Quality and Safeguarding Updates

Welcome to the latest edition of NDIS Quality and Safeguarding updates!

Changes to provider registration

The NDIS Commission has written to participants (via providers) to advise them of a change to the conditions of NDIS provider registration. From 19 December 2020, a registered NDIS provider of Assistance with Daily Personal Activities must take certain steps if a participant chooses to receive personal support from only one individual support worker, and no other, if they live alone.

These conditions remain a little unclear, but they can be briefly summarised as follows.

Risk Assessment

The Commission identifies the following as risk factors that must trigger a risk assessment:

The participant is not receiving, from any other NDIS provider, support or services that involve regular, face-to-face contact with the participant.
One or more of the following applies:
- The participant or the participant’s plan indicates that the participant has limited or no regular, face-to-face contact with relatives, friends, or other people with whom the participant is well-acquainted.
- Without the assistance of another person, the participant has limited or no physical mobility.
- The participant uses equipment to enable or facilitate their physical mobility.
- Without the assistance of another person, the participant has limited or no ability to communicate with others.
- The participant uses equipment to enable or facilitate communication with others, including to enable or facilitate the use of a phone or other device[1].

Service Agreement

In providing this support from a sole support worker, the provider must enter into a service agreement that identifies the following:

The assessment of the participant’s risk factors (including providing a copy to the participant and on their file).
The rights and obligations of the participant and the provider.
How the participant’s support worker will be selected, including the participant’s role in the selection.
A procedure to review the implementation of the agreement, which must include someone other than the support worker checking directly with the participant about their level of satisfaction with the type, quality, and frequency of personal support being provided.
How the provider will supervise and monitor the performance of the support worker (including visits to the participant’s home).
How the provider will communicate with the participant (including face-to-face communication) in their home.
How the provider will engage with other providers involved in providing support or services in the participant’s home or in supporting the participant to access community-based activities (although this point raises some questions for us about the definition of a sole support worker and who would be in scope).

Supervision and Monitoring

The provider must ensure that:

A documented plan exists for supervision of the support worker that is appropriate to the participant’s risk factors.
All the provider’s key personnel receive regular reports in relation to the care and skill with which personal support is being provided to the participant by the support worker, with the frequency of reports being appropriate to the participant’s risk factors.
Appropriate action is taken by the provider, without any unreasonable delay, to address any concerns identified in these reports.
An up-to-date record is kept of all participants to whom the provider ‘allows’ personal support to be provided by a sole support worker.

The Commission says it will be consulting shortly with people with disability, organisations that represent people with disability, service providers, and state and territory governments to put these new requirements into law. We await to hear how participants and providers will respond to these changes. Whether they will be received as welcome safeguards or further intrusion and red tape remains to be seen.

Participants have the right to ask to have this decision reviewed by someone else at the NDIS Commission and have three months from the date they receive the letter to ask for a review. An easy read version of the letter is also available.

A National Framework!

On 1 December 2020, Western Australia (WA) joined the rest of Australia in coming under the regulations of the NDIS Quality and Safeguards Commission (NDIS Commission), thereby making the NDIS Quality and Safeguarding Framework a national one. Details of the dedicated WA NDIS Commission can be found here, and the ‘Then and Now’ fact sheet should help understand some of the changes for WA. This document contains FAQs from the Commission’s provider registration sessions and from other channels. Further, this fact sheet outlines how the NDIS (Restrictive Practices and Behaviour Support) Rules 2018 apply to NDIS providers in WA who have transitioned to the Commission.

Wa’s Amended Restrictive Practice Policy

Amendments were recently made to the Authorisation of Restrictive Practices in Funded Disability Services Policy. This Policy now allows for a two-stage approach to the authorisation of restrictive practices.

Stage One (from 1 December 2020 to 30 April 2021) – authorisation requires restrictive practices to be included in a behaviour support plan tailored to the needs of an individual.
Stage Two (from 1 May 2021) – authorisation requires restrictive practices to be included in a behaviour support plan and involves a newly introduced mandatory Quality Assurance Panel which allows for an independent review of the behaviour support plan and the proposed restrictive practices.

The Department of Communities has advised that additional introductory sessions on the Policy are available for registered NDIS service providers. These sessions aim to increase providers’ understanding of restrictive practices, the amendments to the Policy, and how they will apply to funded disability services. More information on these sessions can be found on their website.

The Department of Communities will also provide workshops for WA Behaviour Support Practitioners to support the Quality Assurance Panel component of the Policy implementation. These workshops will be available from December 2020/January 2021. The Department has advised that more information will be available shortly around further support that will be provided to facilitate the implementation of the Policy.

Queries regarding the implementation of the Policy can be directed to [email protected]. Providers can download the policy, procedural guidelines, and quick reference guides from the Department’s website.

Restrictive practice guide

The NDIS Commission has published a regulated restrictive practice guide. The purpose of this guide is to:

promote the rights and inherent dignity of people with disability.
assist in identifying each regulated restrictive practice.
provide practice advice consistent with a positive behaviour support framework and with practice informed by contemporary evidence to reduce and eliminate the use of restrictive practices.
assist registered NDIS providers and NDIS behaviour support practitioners to meet their obligations under the NDIS Act 2013 and relevant Rules.

The Commission says that this guide has been developed for registered NDIS providers and NDIS behaviour support practitioners supporting NDIS participants. However, it may also be of interest to anyone who supports a person with disability. My colleague Therese Morgante has published a more thorough analysis here.

New NDIS practice alerts

The NDIS Commission has published the following new practice alerts:

Safeguard newsletter

The NDIS Commission has launched a quarterly newsletter for people with disability and their friends, families, advocates, and community. People can sign up to the newsletter here.

In the newsletter, the NDIS Commission has indicated that it has contracted the Australian Commission on Safety and Quality in Health Care (ACSQHC) to develop the following three Provider Practice Alerts:

Comprehensive health care assessments
Lifestyle risks
Dental health care

In early 2021, the NDIS Commission will seek feedback from participants on drafts of these alerts. Participants that want to be involved can e-mail [email protected], and they will be notified when these drafts are available. You can also sign up to the ACSQHC’s e-news to be alerted about these and other consultations.

The NDIS Commission is also producing new materials designed specifically for First Nations NDIS participants. The Commission has indicated that these resources are being developed with an Aboriginal-owned communications company in consultation with Aboriginal and Torres Strait Islander participants, workers, and carers, and they will include icons and graphics developed by an Aboriginal artist. These materials are said to outline the NDIS Commission’s role and how to raise complaints.

Queensland’s new worker screening system

On 4 December 2020, a new law was passed by the Queensland Parliament to implement nationally consistent worker screening for the NDIS in Queensland. This law also establishes a similar state-based system for disability workers outside the NDIS. Current screening requirements under the blue card and yellow card system will continue to apply until February 2021.The Bill will commence with a proclamation, meaning that the commencement date will be confirmed once it is formally approved. After the commencement, new employees of NDIS registered providers, including sole traders, will need to apply for a clearance at workerscreening.communities.qld.gov.au.

The Department has confirmed that existing yellow card holders will be able to continue working for registered NDIS providers until their card expires or is cancelled. To find out more about the upcoming changes, you can refer to this fact sheet.

Strengthening banning orders

The NDIS Amendment (Strengthening Banning Orders) Act 2020 is now in force. It empowers the NDIS Commission to ban unsuitable providers and workers from working with NDIS participants, regardless of whether they are active in the sector or not.

‘The NDIS Commissioner, who is responsible for regulating NDIS providers and enforcing the NDIS Code of Conduct, will be granted additional banning powers to prevent people who may pose a risk of harm to participants from entering or re-entering the NDIS,’ Mr Robert said.

‘This bill ensures that workers who have left the NDIS, including where they have been fired due to unsuitable behaviour, can be banned from re-entering the field’.

‘The amendments also mean the NDIS Commissioner can use information concerning a person’s conduct outside the NDIS, such as a person’s conduct in aged care or child care work, to ban an unsuitable person from entering the NDIS in the first place[2]’.

The NDIS Commission makes the details of providers and workers who have been banned publicly available in the NDIS Provider Register. Anyone can use the register to check whether a person or provider they intend to engage has a banning order against them.

New worker induction modules

The NDIS Commission has newly released New Worker - NDIS Induction Modules to support providers in inducting new staff who may be unfamiliar with the disability sector during the COVID-19 pandemic. The following eight online modules have been developed:

1. Disability awareness

2. Privacy and confidentiality

3. Safe workplace

4. NDIS Code of Conduct and Dignity of risk

5. Incident management

6. Know the person

7. Risk identification and management

8. Managing challenging situations

These learning modules form part of a suite of learning products that new disability workers may complete as part of their induction, including the Worker Orientation Module ‘Quality Safety and You’ and the Infection prevention and control for COVID-19 training.

The Commission iterates that this training is not designed to replace the organisation-specific training employers will provide to new workers to perform their duties, including organisational policies and procedures.

Tools to support providers with worker screening

MPS Law has developed some tools and templates designed to assist providers to understand and comply with their record-keeping requirements under the NDIS (Practice Standards – Worker Screening) Rules 2018. These can be downloaded from their website.

NSW Tool to Support Providers recognise and respond to restrictive practices

enAble RPA has been designed to empower and support the NSW disability sector to recognise and appropriately respond to restrictive practices. The Senior Practitioner, Disability in Victoria, developed the Restrictive Intervention Self-Evaluation Tool (RISET) to assist disability service providers to understand the use of restrictive practices. This tool aims to guide users through important information to help them understand when a restrictive practice could or has occurred. enAble RPA is a tailored version of the RISET tool that is adapted for NSW and is freely available to anyone.

Psychosocial Disability Q&S Webinars

The Mental Health Coordinating Council (MHCC) received grant funding from the Australian Government to deliver ten webinars and one national forum during 2019/2021 for organisations that provide services/support to people living with, or at risk of developing, psychosocial disability as well as their supporters. The project aims to create greater national awareness of the NDIS Practice Standards and Quality Indicators as they apply in the provision of psychosocial support services. These webinars can be viewed on their website.

Royal Commission update

The Royal Commission has released the Safeguards and Quality Issues Paper for people to share their views about how people with disability experience safeguards; what promotes quality in services; and how these may prevent and reduce their exposure to violence, abuse, neglect, and exploitation. The Royal Commission encourages responses from individuals and organisations by 1 February 2021. After this date, any comments about this Issues Paper can be made via the submission process. There are also currently Issues Papers for promoting inclusion and violence of people with disability at home.

Public hearing 9: Pathways and barriers to open employment for people with disability is in full swing this week in Brisbane. You can keep up to date with the proceedings here. This hearing is focussing on open employment, however the Royal Commission is also intending to consider segregated employment settings further in later hearings.

The next public hearing will be held on the 15th and 16th December 2020 and will focus on the training and education of health professionals, specifically in relation to treating people with cognitive disability.

You can subscribe to the Royal Commission ‘Connect’ newsletter here.

That concludes the NDIS Quality and Safeguarding updates for the year. We wish you and your families a safe and happy Christmas and look forward to navigating all things quality and safeguarding with you in 2021.

[1] https://www.ndiscommission.gov.au/sites/default/files/documents/2020-12/letter-participants-decision-change-conditions.pdf

[2] https://ministers.dss.gov.au/media-releases/6506