Professional Boundaries

Deanne York Douglas
Deanne York Douglas
Last updated 
Guidelines to establish and maintain professional boundaries 

Overview

All formal working relationships need rapport and trust to function well. The relationship between a client and their support worker is unique, yet sometimes difficult to navigate.

This policy is intended to help you understand your role as a support worker and how to avoid overstepping personal and professional boundaries, which may compromise the duty of care for you and your client. 

Scope

Compliance with this policy is a condition of employment at HomeWise Health for all persons providing services on behalf of HWH.

Definitions

Client- any person(s) for whom services are provided either directly or indirectly, including a person with a disability or the family members of that person.

HWH Support Worker - any person employed in either a paid or voluntary capacity to work with clients, client families or in an administrative capacity within HWH (including the Board).

Boundaries 

What are these boundaries?
We all have boundaries. Boundaries are the rules by which we interact with others in our relationships. These rules help us define what behaviours we find acceptable. Boundaries can differ for everyone as our sense of self-worth and personal values determine them. 

As health professionals, and for safety reasons, we must follow the company's professional boundary guidelines and practices. 

What is a professional boundary?
Professional boundaries are limits set by the legal and ethical frameworks that govern HWH to protect the relationship between a support worker’s professional power and their client’s vulnerability. They outline rules and limits that define the relationship between the client and the person delivering the service.

The provision of services to a client is limited to and must be delivered as per the client's Care Instructions. These limits help maintain a quality service and a safe working environment for clients, families and HWH support workers. Working outside these limits is beyond the scope of your role.
Some examples of professional boundaries include:
  • Not discussing a client's private health information with others
  • Keeping work contact numbers separate from your personal contact numbers
  • Disclosure of the client's personal information by the support worker, including excessive self-disclosure
  • Excessive self-disclosure of your personal information
  • Not performing additional favours for clients in your own time
  • Not performing duties outside the scope of your job description
What is a personal boundary?
Personal boundaries are less explicit than professional boundaries. They may include physical, emotional and mental limitations support workers adopt to protect themselves from being drawn in or overly invested in their clients' lives. Personal boundaries allow HWH support workers to maintain psychological safety for themselves and their clients.

Some examples of personal boundary crossings that set up unrealistic expectations for the client, their family members, and other support workers can include:
  • Inappropriately disclosing your or others' personal information (phone numbers, address)
  • Socialising with clients outside of the work setting 
  • Social media contact and relationships with clients and their families
  • Starting social media chat groups between the support workers of a client, and, or their family members
  • Breaching confidentiality to the client's neighbours and friends or your friends
  • Giving and receiving gifts (refer to the HWH Gift Policy below)
  • Keeping information to yourself and not reporting or documenting appropriately
  • Inappropriate touching or physical contact
  • Shopping for the person on your own time and, or with your own money
  • Bringing meals for the client from your home. Making this a practice also prevents the client from experiencing the smells of home-cooked foods.
Crossing a boundary
Realistically, boundaries will become blurred or crossed at various points in a support worker/client relationship. Recognising when this has happened and taking steps to rectify the situation is essential to keep the relationship healthy. You can always call your CCM to check if you think you, or someone else has crossed a professional boundary. Crossed boundaries create a greater vulnerability for the client, their family, and your fellow support workers.

Risks associated with poor boundaries:
An inappropriate relationship with a client or family member has risks for clients, their family members, and our support workers, including:
  • Increasing/or unreasonable demands and expectations from the client or family outside of your work hours
  • High worker stress and burnout
  • Inability to provide professional and objective support
  • When using phones or other devices for personal use in work time, there is potential for the risk of neglect of the client's needs being addressed and client safety.
  • The loss of important communication related to the client's health or circumstances may place the client's health or mental health at risk.
  • Your duty of care is compromised.
  • Loss and harm caused by a breach of privacy and confidentiality
  • Difficulty setting limits and dealing with inappropriate behaviour
  • Distress when relationships break down
  • Grief and loss for clients when workers leave
  • Potential for food poisoning if meals are not made fresh at the client's home

Related Principles 

All clients have a right to privacy in their personal information, and workers should not seek irrelevant or necessary information to perform their duties. HWH support workers also have a right to privacy. These boundaries must often be set with clients and families who may seek personal information about you or want a personal relationship.

Code of Conduct
The NDIS* philosophy is designed to promote safe, legal and ethical service delivery by setting out expectations for the conduct of both HWH as a company and a professional Support Worker. A client's Care Instructions culminate in extensive collaboration between the client, families, and healthcare professionals and a home assessment for HWH services. Therefore, following the Care Instructions for the client's care and support is the responsibility of the Support Workers.

Confidentiality
Confidentiality means that any information obtained or received by HWH Support Workers must be kept confidential, except with the individual client's or their legal guardian's written or verbal consent. HWH Support Workers must not discuss or disclose confidential information with anyone without this permission. HWH Support Workers are sometimes expected to need to discuss matters with co-workers, peers or supervisors, but this should always be appropriate, respectful, and adhere to privacy principles.

Duty of Care
HWH Support Workers have a duty of care to anyone who might reasonably be affected by their activities, requiring them to act in a way that does not expose others to an unreasonable risk of harm – physical, psychological or financial. HWH Support Workers are required to protect any individual from risks of injury or harm that you can foresee or anticipate. This means you must act with knowledge of the individual (particularly about their capabilities and living situation) and of your abilities, knowledge and limitations. It would be best if you did not give assistance or advice outside your role or expertise, e.g. medical advice, financial advice, family counselling or relationship advice.

Friendships
The role of HWH Support Workers is to build, support and strengthen the existing social, family and community network of a person with a disability or age. The role of a friend differs from that of a paid Support Worker. HWH Support Workers may find this difficult as clients are often isolated and lonely and need friends, but it is the role of HWH Support Workers to build friendships, and the client's capacity for friendships, not be the friendship.

Similarly, relationships with client family members are also inappropriate and risk blurring the boundaries of the professional relationship. You must avoid clients from your social media or family life and social activities. Furthermore, establishing a social media chat group with the client's other support workers would be an ethical breach. You may place important and confidential information in the chat group when it belongs in a shift note.

Gifts
Occasionally, clients and family members may offer gifts to HWH carers as a “thank-you” for work done, for example, chocolates, flowers, cards etc. HWH carers may not want to refuse a small token gift and cause offence. However, accepting gifts from emotionally vulnerable clients can be misinterpreted and should always be considered cautiously, particularly gifts of money or expensive items. An appropriate response to these offers would be, “Your thanks are enough – this is my job, and I am paid accordingly.” "Could we leave your beautiful gift here to it can be shared and enjoyed together"? Further information is contained in our Gifts and Donations Policy.

Social Media
All formal working relationships need rapport and trust to function well. Our relationship with a client is unique and may sometimes be difficult to navigate, especially regarding privacy and social media confidentiality.
The Social Media policy intends to help us understand our role when interacting with our clients and meet our professional legal and ethical obligations when using social media in the context of our code of conduct, communications policy, work relationships and professional boundaries and protecting a client's and our privacy. As previously stated, it is an ethical breach to establish a social media chat group with the client's other support workers and with the client or their family members.

Phones and Personal Devices in the Workplace
Using phones and personal devices in the workplace is for work-related duties. They are a tool of trade and may be a tax deduction for staff. Using phones and personal devices in the workplace for other purposes may create safety risks and neglect for the client. It is unacceptable for staff to work for another company during their shift with the client. The level of care and duties required to support the client will be compromised when staff are distracted by the demands of another employer in a digital space. Equally, for the safety of the client, gaming and gambling on phones or personal devices in the workplace are prohibited

Responsibilities

The Board is responsible for the following:
  • The governance and oversight of HWH and behaving ethically upholds this Code's principles.
The Executive Officers are responsible for the following:
  • enforcing this code
  • behaving in a manner that upholds the principles of this Code.
Human Resources Executive is responsible for the following:
  • Reviewing and monitoring the application of this Code in all Divisions of HWH.
Care Managers are responsible for ensuring the following:
  • Persons engaged in providing services have read and understood the Code of Ethical Behaviour before employment
  • Persons engaged in providing services have signed the Code of Ethical Behaviour Declaration upon commencement of employment, and the declaration is forwarded to the Human Resources Department.
Support Workers engaged in providing services are responsible for:
  • Reading the Code of Ethical Conduct and signing the Code of Ethical Behaviour Declaration upon commencing employment. The signed declaration should be handed to a Manager/Supervisor to be forwarded immediately to the Human Resources Department for inclusion on their file.
  • Making a Declaration of Interest, if the support worker has a delegated financial authority or a personal interest that might influence their decisions or conflict with the interests of HWH
Related Legislation
  • Sex Discrimination Act 1984 (Cth) 
  • Racial Discrimination Act 1975 (Cth)   
  • Disability Discrimination Act 1992 (Cth)  
  • Age Discrimination Act 2004 (Cth)   
  • Australian Human Rights Commission Act 1986 (Cth)    
  • Children's Protection Act 1993
  • Equal Opportunity Act 1984 
  • Health and Community Complaints Commissioner (HCSCC) - Code of Conduct for Unregistered Health Practitioners.
  • National Disability Insurance Scheme (Code of Conduct) Rules 2018, rule changes in 2021
  • National Standards for Disability Services
  • Privacy Act 1988 (Cth)
  • Privacy Amendment (Notifiable Data Breaches) Act, No. 12, 2017 (Cth) 
  • Workplace Gender Equality Act 2012 

Breaches of this Policy

Breaches of these processes may compromise the safety of the client, their family or fellow support workers. Depending on the risks associated with the breach, there are grounds for disciplinary action, or up to termination of employment. Ignorance of these processes will not generally be accepted as an excuse for non-compliance. Only in extreme circumstances and where such ignorance can be demonstrated to have occurred through no fault of the individual concerned will HWH accept such an argument.

Distribution and Review

HWH will ensure all persons engaged in providing services, either paid or unpaid, will be aware of this policy and have easy access to it in an appropriate format. All policies are to be reviewed periodically or when other circumstances dictate.

Related Policies & Procedures