Client rights

What are human rights?

We often hear in the media that a person or a group of people have had their basic human rights violated. While most of us have an idea what this means, we don’t often stop to consider what human rights actually are.

The range of human rights that everyone should receive is outlined in the United Nations Declaration of Human Rights. There are 30 Articles in the Declaration that highlight the basic rights of all people.

The Declaration includes the rights to:

• not be discriminated against
• be treated equally before the law
• be presumed innocent until proven guilty
• have one’s privacy respected
• move to, and live, where one wants to within their country
• visit another country
• marry and have a family
• own property
• work and have free choice of employment
• be paid reasonably for work done
• have an education
• a standard of living adequate for the health and well being of oneself and one’s family (with food, clothing, housing and medical care and necessary social services)
• security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond one’s control
• participate in the cultural life of the community.

In the past some people with a disability have been denied some or all basic human rights. For some people, this is still happening. The reasons why this can occur may include:

• They are judged as incapable of thinking or feeling.
• They have little political power.
• They may not be seen as real people.
• They were put into institutions in the past and the public did not know (or think about) what went on in those institutions.
• They may have no concept of their rights.
• They may have a very limited education.

Human rights in an Australian context

Some concepts that underpin rights in an Australian context include:

• Every person has the same rights.
• Rights and freedom are part of the Australian tradition, customs, value systems and laws.
• Every person has the responsibility of accepting the rights of others.
• It is against the law (both Federal and state) for anyone to deprive you of your rights, and against the law for you to deprive anyone else of his or her rights. You can’t have your rights taken away from you unless you are convicted of breaking the law (and there are still rights attached to this process).
• Rights and responsibilities go hand-in-hand; you must also fulfil your responsibilities.
• Clearly, all Australians are entitled to receive their basic human rights. As part of your practice, it is essential that you work in a way that protects the rights of your clients. There will be times that you will, no doubt, be required to speak out and advocate on behalf of your client/client groups who may be unable to do it for themselves. They may be overwhelmed by the difficulties they face, let alone think about and assert their rights. Or, they could also be affected by issues such as race, gender, health and age that act as a double bind when coupled with a disability. It is also important that you support the clients you work with to understand and assert their rights.

Rights and responsibilities

In this section we will explore the rights and responsibilities of all Australians and then begin thinking and talking about the rights and responsibilities of others in the CSI.

As members of the Australian community we all have rights and corresponding responsibilities. The word rights is often used but what does it mean and what are our rights? Rights are our basic entitlements as members of a community.

Some points on rights are:

• Every person has the same rights.
• Rights and freedoms are part of the Australian tradition, customs, value system and laws.
• Every person has the responsibility of accepting the rights of others.
• It is against the law (both Federal and state) for anyone to deprive you of your rights, and against the law for you to try to deprive anyone else of their rights. You can’t have your rights taken away unless you are convicted of breaking the law.
• Rights and responsibilities go hand-in-hand. If you want to exercise your rights, you must also fulfill your responsibilities.
• Rights are linked to the concepts of social justice and empowerment (ensuring that everyone has the knowledge, skills and confidence to take control of their lives and be treated equally in society).

Activity: The basic rights of all Australians

When considering the concepts of rights and responsibilities it can be useful to add the notion of roles. A role describes what we do in a particular situation. Consider the different things that you do throughout the day or week—be a part of a family, go to work, be a tenant or homeowner, spend time with friends, go shopping and so on. You have a role to play in each situation.

We have a right to do each of these things and we also have responsibilities while doing them. (For example, all women have the right to be a mother (role) but they have a responsibility to make sure that their children’s physical, social and emotional needs are met.) Everyone has responsibilities of some kind. They may be the same as those of others or different, depending on the situation you are in and the role you play.

Where do rights come from?

There are a number of significant factors that influence the established rights of clients in the CSI—some rights are common to all people and some are specific to clients in care or as service recipients.

International charters

The Universal Declaration of Human Rights discussed earlier is the best example of an internationally agreed position on human rights. When a country ratifies (accepts) a UN Convention, it agrees to take on the responsibilities of meeting the standards set down in that Convention. The Convention is an important piece of international legislation that has formed our national and state legislation. If you think of a tree, the state legislation is a branch but the international Convention is the main root.

Legislation or laws

These mean rules and regulations that are passed in state or Federal Parliament. An Act of parliament clearly defines what is legal and illegal, and you can be punished by law by not abiding by legislation.

A good example is the NSW Disability Services Act 1993. This Act ensures that people with disabilities are treated with respect and receive an individualised service which is appropriate to their needs. They have a right to live in and be part of the community, make decisions that affect their lives, realise their individual capacities for physical, social, emotional and intellectual development, take risks and receive protection from exploitation and discrimination.

Another example is the Human Rights and Equal Opportunity Commission Act 1986 that declares people with disabilities have the right to:

• respect and dignity
• assistance to become as self-reliant as possible
• education, training and work
• family and social life.

Regulatory requirements

Regulatory requirements refer to standards or rules on how a service should be run in order to meet the needs of the clients effectively and safely and to enhance the client’s well being. Regulations are the details that attach to the broader directions of a particular Act.

Statutory requirements

If a legal obligation is statutory, it means there is an Act that says you have to do something, or not do something. You can be legally punished if the Act is not followed. For example, it is a statutory obligation in NSW for community welfare workers to report situations where they feel a child in their care is at risk of harm. If they do not, they risk a fine at the very least.

Why have statutory and regulatory requirements?

We all have legal obligations when we drive, and these are set out in booklets we feverishly memorise before our driving test. The original road rules come from the Transport (General) Act 1999 and the Road Transport (Safety and Traffic Management) Act 1999 and the regulations (rules from the Act, with more explanations) made under those Acts. If we don’t follow the obligations laid out there we know we will be punished by fines or jail sentences.

The road rules are very clear about what is expected from drivers under various conditions. We have a legal obligation to drive safely so we don’t put other drivers in danger.

We also have a legal obligation to work to our statutory and regulatory requirements in our clients’ service in order to keep the clients in our care safe. We keep them safe by making sure the environment they are in is safe and through protecting their safety if we believe they are at risk of harm.

The statutory and regulatory requirements contained in Acts and Regulations shape community service organisations’ policies and procedures—they guide your decisions about what is ‘right’ in regard to your clients.

Standards

Standards are guidelines developed to ensure consistency of practice in human/community service organisations. They may be related to legislation. For example, the NSW Department of Ageing, Disability and Home Care has developed standards that services receiving government funding must adhere to. These are guidelines or principles for how the service should operate under the legislation.

Standards can be developed without legislation. For example, the NSW Department of Community Services has standards for the Supported Accommodation Assistance programme (non government services working with homeless people) but no legislation. These standards focus on guidelines about allowing clients the right to complain and be treated with respect, etc.

Codes of conduct

Each professional discipline or its professional association, e.g. social work, psychology, nursing, welfare work etc has its own particular code of ethics. All members are required to abide by their own professional code of ethics and sanctions may be applied by the professional body for breaches of these codes. Ethical codes are usually broad in community services but the concept of client rights (such as the right to confidentiality) underlies many of the ethical principles.

Duty of care

This refers to the obligation to take responsible care to avoid injury to a person whom, it can be reasonably foreseen, might be injured by an act or omission. A duty of care exists when someone’s actions could reasonably be expected to affect other people. If someone is relying on you to be careful, and that reliance is, in the circumstances, reasonable, then it will generally be the case that you owe them a duty of care. You need to be clear about exactly what the nature of the care or support is that you are providing, and on which the person is relying. Failure to exercise care in that situation may lead to foreseeable injury (in other words it could have been avoided with due care taken).

Standard of care

Standard of care refers to what is expected of any other reasonable person/worker who performs the same duties. This is not about having to be the perfect worker but about being good enough and doing your job as well as any other worker. Judges, when making their decisions regarding whether or not a worker has failed to provide a reasonable standard of care, looks at many factors such as:

• training that the worker has received
• laws and regulations
• practicalities relating to the situation
• needs of others in the situation
• current trends in the industry
• community values and attitudes.

Some of the questions that you can ask yourself in determining your duty of care, as a worker are:

• What rights exist here for the service user?
• What rights are at risk of being compromised or abused through the action that I do or do not take?
• What rights would be upheld?
• Are some of these rights in conflict or competition with one another?
• Can the different rights relevant to this situation all be upheld or must I make choices between them?
• If there is a conflict or tension between these rights then am I clear about why I am choosing to emphasise one rather than the other?
• Whose values are influencing my judgement—mine or the clients?
• To what extent am I involving the service user in balancing up these issues?

Organisational policies and procedures

These are the guidelines that operate in the workplace and they often reflect legislation. For example, CSI agencies should have written policy and procedure about how staff ensure client rights to confidentiality are maintained. This might include guidelines about what information can be shared and with whom, a process for seeking client approval to share information and appropriate information storage systems.

Client rights and responsibilities

Client rights are protected by legislation, codes of ethics and standards. From these, organisations develop policies and procedures which are the guidelines that operate in the workplace.

Activity: Client rights in the CSI

As you can see, there is quite a long list of client rights. As workers we should strive to ensure that these rights are fulfilled—after all, as a client, we would all expect no less.

Activity: Identifying client rights

Read the following case study and answer the question that follows.

Julie is living in a youth supported accommodation service and attending the local school. She has lived there for a few weeks and enjoys bringing her friend home to study one afternoon a week. One day, when they arrive home, the worker on duty informs Julie that friends are no longer allowed at the service and asks her friend to leave. While Julie was at school, her report arrived in the mail and was opened by the worker. The worker informed Julie that she had discussed the results with the school counsellor (Julie wasn’t aware that the counsellor had any contact with the service) and they had decided to send Julie to a maths tutor, starting the next day.

Poor Julie! She should complain, but more on that later …

Client responsibilities

The concept of rights cannot be viewed in isolation from the concept of responsibilities. While clients have a right to expect organisations to uphold all their rights, they also have responsibilities to fulfill as a client of a CSI agency. These include:

• letting the service know if they will not be available to attend an appointment
• respecting the rights of staff, management, volunteers and other clients
• taking responsibility for the decisions that they make
• following through on tasks that have been agreed to
• respecting and abiding by the rules of the service (as long as they are reasonable and have been agreed to in the first place).

The more we encourage clients to fulfill their responsibilities, the more we are fostering independence, which should be part of our ultimate goal in providing assistance. For example, if you are working with a young person in supported accommodation and they are continually breaking the rules, coming home after curfew, not paying agreed rent, being rude and disrespectful to staff and other residents and you do nothing about it, then what are you teaching them? By having clear rights and responsibilities (and clear sanctions for not fulfilling responsibilities) the young person may learn that responsibilities are part of life and there are consequences when we don’t fulfill them (such as being evicted). A hard lesson in life learnt early on may lead to improved life skills and a step towards independence.

Upholding rights of clients

What are the ways that we can ensure client rights are upheld?

Keep clients informed

Clients need to be as informed as possible about their rights and responsibilities. Comprehensive information about the service should be provided at the referral and assessment stage, including information about the eligibility criteria (who can use the service), the assessment process, service rules, services offered, staff qualifications, confidentiality exclusions, client rights and responsibilities, complaints procedure and any fees involved This can be in the form of an information handbook or pamphlet and should be in a format accessible to clients. For example, translated into relevant languages or in simple format for a client with an intellectual disability.

Client participation forums

Agencies need to have a structure in place for clients to have a say about the services being offered and what needs to be improved. This may be through representation on management committees, holding focus groups and surveying regularly to seek client feedback.

Monitoring by funding bodies

This varies across government departments and funding programmes; however funding bodies should play a role in ensuring that services are fulfilling their legislative and funding responsibilities in the area of upholding client rights. This may be through visiting agencies occasionally or written reports provided every year as part of the accountability process.

Making sure that clients know how to complain

Basic human rights include the right to be heard—better still, some rights, like legal rights, mean being able to take action to recover any lost rights or even seek compensation. Legitimate client complaints also provide valuable feedback to the service, so that services and staff can improve.

Legitimate client complaints also provide valuable feedback to the service, so that services and staff can improve.

Activity: Upholding client rights

Choose an agency that you have access to and find out how client rights are upheld in that agency. Inform the agency that you are asking the following questions as part of your study.

1. What information, about the service is provided to clients when they are referred and assessed? Comment on the format.
2. What ongoing forums exist for clients to give feedback about the service they receive?
3. What monitoring of the service is conducted by the funding body?
4. Is there a complaints procedure in place?
5. Comment on anything the agency could do to further ensure that client rights are upheld.

It would be useful to do this exercise again with a different agency, and compare the approaches and procedures for managing client rights.