Happy Wednesday occupational therapists navigating the NDIS world!
One pressing question often surfaces: “How do I document safety risks effectively in home mods and AT funding requests?” Crafting reports that highlight safety concerns is crucial in advocating for your clients’ needs. Here’s a concise guide to ensure your home mods or AT request stands out:
1. Detailed observations: Begin with a thorough assessment of the environment. Document specific hazards observed, such as uneven flooring, narrow hallways, or inaccessible bathrooms, with precise details about their impact on safety.
2. Risk assessment tools: Utilise objective risk assessment tools to quantify and categorise risks. Tools that can provide objective data that can enhance your report’s credibility:
Falls Risk Assessment Tool (FRAT) – Provides objective scores for fall probability (Peninsula Health FRAT)
The Adapted Waterlow Scale – Quantifies pressure injury risk with clear scoring criteria
The Safety Assessment of Function and the Environment for Rehabilitation (SAFER) tool – Identifies specific environmental hazards
3. Functional impact:Clearly explain how identified risks affect the participant’s daily activities. How do these risks compromise their safety, independence, or ability to achieve daily living tasks? Document specific hazards with precision:
— Exact measurements of problematic steps, doorways, or paths
— Specific surface conditions (slippery tiles, loose carpeting)
— Lighting measurements in critical areas
— Furniture heights and their relationship to safe transfers
Connect each risk directly to functional limitations:
— “The 15cm step at the entrance requires Mrs. Smith to navigate without handrails, causing her to lose balance 3x in the past month when returning from medical appointments.”
— “The narrow bathroom doorway (72cm) prevents wheelchair access, forcing unsafe standing transfers on wet surfaces.”
4. Client feedback: Include direct quotes or insights from the person about their experiences with these risks. Their perspective adds an important human element that underscores the significance of addressing the issue.
5. Visual evidence: Photographs of the hazards can be compelling additions to your report. They offer a visual context that underscores the necessity of addressing the safety risks. Pictures tell a thousand words!
6. Potential consequences: Discuss the potential consequences of not addressing the risks. Link the risks to possible injuries or incidents to highlight the urgency of the modifications. Include details about incidents that have already occurred, including frequency and pattern. Create compelling evidence with incident history:
— Dates / time patterns of previous falls or near-misses
— Pattern of circumstances surrounding each incident
— Resulting injuries or hospital visits
— Pattern analysis showing increasing frequency
7. Risk hierarchy framework Categorise risks by severity and immediacy:
— High: Immediate danger requiring urgent intervention
— Moderate:Significant risks that inhibit essential activities
— Low: Issues that impact quality of life but pose minimal immediate danger
7. Recommendations: Provide clear, actionable recommendations for mitigating each identified risk. Ensure these align with the participant’s goals and NDIS criteria for reasonable and necessary supports. For each identified risk, explicitly address:
1. How it directly relates to the participant’s disability
2. Why addressing it is reasonable and necessary
3. How proposed solutions represent value for money (link to goals and functional outcomes or cost of care, rather than linking to increased public healthcare system costs – crazy rationale but NDIS-world lacks common sense)
By framing safety risks within a structured, evidence-based approach, your reports will not only meet NDIS requirements but also champion the safety and well-being of those you serve.
Remember: the difference between approved and rejected home modification requests often comes down to how effectively you document and communicate safety risks. Use this framework to create compelling evidence that the NDIS can’t easily dismiss.
#OccupationalTherapy #NDIS #SafetyDocumentation #ClientAdvocacy
