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I 11 October 2020
To: Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
Dear Commissioners,
Re: The impact of Covid-19 on disabled residents living in group homes in Victoria
I represent families of people with disabilities who live in group homes in Victoria. I make this submission on behalf of the members of the Supportive Families and Friends Association Inc. (SFF), who have expressed their deep concern about the risks and issues facing the residents since the rise of Covid-19.
Supportive Families and Friends Association Inc. is a volunteer-led association for families in Victoria with a family member living in supported disability accommodation.
The group home ‘landscape’ in Victoria is complex. This is because it is in a state of transition. The State Government has transferred the management of approximately 450 group homes, previously managed by the Department of Health and Human Services (DHHS), to five non-government providers selected by a tender process, whilst continuing to employ the transferred staff through secondment, and retaining a landlord role over the majority of the properties. This Transfer sector is still funded by the State Government until it is fully funded by the NOIA.
There is also a sector of the supported disability accommodation sector (approximately 50%) which has not been managed by DHHS, comprising a mix of other landlords and Supported Independent Living (SIL) providers across the State. I understand that this part is already fully funded by the NOIA
The members of the SFF are very fearful of their vulnerable loved ones being exposed to Covid-19 unnecessarily. They can foresee a repeat of what has happened in the Victorian aged care sector. Even though the DHHS has published guidelines, the members still have concerns.
Problems
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There has been an increased casualisation of the workforce. This is due, in part, to residents being home 24/7 and unable to attend their regular day programs since March. There has also been a mass exodus of the most experienced support staff under a Victorian Government Early Retirement scheme. Departing staff have generally been replaced by casual staff. This has resulted in casual staff working in more than one residence, which significantly increases the risk of residents being exposed to Covid-19
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The casual support workers are generally a younger cohort than the more experienced staff they replaced. It has been noted in the Health sector that this increases the risk of staff being exposed to the virus
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There is a lack of clarity about the availability of PPE.
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Some providers have been prioritizing the use of casual staff, rather than encouraging existing staff to do overtime, which again increases the number of avoidable contacts residents could have.
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The residents, who need structure and predictability in their days, have had their routines disrupted, causing stress and behavioural issues, which is exacerbated by the employment of less skilled and unfamiliar support staff
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Due to the cognitive impairments of many residents, they are unable to use protective Covid practices (mask wearing, good hygiene practices and social distancing) This poses an added transmission risk in the homes. Residents share bathrooms, eating areas and lounge areas with other residents and staff.
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Residents normally attend day activities (Programs or supported employment) for 30 hours per week, plus travel time. Currently, they are at home for those hours. Many are not given alternative in-home activities to do and lack stimulation. They are at risk of losing skills and becoming bored and irritable. There is an increased likelihood of challenging behaviours and mental health issues.
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The Federal Minister for the NDIS, Stuart Robert, has claimed that the disability workforce is skilled and trained. The skill level is rapidly declining because the NDIS does not fund staff to attend non-face to face training for group home care. Also, the NOIA does not fund employers to ‘shadow shift’. This involves a new staff member being mentored by an existing staff member, so that they get to know about the individual needs and preferences of the residents, before being left in charge. Shadowing is necessary to ensure consistency in implementing safe practices in the home. Covid-19 management techniques could also be at risk of misinterpretation. This deliberate underfunding is a form of abuse and neglect!
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The guidelines provided by the Victorian DHHS seem to be an afterthought; This is disrespectful of di sabled people ( https ://www.d h h s. vi c.gov. au/disabiI ity-servi ces-sector-coronavi rus-covid-19)
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As mentioned earlier, hundreds (the union, HACSU, quoted 570 staff) of the most experienced support staff have recently left the sector in monthly waves during 2010, after accepting an Early Retirement package from the Victorian Government. This had been planned for well over two years. The providers could have been recruiting permanent replacements, but they appear not to have been. This contributed to an inappropriate number of casual staff now employed. There are currently hundreds of unfilled vacancies for ongoing permanent staff in the sector.
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In Victoria SIL quoting has been underway in the first half of the year. We understand that Draft quotes were prepared by Transfer SIL providers, under pressure from the State Government, even during the pandemic. In many instances, families were not involved in this process. On 1 July 2020, the NOIA ‘moved the goal posts’ for SIL quoting. The draft quotes were cut substantially, with no explanation about which parts of the quotes had been rejected. We understand that SIL providers were told that the reduced budgets were final. This has made it extremely difficult for Transfer providers to do workforce planning and adequately involve the residents and their families in the quoting process.
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The risk of abuse to those in group homes is increased in the current circumstances. Usual safeguards are not in place. Community Visitors cannot visit houses and families are, in many cases, not visiting the homes. No one is visiting homes to observe practices. Many residents are not seeing anyone
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except the staff working in their home. Community access is severely limited. Residents are also not seeing familiar staff at day programs or at their employment. Many experienced support staff, who knew residents on a more personal level, could identify disquiet, and be a trusted confidant, have left.
As the COVI D-19 Pandemic, continues, group home residents remain a high risk group, in terms of catching the virus. SFF requests the Disability Royal Commission to make findings and recommendations to protect the vulnerable residents with disabilities.
SFF recommendations
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Support workers must be given appropriate Covid-safe training (infection control, use of PPE etc.)
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Replacing experienced staff who have left with inexperienced casual staff is not good enough! We reject the notion that “any warm body will do”! Support staff need to engage residents in activities; they need to provide Active Support, and engage residents in meaningful pastimes whilst in lock-down
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Providers should be required to prioritise the use of permanent staff, including the use of overtime, rather than use casual staff.
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Providers should be given minimum permanent staff ratios which will be especially beneficial for residents during the Pandemic.
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The NDIS Quality and Safeguarding Commission should monitor, penalize and direct SIL providers on staffing arrangements, to minimize the risk to residents from an increased casualisation of the workforce. To date this Commission has been invisible to families.
In summary, SFF has identified several Covid-related problems in the group home environment that put the residents at increased risk. The problems are typically systemic, which amount to a type of neglect, if not abuse. Neglect has occurred at each level of Government, the NOIA changing its policy apparently without regard to the impacts on group home functioning; the Quality and Safeguarding Commission being silent; and the Victorian Government refusing to exercise influence within its current provider contracts to reduce staff loss. There are problems with providers as well, but it seems they are often due to the restrictive and unexpected policy changes by the NOIA, and an opaque Transfer contract with the Victorian Government.
The SFF has put forward several ideas which it believes will help to reduce the risks of Covid-19 to the health and welfare of group home residents, now and into the future. We hope that the Royal Commission will expose the poor policies and responses of various stakeholders, and drive change so that the residents in group homes have the best chance of leading safe and fulfilling lives.
The SFF is pleased that the Victorian Premier recently bowed to pressure and is implementing a Disability Response Centre and Rapid Response Group. This included the requirement that a disability support worker may work at a maximum of two sites. To date there has not been any statement about how compliance will be monitored and enforced. The SFF recommends that there be transparency about how the 1 worker:2 sites rule will work in practice.
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I would be happy to speak about any of these issues in more detail.
Yours sincerely,
Phil Lipshut
President
Supportive Families and Friends Association Inc.