Submission on the NDIA Amendment (Quality and Safeguards Commission and Other Measures) Bill 2017

Date: 15 August 2017

Recipient: Senate Standing Committees on Community Affairs

Department: Department of the Senate

Dear Chairperson,

Thank you for the opportunity to submit to the current consultation on the proposed NDIS Amendment (Quality and Safegards and other Measures) Bill 2017 (the Bill).

About Northcott

Northcott was established in 1929 as the NSW Society for Crippled Children. The Rotary Club of Sydney established the Society with the long term objective to prepare children with disabilities to be included in the community.

Northcott’s vision today is to build and inclusive society where people can live the life they choose. This is achieved by assisting people with disability to develop their skills and achieve their goals – including their potential for independence and ability to participate in their community. Every year Northcott supports over 14,000 people with disability and their families across NSW and the ACT. We employ over 700 staff providing over 100 services from 33 sites and offices across NSW.

Recently Northcott was successful at acquiring over 100 accommodation and respite service sites in five geographic areas of NSW as part of the NSW Government’s devolution process for the NDIS transition. This means that Northcott is now one of the largest specialist disability service providers within NSW. We work tirelessly with each customer to unlock, discover and unleash their potential, supporting and empowering them to be the best they can be now and in the future.

Disability Rights

The National Disability Insurance Scheme (NDIS) is part of Australia’s commitment to implementing the Convention on the Rights of Persons with Disabilities. The Bill does not clearly articulate the need to consider the rights of people with disability. It substantially lacks an overall vision and framework of disability rights to guide all aspects of the proposed Commission’s processes and regulatory actions.

Disability Discrimination Act 1992

The Disability Discrimination Act 1992 protects individuals across Australia from unfair treatment in many parts of public life. However, it is important that a vision and framework to ensure a commitment to the Rights of Persons with Disabilities is stated within the Bill to guide the Commission and all NDIS service providers and to strengthen disability rights.

Explicitly stating the rights and enshrining the actions of disability rights as part of the outcomes of the NDIS is an important driver to reduce disability discrimination when accessing NDIS funded services. Development of a Framework will also help articulate disability rights. A successful model is the Early Years Learning Framework, which has national agreement, and sets out the vision for all children’s learning from birth to five years. This Framework guides and focuses all Australian educators, families and the community and conveys the highest expectations for all children’s learning from birth to five years.

A similar Framework for the Quality and Safeguards Commission will help to drive the concept of disability rights and ensure that it conveys the highest expectations of the rights of people with disability when accessing services under the NDIS.

Disability Standards

The Bill also has no clear articulation or system of compliance against the existing Disability Standards. Aligning the National Disability Service Standards with the proposed mandated registration requirements and compliance activities for all providers will safeguard disability standards and rights. This would ensure that compliance against the Standards has a clear focus within the NDIS.

Reporting and pricing structures

Northcott supports the principle of the increased reporting and quality assurance regime that the Bill outlines. In particular, Northcott supports the proposed reporting and quality assurance regimes relating to restrictive practices, registrations and incident management reporting.

Back office activities are an important component for meeting robust compliance and reporting requirements. They are also an essential element in the delivery of efficient, consistent and quality service delivery. The new reporting requirements outlined in the Bill will add significantly to the cost of doing business with the NDIS and unless this is factored into pricing, the pressures to cut costs in other areas i.e. by reducing the quality of service delivery, will be high across the sector. In addition, many services have not previously been required to report and the establishment of

Behaviour Support and Restrictive Practices

Northcott supports the introduction of the Office of the Senior Practitioner to provide practice leadership and clinical governance. Nevertheless, we have concerns that there is a high risk of the Office promoting a strong focus on clinical practice i.e. the medical model of disability support rather than an empowering behaviour support focus.

The behaviour support model is currently the best evidence based practice that supports the person to be the best they can be and to live in an inclusive society. It is important the Bill strongly identifies that while clinical oversight is important, the overall approach is to support the person to live the life they choose in an inclusive society.

The Bill has identified comprehensive reporting requirements for all behaviour support incidents. Northcott already operates an internal approval and reporting system for behaviour support. All reportable incidents are reviewed by an internal expert panel and approval must be sought for the use of restrictive practices. Our aim is to reduce and eliminate all restrictive practices through the use of comprehensive behaviour support and ongoing learning and we are achieving good results from this proactive approach.

Incident reporting requirements and incident management oversight must be graded at different levels and types to ensure a comprehensive safeguards system. Currently, reporting requirements are focused on accommodation services, with community based services excluded. A graded approach will help to eliminate onerous reporting requirements of trivial incidents that are easily dealt with and better resolved and reported at the local level, while at the same time ensuring that all services are reviewing and reporting on all serious incidents.

This will help to reduce and eliminate restrictive practices across the disability support sector, streamline reporting, reduce costs and improve accountability requirements. Serious incidents in both community and accommodation services will

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be reported and reviewed at the appropriate level and allow accurate analysis and consideration of serious incidents.

Northcott recommends a graded approach to reporting of incidents be introduced in the Bill, to encourage better behaviour support practices and eliminate restrictive practices.

Practitioner Qualifications

Northcott strongly advocates that behaviour support practitioners be required to have a minimum qualification of a university degree. However, the qualifications should not be specifically focused on the need to be an allied health care provider. Our experience indicates that restricting behaviour support practitioners to the allied health disciplines contracts the market, and has the potential to move to the medical model of disability support.

The characteristics and skills of good behaviour support practitioners are not necessarily the skill set of allied health professionals. It is more important that all behaviour practitioners have the right personal characteristics and professional skills with a holistic, empowering focus on disability supports. A person with the right personal skills who has completed a university degree with for example, a major in psychology, also has the potential and capacity to be a sound and professional behaviour support practitioner with the right training and support.

It is recommended that the draft Bill not restrict behaviour support practitioner to allied health care practitioners to support the expansion and broad development of behaviour support practitioners within the disability sector.

Behaviour support training

Currently there is no formalised training for behaviour support practitioners. There is an urgent need to address the training gaps and the Office of the Senior Practitioner would be well placed to develop the framework and disseminate this training.

Northcott supports the introduction of a requirement for the Office of the Senior Practitioner to develop national training modules and a national training framework for behaviour support practitioners. This requirement would ideally sit with the Senior Practitioner because they will have access to substantial information and analysis about the use and incidents of restrictive practices and will be well placed to take a strong leadership role in this area. A high quality system is reliant on participants having high quality options and from providers having adequate resources to provide a quality system.

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Northcott recommends that the Bill include a requirement that the Office of Senior Practitioner support the development of a national training framework to improve and expand the use of high quality, best practice behaviour support across the disability sector in Australia.

Code of Conduct

The Code of Conduct is an important initiative in the Bill, however recent consultations have been very limited with little opportunity made to provide expert advice that could improve the final draft of the Code of Conduct. Due to the restrictions of the consultation process, it is anticipated that the Code of Conduct as currently drafted is unlikely to reflect the needs and concerns of people with disability or the disability sector. There have been limited opportunities for comment and there appears to be a restricted capacity and willingness to make changes to the current draft.

It is recommended that the requirements for the Code of Conduct be clearly articulated in the Bill and that comprehensive consultations be undertaken prior to its adoption.

Thank you for the opportunity to comment on the draft Bill. If you require any further information please do not hesitate to contact Ruth Callaghan the General Manager Stakeholder Relations. Northcott remains a strong supporter of the NDIS and works to ensure that we deliver a high quality, evidence based practice to our NDIS customers.

Yours sincerely

Kerry Stubbs Chief Executive Officer