Part F: Frequently asked questions (Residential Aged Care Toolkit)

Registration

NDIS participants in RAC should be afforded the same quality and safeguarding provisions as NDIS participants not in RAC. NDIS legislation requires that NDIS providers must be registered if they are supporting participants whose NDIS plan is managed by the National Disability Insurance Agency (NDIA or the Agency) and/or develop behaviour support plans through NDIS funding and/or to implement regulated restrictive practices in the course of providing NDIS funded supports.

Registered NDIS Providers can provide services to any NDIS Participant irrespective of how their NDIS plan is managed. Registration as a registered NDIS provider demonstrates to people with disability that you have been assessed as providing safe and quality support in the NDIS.

If you were supporting NDIS participants on November 2020, you were automatically registered with the NDIS Commission and would have received a Certificate of Registration on 1 December 2020 with details of your registration renewal date. This is the date that you are required to begin the application process to renew your registration and be assessed against the NDIS Practice Standards. Your Certificate of Registration includes a condition of registration that gives nine months from the registration renewal date to complete the application, including being assessed by an approved quality auditor against the NDIS Practice Standards. Most RAC providers will need to start an application by 1 December 2022 and have all requirements finished by 1 September 2023. RAC providers can ask the NDIS Commission to consider changing this date to align with your aged care accreditation processes.

The NDIS application and registration process is free for providers.  However, the provider is responsible for the costs of engaging an Approved Quality Auditor (AQA) to undertake their audit against the NDIS Practice Standards.

Yes, the NDIS Commissioner may vary the registration of a registered NDIS provider where satisfied it is appropriate in all the circumstances to do so.

Variations may include reducing or extending the period of registration (renewal date), imposing additional or varying existing conditions of registration (such as a condition that requires an audit to be completed within a specified period) and/or adding or removing registration groups.  Registered NDIS provider will need to submit a variation application form obtained from the NDIS Commission.

Determination of a variation application will consider any increased risk to participants including whether the provider has been assessed against the relevant NDIS Practice Standards where seeking to add registration groups.

  1. Extended registration renewal dates for RAC providers supporting low numbers of NDIS participants (1 – 5 participants).

The NDIS Commission has extended the registration renewal date for this category of providers from 1 July 2022 to 1 December 2022. This means these providers have nine months from 1 December 2022 to complete all elements of the registration application, including the external audit.

  1. Alignment of aged care and NDIS audit activities.

RAC providers can ask the NDIS Commission to consider changing the registration renewal date to align with aged care accreditation processes. This involves contacting the NDIS Commission to discuss a variation and submitting an application for variation of registration. A variation is required to change the conditions of registration. In deciding on an application for variation of registration, the NDIS Commissioner’s delegate will consider the provider’s reasons for seeking the variation and risks for participants in making a variation decision. 

3. Consideration of recent aged care audit findings in NDIS audit activities

There may be scope for some RAC providers to undergo a modified NDIS RAC audit, this will allow the approved quality audit team to consider the findings of a recent aged care audit for requirements that are applicable to both aged care and NDIS.

If eligible, your auditor will need to gain approval from the NDIS Commission under Section 5(3) of the NDIS (Provider Registration and Practice Standard) Rules 2018 to undertake a modified NDIS RAC audit.

If the renewal application is not commenced in the NDIS Commission portal by your renewal date, your NDIS registration will lapse. Lapsed or expired registration has implications for the NDIS participants you support, as you must be a registered NDIS provider to continue supporting NDIS participants in your facility. There may also be implications for you organisation under the NDIS Act 2013 and associated Rules.

NDIS participants in your facility are covered by security of tenure provisions for all care recipients in the Aged Care Act 1997.

It is a key principle of the NDIS that all NDIS participants are supported to exercise choice and control over their lives, including decisions about changes to their services providers.

NDIS participants must not be forced or coerced to move out of a RAC facility. The registered RAC provider, following mutual agreement with the participant to transition out, should liaise with the NDIA Young People in Residential Aged Care Team to ensure smooth and timely transfer of NDIS participants.

If the NDIS participant you support wishes, or has a goal in their NDIS plan, to leave RAC, the NDIS participant should be encouraged to work with the NDIA to explore options. The NDIA is able to support the participant with a plan review if appropriate, or provide information about living in and moving out of RAC so they are able to exercise choice and control about changes to their services providers and care needs.  

Audit process

There are two separate processes as the aged care and disability sector have different legislation and rules underpinning their respective support systems.  However, there are overlaps in many areas of quality standards, complaints and incident reporting where evidence of compliance with Aged Care Standards will contribute to demonstration of compliance with NDIS Practice Standards. This will reduce the burden on RAC providers.

The Aged Care Quality Commission undertakes audits against the Aged Care Quality Standards, while NDIS audits assess a provider’s conformity with the NDIS Practice Standards and Quality Indicators.

Both the NDIS Commission and Aged Care Quality and Safety Commission audits require assessment of the provider against standards which have been legislated by the Australian Government. While a high degree of commonality exists between the two sets of standards, there are gaps which present risks to the quality and safeguarding of supports to NDIS participants.

The NDIS Commission audit is about the support you provide to NDIS participants only. It does not look at supports you provide to other aged care consumers.

No, providers will only be audited against the scope of NDIS funded supports and services that they are currently providing to NDIS participants. This scope of supports and services will be detailed in the ‘initial scope of audit’ document produced by the NDIS Commission on submission of your application. RAC providers must include at a minimum registration group 0115 in their renewal application as this is how the accommodation in RAC for the NDIS participant is paid.

To demonstrate that your organisation satisfies the NDIS Practice Standards, you will need to present supporting documentation as part of your quality audit. The amount of evidence you must provide will be proportionate. This means that a provider providing support to a small number of participants is not expected to present the same level of evidence and documentation as a larger provider with many NDIS participants. Participants will also be asked about their experience with you.

RAC providers should:

  • Ensure you have received a Certificate of Registration from the NDIS Commission which details your period of registration, the renewal date, and any conditions of registration.
  • Understand your obligations and conditions of registration as a registered NDIS provider, including the NDIS Practice Standards and related Rules under the NDIS.
  • Perform a document review of your existing policies, procedures, and systems against the NDIS Practice Standards and applicable Rules to identify where they align and where gaps exist. You may use the optional Concordance Table in Part H to assist you with this.
  • Develop and/or update policies, procedures, and systems to meet the NDIS requirements and include progress in a continual improvement plan. You can use the Standards Comparison Tool (Part E) and Evidence Guide (Part I) during this process.
  • Communicate with your workforce to ensure they are aware of the changes and actively support your staff to understand the requirements of the NDIS Practice Standards including completing the mandatory NDIS Worker Orientation Module.
  • Engage a NDIS Approved Quality Auditor for your audit at least six months before the date by which the registration and audit must be completed to allow time for scheduling of the audit and the conduct of both a stage 1 (desktop review type audit) and stage 2 (on-site) audit and any corrective actions that may be required in order to be considered for NDIS registration.

No, your chosen approved quality auditor will conduct one audit and undertake site sampling across your sites that have NDIS participants only.

Site sampling is based on square root of number of sites/outlets. Where sample population is greater than 5, the square root of the number of participants and files will determine the sample size. Where sample population is 5 or less the sample population is the minimum sample size for that provider.

For all mid-term audits: 0.6 times the square root of the number of participants and files determines the sample size.

Information is also gathered from a sample of family, friends and carers/nominees.

Audit methodology, including sampling requirements, are set out in the NDIS  (Approved Quality Auditors Scheme) Guidelines 2018. 

Similarities between the two sets of standards where your current aged care compliant system are likely to comply with NDIS Practice Standards are in:

  • Organisational systems covering: feedback and complaints, incidents management, compliance, risk, continuous improvement, governance, information management, human resource management.
  • Support provision processes, including assessment, planning, review of supports, and management of individual risks.
  • Support and respect for individual choice, independence, privacy, dignity, culture and diversity
  • Infection control processes
  • Safe environments.

Differences between the standards where you may need to review your current systems include:

  • Governance and operational management, especially around participant involvement, human resource management, quality management
  • Support plans and service agreements
  • Implementing NDIS Behaviour Support Plans

The NDIS Practice Standards have an emphasis on how providers support NDIS participants to achieve outcomes and make decisions about their care and support.

RAC providers may need to consider: how they support NDIS participants to make decisions about their care and support; staff training in supported decision making; and policies and procedures that articulate how NDIS participants will be supported to make decisions about the supports provided by your organisation.

The NDIS Practice Standards require providers to actively facilitate access to advocacy support for NDIS participants. RAC providers may need to identify how they facilitate access to advocacy supports and services for NDIS participants and their policy and procedures for advocacy support.

Registered NDIS providers are also expected to implement measures to actively involve NDIS participants in their governance mechanisms. For example, RAC providers may need to consider whether their governing body includes people with lived experience of disability, the role of NDIS participants in developing the strategic direction of the organisation and in whole of organisation decision making processes.

Approved Quality Auditors (AQA)

Do not start any NDIS audit or related processes before you have started an application for NDIS registration.

After you submit your online application for NDIS registration renewal, you will receive an ‘initial scope of audit’ document by email from the NDIS Commission, summarising the registration requirements that apply to your organisation.

NDIS Providers must use a quality auditor approved by the NDIS Commissioner when registering with the NDIS Commission. It is your responsibility as a registered provider to engage an approved quality auditor to complete the audit for your renewal application. You can request a quote from more than one auditor to make your decision. They will use the ‘initial scope of audit’ document you received to quote for their services.

To assist providers in finding auditors available in their area, see the list of NDIS approved auditors

There is no cost to apply or to register your organisation with the NDIS Commission. However, all providers are required to pay for the audit as part of the registration process.

Audits are proportional and the cost of the audit will be determined by the number of NDIS participants you support, the size and scale of your organisation, and types of supports and services for which you are seeking to register.

The NDIS Commission does not set prices for audit services.

It is important that you compare quotes from a number of approved quality auditors once you have received your scope of audit document from the NDIS Commission, as prices will vary.

Approved quality auditors are subject to Australian consumer law and accredited by the Joint Accreditation Scheme for Australia and New Zealand (JAS-ANZ), an internationally recognised accreditation agency that accredits auditing firms. Auditor behaviour is regulated through JAS- ANZ, and through the Auditor Guidelines, including a Code of Conduct for auditors. The NDIS Commission meets regularly with JAS-ANZ and with approved auditor bodies to discuss audit expectations, experiences, and any feedback from providers.