Quality Evaluation Report

Quality Evaluation Report

Version 1:0, April 2015

Assessment against the

National Standards for Disability Services

Disability sector organisation: / Disability Services Commission
Service point name: / WA NDIS My Way Lower South West
Outlet name(s): /

Busselton
Margaret River

Director General: / Dr Ron Chalmers
Final report date: / 4 June 2015
Evaluation team: / Cheryl Lewis and Penny Blackburne

*This report was prepared by a member of the Panel Contract of Team Leaders and Evaluators. The Panel Contract is managed by the Disability Services Commission.

Further information

Please contact the Quality and Evaluation team.

Contact details:

Quality and Evaluation

Disability Services Commission,

146 - 160 Colin Street, West Perth WA 6005

Phone: 9426 9200

Contents

Part A: Executive summary

Introduction

Summary of findings

Part B: The Standards

Standard 1: Rights

Standard 2: Participation and inclusion

Standard 3: Individual outcomes

Standard 4: Feedback and complaints

Standard 5: Service access

Standard 6: Service management

Appendix 1: Definitions

Disclaimer

Acknowledgments

The Evaluator(s) extend thanks to individuals, families, carers, management and staff for the assistance they provided throughout the evaluation visit.

Part A: Executive summary

Introduction

This report describes the findings of the evaluator(s) who visited WA NDIS My WayLower South West during March and April 2015 and completed an assessment of feedback from individuals with disability, their families and carers, staff and management; and the service’s compliance against the National Standards for Disability Services.

A preliminary meeting was held on 9 March 2015 in Bridgetown and 10 March 2015 in Busselton. Anexit meeting was held on 4 June 2015.

The organisation uses the term individual/personto refer to people with disability who access the services.

Note: Under the Carer’s Recognition Act 2004, a carer refers to a person who provides care or assistance to another person who is frail, has a disability, a chronic illness or a mental illness, without payment apart from a pension, benefit or allowance.

Service profile
Service description
The services provided / The WA NDIS My Way Lower South West trial provides ongoing support to people with disability, their family and carers to enhance wellbeing, promote choice and control, support participation in the community and continued learning. Planning focuses on natural networks, community supports and local connections wherever possible. Plans are individualised and may change over time as the person’s needs and goals change.
The resources / The My Way Lower South West team includes:
1 x Regional Director
2 x Area Managers
1x Allied Health Consultant
1 x Technical Officer
17 x My Way Coordinators across three offices: Busselton, Manjimup and Margaret River.
Administration is provided in the Busselton office and the Commission’s head office in West Perth.
The people using services / The Commission’s second quarterly report to the Commonwealth Government, December 2014, identified 623 people eligible for supports and services; of those, 595 had a completed WA NDIS My Way plan.People accessingsupports have anintellectual, cognitive, neurological, sensory or physical impairment, or a combination of these impairments. These figures also include 44 people with a psychosocial disability.
Consultation
Statistics
Number of visits to group homes / n/a
Number of individuals with disability present in group homes during visits / n/a
Number of visits to private homes / 1
Number of interviews with individuals with disability / 4
Number of interviews with family members/friends/ carers/advocates / 8
Number of telephone interviews or emails with individuals with disability / 7
Number of telephone interviews or emails with family members / friends / carers / advocates / 12
Number of individual files/ plans reviewed / 16
Number of complaints reviewed / nil
Number of staff meetings attended / nil
Number of staff consulted / 9
Number of external stakeholders consulted / 6
Quality Evaluation assessment against the Standards
The following scale has been used to measure performance against each National Standard
Met / Feedback, observed and written evidence clearly demonstrates that the service provider meets the requirements
Not met / Feedback, observed and written evidence clearly demonstrates that the service provider does not meet the requirements

Based on the information provided by individuals, their families, friends, carers,advocates, staff and management; and throughdocumentation and observations made by the Evaluation team, this organisation’s performance has been assessed as:

Assessment against the Standards
Standard / Assessment
Standard 1: Rights / Met
Standard 2: Participation and inclusion / Met
Standard 3: Individual outcomes / Met
Standard 4: Feedback and complaints / Met
Standard 5: Service access / Met
Standard 6: Service management / Met

Summary of findings

Please refer to Appendix 1: Definitions

Good Practices (GP)
If/where noted during a Quality Evaluation, GPs refer to exemplary contemporary practices that demonstrate how services support people to achieve better individual outcomes.Examples of GP inform the Commission’s Board and enhance sector development. The following includes up to two (2) brief example/s of GPs implemented.
Person-centred practice/s /

One My Way Coordinator gives newly referred people a ‘little show pack’ that provides information about local resources that may be useful for that person and their family before the Plan is established.
The obvious time and effortput in by My Way Coordinatorsto develop a positive relationship with individuals and families.

Business practice/s
Other good practices noted /

The overwhelmingly favourable feedback from individuals and families about the services they are receiving and the changes these have made in their lives.

Required Actions (RA)
If/where noted during a Quality Evaluation, RAs focus on the minimum satisfactory level of service and refer to action necessary to address matters that have serious implications for the safety, wellbeing and dignity of people with disability. They may also relate to legal requirements and duty of care issues as reflected in all the National Standards for Disability Services. RAs are a major gap in meeting Standards.
No / Standard / RA statement / Compliance date
No Required Actions were identified
Service Improvement (SI)
If/where noted during a Quality Evaluation, SIs identify actions to enhance practices in addressing outcomes for people with disability and enhancing compliance with the National Standards for Disability Services. While still a gap in meeting Standards, SIs are less major; and are required to be reported on in the annual self-assessment.
No / Standard / SI statement
3 / Clearly articulate to individuals and families the priority and processes for plans to be reviewed.
1,2,3 / Systematically collect and share information of available community resourcesbetween My Way Coordinators and make it available to service users in accessible formats. Inform people of funded and unfunded options.
3 / Procedures for measuring and recording progress towards meeting goals to be consolidated in the central system.
6 / An emergency evacuation plan is established for all offices, the plan is practised and records are kept of the trials.
Other matters (OM)
If/where noted during a Quality Evaluation, OMs refer to identified matters that are not within the scope of a Required Action/s or Service Improvement/s – and therefore, do not have reporting requirements. These matters are highlighted as continuous improvement activities and may be noted in future Quality Evaluations. The following includes up to four (4) brief example/s of OMs noted.
No / Standard / OM statement
1,2 / People new to the program stated they were not always able to articulate their needs, know what to ask for or know how to negotiate with service providers. In the early stages of the program people would benefit from assistance in this area.
6 / There were a few file notes that included judgements of a personal nature, it is suggested that My Way Coordinators be reminded of the need to write objective records.
6 / Internal communication needs to be improved to ensure all staff are kept updated about changes and new policies and procedures.

Part B: The Standards

In this section, the Standards are assessed against compliance requirements and qualitative elements. A brief comment is provided regarding the Standard.

There are six National Standards that apply to disability service providers.

Rights: The service promotes individual rights to freedom of expression, self-determination and decision-making and actively prevents abuse, harm, neglect and violence.

Participation and inclusion: The service works with individuals and families, friends and carers to promote opportunities for meaningful participation and active inclusion in society.

Individual outcomes: Services and supports are assessed, planned, delivered and reviewed to build on individual strengths thatenable individuals to reach their goals.

Feedback and complaints: Regular feedback is sought and used to inform individual and organisation-wide service reviews and improvement.

Service access: The service manages access, commencement and leaving a service in a transparent, fair, equal and responsive way.

Service management: The service has effective and accountable service management and leadership to maximise outcomes for individuals.

Further information about the National Standards and the Commission’s Quality System can be access on the website:

Standard 1: Rights

The intent of this Standard is to promote ethical, respectful and safe service delivery that meets legislative requirements and achieves positive outcomes for people with disability.This Standard has a focus on particular rights including: freedom of expression, decision-making and choice; freedom from restriction; freedom from abuse, neglect, harm, exploitation and discrimination; privacy and confidentiality.

Compliance
This section relates to the policy component of the Standards and indicates where policies and procedures are in place for the service point.

(P) proposed: yet to be developed
(E) existing: currently in place
(R) under review:in place and scheduled for review
(NA) not applicable: not relevant

/ P / E / R / NA
The service point has the following policies and / or procedures for:

treating individuals with dignity and respect

/ x

promoting and supporting individuals’ freedom of expression and decision-making and choice

/ x

recognising, preventing, responding to and reporting abuse, neglect, exploitation and other serious incidents

/ x

safeguarding individuals’ rights

/ x

providing contemporary, evidence-based support strategies with minimal restrictions

/ x

maintaining individuals’ privacy and confidentiality

/ x
Qualitative information
This section relates to evidencegathered to assist in the assessment of practices related to compliance for this Standard.
Feedback from individuals with disability, their families, friends, carers and advocates

Every individual and family member consulted stated they were always treated with dignity and respect. They all felt they took the lead role, with assistance from the My Way Coordinator, in determining what was to be included in their plan. There was strong ownership by individuals and families of their plan. Nobody felt pressured by their coordinator to agree to anything they did not want.
One person expressed her thoughts in writing and read them to the evaluator. She said, “I have been given the right as an individual to make my own decisions and have been given the right to have choice and control of my own life. I have been continually treated with dignity and respect. I like that my mum/carer has been given the opportunity to participate in developing my plan, because mum has been my carer/advocate and has supported me for many years.”
Another family member commented they were, “Overjoyed at the way things were working.” However, this same family expressed concern that there was no real sense of ‘permanence’ now that plans would be reviewed every 12 months.
People felt respected and valued when the coordinator knew about their disability and devalued when they sensed they did not. For example one person said how satisfied and confident they were when the My Way Coordinator shared that he/she had a family member with a similar condition. Another person commented their My Way Coordinator did not appear to understand their psychosocial disability; the impact this had on their life and on the way supports need to be delivered.
A few people spoke about lack of contact from their My Way Coordinators – one person with an unfunded program had not been contacted for sevenmonths; this person said he/she would appreciate contact as it would provide a small level of support. A number of others felt a phone call to just ‘check-in’ would be useful.
All people spoken to recognised the very high work pressure on My Way Coordinators and understood that this would limit contact, but felt that a quick follow up phone call once every three months would be welcome.
All persons asked said they were confident the privacy and confidentiality of their information was maintained.
A number of families believed that greater access to activities occurring as a result of their plan in the wider community was in fact a safeguard for their family member.
People who do not self-manage felt they had less choice and control as they must select services only from endorsed service providers.Management advises shared management arrangements can be negotiated with service providers to increase the choice of support arrangements.

Staff and management knowledge

Staff spoken to display a sound knowledge of the people they are working with. Examples of individual stories and achievements gained were discussed.
Individuals and their families were spoken of with respect. All staff demonstrated concern for the privacy and confidentiality of information.
Individuals who receive funding are able to make choices as to how this funding will be managed. For example they are able to self-manage the funds, contract with a disability service provider to manage and control the funding or choose a combination of the two.
My Way Coordinators stated that choice belongs to the person. They know how much funding they have been allocated and have the control andare able to choose their preferred provider.
One family sat around the table with six service providers to discuss their options and support requirements.

Observations

Individuals and families spoke of the very good relationships they had with their My Way Coordinator. When talking to individuals/families and staff the mutual respect one had for the other was very evident.
During discussions with staff, the privacy of individuals and families was paramount.
There was a greater than average interest demonstrated by individuals and their families to participate in the evaluation, gauged by willingness to participate in telephone interviews and the number of people who attended the service users’ focus group. This is an indication of their level of involvement in the program and their relationships with the My Way Coordinators.
The office in one area is colourfully decorated with large art works that have been commissioned from alocal art group with inclusive membership and the reception area had a small stand promoting an artist’s work.

Critical documents, systems and processes

Evaluators were able to sight internal documents that presented a significant, clearly articulated framework to ensure risks and opportunities are identified in all life areas, for example, education, employment, social communication and mobility.Assessment of the level of risk may include interface with mainstream services such as police or child protection services.

Assessment against the Standard
General statement / Feedback from individuals and familieswas very positive.Individuals were always treated with dignity and respect and were empowered to make choices important to them.
Standard 1: Rights / Met

Standard 2: Participation and inclusion

The intent of this Standard is to promote the connection of people with disability with their family, friends and chosen communities. It requires services to work collaboratively with individuals to enable their genuine participation and inclusion, and that the individual’s valued role needs to be one of their own choosing.

Compliance
This section relates to the policy component of the Standards and indicates where policies and procedures are in place for the service point.

(P) proposed: yet to be developed
(E) existing:currently in place
(R) under review:in place and scheduled for review
(NA) not applicable: not relevant

/ P / E / R / NA
The service point has the following policies and / or procedures for:

promoting and supporting participation and inclusion

/ x

respecting Aboriginal and Torres Strait Islander culture, and promoting Aboriginal and Torres Strait Islander peoples’ cultural and community connection

Individuals and families commented on the range of community activities they or their family member were involved in. “He is doing more independent stuff then he ever has before.”
Families discussed their family member’s involvement in volunteer work, better exercise opportunities (eg a walk to the beach), increased independence achieved through doing their own banking, shopping and paying bills.
For many individuals and families WA NDIS My Way had opened opportunities for participation in the community that they had not been able to access before. Examples included karate, massage and piano lessons.
One mother described her daughter as gaining so much in confidence that in some areas support has been scaled back, as she is now doing many things in the community on her own, stating that the program has, “Made a huge difference to her life.”
People said they expect their My Way Coordinators to have a sound knowledge of local resources. Most said their My Way Coordinator had good local knowledge, but a few thought they knew more about what was available than their coordinator.
One parent said of their My Way Coordinator, that “[Name] talks about things, he/she doesn’t just give web sites.” People valued My Way Coordinators who made suggestions, looked outside the box for solutions and used their initiative.
People wanted the opportunity ‘to try before they buy’.Before committing to a service provider they would like an opportunity to experience what that organisation could provide. Possibly the My Way Coordinator could advocate for this and be more involved in the connections with disability service providers, especially for people who have not accessed community services before. See OM 1

Staff and management knowledge

One staff member described how one gentleman was able now to leave the nursing home where he is a resident, to go out into the community for coffee or lunch, or simply go for a drive. “He is doing some of the things he always wanted to do.”
An example of participation and inclusion was recently reported in the WA Disability Update Summer Edition and referred to by staff. The person concerned had limited social contacts due to life-long communication difficulties. After identifying goals and strategies he was supported to communicate with people in his local community. Now he independently takes part in indoor bowls, table tennis and tai chi at Busselton’s Senior Citizens Centre, participates in a Busselton volunteers program, goes fishing and is developing his passion for photography. A natural support network is developing and the person is reaching his goals and looking forward to more opportunities in 2015.
The My Way Coordinators refer people to organisations and services for funded and unfunded activities. People are provided with a list from which to choose the organisations they will approach. People who self-manage their funding can use any service provider/organisation they choose, but those who do not self-manage must select services from endorsed providers;staff felt these individuals may have less choice available. It must be noted that the number of endorsed providers is growing exponentially and this will assist people who do not self-manage.
One My Way Coordinator described little show packs that she takes to newly referred people. This pack has information about a range of local services that may meet the needs of the individual and their family. Information is relevant to the life stage of the person newly referred, for example for a mother with a newly diagnosed child with a disability, information is included about Noah’s Toy Library, the Regional Health and Therapy team, a local play café and sensory room, companion card for travel and information about the regional fuel card.
My Way Coordinators have their own areas of interest and have developed their own bank of resources. There is not a mechanism whereby these resources can be shared easily.See SI 2

Observations

There are a number of information brochures from disability service providers and the Commission in the reception area of the local offices.
‘Service Guide Lower South West’ is a large document available in the reception area and provided to people selecting service providers.

Critical documents, systems and processes

The Service Guide details the services provided by endorsed service providers in the Lower South West, each page has a service description, pricing information and contact details. This is an excellent resource developed by WA NDIS My Way to help people select services.This document is also available on the Commission’s web site.
In the Commission’s second Quarterly Report to the Commonwealth Government, Measure 113: Community capacity building activities undertaken by NGOs within the period, there is reference to initiatives funded by the National Disability Insurance Agency Sector Development Fund to build community capacity. As a result the Commission has funded four projects one of which will expand the range of individual service options provided by disability service organisations, and mental health organisations. Although commenced this project is yet to be completed.

Assessment against the Standard
General statement / Individuals and families gave numerous examples of the very positive difference My Way Coordinators had made to their connection and inclusion in their local communities.
Standard 2: Participation and inclusion / Met

Standard 3: Individual outcomes