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Continual supervision
Supervision means the continual presence of another person for the purpose of reducing the real risk of harm to the individual and to others (PADP regs, reg 5(5))
Supervision is a more passive concept than attention. All of the following criteria must be met in order to meet the eligibility criteria:
- the individual’s disability can cause a substantial danger to the individual or to someone else
- the danger must not be too remote a possibility
- there is a need for supervision to ensure that the individual avoids the substantial danger
- the supervision needed must be continual.
The supervision an individual requires must be ‘continual’. This means the supervision needs to be required repeatedly, but is not necessarily constant and uninterrupted.
The supervision must involve the presence of another person, but this presence can be precautionary or anticipatory.
The level of supervision may be what is reasonable in the circumstances and can be more passive depending on the nature of the danger.
‘Continual supervision’ only applies to the daytime condition (PADP regs, reg 5(2)(b)).
Case managers should consider:
- whether the individual’s health condition is predictable
- if there are any practical steps an individual can take to guard against danger
- the individual’s age and nature of their health condition
- the individual’s ability to understand the risk of danger.
Example: an individual requires supervision to avoid substantial danger
Catherine is 68 years old and has developed epilepsy. Attempts to control Catherine’s epilepsy with medication have so far not been successful. Catherine has seizures around once or twice a day.
Catherine’s partner makes an application for PADP on Catherine’s behalf. One of Catherine’s recent seizures occurred while bathing. Catherine’s partner had to intervene to stop her inhaling water or hurting herself in the bath. Her partner now stays in the bathroom while Catherine is having a bath. The application form sets out further details of the supervision that Catherine’s partner provides during the day.
The application form notes that Catherine’s partner is required to care for Catherine during the night if she has a seizure while sleeping. This is because Catherine could injure herself during a seizure. She has struck her head on furniture previously during a seizure.
Catherine’s partner also has to monitor the length of the seizure accurately. If it goes on too long, they need to phone an ambulance. For up to an hour after a seizure, Catherine can be disoriented, distressed and confused. Her partner helps to settle her and ensure she remains in her bed.
Although the case manager has useful information about Catherine’s needs at night in terms of attention required, the case manager has to look exclusively at Catherine’s daytime needs to establish whether she meets the test for requiring ‘continual supervision throughout the day to avoid substantial danger to herself or others’.
The case manager determines that Catherine needs continual supervision while bathing, which happens during the household’s daytime. This supervision avoids substantial danger to Catherine should she bathe alone. The case manager reviews all of the information provided and awards the higher rate of PADP. This is because Catherine requires continual supervision throughout the day and prolonged or repeated attention from another person at night in connection to her bodily function of sleeping.