Supporting every person to make choices about their own life
This policy sets out how Together Two Limited supports participants to make decisions about their own lives and how we obtain, record, and manage consent. It establishes the principles, processes, and responsibilities that ensure every person we support is empowered to exercise choice and control.
Decision making is at the heart of a good life. The Keys to Citizenship framework that guides our practice begins with Freedom, the right of every person to make decisions, take risks, and live on their own terms. This policy translates that principle into practice by establishing a clear hierarchy: autonomous decision making first, supported decision making where needed, and substitute decision making only as a last resort.
Together Two supports many participants with complex communication needs, cognitive disability, psychosocial disability, and autism. For these participants, the capacity to make decisions may fluctuate, may require specific communication supports, or may need to be understood through the knowledge held by their Circle of Support. This policy ensures that complexity of need never becomes a reason to bypass a participant’s right to be involved in decisions about their own life.
→ Person-Centred Practice Policy: Section 4.1 (Freedom); Circles of Support Engagement Framework: Giving Voice to Those Who Cannot Speak.
This policy applies whenever decisions are made about or on behalf of a participant, or when consent is required from a participant or their substitute decision maker. It applies across all Together Two services including Supported Independent Living (SIL), the ZigZag Day Program, in-home supports, community-based supports, School Leaver Employment Supports (SLES), support coordination, and aged care services delivered in partnership with Trilogy Care.
It applies to all representatives of Together Two including the Board of Directors, Senior Leadership Team, permanent and casual workers, contractors, volunteers (including Good in the Hood volunteers), and students on placement.
This policy supports compliance with:
National Disability Insurance Scheme Act 2013 (Cth)
NDIS (Provider Registration and Practice Standards) Rules 2018, Core Module: Rights and Responsibilities (Independence and Informed Choice outcome)
NDIS (Code of Conduct) Rules 2018
NDIS (Restrictive Practices and Behaviour Support) Rules 2018
Guardianship Act 1987 (NSW)
NSW Trustee and Guardian Act 2009 (NSW)
Capacity Toolkit (NSW Attorney General’s Department)
Privacy Act 1988 (Cth) and Australian Privacy Principles
Children’s Guardian Act 2019 (NSW)
United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), in particular Article 12 (Equal recognition before the law)
→ Business and Operational Plan 2025–2028: Section 9 (Legislative and Regulatory Framework) and Compliance Register (Form 17).
Together Two presumes that every participant has the capacity to make their own decisions. This presumption applies regardless of the participant’s age, appearance, disability, behaviour, language skills, communication method, or any other condition or characteristic.
Capacity is decision-specific and time-specific. A participant may have capacity to make some decisions but not others. Capacity can also change over time and may be affected by illness, fatigue, medication, emotional state, or environmental factors. A decision that appears unwise to others does not in itself demonstrate a lack of capacity.
Before any assessment of capacity is considered, Together Two will:
Provide the participant with all relevant information about the decision in a format they can understand, including Easy Read materials, visual supports, interpreting services, or other communication aids.
Allow the participant sufficient time to consider the information, ask questions, and seek advice from their Circle of Support or an independent advocate.
Ensure the environment supports the participant’s decision making, for example by choosing a time of day when the participant is most alert, a setting that is comfortable and familiar, and minimising distractions.
Offer the participant support to make the decision, including the involvement of trusted people from their Circle of Support who understand the participant’s communication and preferences.
Only after all practicable steps have been taken to support the participant to make the decision, and the participant is still unable to do so, should capacity be considered impaired for that specific decision.
→ Circles of Support Engagement Framework: Giving Voice to Those Who Cannot Speak.
Together Two recognises a clear hierarchy for decision making. The guiding principle is that the participant’s own voice is always sought and respected, even where substitute decision making is in place.
Where a participant has the capacity to make a decision independently, that decision is theirs to make. Workers:
Refer all decisions to the participant, including everyday choices (meals, clothing, activities, routines) and significant decisions (support planning, service changes, health decisions).
Provide relevant information to help the participant make an informed choice, including the benefits, risks, and alternatives.
Respect the participant’s decision even if they disagree with it, consistent with the principles of dignity of risk.
Support the participant to seek advice from family, friends, advocates, or professionals if they wish, while recognising that the final decision belongs to the participant.
Do not pressure, rush, or influence the participant’s decision with organisational interests, personal opinions, or resource constraints.
Where a participant needs help to make a decision, Together Two provides supported decision making. This means helping the participant to understand the decision, consider the options, and communicate their choice. It does not mean making the decision for them.
Supported decision making may involve:
Providing information in the participant’s preferred communication format, including Easy Read, visual supports, social stories, or interpreting services.
Involving trusted people from the participant’s Circle of Support, particularly the Circle of Intimacy, who understand the participant’s communication, preferences, and values.
Arranging an independent advocate through the Disability Advocacy Network Australia (DANA) or other advocacy service if the participant or their family requests one.
Breaking complex decisions into smaller, more manageable steps.
Providing additional time and revisiting the decision across multiple conversations if needed.
Choosing a time, place, and setting that best supports the participant’s decision making capacity.
Supported decision making is the preferred approach for all participants who need assistance. Together Two will always attempt supported decision making before considering substitute decision making.
The participant’s Circle of Support plays a central role in supported decision making. Family members who have known the participant their entire life carry irreplaceable knowledge about the participant’s known will and preferences. Workers draw on this knowledge to help the participant express their choice, even when the participant cannot verbally articulate it.
→ Circles of Support Engagement Framework; Advocacy Policy; Diversity and Inclusion Policy (interpreting services).
Substitute decision making occurs when another person makes a decision on behalf of a participant who has been assessed as lacking the capacity to make that specific decision. Substitute decision making is a last resort and is only used when:
All practicable steps to support the participant to make the decision themselves have been exhausted.
There is clear evidence that the participant lacks capacity for this specific decision at this specific time.
The decision is necessary and cannot reasonably be deferred until the participant regains capacity.
Substitute decision makers may be informal or formal:
Informal Decision Makers
An informal decision maker is a person who makes decisions on behalf of a participant without a formal legal appointment.
Informal decision makers may include close family members, carers, partners, or trusted friends.
Informal decision making is appropriate for everyday decisions such as social activities, leisure, and daily routines, where there is no conflict and no risk to the participant’s safety.
Details of informal decision makers are recorded in the participant’s file and made available to relevant workers.
Formal Decision Makers
A formal decision maker is a person who has been legally appointed to make decisions on behalf of a participant.
In NSW, formal decision makers are appointed under the Guardianship Act 1987 (NSW) by the NSW Civil and Administrative Tribunal (NCAT) or through enduring guardianship or power of attorney arrangements.
Formal decision making may be required where there is conflict over decisions, where the participant’s safety or the safety of others is at risk, or where legislation specifically requires it (for example, consent for certain medical treatments or restrictive practices).
Details of formal decision makers, including the scope and limitations of their authority, are recorded in the participant’s file and made available to relevant workers.
Even where a substitute decision maker is in place, Together Two continues to seek the participant’s views, preferences, and expressed will wherever possible. The substitute decision maker’s role is to make the decision the participant would have made if they had the capacity to do so, not the decision the substitute decision maker thinks is best.
Where there is uncertainty about who can provide consent for a participant with impaired decision-making capacity, the order of priority under NSW law is:
A guardian (including an enduring guardian, private guardian, or public guardian appointed by NCAT) who has been appointed with the relevant decision-making function.
A spouse, de facto partner, or domestic partner who has a close and continuing relationship with the participant.
An unpaid carer who provides or arranges care on a regular basis (the Carer’s pension does not count as payment).
A close friend or relative of the participant.
If the person listed above is not available, lacks capacity themselves, or refuses to consent, the next person in the hierarchy may consent. If no suitable person is available, an application to NCAT may be required.
→ Guardianship Act 1987 (NSW); NSW Trustee and Guardian Act 2009 (NSW).
Together Two obtains informed consent from the participant (or their substitute decision maker where applicable) in the following circumstances:
Before commencing supports and services, including at intake and when entering into a service agreement.
When creating, reviewing, or changing a participant’s support plan.
Before collecting, using, storing, or disclosing the participant’s personal information.
Before sharing the participant’s personal information with a third party, including other service providers, health professionals, or family members.
Before a participant undertakes a health, assessment or receives medical or dental treatment.
When supporting a participant with medication, in accordance with the Medication Policy.
Before commencing a regulated restrictive practice as part of a positive behaviour support plan, including obtaining the required authorisation under the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 and the relevant NSW authorisation scheme.
Before planning the use of any of the participant’s NDIS funds.
Before using images, video, or audio recordings of a participant for promotional, training, or any other purpose.
When a forensic procedure is required as part of a police investigation.
Before providing participant information to the Support Circuits AI portal or any other digital platform.
Consent is not required in the following limited circumstances:
Routine or non-intrusive examination for diagnostic purposes, such as a visual examination of the mouth, throat, nose, eyes, or ears.
First aid or emergency medical treatment when the participant cannot give consent (for example, if they are unconscious).
Urgent medical treatment required to save the participant’s life, prevent serious damage to their health, or alleviate significant pain or distress.
Disclosure of information where Together Two reasonably believes the participant or another person is at risk of harm, where an unlawful act has occurred, or where disclosure is otherwise required by law.
Together Two obtains consent in a way that is meaningful, informed, and documented:
For consent to be valid, the participant (or substitute decision maker) must be provided with:
A clear explanation of what they are consenting to, in the language, communication mode, and terms they are most likely to understand.
The purpose and expected benefits of the proposed action.
Any risks, consequences, or side effects associated with the proposed action.
The alternatives available, including the option of declining.
Information about their right to withdraw or amend their consent at any time without consequence.
Written consent is the preferred method. Consent forms are used for service agreements, support plans, information sharing, medication, restrictive practices, and other significant decisions.
Where written consent is not practicable (for example, for everyday decisions in SIL settings), verbal consent is acceptable and must be documented in the participant’s file, including the date, the decision, who gave consent, and who witnessed it.
For participants who communicate non-verbally, consent may be indicated through established communication methods documented in their support plan. Workers must be trained to recognise and interpret these methods, informed by the participant’s Circle of Support.
All consent records are stored securely in the participant’s file and retained for a minimum of seven years.
Participants have the right to withdraw or amend their consent at any time.
Withdrawal of consent does not affect the participant’s access to services or the quality of supports they receive.
Where consent is withdrawn, the reasons are discussed with the participant (if they wish) and the withdrawal is documented in the participant’s file.
A participant’s refusal to consent is recorded in their file.
Refusal of consent carries no consequences in terms of access to or quality of services.
Where refusal of consent relates to a health or safety matter, the potential risks are explained to the participant and documented. The Duty of Care and Dignity of Risk Policy applies.
→ Privacy and Confidentiality Policy; Participant Rights Policy; Duty of Care and Dignity of Risk Policy.
When supporting participants with medical or dental treatment:
The medical practitioner is responsible for advising the participant about the nature, effects, risks, and alternatives of the proposed treatment.
Together Two workers support the participant to understand the information provided, using their preferred communication methods and involving their Circle of Support where the participant wishes.
For participants with impaired decision-making capacity, medical consent must be obtained from the appropriate substitute decision maker in accordance with the hierarchy in Section 5.4.
Applications to NCAT are required for special medical treatments (such as those likely to result in significant side effects) where the participant lacks capacity and no appropriate substitute decision maker is available.
The use of any regulated restrictive practice (seclusion, chemical restraint, mechanical restraint, physical restraint, or environmental restraint) requires:
A positive behaviour support plan developed by a qualified behaviour support practitioner, with the informed consent of the participant or their substitute decision maker.
Authorisation under the relevant NSW authorisation scheme, in accordance with the NDIS (Restrictive Practices and Behaviour Support) Rules 2018.
Lodgement of authorisation evidence with the NDIS Quality and Safeguards Commission.
Ongoing reporting of every use of a regulated restrictive practice to the NDIS Commission.
Consent for restrictive practices must be specific, informed, and documented. The participant (or their substitute decision maker) must understand what the practice involves, why it is proposed, what alternatives have been considered, and the plan for reducing and eliminating its use.
→ Positive Behaviour Support Policy; Restrictive Practices Policy.
The Support Circuits AI portal provides authorised members of a participant’s Circle of Support with visibility of their supports, goals, and progress. Access to the portal requires:
The participant’s informed consent (or the consent of their substitute decision maker) for each person who is given access.
Clear documentation of what information each authorised person can view.
Respect for the participant’s privacy boundaries, including any information the participant does not want shared with specific people.
The participant’s right to revoke access at any time.
→ Privacy and Confidentiality Policy; Information Security Policy; Circles of Support Engagement Framework.
Children and young people have a right to be involved in decisions that affect them, in ways appropriate to their age and stage of development. Together Two:
Supports children and young people to participate in decision making to the extent they are able, including through age-appropriate communication and the involvement of trusted adults.
Obtains consent from a parent or legal guardian for children under 18 years, while actively seeking the child’s views and preferences.
Recognises that young people aged 14 years and over may have capacity to consent to certain decisions, particularly regarding their own health and support, and supports them to exercise this capacity where appropriate.
Complies with the Children’s Guardian Act 2019 (NSW) and the National Principles for Child Safe Organisations.
→ Child Safe Policy; Participant Rights Policy.
All workers are responsible for:
Presuming capacity for every participant in every interaction.
Supporting participants to make their own decisions using the participant’s preferred communication methods and involving their Circle of Support where requested.
Obtaining informed consent before providing supports, sharing information, or taking any action that affects the participant.
Recording consent (including verbal consent) in the participant’s file.
Respecting the participant’s decision even when they disagree with it, unless there is an immediate and serious risk of harm.
Never pressuring, rushing, or unduly influencing a participant’s decision.
Escalating to their supervisor or the on-call manager where they are uncertain about a participant’s capacity or the appropriate consent process.
Completing training on decision making, consent, and supported decision making as part of induction and ongoing professional development.
Aisling Scully, Head of NDIS Services (Policy Owner), is responsible for ensuring decision making and consent processes are embedded in all NDIS support planning, delivery, and review.
Sergio Pinzon, Head of HR and Business Improvement, is responsible for ensuring decision making and consent training is included in worker induction and ongoing professional development, and that training records are maintained in the Skill and Competency Matrix.
Rei Guzman, Head of Aged Care and Clinical Services, is responsible for ensuring clinical consent processes (medication, health assessments, clinical interventions) are compliant with relevant legislation and clinical governance standards.
All members of the Senior Leadership Team are responsible for modelling and reinforcing a culture where participant choice and control are respected and supported.
→ Business and Operational Plan 2025–2028: Section 3 (Senior Leadership Team) and Section 4 (Operational Priorities).
This policy directly addresses the Independence and Informed Choice outcome within the NDIS Practice Standards Core Module: Rights and Responsibilities.
| Quality Indicator | How Together Two Demonstrates This | Evidence |
|---|---|---|
| Each participant is supported to make informed choices, exercise control, and maximise their independence | Presumption of capacity; decision making hierarchy (autonomous, supported, substitute); Keys to Citizenship (Freedom); Circles of Support for non-verbal participants | Support plans; consent forms; Circle of Support maps; training records; supervision notes |
| Processes are in place to identify and respond to participants requiring support with decision making | Communication preferences documented in support plans; Easy Read materials; interpreting services; Circle of Support involvement; advocacy access | Support plan communication sections; TIS National records; advocacy referral records; Family Committee minutes |
| Information about support options is transparent and promotes choice and control | Service agreements include plain-language information; pricing disclosed before service delivery; participants informed of alternatives including other providers | Service agreements; pricing schedules; participant information packs |
| Together Two Document | Relevance |
|---|---|
| Participant Rights Policy | Rights outcomes including independence and informed choice |
| Person-Centred Practice Policy | Keys to Citizenship (Freedom), support planning approach, participant voice |
| Circles of Support Engagement Framework | Supported decision making through circles, giving voice to those who cannot speak |
| Duty of Care and Dignity of Risk Policy | Balancing safety with the right to take risks and make choices |
| Positive Behaviour Support Policy | Consent for behaviour support plans and restrictive practices |
| Restrictive Practices Policy | Authorisation and consent requirements for regulated restrictive practices |
| Advocacy Policy | Independent advocacy access to support decision making |
| Privacy and Confidentiality Policy | Consent for information collection, use, storage, and disclosure |
| Medication Policy | Consent for medication administration |
| Child Safe Policy | Decision making and consent for children and young people |
| Information Security Policy | Security of consent records and personal information |
| Entry and Exit Policy | Consent at intake, service agreement, and exit |
| Service Agreement Management Policy | Consent embedded in service agreements |
| Skill and Competency Matrix | Training records for decision making and consent |
| Version | Date | Author | Change Description |
|---|---|---|---|
| 1.0 | May 2023 | Emma Pollard (Centro Assist) | Initial version, generic template |
| 2.0 | March 2026 | Steven Lowrie, CEO | Complete rewrite. Organisation-specific content grounded in the Keys to Citizenship framework and Circles of Support model. NSW-specific guardianship legislation referenced. Consent requirements for restrictive practices, Support Circuits AI portal, and clinical contexts added. Decision making hierarchy (autonomous, supported, substitute) clearly articulated. Aligned to NDIS Practice Standards Core Module quality indicators. Cross-referenced to companion governance documents. |