Supported Independant Living (SIL) Best Practice

It’s the calm before the storm, but it’s looking like so many service providers are currently paralysed. Regardless of the likely increased oversight, we are still seeing repeated news stories and NDIS civil proceedings showing very clearly that SIL best practice is not currently occurring. The royal commission and the increasing number of media storms highlighting instances of poor practice are telling us we need to do something. We need to take action for:

• Merna
• Anne-Marie
• Colin
• Alex
• Kyah
• Lee-Anne

And all people who have died or been seriously abused whilst in care of a NDIS Service Provider.

It is very easy to villainise the providers associated with these horrific public cases, and I acknowledge that many of the providers associated are registered providers (which raises much bigger red flags and potentially discounts registration as the ‘fix all’ for the NDIS).  These are large organisations who have invested in systems, processes, internal audits and people with positions specifically designed to review quality. So, what is going wrong? I challenge you, if you are in a senior position within a service provider, what can you say that you do differently so that it won’t be you next time?

The NDIS is now 10 years on. Its initial design was to empower individuals with disabilities by supporting their independence while ensuring they live safely and with dignity. However, the challenge of maintaining high-quality standards and robust safeguarding measures is complex and critical.

As an investigator and a qualified NDIS Auditor, I have been privileged to work alongside many different providers, supporting them to undergo the laboursome administrative effort and technical bureaucracy that comes with an audit every 18 months. Supporting Potential will only work with providers who genuinely want to improve the lives of the people they are supporting, so whilst we acknowledge that there are some more unscrupulous providers trying to take a financial advantage from the NDIS, it is not my experience with the providers I work with. In my opinion there are two key areas where organisations are failing the original intent of the NDIS and therefore short-changing the participants they work with:

1. Organisations are reactive to quality indicators rather than investing in systems to identify where trouble is brewing.
2. Quality care is directly tied to the quality of the staff.

Each of these areas have external drivers that make it more difficult for providers to be successful, but there are things still within the control of the provider.

1.  Reactive quality management systems

We are all aware of the need for SIL providers to adopt a continuous quality improvement approach to regularly assess and enhance their service offerings. But this involves setting clear quality objectives, collecting and analysing performance data, and making iterative improvements based on this analysis. The issue is having the tools to allow the collection and analysis of performance data. Policies and procedures should tell staff how to deliver a quality service, but they are usually large complicated documents and written for legislative and regulatory compliance rather than the cohort of staff that need to implement them.

SIL service providers try to pull levers to ensure staff understand and agree to implement the policy / procedure, often asking staff to read and sign the document, but there are limited mechanisms to test that understanding and ensure the correct process is followed every time, rather than the “this is how we do it here”. Many organisations will rely upon the paper based internal audits, which we know only provide a glimpse of the service as it is being presented that day. Other organisations will rely on their frontline leaders to guide practice and ensure compliance with policy. But in the current employment market, are you confident that your frontline leaders, not only have the skill to identify issues in policy application, but then to correct the issue too? And finally the last line of defence is usually if there is a reportable incident, requiring some sort of review. Currently there are very few solutions that let you maintain daily observations of the quality of supports provided at all of your various SIL sites.

Tendable is one of these solutions. This digital quality assurance platform, overlayed with the way disability support providers operate, provides organisations with an easy to use and cost-effective quality management tool.

1. Organisations collect bite-sized data from across the organisation.
2. Staff at all levels of the organisation answer a few simple questions, related to their role.
3. Questions target both the quantifiable audit requirements (meaning that you no longer have to conduct a laboursome annual audit), as well as a pulse check on some of the ‘soft’ indicators. Are participants engaged and supported with decision making? Are employees still passionate about the job at hand or is burn out beginning to creep in?
4. The intelligence of the tool means these simple questions that attached to existing process are mapped to both the NDIS Practice Standards and best practice quality indicators.
5. Alerts allow senior leaders to see in real-time where there may be a decline or problem beginning to arise.
6. It also helps to identify the root cause of some of the more subtle but continuous improvements that face SIL providers, such as medication errors.
7. This is such a simple tool to implement and within 2 – 3 months you would have established your trend data to begin to utilise your quality staff to be pro-active.

2.  Quality staff drive quality service

In 2024, the idea of a long-term career is gone. Staying in one job or with a single employer for many years is far less common than it used to be. People now often seek new opportunities for advancement, better compensation, or more fulfilling work, which leads to more job changes over the course of a career. But when funding for training is already lean, many leaders struggle with the ROI for training staff. The alternative is what happens when they stay and you haven’t trained them. We also know that adults need to hear a consistent message at least 7 times before a behaviour change can even begin to be initiated. Once again, it’s a simple change to the cadence that you do things. Continuous but short training. The Supporting Potential learning management suite:

• Prioritises incremental learnings which refresh from the learning before
• Each online module can be completed in 15 minutes of less, and
• Has been built with people living in SIL environments to confirm the accuracy and relevance of the training materials.

Consolidating this online training with frontline leaders who can reenforce the messaging and realign if the delivery is slightly off is critical to delivering SIL best practice every time.

 

Disability services in the NDIS is not for the faint hearted. Every person with a disability has unique needs and circumstances. These can vary widely even among those with the same type of disability. This diversity requires individualise support plans and frequent adjustments to services, making standardized solutions difficult. Layer this with cultivating an organizational culture that prioritizes quality and ethics in all aspects of service delivery is not an easy feat, especially when services are geographically spread, and key staff are consistently in bush fire mode. But now is not the time to pause. Perhaps you can spend 5 minutes taking a quick NDIS readiness check? The Disability Org Full Potential Scorecard (scoreapp.com). If not for you then for the Merna’s, Kiah’s and Lee-Anne’s in your organisation.

You don’t have to work with us on any of the solutions, but it may help to guide your strategic planning for the next round of curve balls that will surely come our direction. It may also provide some insight on how to stop yourself from being the next media circus.

For information on Tendable, the NDIS and many other aspects of the disability sector please reach out Contact – Supporting Potential

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