Monday, November 13, 2017

NDIS: The challenges ahead



The National Disability Insurance Scheme (ndis) continues to be rolled out across Australia.  However their are still significant challengers for the disability sector, disability support providers, care workers and participants.  The ndis ushers in a new way we think about 'how we support people living with disabilities' and their families to activity participate in the life of their community.

What people affected by disability want to purchase in terms of their supports has changes.  I have previously shared how the Every Australians Counts campaign lead to the birth of the ndis. The current design and legislation that underpin the workings of he ndis as a result of what Australians with disabilities told the senate enquiry they wanted. 

This was to participate in society at a level suitable for their level of disabilities.  Families and individuals we tired of sitting on the side lines and watching life pass them by.  So now we don't need to guess how people with disabilities want to be supported they have told us.

Reflecting back on the roll out of the ndis over the last two years, much has been learned and failings of the system have emerged. Failings the ndia are seeking to correct. As the roll out commenced participants were sceptical about true reform, after years of neglect and insufficient. We soon realises we needed to the pressure on to ensure the scheme truly delivered what we fought for.


  
Much confusion was experienced by all in the lead up to the introduction of the scheme. Our collective fears have created their resistance and our own barriers to change. For services and potential provider this was about surviving in a market driven sector; for workers it was about job security and enough hours to pay the bills; and for families and participants in was the 'sure, how can things really change'?

In previously posts we saw the general consensuses of participants was a feeling, 'that nothing has changed under the ndis'. In a nut shell this was due to:-


  • Unrealistic expectations 
  • Clarity over what was covered and what wasn't
  • Confusion of choices being offered
  • Feeling pressure to sign agreements
  • Services offering little change
  • Still feeling control by others


After years of fighting for more choice and self advocacy in directing their own supports, the general consensus ia services are continuing to direct and deliver services in much the same way. Same choices at the same time, with a few more 'group' options thrown in for good measure. The natural response to the fear f change is to control others. 

The ndis planning processes comes down to 2 key words, 'Choice and control'. This in itself is misleading.  Participants have clearly stated we want an end to feeling controlled. This is very different to being in control. This is echoed in the statement, 'we are not patients and don't need fixing',  By giving participants more choices in how; when and who supports them, the ndia invites them to participate in the planning of their supports . 

This why we moved from a care model to a model where those affected by disability participated directing in the planning of their supports and the delivery. This lead to service providers fears that participants would have less protection and be irresponsible in spending their funds.

Provider were correct, the ndis was the game changer. However instead of ensuring clients were prepared for this change and felt empowered by the changes they sort to control what the could. Despite the huge amount of funding invested in ndis readiness for providers and participants my own experience tells me we underestimated the impact of the changes.

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We were promised a scheme that would deliver for all Australians not just those living with disability. In other words a scheme that would work towards the inclusion of participants not the isolated scattered activities on the rim of the community. These could not and will not deliver inclusion. 

A day trip to the shops or movies in groups is not going to build inclusion to build inclusion we need to be activity involved in the community.  This includes activities like education, training, developing life skills, volunteering, employment, participating in the community (through festivals, events life Santa arrival to Ipswich, Christmas carols, fund runs) playing and supporting supports and belonging to community groups like Rotary, Poetry Feast, Arts Connect, Photographic Society and Ipswich Rocks.



Offering more options by services providers at service centres does not build or promote inclusion, rather it demonstrates our failure to give participants what was asked for. As a result service providers have not delivered what participants have asked for in their plans, nor prepared for the thousands of additional participants who will be supported by the Scheme.  

Despite the marketing of thousands of new jobs, being created by the ndis, and the expect increased demand for service, providers failed to attract the workforce required to meet this increase demand.  Right up to the roll-out commencement in Ipswich fears that participants would be worst off, was the warning from providers. 

As they claimer to retain participants and attract new ones, little changes have been made to what services are being offered and how these services are being the delivered. Since personally transferring to the ndis, I elected to use one provider to meet my individual support needs. Being a self-employed artist my day is never nine to five.  I need a support network to be flexible for my ever changing work demands. 

I personally find fixed support hours difficult and I never quiet know when work is going to pop up. I had been very impressed with the training being delivered by my current provider for their support workers.  I find the support workers to be highly respectful and their investment in staff recruitment and training has yielded amazing results.

I once  cringed when I heard providers say changes under the nids don't affect workers. However could a change in what was being provided no affect front line workers?  Workers who have been delivering support from a medical model (as paid carers) are not only required in a supporting role.  This is a huge change, where staff have been told its business as usual naturally clients are assuming nothing has changed and the have no more control than previously. 

That's why we need to keep self-advocating, the only way we can experience greater choice in service delivery is to demand better customer service.   My current provider may be doing a great job in recruitment and training.  However failure ti deliver service at a times I need it has resulted in my impeding departure.  I know the lack of consistent service delivery is irritating my staff. Lack of regular work makes it difficult to maintain a personal life.  They feel like there on 24 hour call and that was not what the agreed too. 

So as long as providers continue to struggle with the support staff/ participant ratio and shifts are often not filled.  No one quiet has the answers to what happens when half my team is away.  For a period of weeks my shifts remained unfilled. This week I have been talking to other providers about the availability of suitable staff for myself..  Yesterday they sounded unsure, today they are confident they can deliver.  Now it is myself who is unsure.



Currently I am partially self-managing through a Plan Manager, however engaging my own team is a real possibility, however I want t ensure I chose a model that delivers well for me and then I need to find that team.  That is never going to happen in the next few weeks.  I need time. 

Time that changing service providers will give me.  However for such a short period is it better the devil I know.  Rather that a new team.  It makes a whole lot more sense to put that energy into recruitment and training of team Debbie.  There are a few providers that can assist me with this and are willing to let me hand pick my staff and that's what I am learning towards at present.  The team would be employed be the provider not me. 



Clearly in Ipswich we are not meeting these challenges and ndis participants and their families remain isolated.   


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