Quality Management of Services for People with Disabilities
The DHS Victoria publication, Understanding the Quality Framework for Disability Services in Victoria (2007) says, Management must develop a culture of continuous improvement, more efficient and effective work processes and more time and resources spent on planning rather than reacting to problems and crisis.
This was said in 2007. Yet in 2012, we still have traditional reactive, crises driven, issue avoidance, manoeuvre every which way public service management. Rather than proper, consistent and overall proactive management of government and nongovernment services for people with disabilities and their families.
Many services, especially government direct services, have reactive management at the centre of their service provision - where consumers have to be eternally grateful for whatever they get or don't get! And, must never, ever, complain!
This is the culture of captive market services. It is certainly the entrenched culture of government, public service, captive market services. These services have no reason for customer service, as they have no reason for customers. Employees have secure government funded employment.
The culture of public service safe employment was established and is maintained as a result of successive governments allowing government departments to condone and protect questionable work practices and maintain protective barriers to fireproof these.
It is now almost impossible to breakdown their defensive barriers supporting questionable work practices and ineffective, reactive, management maintained by a traditional public service secure employment culture.
This culture left the Productivity Commission with little choice to achieve one of the main aims of the NDIS - service entitlement for consumers. They had to use the ISP funding process as a vehicle to drive-out entrenched captive market attitudes and move service provision towards market-place driven consumer recognition and service satisfaction - consumers being valued.
Funding for the NDIS does not extend beyond the launch sites. Competition for federal funds is fierce. There is education funding reform arising from the Gonski report, pressure to increase defence spending and a proposal for dental care to be included under Medicare make strong demands on government general revenue.
With the future of the NDIS therefore uncertain, those in group homes and day centres funded by traditional state and federal government bulk funding will, for a very long time to come, have to suffer the captive market restrictive practice services this style of funding sustains.
Traditional group home and respite services where residents receive their service package as an ISP, are unlikely to be NDIS funded for many years, if ever.
In Victoria, both government and non government service providers have a captive market. So those in services funded by traditional bulk funding, are unable to choose their service provider - no-entitlement service provision.
They are especially unable to choose their service provider because, (a) the Department of Human Services, Disability Services, controls the Disability Support Register (DSR) for all group home places in Victoria, (b) the department will not classify residential service packages as ISPs and, (c) the unmet demand is well in excess of supply.
Nevertheless, the non government community service organisations (CSOs) have many service accountability factors. They have a committee of management on which parents and members of the community frequently sit and they retain the right and have the ability and integrity to set, monitor and maintain staff work value expectations within the organisations own care policies, standards and values, and those of the Department of Human Services.
CSO management is supported by NDS, VCOSS and FIELD with management enhancement courses. And each year, the Harvard Club of Australia makes it possible for the CEOs of two nonprofit disability sector organisations to attend the course on Strategic Perspectives in Nonprofit Management at the Harvard Business School in the US.
Contrasting this with the DHS, we see little of this management quality motivation, determination and integrity - that which is clearly depicted in the departments care policy publications.
What we see in DHS group homes is the quality of care being almost totally dependent on direct care staff integrity (and we include the house supervisor in direct care staff), in contrast to consistent quality of care being maintained by regional management direction in setting, monitoring and maintaining staff work values within the direction, intention and spirit of the departments care policies, standards and values.
Certainly it is great to have direct care staff with good integrity, where they naturally treat the residents like they were their second family, but human nature is not consistent.
Good management direction is necessary to ensure consistency of service and ensure residents have little reason to say, Gee, we are lucky to be in a good house!
Since time immemorial, people with disabilities and their families have suffered intimidation in one form or another from many service providers, especially from government direct service provision,
This is as a direct result of service providers enjoying a captive market, where consumers stand in-line for years to get a service for which they must feel eternally grateful and never, ever, complain, as they have no where else to go.
They are often told, "You are so lucky to be chosen from the long line of applicants. If you don't like what we do, go back to your parents".
Group home services are frequently hostel style services, where the management and staff are at the centre of service provision, not the residents. Parents have been told they must wait at the door for their son or daughter to come out, Other parents have been told they must phone before visiting. And, some have had 'PIN' visiting restrictions placed on them
How would the general population feel if there was just one food store within a large area. The store staff would be able to treat the customers with total disrespect, as the store would have a captive market on goods, services and prices.
This was the effect in Britain during WW2. Families were restricted to one particular shop for their food ration, as part of war time restrictions. Shop keepers had total power over people, frequently treating them as undesirables lucky to get anything. It is hard to believe, in these enlightened times, that such restrictive factors can be openly applied to people with such a limited quality of life resulting from their intellectual or multiple disabilities, and where their family have often struggled to provide for them over many years.