulates things for you to help you consider your practice.   The issue here is to understand that the common response to vulnerable people in social policy, political motivated responses is always to locate the problem in the individual 'blame the victim' as opposed to understanding the problem genesis arising from exclusion, prejudice, rejection, fear and hatred of people with disability.

With increasing workloads, it’s not as easy as it once was, but it’s important to find the time to reflect on your practice.  We try and make time for this in staff meetings.  Or, where there is a particular issue, we may organise a meeting and involve the staff available.

We also try to organise an external peer review every five years.  Where the budget is not available for this, we’re considering engaging an external consultant to run some workshops to get feedback from our stakeholders and people with disability because you have to engage people face-to-face to really get feedback.

Over the last few years, our agency has also developed a set of human rights indicators for people with disability in consultation with a range of stakeholders, including people with disability.  Now we also have the UN Charter of Rights for People with Disabilities (CRPD).  When we started the project, there wasn’t a set of human rights indicators for people with disability anywhere, which is surprising considering there are indicators for women, children and other groups.  The human rights indicators are now another tool we can use in considering our practice as agencies as well as informing how you shape your advocacy strategies.

Advocacy often is the last resort; the last stop for vulnerable people.  Advocacy is ultimate safeguard for people with disability’s fundamental need and human rights being upheld in the community and by government. As we will never be able to provide enough advocacy, it’s important that the advocacy we provide is strong, clear and coherent.

13.3 Step 1: Develop a checklist>

Things to consider – protection of human rights and freedom from abuse⁶⁴

1.	We have clearly documented policies and procedures for preventing and responding to abuse, assault and neglect
2.	Management, staff and volunteers have been informed of, and trained in, the policy and procedures relevant to abuse, assault and neglect
3.	Our procedures reflect the best interests of the person alleged to have been abused
4.	Our documented reporting procedures include roles, responsibilities and identification of when and how to report to the police or other relevant bodies
5.	We provide/ make available appropriate support to alleged victims, families and staff/ volunteers around allegations of abuse, assault and neglect
6.	We have an incident reporting process which includes: nature of incident names of people involved outcomes response to person making allegation records which are dated and signed
7.	Our register of incidents and complaints files are kept secure

13.4 Step 2: Conduct a self-assessment

• Section 13.4 Step 2: Conduct a self-assessment [RTF 218kB]

13.5 Evidence guidelines

All agencies

• staff knowledge and skills in recognising and reporting criminal activities, abuse and neglect
• agency management and staff can provide practical examples of how they act to prevent abuse and neglect – including seeking out people with disability who are abused or neglected and who would not normally come to the attention of other agencies (eg outreach programs)

13.6 Step 3: Plan quality improvement actions

• Section 13.6 Step 3: Plan quality improvement actions [RTF 218kB]

13.7 Step 4: Review your progress

13.8 Resources

13.8.1 Indicators of abuse assault and neglect⁶⁶

Management, staff, volunteers, people with disability, their families, friends, carers, and advocates all play a significant role in preventing and detecting the occurrence of abuse, assault or neglect.

The table below provides some examples of indicators of abuse and neglect of children and adults.  It is important to remember that the indicators listed below are not the only indicators and that the presence of one or more indicators does not necessarily ‘prove’ that abuse, assault or neglect has occurred.  This list of possible examples should not be considered a complete list of possible indicators.

Type of abuse	Physical indicators	Behavioural signs
Physical abuse	unexplained cuts, abrasions, bruising and/swelling: on face, lips, mouth, torso, back, buttocks thighs in various stages of healing unexplained burns or scalds: cigarette burns especially on soles, palms, back or buttocks rope burns on arms, legs neck or torso unexplained fractures, strains or sprains dislocation of limbs in various stages of healing bite marks dental injuries ear or eye injuries ligature marks welts	avoidance of a particular staff member fearfulness or fear of a particular person sleep disturbance obvious changes in behaviour changes in appetite changes in daily routine unusual mood swings withdrawal unusual passivity out of character aggression self-abuse drowsiness inappropriate or changing explanation of how an injury occurred excessive compliance
Psychological / emotional abuse	speech disorders in the case of a child, there may be lags in physical development or a non-organic failure to thrive injuries sustained from self-abuse or self-destructive behaviours suicide attempts anxiety attacks	self-abuse or self-destructive behaviour challenging or extreme behaviours excessive compliance extreme low self esteem depression feelings of worthlessness lack of interpersonal skills necessary for adequate functioning extreme attention seeking behaviour
Sexual abuse	direct or indirect disclosure of abuse or assault difficulty in walking or sitting pain or itching in genital and/or anal area vagina or penile bruising, bleeding or discharge self-abusive or self-destructive behaviour attempts at suicide torn, stained or blood stained underwear or bedclothes sexually transmitted diseases trauma to the breasts, buttocks, lower abdomen or thighs unexplained accumulation of money or gifts pregnancy	sleep disturbances changes to eating patterns inappropriate or unusual sexual behaviour or knowledge changes in social patterns sudden or marked changes in behaviour or temperament anxiety attacks refusing to attend usual places eg work, school, respite depression going to bed fully clothed excessive compliance of staff
Financial abuse	no access or unwarranted restrictions to personal funds no control over personal funds or bank accounts no records or incomplete records kept of expenditure and purchases no inventory kept of significant purchases person controlling the finances does not have the proper legal authority misappropriation of money, valuables or property forced changes to wills or other legal documents persistent failure to produce receipts receipts indicating unusual or inappropriate purchases	person has insufficient money to meet normal budget expenses person is persistently denied outings and activities due to a lack of funds

13.8.2 Human Rights Indicators Project – Queensland Advocacy Incorporated⁶⁷

“A human rights indicator is designed to be an objective measure of the degree to which persons with disability enjoy (or experience) a particular human right or freedom.

Over time, QAI will use its Human Rights Indicators to build a database that records the lived experience of human rights of persons with disability in Queensland. The database will be compiled from a range of sources, including consultations with persons with disability and reports made by individuals and organisations.

The database will provide evidence of the key issues that need to be addressed by governments and communities to improve recognition and respect for the human rights of persons with disability in Queensland”⁶⁸.

There were a few drivers behind our project – we’d become aware of some unscrupulous operators of boarding houses for people with disability.  For example, one boarding house had forty residents in its care although it no longer met the service conditions.

We thought we needed to develop a set of indicators so that when someone went into a boarding house they could easily judge whether or not it was operating in a way that upheld the rights of people with disability.   Although these services had to be accredited to operate, accreditation alone wasn’t enough to protect the rights of people with disability.

In developing the indicators we consulted with agencies, the anti-discrimination board, service providers, the Office of the Public Advocate, advocacy groups and people with disability.  At the first cut we developed a set of plain English standards.

Now we have additional funding from a service provider for reviewing the first round of indicators and to produce a publication that will be a snapshot of how people with disability feel their human rights are being met in Queensland.  It will also be a way of testing our indicators.

We are running a set of hands-on workshops on human rights around scenarios for human rights for people with disability, their parents and service providers.  We are taking an action learning approach and from that are hoping to develop a set of fact sheets for people with disability to understand when their rights are not being met.

 

 

 

13.9 Sample policies and procedures

Human rights, as outlined in the United Nations Declaration of Human Rights, include the rights to physical integrity, mental and moral integrity, civil rights and legal integrity, socio economic rights, and the right to a family.

• Our agency believes that people with disability have the same legal and civil rights as other people in the community and that advocacy has an important role in safeguarding people with disability against abuse.
• Abuse and/or harassment of a person/ people with disability will not be tolerated. Staff, volunteers or Committee Members who engage in such activity will be liable to dismissal from employment.
• Our agency will endeavour to ensure that all involved with our agency possess a full understanding of the legal and civil rights of people with disability.
• Our agency will seek potential staff, volunteers and Committee Members who are committed to defending the legal and human rights of people with disability.
• Our agency will provide adequate training for staff/ volunteers in reporting and supporting clients in relation to abuse.  
• Our agency will ensure that all staff recruited and potential advocates are screened as a safeguard to minimise the risk of exposing people with disability to abuse.
• Our agency will source and make available relevant information and resources which can assist in dealing with issues relating to abuse.
• Our agency has a commitment to upholding the legal and human rights of people with disability.

Where people with disability are the clients of the agency, our agency will:

• provide information to clients (and their families and carers, as appropriate) about their right to live free from abuse and their entitlement to independent advocacy and support if their human rights are infringed.
• ensure that the legal and human rights of people with disability involved with our agency are upheld, both in the context of the advocacy undertaken and in the community in general.

Outreach to people with disability

Where people with disability are the clients of the agency, consistent with our purpose and contractual obligation, our agency will:

• endeavour to seek people with disability who would not otherwise have come to the attention of our agency, or may have a limited ability to access our agency
• seek out people with disability who may have been subject to abuse or neglect.

Our agency may seek these clients through outreach programs.

13.10 Useful links

Disability Services Queensland, the website provides a glossary of key terms related to abuse and neglect http://www.disability.qld.gov.au/publications/abuse-policy/glossary-booklet.html]

Queensland Advocacy Incorporated, Human Rights Indicators Project, see the website for  the full text of the Easy English booklet on Human Rights ‘Everyone has human rights Understand Yours!’, http://www.qai.org.au/content/humanrights.cfm.

 

64. Disability Services Queensland, http://www.disability.qld.gov.au/publications/abuse-policy/checklist-booklet.html.
65. Disability Services Queensland, http://www.disability.qld.gov.au/key-projects/quality/publications-tools-resources/tools/implementation-plan-template.html.
66. Disability Services Queensland, 2007, http://www.disability.qld.gov.au/publications/abuse-policy/indicators-booklet.html (updated May 31 2007).
67. Queensland Advocacy Incorporated,  http://www.qai.org.au/content/humanrights.cfm.
68. Queensland Advocacy Incorporated,  http://www.qai.org.au/content/humanrights.cfm.

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