Respite programs provide planned short-term and time-limited breaks for families and other unpaid care givers of children with a developmental delay and adults with an intellectual disability in order to support and maintain the primary care-giving relationship. Respite also provides a positive experience for the person with an intellectual disability.
There are four types of respite activity: -
1. Centre-based (General and Specialist)
2. Home based
3. Host Family
4. Community-based
1. Centre-based Respite - where a person stays for a day stay, overnight or longer in a General respite centre providing respite services for people with an intellectual disability. Day stays should only be provided when all other flexible respite options have been explored thoroughly by the Case Manager eg Carers Respite Centres and other non government respite providers.
Centre based respite may have a specialised focus or may dedicate periods of time for a specialist focus. For example:
- a respite centre may dedicate particular periods of time for the exclusive use of the centre by women only or men only, or other client characteristics, depending on the needs of the client group
- a respite centre may specialise in the school age or adult age groups. A generalist centre may also dedicate particular periods for the use of a single age group
- Centre based respite in a general respite centre is not provided to children from 0 to 6 years of age
Specialist Centre-based respite - we operate one such centre for medically frail children 0 – 6 years of age. This centre provides intensive support by staff trained in meeting these clients’ specific needs.
2. Home Based: - where respite is provided in a client’s home.
3. Host Family: - where a client receives planned, short term respite from a designated (host) family. Host family or families are matched to the age, interests and background of the individual and their carers.
4. Community-based Respite:- where a person with an intellectual disability is provided with the opportunity to participate in a positive experience in the community whilst their usual carer has a break. Community-based respite activities may include:
- Group activities: where a group of people is supported to access common activities such as a teenagers group
- Camps/holidays/weekends away
Periods of client stays in respite
Wherever possible respite should be planned and allocated as equitably as possible based on assessed client need (please see section below titled Who is eligible).
The typical or ideal stay is of 4 – 7 days in the school aged (6 – 18) and adult groups (over 18). Alternative lengths of stay include planned extended respite of 2 – 6 weeks or a single day to accommodate carer needs such as a holiday or medical issues or client needs such as monitoring changes in medication or behaviour changes.
For children using respite services that involve separation from their usual caregiver/s especially children in the 0- 6 age group who are accessing specialist centre-based respite, an assessment must be made that the length of respite is in line with their needs, age, and development. The impact on the child of separation from their primary caregiver must also be assessed. The need to provide opportunities for the child to have ongoing contact with their family during a stay in respite must also be assessed.
In some instances respite is an appropriate service option although not planned. Emergency Short Term Respite is an immediate, time-limited break for families and carers who are unable to provide care due to an unforeseen crisis. Emergency respite is provided on the assumption that the usual care-giver will assume their role in the near future. Emergency respite is usually provided for 96 hours where issues of high support, risk or urgency have been identified although this may be extended in some circumstances and is subject to review.
Maximum stays
Children and young people (0-18years) should not be in respite for 21 consecutive days or 28 days in any period of 12 months without a restoration or care plan being submitted to the Children’s Guardian.
Clients should not exceed the length of the agreed time stipulated in their respite plan
Clients entering emergency respite should not exceed 96 hours without an extension granted through a review.
If an adult client exceeds 63 days per financial year in one of more centre based respite service it may indicate that the individual requires more than respite support. If care reaches or exceeds the 63 day period, an assessment of the client/carer needs must be conducted and a plan developed to meet those needs.
What is Centre Based Respite
Where respite occurs in a centre, it occurs in a dwelling for at least 4 to 6 people that is, wherever possible, located in a residential neighbourhood, or in an area zoned residential by the local government authority. The location should be accessible to services and supports as maybe required to meet client needs, including, transport, commercial services, medical, and recreational facilities.
Basic Physical requirements:
- 4 to 6 bedrooms, to allow adults to have individual bedrooms unless they choose to share a bedroom or their support person consents to the client sharing a room. Children may share a bedroom
- There will be adequate space for clients, staff (including some office capacity) and provision for visitors
- The provision of sufficient out door recreational and leisure space is essential.
- A cyclic program of repair and maintenance is undertaken. Urgent repairs are organised locally and within an appropriate time frame
The property should conform to or exceed the minimum standards as defined in the Departmental "outline brief for homes in the community".
Accommodation is fire safe, conforming to fire standards and departmental guidelines and have conformity with State Environmental Planning Policy No.9 – Group Homes.
A policy manual for respite is currently in development. When completed, these service descriptions are to read in conjunction with the policy manual
Service Capacity
In determining the capacity of a centre based respite service there are two areas to consider:
1. Physical capacity of centre based services. This is the number of beds in bedrooms in the centre. The minimum number of beds in an adult centre based respite service is five.
2. Resourced beds. This is the number of clients who can be accommodated in the centre at one time given the total staff establishment of the centre. The factors which determine the number of resourced beds a centre can provide are:
- the level of staff support required to meet the needs of individual clients
- the level of staff support required to meet the collective needs of a group of clients who are using the service at the same time
Currently the capacity of a respite centre is determined by the respite allocation committee based on the client needs assessments. The Manager, Respite is responsible for approving the resourced bed numbers. The Disability Services Directorate is developing a point score methodology to assess capacity.
The vacancy rate of a respite centre is expressed as:
Vacancy rate = The number of beds available minus the number of resourced beds occupied
Who is eligible?
The target group is:
- Persons with an intellectual disability with moderate to high support needs
- Person must have a needs assessment to guide service prioritisation and must be reviewed through the central intake system
- Our Primary clients are those people over the age of 6 who have an intellectual disability or multiple disabilities where an intellectual disability is also present. We define intellectual disability using the international definition as:
- an IQ of two standard deviations below the mean
- with significant deficits in adaptive behaviour skills
- as manifest in the developmental period prior to 18 years
- For our clients under the age of 6 years, we determine their eligibility on the basis of their developmental delay. To continue as a client accessing DADHC Disability Services past their sixth birthday we require a reassessment to determine if the child has an intellectual disability
Who has priority of access
- People living with a sole carer
- People living with an aged carer
- People with fragile health and complex multiple support needs
- People with assessed complex challenging/assaultive behaviour
- People with forensic issues
- People who have no or limited access to other services
Respite is not
- Long term accommodation
- Crisis accommodation
What are the outcomes for clients
- Positive experience including the opportunity to mix with other people with an intellectual disability and carers.
- Return to their regular care arrangement that has been replenished due to the break
- Maintenance of regular caring arrangement
- Security and safe care for the client