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Quality and Safeguarding Updates

Get up to date with the latest quality and safeguarding developments here!

By Jessica Quilty

Updated 15 Apr 20243 Mar 2020

The NDIS (Approved Quality Auditors Scheme) Guidelines 2018 have been amended to reflect the changes recently made to the NDIS (Provider Registration and Practice Standards) Rules 2018. To keep things simple we have updated this article that deciphers the audit guidelines for providers. Some notable changes include:

  • A general alignment between the revised Registration Rules and the Audit Guidelines.
  • The reduction in frequency of surveillance auditing (now known as mid-term), from annual to 18 monthly.
  • What auditors will be reviewing at the mid-term audit, including which standards.
  • There is a new clause that in conducting a verification and certification audit, auditors should have regard to the verification module guidelines. This document states that it applies to providers undergoing the verification pathway so we were a bit confused. The Commission has clarified that this document will also be relevant to the stage 1 component of a certification audit (where they gather evidence of qualifications, experience, appropriate systems and processes). So we just take this to mean that an auditor will have regard to this document in relation to their Stage 1 credentialing etc. We think.

Review of causes and contributors to deaths of people with disability

The NDIS Commission commissioned Professor Julian Trollor of the Department of Developmental Disability Neuropsychiatry University of NSW to undertake a major research project to obtain an Australia-wide perspective on the prevalence and factors contributing to, the deaths of people with disability. This report is the first of its kind to provide a national baseline picture of death trends and related factors. The report details findings from the death reviews of 901 people between 2007 - 2018 in VIC, QLD and NSW. A word of warning this information whilst important, could be distressing for some readers.

Of the 901 people included in the report that died:

  • The median age of death was substantially lower than that of the general Australian population (by 20-36 years).
  • Deaths of men were overrepresented across jurisdictions.
  • The overwhelming majority of in-scope deaths involved people with intellectual disability.

Risks and vulnerabilities identified:

  • High levels of co-occurring mental health concerns including depression, self-harm and anxiety.
  • Multiple physical health problems in addition to disability including dental problems, epilepsy, constipation, urinary incontinence and Gastro Oesophageal Reflux Disease (GORD).
  • Swallowing and mealtime support, including dental issues and swallowing problems related to GORD, medications and disease processes.
  • Mobility and/or communication support, whether a communication plan was in place was often unknown or not reported in samples.
  • High Rates of polypharmacy, psychotropic medications were commonly prescribed, often in the absence of a diagnosed mental illness.
  • Vaccination status for influenza and pneumonia.
  • Lack of comprehensive health assessment in a significant minority (as well as failure to adequately follow up on health risks identified in some cases).
  • Weight, exercise and other lifestyle risks, where reported, it appeared that over half of people who died were outside of a healthy weight range.

Causes of death:

  • The majority of deaths were ‘unexpected’ (59%-71%).
  • The majority of deaths  were attributed to 'natural' causes (i.e. illness and disease) (88%-93%).
  • QLD was the only state to analyse cause of deaths based on whether they were potentially 'avoidable', 'treatable' or 'preventable': They found that over half of all deaths reviewed (53%) were due to potentially treatable or avoidable causes.
  • Unnatural or external causes of death accounted for 5% to 8% of all deaths investigatedwith the vast majority of these deaths related to accidental choking.

Source: Summary of key findings: Scoping review of causes and contributors to deaths of people with disability in Australia

To find the full report, recommendations and response from the NDIS Commission, the following documents have been published on the Commission’s Website:

Findings:

Salomon, C & Trollor, J (2019). Findings: Scoping review of causes and contributors to deaths of people with disability in Australia (2013-2019).

Summary of key findings: Scoping review of causes and contributors to deaths of people with disability in Australia

Recommendations:

Summary of recommendations: Scoping review of causes and contributors to deaths of people with disability in Australia

The Commission’s Response:

Research: Causes and contributors to deaths of people with disability in Australia – NDIS Commission’s response to recommendations

Easy Read:

Report on the causes and contributors to deaths of people with disability in Australia

NDIS Commission annual report

The NDIS Commission has produced an easy read summary of it’s first Annual Report. If you missed the full report you can catch up here.

NDIS Commission updates

A February Newsletter has been sent out to registered providers that includes:

  • Information about the Scoping review: Causes and contributors to deaths of people with disability in Australia (as discussed above)
  • Information about respecting the privacy of NDIS participants
  • Provider registration rule changes
  • Registration, audits and the NDIS Practice Standards including links to Commission resources to assist providers in meeting registration requirements
  • A summary of the projects that have been grant funded by the NDIS Commission to help providers with their quality and safeguarding responsibilities
  • Provider information sessions coming up in WA
  • NDIS Workforce Capability Framework update
  • Reportable incident final reports in the NDIS Commission Portal 
  • A fact sheet on the Commission’s powers to investigate
  • Q&A on Complaints Management.

NSW RPA updates

The Department of Communities and Justice NSW RPA Portal has produced this case study animation to help providers understand and identify chemical restraint. The RPA also has a monthly newsletter you can subscribe to here.

Catch you next month!

Authors

Jessica Quilty

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