NDIA Accountability Project

NDIS Workforce: Qualifications, Skills, and Remuneration

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Submission to NDIS

Workforce Inquiry

Joint Standing Committee on the

NDIS

MAY 2020

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Enquiries regarding this submission can be directed to:

Debra Parnell

Manager, Policy and Advocacy

Angela Scarfe

AASW Senior Policy Advisor

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The Australian Association of

Social Workers

The Australian Association of Social Workers (AASW) is the professional body representing more than 12,000 social workers throughout Australia. We set the benchmark for professional education and practice in social work, and advocate on matters of human rights, discrimination, and matters that influence people’s quality of life.

The social work profession

Social work is a tertiary qualified profession recognised internationally that pursues social justice and human rights. Social workers aim to enhance the quality of life of every member of society and empower them to develop their full potential. Principles of social justice, human rights, collective responsibility and respect for diversity are central to the profession, and are underpinned by theories of social work, social sciences, humanities and Indigenous knowledges. Professional social workers consider the relationship between biological, psychological, social and cultural factors and how they influence a person’s health, wellbeing and development. Social workers work with individuals, families, groups and communities. They maintain a dual focus on improving human wellbeing; and identifying and addressing any external issues (known as systemic or structural issues) that detract from wellbeing, such as inequality, injustice and discrimination.

Our submission

The AASW welcomes the National Disability Insurance Scheme (NDIS) as a rights-based approach that supports the independence and the social and economic participation of people with a permanent impairment or condition resulting in disability. The values of ‘choice and control’ that underpin the NDIS are consistent with the values and principles of self-determination and empowerment that have guided the social work profession for many decades. The AASW believes that two aspects of the NDIS workforce have critically important roles in determining the quality of participants’ overall outcomes. The first group is the staff who draw up and approve participants’ plans. The second group

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is the staff who ensure that all aspects of a plan cohere into a holistic, person centred, strengths based response to a participant’s situation. This latter function occurs under the title of support coordination and specialist support coordination. The AASW welcomes the opportunity to contribute to the NDIS Workforce inquiry and our focus will be on these aspects of the workforce.

OUR RESPONSE

The experience, expertise, and qualifications of planners

The AASW is concerned at the variation in the level of qualifications, skills, and experience of people in the planning role, and the low levels of these that some planners appear to display. Several reports into aspects of the NDIS have heard evidence from participants describing shortcomings in the process of formulating plans, the poor quality of plans and the impact of this on their overall experience of the NDIS. People described planners with low levels of understanding about the issues facing people who live with a disability in general, and about the details of particular disabilities; these resulted in plans that did not adequately capture people’s needs nor describe the services that those needs require. People cannot exercise choice in and control over the services they need unless their needs are properly identified and their aspirations for their lives are understood.

The ability of planners to understand and address complex needs;

In this context, the AASW is particularly concerned at reports which suggest that many current planners do not have the knowledge or skills that are required to work with people with complex needs, such as Aboriginal and Torres Strait Islander people, people with multiple conditions, people who live in a rural community or people who do not speak English. To adequately assess and respond to people with complex and changing needs, planners need specialist knowledge and competencies. Social workers know that to assist someone to articulate their goals, to express the nature and extent of their needs and to formulate an achievable and empowering plan is the result of a process which includes: getting to know the person, building rapport, understanding the broader environmental factors and systems, for example, the person’s social connections, other informal supports and knowledge of the interactions between multiple needs. Some social workers working with participants after their plan has been finalised have reported that they have discovered aspects of a participant’s situation that was relevant to a plan, but has not been incorporated into it.

Support coordination and social work;

AASW members report that the need for support co-ordination is not always recognised by planners. Social workers report that many participants who do not have Support Coordination funding on their NDIS plan do in fact need assistance to coordinate their supports and to incorporate supports from non-NDIS related services into an overall plan due to various complexities in their lives. Although the NDIS maintains that this is the role of the NDIA/Local Area Coordinators, in our experience, LACs are often unresponsive or too busy to provide the required support to a family. Social workers who have

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an existing relationship with participants through their organisation find that the family will request this from them.

Social workers report that there is a low level of understanding of the definitions of support co ordination and specialist support co-ordination and that these are the source of poor outcomes for participants. The AASW has described the essence of Case Management and Care Co-ordination1, a central skill of social work and which can include the following:

  • Service brokerage
  • Coordinating support
  • Collaborating with multidisciplinary teams
  • Referrals to other services
  • Accessing resources
  • Assistance with housing
  • Assistance with advanced care planning including obtaining guardianship and/or administration orders if necessary to support decision making

In all contexts, social workers focus on individual, family, carer and community strengths and needs, and work collaboratively to support people to achieve the lives they want. Social workers take a holistic approach that includes the individual and systemic factors. Social workers work alongside people with disability to advocate for their rights and facilitate their empowerment (and that of their families) and achieve their needs and aspirations.

Social workers with experience of this role before joining the NDIS and of the support co-ordination role within the NDIS report that the work they previously undertook was very similar to their present role of Support Coordination, which the NDIA defines as:

Strengthen a participant’s ability to design and the build their NDIS supports with an emphasis on linking the broader systems of support across a complex service delivery environment (ie. Coordinating NDIS funding / supporting families to navigate NDIS system / Linking into providers / liaising with providers / ensuring funding is being utilized).2

The elements that these members report as being common to both roles are

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  • Supporting transitions (ie. school / post-school)
  • Support in relation to accessing broader systems of support (ie. school, medical,

  • Referrals to external agencies where needed (DV services, migrant services, financial services)

  • Accommodation assessments / exploring housing options

  • Assessment and support re. carer stress

  • Building participant/parent capacity

  • Assistance to resolve points of crisis and developing capacity/resilience in the participant’s network

  • Supporting participants to direct their lives, not just their services. AASW member.

Although the tasks of the support coordination appear to be similar to the work of a social worker, there is no required minimum qualification nor professional membership required for the people who undertake this work. Social workers who have experience in this work believe that this indicates a failure to appreciate the level of knowledge and skill required to fulfill this role in way that ensures the best outcomes for participants. Similarly, this work is paid at a lower rate than other skilled roles in the NDIS. Combined with the absence of a professional qualification or credential, this means that this important work is not being undertaken with sufficient skill or knowledge to deliver the optimum outcomes for participants. The result is that, many clients and families who have very complex needs requiring social work intervention, and who would have had access to a social worker under previous state-government funded models of disability services, are not receiving all the potential benefits from this important work.

Support co-ordination, Specialised Support Coordination and social work

The NDIA describes Specialist Support Coordination as appropriate for people with specific high complex needs or high-level risks in a participant’s situation. It lists the people that Support Coordination will benefit – they are all vulnerable/marginalised people groups who social workers typically work with.

Specialist Support Coordination is designed to address highly complex barriers impacting on the ability to implement their plan. Specialist Support Coordination should reduce complexity in the participant’s support environment in the context of broader systems of support, whilst also assisting the participant to connect with NDIS supports, negotiate solutions with multiple stakeholders, and build capacity and resilience. Specialist Support Coordination may also involve assisting in resolving points of crisis for participants and ensuring a consistent delivery of service during crisis situations.

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Specialist Support Coordination is generally delivered utilising an expert or specialist approach, in a time limited, outcomes focused manner and by an appropriately qualified and experienced practitioner to meet the individual needs of the participant’s circumstances.

An AASW member reported that there is a lack of clarity about the difference between Support Co ordination and Specialist Support Co-ordination leading to inconsistencies in the way that the roles are incorporated into plans:

“The challenge we have is that many of our clients have significant complexities and high level risks, and require a skilled social worker to provide their support coordination, but often it is not funded appropriately, and instead of being funded as Specialist Support Coordination it is funded as regular Support Coordination at the lower rate.

And furthermore, the stipulation that Specialist Support Coordination is “time-limited” (i.e. only for 1

plan period) does not take into account the fact that for many of these clients, their complexities will be ongoing (potentially life-long) and will not be ‘resolved’ in a 12 month period”

Nevertheless, there is a clear difference in the qualifications of the staff who can provide these different roles. In contrast to providers of Support Coordination, providers of Specialist Support Coordination, do need to be qualified Allied Health Professionals.

AASW members report that many participants’ plans underestimate the need for this work in the same way that occurs with support co-ordination. Social workers discover that the work has either been inappropriately judged to be Support Co-ordination, or that it has been recognised as Specialist Support Co-ordination but that an inadequate amount of time has been allocated to it. This has impacts on the day to day lives of NDIS participants and the possibility of reduced outcomes for better quality of support provision and overall participant wellbeing.

Conclusion

The AASW recommends that

  • the level of qualifications required to enter the roles of planners, support co-ordination and Specialist Support Co-ordination should be raised to recognise the level of skill required to assist participants achieve the optimal outcomes envisaged for them by the NDIS.

  • Similarly, the quality standards for the delivery of these roles should also be revised upwards, equating with other trained roles such as that of an Allied Health Worker, in order to meet the needs of NDIS participants.

  • Lastly, these roles need to be appropriately remunerated to ensure a quality of staff, job satisfaction and retention, and continuity of care and service provision.

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