SIL is about Supported Independent Living, it's the funding people who live in group homes need to have in their NDIS Plan.
Not the best choice of names because, let’s just get really clear, meeting individual needs, exercising choice and control in a group home are at best limited and most likely to be completely wrapped up in the needs and choices of the other people in the home (and the needs of service who provides the support).
Until recently the group home provider submitted a Roster of Care (RoC) and SIL funding documents to the NDIS and between themselves they worked out how much funding a person got. Although people with disability, their families and us as Coordinators of Support tried to insert ourselves into that conversation, mostly it felt like a secret deal between the NDIS and the provider. We were lucky we got to see the RoC after it was signed off.
So, now things are changing, and they are changing fast. Now we have new guidelines, and it seems, under the guise of choice and control, the NDIA is giving ‘control’ to participants while exiting from the previous arrangements they had with the providers.
Going forward, with SIL funding, like funding for most other support services, the NDIA will determine what kind and levels of support and funding a person needs based on the evidence they have (might be a previous RoC or might be a new OT assessment, etc).
Now the NDIA determines what is needed and then provides the funding to the participant, who in turn (and together with their Coordinator of Support) negotiates the agreements with the SIL provider … mmh??
Unlike most negotiations, in most situations and locations, it seems to us that there really isn’t much to negotiate, as there isn’t much choice and control a person has who is dependent on the provider for accommodation and day to day support.
And it also important l to remember, that the people who live together in the house rarely, if ever, get to choose a new housemate when there is a vacancy (and get to talk about whether the potential new housemate’s funding is compatible with and contributes positively to the funding) and there really isn't an open market of vacancies in group homes.
Despite new options in accommodation and support, and people trying out new things (stay tuned, we’ll write more about this in the coming months), group home accommodation (now called Supported Independent Living) remains the main model of accommodation for people with complex needs.
As of September 2021, about 25,600 people across Australia received SIL funding in their NDIS plans and there are about 4000 younger people with disability living in aged care facilities (that is a reduction from the numbers a few years ago, but still way too many people, including quite a few that are under 45 years of age). (NDIS Quarterly Report, September 2021)
One of the first things we did after we got involved was to ask for her NDIS to become partly Plan Managed and then to open up to new opportunities and more transparency. Then we engaged Louise, an independent support worker, who usually visits Lorraine 3 times a week.
Institutional care was not so long ago seen as the best option for people with complex needs. Mums and Dads were told to ‘hand over their child to a nurse and get on with their lives'. Most, but not all the institutions are now closed as they are seen, by almost everyone, as totally inappropriate. In the 1980s, group homes were hailed by many as the solutions. Family-led services emerged, quickly developing group home after group home. Some of those have now morphed into big service providers.
Yet, many of us think, that group homes have in many ways simply replaced institutions and are not fit for purpose and do not meet the human rights of people with disability.
There are plenty of resources that are available to get better at connecting and understanding the needs and wants of people with complex needs, and we will write more about this in future posts.
If you are wanting to know more now, we love to direct you to these two resources:
For this post today, we want to focus on making stuff better for people in group homes, by looking at supporting and influencing group home managers and workers.
Another key to supporting people more successfully is to get to know the group home manager and workers, as they are the people who spent loads of time with the person with disability.
What we know of group homes is that the quality of care and support varies, like with all services. We also know that while the values and mission of the organisation is important, it is the values, attitudes, skills, and behaviours of the group home manager that really shape what goes on in a group home.
What we also know is that when we invest energy and time into frontline workers, the results are often good for people. If we build on the skills and knowledge of the workers in the group homes, most workers thrive and appreciate it and, most importantly from our perspective, care more and do more and become better workers.
One of the keys to supporting people more successfully is to get to know the group home manager and workers, as they are the people who spent loads of time with the person with disability. We know it works to invest in building a relationship with group home manager and group home workers:
We also know that we should invest in the longest stayers, as sadly many staff move on after too few months and all our investment in them disappears and we must start again.
We have found working together with group home managers and worker, getting people onto the same page is important and working more collaboratively by:
Despite group homes being often very busy places, what keeps people working there busy is often the same day in day out (and of course loads of paperwork). There is often a distinct lack of excitement and motivation that permeates into everything that happens in the house. So, what we know works is to introduce some excitement by:
As we said above, we’ll post some more about other ways of opening up closed systems. We hope to talk about “circles” soon and we’ll also explore some other housing and support options that are becoming more readily available.