It started off as a fun day for the people in your nonprofit’s care — an outing for ice cream and a movie — but the good times ended in an instant when one of your clients tripped and fell in the parking lot and wound up in the hospital with an injured leg.
Now, the spotlight is on you and your nonprofit in a way you never imagined, as people are demanding to know how this happened — and why supervision was challenging at that moment.
When you support people with disabilities, safety planning is essential. It’s important to build activities around clear supervision and documented controls, and train staff to follow consistent practices.
Below, we will explore a scenario where a nonprofit’s disabled client was injured in their care — what went well, and where common challenges arose, and discuss how your nonprofit might prevent a similar incident from happening during your mission work.
The Nonprofit:
A nonprofit operated an adult daycare facility which provided supervised care, enrichment, and transportation for people with various physical and mental disabilities, as well as training and respite services for their caregivers.
The Incident:
One day, a group of about 10 adult clients, along with four staff members, left the nonprofit’s facility in the organization’s 15-seat van for an outing to an ice cream parlor and then to see a movie.
Among the clients was a nonverbal man with mobility issues, who had a safety plan on file that included a note that one‑to‑one assistance was recommended when walking.
When the group arrived at the movie theater, two staff members helped the clients out of the van while the other two set about setting up another client’s wheelchair.
The wheelchair was new, and unfamiliar to the staff members, who were having difficulty configuring it.
When a third staffer came to help troubleshoot with the wheelchair, the fourth one was left watching all 10 clients alone — and that’s when the nonverbal client wandered off and tripped over a concrete parking barrier.
The client was transported by ambulance to the hospital, where it was determined that he’d sustained injuries to his knee severe enough to require orthopedic surgery, rehabilitation, and physical therapy.
The Coverage:
As soon as the nonprofit was certain that the client was secure, they alerted their insurance broker, who began the process of making a claim on the organization’s Social Service Professional (SSP) policy with Nonprofits Insurance Alliance (NIA).
NIA’s claims examiners quickly began reviewing the events and circumstances surrounding the incident.
The Legal Action:
The family of the client moved to file legal action against the nonprofit, alleging that the nonprofit’s staff had failed to properly supervise and provide care to the client, and that their failure to adhere to the agreed-upon safety plan had directly resulted in the client’s injury.
The Result:
NIA’s claims examiners reviewed the events and circumstances surrounding the incident, along with witness statements, the client’s individual safety plan, and the nonprofit’s policies and procedures around off-site activities.
Based on available documentation, it appeared that some procedures may not have been followed during the transition period, which could have contributed to the incident.
By leaving only one staffer in charge of overseeing of all 10 clients while the other three were working with the wheelchair, this resulted in a supervision gap during a busy moment.
With this conclusion in-hand, NIA began working with the family’s legal representation to reach an appropriate settlement, resolving the legal action before it reached a courtroom setting.
What Did the Nonprofit Do Right?
During the busy transition, parts of the plan were not followed, placing them at risk of injury, and one left with serious injury. This created additional risk for the organization.
The news wasn’t all bad though. Let’s review a couple steps that the nonprofit did take that helped them in this situation.
Quick Activation of the Claims Process
As soon as the incident happened, the nonprofit notified their insurance broker, who then activated the process of making a claim on their SSP policy with NIA.
Doing this quickly was important because it enabled NIA to be involved in the defense process from the start, review the situation, get key witness statements, any other evidence that could disappear over time, and determine the potential for liability — before any legal action was even filed.
This meant that, by the time legal action was filed, the claims examiners were ready and prepared to respond appropriately.
Procedures Around Special Needs, Supervision, and Safety
Although they failed to follow them properly, the nonprofit did have the right procedures in place for working with clients with low vision, special needs, or those in need of accommodation.
- Parents/guardians were required to work with staff to create individualized safety plans for clients to ensure proper care and supervision.
- The nonprofit required permission slips for off-site activities.
- All staffers that worked directly with clients were required to have first aid and CPR training.
- For off-site activities, there were set requirements addressing the number of clients to the number of staff present — all of whom were required to know the safety plans for each client.
Multiple Supervisors Present
By having multiple staff members present when the incident occurred, the nonprofit ensured that there were enough trained staff present to simultaneously:
- Provide first aid to the client.
- Call 9-1-1 and alert the nonprofit’s director.
- Supervise the remaining clients.
This helped to keep everyone calm, reassured, and not in the way of the medical responders.
Incident Reports & Documentation
The nonprofit had procedures in place around incident reports and recordkeeping. Staff members were trained on these procedures and the nonprofit regularly held refresher sessions.
Once they were aware something was wrong, the nonprofit’s staff knew to document the relevant times, dates, locations, witnesses, steps taken, and other details surrounding the incident.
This helped the nonprofit’s legal defense team get a clear timeline of events, identify potential witnesses, and to review the nonprofit’s actions and processes to spot potential liabilities.
How Can Your Nonprofit Protect Itself?
Any activity comes with the risk that people might get hurt. It’s important to prevent it where you can and respond appropriately when you can’t.
Some steps you might consider include:
Safety Protocols & Procedures
Planning ahead helps teams respond smoothly, especially off‑site — so what can help you keep everyone (and your mission) safe?
Here are some things you might consider as you review your overall risk management plan:
Are There Any Special Needs to Consider?
Be sure to have parent/guardians disclose all known special needs, any and all medications required, and any required accommodations or safety concerns.
Once you have that information, make your plans and train your staff accordingly.
Are There Individual Safety Plans? Are You Ready to Follow Them?
If you work with individuals with disabilities, it’s a good idea to meet with their parents/legal guardians/caregivers when onboarding new clients.
This can give you a chance to agree upon — and document — an appropriate plan that lays out how your team can best accommodate that client’s needs and ensure their safety while they’re in your care.
Once a plan is in place, make sure staff understand it and can apply it in real‑world situations.
This can be beneficial for both parties:
- It helps the families be confident that their loved ones will be safe in your care.
- In addition to knowing how better to serve your clients, your nonprofit also gets documentation of all the special requests and individual needs that have been shared.
As the relationship with the client continues, be sure to meet with the parents/legal guardians/caregivers regularly, to update the plans as needs evolve and change.
First Aid Kit Readiness
A fully stocked first aid kit is crucial. Be sure to confirm what items can and cannot legally be included in a kit in your area, but the basics can include:
- Bandages
- Single-use ice packs
- Gauze
- Gloves
- Antiseptic wipes
- Prescribed emergency medications:
- Asthma inhalers
- EpiPens
Having your first aid kits present, fully stocked, and ready whenever there are clients around can help you be sure that you’re ready to protect them in case of emergencies.
Is There Enough Staff?
When you’re planning an activity or event, consider the number of people you can realistically expect to have available, and plan your activities around that.
Ideally, you want to be sure you have enough people to safely run all your activities, with several additional people on hand to provide breaks and extra help as needed.
Can Everyone Operate Needed Equipment?
A brief practice run before heading out helps avoid confusion in the field.
For example, say one of your clients gets a new wheelchair, and they’re joining you on an off-site activity.
You’re going to want to make sure that all staff accompanying that activity have had a chance to get familiarized with the chair and can confidently operate it, transport it, and set it up/pack it up — before you get out into an uncontrolled environment.
Proper Supervision:
Clear roles and communication help maintain awareness during busy moments. That means that, not only do you need to make sure your team members are following your practices and procedures, but that your supervisors are following them, too.
Some questions to consider ahead of time:
- Does everyone understand their roles?
- How will your people communicate?
- Where should supervisors be positioned?
- Are there any blind spots?
- Are shifts properly covered, and does everyone know how and when to safely rotate?
- Who is in charge in an emergency?
- Do all staff members know the emergency procedures, and how to activate them?
- Is everyone aware of known, reported allergies?
- If someone with an allergy has a reaction, does everyone know where the medication is?
Incident Reports:
Keeping detailed incident reports can help protect you in a variety of ways. Even for minor bumps and scrapes, be sure your team knows to record:
- What happened
- Who was involved
- Any and all care given
- Who was notified
- Any other relevant details
Some organizations offer families the option to review and acknowledge reports.
NIA Resources:
- All nonprofits insured by NIA get free access to My Risk Management Plan — online tools to help you create a risk management plan that reflects your organization’s unique needs, priorities, and culture.
- NIA offers members free access to a library of e-books to help them navigate specific types of risks. For your special events, consider checking out “Sound Advice for Functions and Events: Tips for Staging Safer Special Events E-Book,” available online and in PDF.
The Right Training
Preparing staff and volunteers can help support responses in a crisis.
This preparation can support clearer actions in an emergency.
Types of training some nonprofits use include:
- First Aid/CPR training
- Conflict resolution/crisis prevention training
- Leadership training
- Risk management training
- Harassment prevention training
- Abuse prevention training
- Mandated reporter training
Note: Training requirements vary from state to state. Be sure to check and see what your state’s requirements are for training, and what your nonprofit’s responsibilities for providing training include.
Documentation & Recordkeeping
Clear records can help provide information if questions arise.
Many nonprofits choose to document key processes and activities — processes, procedures, times, dates, decisions, attendance, every incident report, all security footage, and more.
Keeping good records not only helps your team stay more organized, but if your nonprofit ever needs to defend itself in court, your records can serve as proof that:
- You operated responsibly and in good faith
- Your policies, training, and procedures complied with the law
- Rules, policies, and procedures were documented and communicated
- Safety plans were referenced and applied as appropriate
- Everyone understood their responsibilities and duties
- Staff actions and responses were documented
Strong recordkeeping practices may support your response if legal questions arise, which can help put you in a much stronger position to defend your mission and your good name.
Conclusion
Caring for people with disabilities means more than providing services — it means earning and keeping their trust.
Unexpected situations can occur even with careful planning. But, by following established procedures, training your team, and documenting everything, you can reduce risks and respond effectively when emergencies arise. Effective preparation can support both client well being and organizational stability.
From the Claims Files stories are for general information only. They are simplified examples and do not guarantee coverage, a defense, or any specific outcome. Some losses described in this series may not be covered.
Coverage depends on the specific facts and on the terms, conditions, and exclusions in your policy. Contact your insurance broker or agent for guidance, and follow your policy’s claims reporting procedures if an incident may involve a claim.
This story is not legal, medical, financial, or professional advice. In an emergency, contact local emergency services first. Any risk management practices mentioned are general suggestions and may not apply to every nonprofit. Follow all applicable laws, licensing rules, and reporting requirements.
