6 September 2019
Joint Standing Committee on NDIS Submission – NDIS Planning
Service Profile
Sharing Places Inc is an ACT based, not for profit disability service provider, providing community access and social participation support (day services) for adults aged from 18 years who have severe to profound disability. The people who access Sharing Places have high and complex needs and require full time support and intervention. All clients accessing Sharing Places have a primary intellectual disability, requiring 24/7 intensive support. Clients present with high and complex needs in the areas of mobility, challenging behaviour, communication, personal care, PEG feeding, seizures, self-injurious behaviour, sensory disorders, and dual disability disorders. Sharing Places is the only disability service provider in the ACT delivering quality day options and catering to such a diverse set of needs. Sharing Places supports individuals to achieve self-determination in all matters important to them and strives to remove barriers which prevent people from participating fully within the community. We promote a person directed culture that empowers participants, providing not only choice and control in their lives but also opportunities to move forward towards the future they desire. Individual plans are developed between our clients, staff, families and carers and other disability service providers. These individual plans include specific and detailed strategies and skills development against goals from a range of learning domains. Sharing Places provides for social and community participation; the development of daily living and life skills; the development and implementation of communication skills and
strategies and use of augmentative communication aids; and the development and
implementation of positive behaviour support plans.
Sharing Places currently supports 170 people across 14 support teams in the ACT, with each
support team having a team base and wheelchair accessible vehicles. Due to the
complexities of the people we support and the need for specialist knowledge across the organisation, Sharing Places employs permanent staff members (both full time and part time), and only employs a small number of casual employees. Sharing Places currently employs a total of 105 employees. It is essential for our workers to build relationships with participants that are based on trust, as people with high and complex needs can only achieve their goals when they are in environments where they feel comfortable to take on challenges.
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Planners’ Experience and Qualifications
People with intellectual disabilities and very high and complex support needs are not well understood by many NDIA planners. People with high and complex needs would greatly benefit from a more in depth assessment and planning process. In many cases, there is ample evidence for the required supports, however this is not being considered by planners and, unless families are extremely vocal and effective advocates, people with very high and complex needs miss out on required supports.
Some high and complex needs are well understood and generally these are the physical support needs such as the use of a wheelchair, PEG feeding, sight impaired. However, for people who may have high supports needs due to limited communication, complex
behaviour (including self-injurious), sensory disorders, or a combination of support
requirements, these are less understood and in many cases planners would require specialised knowledge to adequately understand the required support needs for some people. In some cases, people may present as higher functioning when, in fact, their support needs are complex enough that they are excluded from services (including mainstream services) that they may have otherwise been able to access. These situations are not well understood by planners and this can have a huge impact on the person having adequate funding in their plans for their support needs.
Large inconsistencies can occur across plans for people who have similar needs. This can arise for a variety of reasons including: a lack of consistent training for planners leading to divergent support outcomes, more experienced planners understanding how to obtain better outcomes for participants, and pressure on planners to keep costs down. It may also be due to different informal supports being available for some people, or individuals having varying levels of aspirations requiring different supports.
Planning Processes
Planners, including Feros Care (the community partners/LAC), are currently mostly on time with plan reviews and the instances of plan gaps is lessening, although it still does occur. However, when plan gaps do occur it can be extremely disruptive for participants. We have had instances where we have had to cease services to participants until such time as we could be guaranteed that funding would be available to recommence supports. This is essential as the risk for our organisation that we may not be paid for supports is too great. In instances where services have ceased, this has unfortunately meant that participants had no alternative but to have no supports during this time which, in turn, puts extra pressure on families and there are increased instances of crises.
Communication from NDIA planners about plan reviews is non-existent for Sharing Places and this is a significant issue for us. When plans are reviewed, we are not informed and this can lead to a large amount of administrative time being wasted unnecessarily. A simple automated email advising current providers that a plan has been reviewed would solve this problem.
People with high and complex support needs have extremely differing needs depending on their individual characteristics and circumstances. These people require more flexibility, and some price deregulation within their NDIS plans would be beneficial. The current processes tie people in too much to supports that might not fit their needs. Items that are
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being included in support plans may not necessarily match those that have been requested by participants, leaving a shortfall in one budget while another budget remains unspent.
The speed of the NDIS rollout is making it impossible for participants and service providers to communicate with the NDIA, as they are so busy and not contactable. Some examples are that calls go unanswered, messages are not returned in a timely manner and some messages are not returned at all.
Participant Involvement
It is being reported to us by the people we support that there are still too many instances when participants have gone through the planning process only to receive a plan that is inadequate to meet their needs. Over the past few years, there have been very few plans that remained inadequate once a review of the decision was carried out, and mostly participants that have gone through the process of reviewing of a decision had their funding reinstated. This indicates a lack of proper planning processes and involvement of participants prior to the plan being finalised. If participants had the option of reviewing a draft plan prior to it being processed, it would provide the opportunity for them to produce evidence or extra information as required.
It has also been reported that many NDIA planners are recommending plan management to participants who do not have an adequate understanding of the role of a plan manager. This has caused very much anxiety and frustration for participants and their families who are then required to develop the set of skills necessary to source, analyse and secure a provider that is suitable to their individual needs.
Plan Improvements
Annual planning reviews are a constant source of anxiety for participants and their families because there is no continuity from one plan to the next. Emotional support for families is more limited than ever due to limited support coordination, limited resources of the LAC provider, and providers having less and less capacity to provide this support without adequate recompense.
People with high and complex support needs are less likely to require less supports going forward from year to year, and are more likely to have needs that are more stable. While some people have needs that are ever-changing and require more flexibility and more contact with NDIA planners, there are a large number of people who don’t require this and would benefit from a plan that provides them with stability and to feel confident to make long term plans. In many instances, people with high and complex needs have long term goals that are then cut into short term goals as stepping stones to the longer term goal. In these instances, longer plans would be beneficial, as would the opportunity to have certain aspects of the plan automatically rolled over, for example, Core supports.
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