A Sector in Crisis: Illegal and Unauthorised Restrictive Practices and Neglect

Photo by cottonbro from Pexels

The recent decision of the South Australian Court regarding the case of NDIS participant Ann Marie Smith is reported by ABC News dated 18 March 2022. The ABC says that, “An Adelaide disability support worker has been jailed for more than six years for committing one of the most serious examples of manslaughter by criminal neglect South Australia has ever seen.” We warn readers that the article is extremely confronting and disturbing. But it is so important to read and to apply our key insights below.

We work in the NDIS funded space of Specialist Behaviour Support. As such, over the years we have seen many examples ranging from questionable practices to the early signs of neglect. Because our role is based in a clinical capacity building and supportive approach, we have taken the appropriate steps to address issues with carers or staff, whoever is involved in providing care. Our behaviour support reports and plans provide best practice advice to change circumstances for the better, and our role over time has attempted to provide quality review and support.

Under NDIS, we observe system wide shifts over this past decade in failure to fund critical capacity building behaviour support training. We see an unfortunate message coming from the NDIS Commission that is perceived as too highly complex, frightening, and punitive. As high level specialists in our field, we saw a radical drop in referrals from disability providers. And the trend toward in-house clinical supports rather than independent clinical reviews, decreasing the quality and impartiality of clinical support across the sector.

These disturbing trends have not changed. We have continually warned the NDIS for years about the downward trends we have seen, in partnership with providers who shared our concerns. We have often commented on the likelihood of restrictive practices going unreported and the fear of providers to even contact a behaviour specialist because they do not understand how to apply or comprehend the quality framework that can literally save lives and increase quality of life.

The NDIS is already “entrenched” in Australia, even where some states like Tasmania, are still in transition into the full scheme by way of needing to review state level legislation. By entrenched, we mean to say that the model has been deployed in ways that do not work. And notably nearly everyone acknowledges these failures, including high level specialists within the system itself, even while most of us celebrate the wins that the NDIS has made.

Following the disturbing case facts disclosed by the legal proceedings in South Australia, it is high time for critical review of the NDIS Commission’s persona, role, and deployments. They are, after all, charged with quality control and review. They are, after all, the very body that ought to be helping to build the very capacity in disability providers and staff that will actually, concretely, prevent cases of unauthorised restrictive practices and abuse and neglect.

The Court found that the gross neglect leading to the death of Ann Marie could have been completely prevented by quality care, professional conduct, and by applying very very basic standards of care.

It is a criminal offence against human rights in Australia that, on the part of the NDIS itself, that this case comes to light. The NDIS Commissioner should be held accountable, and the Ministers responsible should be held accountable, because the buck stops with government officials in charge of these matters.

We have been saying for years that these types of cases will increase across Australia because the trends are all too clear under the NDIS that disability providers are not being given the quality training and staff and manager support that they had in past. For example, as provided by the NSW Department of Ageing, Disability and Home Care. The older systems were not ideal, and everyone knows that. But they surely did make better attempts at providing direct quality control and capacity building training even across regional and remote NSW.

We urge anyone from any family or disability support organisation reading this to take your actual day to day quality behaviour support concerns to a behaviour specialist or other senior clinician who you are confident will address the issues honestly and directly. Seek independent review, and do not allow your provider to address things and perhaps cover things over by internal review alone. Do not assume that lodging a complaint with the NDIS Commission will lead to solving issues. Stay on top of things until you see results. Where things are not addressed in a timely way, seek legal aid assistance, go to an Ombudsman, write to your MP with the facts at hand, and do not rest until something is done.

It is a very sad day in Australia where we are already relying on Royal Commissions to address what should have been done on day one of the scheme.

Featured Photo by Mikhail Nilov from Pexels

#NDIS #BehaviourSupport #RestrictivePractice #Abuse Neglect

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