NDIA Accountability Project

Submission 3 — Gateway Health — Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability

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Section 1: Questions about your experiencesIIThese questions are just a guide. You can answer as many or as few as you like, or if you like, you can make a submission on any issue covered by the Terms of Reference.3

Incidents of violence, abuse, neglect and/or exploitation We as providers are concerned about the

1.  Have you been or are you aware of a             following aspects of the model:

person with disability being exposed to           •   Service providers can advertise as a

violence, abuse, neglect or exploitation? NDIS provider without accreditation, for self-manage funds. This unregulated If yes: system opens up the possibilities of neglect, abuse and exploitation. a. What happened?

  • “Planned Managed” are misrepresentative as this service is a b. Did it happen once or a number of times?

financial administration service and can be misinterpreted by participants.

  • Lack of cohesion of services, record­ keeping, failure of service providers to identify risks and escalate safety concerns

  • In our view there is a lack of appropriate training of DSW, resulting in lack of knowledge around scope of practice and professional boundaries.

Complaint processes and outcomes

Gateway Health appreciates the objectives of2. Have you made a complaint about violence, the new NDIS quality Framework for managing abuse, neglect or exploitation on your own complaints and feedback. behalf or on behalf of a person with disability? If yes:

a. What was the complaint? b. Who did you make the complaint to? c. Was the complaint followed up? 3 https:// disability .royalcommission.gov .au/ about/Pages/Terms-of-reference.aspx

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Complaint processes and outcomes

d. What was the outcome of the complaint? e. Were you satisfied with the outcome? If yes, why? If no, why not?

Access

  1. We are concerned about the My Aged
  2. Do you have concerns about access to Care interface with Disability services places and services and whether this has -ACAS assessors are required to approve clients for Residential Aged placed you or people with disability at risk Care facilities …. Respite or Permanent of violence, abuse, neglect and/or care and we hold concerns with exploitation? If yes: knowledge of NDIS requirements and funding and authority of ACAS …

a. What are your concerns? particularly where the participant requests to enter a Residential Aged

b. Have you raised those concerns Care facility due to choice and not with anybody? need …. This reduces the access of the RAC to the older persons for

C. Who did you raise your concerns with? potentially decades. d. What was the outcome? 2. Concerns with NDIS delays in reviewing

plans when needs change

  1. Once request for reviews is received the review can take up to 9 to 12 month to complete the review … concerns this causes for participants

  2. Concerns with competencies with LACs and inconsistencies with planning process and quality

  3. Concerns with funding model not supporting back of house roles required to deliver a safe service

  4. Transport allowance grossly inadequate for care requirments

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Access

  1. Concerns with rural and remote participants and the additional costs and care the participants require due to location often is not replicated in the planning documents

  2. Cross boarder issues with care services

  3. NDIS participants can be eligible for aged care packages - concerns this is inequitable

  4. Providers look at low cost options, rather than acknowledging expertise of specialised clinicians

  5. Lack of specialist clinicians in regional areas. General shortage of Allied Health clinicians. Individuals unable to use plan funds due to clinician shortages

  6. Participants specialty, high tech equipment needs were previously supported by companies who would travel to regional areas for trials and set-up. Companies will no longer travel due to travel funding restrictions. Rural clinicians and participants need to travel to metropolitan areas to access same service.

  7. Lack of advance notice of planning meetings, so clinicians unable to provide supporting documentation

  8. NDIS pricing is grossly inadequate to provide quality services and support

  9. Working with vulnerable clients who may not shop around so issues with services aren’t highlighted and escalated

  10. Cost of compliance is high

  11. Psychosocial disability is inadequate and concerns with deskilled workforce to support and service

  12. Gap in accommodation options for NDIS participants and large impact on

Aged Care placements

  1. Providers without disability Page 5

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Access

background do not understand the health needs of people with disability and how they are linked to their disability

  1. Providers don’t know what they don’t know- don’t know where to access appropriate information and training­ ignorance around disability is widespread and disturbing.

  2. Lack of appropriate training of

Disability Support Workers­

accreditation inadequate

  1. Imposts on small rural businesses registering as NDIS providers prohibitive, which further reduces access for individuals to quality services

  2. Lack of carers- individuals unable to use plan funds due to staffing shortages

  3. Young people with disability considering going into residential aged acre due to lack of carers to support needs at home

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Best practice and innovation

  1. Program Officers model - assists with

  2. Have you been part of a process that individualising goal care however designed or implemented best practice or funding doesn’t support this model

    1. Use of AHA’s to support groupwork, innovative models for the prevention,

1:1, reporting and investigation of, or

  1. Providing flexible service delivery responding to violence against and abuse, model - offering participants clinic neglect or exploitation of, people with appointments to reduce clinician travel disability? If yes: costs

  2. Telehealth opportunities a. Where and when did this occur? 11. Disability services, aged care services and HACC services working

b. What led to this process? collaboratively to ensure all participants get the right services, right time when

c. How has it been implemented? they need it. Service helping the participant navigate through the

d. Has there been any evaluation or funding models for optimal needs gain. independent assessment of this model?

e. What was the outcome of the independent assessment or evaluation?

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More inclusive society

  1. Disability services, aged care services
  2. What could be done to promote a more and HACC services working inclusive society that supports the collaboratively to ensure all participants independence of people with disability and get the right services, right time when they need it. Service helping the their right to live free from violence, abuse, participant navigate through the neglect and exploitation? funding models for optimal needs gain.

Effective reporting, investigation and prevention

The NDIS accreditation is well placed to do   16. What   is  already  working  well  to

this … the gap needs to extend to ALL

encourage    reporting,    investigation                                               providers of care for this cohort so that all

and/or prevention of violence, abuse, providers are subject to the rigor this clientele neglect or exploitation towards people deserves ….. including the one man businesses with disability? who do supports.

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