responses from the new NDIS Quality & Safeguards Commission

Following is correspondence with the new NDIS Quality & Safeguards Commission. It shows this Commission:

  • does not regard insufficient/inadequate NDIS supports, especially behaviour supports, for an NDIS participant as being within the jurisdiction of the Commission. Instead, it refers back to the NDIS (who were included in communications about the matter and who did not respond to the complaint).
  • says that this lack of NDIS supports should be referred to the NSW Health or the Health Care Complaints Commission. This is true in respect of the hospital's conduct, but not in relation toi the failures of the NDIS in this matter. When the Commission was announced, advocates were assured by an extensive (and incomplete) panel of complaints/review agencies that they would work together. Clearly, that approach didn't last long.
  • regards assurances from a service provider (the hospital) is grounds for no further investigation. The Commission doesn't even appear to have investigated why the NDIS didn't ensure a behaviour plan is in place and is implemented effectively ... the part of this saga that is in the Commission's jurisdiction.

This is an extremely disappointing start for this new Commission. This will not protect vulnerable people with disability.


Subject: RE: Please work harder on improving XX's services and supports [SEC=UNCLASSIFIED]
Date: Tue, 18 Sep 2018 06:58:47 +0000
From: HUMPHREYS, Graham <Graham.HUMPHREYS@ndiscommission.gov.au>
To: Bob Buckley (A4 Convenor) <convenor@a4.org.au>

Dear Mr Buckley

I refer to your email dated 13 September 2018. I note the email was also copied to a number of people however, I have decided not to include them in my reply to respect the X family’s privacy.

On 18 September 2018, the NDIS Quality and Safeguards Commission (‘the Commission’) contacted the Shoalhaven District Memorial Hospital and spoke with the Director of Allied Health as the issues raised in your complaint relate to the health and wellbeing of Mr XX at Shoalhaven District Memorial Hospital. 

This includes:

  1. Mr XX has now been in the hospital for 209 day and is confined to his room;
  2. Mr XX’s behaviour and health are deteriorating,
  3. Mr XX is being physically restrained to administer medication
  4. Mr XX is being chemically restrained (sedated).

The Director advised that Mr XX’s behaviour makes it difficult to conduct a full heath assessment, however we were told Mr XX appears to have gained weight and the hospital have said that he is well.

While the NDIS Commission undertook these preliminary enquiries, the issues you have raised fall outside the Commission’s jurisdiction. The allegations relate to actions within a state run Hospital they fall within the jurisdiction of NSW Health or the Health Care Complaints Commission.

A complaint can be lodged directly with the Health Care Complaints Commission by:

Phone:                  1800 043 159

Online:                 http://www.hccc.nsw.gov.au/

You have mentioned that Ms MX is concerned with the involvement of NDIA staff member Ms ZZ. This aspect of your complaint is outside the jurisdiction of the NDIS Commission and would be better dealt with by the NDIA.

A complaint can be lodged directly with the NDIA by:

Phone:                    1800 800 110

Online:                    feedback@ndis.gov.au

In accordance with the NDIS Complaints Management and Resolution Rules 2018, (‘the Rules’) section 17(1)(e), I have determined that the above mentioned issues are better dealt with by another person or body.

If you are dissatisfied with the response of the NDIA you have the option of contacting the Commonwealth Ombudsman.

With regard to your concerns raised about Mr Payne from the Benevolent Society, the NDIS Commission will make enquiries into the claim that “his approach is to allow XX's distressed behaviour to escalate while XX is in hospital; he is allowing XX to deteriorate rather than seeking to support him immediately”.

In regards to Mr XX’s Behaviour Support Plan, the NDIS Commission have been advised that CareSouth are working with Mr XX to develop a plan. The NDIS Commission will make contact with this provider to seek further information about the plan.

The NDIS Commission will continue to monitor the progress of Mr XX’s circumstances.

I trust this information is of assistance to you.

Graham Humphreys

Director | Complaints

NSWComplaints@ndiscommission.gov.au  | www.ndiscommission.gov.au

The NDIS Commission acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to elders both past and present.        


From: Bob Buckley (A4 Convenor) <convenor@a4.org.au>
Sent: Thursday, 13 September 2018 3:38 PM
To: HUMPHREYS, Graham <Graham.HUMPHREYS@ndiscommission.gov.au>
Cc: MX; nswombo@ombo.nsw.gov.au; office@williams.minister.nsw.gov.au; McNAUGHTON, SCOTT <SCOTT.MCNAUGHTON@ndis.gov.au>; HAMMOND, Cassie <Cassie.HAMMOND@ndis.gov.au>; office@hazzard.minister.nsw.gov.au; office@goward.minister.nsw.gov.au; office@roberts.minister.nsw.gov.au; canterbury@parliament.nsw.gov.au; bankstown@parliament.nsw.gov.au
Subject: Re: Please work harder on improving XX's services and supports [SEC=UNCLASSIFIED]

Dear Mr Humphreys

Yesterday, I participated in a meeting run by Ms ZZ from the NDIS about XX (see below).

It was very clear that XX is not "being cared for and his welfare and needs accommodated at the Hospital", as you claim in your email below. His welfare and needs are not being "accommodated" (met).

  1. XX has now been in the hospital for 209 day and is confined to his room;
  2. his behaviour and health are deteriorating,
  3. he is being physically restrained to be "medicated", and
  4. I understand that he is being chemically restrained (sedated).

He has not had a functional assessment and he does not have a behaviour management plan. I am concerned that the lack of behaviour management and subjecting him to probably excessive restraints without proper documentation and approval may be illegal. I hope you will do more than asking for assurances ... which seem so far to have all been worthless.

I recognise that the hospital is not meant to accommodate autistic people like XX as a patient; the failings are largely in the disability support sector.

The discussion in the meeting yesterday focused on delaying any action until officials found new accommodation for XX; but NSW Housing did not attend the meeting so there was no discernible progress for XX. The meeting refused to recognise that their approach to XX is extremely risky; they are not preparing XX sufficiently for his transition out of the hospital. XX's current situation is escalating his distressed behaviour which will lead to a much more complicated transition than if they started addressing XX's distressed behaviour immediately ... and ensure that they had sufficiently skilled staff at the time of transition.

The continued involvement of Ms ZZ in XX's situation is unwanted. Ms MX asked that she be removed. Apparently, the NDIS does not respect Ms MX's wishes particularly in relation to Ms ZZ's involvement.

I was also concerned that Mr D. Payne from the Benevolent Society is involved in XX's case management. Mr Payne told us in the meeting that he has 30 years experience managing "challenging behaviour" yet his approach is to allow XX's distressed behaviour to escalate while XX is in hospital; he is allowing XX to deteriorate rather than seeking to support him immediately. This is not best practice.

Please can you let me know whether there is a registered behaviour and restraint management plan for Mr XX in place? If so, who is the registered behavioural clinician/professional responsible and is his plan progressing as expected? If not, when will it be there?

XX needs help now. Please ensure that XX gets a behaviour management plan and the supports needed to ensure its effectiveness immediately. And please monitor it closely to ensure that it actually happens.

sincerely,
Bob Buckley
Convenor, Autism Aspergers Advocacy Australia (A4)
website: http://a4.org.au/
M: 04xx xxx xxx

A4 is the national grassroots organisation advocating for autistic people, their families, carers and associates. A4 is internet based so that Australians anywhere can participate.

“The first step in solving any problem is recognising there is one.” Jeff Daniels as Will McEvoy in The Newsroom.


On 28/8/18 1:41 pm, HUMPHREYS, Graham wrote:

Dear Mr Buckley

I refer to your email dated 21 August 2018 on behalf of XX and to our conversation of 15 August 2018.

In my email to you dated 15 August 2018 (below), I advised that the NDIS Quality and Safeguards Commission (‘NDIS Commission’) would contact the Shoalhaven District Hospital (‘the Hospital’) to make enquiries into XX’s care and wellbeing. I can assure you that the NDIS Commission immediately followed up on that undertaking.

On 16 August 2018, the NDIS Commission contacted the Hospital and spoke with the Director of allied health.  The NDIS Commission sought an assurance that XX is safe and well. The NDIS Commission was given an assurance that XX is being cared for and his welfare and needs accommodated at the Hospital.  

However, the Director noted that this form of care arrangement was not preferable in the longer term for XX. We are advised that Illawarra Advocacy are providing support to the family and participated in meetings at the hospital where XX’s longer term care needs were discussed.

The NDIS Commission has also held regular discussions with ZZ from the National Disability Insurance Agency (NDIA). Ms ZZ has informed the NDIS Commission the NDIA is working towards finding XX suitable accommodation and support arrangements.

Ms ZZ has told the NDIS Commission she is liaising with Housing NSW and XX’s parents to find suitable accommodation to meet XX’s needs. In this regard, I understand that the NDIA and Housing NSW are exploring an option of modified accommodation in East Nowra.

I understand there is also another meeting with the hospital in the next few days to include all key stakeholders to discuss a transition plan. Ms ZZ has also indicated the NDIA is working towards engaging a provider appropriate for XX’s needs.  

Based on the assurances the NDIS Commission has received from the Hospital, the involvement of NDIA and the active involvement of Housing NSW, the NDIS Commission is not able to do anything further at this stage and it would appear that XX’s circumstances are being addressed. While the NDIS Commission will continue to monitor the progress of XX’s circumstances, I do not propose taking any further action at this stage. The NDIS Commission is available to respond to any further complaints or concerns raised by XX’s parents or advocate directly with the Commission.

I trust this information is of assistance to you.

Graham Humphreys

Director | NDIS Commission  - Complaints handling

  (02) 4722 7239 |  graham.humphreys@ndiscommission.gov.auwww.ndiscommission.gov.au

The NDIS Commission acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to elders both past and present.     


From: Bob Buckley (A4 Convenor) <convenor@a4.org.au>
Sent: Tuesday, 21 August 2018 3:01 PM
To: Dan Tehan (APH) <dan.tehan.mp@aph.gov.au>; Greg.Hunt.MP@aph.gov.au
Cc: HUMPHREYS, Graham <Graham.HUMPHREYS@ndiscommission.gov.au>; Contact Centre (NDIS Commission) <ContactCentre@ndiscommission.gov.au>; NDIA - Chair <Chair@ndis.gov.au>; De Luca, Roberts <Roberts.DeLuca@ndis.gov.au>; LYE, Michael <Michael.LYE@dss.gov.au>; MX
Subject: Re: Please work harder on improving XX's services and supports [SEC=UNCLASSIFIED]

Dear Ministers

As I have not heard of any progress toward meeting XX's needs since I wrote previously (see below), I called Minister Hunt's Office today. Ms Briony helpfully suggest that I write to you making as clear as I could what needs to be done for XX. So here is my suggestion.

Mr XX needs supported accommodation and other services that specifically meet his needs and provide him with a safe place to reside.

I suggest the two Ministers act together to make an appropriate individual responsible for XX's immediate outcome.

I recognise this person will have a difficult job because it is very unlikely such a facility currently exists. The person needs the authority and resources to ensure the outcome XX requires is achieved quickly.

I suggest that unless the Ministers for Health and Disability act jointly to ensure some individual is made responsible for this outcome, and this outcome is given top priority, there will be very little, probably no, progress.

I suggest that XX's situation be addressed before a systemic approach is considered.

Bob Buckley
Convenor, Autism Aspergers Advocacy Australia (A4)
website: http://a4.org.au/

A4 is the national grassroots organisation advocating for autistic people, their families, carers and associates. A4 is internet based so that Australians anywhere can participate.

“The first step in solving any problem is recognising there is one.” Jeff Daniels as Will McEvoy in The Newsroom.


On 15/8/18 5:45 pm, HUMPHREYS, Graham wrote:

Dear Mr Buckley

I refer to your email dated 13 August 2018 concerning the welfare of XX (last name unknown).

As you are aware, your representations have been referred to the NDIS Quality and Safeguards Commission (‘the Commission’).  

Thank you for your time this afternoon to discuss your concerns and XX’s welfare in more detail.  Following our conversation, I am writing to confirm that the Commission will contact the Shoalhaven District Hospital tomorrow as part of its preliminary enquiries into his care.  

You mentioned there was a recent meeting with the Hospital and MX but the outcome of that meeting was not known. I can confirm the Commission’s enquiries will initially look into the outcome of that meeting and planned next steps for XX’s care. 

At your suggestion, the Commission will also explore the supports being provided to Belinda such as a case manager and advocate.

Ministers Tehan and Hunt have requested that the Commission keep them informed about the progress of our enquiries into XX’s care.

I can be contacted on 02 4722 7239 if you would like to have a further conversation about XX’s care or have any additional information to provide.

Graham Humphreys

Director | Complaints

  (02) 4722 7239 |  graham.humphreys@ndiscommission.gov.auwww.ndiscommission.gov.au

The NDIS Commission acknowledges the traditional owners of country throughout Australia, and their continuing connection to land, sea and community. We pay our respects to them and their cultures, and to elders both past and present.        


From: Bob Buckley (A4 Convenor) <convenor@a4.org.au>
Sent: Monday, 13 August 2018 7:24 PM
To: Dan Tehan (APH) <dan.tehan.mp@aph.gov.au>; Greg.Hunt.MP@aph.gov.au
Cc: Contact Centre (NDIS Commission) <ContactCentre@ndiscommission.gov.au>; NDIA - Chair <Chair@ndis.gov.au>; De Luca, Roberts <Roberts.DeLuca@ndis.gov.au>; LYE, Michael <Michael.LYE@dss.gov.au>
Subject: Please work harder on improving XX's services and supports

Dear Minister

A young autistic man named XX has now been in Shoalhaven District Memorial Hospital for 178 days. He sleeps on a mattress on the floor with a "guard" outside his door. Autism Aspergers Advocacy Australia (known as A4) regards hospital as a less-than-ideal setting for this young man.

A4 understands that since his admission the hospital has been trying to discharge XX into a suitable setting, but so far their efforts have been thwarted. Government Health and Disability services need to do much better than this.

MX is keen that A4 do what we can to improve XX's situation. So we write to you initially asking that your Government make XX's well being a substantially higher priority than it currently is. We request that you intervene directly in this matter to ensure the required attention and resources are immediately available. For example, we understand that a meeting about XX is scheduled with MX tomorrow, but whoever arranged this meeting failed to ensure XX's disability advocate and case manager (NDIS?) can attend.

We also understand that the NDIS Quality and Safety Commission came into effect on the 1st July 2018 in NSW. As yet, A4 has seen no indication that the newly-required management and reporting of restrictive practices is in place. Or is no one actually responsible for overseeing XX's support in NSW?

A4 understands that the NDIS Quality and Safety Commission approach is modelled on the Victorian model. A4 is concerned that the Victorian model is demonstrably inadequate in relation to some autistic Australians -- see for example, a Victorian family needs a GoFundMe campaign for disability support. Another example, where prison was the "provider of last resort", appears here. Clearly, the Victorian model is not a good model for supporting autistic Australians. Australia and NSW must do much better to meet the needs of autistic citizens.

Please work harder on improving XX's services and supports.

I can be reached on 04xx xxx xxx if you want to discuss this matter.

--
Bob Buckley
Convenor, Autism Aspergers Advocacy Australia (A4)
website: http://a4.org.au/

A4 is the national grassroots organisation advocating for autistic people, their families, carers and associates. A4 is internet based so that Australians anywhere can participate.

“The first step in solving any problem is recognising there is one.” Jeff Daniels as Will McEvoy in The Newsroom.