Tuesday, March 05 2013
- They fear retribution and intimidation of their vulnerable family member and themselves, and the threat of service withdrawal or reduction,
- They don't fully understand their rights to service level and quality,
- They don't want to be seen as a whinger,
- They don't fully understand the service process,
- They have concerns about how complaining will affect their relationship with service management and staff,
- They have insufficient information on how or where to complain,
- Their previous negative experiences of complaining, put them off,
- They don't 'know' anything other than the service they're receiving and,
- They feel, complainants can lose more than what they have lost as a result of that which they were complaining about.
Wednesday, January 09 2013
THE DIRECT CARE STAFF TIME-IN-LIEU (T.I.L.)SAGA
Time-in-lieu is a process which allows staff to take time-off in lieu of payment. Time-in-lieu is also used where staff are, allegedly, not able to take a meal break.
The time-in-lieu process is frequently used in direct care services for people with intellectual and multiple disabilities. The process has the potential to seriously reduce the quality of life care of the very people the service is intended to serve – people needing PCAS and PBS (Quality of Life Care).
Time-in-lieu of payment directly reduces the staff hours at the service point! This generally impacts on the level of developmental, interactive and social care being provided, rather than on basic care. This means that the lifestyle of the residents of supported accommodation group homes (CRUs) isolated in the community becomes more isolated and looking at four walls!
Time-in-lieu of meal breaks can be quite questionable, especially where the point of employment is isolated - like supported accommodation group homes in the community. It is quite easy for staff to claim they had no time for their meal break, and leave early. Again, those who are disadvantaged are those the service is intended to serve, the most vulnerable, the most disadvantaged – people with limited intellectual capacity.
The use of time-in-lieu makes it is very difficult for service management to monitor staff working hours. If a staff member leaves, say two hours early, unnoticed by management, then no excuse is needed! If, however, the action of leaving early comes to the notice of service management, the staff person can say that they are using accumulated time-in-lieu…
“Always keep some T.I.L. up ones sleeve!”
Thursday, June 14 2012
Natasha Robinson of The Australian, on May 22 2012, wrote: “A systemic culture of low expectations means that for disabled children the nation's schools are just babysitting services’, a high-level meeting of figures in education and social service has been told”.
The story is mainly about children with a disability in main stream schools. Whereas, little is mentioned of, ‘Special, or Special Developmental Schools’. We find these schools, and their outreach programs, in Victoria, very good.
The ‘babysitting/minder care’ occurs when the children become adults and, where many move into ‘Day Services’ funded by the Department of Human Services.
Special Developmental Schools provide their students with very good early intervention, behaviour management and skill training, to raise them to a good quality of life. It is disappointing, this drops like a brick for those who, as adults, move into ‘Day Services’, where there is little continuity.
Most of the ‘Day Services’ claim their clients are adults, and should do adult activities. Rather than continue with ‘lifetime learning’ similar to TAFE, as many people with intellectual and multiple disabilities need more time to learn.
In many ‘Day Services’, their clients receive little more than basic minder care with a few simple activities such as going for a walk, going for a coffee and maybe a swimming program. All in the name of not treating them like children, When, in reality, most are functioning at a level far less than a legal adult.
Special and Special Developmental Schools raise the skill level of their students. This skill training should be continued by education department resources, rather than their students be transferred to very second-class minder care services receiving poor funding and resources from the Department of Human Services, Victoria.
Thursday, March 29 2012
Most government supported accommodation services have run a traditional, unwritten, practice of discouraging parent involvement. It is a breath of fresh air to see the Eastern Region of Melbourne actively attempting to break this traditional restrictive practice.
Whereas, our recent information indicates adult day service, adult training and support services, are reinforcing their practices of keeping parents/families out.
One of their arguments for keeping parents/families out, is their claim that clients are adults, and adults in the general community do not have their families involved in their work place.
What they fail to accept is, (a) most day service clients have limited capacity to self advocate in respect to service level and quality (Mum worries about her regular 3 year old at Kinder, but the little on can tell mum. Whereas, she worries far more about he 33 year old with no meaningful communications) and, (b) most day service clients need their ‘positive behaviour support’ reinforced in all living areas, and by as many people as possible.
The restrictive practice of keeping families out, is not as a benefit to clients, but as a benefit to service provider management and staff, of both day services and group homes – professionals to professionals.
The National Autistic Society is now a multimillion dollar service provider in the UK. The NAS started as a parent support group in a church hall in Ealing Broadway, West London.
When the group got so large that professionals were needed to manage the business, the parents made sure that sufficient parents would always be on the ‘board of management’ to ensure parents and families were always front and centre of all services.
Please feel free to provide us, LISA Inc, with your experiences of 'Day Services' - good or bad. Your identification will be kept strictly confidential
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, December 28 2011
Holiday time is extra, extra cost for many accommodation service providers. Support costs are up, as residents are home. Frequently, support costs are extra high as all residents do not have their holiday breaks at the same time.
Group homes with five or six residents, may have each resident attending a different day service. Extra support has to be provided to cover the different holiday periods of the various day services.
Whereas, all day services could easily have standard holiday periods, like state schools.
Despite most day services are government funded, governments appear reluctant to insist day service standardise their holiday periods.
Sunday, December 04 2011
A field Professional Development Workshop
This “Values & Attitudes in Action”, free one day workshop was designed for disability support workers to work together with the trainer to establish and explore a shared understanding of the values that underpin working in the disability sector and the attitudes required to perform their job.
These understandings looked at the difference between personal and workplace values, shared community values, laws and the expression of these in our work behaviour.
The workshop was specifically designed for disability direct support workers. It would also be valuable for the supervisors and managers of those workers. Learning activities in the session assume participants are working directly with people with a disability.
This all day workshop was very much about all staff having the right “Values & Attitude”. Number one factors in the provision of quality of life care.
It was FREE, provided a free lunch and it was FUNDED by the DHS. Yet despite this, just12 people attended, and only one was from the DHS!
So, again, we see DHS reactive not proactive management funding events, but unable to ensure their staff attend such valuable attitude training.
This is disappointing, but not surprising given this government department’s captive market, secure employment, reactive management, no customer service, the customer is always wrong bureaucratic ‘system’.
Or, as the Productivity Commission says, “The current ‘system’ cannot be called a genuine ‘system’ to achieve desired outcomes.
Monday, November 14 2011
The quality of life of people with an intellectual disability is directly proportional to their level of ability. Every avenue and opportunity having the potential to expand their quality of life should be considered. All travel is an opportunity to expand their horizons, and should not be missed. They should therefore be considered the priority focus of all travel opportunities.
Adherence to the following guidelines will help ensure those disadvantaged by intellectual disability enhance their quality of life through a positive travel experience.
• Ensure that everyone has a seat belt, harness, or wheel chair restraints firmly secured.
• Wherever possible, have suitable residents or students share the front seat next to the driver
• Wherever possible, all support staff except the driver should be in the back with the residents or students, for safety and to enhance communications.
• Ensure people sitting beside each other are as compatible as possible.
• Count the number of people before leaving, and each time they re-enter the vehicle, after the doors are closed, and before moving off.
• Ensure everyone is informed what is intended during the outing.
• Remember to include everyone in the discussions when travelling and stopped, even if there is a view that they don’t understand.
• Talk to everyone about their day.
The above steps will help to ensure that everyone achieves a positive and productive outcome from the outing
Friday, October 07 2011
DHS, DSR, Restrictive Practice – Victoria
Those with high support needs require two basic support packages – “Accommodation Support” and “Day Service”
Everyone who lives in a state government funded supported accommodation group home for people with an intellectual or multiple disability, has a level of unit-cost funding depending on the level of support they are considered to need. This is the cost of support. The cost of living (rent, food, utilities, clothes, recreation, etc), is from the person’s DSP, or other sources of income.
Traditional accommodation support, unit-cost, funding for each person in a group home is through “bulk-funding”, for which the person or their family, currently, has no right of access. A ball-park figure for each person is around $120,000pa.
Placement and re-location of those on “bulk-funding” is through the DHS controlled DSR (Disability Support Register). With “bulk-funding”, both the person and the service provider are under the total control of the DSR Committee.
In contrast, where a person has “Accommodation Support ISP-Funding”, they may directly seek a supported accommodation service. Whereas, a person on similar unit-cost “Accommodation Support Bulk-Funding”, the DSR select the service provider – the person has no choice of, or say in the matter. And, they are not permitted to convert their existing bulk-funding to ISP-funding.
With the Accommodation Support unit-cost funding called “bulk”, the person has to go through the DSR, with no choice of service provider. Whereas, if the similar unit-cost funding is called “ISP”, the person is free to directly seek a service provider of their choice.
If all DHS bulk-funded accommodation support unit-cost funding was directly to ISP funding, a mere name change, almost all group home residents in Victoria would have early taste of NDIS intentions - CHOICE of Service provider, rather than a despotic and restrictive practice DSR, and their residential tenancy rights blocked by section 23 of the Residential Tenancies Act - Victoria.
Tuesday, September 06 2011
The quality of life of people with an intellectual disability is directly proportional to their level of ability. Every avenue and opportunity having the potential to expand their quality of life should be considered.
All travel is an opportunity to expand their horizons, and should not be missed. They should therefore be considered the priority focus of all travel opportunities. Adherence to the following guidelines will help ensure those disadvantaged by intellectual disability enhance their quality of life through a positive travel experience.
- Ensure that everyone has a seat belt, harness, or wheel chair restraints firmly secured.
- Wherever possible, have suitable residents or students share the front seat next to the driver
- Wherever possible, all support staff except the driver should be in the back with the residents or students, for safety and to enhance communications.
- Ensure people sitting beside each other are as compatible as possible.
- Count the number of people before leaving, and each time they re-enter the vehicle, after the doors are closed, and before moving off.
- Ensure everyone is informed what is intended during the outing.
- Remember to include everyone in the discussions when travelling and stopped, even if there is a view that they don’t understand.
- Talk to everyone about their day.
The above steps will help to ensure that everyone achieves a positive and productive outcome from the outing
Sunday, June 26 2011
Although most people using “Day Services” have an ISP (individualised Funding Package), there is little potential to move if the service is poor, as there are few services with few vacancies.
The intention of the NDIS (National Disability Insurance Scheme), through the NDIA (National Disability Insurance Agency), on the recommendations of the Productivity Commission, is to fund all services for people with a disability through ISPs. Sounds good, but is it…
Apart from the massive array of problems in moving to a different service provider for many people with an intellectual or multiple disability who do not easily tolerate change, there is the service providers’ covert “black list” of people who dared to question service provision,
Service providers rely on the “black list” to reduce the impact of families with a track-record of assertively questioning the service level and quality their family member is receiving.
The “Black-List” is likely to be quite extensive when all services are funded by ISPs. So the NDIS principle of “market driven quality” could be significantly reduced in practice by both black lists and that people with a disability don’t move as easily as changing from Telstra to Optus.
Monday, May 16 2011
It is a priority to ensure that all individuals [clients/residents] we are supporting are actively included and involved in all activities within the environment. They are the priority focus of the activity, ensuring we are providing every opportunity for them to achieve the best possible outcomes of the experience.
Ensure people sitting beside each other are well suited.
When 2 staff, or more, are travelling in the vehicle, at least one must be in the back with the passengers, for safety reasons and to enhance communications.
Ensure you let them, passengers/clients/residents, know where you are going and why. Remember to include all individuals, passengers, clients, residents. in discussion when you are travelling.
Communicating with them, passengers, clients, residents, often in regards to where they are and what is around them. This helps individuals s] to obtain the most out of the opportunities they are provided with, as well as ensuring people are actively involved and enjoying themselves.”
Please talk to all the individuals about their day etc.
The above steps will help to ensure that all people achieve a positive and productive activity/day.
Wednesday, May 11 2011
(We are seeking views and comment on this - via our Email or Mail)
Caring parents having a son or daughter with an intellectual or multiple disability need to live for ever because almost all services, supported accommodation, in-home support, respite day services, sheltered workshops, education, etc, etc cannot, at present, be relied upon to get it right for those with little or no ability to adequately advocate for themselves.
These are just some of the reasons why! (If you know more, let us know):
- Clothes being mislaid or lost, even when clearly marked.
- Wearing the same shoes all the time, especially runners ( when has a range of shoes)
- Washing quality poor - stains frequently not removed with Preen – woolens ruined in hot water, etc, etc.
- Clothes not ironed, or consistently ironed.
- Inappropriately dressed for the weather and environment.
- Generally, poorly dressed.
- Bed made up when wet.
- Top sheet not consistently put on bed.
- Manchester and towels in poor condition.
- Meals poor – lots of takeaway
- Cut lunches, for day activities, poor.
- Poor grooming, including teeth cleaning and nail cutting.
- Shoes not cleaned.
- Reluctance to use generic services for medical, hair care, etc, etc.
- Very little meaningful interaction, developmental and social activities – loss of skills.
- Failure to make or attend medical and dental appointments – Not in the staff diary, no one read the diary, or no staff wanted to go.
- Casual staff sent with resident to medical appoints, because regular staff don’t want the bother
- Staff infrequently attending a resident admitted to hospital.
- Resident's injuries frequently not noticed, treated or reported.
- Reluctance to treat minor abrasions and rashes.
- Residents needs have to fit in with staff needs, mood and availability.
- Delays in taking residents to a doctor (Example: Sector manager visiting a CRU on a Friday, observed a resident with a streaming cold. On asking when the resident will be taken to a doctor, the staff said, “On Tuesday when his key worker is back!”
- The “Key Worker” is intended to represent the resident’s interests with the service provider, especially where the resident has no family or effective family. Yet key workers frequently do little more than the average workers (staff). And the key worker’s loyalty is naturally with their employer – the service provider.
- A “Case Manager” is also intended to represent the resident’s interests with the service provider. Again, the case manager is employed by the service provider!
- Apart from parents, family and friends, there is little provision for purchasing or replacing items and equipment which would help to enhance the resident’s lifestyle. The resident’s finances build year after year, with the resident having few possessions. Whereas, most residents can benefit from such items as, a trampoline, an exercise bike, balls, talking toys, communication aids, TV, video recorder, drawing boards, etc, etc.
- Staff loaned a resident’s radio to another resident for an extended period, without consulting the parent of the resident to who the radio belonged. The resident to whom the radio belonged had no meaningful communications.
- Staff threw all washing in together, into the industrial washing machine – colours, whites and soiled clothing!
- Staff refused to soak stained clothes in Napisan, just sent it to the mother of the resident to deal with.
- Resident’s rooms and windows frequently dirty.