2017

THE LEGISLATIVE ASSEMBLY FOR THE AUSTRALIAN CAPITAL TERRITORY

OFFICIAL VISITOR FOR DISABILITY SERVICES ANNUAL REPORT 2016-2017

Presented by

Rachel Stephen-Smith MLA

Minister for Disability, Children & Youth

OFFICIAL VISITORS DISABILITY SERVICES ANNUAL REPORT SUMMARY 1 July 2016 to 30 June 2017

TABLE OF CONTENTS

1.INTRODUCTION

2.APPOINTMENTS

3.ADMINISTRATION

4.ACTIVITIES

4.1Visitable Places

5.CHANGES TO SERVICES

6.NUMBER AND KINDS OF COMPLAINTS RECEIVED BY THE OVDS

7.NUMBER AND KINDS OF MATTERS REVERRED BY THE OVDS TO AN INVESTIGATIVE

ENTITY

8.SYSTEMIC OR SERIOUS ISSUES IDENTIFIED

9.OTHER MATTERS RAISED

10.CONCLUSION

11.RECOMMENDATION SUMMARY

1.INTRODUCTION

The Official Visitor for Disability Services (OVDS) provides a mechanism to monitor the quality of services received by people accessing disability services in the ACT. The aim of the OVDS is to improve service quality and create better outcomes for people with disability and their families. The OVDS is part of the ACT Official Visitor Scheme and complements other safeguards in place for people with disability by providing an avenue for resolution of complaints in a proactive manner and by facilitating a forum to discuss and address personal concerns.

2.APPOINTMENTS

An OVDS is appointed by the Attorney-General in consultation with the Minister for Disability. There are currently two part-time OVDS:

•Ms. Narelle Hargreaves OAM JP was originally appointed from 1 September 2013 for an initial six-month period. Ms. Hargreaves has had successive reappointments and her current term will expire on 31 August 2017.

•Ms. Sue Salthouse was appointed for a period of 12 months commencing 1 March 2014. Ms. Salthouse has had successive reappointments and her current term will expire on 28 August 2017.

3.ADMINISTRATION

The Public Trustee and Guardian for the ACT is responsible for the administration of the ACT Official Visitor Scheme. The Public Trustee and Guardian ACT has made a number of administrative arrangements regarding the ACT Official Visitor Scheme. These arrangements are:

•an Official Visitor web page that can be accessed at

•a centralised phone number for intake of contacts on 1800 150 036;

•provision of business cards and identity cards for each Official Visitor;

•development of a fact sheet, and poster about the ACT Official Visitor Disability Services Scheme;

•management of Official Visitor remuneration arrangements.

The Public Trustee and Guardian in conjunction with the (then) Disability ACT (DACT) commissioned the development of a series of explanatory videos, and along with the Fact Sheets, these can be accessed at:

This explanatory information has been distributed widely to Accommodation Service Providers and other community organisations for information. During 2016-17 additional copies have been provided for new service providers.

Under the Disability Services (Service Providers) Amendment Act 2014, which came into effect on 1 July 2014, the role of the OVDS was strengthened. The amended Act ensures that the OVDS can continue to operate now that the ACT has fully transitioned to the National Disability

Insurance Scheme (NDIS) and there is no longer any funding relationship between an Operating Entity (disability service provider) and the ACT Government. Some difficulties have come to light and will be dealt with below and elsewhere in this report.

The ACT Human Services Registrar (HSR) provides secretariat function and is a necessary liaison point on quality and safeguards for the OVDS, because the National Quality and Safeguards Framework will not be operational until 2019. The OVDS meet with the HSR every quarter to discuss the content of the OVDS reports to the Minister for Disability, Children and Youth. The HSR is also responsible for maintaining the Register of Visitable Places. The Register contains a list of locations and service provider management details of places within the definition of a Visitable Place under the Disability Services Act 1991. The register of Visitable Places provided to the OVDS includes the address/location of the place, the number of individuals at the place, the relevant service provider and contact information. The majority of properties are under the management of Housing ACT, or Havelock Housing Association Inc.

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The Visitable Places Register is now updated only semi-regularly. The difficulty of getting accurate updates is a matter under discussion with the National Disability Insurance Agency (NDIA). Residents are now relocating more frequently, sometimes to accommodation which does not qualify as a Visitable Place. Knowing where NDIS Participants are living depends on closer liaison with Service Providers, individuals and families/guardians. It is therefore concerning to note that knowledge of the Scheme is waning at the same time thatkeeping the Visitable Places register up to date is becoming problematic.

The Disability Services ACT 1991 states that a Visitable Place means:

(a)accommodation provided for a person with disability for respite or long-term residential purposes other than a private home and

(b)any residential age care facility that accommodates a person with disability who is less than 65 years old.

The OVDS keep in regular contact with the Public Trustee and Guardian, and seek advice from the ACT Disability and Community Services Commissioner at the ACT Human Rights Commission as needed. During the year, matters have also been discussed regularly with the Office of the Public Advocate. Thanks are due to the officers in these agencies for the assistance and advice given.

4.ACTIVITIES

Contact with ADACAS was established early in the year on a project to ensure that young people in ACT Residential Aged Care Facilities (RACF) were given information about the NDIS. A series of meeting were held in each quarter with the management of Service Provider organisations. For the most part these were at the instigation of the OVDS, in order to keep staff informed about the purpose of the Scheme.

One meeting has been held with the Minister for Disability. In each quarter meetings were held with the Human Services Commissioner and/or staff to discuss the quarterly reports and actions arising; the ACT Human Rights Commission and the Office of the Public Advocate. The OVDS have participated in the annual information and training day held for all Official Visitors in the Scheme.

The OVDS have made semi-regular visits to activity centres such as Anglicare Community

Centre, Community Link Catholic Care, and Sharing Places to catch up with a number of Residents when they are on outings away from their homes. In addition the OVDS attended celebratory events in the community. Fifty percent of these were government occasions, for example at the launch of the restructured ACT Human Rights Commission, and 50% associated with service providers, for example the 50th Birthday celebrations of Valmar. The OVDS have also participated in a range of relevant community forums, e.g. on Human Rights and Gendered Violence, and presented to the (then) Disability Quarterly Forum.

Narelle Hargreaves has been voted by all Official Visitors to become a member of the Board for the Official Visitor Scheme.

4.1Visitable Places

As at 1 January 2017 there were 121 Visitable Places being group houses, with support services supplied by 21 different Operating Entities (Disability Service Providers). These houses accommodate 303 Residents, 17 RACF which accommodate 50 Residents, and [insert number] respite facilities which have the capacity to accommodate 303 people (see Table 1). There may be 7 residents in RACF which the OVDS has been unable to visit. There are several large Operating Entities: Care Plus with 13 houses and 25 residents; Hartley Life Care with 19 houses and 62 residents; Focus with 19 houses and 33 residents; and Valmar with 14 houses and 45 residents. These 4 organisations support 54% of the residents.

Table 1: Visitable Places 1 January 2017

Managing Organisation / Number of
Operating
Entities / Number of
Visitable Places / Number of
Residents
Specialist Disability Service / 21 / 121 / 303
Respite facilities / 6 / 31 / N/A
Residential Aged Care Services / 17 / N/A / 57
Total / 44 / 152 / 360

The number of Visitable Places visited during the year is summarised in Table 2. A total of 180 visits were made to Group Houses, with many Residents receiving multiple visits. A total of 15 visits were made to RACF with 39 Residents visited. Once again some RACF received multiple visits. Twenty-seven people, both adults and children were seen when visits were made to respite facilities. Some of the people seen in Respite Centres do not reside in Visitable Places and information about the Scheme is left with staff to give to family members.

Table 2: Summary of Visits by Official Visitors Disability Services (1 July 2016 to 30 June 2017)

Visits to
Group
Houses / Number
of
Residents / Visits to
RACF / Number
of
Residents / Residents
Group
Meeting / Number
of
Residents / Visits to
Respite
Houses / Number
of
Residents
Sue
Salthouse
01/07/16 to
30/06/17 / 44 / 162 / 10 / 19 / 0 / 0 / 6 / 27
Narelle
Hargreaves
01/07/16 to
30/06/17 / 136 / 324 / 5 / 20 / 3 / 19 / 0 / 0
Total / 180 / 486 / 15 / 39 / 3 / 19 / 6 / 27

In addition, a number of meetings were held with various organisations, referrals were received and followed up (see Table 3).

Table 3: Summary of meetings (I July 2016 to 30 June 2017)

Exec.
DACT / Government:
(then)
DACT/HSR / Service
Provider
Exec1 / Residents’ meeting / Family member/
Guardian / Public
Advocate / Public referral / Referral: person with disabilities / Referral:2
ACT HRC/
Advocate/
Trustee
2 / 2 / 11 / 7 / 1 / 3 / 0 / 0 / 3

5.CHANGES TO SERVICES

The transition to NDIS of individuals living in group houses continued during 2016-17 in accordance with the agreed transition schedule. In tandem with this, all the houses under the management of (then) Disabilities ACT were gradually transitioned to management by Operating Entities as chosen by the Residents themselves in collaboration with their families and guardians. Despite the enormity of these changes, this was achieved with minimal disruption to the lives of the Residents. Many of the Disability ACT staff remained as core staff in the same residences. All service provider organisations and their staff are to be congratulated for making these transitions as smooth as possible.

A number of individuals took this opportunity to change to different group house accommodation. A smaller number moved into the community in to accommodation which does not meet the definition of a Visitable Place. The OVDS are no longer notified when such changes occur and this highlights a need for changed protocols for the Scheme to continue to be effective in safeguarding the lives of NDIS Participants.

There have been many positive changes as a result of the transition to the NDIS. The OVDS have noted that many Residents are using their NDIS packages to change their lifestyles. Notably they are able to travel a little more widely including trips outside the ACT. With careful planning weekend cruises along the coast are popular.

In one case, a change of support worker personnel who put effort into learning communication techniques meant that a Resident made a positive change in his behavior patterns, and is now able to develop friendships with Residents in other households nearby, and enjoy trips into the community.

During the year Havelock Housing Association Inc. (HHA) took over the management of a large proportion of the properties. Housing ACT has retained management of most of the remainder.

A small number of properties are owned and managed by the service providers themselves. The OVDS met with HHA management and agreed to keep each party informed of any chronic maintenance issues. This has been working well, and service providers report that maintenance is proceeding in a more timely way. However, there is ongoing maintenance needed in older properties. In addition, because of the ageing of Residents, some properties are no longer fit for purpose.

The OVDS are encouraging support workers to think about how they might enhance the quality of interactions with Residents during their time at home. Whilst acknowledging that everyone likes to relax when they are at home, activities which maintain or enhance Residents’ skill levels and which are enjoyed by the Resident could be fostered in the home, so that the TV is not so heavily relied on as an activity. Staff at some Respite Care facilities do interact well and provide a range of activities.

6.NUMBER AND KINDS OF COMPLAINTS RECEIVED BY THE OVDS

In contrast, complaints about inappropriate changes to households have been discussed with the Public Advocate. A change of residence, from one household in a service provider portfolio of houses to another, may be at the behest of the service provider, rather than a choice exercised by the Resident. In other cases, the addition of another person to an otherwise stable single-person household may result in disruption to both Residents. In some cases, a Resident’s expressed choice to live alone may be overridden by the service provider. The OVDS are continuing to monitor these situations and as yet are unclear about the degree to which this is driven by the NDIA allocation of funds in Plans, or by the service providers themselves.

The OVDS has made a number of visits to Ricky Stuart House(RSH) which began operation as a

Respite facility for children with autism in the first half of 2016 under management by Marymead. In 2016-17, RSH has become the semi-permanent home for a 12 year old after a breakdown of foster care arrangement in NSW. Despite good care by Marymead staff, this is not a viable situation and needs resolution. In addition the OVDS have concerns about the viability of Short Term Accommodation funding levels and the rationale applied to such funding by the NDIA. The OVDS are concerned that young Residents staying at RSH need one-to-one or one-to-two staff ratio at most times, and that funding is not sufficient for this.

The OVDS made three visits to Jindalee, regarding the care of two different Residents at the request of families concerned about the level of care. Staff have been cooperative and helpful and issues were resolved. There has been an excellent positive change in interaction with and assistance from their staff.

Over the year, the OVDS have noted that fewer referrals have been received about the care of people with disabilities in group houses. In addition very few referrals have been received from the community about people with disabilities who do not reside in Visitable Places, but who receive support services. Both these situations may be due to improved levels of care across the city. However, there is a possibility that this is due to a need for improved public, family, guardian and individual awareness of the Scheme.

7.NUMBER AND KINDS OF MATTERS REVERRED BY THE OVDS TO AN INVESTIGATIVE

ENTITY

During Quarter No. 1, one matter was referred to the ACT Human Rights Commission, and was resolved.

8.SYSTEMIC OR SERIOUS ISSUES IDENTIFIED

The Human Services Registrar has regular meetings with the NDIA, and all matters raised about the NDIS during the year are under discussion with the Agency.

These matters are:

•The OVDS are concerned that there are new Residents under 65 in Nursing homes. Greater effort needs to be made to find alternative accommodation, and not use RACF as the default option.

•The OVDS have had an ongoing issue for the entire year of being denied entry to several RACF. These include BUPA Calwell (until this is resolved no request has been made for a visit to BUPA Stirling), Mirinjani (Namatjira St campus) and St Andrews Village. All other RACF have been welcoming and cooperative in enabling visits to be made.

•The OVDS are concerned that some individuals who appear to need 24/7 support do not have sufficient funds in NDIS Plans which enable this, and are therefore at risk.

•The OVDS have requested clarity about the decoupling of service provision and property management, and the Supported Disability Accommodation Rules.

•The OVDS are concerned that the choice of housemate/s should be a matter for

Residents to decide and not be imposed by the service provider or by changes to Participants’ Plans which make is impossible to maintain the household. Evidence is that where new arrangements have been imposed, it has been to the detriment of all Residents involved.

•The most significant systemic issue is the inability to keep the database of Visitable

Places appropriately updated. The OVDS have recommended that information about the Scheme is included whenever an NDIS Plan is Reviewed or a new Plan developed.

9.OTHER MATTERS RAISED

The OVDS have requested further information about NDIA policy about decoupling property management and service provision being done by the same organisation. There is also no clear ruling on whether NDIS participants, who are Residents in RACF and are now over 65, are still considered to be visitable individuals. In the absence of any ruling, the OVDS continue to visit these individuals.

10.CONCLUSION

Official Visitors for Disability Services have now been making visits to Visitable Places since September 2013, and have continued these visits whilst major changes have been happening to the sector as the ACT has transitioned to the NDIS. On the whole this has been achieved with minimal disruption to Residents, whilst Operating Entities have made considerable adjustments to their staffing and operations. As the first NDIS jurisdiction in Australia, it is inevitable that some anomalies in the relationship between the NDIS and OVDS have been uncovered. Nevertheless, the majority of Residents visited in community accommodation continue to be well supported, and there is evidence that the scope and range of their activities is changing with more mainstream activities being undertaken. Staff continue to be helpful in arranging OVDS visits to the Residents’ homes. However over time, it appears that community awareness of the Official Visitor Scheme has waned. It is not well known or understood by Residents, their parents/families/guardians, or by the frontline staff of the Operating Entities (Service Providers). Steps should be taken to raise the profile of the Scheme again. The OVDS continue to be grateful for the privilege of working in this community role.