Submission to the Standing Committee on Health, Ageing and Social Services inquiry into the implementation, performance and governance of the National Disability Insurance Scheme in the ACT
Contact:
Nathan Jones
Disabilities Manager
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Quest Care
Unit 104, Northpoint Plaza, Benjamin Way, Belconnen
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About Quest Care
QuestCare is a registered provider under the National Disability Insurance Scheme. QuestCare provides a range of personal, home and community supports to adults and children with a disability, and ensures that Support Workers have the most thorough training and up-to-date skills in the sector by training them through our sister vocational training company Quest Training.
QuestCare employs more than 100 DSO staff who are trained in all aspects of disability, including high support needs. QuestCare provides in excess of 2,500 service hours per week of to our more than 100 clients.
Our Mission is to provide high-quality support workers as carers to clients across the ACT and surrounds. A goal which includes ethical, professional, client focused provision of services.
Response to the Terms of Reference
c. Unique factors relating to the provision of disability services affected by the implementation of the NDIS in the ACT.
The following is a summary of the main issues that have faced us as a service provider since the implementation of the NDIS in the ACT.
Payment Delays
There have been significant delays in payments to Service Providers since the implementation of the NDIS in the ACT. Initially, after the NDIS was first implemented in the ACT, Quest Care had to wait six months or more to receive approved funding for some clients. During that time Quest Care had to continue to provide services for clients and pay employees.
While those initial problems have since been resolved there are still often gaps which may start 6 weeks before a client’s plan ends during which time we are unable to claim payments. The new plan may take weeks or months to process and payments sometimes do not resume for a further considerable period of time. During that time we continue to provide services for the clients, pay our support workers and cover the general costs of operations.
Cuts to Services
As a Service Provider we have seen clients who have had funding cut, resulting in an inadequate level of care being able to be provided for the client which has subsequently put the client in danger. For instance, one client had his level of care and associated funding reduced leaving him unsupervised for two hours. Subsequently during the unsupervised time the client went missing and was lost for a number of days. That same client has recently had his funding reduced again.
QuestCare is constantly being put in the position of having to decide whether to cut services to a client as there is no funding to cover the service, or to cover the shortfall ourselves whether on a temporary basis or longer term, and depending on the specific needs of a client.
QuestCare is sometimes not able to provide services to clients due to inadequate NDIS funding available to ensure both the safety of our staff and the physical safety for a client, for example when a client is required to be transferred and this requires two support workers, one of whom is not funded.
Contact with NDIS
We have found very limited response to emails sent to the NDIS although this has improved recently with the introduction of the Provider Payment issues email. It seems to now take approximately 3 weeks to have a query answered, whereas previously we would not have any answer to emails.
As far as telephone enquiries go we have found that the NDIS staff fielding phone enquiries are sometimes less informed that our own staff. QuestCare has received misinformation through phone enquiries and requests to have such advice put in writing are always refused.
A dedicated, experienced contact within the NDIS is needed to support Service Providers, ensuring the NDIS contact understands the clients and issues facing that particular provider.
Use of the Portal
The NDIS Portal at present has limited reporting capability, operating more through enquiry screens. While improvements are slowly being made, use of the portal is very time consuming and frustrating. For instance payment remittances are usually generated after bulk uploads to the portal, however in some instances the remittance is not generated and it is a very time consuming and difficult task to try and work out how to allocate a payment.
Trying to find out the current plan that clients are on is a very cumbersome task. For example, there is no reporting mechanism to find out all the payments made for a client under a particular service
booking, nor the facility to run a report of all current clients and their plan details. These types of reporting facilities would significantly cut down on the administration costs faced by service providers.
The time and resources wasted on dealing with the vagaries of the portal would be much better placed in serving our clients.
Support Coordination
QuestCare does not currently provide support coordination services, however we do have to work closely with services that are supposed to provide these services. QuestCare must often advocate for our clients who are mostly dissatisfied with the performance provided by coordinators resulting in receiving an unacceptable level of service. Many of our clients have not even met their support coordinator.
Clients accessing NDIS funding are vulnerable people and not always able to navigate the vast and complex system of services that are available to them through their NDIS plan. They rely on their support coordinators to navigate through these complexities and to provide outcomes that will assist them greatly with their lives. Importantly, support coordination should provide clients with advice and assistance to ensure a client’s NDIS funding is spent according to the participant’s determined needs.
QuestCare has found that the majority of support coordination is not fulfilling the goals of the client’s plans.
Summary
Since the implementation of the NDIS in the ACT, the NDIA has relied on the ability of Service Providers to fund gaps and delays in payments. We have seen a number of Service Providers unable to continue operating in this environment. Those that continue are still stretched to their limits as they attempt to provide quality service to clients who may have had funding inappropriately cut or delayed due the ineffectual and cumbersome processes of plan approvals and payment claims.
In the end all these factors put the individuals who should be benefitting from the provision of disability services most at risk. In addition, in many cases support coordination is not ensuring that all the goals of participant’s plans are achieved.