8.4 Defining roles and responsibilities – the doughnut sort

Given the history of disability service provision, where sometimes overly protective approaches were taken to supporting people with a disability, it can be useful to delineate what is the responsibility of the service provider and what is not. One way of doing this is to use the doughnut sort. This approach asks:

What are your core responsibilities?
What are areas where you can exercise creativity and judgement?
What is not your paid responsibility?

Peter’s story

Peter is provided with in home support following the death of both his parents. He has limited cooking skills and on two occasions the worker arrived to find the gas on after he had cooked something on the stove. They had previously tried delivered meals but he did not eat these, and they had learned that when he cooked the meal himself he tended to eat it. Peter took great satisfaction from having cooked the meal himself.

As the disability service could not provide a worker to support him in cooking each meal they decided to do a couple of things. The first was to change to an electric stove and make sure smoke detection and other fire safety equipment was installed and that Peter knew how to use it. Then they worked with Peter on a menu schedule and shopping twice a week, to see if he could follow the menu when the support worker was not there on alternate days. For the weekend he chose to eat meals from a local take away venue for which he had the numbers programmed into the phone and his favourite dishes highlighted on the menu.

If we consider the earlier example of John, it is the core responsibility of the service provider to provide him with appropriate accommodation and support. Where they exercised creativity and judgement was in relation to how best to support him to access the community, and they developed a strategy with John to achieve this. This did not eliminate the risks involved but did mean they had taken reasonable steps to achieve this; the provider could not be responsible for his care every hour of the day, given his desire and ability to access the community independently.

This approach can also be important as service provision becomes increasingly community based, potentially blurring the responsibilities of the service provider. Working through the doughnut gives your organisation an opportunity to clarify your core responsibilities in relation to the complaint, and where it is possible to exercise judgement and creativity. It can also help clarify those areas that are not the responsibility of the provider.

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8.4 Defining roles and responsibilities – the doughnut sort

Peter’s story