Quality and Safeguarding Updates

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

NDIS Commission second annual report

The NDIS Commission has published its second annual report for the 2019-2020 financial year. There were 17,253 registered NDIS providers as at 30 June 2020. Of those, 9,144 were ‘active providers’ meaning they had made a claim for an NDIS payment in the last three months. 5,803 audits were conducted during this period.

The most popular three registration groups remain unchanged from last year, Therapeutic Supports, Household Tasks and Assistance with Travel / Transport Arrangements. The fourth and fifth most popular registration groups in the last annual report were Early Intervention Supports for Early Childhood and Assistive Products for Personal Care and Safety. These have been replaced in this period by Innovative Community Participation and Participate in Community, Social and Civic Activities. Interestingly, the top four registration groups only require a verification audit.

2018/2019 – Annual Report

2019/2020 – Annual Report

The NDIS Commission highlights the key matters it faced in 2019-20 including its response to:

The Black Summer bushfires
COVID-19
Transitioning ACT, VIC, QLD, NT and TAS
Disability Royal Commission and Aged Care Royal Commission
The death of Ann Marie Smith

The legislative and regulatory changes introduced included:

Changes to the rules under the NDIS Act to address disproportionate regulatory impact on smaller businesses delivering lower risk supports. The changes included removing the requirement for all body corporates to undergo a certification audit irrespective of the types of supports being provided.
Changes to the certification cycle, reducing the annual surveillance audit to an 18month mid-term audit.
The Australian Government announced the powers of the NDIS Quality and Safeguards Commissioner will be expanded to ban unsuitable providers and workers from working with NDIS participants, regardless of whether they are active in the sector or not. During this reporting period the Strengthening Banning Orders Bill had been introduced but not yet passed by the Parliament at the time of the report.

In the 2019-20 financial year there was a staggering 311,040 reportable incidents, over 97% of which were the use of unauthorised restrictive practice. This was reported by 492 providers and impacted 4,327 participants. 96% of reports of unauthorised use of restrictive practice related to chemical or environmental restraint, with each use of the restraint required to be reported. The Commission stating that the volume of reports on the unauthorised use of restrictive practices increased month-on-month due to increased provider reporting and the introduction of streamlined reporting mechanisms in October 2019.

In 2019-20, 2,264 additional behaviour support practitioners were considered provisionally

suitable across all participating states and territories and 6,003 behaviour support plans were lodged with the NDIS Commission in this time. The behaviour support team completed an audit of 100 randomly selected behaviour support plans to provide insight into the extent to which they may require development.

In relation to COVID-19, the Commission received 166 complaints, 837 contacts and 1,297 notifications of changes to support. There is plenty more information and detail in the report which can be viewed on the Commission’s website.

NDIS Commission second activity report

The NDIS Commission has published its second annual activity report that includes its first year of operation in VIC, QLD, TAS, NT and the ACT. The activity report covers the period from 1 July 2019 to 30 June 2020.

The NDIS Commission has a two-stage compliance action underway, targeting all providers who have used an unauthorised restrictive practice. The first phase targeted providers in NSW and SA. The second phase was said to commence in October 2020, targeting providers in VIC, QLD, TAS, the NT and the ACT. See the media release for more detail.

The compliance activity requires providers to provide information about all the unauthorised restrictive practices notified in 2019-20 and demonstrate compliance with regulatory requirements in relation to a number of those. The preliminary results for NSW and SA for the first part of the compliance activity for around 120,000 unauthorised restrictive practices was as follows:

The second part of the compliance activity requires providers to demonstrate compliance with key regulatory requirements for the 53% of unauthorised restrictive practices that should have authorisation and a behaviour support plan. Providers were required to demonstrate compliance by 30 September 2020. The NDIS Commission will analyse providers’ responses and determine if further compliance action is warranted in particular cases.

The NDIS Commission also providers information on other compliance activities. In the 2019-20 period there were:

17 Banning orders
3 Registrations revoked
4 Registration suspensions
3 Registration refusals
1 Infringement notice
2 Compliance notices
168 Investigations underway
365 Corrective compliance activities undertaken
2,466 Providers subject to compliance activity

The Commission was notified of 98 participant and 176 workers who tested positive for COVID-19. Sadly, eight participants and one worker passed away.

You can read the full activity report on the Commission’s website.

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

The NDIS Commission engaged Professor Julian Trollor to undertake research to review the causes and contributors to deaths of people with disability, and to identify population mortality trends and risks concerning the deaths of people with disability. The NDIS Commission has provided a response to the recommendations here.

The Commission has referred to a number of actions to be taken including:
A number of 'practice alerts'
Targeted projects and training
e-learning module targeted at workers who are involved in mealtime management to improve their understanding of dysphagia and risks in relation to respiratory conditions and aspiration.
Practice guide on reducing chemical restraints
Information sharing with auditors
Develop an explicit practice standard to address mealtime supports

2020 report: mortality patterns among people using disability support services in Australia

In 2019 the NDIS Commission engaged the Australian Institute of Health and Welfare (AIHW) to provide a report about the rates of death among people with disability and the causes of those deaths. The best available data was for people who had used disability services in Australia between 2013 and 2018. This was linked to Medicare records and a national register of deaths. The findings from the research include:

Compared with the general population, people using disability support services had higher rates of mortality
Leading causes of death varied across the study group.
People with disability had higher rates of potentially avoidable deaths
The rate of death varied by type of disability
The rate of potentially avoidable deaths varied by type of disability
The rate of death varied by type of disability service

You can find a summary of the above findings on the NDIS Commission’s website or the full report on the AIHW website. An Easy Read: 2020 Report - Mortality patterns among people using disability support services in Australia has also been released.

Royal Commission into violence, abuse, neglect and exploitation of people with disability

They Royal Commission has released its interim report. This report is based on the Royal Commission’s work from 5 April 2019 to 31 July 2020. It draws on what the Commission has heard so far from people with disability and their families and supporters, as well as many organisations, our First Nations Peoples Strategic Advisory Group and other experts who have provided their insights.

The Royal Commission held its sixth public hearing in September which examined the use of psychotropic medication to address behaviours of concern. Numerous documents and statements were supplied as evidence to the Royal Commission including some new draft NDIS Commission documents. Examples include a restrictive practice guide for chemical restraint, a restrictive practice guide for working with children and young people, principles for nationally consistent authorisation and a roadmap to a nationally consistent restrictive practice regime. Many of these are still draft and in consultation but if you are interested,the exhibits and the transcripts are available on the Royal Commission’s website.

The Public Hearing Reports for the experience of living in a group home for people with disability and healthcare for people with cognitive disability have also been released.

Upcoming public hearings include:

Week of 23 November: Public hearing – The experiences of First Nations people with disability and their families in contact with child protection systems
Week of 7 December (5 days): Public hearing - Pathways and barriers to open employment for people with disability
Week of 14 December (1-2 days): Public hearing - Health care professionals – education and training.

NDIS Commission complaints and feedback policy

The NDIS Commission has uploaded its own Complaints and Feedback Policy including an easy read version. The policy confirms the right of anyone – including participants, carers, advocates, providers, disability workers and members of the public – to provide feedback to the NDIS Commission and have any dissatisfaction with the NDIS Commission dealt with fairly. It explains how people may inform them of their feedback, and it guides staff in handling any compliments, suggestions or concerns made to them about any aspect of their performance, policies, processes and staff behaviour.

The NDIS Commission has also put out another new brochure about how they deal with complaints.

NDIS Commission reportable incident videos

The NDIS Commission has released a number of videos in relation to incident management and reportable incidents:

Fair Work reminder

The NDIS Commission recently put out some correspondence in relation to Fair Work obligations. The Fair Work Ombudsman alerted the NDIS Commission that some NDIS providers are not complying with their obligations under the Fair Work Act 2009. The Commission reminding provides that a failure to comply with applicable workplace laws is a breach of the conditions of their registration under the NDIS Act 2013 . Read the notice here.

Restrictive practice e-Learning

The Senior Practitioner Act 2018 directly affects providers of Disability services, Education and Care and Protection of children in the ACT. An e-Learning module has been developed to provide information on the Act including understanding of the role of the Senior Practitioner and how the Act contributes to the whole of government approach to reducing and eliminating restrictive practices.