Thursday, January 26 2012
With disability services there are care plans for almost every aspect of a person’s life. Service provision seems to consider a person’s quality of life is directly proportional with the number and complexity of their care plans, directives, standards, guidelines and values.
There are ‘Behaviour Support Plans’, ‘Residential Statements’, ‘Person Centred Plans’, ‘Action Plans’, ‘Oral Health Plans’, ‘Communication Plans’, Residential Services Practice Manuals, Quality Frameworks, Active Support Guidelines, Quality Assurance Handbooks, Day Service Procedures, Disability Standards, Disability Acts, etc, etc, etc.
Yet, with all this directive, there is almost no direction that this bevy of direction shall be implemented in a practical and meaningful way for those for whom all this direction is intended to benefit – those with disabilities and their families.
There is also no obligation within all this direction, that there shall be transparent, meaningful and accountable outcomes for those for whom all this direction is intended to benefit – those with disabilities and their families.
There needs to be mandatory expectations placed on those producing and responsible for regulation intended to benefit people with disabilities and their families, to ensure the regulation is implemented with its direction, intention and spirit.
Thursday, January 26 2012
This is the Department of Human Services, Victoria, restriction on freedom of choice for people with disabilities and their families.
This all-powerful state government department uses its huge bucket of government/public funds to play its power-over-people game.
The Productivity Commission realised the only way to break this strangle-hold on vulnerable people by state governments, was to put ‘NDIS dollar-power’ in the pockets of consumers, by funding services through ISPs (Individual Support Packages).
With the NDIS (National Disability Insurance Scheme) some years away, if ever, state government power brokers, government departments like the DHS continue to enjoy their bevy of conflict of interest power over people – vulnerable people.
• “If we must have a DSR, why should a CSO (Community Service Organisation) not run this, rather that the DHS?”
• “What is the CSO answer to having no DSR or ‘Central Placement Allocation Process’, given the NDIS ISP service funding process is intended to give consumers freedom of choice – with the potential of improved service?”
• Why will the DHS not allow its existing group home residents freedom of choice, by allowing them to take the full level of their existing service provision bulk-funding, in an exit-package to seek a group home with the CSOs, or a good ‘SDA’ (Self Directed Approach)?”
Release of the full level of their existing service provision bulk-funding, the residents of an existing DHS group home could replace DHS staff, with CSO staff and a firm service level and quality contract to provide them with real and meaningful quality of life care.
Tuesday, January 24 2012
Theory that children can 'recover' from autism is controversial UK Daily Mail, 24th January 2012
Children or teenagers diagnosed with autism alongside early hearing problems were less likely to be considered autistic later on
Development: Children or teenagers diagnosed with autism alongside early hearing problems were less likely to be considered autistic later on
Many children diagnosed with autism at a young age no longer display symptoms when they are older, researchers say.
A study published in the journal Pediatrics, found one-third of youngsters who had ever been diagnosed with an autism spectrum disorder no longer had the diagnosis at the time their parents were surveyed.
The researchers noted in their report, published in Pediatrics, that past studies have also found some children who originally have an autism spectrum disorder eventually lose that diagnosis and are no longer considered autistic.
However, whether this is due to a mistaken first diagnosis or actual changes taking place in their brains is controversial.
A team, led by Dr Andrew Zimmerman from Massachusetts General Hospital for Children, studied data from a phone survey of 92,000 parents of children aged 17 and younger in the U.S in 2007 and 2008.
In total, 1,366 said their child had a past or current diagnosis of an autism spectrum disorder. In 453 of those cases, children had been diagnosed by a doctor of having a disorder but parents said they didn't have one any more.
Tuesday, January 24 2012
Day Services are generally for those adults with intellectual or multiple disabilities who do not have the capacity for sheltered workshop or outside employment.
Those who attend ‘Day Services’ frequently have limited communications ability, and need to have a ‘Communications Diary’ to facilitate two-way communications of their welfare between their home and the day service.
The main intention of ‘Day Service’ is not the general belief of somewhere to pass the time. It is to help improve the quality of life of those with limited capacity by helping them learn new skills, both intellectual and community based
Those with limited capacity frequently need significant support, reinforcement and encouragement from all their life areas. Basically, they need their home and the day service to work together to provide the person with coordinated direction.
Consistent and valued coordinated direction rarely occurs for many of those living in group homes, especially DHS group homes. As most day services are well aware of many DHS group homes being little more than basic minder care.
And, as most day services are funded by DHS, they do not want to make waves with DHS group homes. So the silo effect remains to limit those already limited by their disability.
Extracts from the Senior Practitioner’s Report dated May 2009, in relation to ‘basic minder care’:
• The findings of this study clearly show that power rests to a substantial degree with direct support staff. Their requirement to meet organisational needs is often at the expense of ‘client’ choice.
• “Like all of us, we get bored if there is nothing to do…. What are staff: minders or carers? Staff should be interacting with the residents …. Not just domestic work and not interacting. Staff were on the porch smoking, with nothing to do!
• When the professional assumes there is nothing the service can do, then the service does nothing!
• In many circumstances, families have had to argue their case to the very top, and then make it a public issue before their voices are heard.
• Organisations inevitably protect themselves. This mean the system of reporting incidents becomes adversarial.
• Staff have significant powers to choose how environments are organised, to develop formal and informal rules for how services operate [“This is lore!” Lore is developed and maintained as a direct result of poor management – reactive, rather than proactive management]
Wednesday, January 18 2012
The Department of Human Services fails to condemn and properly control the driving of department vehicles in unsuitable footwear – especially thongs.
Failing to properly control quality of care practices, like driving department vehicles in unsuitable footwear, is yet another example of the department’s overall reactive management of its services for vulnerable people.
The department’s disability services has policies regarding the wearing of unsuitable footwear for staff safety, client safety and the ability of staff to provide a duty of care in often adverse circumstances in its group homes. Yet this department has no firm policy on the driving of its vehicles in unsuitable footwear!
There is almost an epidemic of direct care staff wearing basic thongs whilst on duty, even in the sight of their management. This is yet another a very clear illustration of strongly supported findings of ‘reactive’ rather than ‘proactive’ management being number-one reason for the massive range of on-going care problems throughout disability services.
Victoria Police say it is not against the law to drive in unsuitable footwear, but they strongly condemn the practice. Yet, there is no restriction on driving state government vehicles in unsuitable footwear. Therefore, DHS direct-care staff are free to drive vulnerable group home residents, in house mini buses, wearing basic thongs.
Many of these residents have little ability to help themselves if the vehicle was involved in an accident where there was significant damage and/or fire. The driver wearing just basic thongs (assuming they were still on the person’s feet) would be seriously limited in their ability to assist those for whom they have a duty of care, let alone a moral responsibility
Friday, January 13 2012
by Lifestyle in Supported Accommodation (LISA) Inc.
Behaviour management is beneficial for those with adverse behaviours, as well as those with more moderate behaviours. Behaviours of concern often disrupt meaningful activities, and reduce the person’s acceptability in the community.
People living in group settings need reasonable compatibility with each other, if they are to achieve a living situation which is conducive with consistent quality of life activities. This is especially relevant where those living together have high-support needs.
One of the most important tools in the reduction of behaviours of concern is consistent, ‘Person Centred Active Support (PCAS)’ and ‘Positive Behaviour Support (PBS)’.
Like most people, people with limited capacity due to intellectual disability do undesirable things if they are bored. This is compounded as their limited capacity reduces their ability to do nothing meaningful or constructive without PCAS/PBS being consistently implemented by support staff.
The catch-22 is where the residents of the group home have one member with behaviours of concern , which can upset the other residents, disrupt the consistent implementation of PCAS/PBS and reduce staff incentive to do consistent active support through interaction and developmental activities.
The ‘incompatible client syndrome’ has a negative impact on all residents and support staff. The incompatible client with behaviours of concern is disadvantaged, as are the other residents.
Regular support staff are not trained, supported, remunerated, or have the time to do the intensive behaviour management. Frequently, therefore, all residents receive little more than compromise behaviour management and basic minder care.
Whereas, if the department (DHS/DS Victoria) had proper behaviour management facilities, clients with behaviours of concern would achieve a level of behaviour compatible with most residents, and manageable by regular support staff with regular quality of life interactive and developmental activities.
Achieving this level of compatibility would require, (a) a behaviour scale, (b) client assessment against this scale, (c) a proper behaviour management and correction facility and, (d) outcome expectations set-on well trained, motivated and remunerated facility staff.
Thursday, January 12 2012
By Maris Beck of The Age, Melbourne, Thursday, 12 January 2012
The Department of Human Services showed an "adversarial, ‘win-at-all-costs’ attitude, the likes of which I have rarely seen", said a magistrate in Melbourne.
A foster mother wept in court yesterday as a magistrate ordered she be reunited with her long-term foster children and berated the Department of Human Services, which he said psychologically harmed the children by removing them against their will almost 11 months ago.
The Children's Court magistrate said the department had shown an "adversarial, win-at-all-costs attitude, the likes of which I have rarely seen" and had done "whatever it could" to prevent the return of the children to their foster mother.
The children, who had been in their foster mother's care since 2007 and called her "Mum", were removed last March after the department disagreed with her on issues such as her attempt to enrol the children (some of whom are intellectually disabled) in a special school, and the carer disagreed with the department's view that the children should be prescribed Ritalin, a drug for attention deficit disorder.
The magistrate said the children were "suffering ongoing emotional harm" since the removal, in which the court previously heard the department had arrived unannounced at their school and taken them under a police guard to live almost 200 kilometres away, with their carer permitted infrequent and supervised contact.
He recommended the children, aged seven to 11, go back to their carer immediately, ordered the guardianship of the department's secretary be extended only until February 13, and ordered the department to apply to place the children in the foster mother's permanent care.
The magistrate said the department's attitude was "now so hostile that ongoing involvement of the department in their lives is contra-indicated".
In defiance of the non-binding recommendation the children's return be immediate, counsel for the department said they would not be returned yesterday. The department was considering its rights of appeal.
The magistrate, who had earlier in the hearing noted a recalcitrant attitude by the department, told it that if it did not return the children, it could be considered to be causing ongoing harm and be open to Supreme Court action.
He ordered it to pay some of the carer's court costs, a total of $1760, to cover three "fairly small" instances in which he deemed the department had acted irresponsibly or mischievously to prolong proceedings.
Speaking outside the court, the carer said the children were "my angels" and the magistrate's order "meant everything" to her.
The children's lawyer said it was disappointing the department had not agreed to hand them back immediately and they would suffer as long as they were away from their foster mother.
A department spokesman said it was "reading the judgment very carefully and we will act in the best interests of vulnerable children". Identities of those in the case cannot be published for legal reasons.
LISA Inc Comment: This is a very traditional attitude of this totally out of control government department. The ‘power over people’ attitude, is very similar for people with disabilities and their families. Vulnerable people suffer in the hand of the power hungry, captive market, secure employment, no need for customers or customer service, public servants. Successive ministers have totally failed to reign-in the overwhelming and ever growing power of this out-of-control juganaught!
Thursday, January 05 2012
It seems the movement of rubber stamp signatures for people with disabilities is growing.
Rather like company seals, automatic signature processes require tight security and integrity to reduce the potential of fraud, as a signature is a very personal mark of a person’s discretion.
A person’s regular signature is very personal. It is produced solely as a result of biological actions (brain controlling hand, for example).
Similar security with the use of a mechanical or electronic signature device will be quite difficult to achieve in practice. Nevertheless, a mechanical or electronic signature device may be the only way for those with just physical challenges to exercise their discretion,
In contrast, the concept of those intellectually challenged using a mechanical or electronic signature device would be very much dependent on their intellectual capacity to understand consequences and intentions. Similar to that needed to authorise an enduring power of attorney.
Seek Legal Advice!
Monday, January 02 2012
This is a show, not only in theatre, but in every government department as a perspective of the type of bureaucracy which adversely affects the lives of people with disabilities and their families.
Dr Rhonda Galbally, at the National Press Club in Canberra, said, “What does it mean to be an Australian with a disability? What is life like in the lucky country, in this land of the fair go? One answer we might expect would be, A citizen with the same rights as everyone else!
But if you have a physical, sensory, psychiatric, or intellectual disability, what is life really like? Many Australians would say, It's better, isn't it? The bad old days are gone - Aren't they?
The horror and abuse that went on in institutions, that's all gone now, hasn't it. The poverty, the discrimination, the exclusion, the fear and hatred, that's all ancient history, isn't it?
I would love to be able to say yes, that is all ancient history, but I can't. I'm here to tell you that despite this nation enjoying the longest economic boom in its history, very little has changed for most Australians with a disability”.
Most of the problems people with disabilities and their families face every day are directly due to the type of bureaucratic bungling depicted in the classic BBC TV series, “Yes Minister!” and, “Yes Prime Minister!”
These shows which appeared on British TV in the 1980s, and which has been a hit stage show in London’s West End for sometime, is now in Australia from the end of January 2012
The episode which especially depicts the attitude of government departments towards people with disabilities and their families is entitled, “The Compassionate Society”. This is about a new public hospital which had been fully staffed for a long while, but with no patients. When it was suggested, after public outcry, there should be patients, the staff said the hospital was running fine as it was. This is very similar to most public services.
The public service doesn’t need or want customers, as they have a captive market, bulk funding and, therefore, safe employment - Where consumers are considered unnecessary, undesirable, always wrong, and should feel eternally grateful for anything they might eventually get after long negotiations. Consumers have no rights or entitlement to anything!
When governments decide there is a need for a “social service”, they ‘bulk fund’ a public service department to operate this. The first act of any such department, is to close its doors to the public, install wall to wall staff, bureaucracy and regulations, and make the public fight for everything the department is funded/intended to provide. As they are bulk funded from the government’s general revenue, all staff have safe employment no matter what they do, or don’t do.
The initial government concept is a “charity hand-out’ in itself, but the government department enhances this to develop the traditional public service power-over-people, to ensure consumers know their place. A place where consumers have no rights, must beg for everything, and must never, ever, complain about their captive market, no-choice service.
In total contrast, market-place business opens its doors, welcomes potential customers, and treats customers and potential customers as always right, as the customer has choice of service provider and staff are dependent on customers for their continued employment
This is clearly one of the main reasons the Productivity Commission has taken the ISP (Individual Service Package) track, for the NDIS (National Disability Insurance Scheme).
The ISP is essentially a relatively easy way to reverse the standard public service restrictive practices against consumers. The ISP concept puts the money in the consumer’s pocket, rather than the bureaucratic pocket. Service providers will then have to provide customer satisfaction
Sunday, January 01 2012
DHS Victoria pulled the contract on a NFP, CSO.
ABC Report - November 2011
The State Government terminated its contract with Community Connections Limited, after the DHS found a series of breaches had not been addressed.
The group runs a care home for 12 children at Warrnambool.
The chief executive of Community Connections, Bruce Du Vergier, says the breaches have been addressed and is seeking legal advice.
"They have no reason whatsoever, no substantial reason to withdraw the contract of residential care program," he said.
The assistant secretary of the Australian Services Union (ASU), Lisa Darmanin, says the moves validate its concerns about the organisation.
"The ASU is pleased to see the Department of Human Services take some action on concerns raised over an extended period of time," she said.
The DHS will transfer care of the children to other agencies in the region from December 6, 2011
LISA Inc. maintains CSOs can be made accountable for service level and quality through the potential to terminate service contracts, in contrast with DHS direct care service which have no such potential for accountability for service provision.
Although this example demonstrates the DHS do have the guts to terminate CSO contracts, there should be an independent of government tribunal to review such cases