Quality and safety is important no matter your role in this game. A number of our recommendations addresses. It is clear that some aspects of the scheme aren't working as they should be to protect you. Part of this is about choice and control over who provides your support.
If you were lucky, you got a good service, if you were unlucky, you got a mediocre one, and if you were abandoned and you just got a terrible service and there's been shonky providers around forever and there's elements of good providers. So what we've heard over the course of this inquiry is nothing different.
We want regulation to strike a better balance with a risk proportionate approach for providers depending on their services.
A risk based approach to registration providers will strengthen this game and keep you safe. Regulation is so important. It is how the scheme ensures your safety and quality support. We have heard too many troubling stories of people in dangerous situations. This has to change.
We’ve heard how the scheme is not doing enough to keep people safe. We also understand that choice and control is important to you. We do believe changes are required to improve quality and visibility while also supporting control and choice.
The Disability Royal Commission also had a lot to say about this.
One of the ways that the NDIS can do this better is by knowing who is providing supports. Knowing who is providing supports is also essential in order to track and prevent fraud.
Not all providers are registered with the NDIS Commission. We know that around 150,000 providers are unregistered. This means many providers are flying below the radar – with limited oversight and limited requirements that help ensure safe and quality supports. While registration is not a guarantee of either safety or quality, it does indicate a provider has taken steps to deliver supports professionally and competently, and is an important way of holding providers to account.
Many providers find the process of registering too burdensome and expensive with not enough benefit. In addition, the NDIS is not the only system that many providers work in, and it means meeting similar requirements across multiple service systems. Because of this, many choose to stay unregistered.
We want regulation in the NDIS to strike a better balance, with a risk-proportionate approach for how service providers are regulated to provide services, while making sure participants still have choice and control in the supports they receive.
An example of a risk-proportionate approach is when we compare the amount of regulation applied to someone who does your gardening for you, compared to someone who provides personal support to you in your home.
The inherent risk of harm to participants is less in one support compared to the other, so we think the level of regulation needs to match that risk. The regulator should also prioritise their oversight based on the areas of greatest risk to participants and the track record of the provider. At the moment this is not always the case. A risk-based approach will strengthen the regulatory responses to long standing and emerging quality and safeguard issues, including duty of care expectations. Kevin Cocks notes:
"Regulation is so important. It is how the scheme ensures your safety and quality supports.
We want regulation to strike a better balance, with a risk-proportionate approach for providers, depending on their services."
We want to see better regulatory oversight and coverage of the entire provider market in a way that is graduated and proportionate to risk. This should be supported by Practice Standards and Quality Indicators that reflect expectations for safe and good quality support delivery.
Until next time,
Bruce and Lisa
Public submissions available to view
Many comments, discussions and submissions commented on the need to better protect the safety for people with disability.
“…the focus needs to be on quality and outcomes, rather than simply price… Quality should be the bottom line for eligibility to provide services.”
“It is not up to individuals and their supports to enforce those safeguards. Despite all those supposedly existing safeguards, people like me are experiencing poor quality and unsafe services. And I worry a lot about what people with higher needs, not able to communicate for themselves, etc are experiencing.”
“[Unregistered] providers do not have to show compliance with NDIS safety, quality and workforce regulations. The lack of transparent control on quality standards and supervision would cause harm to NDIS participants…the lack of registration means there would be operations with unregulated quality standards, unaccountable operators, and little visibility on who receives payments, opening the door to fraud and scams as well as risks of violence, abuse, neglect and exploitation.”
View the submissions published to date at the NDIS Review website - submissions page.