Recognising Clients in Vulnerable Situations Policy v8.0
Summary
Objective
A vulnerable situation for a client is when there is a potential threat to their safety, health, or wellbeing. If you're working on some-
one's claim and recognise the signs that they may be in a potentially vulnerable situation, you must immediately report your concerns
to your manager so decisions can be made about reducing the chances they will come to harm.
Owner
9(2)(a)
Expert
9(2)(a)
Policy
1.0 Recognising vulnerable situations
a Vulnerable situations for clients come in many forms. Sometimes the potential for harm comes from the addictions, mental
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health conditions, or aggressive or anti-social behaviours the person exhibits. Sometimes it is the person’s poor health or med-
ical conditions in combination with the conditions they’re living in. Sometimes the potential harm comes from others the person
is living with.
All of these situations present risk but the most dangerous situations are where a person is unable to reduce or remove them-
selves from these risks.
NOTE Please refer to process of Respond to clients in Vulnerable Situations
PROCESS Respond to Clients in Vulnerable Situations
2.0 Rules
a If you become aware that a client is in any of the situations described in the following table, or if a supplier reports that one of
their clients is in a vulnerable situation, refer to the Responding to clients in potentially vulnerable situations process.
Rules - Recognising clients in vulnerable situations Policy.docx
3.0 Reporting child abuse or neglect
a If you suspect a child is the victim of abuse or neglect, you need to be mindful that the perpetrator of the abuse will be highly
aware of the negative consequences for them after the abuse is reported, and either:
• attempting to deny that the child has been abused
• trying to prevent the abuse from being reported, or
• denying responsibility for the abuse.
Refer to the Referring children in suspected vulnerable situations process to file a report. In the case of at-risk children the
Oranga Tamariki, Ministry for Children will take the actions to safeguard the child (Oranga Tamariki, Ministry for Children, have
the statutory authority to do this, ACC doesn’t).
Referring Children in Potentially Vulnerable Situations (Te WHāriki)
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Situations Policy
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4.0 Reducing the potential for harm
a When developing a risk mitigation plan, seek a wide range of advice as good risk mitigation can reduce the potential for harm.
Any of the following should be able to assist.
• Client Service Leader
• Clinical, Psychology or Medical Advisor
• Team Leader
In some cases there are obvious steps that ACC can take. For example, ACC can support applications for the Family Court to
appoint a welfare guardian for a person with diminished decision-making capacity (see instructions for Protection of Personal &
Property Rights Act orders)
Sometimes other people and agencies may need to be involved. For example, a person’s GP and Mental Health Services may
need to be involved to manage that person’s aggressive behaviour towards others. See Additional contacts and links for man-
aging vulnerable situations.
Sometimes the best course of action is monitoring of the situation via regular communication – either directly with the client or
through others such as service providers.
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ACC > Customer Insights and Comms > Manage Customer Reviews and Disputes > Operational Policies > Issues > Vulnerable situations > Recognising Clients in Vulnerable
Situations Policy
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Situation
Potential for harm
Mental health conditions that co-exist with a person’s injury may mean they are anxious or
suspicious of people they don’t know. They may be reluctant to have support services delivered
in their home, or they may be reluctant to leave home for assessment, medical treatments, or
Mental health or
meetings at an ACC branch.
behaviour
problems
Behaviours that are caused by the person’s injury (often a brain injury) such as getting angry
quickly, using abusive language or making threats (including threats of suicide) can make it
difficult to provide them with support services they need. It may also exhaust the patience of
others trying to support them.
Substance abuse habits or addictions that co-exist with the person’s injury. This includes alcohol
Addiction problems abuse, drug taking, and out of control gambling.
Living alone in an isolated situation, such as a long way away from neighbours or other people
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Isolation
has the potential to be harmful if the person is unable to seek help for themselves if they
suddenly get sick, or if they’re in an emergency such as a fire or natural disaster.
Dementia and brain injuries often result in impairments that affect a person's ability to make their
own financial or personal care decisions, including the ability to communicate concerns for their
safety or to advocate for themselves. These situations have a high potential for harm when no
Decision-making formal management arrangements are in place, like a welfare guardian appointed by order of the
capacity impaired Family Court.
The ability to make decisions is the important factor here – it should not be confused with the
quality of the decisions a person is able to make.
Living in a household or associating with people with a known history of alcohol abuse, violence,
Violence or abuse physical or sexual abuse, drug taking or making, or other criminal activity. The potential for harm
from others
is increased if the person is unable to remove themselves from these risky situations with others.
The person has limited or no support from family or friends. The potential harm in this situation is
No family support increased if the person has high medical or personal care support needs and their care
or backup
arrangements are not always reliable.
Living in a situation where the person can be taken advantage of by dishonest carers or
Taken advantage household members. The potential for harm is increased if the person is unable to communicate
of by others
concerns for their safety or to advocate for themselves.
The person has constrained financial resources to deal with unplanned expenses, such as
Money problems needing to take a taxi to the doctor.
Some health or medical conditions can be fatal if not treated promptly, like autonomic
Health problems
dysreflexia, or can have serious consequences if not managed correctly, such as pressure
sores.
If care arrangements for the person are unreliable, or the carers are no longer physically capable
Unreliable care
of providing the care needed, it can be potentially harmful. Sometimes the situation occurs if
arrangements
there are other members of the household whose behaviour, such as abusing or bullying carers,
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interferes with delivery of care.
Being homeless or living in an overcrowded household in a dwelling that is not insulated, poorly
Housing problems maintained or not weatherproof has the potential for harm if the person has health conditions
that are made worse by cold, damp, and overcrowding.
Uncontrolled Copy Only : Version 3.0 : Last Edited Wednesday, June 9, 2021 8:09 AM : Printed Tuesday, August 10, 2021 3:06 PM situations ACC > Customer Insights and Comms > Manage Injury Prevention > Implement and Evaluate Injury Prevention Programmes > Referring children in potentially vulnerable
Referring children in potentially vulnerable situations
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Triggers & Inputs
1.0
2.0
Consider
Email Safety
ACC Staff Member
vulnerability for a
Response Team
child or young
person
Linked Process
Assess risk for
Safety Response Coordinator
children and young
people
v3.0
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Referring children in potentially vulnerable situations v3.0
Summary
Objective
To refer children to Safety Response Team when we are concerned that they may be in a potentially vulnerable situation.
Background
When an ACC staff member becomes aware or suspects that a child may be in a vulnerable situation, then an email should be sent
to Safety Response team for further risk assessment.
A vulnerable situation could be in relation to their safety, wellbeing, their access to treatment, or concerning claims within their history.
Owner
9(2)(a)
Expert
9(2)(a)
Procedure
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1.0 Consider vulnerability for a child or young person
ACC Staff Member
a In Eos, identify indicators on the claim that the child is vulnerable or at risk.
NOTE What are some of the indicators to look for in the claim or claims history of a child?
• Descriptions of physical abuse as a cause of injury eg punched / kicked / hit
• Unusual injury/accident description or a claim with no accident description listed
• The client is 17 years or under and has a high number of claims with ACC eg 10 or more ACC claims in the past two
years, or five or more claims in the past six months
• A high number of head injuries and / or facial injuries
• Delayed presentation for treatment of injuries.
• The client is 17 years or under and has recent claim for, Self-Harm/Attempted Suicide/Willfully Self-
Inflicted Injury/Overdose/Ingestion of harmful substances (Bleach, Glass, Petrol etc.)
2.0 Email Safety Response Team
ACC Staff Member
a In Outlook, create a new email to: [email address].
NOTE What details do I add to my email?
1) Subject line: Referral to Safety Response Team.
2) Either: Client ID / NHI / Claim Number.
3) Brief explanation of reason for referral.
4) Note if the claim is active for supports.
NOTE What if Oranga Tamariki are involved?
Include this information in your referral email.
NOTE What if the claim is active for supports?
A Safety Response Coordinator will contact the Recovery Staff member to work together to review information fol-
lowing the referral.
PROCESS
Assess risk for children and young people
Safety Response Coordinator
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ACC > Customer Insights and Comms > Manage Injury Prevention > Implement and Evaluate Injury Prevention Programmes > Referring children in potentially vulnerable
situations
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Respond to Clients in Vulnerable Situations v24.0
Outputs
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4.0
Review plan
riggers & Inputs
T
1.0
Identify potential vulnerable situation
2.0
Activate vulnerable situation indicator and record risk
3.0
Implement risk mitigation plan
Assistant
Recovery
Recovery Coordinator
Recovery Partner
Team Leader
Recovery Coordinator
Recovery Partner
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ACC > Claims Management > Manage Claims > On-Board Client and Manage Recovery > Respond to Clients in Vulnerable Situations
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Respond to Clients in Vulnerable Situations v24.0
Summary
Objective
The purpose of this process is to ensure we effectively identify a vulnerable situation for a client, when there is a potential threat
to their safety, health, or wellbeing. If you're working on someone's claim and recognise the signs that they may be in a potentially
vulnerable situation, you must immediately report your concerns to your Manager so decisions can be made about reducing the
chances they will come to harm.
It allows us to be proactive in a client’s recovery.
Background
While providing support to our clients, we may identify that they are at risk. It is important to understand how to respond to vulnerable
situations. Vulnerable situations for clients come in many forms. Sometimes the potential for harm comes from the addictions, mental
health conditions, or aggressive or anti-social behaviours the person exhibits. Sometimes it is the person’s poor health or medical
conditions in combination with the conditions they’re living in. Sometimes the potential harm comes from others the person is living
with.
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Identifying the triggers that will help us to proactively respond to a client's needs and take the required action or interventions in-
cluding formulating a risk mitigation plan.
Owner
9(2)(a)
Expert
9(2)(a)
Procedure
1.0 Identify potential vulnerable situation
Recovery Assistant, Recovery Coordinator, Recovery Partner
a Collect details of the client's potential vulnerable situation. Refer to the 'Situation and Potential for Harm' table in the 'Recog-
nising clients in vulnerable situations Policy'.
Recognising clients in vulnerable situations Policy
NOTE What are the signs of vulnerable situations?
• mental health or behaviour problems
• aggressive or anti-social behaviours
• addiction problems
• isolation
• decision-making capacity is impaired
• violence or abuse from others
• no family support or backup
• taken advantage of by others
• money problems
• poor health problems
• medical conditions
• unreliable care arrangements
• housing problems
• conditions they’re living in
• harm from others the person is living with.
All these situations present risk, but the most dangerous situations are where a person is unable to reduce or remove
themselves from these risks.
NOTE What if a child is affected?
If no, continue.
If yes, go to Referring children in potentially vulnerable situations process, and file report.
See also Interagency protocol for at-risk or vulnerable children Policy.
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Referring children in potentially vulnerable situations
Interagency protocol for at-risk or vulnerable children Policy
b Obtain details of the potentially vulnerable situation.
NOTE Who could you obtain details from?
The treating provider, a family member, a carer, school or contracted agencies.
ACC > Claims Management > Manage Claims > On-Board Client and Manage Recovery > Respond to Clients in Vulnerable Situations
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c Identify and contact all parties involved, eg:
• Police
• Oranga Tamariki - Ministry of Children
• Ministry of Health
• Housing New Zealand
• Work and Income New Zealand (WINZ)
• client’s doctor or General Practitioner
• contracted service suppliers.
NOTE What if you are referring your client to a provider?
Contact and discuss with the provider prior to them accepting and contacting the client.
If creating a task, clearly outline that the client is in a vulnerable situation.
d Discuss with your Team Leader.
NOTE What if my Team Leader advises the client is considered vulnerable but doesn't meet the Vulnerable Indi-
cation criteria?
Update the Cultural needs life area of the Recovery Plan with the following information:
• Provider Safety Plan
• Concerns that have been identified
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Update or add safe or alternative contacts if required. Continue with previous process.
e Consider if the client needs to be transitioned to a different team.
NOTE What do you need to consider?
As a result of the change in Vulnerable Situation Indicator consider transitioning the client to a different team. If your
client is in Assisted Recovery transition the client to Supported or Partnered Recovery. For more information refer to
the guidelines and process below.
PROCESS Transition Claim
GUIDELINES Choosing the right Recovery Team
2.0 Activate vulnerable situation indicator and record risk mitigation plan
Team Leader
a Contact the Recovery Team member to discuss the actions.
b Request CSL to activate the Vulnerable Care Situation Indicator in EOS through the claim party record:
1. Navigate to the Indicator tab
2. Click Add
3. From drop-down menu select Vulnerable Situation Indicator
4. Click Yes
5. From drop-down menu select Vulnerable Status
6. Select Active
7. Complete the section Why the client is believed to be in a vulnerable situation
8. From drop-down menu select Risk Mitigation Plan Update Type
9. Select Initial
10. Complete the section Parties affected by situation
11. Complete the section Risk mitigation actions undertaken by ACC
12. If there are other parties involved, complete Other parties involved in managing the situation
13. Click OK
c Advise the Recovery Team member that the indicator is active and tasks in the risk mitigation plan can now be carried out.
3.0 Implement risk mitigation plan
Recovery Coordinator, Recovery Partner
a In Eos, open the clients party record and navigate to the Indicator tab.
b Review the plan.
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c Meet with Team Leader to review and agree on each task and the dates.
d Implement the risk mitigation plan.
e Update the Recovery Plan with the action taken.
NOTE Go to the Create or Update Recovery Plan process.
PROCESS Create or Update Recovery Plan
Recovery Plan - Create Reminder Actions - System Steps
f Create a reminder to review the risk mitigation plan in 6 months.
g Set up an action to contact the client again to monitor the situation.
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4.0 Review plan
Team Leader
a Review the risk mitigation plan after 6 months. Go to Reviewing Vulnerable Situation Indicators for clients process.
Reviewing Vulnerable Situation Indicators for clients process (CHIPS)
http://thesauce/team-spaces/chips/issues/vulnerable-situations/process/reviewing-vulnerable-situation-indicators-for-
clients/index.htm
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Document Outline
