Practice Guide – Safeguarding the participant’s interests

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Contents

• Practice Guide – Safeguarding the participant’s interests
  • Purpose
    • 4
  • To be used by
    • 4
  • Scope
    • 4
  • Context in the Broader Framework
    • 5
      • Quality and Safeguarding Framework
        • 5
      • National Disability Services Zero Tolerance Framework
        • 5
      • The National Disability Abuse and Neglect Hotline
        • 5
      • Complaints Resolution and Referral Service
        • 5
  • NDIA Context and Background
    • 6
      • NDIA Incident Management Frameworks
        • 6
      • Reportable Incidents
        • 7
      • Critical Services Issues Response
        • 7
  • Critical Incidents in the Home or Community
    • 7
      • NDIA Participant Critical Incidents Framework
        • 8
      • Exceptionally Complex Support Needs Program
        • 9
      • Other key resources
        • 9
  • Safeguarding the participant’s interests
    • 10
      • Assessing risks and safeguards
        • 10
      • The planning process
        • 12
  • Access
    • 12
  • Pre-planning
    • 13
      • Streaming
        • 13
      • Primary disability
        • 13
      • Severity Indicator Tool
        • 14
      • The participant statement
        • 14
      • Informal, community and mainstream supports
        • 14
      • Risk assessment and plan duration
        • 15
      • Planning conversations for complex needs
        • 15
      • Representation by nominee or party with consent/authority
        • 16

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9.9 Restricted Access …………………………………………………………………………………….. 16

Planning …………………………………………………………………………………………………….. 16

General planning principles that safeguard the participant’s interests ……………. 16

Core supports in the plan ……………………………………………………………………….. 17

Capacity Building supports ……………………………………………………………………… 17

Capital support ……………………………………………………………………………………… 19

Plan management …………………………………………………………………………………. 20

Plan Implementation and Monitoring ………………………………………………………………. 20

Assistance for the participant to implement their plan …………………………………. 20

Plan reviews ……………………………………………………………………………………………….. 22

Unscheduled Plan Review………………………………………………………………………. 22

Supporting material ……………………………………………………………………………………… 23

Process owner and approver ………………………………………………………………………… 23

Feedback …………………………………………………………………………………………………… 24

Version change control ………………………………………………………………………………… 24

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Purpose

This Practice Guide will support you to understand how we safeguard the participant’s interests on a day-to-day basis as they engage and connect with the NDIS.

This includes understanding where to locate information to assess and report risks though the NDIA Issues and Incident Management Framework and Participant Critical Incidents Framework.

Note: Check you have read and understood the Participant Experience Delivery (PED) Key Performance Indicators (KPIs) and are complying with the PED KPIs and target relevant to this Practice Guide.

To be used by

This Practice Guide is for use by all staff of the National Disability Insurance Agency (NDIA), with a particular focus on staff in service delivery including:

• Plan Developers – Planners and NDIS Partners in the Community (PiTC - Early Childhood Partners and Local Area Coordinators [LACs])
• NDIA Plan Delegates
• Payment Analysts
• Business Support Officers (BSOs)
• National Contact Centre (NCC)
• National Complaints Resolution Team (NCRT) - including National Escalations Team (NET)
• Member and Senator Contact Officer (MASCO)
• Ministerial Coordination Team.

Scope

This Practice Guide considers the frameworks that underpin the safeguarding of the participant’s interests by addressing:

• the context of the NDIA within the broader framework
• the programs within the NDIA to address risks to the participant
• how conversations with the participant, their nominee or child representative may highlight safeguards as they engage with the NDIA.

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Context in the Broader Framework

Quality and Safeguarding Framework

The NDIS represents a fundamental change to how people with disability receive support across Australia. To support providers and the community to be ready for this change, the Department of Social Services NDIS Quality and Safeguarding Framework (external) was developed. This framework provides a national approach to empower the participant to exercise choice and control, with appropriate safeguards in place, and establishes expectations for providers to deliver high quality services.

The NDIS Quality and Safeguarding Framework underpins the NDIS Quality and Safeguards Commission (external) which is responsible for receiving and investigating allegations of reportable incidents. Reportable incidents are serious incidents or allegations which result in harm to an NDIS participant and happen in connection with NDIS supports and services. Refer to section 6.1 NDIA Participant Critical Incidents Framework for more information about the Participant Critical Incident process.

If the participant is a younger person in residential aged care, you may also need to report to the Department of Health – Aged Care (external). This is communicated to the participant by the NDIA.

National Disability Services Zero Tolerance Framework

The National Disability Services Zero Tolerance Framework (external) was developed to help providers understand actions they can take to prevent and respond to abuse, neglect and violence of people with a disability. This includes resources for provider staff to understand their responsibilities in preventing and responding to abuse and to reinforce the human rights of people using disability services.

The National Disability Abuse and Neglect Hotline

The National Disability Abuse and Neglect Hotline (external) (the Hotline) provides national access for the reporting of abuse and neglect of people with disability. The Hotline works to promote fair and just treatment of people with disability to achieve social justice, equality and the same rights, responsibilities, opportunities, access and participation as other people in Australian society.

For critical incidents in the home or community setting, escalation and reporting via the Hotline is recommended. The Hotline can provide referral and linkages to the most appropriate agency to investigate and address the report.

The Hotline is closely aligned with the Complaints Resolution and Referral Service (CRRS), outlined below.

Complaints Resolution and Referral Service

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NDIA Context and Background

NDIA Incident Management Frameworks

The NDIA Issues and Incident Management Framework consolidates the NDIA incident response when considered with the Participant Critical Incident Framework. The Issues and Incident Management Framework creates a documented, streamlined approach and is aligned to the NDIA risk management cycle.

The Issues and Incident Management Framework details the requirements for managing issues in a consistent, methodical, risk-based approach. For more information, refer to the Welcome to Risk intranet page.

The Participant Critical Incident Framework is designed to assist NDIA staff and PiTC to determine the necessary and appropriate actions to undertake when they are made aware of a participant critical incident.

A report of a participant critical incident is any information provided to the NDIA that alleges:

• The death of an NDIS participant
• Serious injury of an NDIS participant
• Abuse or neglect of an NDIS participant
• Unlawful sexual or physical contact with, or assault of, an NDIS participant
• Sexual misconduct committed against, or in the presence of, an NDIS participant, including grooming of the NDIS participant for sexual activity
• The unauthorised use of a restrictive practice in relation to an NDIS participant
• An NDIS participant threatening or attempting self-harm.

A participant critical incident allegation may involve any stakeholder including NDIS registered providers, NDIA staff, informal supports, family or other person/s.

Participant critical incidents which relate to unreasonable behaviour of the participant, or other third party, should be managed by NDIA staff and PiTC consistent with the NDIA Managing Unreasonable Behaviour Framework, Policy and Guideline. This includes information, advice, reporting and escalation protocols in circumstances where the health, safety or security of staff, partners or others is placed at risk.

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Reportable Incidents

The NDIS Quality and Safeguards Commission (NDIS Commission) is responsible for receiving and investigating allegations of reportable incidents. Reportable incidents are serious incidents or allegations which result in harm to an NDIS participant and occur in connection with NDIS supports and services.

Registered NDIS providers in all states and territories, except Western Australia, are required to notify participant critical incidents that relate to services and provisions provided by a registered provider. Notification is to be made to the NDIS Quality and Safeguards Commission, under s73Z of the National Disability Insurance Scheme Act 2013 (NDIS Act) and Part 3 of the NDIS (Incident Management & Reportable Incidents) Rules 2018. For further information about participant critical incidents which are notifiable to the NDIS Commission, refer to NDIS Quality and Safeguards Commission.

Critical Services Issues Response

Each state and territory, together with the NDIA and DSS, have signed a Critical Services Issues Response (CSIR) agreement to manage the escalation of critical issues that impact on an individual, primarily a NDIS participant.

The CSIR is a process for coordinating the escalation of complicated and intractable matters impacting on an NDIS participant that cannot be resolved at the local level. Matters include issues, which relate to mainstream services including but not limited to the following:

• health and mental services
• early childhood education
• child protection and family support
• school education
• vocational education and training
• social housing
• public transport
• justice, including corrective services.

Critical Incidents in the Home or Community

People with disability are among some of the most vulnerable people in society and have the right to freedom, respect, equality and dignity. They have the right to live to their full potential, to have control over their own life and to live free from abuse or neglect.

Violence can be physical, sexual, intimidating or forceful. People with a disability may experience violence from a carer or family member. This can occur in the home or a community setting. Abuse is when actions violate another person’s human rights and can be physical, mental, psychological, sexual or financial.

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Neglect is the failure by a service provider or person caring for a person living with a disability to provide adequate care.

Escalation and reporting via the National Disability Abuse and Neglect Hotline (external) is recommended for critical incidents in the home or community setting. Referral and linkages may be provided to the most appropriate agency to investigate or address the report. The principles outlined in the Participant Critical Incident Framework should be followed to make contact with the Hotline and escalate to a line manager before any report is made. After escalation and full consideration it may also be necessary to make a police report.

Note: The Hotline is not a crisis service. Life threatening services should immediately be reported to emergency services by calling 000.

There may be situations where allegations are made regarding critical incidents involving NDIA or Partner staff. All Australian Public Service (APS) employees are required to comply with the APS Code of Conduct and APS Values and Employment Principles. Refer to the Australian Public Service Commission (external) for more information.

There is a duty to report inappropriate behaviour and suspected misconduct. Perceived inappropriate behaviours or allegations received about a staff member should be discussed with or reported to a senior manager. The matter can also be discussed with People and Culture.

Partner staff are expected to share the NDIA values however are not direct APS employees. PiTC are independent organisations with their own employment guidelines, policies and processes. As a PiTC, there is a contractual obligation to report serious complaints regarding staff, breaches or incidents. Under the NDIA Issues and Incident Management Framework this information is reported and investigated by the NDIA.

6.1 NDIA Participant Critical Incidents Framework

The Participant Critical Incidents Framework details your roles and responsibilities when you suspect or receive information about an alleged critical incident including abuse, neglect or exploitation. Anyone can report a critical incident to the NDIA, including Partner staff.

The Participant Critical Incidents Framework helps you to determine the appropriate action to take when you suspect or obtain information, indicating a critical incident or situation of concern for a person with disability who may be subject to abuse, neglect or exploitation.

This Framework compliments the broader NDIA Issues and Incident Management Framework, which uses a risk based approach to provide overarching guidance to managing issues and incidents in a consistent and methodical manner.

In responding to reports of critical incidents, the NDIA and PiTC may disclose information to relevant authorities such as police or child protection services if:

• the consent of the individual is obtained (s60(2)(d)(iii) of NDIS Act)

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Exceptionally Complex Support Needs Program

The Exceptionally Complex Support Needs Program (ECSNP) is designed to contribute to growing market and community capacity and capability to support participants with exceptionally complex support needs.

The ECSNP has been designed to enable the NDIA to respond to participant crisis situations that cannot be supported by regular NDIA functions, including the CSIR and Complex Support Needs Pathway.

The ECSNP has three functions:

• Sector and Community Development and Delivery Activities This includes workshops, training sessions and individual engagement with mainstream and community services (such as health services, justice services). The aim of these activities is to support the growth and capability of people working with participants with complex support needs. This work will also build capabilities, knowledge and skills of NDIS providers who work directly with participants with complex support needs.

• Subject Matter Expertise Activities This includes providing guidance and advice to services for specific issues related to providing support for people with exceptionally complex support needs. The Program Providers will also be able to provide skilled support coordinators to support a participant if required.

• Crisis Referral Activities This is for approved referrers (key emergency service responders) and will only accept referrals for participants over 18 years.

Approved referrers to ECSNP include:

• Key emergency services organisations

  • State police services
  • State ambulance services
  • Hospitals (public and private)

• Acute state mental health services

• Australian Federal Police

• State justice officers.

Other key resources

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Safeguarding the participant’s interests

Assessing risks and safeguards

Assessment of risks and safeguards occurs throughout the planning process, as outlined in the Planning Our Guideline – Performing a support needs assessment. A support needs assessment involves:

• reviewing existing information
• conducting a planning and assessment conversation
• requesting further information or reports to inform a participant’s plan, where necessary
• assessing risks and safeguards. A general principle which guides actions under the NDIS Act is the support of people with disability to exercise choice in the pursuit of their goals and the planning and delivery of their supports. This includes taking reasonable risks. One of the NDIA’s functions is to ensure that a reasonable balance is achieved between safety and the right of the participant to choose to participate in activities involving risk, as stated in Section 118(1)(a)(v) of the NDIS Act. The NDIA manages risk by putting in place reasonable safeguards, which balance the safety of the participant with the risk of harm, while imposing the minimum necessary restrictions. This allows a participant to exercise choice and the control over their life and recognises their ability to take reasonable risks and make reasonable mistakes.

The planning and assessment conversation with the participant provides an opportunity for open discussion during the development of their plans. Actual and potential risks may be identified and a range of safeguards and support mechanisms explored, particularly in the following ways:

• Choice and control - The participant is empowered to make their own decisions about their supports and the management of their funding arrangements.
• Risk-based and person-centred approach - Safeguards are proportionate to the actual level of risk the participant faces, based on their functional capacity, natural support network and the supports available to them.
• Presumption of capacity - The participant is presumed to have the capacity to exercise choice and control and support will be provided to develop and exercise this capacity. The participant is encouraged to develop their own strategies and safeguards to reduce their potential exposure to harm or to manage the exposure. The following levels of safeguards can be used as a guide in the development of appropriate measures:

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• Individual level safeguards – informal and formal safeguards for the participant:
  • Informal safeguards acknowledge the participant is more likely to be safe when they are actively involved with their family and the community. The things that make people safe can be seen as the same things that are needed to have a good life. For example, caring relationships and enhanced opportunities for participation in daily life.
  • Formal safeguards include rules for restrictive practices and serious incident reporting.
• Service level safeguards – This includes quality frameworks, complaint mechanisms and workforce requirements such as qualifications, recruitment practices and performance standards. For many providers, having appropriate service level safeguards will be one of the requirements for registration with the NDIA.
• System level safeguards - The NDIA will use existing system level safeguards to protect the participant. These include internal and external processes for making complaints, processes to have decisions reviewed by an independent body and statutory power.
• Community based safeguards - The NDIA uses and operates in the context of existing community-based safeguards that are not formally a part of the disability service system. These include advocacy organisations, community visitor schemes, public advocates or guardians, ombudsman offices and discrimination commissioners. People with disability can also use a range of community safeguards including anti-discrimination and consumer protection legislation.

Additional safeguards that can be included in the participant’s plan are:

• setting a shorter period between plan reviews
• establishing arrangements for regular contact between the NDIA and the participant
• providing funding for supports to assist the participant in managing their own plan, for example, budget training.

The planning process

The assessment of risks and safeguards occurs during contact with the participant as they develop their plan. The plan developer should review streaming factors to ensure the participant receives appropriate assistance to participate in this process. Relevant information is considered and recorded using the following tools and processes in the NDIS Business System (System):

• participant streaming tool
• planning conversation tool and the actual planning conversation
• risk assessment
• informal, community and mainstream supports
• determine reasonable and necessary funded supports
• determine plan management.

Safeguards include facilitating the participant to be supported in their decision making and/or interactions if they require that level of support. The participant may be appointed a plan nominee, correspondence nominee, or be supported by a third party with authority or consent.

Access

The National Access and Reviews Branch (NARB) assesses risks and implements safeguards as a fundamental part of the access process. Each step in the access process includes strict requirements and standards for processing and assessing an access request. Quality Control is inbuilt into work practice to mitigate risk and safeguard the participant prior to an access decision being finalised. The resources listed below allow staff to follow comprehensive procedures at each part of the process:

• Task Card – Verbal Access Request (VAR)
• Staff Manual – Access and the NDIS for all staff
• Staff Resource – Types of documentary evidence – Age & Residence
• Staff Manual – Access information gathering for Access Officers
• Task Card – Enter the Access Request Form
• Staff Manual – Access Decision Making for Access Assessors
• Quality Control Audit Guide
• NDIS Business System: NAWMB Security Roles

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Pre-planning

The following sections highlight the areas of pre-planning where there is opportunity to discuss and develop safeguards to ensure the participant’s interests are considered, risks identified and mitigated where necessary.

Take the example of the participant who lives in public housing with inadequate bathroom facilities that do not meet the relevant codes and standards. This information is highlighted when completing the functional assessment questions. They require some support with self-care tasks however they experience additional difficulties because the bathroom is inadequate. Actions that may be taken are to:

• consider reasonable and necessary support to assist with self-care, which may include assessment and reporting to be included in the plan
• in the System, record in the informal, mainstream and community support task the participant’s mainstream housing circumstances
• discuss with the participant and the avenues that may be followed with the mainstream housing supplier
• inform the plan implementer (support coordinator or PiTC) of the funded and mainstream support requiring follow up.

Streaming

In the System, streaming can be updated at any point in the pathway. Based on how the participant is streamed, they will be provided with the appropriate level of support to engage in the development of their plan. For example, the participant may have one or more Super Intensive streaming factors. The Super Intensive streaming results in plan development with an NDIA planner and the inclusion of a support coordinator to support the implementation of the plan. In this way, participant streaming levels safeguard the participant by ensuring appropriate resourcing and expertise.

The participant may also be referred to the Complex Support Needs Pathway for additional support. As circumstances stabilise for the participant and this safeguard is no longer required, they may exit the Complex Support Needs Pathway. A handover of information should occur so the participant is supported in the generalist pathway.

For more information, refer to the Standard Operating Procedure – Update Participant Streaming.

Note: The term streaming is for internal use only.

Primary disability

It is important the correct primary disability is recorded in the System. This means the appropriate disability severity indicator tool for the participant’s disability is generated and completed. This helps inform the Typical Support Package (TSP) to better reflect supports

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needs. The TSP is the starting point of support the participant may require. Secondary disabilities and impairments should also be considered to support a ‘whole of person’ approach to the participant. By using reasonable and necessary decision-making for the participant’s disability-related supports you are using a measure which potentially protects the participant from risk.

For information on how to change the participant’s disability post access, refer to the Standard Operating Procedure – Change Disability (Post Access).

Severity Indicator Tool

Functional capacity assessment information (known in the System as severity tools) may be provided by the participant as a professional report, or may be a tool completed by the plan developer with the participant. It is used to assess the level of impact the participant’s disability has on their daily activities. This information may highlight a risk to the participant and can help inform other aspects of the planning process where both risks and safeguards are recorded.

For more information, refer to Standard Operating Procedure – Complete the Update the Severity Tools task.

The participant statement

The participant statement captures the environmental and personal context of the participant. Through discussion of the living arrangements, relationships and goals, the participant’s interests guide the planning process. The participant’s long and short term goals and how they will be supported to achieve their goals is recorded. Where appropriate, safeguard information may be recorded in this section. For example, referral to family support services and child learning programs may be required to reach a family orientated goal.

For more information, refer to the Planning Our Guideline – The participant’s statement of goals and aspirations and the Standard Operational Procedure – Complete the Participant Statement.

Informal, community and mainstream supports

Mainstream and community supports are available to all members of the community regardless of whether they have a disability or not. Supports captured in the informal, community and mainstream supports tool highlight areas where support may be required or unsustainable. The participant may have areas of their life which require involvement of mainstream services to provide additional support. For example health services, housing, child protection and mental health services.

The level and availability of informal support and what is reasonably expected of families are considerations for determining reasonable and necessary supports included in the plan. By understanding the natural supports of the participant you may safeguard the participant by:

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• determining where funded support is not necessary to replace or disrupt a support provided informally
• understanding where someone who provides informal support may need support or referral to another service
• identifying where additional supports in the plan are reasonable and necessary due to informal support being unavailable, changing or otherwise. For more information, refer to the Standard Operating Procedure – Discuss and Record Informal, Community and Mainstream Supports.

Risk assessment and plan duration

When developing the plan, the risk assessment should be used to identify risks and record safeguards in the participant’s life. This is done by asking questions of the participant or their authorised representative as well as recording information gained from the overall planning conversation and available supporting evidence. Information is recorded in the risk assessment in the following areas:

• Plan Management Request
• Compensation
• Plan Duration
• Safeguards – Informal Supports
• Participant Vulnerability
• Decision Making Capacity
• Capacity and Interests of Nominees or Child Representatives. The plan duration is determined when completing the risk assessment tool. This follows on from a conversation with the participant or their authorised representative regarding life changes the participant is expecting to make over the next three years such as leaving school, starting or leaving work, or a change to their living situation. Shorter plan durations may be implemented in response to situations where the participant is experiencing higher risk, until their condition stabilises. For example, while the participant undertakes rehabilitation and function reaches a stable level. For more information, refer to the Standard Operating Procedure – Complete the Risk Assessment task.

Planning conversations for complex needs

The Complex Support Needs Pathway exists for the participant experiencing additional obstacles requiring a high level of support to engage in the development and implementation of their plan. This may result in a higher level of support provided to coordinate multiple services and support the development and implementation of the plan. V8.0 2021-01-14 Safeguarding the participant’s interests Page 15 of 25 Page 234 of 438 OFFICIAL This document is uncontrolled when printed.

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For more information, refer to the Practice Guide – Complex Support Needs Pathway.

Representation by nominee or party with consent/authority

Nominees are appointed in circumstances where the participant is unable to make decisions independently and does not have informal or formal support networks to support their decision-making. Where the participant cannot make decisions, the appointment of a plan nominee or correspondence nominee safeguards their interests. For more information, refer to the Nominees Our Guideline – Appointment of Nominees, Standard Operating Procedure – Record a Nominee Request and Standard Operating Procedure – Appoint a Nominee.

The participant may need one-off or ongoing support from a third party that has consent or legal authority to act on the participant’s behalf. In doing so, they may support the participant to communicate or advocate for the participant’s interests. The third party may be an individual or a person from an organisation such as legal firm or advocacy group. For more information, refer to the Information and Your Privacy guidance on the General resources Intranet page.

Restricted Access

Information relating to participants with restricted access is to be treated with additional sensitivity. Records for restricted access participants can only be viewed by a limited number of staff with specific permissions. Restricted access can be requested by the participant or their authorised representative. Examples where this may occur are for NDIA or Partner staff who are participants, or who have family members who are participants, participants under police protection, participants where there are legal orders in place, or the participant has a protected address.

For more information, refer to the Our Guideline – Your privacy and information.

Planning

Plan developers take into consideration all the information gathered in pre-planning, including risks and safeguards and build the plan to meet the needs of the participant. Consideration is given to plan duration, plan management type and inclusion of supports specific to the participant’s needs.

General planning principles that safeguard the participant’s interests

Reasonable and necessary support

Appropriate reasonable and necessary funded supports, as defined by Section 34 of the NDIS Act, are identified and included in the participant’s plan. These supports are in the budget areas of Core, Capacity Building and Capital.

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In developing the plan, NDIA Staff and Partners must consider whether any funded supports should not be provided or funded under the NDIS. A support will not be funded under the NDIS if it is likely to cause harm to the participant or pose a risk to others. For more information, refer to the Our Guideline – Reasonable and Necessary Supports.

10.1.2 Planning guidance for specialist areas

The Planning intranet page contains practice guidance for participants with certain disabilities, in specific cohorts or with specialist needs and should regularly be referred to by plan developers. For example, there is specific guidance for participants with motor neurone disease to have supports in place that respond to rapidly declining function as a safeguard for the participant.

10.1.3 Stated Support

In some circumstances, supports may be included in the plan as a Stated Support. This ensures the funds are used for a vital service and cannot be used flexibly for an alternate support. An example of a Stated Support is specialist support coordination.

10.2 Core supports in the plan

Core supports assist the participant to manage aspects of daily living including self-care, accessing the community, consumable items such as daily adaptive equipment and transport. Using all available information, the appropriate level of funds are included in the plan to ensure needs are met and the participant is safeguarded from risks.

10.2.1 Core flexibility

Developing the plan with core support flexibility across the budget areas allows the participant varying levels of control over how they use their support and respond to their changing needs. The flexibility of this support helps reduce the likelihood of risks that may come up during the plan duration. For more information on the inclusion of and limitations to flexibility, refer to the Standard Operating Procedure – Complete the Determine Funded Supports task.

10.2.2 Low Cost Assistive Technology (AT)

For more information on Assistive Technology (AT) see section 10.4 Capital supports. Low Cost AT is less than $1,500 in value and is generally also low risk. Where needed, these funds are included in the Core - Consumables budget, to enable the participant to purchase low cost items such as a walking stick or basic shower chair. These funds can also be used for minor repairs to AT (for example to fix a puncture). Funding is also included in the Capacity Building – Improved Daily Living to assist the participant in deciding which AT to purchase. This provides the participant with immediate access and flexibility to purchase AT, without the risks associated with waiting for an assessment or approval for purchase.

10.3 Capacity Building supports

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Capacity building supports are linked to the goals and aspirations of the participant.

When determining the funded supports in the System, funding is allocated to the specific areas of support needed by the participant. This enables the tailoring of support specific to the needs of the participant in their daily life. The inclusion of funded supports in the plan to build capacity for independence or build skills in an identified area can be in response to a risk and therefore a safeguard.

10.3.1 Support Coordination

Plan developers consider the level of support the participant will require to build their capacity to connect with supports and services, including informal and mainstream supports. Support coordination ensures the participant is supported to understand their plan and how to:

• implement funded supports
• build capacity
• strengthen their ability to achieve their goals. In situations where multiple mainstream interfaces are involved and/or a high level of risk, specialist support coordination may be included in the plan. This is where an allied health professional coordinates and manages the supports with the participant. For more information on support coordination, refer to the Standard Operating Procedure – Include Support Coordination in a Plan.

10.3.2 Psychosocial Recovery Coach

Psychosocial recovery coach (recovery coach) support is available to participants whose primary disability is psychosocial disability. A recovery coach is a qualified mental health worker and through their own experiences and training, understands mental health and its impacts. They can support the participant to build confidence and motivation to achieve their goals and use their supports to live a fulfilling life. A recovery coach will also support the participant to understand how the NDIS operates within a broader ecosystem of supports including mainstream and community supports. For further information refer to the Practice Guide – Psychosocial Disability and the Standard Operating Procedure – Include Psychosocial Recovery Coach Support in a Plan.

10.3.3 Specialist Behaviour Support

Some participants may need positive behaviour support to address behaviours of concern that represent a risk to themselves or to others. These supports are recommended to:

• support the participant’s safety and wellbeing
• promote options for increasing the participant’s capacity and community and mainstream connections to achieve plan goals
• provide long term sustainability of the participant’s plan and informal support systems.

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The reasonable and necessary inclusion of specialist behaviour support in the plan is to identify and reduce behaviours of concern, improve the participant’s quality of life, uphold their dignity and safeguard their rights. As a further safeguard for the participant, positive behaviour support must be provided in accordance with the NDIS Quality and Safeguards Commission’s requirements. This means providers of this support must be registered with the Commission and ensures the regulation of restrictive practices.

For more information refer to the Practice Guide – Positive Behaviour Support and Behaviours of Concern.

10.4 Capital supports

Capital supports include AT, repairs and maintenance to assistive technology, vehicle modifications and home modifications (HM). The following AT processes ensure the participant’s interests and risks to the participant are considered, and minimise delay in vital equipment needs.

10.4.1 Higher Cost AT and HM

Higher cost AT, including more complex AT, is usually funded in the Assistive Technology – Capital budget. There is a higher risk of injury, hospitalisation or even death if appropriate assessment, setup or construction is not undertaken. This type of AT support may include vehicle modifications. HM are in the Home Modifications – Capital budget, and can have similar risks along with the complexity of ensuring the modification is compliant with local authority requirements.

Specialised and Complex AT require an assessment and supporting evidence from a qualified AT assessor to identify, trial and specify AT solutions. Assessments will consider options such as the participant’s environment, skill building (both in doing activities and/or using AT), and the ongoing support (including specialised set up and training) required.

Home modifications will require assessment usually by an occupational therapist. In more complex cases, a building professional is also involved to determine the feasibility of the solution and assist in identifying building risks (for example asbestos or structural risk). For more information refer to the Standard Operating Procedure – Include Home Modification Supports in Plans.

10.4.2 Replacement AT

Replacement AT involves a streamlined process to avoid delays and provide a like-for-like replacement of equipment, following specific criteria and ensuring no unreasonable risks to the participant are identified.

10.4.3 Rental/Hire of AT

It may be reasonable and necessary to include funding for rental of AT for a specified period of time whilst the participant awaits supply of their customised AT equipment. This will ensure the participant’s safety is not at risk, where AT supply may be delayed.

10.4.4 AT during the course of the plan period

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During planning, supports are included based on the information available at that time.

If an assessment recommending AT is received during the course of the plan period, the delegate must determine if there are any risks to the participant in delaying access to the AT supports and if the recommended AT is reasonable and necessary. A delegate must consider if the AT needs to be funded immediately to mitigate risks, or can be funded at the next scheduled plan review. An unscheduled review may be initiated based on the participant’s request or as an Agency initiated review.

Refer to Our Guidelines - Assistive technology on the NDIS website and Assistive Technology guidance on the Planning resources Intranet page.

10.5 Plan management

Plan management is how the participant or their representative manages the support budgets of the plan. Plan management may be self-managed, plan managed, Agency managed or a combination. Throughout the pre-planning, planning and implementation stages of the participant pathway, the participant is made aware of the benefits and responsibilities of each plan management option.

The risk assessment tool assesses the participant’s capacity to undertake self-management or plan management, if they have requested this, and what supports they may need to help them manage their plan. This tool is used in pre-panning, see section 9.6 Risk assessment and plan duration. During the planning process, the Determine Plan Management task is completed in the System to divide funds as Self, Agency or Plan managed at the individual budget level. For more information refer to the Standard Operating Procedure – Complete the Determine Plan Management task.

A request by a participant to manage their funding should be considered positively unless there is evidence a financial or personal risk exists. Specific plan management options may be preferable due to individual circumstances which may include State Trustee/Public Guardian involvement or NDIA arrangements. For further information on plan management and behaviour supports refer to the Practice Guide – Positive Behaviour Supports and Behaviours of Concern.

Where the participant needs support to self-manage, reasonable and necessary supports to build the participant’s capacity to self-manage are considered. This may include support to assist the participant, their plan nominee or child representative to learn budgeting, book keeping, skill building by a plan manager or support coordinator. Plan management discussions, requests and decisions are recorded in the System.

If the funds will be self-managed by the plan nominee or child representative, risks to the participant of them managing these funds must be assessed. The assessment of risk of harm is always related to risks to the participant, regardless of who will be managing the funding.

11. Plan Implementation and Monitoring

11.1 Assistance for the participant to implement their plan

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The participant is supported to implement their plan by either a PiTC or support coordinator, based on their streaming. For participants with psychosocial disability a recovery coach may support them with implementation of their plan. Specific information regarding a risk or safeguard may be communicated to the PiTC through an interaction in the System and/or Plan Alignment Meeting. The partner staff member completes the implementation section in the System. For more information, refer to the Standard Operating Procedure – Complete the Determine Plan Management task.

If the participant has a support coordinator or recovery coach to support them to implement their plan, specific information regarding risks and safeguard measures can be communicated through the Request for Service form completed in the System. For more information refer to the Standard Operating Procedure – Request for Service – Make a request. Along with the information contained in the plan, safeguard strategies and additional information specifically for the support coordinator or recovery coach to follow-up may be recorded on the form.

Plan implementation includes empowering the participant to negotiate their supports and create service agreements with providers of support. Specific requirements to safeguard the participant may be communicated to providers of support at this point.

In the process of implementing the plan, further risks and safeguards may be identified and managed. If necessary an unscheduled plan review request (PRR) or internal review of a decision may occur to address the interests of the participant. Refer to Practice Guide – Unscheduled Plan Reviews and Our Guideline – Reviewing our decisions (external).

11.1.1 Communication preferences

The participant’s communication preferences are considered and recorded in the System. Their plan is communicated in a format that assists them to understand their supports. For more information, refer to the Standard Operating Procedure – Assist the Participant with their Preferred Method of Communication.

11.1.2 My NDIS Contact

The participant’s plan and the participant portal state the name and phone number of their My NDIS Contact, allowing them to make contact with the appropriate staff member.

Regular contact with the participant can be organised as part of the safeguard approach. Contact may be made by the PiTC, support coordinator or recovery coach who can also make regular monitoring arrangements.

11.1.3 Monitoring

Monitoring the participant’s plan may occur by NDIA staff including when contact is made to resolve enquiries or implement quotes. The utilisation of supports in the plan can be monitored through the reporting platform – NDIS Panda Live.

Monitoring can include reviewing the plan budget, payment requests, periodic payments and risks that may escalate requiring a plan review.

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Plan reviews

The plan review process includes completing the pre-planning, planning and plan management tasks. The participant’s circumstances may have changed and a review is an opportunity to identify new risks, assess previous risks and implement new safeguards. The following is reviewed and adjusted:

• the participant still meets the requirements of their current stream - general, supported, intensive or super intensive to ensure support to engage with the NDIS is appropriate
• current circumstances, any change to environmental context, mainstream supports and in particular informal supports
• progress towards goals and what funded supports may no longer be required where capacity has been developed, for example support coordination. New goals and supports that may now be required, for example progressing to volunteer work or gaining employment
• plan length and plan management requirements
• when determining reasonable and necessary supports for a review plan, consideration is given to the previous plan’s value and the utilisation of any funded supports in comparison with the new plan’s generated funded supports.

For further information refer to the:

• Standard Operating Procedure – Support Tool to Determine the Scheduled Plan Review Approach
• Standard Operating Procedure – Complete a Plan Review (Full)
• Standard Operating Procedure – Complete a Plan Review (Light Touch)
• Standard Operating Procedure – Complete a Scheduled Plan Review (Renewal)
• Practice Guide – Scheduled Plan Reviews.

Unscheduled Plan Review

A participant requested plan review may be undertaken as a result of a change to a participant’s circumstances. For example, the participant’s functional capacity has changed, which has resulted in a change to their support needs.

An Agency initiated plan review may be required during the course of the participant’s current plan period to meet the participant’s needs. For example, information indicating a risk to the participant and they are unable to request the review themselves, or they have no representative to do so. An Agency initiated review may also occur where information is

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received recommending AT and the participant would be placed at risk if this was not considered until the next scheduled review.

For more information refer to the Practice Guide – Unscheduled Plan Reviews.

Supporting material

• Participant Critical Incident Framework
  • Form – Participant critical incident notification form
  • Standard Operating Procedure – Initial Response to a Participant Critical Incident Notification
  • Standard Operating Procedure – Internal notification of a participant critical incident
  • Standard Operating Procedure – Undertaking Follow Up Action for a Participant Critical Incident
  • Standard Operating Procedure – Closure and Reporting of a Participant Critical Incident
• Our Guideline – Your privacy and information
• Overview of the NDIS Our Guideline – Quality and Safeguards
• Overview of the NDIS Our Guideline– Section 4.4.4 Principles relating to the participation of people with a disability
• Access to NDIS Our Guideline – Section 4.11 Prioritising prospective participants with urgent circumstances
• Planning Our Guideline – Performing a support needs assessment – Section 8.4 Assessing risks and safeguards
• Our Guideline – Younger People in Residential Aged Care
• Practice Guide – Children at Risk of Requiring Accommodation Outside the Family Home
• Our Guideline – Justice system (external)
• Practice Guide – Psychosocial Disability

Process owner and approver

General Manager, Participant Experience Design.

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Version change control

Version No	Amended by	Brief Description of Change	Status	Date
3.0	CS0074	Class 1 approval. Revised wording to section 10.5 - Plan management, to emphasise that requests from participants to self-manage should be considered positively unless there is evidence that a financial or personal risk exists.	APPROVED	2020-07-06
4.0	CS0074	Class 1 Approval Included links for participant check in resources. Included information on the new psychosocial recovery coach support for participants with psychosocial disability.	APPROVED	2020-07-20
5.0	CS0074	Class 1 Approval Removed reference to SIL being a stated support	APPROVED	2020-07-29

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Version	Document ID	Description	Status	Date
6.0	JS0082	Class 1 Approval - Sentence on PED KPIs included in Purpose to encourage compliance with KPIs relevant to pre-planning; General updates to wording and formatting for consistency and readability.	DRAFT	2020-12-22
7.0	NAN927	Class 1 Approval - Updated links to assistive technology resources.	APPROVED	2021-01-13
8.0	CS0074	Class 1 approval received on 2021-01-08 to update links to nominee resources	APPROVED	2021-01-14

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