Supported accommodation

• Develop new Practice Standards and quality indicators specific to supported accommodation and amend existing standards in the Core module of the NDIS Practice Standards, with reference to best practice elements identified in the research conducted by Professor Bigby, ‘Evidence about Best Practice in Supported Accommodation Services: What Needs to be in Place?’. Amended standards will also consider elements of the NDIS Workforce Capability Framework and evidence of provider commitment to continuous improvement drawing on data and analysis relating to incidents and complaints.
• Adjust the audit methodology adopted in the assessment of registered NDIS providers against the new Practice Standard to include additional sampling arrangements for on-site assessments of supported accommodation settings.
• In developing new standards and reviewing existing standards, consider how quality indicators can support the management of complex situations in group homes, whether the SIL provider and the SDA provider are the same, or different.

• Prioritise the continued development, enhancement and promotion of the NDIS Workforce Capability Framework to build capability among those working directly with people with disability, including in supported accommodation.
• Work with providers to co-design and pilot aspects of the best practice model for supported accommodation proposed by Professor Bigby, including Frontline Practice Leadership and Active Support.
• Incorporate key areas identified through the Inquiry into targeted education initiatives for supported accommodation providers and workers, including:
  • best practice in complaint and incident management, including the use of data and insights to inform the development of practice and incident prevention
  • best practice in governance models that embed a person-centred culture that acts on issues and incidents affecting people with disability and holds the organisation as a whole to account for quality and safety
  • best practice elements identified through Professor Bigby’s review and promotion of person-centred Active Support
  • understanding participant rights and abuse and neglect, and
  • managing individual choice and control for individuals living in a group setting.
• Promote guidance for providers and their workers on monitoring for health support needs and continue to promote good practice in this regard.
• Consider how best to identify best practice models for key areas identified through the Inquiry, including supporting healthy lifestyles and access to health care in supported accommodation, design and delivery of services that take the perspective of people with disability and families into account, determinants of compatibility of people living together in a group home, and how group home and specialist supports are coordinated and providers collaborate to enable individual planning and supported decision making.

• Develop a compliance strategy aimed at supported accommodation services, both registered and unregistered, and prioritise compliance activities related to these services including on-site monitoring visits as resources allow.
• Undertake compliance activities aimed at reducing the use of restrictive practices and psychological or emotional abuse of a person with disability, including verbal abuse, and reinforcing obligations under the NDIS Practice Standards, particularly in regard to Tenancy Management, participant feedback and complaints, and incident management.

• Develop additional guidance for providers about what incidents should be notified as they relate to the categories of reportable incidents defined in the NDIS Act.
• Consider whether changes to the Incident Management Rules would be appropriate to adjust the notification timeframes for some incidents, and what is required to be reported for some incidents.

• Develop and deliver a targeted program of communication, engagement and education to support people with disability in supported accommodation and at other at risk/hard to reach participants, including people with intellectual disability, to exercise their rights.
•  Draw on a range of resources including the consultation reports about the experience of people with disability living in supported accommodation developed through this Inquiry, and consultation with people with disability directly, in undertaking this work.

Work with providers and the NDIA to ensure that the perspectives of people living in larger sites are sought and taken into account in relation to changes to their living arrangements and the design and delivery of supports in their new homes, where they choose to remain living in supported accommodation.

Incorporate a focus on supported accommodation settings into the design of the Consumer Technical Expert component of the audit scheme, currently in development.

Undertake further work with the NDIA to build a deeper understanding of the composition of the supported accommodation market and the interaction of supported independent living and specialist disability accommodation funding arrangements to assist in developing and targeting activities arising from this Inquiry.

Commission expert research to grow our understanding of the factors that influence participant personal wellbeing, including the role of choice, particularly in supported accommodation settings.

In addition to these initial actions, the NDIS Commission is currently committed to an extensive array of work across a range of areas that will address many of the issues raised in the Inquiry. This includes activities related to:

• promoting positive behaviour support, including improving the quality of behaviour support plans; education initiatives for providers and workers to reduce and eliminate restrictive practice; and continuing to work with state and territory governments to achieve national consistency in the authorisation of the use of restrictive practices
• conducting research into supported decision-making through a grant initiative
• conducting updated inquiry and research into participant deaths notified to the NDIS Commission
• increasing outreach activities with participants and our systems for identifying and responding to ‘at risk’ participants
• continuing to provide training for workers on the NDIS Code of Conduct through the Worker Orientation Module and other worker and provider education activities
• implementing resources to support practice quality in key areas such as mealtime support and communication, and
• actively engaging in work being led by the Australian Government Department of Health and Aged Care to implement the National Roadmap for Improving the Health of People with Intellectual Disability.

As the NDIS Commission matures and evolves as the Scheme regulator, we are developing our understanding of the issues faced by NDIS participants and our role in addressing these, including through analysis of our growing set of data about incidents and complaints, feedback from participants and advocacy groups, and input from researchers. This will lead to new initiatives and areas of focus for the Commission, including new research and future Own Motion Inquiries.

As resources allow, we will continue to build the capacity of NDIS Commission systems to collect and use data to identify and respond to trends and risks, including analysis of the relationship between data available through the reportable incidents function and other functions, to inform compliance and monitoring priorities.

A number of the issues raised in the Inquiry may be considered as part of the Australian Government’s review of the National Disability Insurance Scheme (the NDIS Review), which is underway at the time of writing. We will provide a copy of the Own Motion Inquiry Report and this Action Plan to the NDIS Review for its consideration.

Our progress on the actions set out in this plan will be reflected in our corporate planning and reporting processes.