CLIENT EXIT POLICY AND PROCEDURE CS 510

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1 PURPOSE 1.1. This policy and related procedures provide a clear exit process ensuring that clients are well informed, supported and smoothly transitioned from Ermha services Clients are interviewed as they leave Ermha to measure the effectiveness of our services and to learn about users experience and degree of satisfaction with Ermha. Client feedback is an important component of quality service and the interview process is an opportunity to gather information that can be used to improve service delivery. SCOPE 2.1. Staff, clients and carers (past and current). DEFINITIONS 3.1. Staff Ermha paid employees, Volunteers, Students and Contractors, who provide direct service delivery to Ermha clients Exit the process through which, clients transition out of Ermha programs and services Exit Planning a process that should begin for clients on initial contact and assessment, with clients given a clear understanding of Ermha s role in helping them transition to mainstream services Voluntary Client Exit may occur in the following circumstances: completion of client s stated goals; client no longer wanting support from Ermha; end of funding; moving out of the region; client choosing another service 3.5. Involuntary Client Exit - may occur in the following circumstances: when clients are violent towards other service users and/or staff; when clients present with challenging behaviours that are unable to be addressed within the context of service delivery (e.g. supplying drugs); when the NDIS funding package is inadequate; when funding ceases under the NDIS; when the client is incarcerated; or other circumstances which require a cessation of service. POLICY 4.1. Ermha will ensure that, the client exit process is a planned and supportive one Ermha will ensure that due process is followed, that exit procedures are fair and the clients rights are upheld Staff will support clients to exit the service, without discrimination Staff will ensure that, clients are provided with information as part of the transition process, including referrals and introductions to other services where required. Page 1 of 5

2 4.5. Where relevant, Staff will liaise with the client s concurrent support service, when planning the client s exit or transition The Exit Planning process begins from the start of the relationship and develops over time through the use of tools to gather appropriate information about goals, needs and supports which will assist in supporting clients as they leave Ermha. PROCEDURE 5.1. Staff will conduct exit planning in consultation with the client and where appropriate, with the client s carer (as agreed to by the client) Staff will inform clients about the process for leaving the service and how to re-enter Ermha programs if and when required Most exits will result from a planned approach developed between the service and client, though in some instances clients will leave the service without informing support staff. In such cases, staff will specify client withdrawal as the reason for exit, on the Client Exit Planning Document Exit planning and coordination Agreed timelines for reviewing progress and when support should cease, should be identified in the client s support plan Support workers and clients will jointly review progress made against the goals in the support plan and if relevant complete a Relapse Prevention Plan, which will support the client to manage the exit effectively Staff will provide the client with information about other relevant services, referral, advocacy and options for follow up Clients with complex needs may require additional transitional support and active linkage to other support services or community activities that can help them maintain or enhance the outcomes achieved to date Exit plans for children and adolescent clients need to be developed with consideration for issues specific to their demographic Voluntary client exit If a client wishes to withdraw from an Ermha program or service, staff will discuss other forms of service including a referral to another service where appropriate. However, if refused, the client s decision must be upheld If a client is flagged for a potential exit, the client is entitled to appeal the decision and Ermha s complaints and appeals process must be followed Staff will provide appropriate information, with the permission of the client, to the new service. This may include meeting with the client, to ensure the client fully understands the implications of the decision. Page 2 of 5

3 Staff will continue to follow up with the client and liaise with the new service provider for an appropriate period of time, to facilitate the transition. After this timeframe, if the client wishes to re-enter Ermha, a new intake application will need to be completed Involuntary client exit Involuntary service exit should be an option of last resort. Programs should develop a range of options for dealing with challenging behaviours, including seeking the assistance of specialist services where required Once the decision to exit a client is made by the Team Leader or determined by the end of a service agreement, staff should send the client an exit letter, informing the client of the reasons for the decision and any conditions that must be met before recommencing support In cases of involuntary service exit, clients need to be provided with information on how to appeal the decision to terminate engagement with service and programs, as well as advocacy options Where clients are at risk of harm to themselves or others, every effort will be made to link them to appropriate services Where the client is receiving support under the NDIS, Support staff should provide the client with a 30 days notice before terminating their service, as aligned with the terms of their Service agreement Monitoring and reviewing client exit Staff must monitor and review client exit and exit planning so that clients are supported through the transition phase. This is particularly true for clients with unmet or ongoing needs Monitoring includes the completion of the Client Exit Planning Document and Client Exit Interview. Follow up contact is required within 30 days, to identify and measure outcomes and to provide assistance or referral for further support where and when identified, prior to final exit Documenting client exit Where possible, staff will carry out an exit interview with the client, using the relevant Program s client Interview form Staff involved in client exit from Ermha programs or services need to ensure they document the process by using the Client Exit Planning Document. The Client Exit Planning Document is to be completed collaboratively with the client The reasons for the decision and confirmation that, the client has been provided with information on how to appeal a decision should be documented. The Client Exit Planning Document details the mandatory information required for exit, including the following: a) Client Information b) Reason for Exit c) Summary of Involvement d) Achievements Page 3 of 5

4 e) Exit Plan f) Other Services g) New Services h) Signed by client and worker i) Administrative tasks Depending on the Program, if a client is being referred to another service, a copy of the referral should be held on file and support staff are required to contact the referred service, and the client, within three months of exit to ascertain the level of engagement Once all client exit documents and forms are completed and placed in the client s file, the client will need to be deactivated from the Case Management System Notifying relevant people about client exit Staff will ensure that, the relevant service providers (including referral source) and informal support networks are informed that the client has exited from Ermha Staff will ensure that any exit or final reports are sent to the relevant Funding bodies Re-entry Some clients who leave Ermha, will need to re-enter at some future stage. The process for re-entry to Ermha will be made as simple and as streamlined as possible Re-entry strategies include: Review previous files/records on re-entry clients will not have to tell their history/story again if re-entry is within a Program specified timeframe. Make contact with any other organisation involved (subject to client consent) to identify the triggers for re-entry Review the previous treatment plan to identify what worked and what didn t Where possible, the same worker will be allocated to the client. FORMS AND ATTACHMENTS 6.1. CS CF03 Client Exit Planning Document 6.2. CS CF04 Client Exit Planning Interview 6.3. F1 Involuntary Client Exit Process Flowchart 6.4. F2 Voluntary Client Exit Process Flowchart 6.5. CS 529 F1 Relapse Prevention Plan 6.6. CS 520 F1 Client consent to share Information Form 6.7. CAR 535 Client-Carer Exit document 6.8. CSP 650 Client Satisfaction Interview Clayton Page 4 of 5

5 6.9. CSP 651 Client Satisfaction Interview Springvale RELATED DOCUMENTS 7.1. CS 500 Client Rights and Responsibilities 7.2. CS 501 Client File Policy and Procedure 7.3. CS 522 Rights and Responsibilities Policy and Procedure 7.4. CS 600 Feedback, Complaint & Appeals REFERENCES 8.1. Charter of Human Rights and Responsibilities Act Department of Health: Exit and re-entry guidelines accessed at: VERSION CONTROL VERSION NO. DATE APPROVED: SHORT DESCRIPTION OF AMENDMENT DATE TO BE REVIEWED: 1. 27/07/2011 Review existing policy Client Support Closure 30/08/ /06/2016 Reviewed Nov 2012 minor changes (e.g) remove repetitive statements Changed name from Client Exit planning to Client Exit. Included a scope and new definitions. Added new sub-headings and materials. 01/06/ /06/2018 Page 5 of 5