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Welcome to DSC’s first edition of quality and safeguarding (Q&S) updates for 2023. If you are new to this newsletter, it’s where we share all things happening in the Q&S space.
Latest Activity Report
The NDIS Quality and Safeguards Commission (NDIS Commission) has published the latest activity report, covering the period from 1 October to 31 December 2022. It provides an overview of NDIS Commission activities, including complaints, registrations, reportable incidents, behaviour support, compliance, and stakeholder engagement.
The activity report for the reporting period shows:
- The number of complaints lodged nationally was steady, with a 1% increase from 1,976 last quarter to 2,001 this quarter.
- The total number of registered providers remained stable at 19,315 in this quarter, compared to 19,536 last quarter.
- There was a 7% increase in reportable incidents (excluding unauthorised restrictive practices [URPs]) in this quarter.
- The number of NDIS behaviour support practitioners considered suitable to deliver behaviour support services increased 40%, from 3,252 last quarter to 4,544 this quarter.
- There was a 13% increase over last quarter in NDIS worker screening clearances nationwide.
- At 31 December 2022, there were 449 NDIS worker screening exclusions in place, compared to 329 last quarter.
42 banning orders were issued between 1 July 2022 and 31 December 2022, with a further 4,868 instances in which the NDIS Commission worked to educate providers on compliance.
The NDIS Commission was advised of 4,470 NDIS participants subjected to 410,657 URPs, a 6% increase over the previous quarter. The NDIS Commission continues to focus on ensuring that registered NDIS providers understand their responsibilities regarding the use of URPs and promoting the use of positive behaviour support strategies to reduce the use of restrictive practices. The NDIS Commission has released a detailed analysis of URPs received during the 2021/22 period, including an outline of activities undertaken in response to the data.
Visit the NDIS Commission Activity Reports page for more information.
NDIS Commission Own Motion Inquiry – Supported Accommodation
In August 2021, the NDIS Commission initiated its first Own Motion Inquiry into aspects of supported accommodation in the NDIS. The inquiry examined reportable incidents and complaints in supported accommodation services (specifically, group homes).
A literature review conducted by the Living with Disability Research Centre at LaTrobe University will inform the NDIS Commission’s capacity-building work with providers and the development of relevant practice standards and quality indicators.
The NDIS Commission has produced a comprehensive action plan in response to the inquiry. Providers can expect a range of changes, including new practice standards, an updated compliance strategy, and more guidance on incident notification requirements. Check out the full action plan on the Commission’s website.
NDIS Commission Own Motion Inquiry – Platform Providers
The NDIS Commission initiated another inquiry into platform providers operating in the NDIS market. The purpose is to better understand how services accessed through platform providers support choice and control and facilitate the delivery of quality NDIS-funded services.
The Commission wants to hear directly from people with disability, families, advocates, workers, and providers. Consultation is open until 28 April 2023. Read the full details, including the terms of reference, on the Commission's website.
NEW NDIS Behaviour Support Practitioners Register
You can now confirm whether a behaviour support practitioner is considered suitable by the NDIS Commission by using this new search tool. Only behaviour support practitioners who have consented to publish their details are included in the search results. A number of provisionally suitable behaviour support practitioners awaiting an outcome on their applications will not appear until their applications are approved and they have been deemed suitable.
NEW Participant Fact Sheets on Behaviour Support
The NDIS Commission has created five fact sheets about behaviour support. They have been written with and for NDIS participants in regular and Easy Read versions.
- What is positive behaviour support
- Understanding your rights
- Choosing a specialist behaviour support provider
- What to expect from your specialist behaviour support provider
- What to do if you are not happy with your specialist behaviour support provider
Quality of Behaviour Support Plans (BSPs)
The NDIS Commission produced a report on quality evaluations of 2,744 BSPs submitted between 1 July 2020 and 31 December 2021. evaluations were conducted using the BSP-QEII and the NDIS Commission’s own Companion Tool for compliance with the NDIS Restrictive Practices and Behaviour Support Rules 2018. The national median score of evaluated plans was 12 out of 24, which falls in the “weak” quality range, and 80% of BSPs scored in the underdeveloped or weak quality categories.
Based on the findings of this audit, the NDIS Commission is undertaking a series of actions to lift the capability of behaviour support providers and improve the quality of plans. Registered NDIS behaviour support providers have received correspondence from the NDIS Commission about the review, specifically the requirement to take all reasonable steps to consult with
- the person subject to the BSP, when developing and reviewing a BSP;
- that person’s family, carers, guardian, or other relevant persons; and
- registered NDIS provider(s) that may use a regulated restrictive practice under the BSP.
The NDIS Commission has highlighted that its draft interim and comprehensive BSP templates do not provide for recording the consultation with participants, and it is not apparent from the BSPs evaluated that there has been direct contact between the behaviour support practitioner and the relevant participant. The Commission will exercise its powers to obtain information about the engagement and consultation with NDIS participants and other aspects of behaviour support providers’ practices to help target further education, guidance, and compliance actions.
To begin this effort, the NDIS Commission will engage with behaviour support providers who lodged one or more BSPs with the NDIS Commission between 1 July 2021 and 30 June 2022. Selected participants will receive further information by the end of March 2023.
Review of BSB Templates
The NDIS Commission is seeking input into the review of the interim and comprehensive BSP templates. They want to know what stakeholders like about the current templates, what they do not like about them, and how the templates can be made better. Feedback can be provided anonymously using an online survey until 17 March 2023.
If you prefer to provide identifiable feedback on behalf of your organisation, this can be sent directly to [email protected].
Updates to the Restrictive Practice Safe Transportation Guide
The Safe Transportation Guide was updated by the NDIS Commission in February 2023. This guide was developed for registered NDIS providers and NDIS behaviour support practitioners supporting NDIS participants, but it may also be of interest to anyone who supports a person with disability. It provides guidance on the use of restrictive practices in transportation.
Compliance activity for Specialist Disability Accommodation (SDA) Providers
The NDIS Commission has recently written to registered SDA providers in relation to the requirements for
- service agreements to fairly and transparently set out the terms and conditions that apply to their SDA dwelling and any associated service or tenancy agreements;
- accommodation to not be adversely impacted by any decisions relating to a person’s choice of providers for other NDIS supports or services; and
- not unduly limiting people’s right to choose the NDIS providers they engage within an SDA dwelling through any coercive behaviour, contractual or other agreements entered into by the SDA provider with other NDIS providers.
The letter raises concerns about SDA provider practices that may have the effect of limiting the independence, choice, and control of NDIS participants and breach the NDIS Practice Standards and Code of Conduct. Concerns were raised about SDA providers that
- enter into commercial arrangements with other NDIS providers to provide NDIS supports and services exclusively within the SDA dwellings, in the absence of participants’ freely given agreement;
- specify who may provide other NDIS supports and services within an SDA dwelling, including requiring participants to engage the SDA provider to provide all NDIS supports and services within an SDA dwelling, in the absence of participants’ freely given agreement; and
- charging fees to NDIS participants and/or other NDIS providers to deliver supports and services within an SDA dwelling in the absence of transparent service agreements that allow NDIS participants to make an informed decision.
The NDIS Commissioner will be issuing requests for information to SDA providers to assess their compliance, so it is important to make sure your email contact person is up to date with the Commission.
Updated High Intensity Support Skill Descriptors
The NDIS Commission has modified the High Intensity Support Skills Descriptors, which came into effect on 1 February 2023.
The descriptors detail the knowledge and skills that workers should have when supporting participants with high intensity daily personal activities listed in the NDIS Practice Standards (High Intensity Daily Personal Activities Module 1).
Providers delivering high intensity supports contained in that module should be sure that they are across these new changes:
- Complex bowel care
- Enteral feeding support
- Dysphagia support
- Ventilator support
- Tracheostomy support
- Urinary catheter support
- Subcutaneous injections
- Complex wound care support
There is also updated general advice for providers delivering epilepsy and seizure support. If you missed our original alert, find out more here.
Request Interpreters with Worker Screening Check
Registered NDIS providers must ensure that workers in certain roles have undergone a worker screening check or hold a valid acceptable check. When you request an interpreter through TIS National, you can use the online booking system to ask that the interpreter has a worker screening. Find out how to do this here. This is an interim solution while TIS National updates its system to allow users to select either a working with children check or a worker screening check.
New and Updated Practice Alerts
- The Practice alert: Sun and summer safety provides guidance on heat-related illness, its risk factors, managing this risk, and preventing heat-related illness in NDIS participants.
- The Practice alert: Pain management covers some of the causes of pain, who is at risk, and how to identify, manage, and prevent pain in NDIS participants.
- The Practice Alert: High-risk restrictive practices describes practices which place participants at high risk of harm and may constitute or result in abuse, unlawful physical contact, or neglect of a participant. The NDIS Commissioner and Senior Practitioner will take action when any of these practices are being used.
All practice alerts are available on the NDIS Commission website.
Residential Aged Care Audits and Code of Conduct
On 1 December 2022, a new Code of Conduct for Aged Care was introduced. All providers delivering NDIS supports to participants have been required to comply with the NDIS Code of Conduct since 1 July 2018, and that requirement is not changing.
Providers and workers delivering both aged care services and NDIS supports will be required to comply with both the Aged Care Code and the NDIS Code. However, as the Aged Care Code is based on the NDIS Code, with slight differences in language and definitions that are specific to each sector, the obligations are largely the same.
Information about the Aged Care Code is available on the Aged Care Quality and Safety Commission website:
In addition, late last year the NDIS Commission released a comprehensive toolkit for Residential Aged Care providers to assist with NDIS registration. Read more about the toolkit here.
The NDIS Workforce Capability Framework Supports a Quality Workforce
The NDIS Commission has asked us to spread the word on what is happening in the NDIS Workforce Capability Framework:
The NDIS Workforce Capability Framework (the Framework) describes the attitudes, skills and knowledge expected of workers, with supporting tools, guides and resources. The latest resources to hit the website are factsheets that explain the Framework and tools, and Supervising for Capability Resources. A top five tips for providers article exploring how to use the framework and resources has just been published for those not sure where to start.
The latest resources available on the Framework website are for providers, workers and participants:
Factsheets for the Framework, tools and guides are available for download with handy ‘in practice’ scenarios
- Supervision resources for participants, workers and providers are ready to download and include:
- Working together guides
- Tip sheets
- Assessment templates.
The Supervising for Capability resources provide guidance and practical suggestions to help NDIS participants, service providers and support workers to work together so everyone understands how supports and services should be delivered. They also assist with discussions about how workers are going in delivering supports to meet the standards and conduct participants expect.
Participants providing feedback with a shared language of ‘what good looks like’ puts providers in a great position to assess and improve the capabilities of workers.
The Framework and its tools, guides and resources can be shared with participants to get their support in building worker quality. This is also great for participants who want to play an active role in the recruitment of support workers, or just want to learn new ways to provide feedback.
The new resources will help providers to get a head start on planning their supervision and service goals for 2023.
Explore the NDIS Commission's top five tips for providers here.
Disability Royal Commission updates
Public Hearing 32
From 13–17 February 2023, the Disability Royal Commission held Public hearing 32: Service providers revisited.
The hearing examined whether the policies and practices of disability service providers prevent violence, abuse, neglect, and exploitation of people with disability and deliver safe, high-quality services. It also examined best-practice responses to incidents or allegations of violence, abuse, neglect, and exploitation.
The Royal Commission heard from 38 witnesses, including the NDIS Commissioner, the NDIA, participants, advocates, and over 20 NDIS service providers. You can view the details of the public hearing, including transcripts and videos, on the Royal Commission’s website.
New Reports
The Royal Commission has published a number of reports this year:
- Economic cost of violence, abuse, neglect and exploitation of people with disability
- Outcomes associated with ‘inclusive’, ‘segregated’ and 'integrated’ settings for people with disability
- Diversity, dignity, equity and best practice: a framework for supported decision-making
- Public hearing 21: The experience of people with disability engaging with Disability Employment Services: Mzia case study
Upcoming Events
DSC Conference: The NDIS is now 10 years old and with the Independent Review, 2023 will likely see the biggest NDIS pivot ever. On 1–2 June 2023, take two days to hear from the people who will shape your future, including the co-chairs of the NDIS Review, Bruce Bonyhady and Lisa Paul and Q&S leaders NDIS Commissioner Tracy Mackey, Professor Christine Bigby, and Dr Alan Hough: The program has just been released!
Get Audit Ready: Due to popular demand, DSC has just launched an exciting Get NDIS Audit Ready series that includes a workshop, Q&A, 5–7 e-learnings, and a Q&S tool resource pack. This is great value for organisations that want a bit of help from some of our top consultants with preparing for an audit.
Podcasts
Let’s end on a high. Check out the latest podcasts in the Q&S space:
- DSC’s Disability Done Different: Episode 44: Tracy Mackey on ... the new age of regulation
- Summer Foundation Reasonable and Necessary: Unregistered NDIS Providers: What Participants Really Think
