Service Level and Quality Monitoring
Service Evaluation Avenues
Better Practice, Internal Audits, Independent Accreditation,
External Evaluation, Community Visitors, Advocates and Families
Services have traditionally been, and many still are block-funded. Where consumers are considered to have little entitlement, lucky to get anything and damned if they make any service observations or dare to complain.
Block funded services are captive-market services, as service providers have a safe funding source with little need for customers or customer service. This is especially so with government direct services, which rely on staff integrity rather than having effective management to set monitor and maintain work-value expectations.
Services which rely on staff integrity frequently fluctuate significantly as staff lore, peer pressure and house politics determine the level and quality of care and support the residents of group homes receive. There is frequently a significant disconnection between service intent and service delivery.
Various service level and quality evaluation is, in theory, intended to protect the consumer, but outcome access is made difficult or impossible for the consumer, as service providers and bureaucratic funding sources do their best to keep the consumer behind a legalistic veil, often unable to be penetrated even by FOI (Freedom of Information).
With the advent of the National Disability Insurance Scheme (NDIS), running on Federal rather than State funding, the Productivity Commission saw little potential in the NDIS providing traditional block funded services with its bevy of ineffective complaint and service evaluation processes
The Commission saw the only real option was to move an entrenched culture which saw the consumer as a charity case bludging on the state, to a model where the funding is in the consumer’s pocket as an ISP (Individual Service Package), rather than in the service provider’s pocket as block-funding. Thus changing the service base from captive market, to marketplace services where consumers are valued.
Money in the consumers pocket works really well for most marketplace products and services, but there are many drawbacks with services for those in our society with high support need disabilities. Many of those with autism and/or limited intellectual ability do not move easily to capture their ISP financial ability to exercise choice.
The ISP model suffers further limitation where there are insufficient service providers to generate competition, and that service providers, then reliant on ‘passing trade’, initially, at least, have a limited war-chest to retain resources necessary to provide random complex service provision for those with complex needs.
The model places onus for evaluating service quality firmly on the shoulders of the consumer and their representative. In most cases this will be family - those least able to evaluate complex service provision, costs and negotiate with service providers.
In total contrast, consumers whose support service funding is ‘block’, their services are allegedly monitored by a range of provisions, such as internal complaints, external complaint, independent accreditation, community visitors and the consumers themselves. Yet none of this service monitoring and evaluation is effective against block funded service providers with a captive market, especially government direct services with public service and union lore.
Captive market and block-funded services need have little real interest in customers or customer service. Their funding is secure and their customer base is secure. And, whilst ISP funded service providers continue to have a captive market, there being few choices for consumers, they have little reason to respect their customers.
Since time immemorial, the disability service provision field, in general, has run on a philosophy of consumers are charity-cases with no real entitlement to services. The consumer is expected to accept whatever is on-offer, without question. If the consumer wishes to complain, they must ensure their case is beyond reasonable doubt and strong enough to stand-up in the supreme court.
The main external complaints body in Victoria is mainly the ‘Disability Services Commissioner (DSC)’. The Commissioner is currently running information seminars to advise service providers how best to deal with complaints. Yet there is little expectation service providers should have a zero tolerance towards complaints - put the DSC out of business. The DSC needs to be put out of business, as it is toothless, takes for ever to process complaints and has a conciliation playing field well tilted against the complainant.
Better Practice Evaluation: Internal - Outcomes not available to consumers through administrative release – FOI, perhaps.
Internal Audit Evaluation: Internal - Outcomes not available to consumers through administrative release - FOI, perhaps.
Internal Complaints: Available to the consumer, but ineffective as the focus is mainly on avoidance and denial.
Independent Accreditation: Mainly internal, consumer service complaints not taken into account – Focused mainly on the administration of services. Outcome not available to consumers due to agencies claiming ‘commercial in-confidence’
External Evaluation: Available to the consumer, but done by pseudo government departments (independent statutory bodies) who’s focus is mainly on avoidance and denial.
Community Visitors: Available to the actual client, but only if they have the communications, intellectual ability and are accepted to express their views during the actual visit. Client representatives may only present to the CV program coordinator.
This bevy of official service evaluation not only ignores the consumer, but makes it especially difficult for consumers to access this service evaluation in an environment where the consumer has little or no service entitlement. All this equals people living in hostel environments, not a real and homely-home.
People with disabilities and their stakeholders have to battle against captive market service provision culture for which they are expected to feel lucky and grateful to receive anything.
Community Visitors started-out being especially outward looking and accessible. They were told to make themselves very available to consumers and their families, and to look into every avenue of services and needs. This was in the late 1900s, when the legislation was first introduced. The program is, now, well watered-down!
Community visitors make their reports on group homes available only to service providers, and the community visitors who visit a group home where the residents have no meaningful communications and/or have limited intellectual capacity to make valued judgements, are not permitted to be contactable by the residents’ stakeholders. Thus, such a group home is evaluated just on contact with service provider staff – a hostel situation.
Although the Productivity Commission saw service provider accountability as a major problem. Their ISP support-service funding in the pocket of the consumer is not the silver bullet for many, especially for those with high support needs who do not move easily to take advantage of access to the ISP-marketplace. That is, if the ISP-marketplace will ever really exist – as it is dependent on competition. With insufficient service providers, there can be little competition.
Extra 1: Who broke the law? Critique exposes deficiencies in Community Visitor's Report by JacksonRyan Partners - 25 September 2014.
Extra 2: Living in Victoria’s disability accommodation sector is a game of chance –
JacksonRyan Partners – October 1, 2014
Extra 3: “Strapped-in and Locked-up” in Special Developmental Schools – Daily
Mail, Australia – September 2014.
Extra 4: Social Inclusion Report, Victoria, September 2014
Extra 5: National Disability Forum, Results – September 2014
LIFESTYLE IN SUPPORTED ACCOMMODATION (LISA) INC. Tel: 03-9434-3810: Email: firstname.lastname@example.org or email@example.com Web: www.lisainc.com.au : www.lisa-aus.blogspot.com
NOTE: We are always interested in feedback and information; general, specific, good or bad.If you wish anonymously: Our mail address is, 73 Nepean Street, Watsonia, 3087.