© 2015 National Skill Set For Effective Case Management in AUS & NZ: Skills Workbook

The CM in partnership with the Client and key stakeholders prioritise risks and possible risk management strategies. These risks and strategies are documented [S1E] The CM informs key stakeholders of identified risk factors, including (as applicable) any issues regarding the Client’s level of competency/capacity [S1E] The CM in partnership with the Client and key stakeholders addresses any identified risks. The CM documents (as applicable) the Client’s voluntary assumption of risk in accordance with the program/agency guidelines [S1E] Documentation by the CM demonstrates regular communication with the Client, inclusive of the Client’s knowledge and understanding of the program expectations and guidelines [S1F] The CM documentation shows ongoing person centred planning and consultation with the Client and key stakeholders (as applicable) [S1G] The CM, in partnership with the Client, records and prioritises the Client’s agreed long-term and short-term goals [S1G] The CM collects information regarding the Client’s current ‘quality of life’ and uses this information to support planning directions [S1G] The CM in partnership with the Client and key stakeholders facilitates referrals to alternative programs or settings where the Client’s individual, diverse and/or special needs and goals can be met more appropriately [S1H] Documentation by the CM demonstrates the provision of information to the Client about available resources, services and supports (internal and/or external to the program) [S2A] The CM demonstrates a sound knowledge of all available formal/informal resources, services and supports to meet the Client’s identified needs and agreed goals [S2A] The CM actively researches local and regional networks to enhance the CM’s knowledge of new and existing (funded/ non funded) resources, services, supports and folk systems to assist in the attainment of Client outcomes [S2A] Documentation by the CM demonstrates ongoing communication with the Client concerning program service options, including optional formal/informal resources, services and supports and eligibility requirements (as applicable) [S2A] Documentation by the CM demonstrates the increasing self autonomy of the Client’s decisions and the Client’s initiative in the instigation of actions to achieve their long-term and short-term goals [S2B] The CM can provide examples of resources, services and supports the Client has arranged/accessed independent of the CM [S2B] Documentation by the CM demonstrates the involvement of key stakeholders to endorse and support Client independence. The CM (as applicable) facilitates the referral of the Client to appropriate (formal/informal) services to facilitate Client independence [S2B] Documentation by the CM demonstrates the process undertaken in partnership with the Client to identify any barrier/s (potential, current or future) and the strategies and/or interventions (as necessary) to minimise the impact on a barrier/s on the Client’s ability to achieve the desired goal [S2C] The CM adheres to program/agency guidelines concerning the management and resolution of conflict between the CM and/or Client and/or key stakeholders arising from a barrier/s to services. The CM utilises available resources and supports to facilitate a mutually beneficial solution and outcome [S2C] The CM acts purposely and decisively, in partnership with the Client, to seek advice and/or recommendations from key stakeholders; engaging their support and collaboration for the removal of Client barriers (within individual local level) [S2C] The CM provides financial information to the Client, in accordance with the program/agency guidelines, including any fees (e.g. program fees and/or Client contribution), funding/budgetary details and the financial limitations/restrictions of the program. The CM ensures the Client understands the information provided [S2D] The CM explains the rationale and steps of developing the care plan with the Client, including the purpose of the goals, objectives, tasks and identified responsibilities (CM and Client), timeframes and the review process [S2E] The CM, in partnership with the Client and/or key stakeholders, applies a strengths based paradigm (e.g. R.O.P.E.S) to develop an agreed person centred care plan that is action orientated, multidisciplinary, flexible, evidence based and time specific. Goals and outcomes are specific, measurable, achievable, realistic and consistent with available resources and program/agency guidelines [S2E] Documentation by the CM demonstrates the execution of the activities and interventions by the CM and Client necessary for accomplishing the agreed goals within the care plan; including ongoing communication and sharing of information between the CM, the Client and/or key stakeholders [S2E] Documentation by the CM demonstrates the CM documents Client’s and/or key stakeholder/s engagement, collaboration and contribution to innovative ideas and solutions to meet the Client’s individual, diverse and/or special needs [S2F]

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National Skill Set for Effective Case Management Workbook

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Chapter One