Submission to Joint Standing

Committee on the NDIS

The NDIS Quality and Safeguards Commission

(July 2020)

Enquiries regarding this submission can be directed to:

Debra Parnell Manager, Policy and Advocacy
MaryAnn Lindsay AASW Policy Advisor

The Australian Association of Social Workers (AASW) is the professional body representing more than 12,000 social workers throughout Australia. We set the benchmark for professional education and practice in social work, and advocate on matters of human rights, discrimination, and matters that influence people’s quality of life.

Social work is a tertiary qualified profession recognised internationally that pursues social justice and human rights. Social workers aim to enhance the quality of life of every member of society and empower them to develop their full potential. Principles of social justice, human rights, collective responsibility and respect for diversity are central to the profession, and are underpinned by theories of social work, social sciences, humanities and Indigenous knowledges. Professional social workers consider the relationship between biological, psychological, social and cultural factors and how they influence a person’s health, wellbeing and development. Social workers work with individuals, families, groups and communities. They maintain a dual focus on improving human wellbeing; and identifying and addressing any external issues (known as systemic or structural issues) that detract from wellbeing, such as inequality, injustice and discrimination.

Social workers are present throughout the NDIS in a variety of roles, working as individuals or in organisations. Many of our members have made, or are making, the transition to being registered providers of early childhood intervention or therapeutic services. Many have extensive experience in assessment, planning and case management with people living with multi-facetted disabilities and are providing support co-ordination or specialist support co-ordination. Social workers are also working in other roles within the NDIS including service development, planning, local area coordinators, supervisors and service co-ordinators

Social workers are well placed to consider and respond to this inquiry and the AASW welcomes the opportunity to contribute to this inquiry

Our submission

The Australian Association of Social Workers (AASW) supports the NDIS (National Disability Insurance Scheme) as a rights-based approach that promotes the independence and the social and economic participation of people with a permanent impairment or condition. The values of ‘choice and control’ that underpin the Scheme are consistent with the values and principles of self-determination and empowerment that have guided the social work profession for many decades.

We consider that individual and societal wellbeing is underpinned by socially inclusive communities that emphasise principles of social justice and respect for human dignity and human rights. These values are in complete accord with the disability advocacy movement and the United Nations Convention on the Rights of Persons with Disabilities, which both inform the NDIS.

Social workers recognise that people can only be understood within the social and community context in which they find themselves, and so they ensure they build a complete picture of the internal and external elements of a person’s life situation. Guided by their value base of self-determination and recognition of people’s strengths, social workers collaborate with people to plan the services that will help empower them to full economic and social inclusion1.

 1.  The monitoring, investigation, and enforcement powers of the Commission and how those powers are exercised in practice.

While the NDIS Quality and Safeguarding Commission monitors and investigates providers, members report that they have seen little evidence of enforcement in this area. There is a concern that quality of care can be compromised in the pursuit of profit and that complaint mechanisms need to be more accessible for NDIS workers and participants to ensure that they are empowered to make complaints.

In cases of fraud where participants are persuaded to sign blank timesheets for services that are not being received, these need thorough investigation and enforced to the full extent of the law. Further,enforcement actions such as banning orders, revoking and suspension of registration and the proposed strengthening of enforcement powers of the commission for the most serious cases welcomed. It is important that the NDIS Quality and Safeguards Commission makes the details ofproviders and workers who have been banned publicly available in the NDIS Provider Register.

People with disability, their supporters and providers can use the Register to check that the peoplethey are engaging to deliver NDIS services have not had a banning order against them2. It is crucial

1 Australian Association of Social Workers 2015. “The Scope of Social Work Practice: Psychosocial Assessments ” AustralianAssociation of Social Workers. December. Accessed April 18, 2019. https://www.aasw.asn.au/practitioner-resources/the-scope-of-social-work-practice;) 2 https://ministers.dss.gov.au/media-releases/5876

The adequacy and effectiveness of provider registration and worker screening arrangements

Including the level of transparency and public access to information regarding the decisions and actions taken by the Commission.

In general, provider registration and worker screening arrangements are more effective where the workers are employed directly by the provider and therefore can be held accountable. Social workers have observed that subcontracting severely undermines the legitimacy of provider registration and the quality of work that registration promises to deliver. As the case of Ann-Marie Smith demonstrated, more tiers of subcontracting result in less oversight. Members also report that an over reliance on agency staff, particularly with supported Independent Living (SIL) providers, there is a lack of training and suitability of certain employees to disability support work. More stringent mechanisms are required to ensure proper experience and qualifications of staff and providers working in this space.

behaviour support

To undertake the roles available to social workers, providers are required to be a member of the AASW. This creates the following mechanisms which underpin the quality of the work they undertake with participants and the safety of participants:

they have graduated with a social work qualifying degree accredited by the AASW
they observe the AASW Code of Ethics and its values of Respect for Persons, Social Justice and Professional Excellence, including ongoing professional development
they are subject to the complaints procedures for all members.

Difficulties with the registration process

As members have registered to become providers, the AASW has observed difficulties in the

registration process. Since the initial introduction of the NDIS, the requirements to register as a

provider have been extended, and have tightened, so that Members find the re-registering process

more onerous than their initial registration.

Although members appreciate the need to establish policies and procedures that apply to conducting a practice as an independent provider, the AASW is concerned by the auditing requirements. The AASW has been informed of wide variability in the prices that members are quoted for these audits of the projected costs inevitably leads to doubts as to the basis on which the rate for the audit was set. Additionally, the financial burden particularly around the re-registration and accreditation process for Behaviour Support has emerged as a disincentive for professionals to register as providers ofBehaviour Support services.

The difficulties in registering as a provider have been compounded by the disparities between the requirements in different states, as the implementation of the NDIS unfolds. The AASW has noticed wide variations in the requirements within states; and social workers have contacted the AASW pointing out that the information provided on registering for some services does not include their state, and they have been unable to receive a definitive answer when they contacted the NDIA directly.

Support co-ordination, social work and registration

Social workers are listed as one of the professional groups who can register to provide support co- coordination services. Both the support coordination and specialist support coordination roles in the NDIS fall within the existing capabilities of social workers because the planning and coordination of care has long been a skill in which social workers specialise. Indeed, the knowledge and competencies that qualify people for this role is a foundational element in the social work qualification and is key element in the accreditation of social work (qualifying) regime.$3$

The AASW endorses the quality and safety assurance measures that have been introduced into the NDIS; and the requirement that service providers be registered. Nevertheless, the current $3 Australian Association of Social Workers, 2017 Australian Social Work Education and Accreditation Standards

registration requirements for providers of support co-ordination services is contributing to the current

gap between the supports that people need and the services they receive. This is because the

process and costs to register are creating an unnecessary obstacle for qualified professionals who

already have the necessary expertise for conducting this work.

Although the AASW agrees that it is appropriate that social workers fill this role, the AASW submits

that in the case of support co-ordination and Specialist Support co-ordination, members of the

AASW should not be required to complete the added registration requirements imposed by the

NDIS. Members of the AASW have already had their qualification assessed as to whether they can

competently undertake this work, have agreed to abide by the AASW Code of Ethics and have

committed to maintain their level of competence.

 5.  The human and financial resources available to the Commission, and whether these
   resources are adequate for the Commission to properly execute its functions.

For providers to be held accountable for meeting the standards outlined in the NDIS practice

standards and Code of Conduct, the Commission needs to be adequately resourced. Fraud is an

issue of concern raised by AASW members. In addition to major fraud cases that attract public

attention, there are unethical financial practices, whether intentional or not, that require focus and a

commitment from the Commission to address. This may include holding the NDIA to account in their

activities in educating providers adequately.

Conclusion

As members have commenced providing services and dealing with participants, they have noticed variability in the quality of other services provided to participants. Some have approached the AASW with their concerns which have included concerns at the quality of an initial plan, the quality of services provided under the plan and the quality of the support co-ordination across the plan.

Therefore, the AASW endorses the creation of the Quality and Safeguarding Commission. We will continue to support its work to ensure that participants receive optimal level of service towards attaining the best possible outcomes.

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