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Level 10, 213 Miller Street, North Sydney NSW 2060
PO Box 785, North Sydney NSW 2059
P 02 9280 4744 F 02 9280 4755 con ta ct@care rsnsw. org. au CarersNSW Australia Carers NSWwww.carersnsw.org.auABN 45 461 578 851ACN1:1!6277 552
30 December 2022
Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
GPO Box 1422
Brisbane Qld 4001
Carers NSW welcomes the opportunity to provide a submission to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Royal Commission). Throughout the Royal Commission’s proceedings, Carers NSW has provided a number of submissions, highlighting the important role of carers in the lives of people with disability. This submission will continue to urge the Royal Commission to recognise the role of carers as reporters and safeguards against abuse, as well as highlight the complex factors that can result in carers acting as perpetrators of abuse or neglect of people with disability. The submission will also highlight a number of carer-inclusive opportunities to reduce the risk and prevalence of abuse of people with disability.
Carers NSW is the peak non-government organisation for carers in New South Wales (NSW). A carer is any individual who provides care and support to a family member or friend who has a disability, mental illness, drug and/or alcohol dependency, chronic condition, terminal illness or who is frail. Carers NSW is part of the National Carer Network and a member of Carers Australia. Our vision is an Australia that values and supports all carers, and our goals are to:
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Be a leading carer organisation in which carers have confidence
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Actively promote carer recognition and support
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Actively support carers to navigate a changing service landscape that will be characterised by ongoing policy reform
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Promote connected community experiences and opportunities for carers that are inclusive of diverse carer groups
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Lead and advocate for carer-specific and carer-inclusive policy making, research and service delivery
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Continue to be a quality-driven, responsive and carer-focused organisation Thank you for accepting our submission. For further information, please contact Jade Alexander, Policy and Development Officer at jadea@carersnsw.org.au or on (02) 9280 4744.
Yours sincerely,
Elena Katrakis
CEO
Carers NSW
SUPPORT ALL CARERS · AN AUSTRALIA THAT VALUES AND PPOR ALL CARERS · AN
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Introduction
Carers NSW thanks the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (the Royal Commission) for the many opportunities to provide submissions, including this final opportunity. Carers NSW believes in the importance of the Royal Commission in highlighting the experiences and support needs of people with disability and has provided a number of submissions emphasising the need for increased carer inclusion and recognition in order to help reduce and prevent violence, abuse, neglect and exploitation.
Carers NSW is concerned to note that carers continue to receive limited recognition, with their role as partners in care and potential reporters of abuse often overlooked throughout the Royal Commission. Carers NSW urges the Commissioners to ensure that the findings of the Royal Commission are carer inclusive, acknowledging the important and supportive role of carers in the lives of many people with disability. Furthermore, Carers NSW recommends a supportive approach, where appropriate, to reducing potential abuse or neglect of people with disability by family or friend carers, including ensuring adequate access to formal support and increasing the range of carer-inclusive, supportive regulatory measures available in the community.
Background
Carers NSW believes in the importance of autonomy and self-determination for people with disability and is supportive of policy and practice that facilitates their independence and meaningful participation in community life. Additionally, Carers NSW recognises that not all people with disability receive informal support or would identify as having a ‘carer’. However, family members and friends are important in the lives of all Australians, and the Australian Bureau of Statistics (ABS) reports that the majority of Australians with a reported disability who need assistance receive at least some of that assistance from a family member or friend; in many cases, on a daily basis.1
The Commonwealth Carer Recognition Act 2010 stipulates that carers should be considered as partners with other care providers in the provision of care, acknowledging their unique knowledge and experience; this extends to recognition of the valuable social and economic contribution of carers, and respect for the relationship between carers and the person(s) for whom they care.2 The important role of carers in representing the interests and rights of the person they support is also highlighted in Australia’s Disability Strategy 2021-2031,3 within the Policy Priority 3: The role of informal support is acknowledged and supported of Outcome Area: Personal and Community Support. It was further supported by the Review into Disability Advocacy in NSW: A report by the NSW Ageing and Disability Commissioner (the Review),4 which identified the important role of carers in disability advocacy as well as the positive outcomes for carers that can be achieved through disability advocacy. It is therefore well established and reinforced through numerous legislative and policy instruments that there is a need to improve the rights and needs of families and carers of people with disability as supporters.
Defining ‘carer’ Carers NSW is supportive of measures to ensure the safety and wellbeing of people with disability and their carers. However, Carers NSW is continually concerned to note how often the term carer is conflated with abuser in the safeguarding discourse. Furthermore, in many cases the use of the term
1 Australian Bureau of Statistics (ABS) (2019) Survey of Ageing, Disability and Carers 2018, TableBuilder Dataset, available online at: www.abs.gov.au 2 Carer Recognition Act 2010 (Cth), Schedule 1 The Statement for Australia’s Carers 3 Commonwealth of Australia (Department of Social Services) (2021), Australia’s Disability Strategy 2021-2031, available online at: https://www.disabilitygateway.gov.au/sites/defaulUfiles/documents/2021-11/1786-australias disability.pdf, viewed 07 July 2022. 4 NSW Ageing and Disability Commission (NSW ADC) (2019), Review into Disability Advocacy in NSW: A report by the NSW Ageing and Disability Commissioner, available online at: https://www.ageingdisabilitycommission.nsw.gov.au/_data/assets/pdf_file/0008/765530/Review-into-Disability Advocacy-in-NSW.pdf, viewed 07 July 2022.
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carer in this context often refers to either a paid care worker, or a family member or friend who is not, in fact, a carer as defined by the Commonwealth Carer Recognition Act 2010.
Ensuring that public reporting and service data collection accurately and consistently uses the term carer in line with the Act will provide a clearer picture of which people are perpetrating abuse in which circumstances, better enabling effective prevention. As it stands, the prevalence of abuse by carers can be difficult to accurately gauge, and therefore to understand and address. Carers NSW advocates for ongoing research to understand and target risk factors for abuse, neglect and violence through an educative and supportive approach.
Understanding risk factors that may lead to abuse There are many complex issues that can lead to situations of abuse and neglect such as a family dynamics, social disadvantage, and poor mental health, and these are not necessarily related to caring roles. The demands of providing informal care are likely to further complicate these complex situations. Unfortunately, research into the nuances of abuse and neglect, particularly in relation to caring roles, is limited.
Carers NSW experience working with carers and recent involvement in ongoing research and consultation on the topic of abuse and neglect perpetrated by carers indicates that common risk factors include carer stress, limited access to support services, social isolation, a lack of understanding and awareness, and financial stress.
Many factors contribute to carer stress and poor mental
health, two risk factors for abuse. These include the "Caring for my person with disability
frequency and intensity of care being above that which the has affected my physical & mental carer can safely manage; financial hardship or poverty; a health. I now have chronic pain & history of violence or conflict in the relationship prior to the health issues due to stress and commencement of the caring role; behavioural challenges physical assaults by one of the manifested by the person being cared for; and a lack of formal persons I care for“
and informal support. Interrupted or limited sleep,5
complicated emotions such as grief and loss, health or mental - 2020 National Carer Survey health conditions, use of alcohol or other drugs and cognitive respondent impairment are other factors that may contribute. Insufficient breaks from the caring role can also greatly increase carer stress.6
Protective factors that contribute to a carer coping with stressors include having a partner or someone who shares the caring responsibilities, being in paid employment and having sufficient financial resources. Engaging in physical and social activities, having strong social networks and access to replacement care, as well as formal and informal support, have also been shown to be protective factors for carer wellbeing,7 with flow on affects for the caring relationship.
Recent public health and environmental crises have posed practical challenges and considerable stress for all people living in Australia. For carers, the risks and challenges posed by these crises are often exacerbated by the support needs of the person they are caring for. Many carers have experienced an exacerbation of their health and mental health at a time when these were already compromised.8
Carers also experience high levels of social isolation. The 2022 National Carer Survey indicates that more than one third (36.6%) of carers of peopled with disability reported being highly socially isolated,
5 Carers Australia (2020), Sleep deficits in Australian carers. Accessed online at: https://www.carersaustralia.com.au/poor-sleep-health-of-unpaid-carers-adversely-affecting-wellbeing/ 6 Carers NSW (2022) 2022 National Carer Survey, unpublished data. 7 Obst, P., Murray, K., Walbank, S., Kelly, R., Brazel, D (2020) Experiences of abuse in Australian family carers and predictors of mental health and well-being. Health and Social care in the community, 2020;00:1-12. 8 Carers NSW (2022).
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with another 24.3% reporting low levels of social support. 9 This isolation can compound carer stress, with limited opportunities for others to identify or support carers where they are isolated.
Often, people who experience abuse in their home are also experiencing isolation, or may have been isolated from their support network by the perpetrator. Isolation can also limit opportunities for formal or informal support that can assist with addressing or alleviating distress.
An inability to access formal or paid services or supports that meet the needs of people with disability can also increase carer stress through an increased reliance on carers to provide equivalent support. The NDIS has provided disability support to many Australians who have previously been unable to access this support. However, of the approximately 4.4 million people with disability in Australia,10 it is estimated that only 475,000 will be eligible to receive supports through the NDIS.11 Additionally, ongoing systemic limitations of the NDIS including inadequate funding in NDIS Plans to meet the needs of participants, poor integration between service systems, a heavy administrative load associated with service navigation and coordination of supports, workforce shortages, thin markets and a lack of opportunities to consider the needs of carers within the NDIS means that the NDIS often still does not adequately meet the needs of people with disability, their families and carers.
The Carers NSW 2022 National Carer Survey12 found that of respondents caring for someone accessing the NDIS, in addition to support provided by formal services, these carers were providing an average of 110.1 hours of care per week, with 47.2% providing 24/7 care. The Survey also found that 84.3% reported that the person they cared for cannot be left alone for more than a few hours and 79% were providing support with 15 or more tasks. While most carers (74%) caring for someone accessing the NDIS agreed that they had been involved in planning decisions about services, a majority disagreed that they were asked about their needs as a carer (58%) or that services met their needs as a carer (51%). Furthermore, just over half (52.5%) of these carers disagreed that services enabled them to keep their job or go back to work and around 2 in 5 (44%) disagreed that services gave them a break from providing care.
For those unable to access the NDIS, especially in states “ … we don’t get any NDIS. So I such as NSW which have limited residual disability supports have to pay someone every
in place, it is often even more challenging to access fortnight just to come and be a
specialised disability support. While there has been an companion to my son for the
increasing focus on building the capacity of mainstream couple of hours that used to be services to ensure they are inclusive of people with disability, funded before. And that funding
many are still unable to meet the needs of people with is gone ... I don't know where
disability and their carers. This has resulted on a significant the money has gone to, but over-reliance on carers and family members of provide high we’ve lost it. .. He used to come levels of support in lieu of formal services or supports. every week, but now it’s cut back too, because we have to The 2022 National Carer Survey13 found that of respondents pay for it.“ caring for a person with disability who was not accessing support through the NDIS, carers were providing an average - Carers NSW 2022-23 Pre-Budget of 104.2 hours per week, with just over half (50.3%) providing Submission Consultations 24/7 care. Almost 2 in 3 of these carers (63%) reported that
9 Carers NSW (2020) The COVID-19 Pandemic: Challenges and opportunities for carers in NSW - Consultation Report, available online at: https://www.carersnsw.orq.au/uploads/main/Files/3.Resources/Policy Research/Consultation report 2020.pdf. 10 ABS (2019).
11 Productivity Commission (2019) Review of the National Disability Agreement: Productivity Commission Study
Report, available online at: https://www.pc.qov.au/inquiries/completed/disability-aqreemenUreport/disability aqreement.pdf. 12 13 Carers NSW (2022).
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they were the only one providing care and 64.3% reported providing assistance with 15 or more tasks.
In addition to these barriers to support, ongoing workforce shortages across the care and support sector and the impacts of COVID-19 and natural disasters have exacerbated barriers to support across all the whole care and support sector. The 2022 National Carer Survey14 found that 67% of respondents providing support to someone accessing disability services reported that services were interrupted due to COVID-19.
While carers can access a range of carer-focused services and supports through Carer Gateway that may be able to complement disability services and supports, awareness of Carer Gateway remains low and it is expected that disability and aged care service systems will continue to provide ongoing, regular support for carers to sustain their caring role.
Findings from the 2022 National Carer Survey15 indicate that while carers of those accessing disability supports through the NDIS fare slightly better in regards to their wellbeing, social connectedness and level of psychological distress, most carers of people with disability continue to report high levels of distress and low levels of wellbeing and social connectedness (Figure 1 ). This suggests that access to formal supports may have a positive effect on carer health and wellbeing, however the inability of formal services to adequately meet the needs of people with disability and their carers may limit this effect.
Figure 1. Comparison of outcomes for carers of persons with disability under 65 accessing NDIS and carers of persons with disability under 65 not accessing NDIS16
Wellbeing level 56% NDIS carers 62% Non-NDIS carers 52%NDIS carers 50% Non-NDIS carers reported high/very high
psychological distress • reported poor-fair health
66% NDIS carers 70% Non-NDIS carers 56% NDIS carers 61 % Non-ND IS carers reported social isolation
Carers as reporters of abuse
While carers can be potential perpetrators and victims of abuse in the home, carers of people with disability are often reporters of abuse. Indeed, carers supporting someone in the home are uniquely placed to directly witness, receive a disclosure of, or identify signs of abuse perpetrated by paid care workers, other family members or friends, or members of the community.
Carers and the Royal Commission According to the Third Progress Report of the Royal Commission,17 of the 669 submissions received, around 43% were made by family members (who may or may not be providing care). Around half of
14 Ibid. 15 Ibid. 16 Carers NSW (2022). 17 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (2020) Third Progress Report. Available online at: https://disability.royalcommission.gov.au/publications/third prog ress-re port
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submissions that discussed people who perpetrate abuse, reported that the perpetrator was in a known relationship to the person with disability; however, most frequently, the Royal Commission were told these perpetrators were medical professionals, paid care workers and teachers. These statistics indicate the key role family and friend carers can and do play in bringing abuse to light.
Furthermore, approximately 1 in 4 people requesting a private session with the Royal Commission were a parent, child or sibling of a person with disability (it is not clear if they were providing care or just acting in their capacity as a family member). 18 It was also noted in emerging themes that “some people who provide support to people with disability as carers or in their professional capacity have told [the Royal Commission] they are afraid to report abuse or neglect in case of reprisal or the loss of employment”.
Unfortunately, there is limited reference to carers throughout the Progress Report and some of these references are to paid carers, who are erroneously referred to as ‘carers’. Whilst 30% of submissions received reported violence, abuse, neglect and exploitation occurring in the home or living arrangement, there was no conclusive evidence to suggest whether this was always perpetrated by a family member or carer, rather than a professional or support worker. This finding emphasises the importance of using correct and consistent terminology, as noted earlier.
Meredith* is a carer for her adult daughter, Sam*, who lives with an intellectual disability and receives NDIS funded services. Meredith contacted the NDIS Quality and Safeguards Commission to report two incidents which occurred at the day program that Sam attends. Soon after reporting these concerns, Meredith received a letter from Sam’s service provider, advising that she would no longer be involved in discussions regarding Sam’s services unless she was appointed as legal guardian.
Meredith is Sam’s nominee for government systems, and supports her with decision making, but does not want to become her legal guardian to support Sam’s autonomy. Meredith found the letter threatening and has tried to seek advice from advocacy services, the NDIS Quality and Safeguards Commission and the NDIS, however she has not received a return call and is unsure whether she should remove Sam from the provider’s services, which she enjoys, or potentially continue the services which may be placing Sam at risk.
*Names changed for privacy
Engaging carers as a means to prevention The Commonwealth Carer Recognition Act 2010 stipulates that carers should be considered as partners in care, and their unique knowledge and experience recognised. The relationship between carers and the person they care for should also be recognised and respected, and carers should be treated with dignity and respect. Government and community services have an obligation under the Act to work collaboratively with carers as part of any investigation into an alleged abuse.
There should be strong justifications for excluding a carer from relevant conversations and decision making, where this is in the best interests of the alleged victim. Investigators and supporters should consider the impact of exclusion on carers. This includes an understanding that false or inadequately investigated accusations of abuse can have a significant impact on the accused, increasing carer stress and affecting the relationship that a carer has with the person they care for.
18 Ibid.
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Carers NSW also wishes to emphasise the need for a holistic and supportive approach to engaging with carers. Language should be carer-inclusive to maximise carer engagement and adequate support should be available to family members and carers who make a report. As important allies in identifying abuse in the home and community, carers also require safe and confidential avenues to raise concerns or complaints with regards to potential abuse and neglect, as well as safeguards that ensure there are no repercussions for reporting, including for the person with disability.
Safeguards
Access to adequate formal supports Carers NSW strongly advocates that access to adequate formal services, for both carers and the people they care for, act as a strong safeguard in reducing and preventing the risk of violence, abuse and neglect.
Carer identification and recognition
Identification of carers, as well as recognition of the important role they play, are key to reducing and preventing abuse and neglect of people with disability. Given the unique position of carers to witness abuse and neglect in institutional and community settings, building the capacity of carers to identify and respond to the abuse or neglect of people with disability will enable them to act more effectively as safeguards within the community.
Additionally, increased carer awareness and earlier identification of carers by service providers and public service agencies will enable them to be referred on for carer-focused support to promote optimal outcomes for carers and the persons they care for. Carers NSW recommends ongoing investment in campaigns and programs that aim to raise awareness of carers within the community to support improved carer identification in the community.
A robust, integrated, carer-inclusive disability service system
Access to adequate, appropriate and timely formal support for people with disability and their carers reduces the systemic over-reliance on carers, which can exacerbate the physical and psychological strain associated with providing high levels of informal care for extended periods. However, many people with disability and their carers are unable to access the support they need. Carers NSW believes that ensuring streamlined access to support across a range of complimentary, robust service systems, will likely reduce the unmet needs of people with disability and their carers and reducing potential strain on both members of the caring relationship. Furthermore, Carers NSW believes that ensuring formal supports are carer-inclusive and that carers themselves are well supported in their caring role will enable optimal outcomes for people with disability and their carers.
Carers NSW believes that there are currently a range of opportunities to improve and expand on existing service systems that will likely improve access to support for people with disability and their carers. This includes, but is not limited to:
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Ensuring that disability services and supports that meet the needs of all people with disability, including for those who are ineligible for the NDIS
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Improving integration between service systems, including improving integration between the NDIS and Carer Gateway, as well as the health, education and housing systems
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Increasing support with service navigation
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Ensuring equitable access to disability advocacy service
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Strengthening the NDIS market and disability care workforce by ongoing improvements to pricing arrangements and continued work to streamline regulation across the care and support sector
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Ensuring that carers are included in planning discussions with opportunities to consider the needs of carers to sustain informal caring arrangements
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Ensuring access to regular, ongoing planned respite for carers
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Increasing access to capacity building such as education and support for carers to support them to provide high quality care
Ongoing development and review of NDIS and Carer Gateway services provide ample opportunities to develop best-practice approaches to the above.
Supportive regulatory approaches Where violence, abuse, neglect or exploitation of a person with disability has occurred a punitive approach is often appropriate to enable justice for persons with disability and ensure redress is available. However, Carers NSW believes that proactive, supportive regulatory approaches that aim to reduce or prevent the prevalence of abuse or neglect in the community, especially where this may occur within complex family or caring relationships, should also be considered.
Access to mediation services Elder or family mediation has provided a valued and effective pathway for resolving potential conflict within families and supports optimal outcomes for people who are ageing and their carers. The
Relationships Australia NSW Let’s Talk Elder Support and Mediation Service19 has highlighted the
effectiveness of this supportive, nuanced approach in resolving family conflict that may be contributing to or may result in the abuse or neglect of someone who is ageing. However, currently Carers NSW is not aware of any family mediation services that are available to people with disability and their families in the context of abuse prevention and safeguarding.
Carers NSW believes that mediation services should be available more widely and beyond the ageing context alone to include other caring situations, such as for people with disability, their families and carers. Furthermore, Carers NSW believes that there should also be avenues for carers to access mediation services in their own right.
Education
Education and awareness raising is a key element of reducing the risk and prevalence of abuse and
neglect of people with disability in the community. Ongoing consultation with carers and key
stakeholders in NSW is providing new insights to Carers NSW about how preventative messaging can be more effectively disseminated to carers and service providers. Carers NSW recommends that this supportive and educative approach which focuses on communicating effectively with, and about, carers in the context of reported abuse and neglect continue, in consultation with carers themselves and the experts who work with them. This will likely raise carer awareness and capacity to identify or prevent abuse or neglect within the community. Additionally, ongoing monitoring and improvement of the data regarding abuse and neglect, and carers’ roles within these situations, will also be important additions to the national conversation about abuse prevention.
Supported decision making framework Many carers in NSW support the person that they care for to make decisions, however there are limited opportunities for carers to receive formal training or support with this. The 2022 National Carer Survey20
found that approximately 83% of NSW respondents provided support with decision making.
Furthermore, 90.4% provided support with cognitive tasks, 76.6% with organising finances, 74.1% with handling finances and 82.8% with coordinating support services. Additionally, 73.6% provided support
19 Relationships Australia NSW (not dated) Let’s Talk: Elder Support and Mediation Service, available online at: https://www.relationshipsnsw.org.au/support-services/lets-talk-elder-support-and-mediation-service/, viewed 04 November 2022. 2° Carers NSW (2022).
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with communication, 16.7% with interpreting, 73% with advocacy and 91.5% with administrative tasks, all of which can play a key role in making, executing and communicating decisions.
Additionally, while carers often support the person they care for to plan for the future, these discussions can be sensitive, confronting and challenging to navigate. Many carers express concerns about making future care decisions on behalf of the person they care for where they may experience a reduction in decision making capacity, wanting to make the ‘right’ decision that would align with their will and preference.
The Commonwealth Carer Recognition Act 2010 highlights the role of carers as partners in care who often are experts on the person they care for, and who should therefore be recognised and included in decision making processes, where appropriate. However, in some cases carers will need the skills or tools to effectively participate in these processes. Carers NSW has recently been working closely with
a number of experts in this area to identify opportunities to improve the understanding and
implementation of supported decision making for carers, as well as professionals and the disability and aged care sectors more broadly.
Carers NSW believes that supported decision making should be considered as an alternative to the appointment of formal guardians, optimising the rights and choices of people with cognitive impairment and minimising the need for tribunals and litigation. However, in order to take a supported decision making approach, community members, including carers and professionals, need to be able to better assess the level and types of support needed with decision making and implement best practice support with decision making.
In line with the Australian Law Reform Commission’s recommendation that state and territory legislation reflect National Decision-Making Principals,21 Carers NSW believes that there must be the development and implementation of a legislated supported decision making framework in NSW. This framework would aim to uphold the rights of people with disability in regards to decision making and provide clarity and guidance for carers, service providers and agencies in supporting people with disability to make decision.
Supporting high quality NDIS services and supports The NDIS Quality and Safeguards Commission plays an important role in the oversight and regulation of NDIS services and supports. However, Carers NSW understands that currently, there is no requirement or mechanisms for unregistered NDIS providers to make themselves known to the NDISQSC. As such, it is not possible for the NDISQSC to have any oversight of or direct communication with these providers.
While Carers NSW acknowledges that the process to become a Registered NDIS Provider is costly andadministratively burdensome, prohibiting some providers from taking this route, Carers. NSW believes that unregistered providers should still be required to identify themselves with the NDISQSC and provide minimum details about their service such as their contact details. At a minimum, this will enable the NDISQSC to provide unregistered providers with regular updates, offer support and promote resources or training that aims to improve the quality and safety of NDIS services and supports.
Furthermore, Carers NSW continues to advocate for improved alignment between quality and safety mechanisms across the care and support sector. While Carers NSW recognises the need for regulatory measures that are sensitive to the needs of different service user groups, including people with disability, with service providers and paid care workers increasingly working across multiple service
21 Australian Law Reform Commission (2014) Towards supported decision-making in Australia, available online at: alrc. gov .au/publication/equal ity-capacity-and-d isab ii ity-i n-commonwealth-laws-alrc-report-124/ 1-executive su mmary-2/towards-su pported-decis ion-making-in-austral ia/, viewed 15 December 2022.
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systems, consistency and clarity of regulatory measures across sectors is needed. This is likely to reduce confusion, enabling greater compliance and a higher level of quality and safety of care provided.
Conclusion
Carers NSW commends the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability on their ongoing work throughout the duration of the Royal Commission. Carers NSW appreciates the sensitivity of this subject area, particularly in raising carer views on the matter, but strongly advocates that the rights of people with disability and their carers can be upheld simultaneously in the process of preventing and responding to abuse.
Carers NSW believes that in order to effectively address violence, abuse, neglect and exploitation of people with disability, the Royal Commission must acknowledge and build on the important role of family and friend carers as safeguards and reporters of abuse. Carers NSW also recommends that the Royal Commission promote a sensitive and supportive approach to preventing and responding to abuse or neglect perpetrated by family and friend carers where appropriate, acknowledging the nuanced complexities within family and caring relationships.
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