Author Peter Rankin
Background
Our foster son is a resident at a specialist disability accommodation house (SDA) at has been a resident since the house opened in 2011. The Supported Independent Living (SIL) provider is . This organisation was appointed by the Victorian DHHS prior to the introduction of NDIS. Participants at the house had no say and were not consulted in regard to this contract.
After the introduction of NDIS, continued to provide SIL services at the house. Participants at the house were not consulted as to whether should continue to provide services or whether there was an alternative.
The guardians of three of the five residents at the house have expressed serious concerns in regard to management of the house and two complaints have been made to the Victorian Disability Services Commissioner.
Since the transition to NDIS little if anything has changed. From the time the house opened, management seem to have made few efforts to foster cooperative relationships with participants and guardians. It does not seem to have been an important issue to them. It has proved difficult to obtain information from them, and communication has been on a “need to know basis”. The attitude seems to have been one of “leave it to us, we know what’s best”. Even since the introduction of the NDIS, there has been little change. I suspect that many SIL providers just “don’t get” the NDIS emphasis on empowerment of the participant. It may well be that the NDIS processes, as they are, have promoted or allowed this lack of empowerment to continue.
House Management and Service Quality
Poor management has resulted in mediocre SIL service for the residents at the house.
Ever since the house opened in 2011 there has been a procession of management changes and restructuring at the house level and at senior levels of management in Victoria. It is our view that this failure to provide stable ongoing management and stable house staffing has been a major factor contributing to less than optimal service delivery at
Since it was established there has been a high staff turnover and consequent over use of casual staff to fill vacancies. House supervision has been poor. Supervisors do not appear to provide supervision. Staff who have shown some promise have been moved to other houses or other roles. This failure to provide continuous and high-quality supervision at has resulted in a culture that accepts mediocre service. Management of the house appears to be ad hoc, rather than systematic. There seems to be very little pride taken in work or in the appearance of the house. Despite assurances from the Regional Manager that there are documented quality management systems in place, they are ineffective. We have not observed any
improvement in services or staffing since started. Assurances regarding the commitment to
continuous improvement have either not been implemented or haven’t resulted in improvements.
Peter Rankin 1
Author Peter Rankin
The house appears to operate in a management vacuum. There does not seem to be adequate systems to define house operations and little management direction and encouragement to improve the service quality. The house appears to limp along on the goodwill and initiative of the individual workers.
Assurances have been provided that the house was addressing the issue of use of casual workers, however there have only been minor improvements. Guardians are concerned that the safety and emotional wellbeing of residents is endangered when workers who are unfamiliar with the residents are on duty.
A recent incident at the house where a resident has sustained injuries consistent with an assault is very worrying. It is our belief that is left to sit in his chair for extended periods of time with little or no interaction. does not now seem to be encouraged to assist with daily living skills as he was earlier in his residence. He does not now go shopping or go out with house staff members as he previously did.
This absence of effective management is not simply frustrating, it is dangerous. It endangers the residents, and at times the staff, as participants struggle to be comfortable in a place which is meant to offer them the highest level of comfort. It also ensures that in the long term the likely reductions in support needs from participant, that could be achieved by quality supports and which would lead to better lives and cost savings, will not occur, and higher levels of support and supervision will continue to be needed. This isn’t in the interests of the participants or tax payers who want to see excellent personal supports provided in a cost effective manner.
The worrying aspect of this from a systemic level is that these failures have have not been identified and addressed in the context of oversight firstly by Victorian DHHS and then NDIS. Both organisations presumably have audit processes designed to verify quality services. They do not appear effective in identifying issues at the level of service delivery. How can they do it better? It’s about improving the lives of house residents.
Issues for Consideration.
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Does NDIA adequately define service standards and other expectations for SIL providers in a way that can be measured against the impact on each participant.
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Should NDIA develop a model SIL service agreement that clearly specifies the services that will be provided.
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Service agreements should be specific to the level of care required by the participant.
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Should the service agreement include a simplified Roster of Care so that participants and guardians know what the staffing levels should be at all times.
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Should SIL service providers be required to report on progress 9 months into the plan as happens with support coordinators. Such a report could be signed off by guardians and nominees. This should go to a NDIA standards team or be automatically submitted to NDIS auditors.
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How does NDIA monitor performance of SIL providers especially where residents do not have guardians who regularly visit and are not actively involved, e.g. older residents?
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Does NDIA need to review and modify its audit process to monitor performance of all SIL providers and to ensure that the audit process reaches an individual house level and it recognises and responds to the specific needs of the house.
Peter Rankin 2
Author Peter Rankin
- Will the NDIS develop mechanisms to strengthen the authority of the participant and families to make decisions which reduce the risk of harm, for example requiring that the NDIS replace the SIL provider.
Physical, emotional and psychological well being The arrangements at house for monitoring of the emotional and physical well-being of the residents appear to be ineffective. It seems as if this role is left to the individual initiative of some of the workers. SIL seems to be aimed more at the physical aspects of support e.g. meal preparation, personal care, cleaning etc. For many older residents of SDA, the SIL workers could be the only people who have the opportunity to observe medical, emotional and psychological issues. In the past when the State ran most Community Residential Units the supervisor probably performed this important task and had the resources of the State agencies to call on. It is not clear whether this is a role that private SIL providers will perform.
Issues for Consideration
- The task of monitoring the physical, emotional and psychological well being of SDA residents, that should be included in the services to be provided as part of SIL.
SIL Quoting Process
Our recent experience in trying to obtain a quotation from for SIL services has resulted in
unnecessary frustration and has taken a considerable emotional toll on my wife and myself.
My wife and I attended a plan review meeting on 30 January 2019. We provided a quotation from day program and were informed by the planner that have not provided a SIL quotation. We may have been at fault in not requesting this from nevertheless the six-month period since the request was made cannot be excused. The lack of the SIL quotation caused the existing plan to be extended by two 3-month periods and the plan has now expired. What this in effect means is any improvements negotiated for other areas of the plan must wait until the whole plan is approved.
Our son has extremely high needs and this process while serving the interests of doesn’t serve him . He requires continuity of services and trained and qualified staff. Agencies such as our day service cannot keep this level of quality staff available when the most they can offer is three-month contracts. This results in unsustainable staffing .
After raising the matter with on 30 January 2019, we were given assurances by the regional manager
that this matter would be addressed urgently. These proved to be empty promises. It was only on 26 April we were informed that the SIL quote has been sent to NDIA on 12 April. This was done without proper
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Author Peter Rankin
consultation with us as required by the NDIA SIL Quoting Guidelines. We have now been informed by NDIA that they have placed the quotation on hold.
Note. We were informed by NDIA on Monday 2 September that NDIS plan had been provisionally approved.
Issues for Consideration
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How can a SIL provider be changed when there are multiple residents in shared supported accommodation. What authority do participants have in changing the SIL provider for a house if there is general agreement? Is there a process for this?
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Should the SIL quote be signed or verified by the participant to ensure adequate consultation has taken place.
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How can SIL quoting process be made more transparent and simpler for participants and guardians, especially the roster of care?
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Should NDIA refuse to renew SIL contracts with providers who submit late SIL quotes or do not comply with the requirements of the NDIA SIL quoting pack
SDA Vehicles
Past practice in Victoria has been that a vehicle, usually a 12-seater bus, has been supplied to share supported accommodation houses. It now appears that under the SIL arrangements no vehicle will be supplied. This will make life difficult for the house as the vehicle is used for shopping, medical appointments, taking participants to community activities etc.
Issues for Consideration
- How can SIL quoting guidelines be changed to include a requirement for a house vehicle?