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Quality and Safeguarding June Update

Fresh from an amazing WTFH hosting gig, Jess is here with all that's been happening in Q&S land of late.

By Jessica Quilty

Updated 15 Apr 202420 Jun 2022

Let us help you get up to speed with the latest quality and safeguarding developments of the last quarter!

NDIS Quality and Safeguards Commission

New Website

The NDIS Commission has a new website (thank goodness) – and they are testing and requesting feedback. A co-design approach was used to develop, research, and user-test with a range of stakeholders, including people with disability and NDIS providers. So, log on, have a look around, and let them know what you think.

Registration Roundtable

Back in March, a Registration Roundtable was convened to gather insights into the NDIS Commission’s registration functions. Following the Roundtable, a short paper summarising the discussions, including key themes and next steps has been developed.

Some key insights include:

  • Registration should give NDIS participants the assurance that they will receive a safe, quality service.
  • Better information is needed for participants about registration, the Practice Standards that providers are assessed against, and how they can contribute to an assessment of a provider’s quality.
  • Participants who self- or plan manage must continue to be able to make decisions about who they access supports from, including unregistered providers. However, further discussion with participants about additional safeguarding mechanisms in these instances might be beneficial.
  • There is a need to reflect participants’ voices in how providers are assessed.
  • There should be minimum standards that apply to all providers in the market.
  • Some people thought all providers should be known to the Commission, although this was not universally agreed.

There was deeper discussion about the safeguarding elements of registration, proportionate and risk-based registration, and registration as an indicator of quality. You can read the full summary on the Commission’s website.

The Commissioner says she will continue to discuss registration matters with stakeholders, including with the Disability Sector and Industry Consultative Committees, in particular – further discussion on audits and auditing is required. The NDIS Commission will continue to test ideas with stakeholders as developments warrant.

Make it Known, Make it Better Resources

The NDIS Commission has produced a series of ‘Make it Known, Make it Better’ resources. The video and poster resources explore each element of the NDIS Code of Conduct (including how to complain) and were co-designed, tested with, and feature NDIS participants, their families, providers, and workers. Accessible versions are available in Auslan, 17 languages, and for First Nations peoples and LGBTQIA+ communities.

NDIS Commission Quarterly Reports

The NDIS Commission has now begun releasing quarterly activity reports. The latest report covers the Commission’s activities from 1 January to 31 March 2022. "This Activity Report is the first in our new quarterly reporting format, having previously released our reports in six month intervals. The NDIS Commission remains committed to ensuring these reports are valuable for all of our stakeholders, and in particular, that NDIS participants will find these reports useful," said Ms Tracy Mackey, NDIS Quality and Safeguards Commissioner.

You can view the above report and past reports on the NDIS Commission website.

Practice Alerts

The NDIS Commission has produced a number of new practice alerts which are now in place for

You can download the practice alerts on the Commission’s website. There are also accompanying worker resources and animations available.

Supporting Safe and Enjoyable Meals

NEW E-Learning Module

The NDIS Commission has released Supporting safe and enjoyable meals, a new e-learning module aimed at improving NDIS worker awareness and understanding of how to provide safe and enjoyable mealtime assistance to people with disability. A number of training modules and resources are available to support registered NDIS provider compliance with the NDIS Practice Standard for Mealtime Management.

Masterclass Resources

In March 2022, the NDIS Commission, in partnership with the Speech Pathology program at the University of Technology Sydney, presented a masterclass, Co-creating safe and enjoyable meals in disability services: Pathways to implementation strategies. You can download the course materials on the Commission’s website.

Notice of Advice from the Victorian Disability Services Commissioner

A letter was sent to Victorian registered disability service providers by the state’s Disability Services Commissioner on 21 March 2022. The letter urged providers to be proactive in recording and monitoring the type and texture of food provided when supporting people who have swallowing difficulties and associated mealtime requirements. The Commissioner considers that this single practice change has the potential to significantly improve the quality of service provision and increase the health, safety, and wellbeing of individuals with dysphagia or swallowing difficulties. Read the full letter and advice here.

More Training and Resources

In addition to the above there are loads more training and resources available on this important safety area at https://enjoysafemeals.com/.

Behaviour Support and Restrictive Practices

NDIS Restrictive Practice Safe Transportation Guide

The NDIS Commission has released a guide to safe transportation of participants and how this relates to the use of regulated restrictive practices. The guide intends to help

  • promote the rights and inherent dignity of people with disability
  • identify the use of regulated restrictive practice during transportation
  • highlight the special considerations and safeguards relevant to the use of safe transportation
  • provide practice advice consistent with a positive behaviour support framework and contemporary evidence informed practice, intended to reduce and eliminate the use of restrictive practices, and
  • registered NDIS providers and NDIS behaviour support practitioners meet their obligations under the National Disability Insurance Scheme Act 2013 (NDIS Act 2013) and relevant Rules.

Joint Statement of Psychotropic Medications

The Aged Care Quality and Safety Commission, the NDIS Commission, and the Australian Commission on Safety and Quality in Health Care put out a joint statement about the inappropriate use of psychotropic medicines among people with disability and older people and a commitment to take collaborative action to reduce it. A video about the inappropriate use of psychotropic medicines is also available.

South Australia: Restrictive Practice Authorisation

The legislation for the South Australian Restrictive Practices Authorisation scheme came into force on 30 May 2022. This legislation is designed to strengthen safeguards for people with disability, and the use of restrictive practices must be authorised under this legislation or another act.

The scheme is administered by the Restrictive Practices Unit, which is part of the Department of Human Services. To find out more, visit the restrictive practices website.

Resources have been developed to support NDIS service providers to understand and comply with the requirements of the Restrictive Practices Authorisation scheme, and help authorised program officers (APOs) when making decisions about regulated restrictive practices.

Victoria: Physical Restraint Directions

The Victorian Senior Practitioner's Directions and Prohibitions provide guidelines and standards for the use of physical restraint which must be complied with by registered NDIS providers as part of Victoria’s authorisation process. Read the full direction on the state website.

Registration Resources

Inclusion Australia – Service for One

Under the NDIS rules, certain providers need to be registered with the NDIS Commission, such as when supports involve the use of restrictive practices. This also applies when participants and families are self-employing their staff. With funding from the NDIS Commission, a host of resources have been developed by Inclusion Australia and VALID, with input from families of people with complex support needs, to help navigate this process. These resources can help participants and families decide if they are running a Service for One and need to register as an NDIS provider. If they do need to register, these resources can also help understand what’s involved and prepare for NDIS registration.

Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (Disability Royal Commission)

Public hearing 23

Public hearing 23 focused on the experiences of people with disability (and their families) who received services from the NDIS registered service provider Australian Foundation for Disability (Afford). It also examined Afford’s structure, governance, policies, and processes and how they may have affected the safety and quality of services provided to people with disability. It also attempted to identify broader systemic issues exemplified by this case study.

Evidence was presented at the hearing on the following matters:

  • The services provided by Afford, with a particular focus on day programs and the experiences of people who participated in one of Afford’s day programs in western Sydney between 2018 and 2021.
  • Afford’s response to the abuse by a support worker of several people participating in its day program in western Sydney in 2019.
  • Measures taken by Afford to prevent and respond to the abuse of people with disability participating in their day programs.
  • Afford’s governance, management, and staffing arrangements and how they affected the quality and safety of services provided.
  • Afford’s systems and training in abuse and neglect prevention, recording, reporting, and responding.
  • How day program services were paid through participants’ NDIS plans.
  • Recent organisational and governance changes made by Afford to prevent and respond to violence, abuse, neglect, and exploitation
  • The external oversight and regulation by the NDIS Commission and/or the NDIA.

 

You can read the full transcript or watch the public hearing on the Royal Commission’s website.

 

Report Released – Public Hearing 14

The Disability Royal Commission has released its report, ‘Preventing and responding to violence, abuse, neglect and exploitation in disability services (South Australia)’, which considers the evidence given by witnesses during Public Hearing 14.

The report examines the South Australian (SA) and Australian governments’ responses to the reports of two inquires (the Robertson and Safeguarding Reports) into the death of Ms Ann-Marie Smith.

The key issues identified in the public hearing 14 report include:

  • risk management
    • whether a person should be designated with overall responsibility for NDIS participants at heightened risk of harm
    • NDIS participants living alone and sole carers
    • potential for conflict of interest
  • information sharing between the state of South Australia, the NDIA and the NDIS Commission

 

The responses of the SA Department of Human Services (DHS), NDIS Commission and NDIA to the recommendations made by the two inquiries are also addressed.

The report also covers two case studies involving two residents of supported disability accommodation operated by DHS and makes nine findings in relation to DHS.

The report concludes by identifying the following areas for further investigation:

  • factors that identify a person with disability as being at higher risk of violence, abuse, neglect and exploitation
  • person-centred approach to service delivery
  • improved communication between service providers, regulators, people with disability and their families
  • quality of services
  • community visitor schemes
  • providers of last resort

 

Royal Commission Schedule

The schedule for the Royal Commission for the rest of the year is as follows (subject to change). 

June 2022

  • 6 – 10 June: Public hearing 24, Canberra – The experience of children and young people with disability in different education settings

July 2022

  • 11 – 15 July: Public hearing 25, Alice Springs – The operation of the NDIS for First Nations people with disability in remote and very remote communities

August 2022

  • 29 August – 2 September: Public hearing 26, Parramatta – Homelessness, including experience in boarding houses, hostels and other arrangements

September 2022

  • 19 – 23 September: Public hearing 27, Perth – Police responses and conditions in detention

October 2022

  • 10 – 14 October: Public hearing 28, Brisbane – Violence against, abuse, neglect and exploitation of people with disability in public places
  • 24 – 28 October: Public hearing 29, Melbourne – The experiences of violence against, abuse, neglect and exploitation of people with disability from culturally and linguistically diverse communities

November 2022

  • 21 – 25 November: Public hearing 30, Homebush – Guardianship, substituted and supported decision making

December 2022

  • 5 – 9 December: Public hearing 31, Brisbane – Service providers
  • 12 – 16 December: Public hearing 32, Brisbane – Vision for an inclusive Australia

 

Authors

Jessica Quilty

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