AnglicareSA
Together we change lives.
31 July 2020
Hon Kevin Andrews MP Chair Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100 Parliament House Canberra ACT 2600
Dear Chair and Committee Members,
RE: New Inquiry into the NDIS Quality and Safeguards Commission
Thank you for inviting AnglicareSA to provide a written response to the Joint Standing Committee on the National Disability Insurance Scheme (NDIS), inquiring into and reporting on the implementation, performance and governance of the NDIS.
AnglicareSA supports approximately 65,000 South Australians annually, and provides NDIS funded individualised, group and supported accommodation services to over 1,200 children, young people and adults living with a disability.
In consideration of the terms of reference for this Committee’s inquiry, the following addresses areas of operations of the NDIS Quality and Safeguards Commission, following the Commission’s commencement of operation on 1 July 2018.
a. With regards to the monitoring, investigation and enforcement powers available to the
Commission, and how those powers are exercised in practice; AnglicareSA strongly supports
the intent and purpose of NDIS Quality and Safeguards Commission and its focus on
behaviour support and NDIS participants’ rights. It could be questioned whether the
administrative burdens placed on providers through the Commission’s processes result in a
commensurate increase in safeguarding of people with a disability, particularly in relation to
the reporting of applications of restrictive practices (frequency and extent) and repetitive
detail required in behaviour support plans and incident reports. Greater emphasis needs to
be placed on proactive monitoring of provider performance, such as that once provided by
the ‘Community Visitors Scheme’, a State Government initiative which could inform the
monitoring and enforcement powers of the Commission. Such an initiative would also need
to extend to the compulsory engagement of non-registered NDIS providers, such as many
Supported Residential Facilities. This is of critical importance given the extensive
accreditation process for registered providers through external auditors, which is not
undertaken by non-registered providers. This risk to the wellbeing of people with a disability
might be best addressed by complementary State and Territory legislation to facilitate
coordinated approaches to safeguarding.
b.
The effectiveness of the Commission in responding to concerns, complaints and reportable incidents has been excellent. AnglicareSA staff consider theBehaviour Support Team to be approachable and helpful with their communication and guidance when it is needed. The level of responsiveness to phone call and emails has significantly improved since first dealing with theCommission. The advice provided is timely and relevant to the incident at hand.
Some concerns have been raised regarding the Commission’s responses to AnglicareSA staff who have made reports regarding concerns perceived about activities of other providers. For example, where staff are concerned that providers are not enabling customer choice regarding use of theirNDISPlans. The Commissionhave regularly advised that thecustomer (or their nominee) must raise the concern, rather thanAnglicareSA, due topotential conflict of interest. However,customers have also provided feedback that they are often not comfortable raising concerns against their current provider, as they feel it may impact ontheir accommodation or support.Allowingotherproviders toraiseconcernswouldalleviatethisissueforsomenon-DisparticipantsandwouldresultinagreaternumberofcareconcernsbeingbroughttotheattentionoftheCommissionandresolvedmorepromptly.
e.Theeffectivenessofcommunicationandenagementbetween-theCommission-andstateandterritoryauthoritiescouldbeimproved-in-SouthAustralia.It-is-AnglicaresA’sunderstandingthat-other-states-have-a-seniorpractitionerwho-can-act-as-anadvocate-and-liason-between-the-Commission-and-thesection-assisting-in-the-development-of-any-guidancematerialsandbestpracticeresources-that-may-be-useful-insupportingevidence-basedapproachestoservicedelivery.Ityould-beyerybeneficial-tothesectioniftheCommission-would-implementasimilarapproach-inSouthAustralia.
AnglicareSawasalsoadvised-more-extensiv eguidance-onchemicalrestraintsasa-restrictive-practicewoul d bemadeavailable inDecember2019.To-date,thisinformationhasnotbeenreleased anditisfeltthatt hisisthetype of informationreceivedfrom the Commissionwhich would improve customer experience and provider responses on the use of restrictive practices. Ensuring consistent information is received from the Commission is imperative as it has been inconsistent in the past (often through individualised consultation processes given via phone contact) and this has been confusing for providers.
f.Regardingthehumanandfinancialresource s available to the Commission, and whether these resources are adequate for the Commission to properly execute its functions; AnglicareSA recommends that greater consideration be given to themonitoringofserviceprovidereffectivenessthroughanincreasedfocusonserviceeffectivenessasm easureofs er vicequality.Ifreport ingwereextendedtoevaluatecustomerexperienceandcustomero utcomes,w ith aparticular focusongoal attainment, thisy ouldelevatethe benefits of theNDISas a consumer driven scheme that still achieved necessary safeguarding.
h.Inrelationt o any other matters,ithasbe enraisedbystaffthat-the-ND ISQuality-and-SafeguardsCommissionPortaliscomplextonavigateandcancreatebarrierstocomplianceefficiency.For example,the capacity-to-view-BehaviourSupportPlansindraftformatbeforeprovidingapprovalwasrecentlyremoved,servic eoutletsareunavailableforselectionwhen
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developing plans and there is an inability to upload documents for evidence purposes. In addition, minor edits to a customer’s existing Behaviour Support Plan, such as a change of Guardian, cannot be made and instead a completely new Plan must be re-written and submitted. This wastes resources and causes unnecessary delays.
AnglicareSA has also encountered delays when seeking compliance withBehaviour Support Plans and the use of restrictive practices. This has included issues associated with a lack of funding available in customers’ NDIS Plans for Behaviour Support, delays in seeking changes to NDIS Plans to have this funding included, and waitlists associated with Behaviour Support practitioners. In addition, delays have also been experienced when applying to South Australian Civil and Administrative Tribunal (SACAT) Ordered Power of Attorney (OPA) for permissions required in association with Behaviour Support Plans. An example of this has been the need to gain OPA permission to use Environmental Restrictive Practice when locking away sharp knives. Due to SACAT hearings being delayed or held prior to the NDIS Plan being approved, delays in approvals for Behaviour Support Plans have also occurred. Further, the OPA have advised that they are not always willing to consent to Restrictive Practices relating to issues such as finances as this is “out of their jurisdiction”.
AnglicareSA therefore recommends greater engagement by the Commission with the NDIA regarding access for customer support funding and with other key stakeholders including the SACAT and GP’s to ensure they are informed on Commission expectations and improve responsiveness accordingly.
AnglicareSA again thanks the Joint Standing Committee on the National Disability Insurance Scheme for this opportunity to inform change and progress growth so that we can continue to achieve a real difference in the sector for our customers.
Yours sincerely,
Peter Sandeman Chief Executive Officer