August 21, 2020
Committee Secretariat contact:
Joint Standing Committee on the National Disability Insurance Scheme
PO Box 6100
Parliament House
Canberra ACT 2600
Phone: +61 2 6277 3083 Fax: +61 2 6277 5829
Ndis.Sen@Aph.gov.au
NDIS Quality and Safeguards Commission Review 2020
Terms of Reference:
As part of the committee’s role to inquire into the implementation, performance and governance of the National Disability Insurance Scheme (NDIS), the committee will inquire and report on the operation of the NDIS Quality and Safeguards Commission since it commenced operation on 1 July 2018, with particular reference to:
a. The monitoring, investigation and enforcement powers available to the Commission, and how those powers are exercised in practice;
b. The effectiveness of the Commission in responding to concerns, complaints and reportable incidents – including allegations of abuse and neglect of NDIS participants;
c. The adequacy and effectiveness of the NDIS Code of Conduct and the NDIS Practice Standards;
d. The adequacy and effectiveness of provider registration and worker screening arrangements, including the level of transparency and public access to information regarding the decisions and actions taken by the Commission.
e. The effectiveness of communication and engagement between the Commission and state and territory authorities;
f. The human and financial resources available to the Commission, and whether these resources are adequate for the Commission to properly execute its functions;
g. Management of the transition period, including impacts on other commonwealth and state-based oversight, safeguarding, and community engagement programs; and
h. Any related matters.
National Office
PO Box 397
Matraville NSW 2036
Spinal Cord Injuries Australia submission
Dear Committee Secretariat:
Spinal Cord Injuries Australia (SCIA) appreciates having the opportunity to contribute to the NDIS Quality and Safeguards Commission Review. The Commission has a valuable role to ensure NDIS participants are able to live good quality lives in the community and be protected from abuse and neglect. SCIA’s submission is responding to some of the review’s Terms of Reference..
SCIA is a member driven organisation that has continued to provide services and supports for and by people with spinal cord injury and similar physical disabilities since September 1967. These services include individual and systemic advocacy as well as a number of other community, health, physical therapy and employment services.
Please contact SCIA if you seek clarification or further information about this submission.
Yours sincerely,
Greg Killeen
Senior Policy and Advocacy Officer
SCIA
Summary of issues contained in this submission:
Registering Support Workers
Safeguarding Through Service Agreements
Support Worker Labour Force
Protecting People With Disability From Physical And/or Sexual Abuse
Improving Communication and Assistive Technology
Importance of Disability Advocacy Support
The Commission’s Authority to Enhance the NDIS
Registering Support Workers
SCIA believes that the Commission should have the power to ensure that all people working as support workers for NDIS participants be required to be registered with their details maintained on a central database. The Commission would need to publicise the change in policy and be given the power to enforce support workers to be registered. The Commission would need to inform NDIS participants as well as service providers about the reason for the policy change as well as the benefits for all stakeholders.
The registration process would require all support workers to sign and comply with a Support Worker Code of Conduct that would cover all support workers, including people working with registered providers, those falling outside registered providers and include sole traders.
An example of why there is a need of support worker registration was when SCIA provided individual advocacy for a participant to lodge a complaint at the Commission against a support worker, and it was an extremely disappointing outcome when the Commission could not take action against the support worker due to the support worker not being registered with the Commission.
SCIA had another experience when providing individual advocacy for a participant about an accommodation issue and the Commission seemed powerless to take appropriate action to achieve a positive outcome for the participant. However there was an investigation by the Commission and in the end it is the word of one person against the other. It left the participant feeling entirely powerless and without any resolution.
The Commission needs greater resources and an increase in authority to investigate and test the validity of the claims. Often there seems to be a power imbalance between the participant and the service provider they complain about.
Safeguarding through Service Agreements
People with disability should have adequate funding to obtain the necessary services to live in the community in accessible and affordable accommodation, feel safe and have networks of people they could choose to interact with.
However, people with disability who are reliant on multiple daily services including personal care, meal preparation and assistance to bed rely on well-trained support workers who assist with intimate personal care. As some participants may only have one or two support workers, and have little or no contact with service coordinators, it may increase the participant’s vulnerability as the service coordinator does not know the dynamics and conditions in the participant’s home. The lack of informal supports can also result in abuse and/or neglect going unnoticed,
When NDIS participants engage a service provider to access their services and supports the NDIS requires a service agreement to be agreed to and signed/authorised by the service provider and NDIS participant.
Apart from the annual face-to-face meeting or contact to sign/authorised a service agreement containing the roles, rights and requirements of the service provider and participant, and other terms and conditions, SCIA would like the Commissioner to recommend that the NDIA require all service agreements to include a mandatory requirement that the participant be contacted a minimum number of times during the service agreement as agreed by the participant.
The contacts should be made in person, phone call or video call to check service quality and safeguarding the participant with any adverse issues be reported to the Commission. The contact could be made by the service provider, or an independent authority or utilising state Visitors Programs that do unannounced inspections of group homes. This requirement could be included as a Key Performance Indicator and an auditable requirement for NDIS registered service provider.
SCIA believes these are necessary requirements that should prevent or minimise the chances of abuse and/or neglect of participants and should prevent a repeat of the appalling neglect, and subsequent death, of Anne-Marie Smith in Adelaide, which is currently before an independent inquiry.
Support Worker Labour Force
The NDIS has provided many tangible and intangible benefits for NDIS participants and opened up the market for care support services of which there are many long standing and new service providers available. It has also increased the options for how participants recruit support workers e.g. the traditional option through service providers, online portals such as Hire Up, Mabel and Home Care Heroes etc or placing employment opportunity notices in classifieds if self-managing.
This has also contributed to the casualisation of the support worker labour force of which many support workers are international students and people on working holidays (backpackers) who are often transient in Australia. With this casualisation of support worker labour force many support workers obtain work with 2 or more service providers at the same time.
This will require the international students and people on working holidays to provide police checks to each agency, however, these would be international police checks that can take longer, compared to obtaining Australian checks.
Furthermore, service providers that use online portals to do police checks, such as fit2work, can use their own discretion and employ a job applicant who has a police record although the record may be noncriminal such as parking fines and traffic infringements.
To ensure the quality of services and safeguarding of potentially vulnerable participants, the Commission should have the power to set guidelines for service providers about the types, levels, frequency and historic timeframe of any criminal or reportable activity the support worker may have been involved in to be considered for employment as support workers.
Although the NDIA is planning to require support workers to have police checks every three years instead of every four years, SCIA would like to suggest the police checks be required annually due to the nature of personal care work and a large transient support worker labour force.
The Commission should also have the power to suspend or deregister a support worker (regardless whether they are registered or not) if the support worker has committed any crime that would make them ineligible to work as support workers. And for the Commission be given the power to review and make recommendations about the effectiveness of the police checks.
SCIA understands the NDIA is developing a central database to register support workers and service providers to transition from the current state and territory checks when the Commission becomes national. SCIA strongly endorses this concept but would also like to suggest that support workers be provided with a national identity and police check card. The identity card should have a number of purposes including recording the agencies they have been working for and the police check details.
Protecting participants from sexual and physical abuse
SCIA is aware of media reports, including an ABC 4 Corners program approximately 18 months ago, raising concern of people with physical and/or intellectual disability being physically and sexually abused by people with intellectual disability living in shared accommodation. Although the perpetrators may be separated or moved away from victims, SCIA understands that some perpetrators have reoffended at their new accommodation, or service providers have not managed the separation adequately.
The sexual and physical abuse of people with physical and/or intellectual disability by people with an intellectual disability may be extremely difficult for victims to understand the situation and/or how to report it and seek support and/or counselling.
Australia has a number of registers for child sex offenders which are national or state based. SCIA is unsure if there is a separate register for sex offenders with disability who had been found guilty of physical and/or sexual abuse of other people with disability, but if not, SCIA would like to recommend that the Commission consider seeking the development and maintenance of such a register.
The above-mentioned offences are of a criminal nature, so SCIA believes the Commission has a crucial role in maintaining the safety of all NDIS participants, and be given the powers to address the issues in conjunction with the relevant state and territory authorities.
Improving Communication and Assistive Technology
To facilitate the regular communication, NDIS participants should have an occupational therapy assessment to identify the most appropriate telecommunication devices and other assistive technology they can use independently. Apart from the telecommunication devices, the assessment should identify if other products are needed to enable the participant to access the devices such as brackets that attach the devices to a bed or wheelchair, or switches or voice activation to operate the devices.
When participants have independent use and control of accessible telecommunication devices they facilitate and improve communications as well as enhance autonomy, spontaneity and safeguarding.
In relation to participants needing access to telecommunication devices and assistive technology, it is essential they have access toproduct information including the accessibility features and other related peripherals.
The NDIS provides ‘Information, Linkages & Capacity Building (ILC) grants for various projects. As the ILC grants only allocate funding for a maximum 2 years can mean the time, effort and resources used to develop a project is eventually wasted if the project isn’t maintained.
An ILC grant was allocated to Australian Communications Consumer Alliance Network (ACCAN) to develop an online portal of all telecommunication devices available in Australia with accessibility features. If the ACCAN telecommunications portal cannot be maintained (which is needed due to the development of new and redundancy of telecommunication devices) it will be considered a waste of NDIS funding and make it more difficult for participants who will need to spend more time researching for and seeking advice on these products.
SCIA believes the ILC grants are part of the overall NDIS and to maintain the quality and safety of participants, SCIA would like to seek the support of the Commissioner to recommend that all ILC’s grants allocated to online portals and/or databases receive recurrent funding.
Importance of Disability Advocacy Support
People with disability who believe they have been subject to neglect, physical or sexual abuse should have access to timely advocacy support services to assist with preparing and lodging complaints and any ongoing mediations to seek justice.
SCIA is funded by the National Disagree Advocacy Program (NDAP) to provide individual and undertake systemic advocacy, as well as funded to provide the NDIS Appeals advocacy.
Since the NDIS started there has been an increase in people with disability seeking individual advocacy to resolve general discrimination, support service issues and NDIS complaints. The increase in demand has required advocacy services to create and manage client waitlists.
The NDAP undertook a wide-ranging review during 2016 – 2017, including consultations and a call for submissions which SCIA participated in. Unfortunately no review report was released. As a result, advocacy funding and the models they operate in, have been under a state of flux for a significant period at a Federal, State and Territory level. The advocacy sector needs greater certainty and this has to include a well-defined overarching policy at all levels of government. For too long, funding has been ad hoc and piecemeal. All disability advocacy organisations require greater certainty and longer recurrent funding timeframes.
A well-funded advocacy sector plays a vital role in acting to safeguard the lives of people with disability; it provides a voice to empower change where there are perceived barriers, physical and attitudinal. It will enable people with disability to hopefully achieve positive outcomes much sooner and reduce any stress and anxiety caused by the subject of complaint which can be exacerbated due to the wait to get it resolved.
SCIA seeks the support of the Commissioner to request the Department of Social Services to increase the recurrent NDAP funding to address the unmet need for advocacy, and is previously mentioned, SCIA would also like to obtain extra funding to develop and deliver disability advocacy training for people with disability to provide them with the skills, knowledge and confidence to be self-advocates.
The Commission’s Authority to Enhance the NDIS
The Commission’s purpose is to receive and address individual complaints by people with disability and/or their representative (or advocate) against support workers and service providers. It is expected that the collected data could be used to identify the types and prevalence of abuse and/or neglect and where these reportable events are occurring.
SCIA would like to recommendations that the Commission be given the authority to use the individual complaints data to implement actions and reforms to systematically improve the NDIS that name to stop or minimise the abuse and/or neglect of people are disability.