The establishment of the NDIS Quality and Safeguards Commission
(the Commission) to provide centralised oversight of safeguarding for the NDIS was an important step towards improving safeguards and quality of service provision for people with disability in Australia, and especially for NDIS participants who may face increased risks of being subject to abuse, exploitation, or neglect.
The committee decided to conduct an inquiry into the Commission after issues with the oversight and regulation of disability service providers, including by the Commission, emerged in light of media attention and subsequent inquiries into the tragic death of Ms Ann-Marie Smith.
This inquiry provided the opportunity for people with disability, families and carers, disability service providers, representative organisations, and other key stakeholders to share their views regarding the effectiveness of the Commission in ensuring safe, quality services for people with disability.
The inquiry has identified areas in which the Commission's approach to its work could be improved, in particular, by incorporating more proactive engagement with participants and the sector and increasing its proactive compliance and enforcement measures. In addition, gaps persist in safeguarding arrangements for NDIS participants and people with a disability more broadly, particularly in the areas where NDIS services interface with services provided by state and territory governments or other areas of the federal system.
Much of the evidence presented to the inquiry was based on experiences with the Commission during the periods in which jurisdictions were transitioning to the Commission's oversight, or in which the Commission had only recently commenced operations. Nevertheless, the committee considers that this evidence provides important insight into the work of the Commission and the experiences of people with disability, their families and advocates, and the disability sector in dealing with the Commission over this time.
The report is divided into 11 chapters and makes 30 recommendations. Chapters 1 and 2 set out background to this inquiry and for the establishment and current operations of the Commission.
Chapter 3 discusses the evidence received in relation to the Commission's communication and engagement with participants, people with disability, providers, and other interested parties, such as advocates and family members. A wide range of voices called for more proactive engagement across the sector, noting the important role for the Commission in building capacity in participants and providers to understand the rights and obligations involved in receiving and providing supports under the NDIS. The committee makes 3 recommendations in this chapter, including calling for the Commission to develop an overarching communications and engagement strategy for building visibility of its work among people with disabilities and providers.
Chapter 4 explores the Commission's approach to compliance and enforcement. Evidence to the inquiry indicated that the Commission's enforcement powers appear adequate, however, there was consensus from a range of submitters and witnesses across the disability sector, along with people with disability and their families, that the Commission should be more proactive in the exercise of its compliance and enforcement powers. The committee makes 5 recommendations in relation to incorporating more proactive approaches to compliance and enforcement and improving the transparency and visibility of the Commission's compliance activity.
Chapter 5 discusses the Commission's functions with respect to registration of NDIS providers and worker screening. The committee heard that registration poses significant administrative and cost burdens on some providers, including costs associated with audits. National worker screening arrangements commenced during the inquiry, and submitters raised concerns about delays in processing applications, and ensuring that the process would be understood. The committee makes 6 recommendations including that the Commission undertake reviews of provider registration requirements, and the new national worker screening arrangements.
Chapter 6 examines complaints handling by the Commission. The committee heard that many participants and people with a disability face barriers in accessing the Commission's complaints process, and that, for those who are able to access it, the complaints process can be frustrating and drawn out. The committee makes 4 recommendations relating to assisting complainants to access and progress through the complaints process, including through facilitating access to external advocacy organisations to assist people with disability to make complaints.
Chapter 7 considers the Commission's approach to reportable incidents. Evidence to the inquiry suggested that some aspects of the reportable incidents framework should be addressed to strike the right balance of ensuring the Commission is notified of serious incidents while ensuring providers are not subjected to unnecessary burdens and understand their obligations. The committee makes 1 recommendation relating to allowing the Commission's incident reporting mechanism to identify systemic quality and safeguarding issues.
Chapter 8 discusses the Commission's functions with respect to behaviour support and national coordination of efforts to reduce and eliminate the use of restrictive practices by NDIS providers. Imposition of restrictive practices presents the risk of systemic and serious incursions on the rights of people with a disability, and the committee is concerned by the high prevalence of unauthorised use of restrictive practices by NDIS providers. The committee makes 4 recommendations in this chapter relating to increasing the number of practitioners who provide behaviour support, formal inclusion of clinical oversight bodies in national coordination work, clarifying responsibilities for regulating restrictive practices at the interface of health and mental health sectors, and information sharing.
Chapter 9 considers the staffing and resourcing of the Commission. The issues raised in evidence can be summarised as being caused by insufficient staff numbers; insufficient training for staff; inefficient ICT systems; and poor communication within the Commission. The committee also notes that during the inquiry the Commission has received increased funding and significantly increased its staffing levels. The committee makes 4 recommendations in this chapter, relating to reviewing staffing levels, ensuring appropriate resourcing for the Commission, staff training, and ensuring ICT resources are adequate.
Chapter 10 examines evidence received in relation to the Commission's broader oversight roles and managing systemic risks to NDIS participants and other people with disabilities. The committee makes 3 recommendations including in relation to matters for consideration in the upcoming review of the NDIS Quality and Safeguarding Framework, and in relation to developing training materials emphasising the systemic factors that increase risks to safety of people with disabilities.
Chapter 11 sets out concluding comments from the committee.
As noted throughout this report, since the inquiry began in mid-2020 the Commission has adopted a range of measures to improve its practice and processes. The committee welcomes these changes and was pleased to note the Commission's willingness to listen to people with disability, their advocates and the sector and to adapt processes in response over the course of the inquiry.
It is nevertheless clear that safeguarding gaps continue to exist for people with disability, and that work by the Commission and all Australian governments needs to continue to identify safeguarding gaps and quickly address them. The review of the NDIS Quality and Safeguarding Framework is crucial in this respect, and, in addition to its specific recommendations, the committee urges the Government to carefully consider all matters raised in this report in that review.
The committee thanks all those who contributed to the inquiry, particularly participants, their family members and advocates who gave the inquiry first-hand information about their experiences with the Commission.