Federal Register of Legislation - Australian Government

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This instrument sets out the guidelines for National Disability Insurance Scheme (NDIS) providers on how to meet the NDIS Practice Standards.
Administered by: Social Services
Registered 18 May 2018

Commonwealth Coat of Arms of Australia

 

 

National Disability Insurance Scheme (Quality Indicators) Guidelines 2018

I, Graeme Head, Commissioner of the NDIS Quality and Safeguards Commission, make the following Guidelines.

Dated   17 May 2018

Graeme Head

Commissioner of the NDIS Quality and Safeguards Commission

 

 

 


Contents

Part 1 – Preliminary                                                                                                     1

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Definitions................................................................................................................................ 1

4A  Interpretation......................................................................................................................... 3

Part 2 – Core Module                                                                                                   4

5  Applicable Practice Standards.................................................................................................. 4

Division 1 – Rights and Responsibilities                                                                 4

6  Person-centred supports........................................................................................................... 4

7  Individual values and beliefs.................................................................................................... 4

8  Privacy and Dignity.................................................................................................................. 4

9  Independence and Informed Choice......................................................................................... 5

10  Violence, Abuse, Neglect, Exploitation and Discrimination................................................... 5

Division 2 – Governance and Operational Management                                       6

11  Governance and Operational Management............................................................................. 6

12  Risk Management................................................................................................................... 7

13  Quality Management.............................................................................................................. 7

14  Information Management....................................................................................................... 8

15  Feedback and Complaints Management................................................................................. 8

16  Incident Management............................................................................................................. 9

17  Human Resource Management............................................................................................... 9

18  Continuity of Supports......................................................................................................... 10

Division 3 – Provision of Supports                                                                        10

19  Access to Supports............................................................................................................... 10

20  Support Planning.................................................................................................................. 11

21  Service Agreements with Participants.................................................................................. 11

22  Responsive Support Provision............................................................................................. 12

23  Transitions to or from the provider....................................................................................... 13

Division 4 – Support Provision Environment                                                       13

24  Safe Environment................................................................................................................. 13

25  Participant Money and Property........................................................................................... 13

26  Management of Medication.................................................................................................. 14

27  Management of Waste.......................................................................................................... 14

Part 3 – Module 1: High Intensity Daily Personal Activities                                   15

28  Applicable Practice Standards.............................................................................................. 15

29  Complex Bowel Care........................................................................................................... 15

30  Enteral (Naso-Gastric Tube – Jejunum or Duodenum) Feeding and Management............... 15

31  Tracheostomy Management.................................................................................................. 16

32  Urinary Catheter Management (In-dwelling Urinary Catheter, In-out Catheter, Suprapubic Catheter)              16

33  Ventilator Management........................................................................................................ 17

34  Subcutaneous Injections....................................................................................................... 17

35  Complex Wound Management............................................................................................. 18

Part 4 –Module 2: Specialist Behaviour Support                                                     19

36  Applicable Practice Standards.............................................................................................. 19

37  Application of Module......................................................................................................... 19

38  Behaviour Support in the NDIS........................................................................................... 19

39  Restrictive Practices.............................................................................................................. 19

40  Functional Behaviour Assessments and Behaviour Support Plans...................................... 20

41  Supporting the Implementation of the Behaviour Support Plan............................................ 21

42  Behaviour Support Plan Monitoring and Review................................................................. 22

43  Reportable Incidents involving the Use of a Restrictive Practice.......................................... 22

44  Interim Behaviour Support Plans......................................................................................... 23

Part 5 –Module 2A: Implementing Behaviour Support Plans                                24

45  Applicable Practice Standards.............................................................................................. 24

46  Application of Module......................................................................................................... 24

47  Behaviour Support in the NDIS........................................................................................... 24

48  Regulated Restrictive Practices............................................................................................. 24

49  Supporting the Assessment and Development of Behaviour Support Plans........................ 25

50  Behaviour Support Plan Implementation.............................................................................. 25

51  Monitoring and Reporting the Use of Regulated Restrictive Practices................................. 26

52  Behaviour Support Plan Review.......................................................................................... 26

53  Reportable Incidents involving the Use of a Restrictive Practice.......................................... 27

54  Interim Behaviour Support Plans......................................................................................... 27

Part 6 –Module 3: Early Childhood Supports                                                         29

55  Applicable Practice Standards.............................................................................................. 29

56  The Child.............................................................................................................................. 29

57  The Family........................................................................................................................... 29

58  Inclusion............................................................................................................................... 30

59  Collaboration........................................................................................................................ 30

60  Capacity Building................................................................................................................. 30

61  Evidence-Informed Practice.................................................................................................. 31

62  Outcome Based Approach.................................................................................................... 31

Part 7 –Module 4: Specialised Support Coordination                                             33

63  Applicable Practice Standards.............................................................................................. 33

64  Specialised Support Coordination........................................................................................ 33

65  Management of a Participant’s NDIS Supports................................................................... 33

66  Conflict of Interest................................................................................................................ 34

Part 8 – Module 5: Specialist Disability Accommodation                                        35

67 Applicable Practice Standards............................................................................................... 35

68  Rights and Responsibilities.................................................................................................. 35

69  Conflict of Interest................................................................................................................ 35

70  Service Agreements with Participants.................................................................................. 36

71  Enrolment of SDA Properties.............................................................................................. 37

72  Tenancy Management........................................................................................................... 37

Part 9 –Verification                                                                                                    40

73 Applicable Practice Standards............................................................................................... 40

74  Human Resource Management............................................................................................. 40

75  Incident Management........................................................................................................... 40

76  Complaints Management...................................................................................................... 40

77  Risk Management................................................................................................................. 41

 

 

                                                                                    

                                                                                    


Part 1 – Preliminary

1  Name

                   This instrument is the National Disability Insurance Scheme (Quality Indicators) Guidelines 2018.

2  Commencement

                   This instrument commences on 1 July 2018.

3  Authority

                   This instrument is made under subsection 181D(2) of the National Disability Insurance Scheme Act 2013.

4  Definitions

Note:          A number of expressions used in this instrument are defined in section 9 of the Act, including the following:

(a)    National Disability Insurance Scheme rules

(a)    nominee

(b)    participant;

(c)    plan;

(d)    restrictive practice

                   In this instrument:

                   Act means the National Disability Insurance Scheme Act 2013.

                   behaviour support plan means:

                     (a)  a comprehensive behaviour support plan; or

                     (b)  an interim behaviour support plan.

                   NDIS behaviour support practitioner means a person the Commissioner considers is suitable to undertake behaviour support assessments (including functional behavioural assessments) and to develop behaviour support plans that may contain the use of restrictive practices.

                   dignity of risk means the right of the individual to choose to take some risk in engaging in life experiences.

                   functional behavioural assessment means the process for determining and understanding the function or purpose behind a person’s behaviour, and may involve the collection of data, observations, and information to develop an understanding of the relationship of events and circumstances that trigger and maintain the behaviour.

                   skills descriptor means the specific knowledge and skills required to perform the work.

 

 

                   key worker means a person who is chosen by the family of a child receiving early childhood early intervention supports to work with them to coordinate information, services and supports for the child.

                   regulated restrictive practice means a restrictive practice that is or involves any of the following:

                     (a)  seclusion, which is the sole confinement of a person with disability in a room or a physical space at any hour of the day or night where voluntary exit is prevented, or not facilitated, or it is implied that voluntary exit is not permitted;

                     (b)  chemical restraint, which is the use of medication or chemical substance for the primary purpose of influencing a person’s behaviour. It does not include the use of medication prescribed by a medical practitioner for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition;

                     (c)  mechanical restraint, which is the use of a device to prevent, restrict, or subdue a person’s movement for the primary purpose of influencing a person’s behaviour but does not include the use of devices for therapeutic or non‑behavioural purposes;

                     (d)  physical restraint, which is the use or action of physical force to prevent, restrict or subdue movement of a person’s body, or part of their body, for the primary purpose of influencing their behaviour. Physical restraint does not include the use of a hands‑on technique in a reflexive way to guide or redirect a person away from potential harm/injury, consistent with what could reasonably be considered the exercise of care towards a person;

                     (e)  environmental restraints, which restrict a person’s free access to all parts of their environment, including items and activities.

Note:          For the definition of restrictive practice, see section 9 of the Act.

                   service agreement means a written agreement between the provider and the participant on the supports to be provided and the conditions surrounding those supports.

                   specialist behaviour support provider means a registered NDIS provider whose registration includes the provision of specialist behaviour support services.

                   support network means family, friends, carers and other people who have a supportive relationship with a participant.

                   support plan means a document developed in response to a request for supports by the Participant and an appropriately skilled professional within the provider organisation prior to the commencement of supports.

                   worker means a person employed or otherwise engaged by a registered NDIS provider.

4A  Interpretation

             (1)  A reference in this instrument to a provider includes a reference to a person who is applying to become a registered NDIS provider.

             (2)  A reference in this instrument to a participant includes a reference to:

                     (a)  a prospective participant; and

                     (b)  a person with disability receiving supports or services from a provider under the arrangements set out in Chapter 2 of the Act; and

                     (c)  a person with disability receiving supports or services from a person included in a class of persons prescribed for the purposes of subparagraph (b)(ii) of the definition of NDIS provider in section 9 of the Act.

             (3)  A reference in this instrument to a participant providing consent, includes a nominee providing consent on a participant’s behalf.


 

Part 2 – Core Module

5  Applicable Practice Standards

                   Schedule 1 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

Division 1 – Rights and Responsibilities

6  Person-centred supports

 

Outcome: Each participant accesses supports that promote, uphold and respect their legal and human rights and is enabled to exercise informed choice and control. The provision of supports promotes, upholds and respects individual rights to freedom of expression, self-determination and decision-making.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant’s legal and human rights are understood and incorporated into everyday practice.

                     (2)  Communication with each participant about the provision of supports is responsive to their needs and is provided in the language, mode of communication and terms that the participant is most likely to understand.

                     (3)  Each participant is supported to engage with their family, friends and chosen community as directed by the participant.

7  Individual values and beliefs

 

Outcome: Each participant accesses supports that respect their culture, diversity, values and beliefs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  At the direction of the participant, the culture, diversity, values and beliefs of that participant are identified and sensitively responded to.

                     (2)  Each participant’s right to practice their culture, values and beliefs while accessing supports is supported.

8  Privacy and Dignity

 

Outcome: Each participant accesses supports that respect and protect their dignity and right to privacy.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Consistent processes and practices are in place that respect and protect the personal privacy and dignity of each participant.

                     (2)  Each participant is advised of confidentiality policies using the language, mode of communication and terms that the participant is most likely to understand.

                     (3)  Each participant understands and agrees to what personal information will be collected and why, including recorded material in audio and/or visual format.

9  Independence and Informed Choice

 

Outcome: Each participant is supported by the provider to make informed choices, exercise control and maximise their independence relating to the supports provided.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Active decision-making and individual choice is supported for each participant including the timely provision of information using the language, mode of communication and terms that the participant is most likely to understand.

                     (2)  Each participant’s right to the dignity of risk in decision-making is supported. When needed, each participant is supported to make informed choices about the benefits and risks of the options under consideration. 

                     (3)  Each participant’s autonomy is respected, including their right to intimacy and sexual expression.

                     (4)  Each participant has sufficient time to consider and review their options and seek advice if required, at any stage of support provision, including assessment, planning, provision, review and exit. 

                     (5)  Each participant’s right to access an advocate (including an independent advocate) of their choosing is supported, as is their right to have the advocate present.

10  Violence, Abuse, Neglect, Exploitation and Discrimination

 

Outcome: Each participant accesses supports free from violence, abuse, neglect, exploitation or discrimination. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Policies, procedures and practices are in place which actively prevent violence, abuse, neglect, exploitation or discrimination. 

                     (2)  Each participant is provided with information about the use of an advocate (including an independent advocate) and access to an advocate is facilitated where allegations of violence, abuse, neglect, exploitation or discrimination have been made.   

                     (3)  Allegations and incidents of violence, abuse, neglect, exploitation or discrimination, are acted upon, each participant affected is supported and assisted, records are made of any details and outcomes of reviews and investigations (where applicable) and action is taken to prevent similar incidents occurring again. 

 

                                     Note: A registered NDIS provider has obligations in relation to incident management systems and reportable incidents that may apply to incidents or a reportable incidents (see sections 73Y and 73Z of the Act and the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018).

Division 2 – Governance and Operational Management

11  Governance and Operational Management

 

Outcome: Each participant’s support is overseen by robust governance and operational management systems relevant (proportionate) to the size, and scale of the provider and the scope and complexity of supports delivered.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Opportunities are provided by the governing body for people with disability to contribute to the governance of the organisation and have input into the development of organisational policy and processes relevant to the provision of supports and the protection of participant rights. 

                     (2)  A defined structure is implemented by the governing body to meet a governing body’s financial, legislative, regulatory and contractual responsibilities, and to monitor and respond to quality and safeguarding matters associated with delivering supports to participants.

                     (3)  The skills and knowledge required for the governing body to govern effectively are identified, and relevant training is undertaken by members of the governing body to address any gaps.

                     (4)  The governing body ensures that strategic and business planning considers legislative requirements, organisational risks, other requirements related to operating under the NDIS (for example Agency requirements and guidance), participants’ and workers’ needs and the wider organisational environment.

                     (5)  The performance of management, including responses to individual issues, is monitored by the governing body to drive continuous improvement in management practices.

                     (6)  The provider is managed by a suitably qualified and/or experienced persons with clearly defined responsibility, authority and accountability for the provision of supports.

                     (7)  There is a documented system of delegated responsibility and authority to another suitable person in the absence of a usual position holder in place.

                     (8)  Perceived and actual conflicts of interest are proactively managed and documented, including through development and maintenance of organisational policies.

 

 

12  Risk Management 

 

Outcome: Risks to participants, workers and the provider are identified and managed. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Risks to the organisation, including risks to participants, financial and work health and safety risks, and risks associated with provision of supports are identified, analysed, prioritised and treated.

                     (2)  A documented system that effectively manages identified risks is in place, and is relevant and proportionate to the size and scale of the provider and the scope and complexity of supports provided.

                     (3)  Support delivery is linked to a risk management system which includes:

                                -  Incident Management;

                                -  Complaints Management;

                                -  Work Health and Safety;

                                -  Human Resource Management;

                                -  Financial Management;

                                -  Information Management; and

                                -  Governance.

13  Quality Management

 

Outcome: Each participant benefits from a quality management system relevant and proportionate to the size and scale of the provider, which promotes continuous improvement of support delivery.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  A quality management system is maintained that is relevant and proportionate to the size and scale of the provider and the scope and complexity of the supports delivered. The system defines how to meet the requirements of legislation and these standards. The system is reviewed and updated as required to improve support delivery.

                     (2)  The provider’s quality management system has a documented program of internal audits relevant (proportionate) to the size and scale of the provider and the scope and complexity of supports delivered.

                     (3)  The provider’s quality management system supports continuous improvement, using outcomes, risk related data, evidence-informed practice and feedback from participants and workers.

 

14  Information Management

 

Outcome: Management of each participant’s information ensures that it is identifiable, accurately recorded, current and confidential. Each participant’s information is easily accessible to the participant and appropriately utilised by relevant workers.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant’s consent is obtained to collect, use and retain their information or to disclose their information (including assessments) to other parties, including details of the purpose of collection, use and disclosure. Each participant is informed in what circumstances the information could be disclosed, including that the information could be provided without their consent if required or authorised by law. 

                     (2)  Each participant is informed of how their information is stored and used, and when and how each participant can access or correct their information, and withdraw or amend their prior consent.

                     (3)  An information management system is maintained that is relevant and proportionate to the size and scale of the organisation and records each participant’s information in an accurate and timely manner.

                     (4)  Documents are stored with appropriate use, access, transfer, storage, security, retrieval, retention, destruction and disposal processes relevant and proportionate to the scope and complexity of supports delivered.

15  Feedback and Complaints Management 

 

Outcome: Each participant has knowledge of and access to the provider’s complaints management and resolution system. Complaints and other feedback made by all parties are welcomed, acknowledged, respected and well-managed. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  A complaints management and resolution system is maintained that is relevant and proportionate to the scope and complexity of supports delivered and the size and scale of the organisation. The system follows principles of procedural fairness and natural justice and complies with the requirements under the National Disability Insurance Scheme (Complaints Management and Resolution) Rules 2018.

                     (2)  Each participant is provided with information on how to give feedback or make a complaint, including avenues external to the provider, and their right to access advocates. There is a supportive environment for any person who provides feedback and/or makes complaints.

                     (3)  Demonstrated continuous improvement in complaints and feedback management by regular review of complaint and feedback policies and procedures, seeking of participant views on the accessibility of the complaints management and resolution system, and incorporation of feedback throughout the provider’s organisation.

                     (4)  All workers are aware of, trained in, and comply with the required procedures in relation to complaints handling.

                                    

                                     Note: A registered NDIS provider has obligations if an incident is the subject of a complaint (see sections 73W and 73X of the Act and the National Disability Insurance Scheme (Complaints Management and Resolution) Rules 2018.

16  Incident Management 

 

Outcome: Each participant is safeguarded by the provider’s incident management system, ensuring that incidents are acknowledged, respond to, well-managed and learned from.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  An incident management system is maintained that is relevant and proportionate to the scope and complexity of supports delivered and the size and scale of the organisation. The system complies with the requirements under the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018.

                     (2)  Each participant is provided with information on incident management, including how incidents involving the participant have been managed.

                     (3)  Demonstrated continuous improvement in incident management by regular review of incident management policies and procedures, review of the causes, handling and outcomes of incidents, seeking of participant and worker views, and incorporation of feedback throughout the provider’s organisation.

                     (4)  All workers are aware of, trained in, and comply with the required procedures in relation to incident management. 

17  Human Resource Management

 

Outcome:  Each participant’s support needs are met by workers who are competent in relation to their role, hold relevant qualifications, and who have relevant expertise and experience to provide person-centred support.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The skills and knowledge required of each position within a provider are identified and documented together with the responsibilities, scope and limitations of each position.

                     (2)  Records of worker pre-employment checks, qualifications and experience are maintained.

                     (3)  An orientation and induction process is in place that is completed by workers including completion of the mandatory NDIS worker orientation program.

                     (4)  A system to identify, plan, facilitate, record and evaluate the effectiveness of training and education for workers is in place to ensure that workers meet the needs of each participant. The system identifies training that is mandatory and includes training in relation to staff obligations under the NDIS Practice Standards and other National Disability Insurance Scheme rules. 

                     (5)  Timely supervision, support and resources are available to workers relevant to the scope and complexity of supports delivered.

                     (6)  The performance of workers is managed, developed and documented, including through providing feedback and development opportunities.

18  Continuity of Supports 

 

Outcome: Each participant has access to timely and appropriate support without interruption.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Day-to-day operations are managed in an efficient and effective way to avoid disruption and ensure continuity of supports.        

                     (2)  In the event of worker absence or vacancy, a suitably qualified and/or experienced person performs the role.

                     (3)  Supports are planned with each participant to meet their specific needs and preferences. These needs and preferences are documented and provided to workers prior to commencing work with each participant to ensure the participant’s experience is consistent with their expressed preferences.

                     (4)  Arrangements are in place to ensure support is provided to the participant without interruption throughout the period of their service agreement. These arrangements are relevant and proportionate to the scope and complexity of supports delivered by the provider.

                     (5)  Where changes or interruptions are unavoidable, alternative arrangements are explained and agreed with the participant.

                     (6)  Where applicable, disaster preparedness and planning measures are in place to enable continuation of critical supports before, during and after a disaster.

Division 3 – Provision of Supports

19  Access to Supports

 

Outcome: Each participant accesses the most appropriate supports that meet their needs, goals and preferences.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The supports available, and any access / entry criteria (including any associated costs) are clearly defined and documented. This information is communicated to each participant using the language, mode of communication and terms that the participant is most likely to understand.

                     (2)  Reasonable adjustments to the support delivery environment are made and monitored to ensure it is fit for purpose and each participant’s health, privacy, dignity, quality of life and independence is supported.

                     (3)  Each participant is supported to understand under what circumstances supports can be withdrawn. Access to supports required by the participant will not be withdrawn or denied solely on the basis of a dignity of risk choice that has been made by the participant.

20  Support Planning

 

Outcome: Each participant is actively involved in the development of their support plans. Support plans reflect participant needs, requirements, preferences, strengths and goals, and are regularly reviewed.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  With each participant’s consent, work is undertaken with the participant and their support network to enable effective assessment and to develop a support plan. Appropriate information and access is sought from a range of resources to ensure the participant’s needs, support requirements, preferences, strengths and goals are included in the assessment and the support plan.

                     (2)  In collaboration with each participant, a risk assessment is completed and documented for each participant’s support plan, then appropriate strategies to treat known risks are planned and implemented. 

                     (3)  Periodic reviews of the effectiveness of risk management strategies are undertaken with each participant to ensure risks are being adequately addressed, and changes are made when required. 

                     (4)  Each support plan is reviewed annually or earlier in collaboration with each participant, according to their changing needs or circumstances. Progress in meeting desired outcomes and goals is assessed, at a frequency relevant and proportionate to risks, the participant’s functionality and the participant’s wishes. 

                     (5)  Where progress is different from expected outcomes and goals, work is done with the participant to change and update the support plan.

                     (6)  Where appropriate, and with the consent of the participant, information on the support plan is communicated to family members, carers, other providers and relevant government agencies.

21  Service Agreements with Participants 

 

Outcome: Each participant has a clear understanding of the supports they have chosen and how they will be provided.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Collaboration occurs with each participant to develop a service agreement which establishes expectations, explains the supports to be delivered, and specifies any conditions attached to the delivery of supports, including why these conditions are attached.

                     (2)  Each participant is supported to understand their service agreement and conditions using the language, mode of communication and terms that the participant is most likely to understand.

                     (3)  Where the service agreement is created in writing, each participant receives a copy of their agreement signed by the participant and the provider. Where this is not practicable, or the participant chooses not to have an agreement, a record is made of the circumstances under which the participant did not receive a copy of their agreement.

                     (4)  Where the provider delivers supported independent living supports to participants in specialist disability accommodation dwellings, documented arrangements are in place with each participant and each specialist disability accommodation provider. At a minimum, the arrangements should outline the party or parties responsible and their roles (where applicable) for the following matters:

                             (a)  How a Participant’s concerns about the dwelling will be communicated and addressed;

                             (b)  How potential conflicts involving participant(s) will be managed;

                             (c)  How changes to participant circumstances and/or support needs will be agreed and communicated;

                             (d)  In shared living, how vacancies will be filled, including each participant’s right to have their needs, preferences and situation taken into account; and

                             (e)  How behaviours of concern which may put tenancies at risk will be managed, if this is a relevant issue for the participant.

Note:          Specialist disability accommodation providers should also achieve the outcomes set out in part 8 of these Guidelines.

22  Responsive Support Provision 

 

Outcome: Each participant accesses responsive, timely, competent and appropriate supports to meet their needs, desired outcomes and goals.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Supports are provided based on the least intrusive options, in accordance with contemporary evidence-informed practices that meet participant needs and help achieve desired outcomes.

                     (2)  Where agreed in the service agreement, and with the participant’s consent or direction, links are developed and maintained through collaboration with other providers to share information and meet participant needs.

                     (3)  Reasonable efforts are made to involve the participant in selecting their workers, including the preferred gender of workers providing personal care supports.

                     (4)  Where a participant has specific needs which require monitoring and/or daily support, workers are appropriately trained and understand the participant’s needs and preferences.

 

23  Transitions to or from the provider 

 

Outcome: Each participant experiences a planned and coordinated transition to or from the provider.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  A planned transition to or from the provider is facilitated in collaboration with each participant when possible, and this is documented, communicated and effectively managed.

                     (2)  Risks associated with each transition to or from the provider are identified, documented and responded to.

                     (3)  Processes for transitioning to or from the provider are developed, applied, reviewed and communicated.

Division 4 – Support Provision Environment

24  Safe Environment 

 

Outcome: Each participants accesses supports in a safe environment that is appropriate to their needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant can easily identify workers engaged to provide the agreed supports.  

                     (2)  Where supports are provided in the participant’s home, work is undertaken with the participant to ensure a safe support delivery environment.

                     (3)  Where relevant, work is undertaken with other providers and services to identify and treat risks, ensure safe environments, and prevent and manage injuries.

25  Participant Money and Property

 

Outcome: Participant money and property is secure and each participant uses their own money and property as they determine.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Where the provider has access to a participant’s money or other property, processes to ensure that it is managed, protected and accounted for are developed, applied, reviewed and communicated. Participants’ money or other property is only used with the consent of the participant and for the purposes intended by the participant.

                     (2)  If required, each participant is supported to access and spend their own money as the participant determines.

                     (3)  Participants are not given financial advice or information other than that which would reasonably be required under the participant’s plan.

26  Management of Medication

 

Outcome: Each participant requiring medication is confident their provider administers, stores and monitors the effects of their medication and works to prevent errors or incidents. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Records clearly identify the medication and dosage required by each participant, including all information required to correctly identify the participant and to safely administer the medication.

                     (2)  All workers responsible for administering medication understand the effects and side-effects of the medication and the steps to take in the event of an incident involving medication.

                     (3)  All medications are stored safely and securely, can be easily identified and differentiated, and are only accessed by appropriately trained workers.

27  Management of Waste 

 

Outcome: Each participant, each worker, and any other person in the home is protected from harm as a result of exposure to waste, infectious or hazardous substances generated during the delivery of supports. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Policies, procedures and practices are in place for the safe and appropriate storage and disposal of waste, infectious or hazardous substances that comply with current legislation and local health district requirements.

                     (2)  All incidents involving infectious material, body substances or hazardous substances are reported, recorded, investigated and reviewed.

                     (3)  An emergency plan is in place to respond to clinical waste or hazardous substance management issues and/or accidents. Where the plan is implemented, its effectiveness is evaluated, and revisions are made if required.

                     (4)  Workers involved in the management of waste and hazardous substances receive training to ensure safe and appropriate handling. This includes training on any protective equipment and clothing required when handling waste or hazardous substances.

 


 

Part 3 – Module 1: High Intensity Daily Personal Activities

28  Applicable Practice Standards

                   Schedule 2 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

29  Complex Bowel Care

 

Outcome: Each Participant requiring complex bowel care receives appropriate support relevant (proportionate) to their individual needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their complex bowel care management. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant receiving complex bowel care.

                     (3)  All workers working with a participant requiring complex bowel care have received training, relating specifically to each participant’s needs, type of complex bowel care and high intensity support skills descriptor for providing complex bowel care, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for complex bowel care.

30  Enteral (Naso-Gastric Tube – Jejunum or Duodenum) Feeding and Management

 

Outcome: Each participant requiring enteral feeding and management receives appropriate nutrition, fluids and medication, relevant and proportionate to their individual needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their enteral feeding and management. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant who has enteral feeding needs.

                     (3)  All workers working with a participant who requires enteral feeding have completed training, relating specifically to each participant’s needs, type and method of enteral feeding and regime, and high intensity support skills descriptor for enteral feeding, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for enteral feeding.

31  Tracheostomy Management

 

Outcome: Each participant with a tracheostomy receives appropriate suctioning and management of their tracheostomy relevant and proportionate to their individual needs. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their tracheostomy suctioning and management. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant with a tracheostomy.

                     (3)  All workers have completed training, relating specifically to each participant’s needs, managing any tracheostomy related incident and high intensity support skills descriptor for providing tracheostomy care (without ventilation) and supporting a person dependent on ventilation, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for tracheostomy suctioning and management.

32  Urinary Catheter Management (In-dwelling Urinary Catheter, In-out Catheter, Suprapubic Catheter)

 

Outcome: Each participant with a catheter receives appropriate catheter management relevant and proportionate to their individual needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for management of their catheter. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant with a catheter.

                     (3)  All workers have completed training, relating specifically to each participant’s needs, type of catheter and high intensity support skills descriptor for catheter changing and management, delivered by an appropriately qualified health practitioner or a person that meets the high intensity support skills descriptor for urinary catheter changing and management.

33  Ventilator Management

 

Outcome: Each participant requiring ventilator management receives appropriate support relevant and proportionate to their individual needs and the specific ventilator used.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their ventilator management. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant who is ventilator dependent.

                     (3)  All workers have completed training, relating specifically to each participant’s ventilation needs, managing a related incident and the high intensity support skills descriptor for ventilator management, delivered by an appropriately qualified health practitioner or person who meets the high intensity support skills descriptor for ventilator management.

34  Subcutaneous Injections

 

Outcome: Each participant requiring subcutaneous injections receives appropriate support relevant and proportionate to their individual needs and specific subcutaneous injections and medication administered.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their subcutaneous injections which includes dosage measurement and calculation. With their consent, each participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  There are documented written or phone orders by the health practitioner prescribing the medication that trained workers may administer by subcutaneous injection.

                     (3)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to participants requiring subcutaneous injections and related medication.

                     (4)  All workers have completed training, relating specifically to the participant’s injection and medication needs and high intensity support skills descriptor for subcutaneous injections, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for subcutaneous injections. Workers must also have a basic understanding of the participant’s related health condition.

35  Complex Wound Management

 

Outcome: Each participant requiring complex wound management receives appropriate support relevant and proportionate to their individual needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each participant is involved in the assessment and development of the plan for their complex wound management. With their consent, the participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

                     (2)  Appropriate policies and procedures are in place, including a training plan for workers, that relate to the support provided to each participant requiring complex wound management.

                     (3)  All workers working with a participant requiring complex wound management have received training, relating specifically to the participant’s needs that are affected by their wound management regime (for example, showering, toileting and mobility) and high intensity support skills descriptor for providing complex wound management, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for complex wound management.

 


 

Part 4 –Module 2: Specialist Behaviour Support

36  Applicable Practice Standards

                   Schedule 3 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

37  Application of Module

                   This module applies to specialist behaviour support providers. It does not apply to providers implementing behaviour support plans.

38  Behaviour Support in the NDIS

 

Outcome: Each participant accesses behaviour support that is appropriate to their needs which incorporates evidence-informed practice and complies with relevant legislation and policy frameworks.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 are understood and applied.

                     (2)  All NDIS behaviour support practitioners have been assessed as suitable to deliver specialised positive behaviour support, including assessments and development of behaviour support plans.

                     (3)  Each NDIS behaviour support practitioner undertakes ongoing professional development to remain current with evidence-informed practice and approaches to behaviour support, including positive behaviour support.

                     (4)  A specialist behaviour support clinical supervisor provides clinical supervision of each work practice of the NDIS behaviour support practitioner.

                     (5)  Demonstrated commitment to reducing and eliminating restrictive practices through policies, procedures and practices.

39  Restrictive Practices

 

Outcome: Each participant is only subject to a restrictive practice that meets any state and territory authorisation (however described) requirements and the relevant requirements and safeguards outlined in Commonwealth legislation and policy.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Knowledge and understanding of regulated restrictive practices as described in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 and knowledge and understanding of any relevant state or territory legislation and/or policy requirements and processes for obtaining authorisation  (however described) for the use of any restrictive practices included in a behaviour support plan.

                     (2)  Each Behaviour Support Practitioner undertakes professional development to maintain an understanding of practices considered restrictive and the risks associated with those practices.

                     (3)  Each participant and, with the participant’s consent, their support network, providers implementing behaviour support plans, and other relevant stakeholders are engaged in discussions about the need for restrictive practices and they understand the risks associated with their use. Alternatives to the use of restrictive practices are promoted as part of these discussions.

                     (4)  Each participant and, with the participant’s consent, their support network, their providers implementing behaviour support plans and other relevant stakeholders are engaged in the development of behaviour support strategies that are proportionate to the risk of harm to the participant or others.

                     (5)  Restrictive practices are only included in a participant’s behaviour support plan in accordance with relevant Commonwealth legislation and/or policy requirements and relevant state or territory legislation and/or policy requirements for obtaining authorisation  (however described) for the use of any restrictive practices.

                     (6)  Regulated restrictive practices in behaviour support plans comply with the conditions prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.

                     (7)  Each participant’s behaviour support plan or interim behaviour support plan includes strategies that will lead to the reduction and elimination of any restrictive practices included in the plan.

                     (8)  Support is provided to other providers implementing a behaviour support plan , in delivering services, implementing strategies in the plan  and evaluating the effectiveness of current approaches aimed at reducing and eliminating restrictive practices.

40  Functional Behaviour Assessments and Behaviour Support Plans

 

Outcome: Each participant’s quality of life is maintained and improved by tailored, evidence-informed behaviour support plans that are responsive to their needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Work is undertaken with each participant and their support network to undertake a behaviour support assessment that identifies unmet participant needs, the function and/or purpose of behaviours, and identify strategies to address behaviours of concern.

                     (2)  Behaviour support plans take into account all appropriate sources of information such as the behaviour support assessment, and with the consent of the participant, the participant’s support network, the providers implementing behaviour support plans, and assessments carried out by other collaborating providers and mainstream service providers.

                     (3)  Behaviour support plans are consistent with evidence-informed practice, including proactive strategies.

                     (4)  The interface between a reasonable and necessary supports under a participant’s plan and any other supports or services under a general system of service delivery that the participant receives, are considered, and strategies and protocols are developed to integrate supports/services as practicable.

                     (5)  Behaviour support plans are developed in consultation with the providers implementing behaviour support plans, and the behaviour support plan is given to those providers for their consideration and acceptance.

                     (6)  All behaviour support plans containing a regulated restrictive practice are provided to the Commissioner in the time and manner prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.

41  Supporting the Implementation of the Behaviour Support Plan

 

Outcome: Each participant’s behaviour support plan is implemented effectively to meet the participant’s behaviour support needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Assistance is given to ensure that the providers implementing behaviour support plans understand the relevant state or territory legislative and/or policy requirements for obtaining authorisation (however described) for the use of a restrictive practice included in a behaviour support plan, including any conditions around the use of restrictive practices.

                     (2)  Reasonable measures are taken to ensure the participant, and with the participant’s consent, the participant’s support network, and the providers implementing behaviour support plans, understand the rationale underpinning the behaviour support plan. Instructions and guidance are developed to support the participant, the providers implementing behaviour support plans and the participant’s support network to effectively implement the behaviour support plan.

                     (3)  Providers implementing behaviour support plans are made aware of the reporting requirements prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.

                     (4)  Person-focused training, coaching and mentoring is facilitated or delivered to each of the providers implementing behaviour support plans, and, with each participant’s consent, their support network (where applicable). It covers the strategies required to implement a participant’s behaviour support plan, including positive behaviour support strategies.

                     (5)  Development of behaviour support plans for each participant, in collaboration with the providers implementing the behaviour support plan.

                     (6)  Where the specialist behaviour support provider recommends that workers implementing a behaviour support plan receive training on the safe use of a restrictive practice included in a plan, oversight is retained to ensure the training addresses the strategies contained within each participant’s behaviour support plan.

                     (7)  Ongoing support and advice is offered to providers implementing behaviour support plans, and, with the participant’s consent, their support network (where applicable), to address barriers to implementation.

42  Behaviour Support Plan Monitoring and Review

 

Outcome: Each participant has a current behaviour support plan that reflects their needs, improves their quality of life and supports their progress towards positive change. The plan progresses towards the reduction and elimination of restrictive practices, where these are in place for the participant.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The progress and effectiveness of implemented strategies are evaluated through regular engagement with the participant, and by reviewing, recording and monitoring data collected by providers implementing behaviour support plans.

                     (2)  Modifications to the strategies contained in each participant’s behaviour support plan are made based on engagement with the participant and the results of the information and data analysis, and with the participant’s consent, these changes are communicated and training is provided (where required) to their support network on the modified strategies.

                     (3)  Opportunities to reduce the use of restrictive practices based on documented positive change are pursued.

                     (4)  The Commissioner is notified and work is undertaken with the Commissioner to address such situations:

                            (a)    where effective engagement with providers implementing behaviour support plans is not possible for any reason; or

                            (b)    if the supports and services are not being implemented in accordance with the behaviour support plan.

                     (5)  Each participant’s behaviour support plan is reviewed at least every twelve months. Consideration is given to whether the participant’s needs, situation or progress create a need for more frequent reviews, including if the participant’s behaviour changes, or if a new provider is required to implement the plan.

                     (6)  The Commissioner is notified of changes in each participant’s behaviour support plan in the manner and timeframe prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.

43  Reportable Incidents involving the Use of a Restrictive Practice

 

Outcome: Each participant that is subject to an emergency or unauthorised use of a restrictive practice has the use of that practice reported and reviewed.

 

 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Support is given to the providers implementing each participant’s behaviour support plan in responding to a reportable incident involving the use of restrictive practices.

                     (2)  Each participant, and with the participant’s consent, their support network, the providers implementing behaviour support plans and other stakeholders are included in the review of incidents.

44  Interim Behaviour Support Plans

 

Outcome: Each participant with an immediate need for a behaviour support plan receives an interim behaviour support plan which minimises the risk to the participant and others.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  When a participant develops an immediate need for behaviour support, the participant and the providers implementing behaviour support plans are involved in evaluating the risks posed to the participant and others by the participant’s behaviour, and an interim behaviour support plan is developed that appropriately manages that risk.

                     (2)  Advice and guidance is given to the providers implementing behaviour support plans and, with the participant’s consent, their support network on the effective implementation of the interim behaviour support plan.


 

Part 5 –Module 2A: Implementing Behaviour Support Plans

45  Applicable Practice Standards

                   Schedule 4 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

46  Application of Module

                   This module applies to providers who implement behaviour support plans. It does not apply to specialist behaviour support providers.

47  Behaviour Support in the NDIS

 

Outcome: Each participant accesses behaviour support that is appropriate to their needs which incorporates evidence-informed practice and complies with relevant legislation and policy frameworks.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Knowledge and understanding of the NDIS and state and territory behaviour support legislative and policy frameworks.

                     (2)  Demonstrated appropriate knowledge and understanding of evidence-informed practice approaches to behaviour support.

                     (3)  Demonstrated commitment to reducing and eliminating restrictive practices through policies, procedures and practices.

48  Regulated Restrictive Practices

 

Outcome: Each participant is only subject to a regulated restrictive practice that meets any state and territory authorisation (however described) requirements and the relevant requirements and safeguards outlined in Commonwealth legislation and policy.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Knowledge and understanding of regulated restrictive practices as described in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018 and knowledge and understanding of any relevant state or territory legislation and/or policy requirements and processes for obtaining authorisation (however described) for the use of any regulated restrictive practices included in a behaviour support plan.

                     (2)  Where state or territory legislation and/or policy requires authorisation (however described) to, the use of a regulated restrictive practice, such authorisation is obtained and evidence submitted.

                     (3)  Regulated restrictive practices are only used in accordance with a behaviour support plan and all the requirements as prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018. Regulated restrictive practices are implemented, documented and reported in a way that is compliant with relevant legislation and/or policy requirements.  

                     (4)  Work is undertaken with specialist behaviour support providers to evaluate the effectiveness of current approaches aimed at reducing and eliminating restrictive practices, including the implementation of strategies in the behaviour support plan.

                     (5)  Workers maintain the skills required to use restrictive practices and support the participant and other stakeholders to understand the risks associated with the use of restrictive practices.

49  Supporting the Assessment and Development of Behaviour Support Plans

 

Outcome: Each participant’s quality of life is maintained and improved by tailored, evidence-informed behaviour support plans that are responsive to their needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The specialist behaviour support provider is supported to gather information for the functional behavioural assessment and other relevant assessments.

                     (2)  Collaboration occurs with the specialist behaviour support provider to develop each participant’s behaviour support plan and the clear identification of key responsibilities in implementing and reviewing the plan.  

                     (3)  Relevant workers have the necessary skills to inform the development of the participant’s behaviour support plan.

                     (4)  Relevant workers have access to appropriate training to enhance their skills in, and knowledge of, positive behaviour supports and restrictive practices.

50  Behaviour Support Plan Implementation

 

Outcome: Each participant’s behaviour support plan is implemented effectively to meet the participant’s behaviour support needs.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Policies and procedures that support the implementation of behaviour support plans are developed and maintained.  

                     (2)  Work is actively undertaken with the specialist behaviour support providers to implement each participant’s behaviour support plan and to align support delivery with evidence-informed practice and positive behaviour support.

                     (3)  Workers are supported to develop and maintain the skills required to consistently implement the strategies in each participant’s behaviour support plan consistent with the behaviour support skills descriptor.

                     (4)  Specialist behaviour support providers are supported to train the workers of the providers implementing a behaviour support plans in the use and monitoring of behaviour support strategies in the behaviour support plan, including positive behaviour support.

                     (5)  Workers receive training in the safe use of restrictive practices.

                     (6)  Collaboration is undertaken with other providers that work with the participant to implement strategies in the participant’s behaviour support plan.

                     (7)  Performance management ensures that workers are implementing strategies in the participant’s behaviour support plan appropriately.

51  Monitoring and Reporting the Use of Regulated Restrictive Practices

 

Outcome: Each participant is only subject to a restrictive practice that is reported to the Commission.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Demonstrated compliance with monthly online reporting requirements in relation to the use of regulated restrictive practices, as prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.       

                     (2)  Data is monitored to identify actions for improving outcomes.

                     (3)  Data is used to provide feedback to workers, and with the participant’s consent, their support network, and their specialist behaviour support provider about the implementation of the behaviour support plan to inform the reduction and elimination of restrictive practices.

52  Behaviour Support Plan Review

 

Outcome: Each participant has a current behaviour support plan that reflects their needs, and works towards improving their quality of life, reducing behaviours of concern, and reducing and eliminating the use of restrictive practices.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The implementation of the participant’s behaviour support plan is monitored through a combination of formal and informal approaches, including through feedback from the participant, team meetings, data collection and record keeping, other feedback and supervision.

                     (2)  Information is recorded and data is collected as required by the specialist behaviour support provider and as prescribed in the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.

                     (3)  Identification of circumstances where the participant’s needs, situation or progress create a need for more frequent review, including if the participant’s behaviour changes

                     (4)  Contributions are made to the reviews of the strategies in a participant’s behaviour support plan, with the primary focus of reducing or eliminating restrictive practices based on observed progress or positive changes in the participant’s situation.

53  Reportable Incidents involving the Use of a Restrictive Practice

 

Outcome: Each participant that is subject to an emergency or unauthorised use of a restrictive practice has the use of that practice reported and reviewed.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The participant’s immediate referral to, and assessment by a medical practitioner (where appropriate) is supported following an incident.

                     (2)  Collaboration is undertaken with mainstream service providers, such as police and/or other emergency services, mental health and emergency department, treating medical practitioners and other allied health clinicians, in responding to the unauthorised use of a restrictive practice.

                     (3)  The Commissioner is notified of all reportable incidents involving the use of an unauthorised restrictive practice in accordance with the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018.

                     (4)  Where an unauthorised restrictive practice has been used, the workers and management of providers implementing behaviour support plans engage in debriefing to identify areas for improvement and to inform further action. The outcomes of the debriefing are documented.

                     (5)  Based on the review of incidents, the supports to the participant are adjusted, and where appropriate, the engagement of a specialist behaviour support provider is facilitated to develop or review the participant’s behaviour support plan or interim behaviour support plan, if required, in accordance with the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018.  

                     (6)  Authorisation processes (however described) are initiated as required by their jurisdiction.

                     (7)  The participant, and with the participant’s consent, their support network and other stakeholders as appropriate, are included in the review of incidents.

54  Interim Behaviour Support Plans

 

Outcome: Each participant with an immediate need for a behaviour support plan receives an interim behaviour support plan based on evidence-informed practice, which minimises risk to the participant and others.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Collaboration is undertaken with mainstream service providers (such as police and/or other emergency services, mental health and emergency departments, treating medical practitioners and other allied health clinicians) in contributing to an interim behaviour support plan developed by a specialist behaviour support provider.

                     (2)  Work is undertaken with the specialist behaviour support provider to support the development of the interim behaviour support plan.

                     (3)  Workers are supported and facilitated to receive training in the implementation of the interim behaviour support plan.


 

Part 6 –Module 3: Early Childhood Supports 

55  Applicable Practice Standards

                   Schedule 5 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards.

56  The Child

 

Outcome: Each child participant accesses supports that promote and respect their legal and human rights, support their development of functional skills, and enable them to participate meaningfully and be included in everyday activities with their peers.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Knowledge and understanding of each participant’s legal and human rights, and incorporation of those rights into everyday practice.

                     (2)  Implementation of practices and procedures to manage risk with a focus on creating a safe environment for children.

                     (3)  Compliance with all relevant state and territory legislation relating to the reporting of risk of harm to children.

                     (4)  Facilitation of the active involvement of the participant’s support network in the participant’s development.

57  The Family

 

Outcome: Each family receives family-centred supports that are culturally inclusive, responsive, and focus on their strengths.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Each support plan is based on child and family choice and control and is undertaken with the family.

                     (2)  The family’s expertise and knowledge about their child is recognised and respected.

                     (3)  The family’s strengths, needs and priorities are identified by working in partnership with the family.

                     (4)  Each support plan is flexible and individualised to reflect the child’s and family members’ preferences and learning styles.

                     (5)  Each support plan is culturally responsive and respectful of the family’s cultural beliefs and their community.

                     (6)  Information and supports are provided in a clear, easy to understand and flexible manner by integrating the support into the child’s everyday routine.

                     (7)  The strengths of the family are promoted and developed and the family is assisted to develop their own network of formal and informal resources, with recognition that positive outcomes for children do not rely solely on therapeutic child-focused programs.

                     (8)  Work is undertaken with the family to inform and strengthen their participation in, and contribution to, the child’s learning and development.

58  Inclusion

 

Outcome: Each participant accesses supports that engage their natural environments and enable inclusive and meaningful participation in their family and community life.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Assessment of each child’s development focuses on the child’s functions in their everyday routines and activities in their natural learning environments.

                     (2)  A child’s inclusive, meaningful and active participation in their family life, community life and natural environments is promoted.

                     (3)  Links with each family’s community and other support agencies are enabled and built upon.

                     (4)  Each child’s inclusion through participation in daily routines in their natural learning environments is promoted.

59  Collaboration

 

Outcome: Each participant receives coordinated supports from a collaborative team comprising their family, the provider and other relevant providers, to facilitate their development and address the family’s needs and priorities.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  If the family wishes to engage a key worker, work is undertaken with the family and other providers to identify a suitable key worker.

                     (2)  Close collaborative links with the family and other collaborating providers are established to coordinate the team around each child.

                     (3)  With the consent of the family, information, knowledge and skills are communicated and shared between the family, the provider, and other collaborating providers.

                     (4)  Where relevant, collaboration between supports and services is undertaken to ensure that transition/exit planning meets the needs of each child and their family.

60  Capacity Building

 

Outcome: Each participant receives supports that build the knowledge, skills and abilities of the family and other collaborating providers in order to support the child’s learning and development. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Work is undertaken with the support network in each child’s life to build their capacity to achieve the functional outcomes identified in the support plan.

                     (2)  Each family’s confidence is built to understand how their family routines and everyday activities can support their child’s development.

                     (3)  The capacity of the child, family and collaborating providers involved with the child is built through coaching, capacity building supports and collaborative teamwork.

                     (4)  Collaboration is undertaken to affirm, challenge, and support the child, family and collaborating providers to further develop their skills and to improve practice and relationships.

                     (5)  Feedback and learnings from the child, family and other professionals is used to improve support delivery.

61  Evidence-Informed Practice

 

Outcome: Each participant receives evidence-informed supports from providers with quality standards and validated practice.  

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Intervention strategies are based on explicit principles, validated practices, best available research and relevant laws and regulations.

                     (2)  Appropriate information, knowledge, skills and expertise are in place to deliver quality supports to families.

                     (3)  Knowledge and skills are maintained through continuing relevant professional development, ongoing self-reflection, self-assessment and monitoring of practices.

62  Outcome Based Approach

 

Outcome: Each participant receives supports that are outcome-based and goal-focused.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  The functional outcomes for the child and their family are based on their needs and priorities, and the skills needed to achieve those outcomes are identified through collaboration with the child and their family.

                     (2)  Each child has a documented support plan that describes the interventions and their functional outcomes.

                     (3)  The family is actively involved in the assessment of the child and the development and review of the support plan.

                     (4)  A copy of the support plan is provided to the family in the language, mode of communication and terms that they are most likely to understand.

                     (5)  The functional outcomes support the child’s meaningful participation in family and community life.

                     (6)  The assessment, intervention planning and outcomes for the child and the family are measured, evaluated and reported in ways that are meaningful to, and understood by, the family.


 

Part 7 –Module 4: Specialised Support Coordination

63  Applicable Practice Standards

                   Schedule 6 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

64  Specialised Support Coordination

 

Outcome: Each participant receiving specialised support coordination receives tailored support to implement, monitor and review their support plans and reduce the risk and complexity of their situation.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Demonstrated knowledge and understanding of the risk factors experienced by each participant with high-risk and/or complex needs.

                     (2)  Participants are involved in the evaluation of their situation and the identification of the supports required to prevent or respond to a crisis, incident or breakdown of support arrangements, and the promotion of safety for the participant and others.

                     (3)  Consultation is undertaken with the participant and, with the participant’s consent, the participant’s support network and mainstream services (as appropriate) in planning and coordinating supports to implement the participant’s plan, and any plan review.

                     (4)  In consideration of each participant’s individual needs, preferences and circumstances, suitable NDIS providers and mainstream service providers that have the appropriate skills and experience to deliver the required support are identified.

                     (5)  There is proactive engagement to ensure that all providers implementing the participant’s plan understand and respond to the risk and/or complexity of the participant’s situation, and collaborate with other relevant providers, where required.

                     (6)  All monitoring and reporting obligations associated with the participant’s plan are managed effectively.

65  Management of a Participant’s NDIS Supports

 

Outcome: Each participant exercises meaningful choice and control over their supports and maximises the value for money they receive from their supports. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Supports and services are arranged using the participant’s NDIS amounts as directed by the participant and for the purposes intended by the participant.

                     (2)  Each participant has been provided with information about their support options using the language, mode of communication and terms that the participant is most likely to understand.

                     (3)  As appropriate, each participant is supported to build their capacity to coordinate, self-direct and manage their supports and to understand how to participate in Agency planning processes such as establishing agreements with service providers and managing budget flexibility.

                     (4)  Supports funded under a participant’s plan are used effectively and efficiently, and are complemented by community and mainstream services to achieve the objectives of the participant’s plan.

66  Conflict of Interest

 

Outcome: Each participant receives transparent, factual advice about their support options which promotes choice and control.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Conflict of interest policies are provided or explained to each participant using the language, mode of communication and terms that the participant is most likely to understand.

                     (2)  Each participant is supported to understand the distinction between the provision of specialised support coordination and other reasonable and necessary supports funded under a participant’s plan using the language, mode of communication and terms that the participant is most likely to understand.

                     (3)  If the provider has an interest in any support option available to the participant, the participant is aware of this interest. The participant understands that any choice they made about providers of other supports will not impact on the provision of the specialised support coordination.

                     (4)  Referrals to and from other providers are documented for each participant.

 


 

Part 8 – Module 5: Specialist Disability Accommodation 

67 Applicable Practice Standards

                   Schedule 7 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

68  Rights and Responsibilities

 

Outcome: Each participant’s access to specialist disability accommodation dwellings is consistent with their legal and human rights and they are supported to exercise informed choice and control.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Knowledge and understanding of each participant’s legal and human rights, and incorporation of these rights into everyday practice, including through reasonable adjustments or modifications to the dwelling to meet each participant’s needs.

                     (2)  Any agreement or contract entered into with each participant, and any communication with the participant about the provision of specialist disability accommodation, including about rights and responsibilities in relation to the dwelling, is responsive to their needs and provided in the language, mode of communication and terms which that participant is most likely to understand.

                     (3)  Each participant’s autonomy, including their right to privacy, intimacy and sexual expression is respected.

69  Conflict of Interest

 

Outcome: Each participant’s right to exercise choice and control over other NDIS support provision is not limited by their choice of specialist disability accommodation dwelling.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Organisational policies are in place that detail how perceived or actual conflicts of interests are managed. The conflict of interest policies are made available to participants in the language, mode of communication and terms which each participant is most likely to understand.

                     (2)  Conflicts of interest, perceived or actual, are proactively managed and documented.

                     (3)  The participant is supported to understand the distinction between the provision of specialist disability accommodation and other NDIS supports delivered in the dwelling. Where a specialist disability accommodation provider is delivering both specialist disability accommodation and other NDIS supports to the same participant, there are separate service agreements.

                     (4)  The participant’s housing rights, including security of tenure, are upheld, irrespective of any decision/s the participant makes about the provision of other NDIS supports within the specialist disability accommodation dwelling (notwithstanding any matters covered by the specialist disability accommodation service agreement).

70  Service Agreements with Participants

 

Outcome: Each participant is supported to understand the terms and conditions that apply to their specialist disability accommodation dwelling and the associated service and/or tenancy agreements.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Work is undertaken with each participant to develop a written service agreement that meets the requirements of the National Disability Insurance Scheme (Specialist Disability Accommodation Conditions) Rules 2018, and any applicable state or territory residential tenancy legislation.

                     (2)  In the absence of any applicable state or territory residential tenancy legislation, written service agreements should deal with the following matters:

                             (a)  specify the rent that must be paid by the participant and the method and timing of making rental payments and arrangements for the issuance of rental payment receipts;

                             (b) specify the value and management arrangements in relation to any bond that is required from the participant;

                             (c)  if applicable, specify any board payments that have been agreed with the participant, what the board payments will cover and the method and timing of making the board payments; 

                             (e)  specify the minimum period of notice that will be given by the provider before the provider increases the amount of rent or board (where applicable) payable by the participant;

                             (f) specify:

                                          (i)  the name, telephone number and address of the provider’s agent (if any) and the responsibilities of the agent; or

                                         (ii) if the provider does not have an agent, the address and telephone number, of the provider;

                             (g) require the provider to notify the participant in writing within 5 business days of any change during the agreement of the matters provided for in paragraph (f), unless applicable state or territory law stipulates an alternative notice period;

                             (h)  specify the commencement date of the agreement, the duration of the agreement, and the manner in which the agreement can be extended;

                              (j) specify the circumstances in which the agreement can be terminated by either the participant or the provider;

                             (k)  require the provider to give the participant a minimum of 90 days’ notice before the participant is required to vacate the premises, unless shorter notice is required to address risks of harm to the participant or others;

                              (l) explain the process for requesting repairs or maintenance to be undertaken.   

                     (3)  The agreement establishes expectations, explains the responsibilities of the specialist disability accommodation provider in relation to the dwelling, and specifies the rights and responsibilities of the participant in accessing the dwelling.  

                     (4)  The agreement includes information about dwelling safety features, including fire alarms and building evacuation procedures, and how this information will be communicated to other providers who deliver supported independent living to each participant in the dwelling.

                     (5)  Each participant is supported to understand the agreement, including any conditions, by using the language, mode of communication and terms which that participant is most likely to understand.

                     (6)  Each participant receives a copy of their agreement signed by the participant and the provider. Where this is not practicable, a record is made detailing the circumstances in which the participant did not receive a copy of their agreement.

 

71  Enrolment of SDA Properties

 

Outcome: Each participant’s specialist disability accommodation dwelling meets the requirements of the design type, category and other standards that were identified through the dwelling enrolment process.  

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Mechanisms are in place to ensure a provider’s enrolled specialist disability accommodation dwellings meet the design type, category and density restriction requirements of the National Disability Insurance Scheme (Specialist Disability Accommodation Conditions) Rules 2018.  

                     (2)  Mechanisms are in place to ensure a provider maintains ongoing compliance with the National Disability Insurance Scheme (Specialist Disability Accommodation Conditions) Rules 2018 and all relevant laws and standards, including building standards and tenancy laws that apply to specialist disability accommodation dwellings.  

                     (3)  Enrolled dwellings are in a good state of repair and are being appropriately maintained, having regard to the safety, security and privacy of residents.

72  Tenancy Management

 

Outcome: Each participant accessing a specialist disability accommodation dwelling is able to exercise choice and control and is supported by effective tenancy management.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Demonstrated adherence to the requirements established in the National Disability Insurance Scheme (Specialist Disability Accommodation Conditions) Rules 2018.

                     (2)  Where applicable, policies and procedures are in place about how a provider will declare, advertise and fill vacancies in shared living, including how each participant’s views, preferences and needs are documented and taken into account. The policies are made available to participants in the language, mode of communication and terms which each participant is most likely to understand.

                     (3)  Documented arrangements are in place with each participant and each participant’s other NDIS providers that deliver supported independent living supports within a specialist disability accommodation dwelling. At a minimum, the arrangements should outline the party or parties responsible and their roles (where applicable) for the following matters:

                             (a)  How the specialist disability accommodation provider will work with other providers who deliver supported independent living supports to ensure the shared living arrangement is working for all tenants;

                             (b)  How potential conflicts involving the participant will be managed;

                             (c)  Policies and procedures for responding to violence, abuse, exploitation or conflict involving one or more participant which may impact on the condition of the dwelling;

                             (d)  How each participant’s concerns about the specialist disability accommodation dwelling will be communicated to and addressed by the specialist disability accommodation provider;

                             (e)  How behaviours of concern will be managed, if this a relevant issue for the participant;

                             (f)  How changes to a participant’s circumstances or supports will be agreed and communicated;

                             (g)  Arrangements for continuity of supports (including specialist disability accommodation) in the event or a natural disaster or other emergency; and

                             (h)  In shared living, how vacancies will be filled including the participant’s right to have their needs, wishes, choices and situation taken into account.

                            Where the participant does not consent to an agreement, the specialist disability accommodation provider has a documented record of this.

Note:       NDIS providers who provide supported independent living supports to participants in specialist disability accommodation dwellings should also achieve the outcomes set out in section 21 of these Guidelines.   

                     (4)  Allegations and incidents of violence, abuse, neglect, exploitation or discrimination, are acted upon, each participant affected is supported and assisted, records are made of any details and outcomes of reviews and investigations (where applicable), and action is taken to prevent similar incidents occurring in the future.

                     (5)  Where a change in participant needs or circumstances occurs, reasonable adjustments are made to accommodate the changes. If the changed support needs exceed the design category or functionality of the dwelling, work is undertaken to modify the dwelling, following consideration of the impact of the modifications on the other tenants (if applicable). Where the participant’s needs or circumstances cannot be accommodated, the participant, and any relevant support providers are made aware of the need to find alternative accommodation.

                     (6)  A complaints management and resolution system is maintained that meets the requirements of the National Disability Insurance Scheme (Complaints Management and Resolution) Rules 2018 and follows the principles of procedural fairness and natural justice.

                     (7)  An incident management system is maintained in accordance with the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018.

                     (8)  State or territory legislative requirements regarding the provision of tenancy-related notices are adhered to and each participant is aware of their right to seek review of a decision, where applicable.

                     (9)  Policies, procedures and agreements relating to any tenancy management are provided in the language, mode of communication and terms which each participant is most likely to understand. 

 


 

Part 9 –Verification 

73 Applicable Practice Standards

                   Schedule 8 to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 sets out the relevant NDIS Practice Standards that apply to this Part.

74  Human Resource Management

 

Outcome:  Each participant’s support needs are met by workers who are competent in relation to their role, hold relevant qualifications, and who have relevant expertise and experience to provide person-centred support.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  Records of worker identity, right to work, pre-employment checks, qualifications and or experience are maintained.

                     (2)  Workers complete mandatory NDIS orientation module and records of continuing professional development are maintained.

 75  Incident Management 

 

Outcome: Each participant is safeguarded by the provider’s incident management system, ensuring that incidents are acknowledged, respond to, well-managed and learned from.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  An incident management system is maintained that is relevant and proportionate to the scope and complexity of supports delivered and the size and scale of the organisation. The system complies with the requirements under the National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018.

 

76  Complaints Management 

 

Outcome: Each participant has knowledge of and access to the provider’s complaints management and resolution system. Complaints made by all parties are welcomed, acknowledged, respected and well-managed.

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  A complaints management and resolution system is maintained that is relevant and proportionate to the scope and complexity of supports delivered and the size and scale of the organisation. The system follows principles of procedural fairness and natural justice and complies with the requirements under the National Disability Insurance Scheme (Complaints Management and Resolution) Rules 2018.

 

77  Risk Management 

 

Outcome: Risks to participants, workers and the provider are identified and managed. 

                   To achieve this outcome, the following indicators should be demonstrated:

                     (1)  A documented system that effectively manages work health and safety risks is in place, and is relevant and proportionate to the size and scale of the provider and the scope and complexity of supports. 

                     (2)  Appropriate insurance is in place, including professional indemnity, public liability and accident insurance.