This article contains references to abuse, violence, neglect and sexual assault of people with disabilities.
This article is part three of a series. Read part one here.
The Quality and Safeguards Commission is the last line of defence for people being cared for under the National Disability Insurance Scheme (NDIS). It’s the service’s watchdog, where people with disabilities can turn with complaints about their care or services.
But an Inq investigation has found it’s so overwhelmed that of more than 71,000 complaints and incident reports it received in the second half of 2019 just 11 resulted in any sanction.
Staff overwhelmed with reports
Former employees paint a picture of an overwhelmed workforce with executives unwilling to impose punitive measures on providers.
“The workload is untenable. I’m being told on a daily basis people are bursting into tears and walking out the door,” one former employee says.
According to the commission’s most recent available annual report, it employed 185 ongoing staff in 2018-19, 113 of whom were in NSW. Of these, 97 were public servants of non-senior and non-executive levels — working at the front line, receiving complaints and incident reports.
From July to December 2019, the commission received a whopping 69,397 incident reports from providers and 2022 complaints. When a person with a disability is harmed or is at risk of harm, the service provider is required to submit an incident report.
Community and Public Sector Union deputy national secretary Beth Vincent-Pietsch told Inq the commission was chronically under-resourced.
“The [commission] is understaffed. Like many Commonwealth agencies and departments, we have seen chronic understaffing since the election of the Liberal government,” she says.
“It is no secret that since the introduction of the average staffing level cap, over 18,000 [public servants] have been cut under the federal government. This will always have an impact on workload and capacity, and it has been felt in [the commission].”
Powers seldom used
After the commission investigates an incident report or complaint, it can ban workers and providers from registering with the NDIS. But these powers are seldom used: since the commission was implemented in 2018, it has banned just 22 of the more than 18,000 registered providers.
“A lot of us left because we were restricted in what we could do,” another former employee tells Inq.
Centre Alliance MP Rebekha Sharkie told Inq fewer than 1% of reportable incidents were referred to the investigation team.
“Files are closed and there’s no action,” she says.
Last month she called for an urgent review into claims of a “hear no evil, see no evil” culture within the commission.
In parliament, she revealed a series of allegations from whistleblowers:
- That the commission didn’t investigate the death of a man who was given strong sedatives during a routine examination
- That the commission ignored an allegation of sexual assault where the person had been photographed
- That an investigation into the alleged rape of an intellectually disabled person by one or more carers was delayed by four months because it was deemed “not serious” enough by the commission’s reportable incident team.
“These cases were found by chance. We just don’t know how many more situations are like that,” Sharkie says.
“I’m personally very concerned about how the commission operates as far as I’ve been told. It passively receives information and makes no attempt to go out and investigate.”
Inq understands issues regarding workload and culture are more prevalent in NSW and South Australia which were the first to adopt the commission in July 2018. Other states signed on later, with the exception of Western Australia which will sign on later this year.
Bans can only be enforced if the worker or provider is still delivering services under the NDIS so if they’re fired, or if the provider closes and reopens under another name, no punitive action can be taken.
Legislation will soon be introduced to change this.
High volumes dismissed
To defend the high number of cases received, commission registrar Samantha Taylor told a federal inquiry that 94% of reportable incidents logged by providers were instances of “restrictive practices” — measures they take to manage behaviour.
“Mostly those reportable incidents related to restrictive practices do not require our investigation,” Taylor says.
But Flinders University social work lecturer Louise Butler told Inq unauthorised restrictive practices could be very serious.
“These are practices that staff use, often on a daily basis, that are intended to be a short term solution to keep people safe,” she said.
“Restrictive practices may be necessary in very limited circumstances but should never be a ‘set and forget’ as prolonged use without oversight is dangerous.”
They can range from chemical restraints like psychotropic medication to physical restraints such as strapping a person down or locking someone in their home.
Of the 65,398 incident reports submitted to the commission in the last half of 2019, more than half related to chemical restraints.
Each time a practice is used without the proper authority — that is, it hasn’t been approved by a state-sanctioned organisation and outlined in the person’s behaviour support plan written by a registered practitioner — it is reported to the commission.
“If reportable incident officers are overwhelmed with these unauthorised reportable incidents — as well as other serious incidents and cases of abuse and neglect — then they are not able to analyse the practices properly, monitor their use effectively, or ensure that they are being managed appropriately,” Butler says.
High levels of these reports lead to high caseloads for commission staff.
“[This] impedes their ability to manage other serious incidents that may require immediate intervention or investigation,” she says.
The commission told Inq that the remaining 6% of reportable incidents involved harm, or allegations of harm, to a person with a disability.
“All such reports made to the NDIS commission are immediately assessed,” it says. “Where these involve allegations of a criminal nature they must be referred to the police or other relevant authorities.”
When reportable incidents are logged by a provider there’s also no legal obligation to let the person involved know, meaning some people with disabilities may have no idea that what’s being done to them is unlawful.
“It is our expectation that providers will engage with the people they support who are subject to these incidents,” the commission says.
Commission ignores UN convention on disability rights
This failure to investigate incidents means the commission — and Australia — is failing to uphold the United Nations Convention on the Rights of Persons with Disabilities, which Australia signed on to in 2007, Flinders University professor in disability and community inclusion Sally Robinson told Inq.
“There are two articles in the convention: the right to be free from violence and abuse, and the right to be free from torture,” she says. To commit to the convention, Australia developed the national disability strategy in 2010.
“It applies rights to people that traditionally have not had them, or had them applied in the same way as other citizens have,” Robinson says.
“People with disabilities have been subject through history to violence seen as service mismanagement or poor practice or staff issues or behavioural issues, all minimising and ignoring and silencing what in the wider community are issues of violence and abuse.”
*Surnames withheld for privacy