Quality Strategy Toolkit
for Australian Disability Enterprises
and Disability Employment Services
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Workplace Violence is defined as any incident where an employee or employer is abused, threatened or assaulted in situations related to their work. Client-related violence is described as violence or aggression displayed by a client of a service, towards the workers, when trying to provide support services to the client.
Disability services work with a varied range of workplace locations and with people with a diverse range of disabilities and needs. Service users often have complex care needs requiring innovative and well-planned responses. These responses have to be both appropriate to the support needs presented and safe for both service users and staff.
Violent or aggressive behaviour on the part of a client can be a component of any disability service. As a result, the day to day work of staff may unavoidably entail the need, from time to time, to cope safely with client-related violence.
Client related violence can be one of many challenging behaviours and can be a particular risk for the disability workplace. An approach was developed during the 1990s which endeavours to deal with the behaviour in positive ways. This approach is still considered a best practice approach as it considers the needs and dignity of the clients involved in addition to improving safety and reducing risks for the workers involved. The main objective of this approach is the prevention of the behaviours in positive ways. The Positive Approach to Challenging Behaviour 1997.
Organisations, in consultation with workers, need to develop approaches to violence and aggression which recognise the risk control hierarchy and the specific needs of their industry and the needs of their individual client.
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Remember
Ask yourself what is the purpose of the client's behaviour? It is important to remember that violent or aggressive behaviour often has multiple and complex causes.
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Remember good communication and the use of an effective behaviour support plan for clients whose behaviour is a concern is an important part of reducing risk. (Risk assessment alone does not prevent incidents but may be a part of a BSP.)
When working with a client with behavioural support needs it is important to be very familiar with and consistently implement their behaviour support plan. The goal of the plan is to prevent or minimise the risk of a violent or aggressive behaviour on the part of the client, i.e. one client may verbally threaten staff but will never escalate into physical violence, and other clients may threaten and act on the threats. This knowledge assists a worker to make judgements about the seriousness of some client situations.
It is important as workers that we identify behaviours that may indicate the potential for client related violence or aggression; early identification increases the possibility of deescalating the situation. A client may appear to be frowning, agitated or irritable. At other times a client may appear to be clenching their fists and making verbal threats, or a client may be pushing other clients and staff, throwing items or furniture and trying to do physical harm to others. The behaviours described may not necessarily appear in any order and it is important to be aware of these signs in context with the client and the environment.
Remember
the earlier potential aggressive behaviour is identified the greater likelihood of successfully de-escalating violence and keeping everyone safer.
The action you take in the event of client related violence will depend on a number of factors such as: *Your knowledge of the client. *The existence of a management plan and critical incident response plan. *Your level of experience and training. * The level of violence and your perception of the immediate threat. * Other staff available for assistance.
Always be aware of your surroundings
Know your escape routes, and available back-up.
When violence or aggression occurs, immediate action is necessary to protect those nearby, including other clients and staff, against the risk of injury, and to protect the person against self-injury. Having a plan that identifies the formal steps to take during & after an incident is referred to as a Critical Incident Response. Post Incident Procedure and Incident Response Chart, Preventing Violence DOCS and Work Cover NSW 1996
Workplace procedures and practices should be geared to preventing violence and aggression.
It is always preferable to have a pro active approach to preventing violence and aggression, irrespective of the client you are working with. Only a small percentage of the clients have violence and aggression as some component of their behaviour. Like everybody else in the community there is potential, given the right circumstances and stresses, for any client to become aggressive or violent. In many instances client-related violence does not escalate past verbal aggression and threats.
The background to violent or service users' aggressive behaviour may be many faceted and complex. The reason for a particular behaviour may be difficult to identify and occasionally the cause of behaviours cannot be identified. There is a difference between the "cause" of behaviour in a particular situation (for example, disappointment at an unexpected cancellation of a visit) and the "cause" of quite a range of events that arises from communication issues.
If the client is irritable, agitated, verbally threatening, you need to assess the situation to identify the purpose behind the behaviour. The client may be unwell, they may be having difficulty with another client, or they may have had a visit by a family member cancelled. A client behaviour plan should outline the preliminary steps. Use non-aggressive language when talking to the client and take a non-aggressive stance. Continually assess the situation in case it escalates to physical violence.
Remember
It is important to remain as calm as possible and know your options.
You should leave the situation when:
You feel you do not have the skill to deal with the situation
Your deescalating attempts are not working
You endanger others by staying
When you are alone with an actively aggressive or violent client
If the situation is moving towards physical violence, without putting your own safety at risk, try to reason with the client using non confrontational language, and utilise the client's behaviour support plan or management plan for the behaviour. Do not try to physically stop them damaging property and do not try to restrain the individual. Be ready to leave if you cannot de-escalate the client's behaviour and there is risk of physical harm or lives are at risk. You may have to call the police.
Remember the busier you are the more at risk you are because:
Under the Occupational Health and Safety Act 2000 NSW (OHS Act) and Occupational Health and Safety Regulation 2001 (the Regulation) employers must ensure the health, safety and welfare of employees in relation to violence in the workplace. The Regulation supports the OHS Act and it requires employers to identify workplace hazards, assess the risks arising from those hazards, implement risk control measures, provide training and consult with employees.
Occupational violence is a significant OHS risk and is specifically referred to in the OHS legislation. Workplace violence should be recognised as a significant workplace hazard. Some of the risks associated with violence in the workplace include physical and emotional trauma, low morale, high staff turnover, financial costs, and lost productivity. OHS legislation requires employers to take all practical steps to eliminate, as far as possible workplace violence risks.
If a violent incident does occur, there should also be response procedures (such as, giving first aid, supporting persons affected, counselling in place for those involved to minimise the impact of the event). Reporting and documenting the incident is also a requirement after an incident. Documentation and reporting allows for management to review incidents and reassess the controls to eliminate or reduce the likelihood of a reoccurrence of a similar incident.
A clear and simple incident response procedure is a key component for organisations in the management of processes after an incident Preventing Violence in the Accommodation Services of the Social and Community Services Industry 1996 NSW Department of Community Services and WorkCover NSW Critical Incident Response Procedure
Organisations have a responsibility to manage client related violence or aggression in a systematic way by identifying hazards, assessing or quantifying the risks and applying risk control strategies.
Risk management need not be costly for you, your business or organisation. Many simple and inexpensive measures can greatly reduce risk. You need to consider the potential exposure of your organisation if you do not manage your risks in relation to client related violence
A proactive and consultative approach can create a safer workplace for staff and clients. Document evidence of how, what, when and by whom actions are required to achieve positive outcomes.
Note: This material has been prepared using the best information available. You should always check current legislation in relation to your own circumstances and what action you may need to take to ensure you have complied with the law.
Any incident where an employee or employer is abused, threatened or assaulted in situations related to their work.
Behaviours that are demonstrated by a person which are of such intensity, frequency or duration that the physical safety or emotional wellbeing of the person or others is placed at risk. The behaviour limits the person's ability to participate or have access to usual ordinary settings, activities, services, and experiences. The behaviour may also interfere with the acquisition of new skills and learning opportunities. The term 'challenging' refers not only to the impact and effect of the behaviour, but also the challenge faced by individual family, guardian, staff members and other people in providing support in an ethical, appropriate and effective manner.
Encompasses clients of a service, their relatives or friends taking violent or aggressive action against the workers who are trying to help them.
A critical incident response plan identifies the formal steps to take during & after an incident when violence or aggression occurs.
A plan developed to support an individual with challenging behaviour. The plan includes three elements to meet minimum practice guidelines: lifestyle, environment requirements, positive support practices, and incident prevention and response plans
A hazard is anything (including work practices or procedures) that has the potential to harm the health or safety of a person.
The process of recognising that a hazard exists and defining its characteristics.
The likelihood and consequence of a potential injury or harm occurring
The overall process of estimating the magnitude of risk and deciding what actions will be taken.
The part of risk management that involves implementing policies, standards, procedures and physical changes to eliminate or minimise risks
The systematic application of management policies, procedures and practices to the tasks of establishing the context, identifying, assessing, controlling, monitoring and communicating risk.