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Understand participant critical incidents

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FOI 24/25-1367 - DISCLOSURE LOG | DOCUMENT 26

Understand participant critical incidents

SGP KP Publishing

Exported on 2025-04-28 03:00:01

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Table of Contents

1 Recent updates …………………………………………………………………………………………………….. 4 2 The importance of responding to critical incidents ………………………………………………… 5 3 Types of participant critical incidents ……………………………………………………………………. 6 4 Unexplained death of a participant connected with NDIS supports or services ……….. 7 5 Serious injury of a participant ……………………………………………………………………………….. 8 6 Abuse or neglect of a participant …………………………………………………………………………… 9 7 Unlawful sexual or physical contact with, or assault of, a participant ……………………. 10 8 Sexual misconduct committed against, or in the presence of, the participant, including grooming for sexual activity ……………………………………………………………………….. 11 9 Unauthorised restrictive practice …………………………………………………………………………. 12 10 Threat or attempt of self-harm or suicide ………………………………………………………….. 13 11 Incidents that fit more than one criteria …………………………………………………………….. 14 12 Near misses …………………………………………………………………………………………………….. 15 13 Response pathways …………………………………………………………………………………………. 16 14 Next steps ……………………………………………………………………………………………………….. 18

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This article provides guidance for a local area coordinator, early childhood partner, planner delegate, internal review delegate, complaints officer, participant support officer, National Contact Centre, liaison officers (HLO/JLO), and complex support needs (CSN) planner to understand:

  • the importance of responding to participant critical incidents
  • types of participant critical incidents
  • incidents that fit more than one criteria
  • near misses
  • response pathways.

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1 Recent updates

October 2023
Current guidance.

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2 The importance of responding to critical incidents

The National Disability Insurance Agency (NDIA) recognises that people with disability can be vulnerable to harm. This might include abuse, neglect and exploitation. While working with participants, their families and carers, you may encounter situations, or become aware of allegations, of serious harm or abuse.

People with disability have the same right as other Australians to have their worth, privacy and dignity respected. They have the right to live free from abuse, neglect and exploitation. We also need to consider the best interests of children and young people, and to protect them from harm.

Participants may experience, or be impacted by, a range of incidents in different settings.

A participant critical incident (PCI) allegation may involve any stakeholder. This could include NDIA staff, partners, providers, informal supports, and family or others.

The way we respond to participant critical incidents aligns with the broader Issues and Incident Management Framework. There is a ‘no wrong door’ approach to providing feedback, complaints and other matters to the NDIA.

To learn about critical incidents involving non-participants, go to article Understand critical incidents involving non-participants.

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3 Types of participant critical incidents

A PCI report is any information provided to the NDIA, National Contact Centre (NCC) or Partners that alleges an event occurred involving the following:

  • unexplained death of a participant connected with NDIS supports or services
  • serious injury of a participant
  • abuse or neglect of a participant
  • unlawful sexual or physical contact with, or assault of, a participant
  • sexual misconduct committed against, or in the presence of, the participant, including grooming for sexual activity
  • unauthorised restrictive practice
  • threat or attempt of self-harm or suicide.

You might become aware of these through a report, allegation, or observation.

There are other appropriate pathways to progress notifications that don’t meet the PCI criteria. The PCI team can educate the team lodging the incident about the appropriate notification pathway.

To learn about incidents that aren’t participant critical incidents, go to article Understand other incidents. This includes guidance on:

  • Security incidents
  • Managing unreasonable behaviour
  • Issues and incident management framework
  • Business continuity management
  • Work, health and safety incidents
  • Risk
  • Legal.

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4 Unexplained death of a participant connected with NDIS supports or services

For example, a death where its circumstances or cause are medically or legally unexplained. This might occur in the context of medical care, suicide, neglect or suspected criminal activity.

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5 Serious injury of a participant

For example:

  • An act which has injured a participant, like a fracture, bruise, wound, burn or concussion.
  • A participant being physically assaulted by a carer, support person, family member, or member of the community which causes serious harm or injury.
  • Serious injury of a participant whilst receiving NDIS supports.

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6 Abuse or neglect of a participant

For example:

  • A family member, carer or support person denying food to a participant as ‘punishment’.
  • A participant subjected to use of offensive, abusive, or demeaning language by a support person.
  • A family member, carer or support person threatening harm to a participant.
  • A participant being financially exploited.
  • Abandonment of a participant.

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7 Unlawful sexual or physical contact with, or assault of, a participant

For example:

  • Inappropriate physical contact between a participant and a carer, support person, family member, or a member of the community.
  • Rape or sexual assault of a participant. This includes any sexual contact or behaviour without the participant’s explicit consent.
  • A participant being physically assaulted by a carer, support person, family member, or member of the community.

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8 Sexual misconduct committed against, or in the presence of, the participant, including grooming for sexual activity

For example:

  • Sexual conduct in the presence of a participant.
  • A person has developed a relationship with a participant with the intent of facilitating the participant’s involvement in sexual conduct. This could be either with themselves or another adult. This doesn’t necessarily involve any sexual activity, or even discussion of sexual activity. It may only involve establishing a relationship to facilitate sexual activity later.

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9 Unauthorised restrictive practice

For example:

  • Use of restrictive practices without authorisation where the relevant State or Territory has an authorisation process. For example, seclusion, chemical, mechanical, physical, environmental, psycho-social restrictive practices.
  • A family member or support person secluding or restraining the participant.

To learn more about what is considered restrictive practice, go to article Behaviours of concern and restrictive practices.

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10 Threat or attempt of self-harm or suicide

This refers to a specific event and does not include progressively escalating behaviours of concern.

For example:

  • The participant threatening self-harm or suicide.
  • The participant has self-harmed or attempted suicide.

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11 Incidents that fit more than one criteria

An incident might meet the criteria of both a participant critical incident and another type of incident. You should escalate these by both processes. For example, contacting the Security Team, Work Health and Safety Team and also creating a participant critical incident case.

Sometimes it’s not easy to decide if an incident is critical or related to another type of matter. You should speak to a line manager or the PCI team to determine the best option for the situation.

To help you work this out, you should think about:

  • Did a specific event happen?
  • Does the allegation relate to a participant being harmed, or at risk of harm, from others’ actions?
  • Who is alleged to have harmed the participant? Is it a provider, informal support or other person?
  • Is the participant threatening, abusing or being aggressive toward others?
  • What is the nature of the allegation?
  • Where and when did the alleged incident occur?
  • Is there a threat of self-harm?
  • Is there an indication a provider or informal support has neglected a participant?

Learn more in article Understand other incidents.

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12 Near misses

Sometimes a participant may be in an unplanned high-risk situation, but an incident has not yet occurred. If you receive a report of potential risks, think about implementing mitigation strategies to prevent an incident occurring.

You can still create a PCI case, and note that appropriate actions have been taken to ensure the participant’s safety and wellbeing. To create a PCI case, go to article Create a participant critical incident case.

The PCI team would categorise this as a Near Miss, noting there may still be risk, but an incident hasn’t yet occurred.

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13 Response pathways

You may be notified of a potential risk, for example an unstable environment, or a threat to homelessness. Unless a specific event has occurred, you may need to assess if the situation is a PCI. Or, if you need to refer it to the appropriate business area for action.

The examples below will help you determine the appropriate response pathway.

Child Protection involvement

Unless a specific incident or event has occurred, Child Protection involvement alone is not a PCI. The participant’s Service Delivery area should investigate the welfare of the child and if the participant needs changes to their plan. For example:

  • Child Protection is involved with the family.
  • No specific incident has been reported.
  • You suspect on reasonable grounds a child is at risk of significant harm.
  • The Education Department has raised concerns regarding Child Protection involvement.
  • A family member has raised concerns regarding Child Protection involvement.

If an incident has occurred to prompt a referral to Child Protection, create a PCI case to refer it to the PCI team. For example:

  • Child Protection are involved because a specific incident happened.
  • You suspect on reasonable grounds a child is at risk of significant harm because an incident has occurred.

Restrictive practice

Restrictive practice means any practice or intervention that restricts a person with disability’s rights or freedom of movement. Under the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 (external), certain restrictive practices are subject to regulation. These are not a PCI. These regulated restrictive practices include seclusion, chemical restraint, mechanical restraint, physical restraint and environmental restraint. A provider who uses regulated restrictive practices needs to provide monthly reports to the NDIS Quality and Safeguards Commission.

For example:

  • The participant is not allowed to access tools that may cause harm. For example, scissors, sharps, knifes, lighters, or matches.
  • There has been consent and approval for a seatbelt on a wheelchair to prevent falls.

If an incident has occurred, create a participant critical incident case to refer it to the PCI team.

For example:

  • The participant has been locked in a room, unable to be let out.
  • The participant is given additional medication above recommended dose to sedate them.
  • The participant is physically restrained against their will.

Death

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The NDIS Act 2013 (external) does not require the NDIA to notify another Australian government department of the participant’s death. However, state and territory legislation may require the NDIA to report the death to the Coroner if either:

  • it hasn’t already been reported to the Coroner by someone else
  • it’s a ‘reportable death’ in the relevant jurisdiction.

For example:

  • A palliative care participant has passed away.
  • A participant has passed away due to natural causes.

If there is an unexplained death of a participant, create a PCI case to refer it to the PCI team. To create a PCI case, go to article Create a participant critical incident case.

For example:

  • A participant passes away unexpectedly and the cause is unexplained.
  • Death in connection with the provision of NDIS supports.

Talk to a line manager about available bereavement supports and services.

Managing unreasonable behaviours

If the participant displays unreasonable behaviours, you can:

  • go to the Managing Unreasonable Behaviour Guideline or the Managing Unreasonable Behaviour intranet page
  • go to the Reporting a Security Incident intranet page
  • report a Work Health and Safety incident relating to the health and safety of staff.

For example:

  • Aggressive acts, verbal abuse, derogatory, racist or defamatory remarks, harassment, intimidation or violence.
  • Rude, confronting and threatening correspondence or behaviour.
  • Threats to harm third parties, damage property or stalking.

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14 Next steps

  • To respond to a PCI, go to articles Principles for responding to participant critical incidents and Respond to participant critical incidents.
  • You must report a participant critical incident internally within 24 hours of the NDIA receiving the information. To do this, go to article Create a participant critical incident case.

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