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The new(ish) SIL Guidelines - and what they mean for participants

7/2/2022

6 Comments

 
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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).  
To think about this in the context of a group home:
For example, if by the determination of the NDIA a person needs 1:4 supports (meaning the individual’s support needs can be met by the attention and support from one-quarter of a staff member (yes, we know how ridiculous that sounds) and there are only two other people living in a house who are also funded for 1:4 supports, then the house is one quarter of a staff member short ( yes we know- ridiculous).
What does that mean in the long term because the funding coming in will fall short of what is needed?
Will a person have to move? Will they have to convert the garage into a granny flat?  
What if the person’s need increase to 3:1?
Now we are short of support, will that mean a person needs to move out, or should we reconvert the granny flat back into a garage?
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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 a
nd contributes positively to the funding) and there really isn't an open market of  vacancies in group homes.
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Looking at these changes, it’s hard to see how this is anything other than an exercise by the NDIA to withdraw from some of the mess they have left to fester since when the NDIS first started. To be fair, it’s not just a mess for participants. SIL providers are also struggling with those changes and must manage less funding coming in while keeping people and their staff safe.

​For now, we see some SIL funding become plan managed. We are a bit excited about this opportunity for a bit more transparency and accountability, but we are seriously thinking this might not make a difference in how people living in group homes have better lives. In fact, it might just make it even worse.
6 Comments

Opening up closed systems - working alongside group home managers and frontline staff

7/2/2022

2 Comments

 
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​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) 
​Lorraine, a person we support, has been living in institutions and group homes pretty much all her life. Some of the experiences she had were terrible and have left her traumatised and with loads of health and well-being issues. 
 
What happened in Lorraine’s life in the last couple of years is that her world got even smaller, with her not being able to even attend a day program anymore. Now she is at home all the time and depends mostly on her group home workers to take her out, provide any stimulation at home, look at her needs and understand her ways of communicating and choice making.
If you would like to read the video described audio transcript please click here
​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:
First, a presentation by Jo Watson, Senior Lecturer at Deakin Uni on
​“Representing the rights of persons with disability”  
​(Please note the subtiles are terrible)
 
Second, espcially if you are a worker reading this looking for some guidance on how to make more of a difference, you cannot go past this resource: Every Moment has potential:  4 learning modules that pack a punch when it comes to exploring potential. https://www.activesupportresource.net.au/
​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.
cartoon of some houses
What usually don’t know what is really happening in the group home. So, our first few recommendations are about trying to work out what is actually going on:
  • Visit, take time to observe, just hang out
  • Enter with  a curious/enquiring mind
  • Listen to the people around – other participants, staff
  • Ask questions – they can be random and what you really want to know might be wrapped in a whole lot of questions you don't really care about
  • Introduce someone independent into the home
​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:
  • Constantly share wins
  • Constantly reflect back to staff the positive stuff they do
  • Value their expertise and input
  • Giving staff back their responsibility
  • Figure out what’s important to a manager/ worker and what motivates them
  • Look for opportunities to collaborate
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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:
  • Keeping communication regular
  • Having action plans and deadlines
  • Having a vision and sharing that with everyone
  • Creating shared agendas with people
  • Building a team inspires everyone
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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:
  • Bring in specialists and train staff
  • Acknowledge staff and what they know
  • Find shared interests and nurture that 
  • Work out what ‘turns staff on’ and work with that (especially if the interest is shared with the participant)
  • Share good stories
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​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.
2 Comments

Choosing your own supports

1/9/2021

2 Comments

 
Banner with words Choosong your own supports and aan image of 6 different hands placed flat on a surface.
Peta’s support workers assist her with some of her household tasks, keeping track of her emails and bills, going to appointments and getting out and about in her community. 
Peta says:

‘That’s been lovely.  Having someone to take you out. It makes me feel good and happy and be a complete new Peta’

​​Peta says that it hasn’t always been like that.  In the past, she had no say in who would be assisting her, or when they would come.  Often they were casual ‘fill ins’ that she didn’t know before they arrived, and they were often very late.  ​
Peta and her Support Coordinator sitting on a lounge at Peta’s home.  They are working on a laptop and are facing each other
Peta has worked with her Support Coordinator to identify what she would like in a support worker, when she would like them to come and what they will assist her with.  Peta interviews potential workers and then chooses the people she feels will be right for her:
​‘We had a talk after and we spoke about the support workers that we had just seen. I thought Pauly was very nice, and S, and L. No, not L.’

Choosing your own supports

​People tell us that their support workers are often involved in very personal parts of their lives.  They rely on them in very vulnerable times when they need assistance the most.  They can be the difference between a bad day and an awesome day.  
Support workers are often key tools in assisting with achieving goals and getting on with living our best lives. We know that people often spend a lot of time with a support worker, so having the right person is important.
Here are our top 7 things to think about when choosing your support worker:
  1. ​Know what you want the support worker to do
  2. Decide when and where you need supports
  3. Decide what skills and qualities you want in your support worker
  4. Know how much you are willing/can afford to pay
  5. Know where to find and engage your support workers
  6. Plan for meeting and interviewing
  7. Know how to make an agreement.​
clipboard with the words To do
a red question mark on top of a pile of white question marks
​1. Know what you want the support worker to do
​
Many people use the funds in their NDIS Plan to engage support workers to assist with a huge range everyday activities including things like personal care, cleaning and gardening.  Some support workers also assist with getting out and about in the community and helping with building skills.
Perhaps you just want to be able to get out of bed in the morning.  Do you want to be able to pursue your hobbies, play sports, try new things or learn something new? Do you need a hand to help keep things organised, like your appointments or your bills?
Have a think about what your goals are; what do you want to achieve, what assistance you need and how a support worker might be able to help you to do that
a hand holding a compass
2. Decide when and where you need support
  • Do you need support every day or just a few days every now and again?  Morning, afternoon, overnight?
  • Do you need someone who is flexible or do you prefer set times on certain days?
  • Do you want an organisation to organise when your support workers come or do you want to do that yourself?
  • Do you want support at home, out and about, in the library or the gym?
  • If you are going out, do you need your support worker to drive you ​
 Also think about what you will do in an emergency or if your support workers calls in sick.
a wall of old woodworking tools
3. Decide what skills and qualities you want in your support worker
It is likely that you will spend quite some time with your support worker, so it’s important that they are the right fit for you and for your lifestyle.
  • Do you want them to be younger or older?
  • Do you prefer them to be talkative or quiet?
  • Do you want them to share your interests?
  • Do you want them to introduce you to new things?
  • Do you want them to have lots of experience supporting people with disability or would you prefer to train them for what you need?
  • Are there any specific skills or training that you need them to have (for example, will they need to be able to use a computer, to assist with bowel or catheter care etc)

Piles of Australian dollars
4. Know how much you are willing/
​can afford to pay


Look at your NDIS budget and work out how much funding you have available to pay your support worker.
  • How much do you want to pay them and how much will the charge you?
  • How much is the NDIS willing to pay?
  • Is the provider open to negotiating the rate?
  • How is your NDIS Plan managed?  
If your Plan is NDIA Managed, you will need to choose your support workers from organisations that are registered with NDIA.
  
If your Plan is Plan Managed or you are managing your Plan funds yourself, you have more choices about who you want to provide your support. You can also try to negotiate more easily.  If your support worker is inexperienced, you might not want to pay maximum amounts; or if your worker has loads of experience you might want to pay more.

Note, that for people who have their NDIS plan plan managed, there are 
upper limits that the NDIA will pay  (and they might change over time).

Remember that often there are different rates for different times of the day and week.
Remember that there is also an industrial award that sets minimum pay rates for support workers.
5. Know where to find and engage your support workers
  • Do you want to be able to find and engage your support workers yourself, or do you want to use support workers provided by an organisation?  
  • Do you want to directly employ your support workers or do you want contractors?
woman using her hands making googly eyes
There are laws that set out responsibilities when engaging other people to do work. These laws outline obligations such as pay rates, tax, GST, insurances, what happens if someone is injured, superannuation etc.
These responsibilities change depending on if the person is working as an employee for an organisation or individual or if they are working as self-employed contractor.
It’s important to be clear about your legal obligations if you are engaging your support workers directly yourself rather than through an organisation.
​

Where to find support workers?
Traditionally support workers worked for disability support organisations and  you can find workers by contacting those organisations.
Now, lots of people prefer to find their support workers themselves.
Some places you can look for support workers may also include:
  • university or TAFE student association
  • ask your friends, extended family and neighbours if they know anyone
  • people from your church or faith community, or a social group or club you go to
  • ask your therapists or other support workers you know if they know anyone who might be interested
  • through a platform such as HireUp, Like Family, Care seekers or Mable
  • advertise on Gumtree, in your local paper, or through employment websites like Seek (be careful about how much personal information you share in your advertisement)​
back of three people sitting on a bench one has the rainbow flag over their shoulder
6. Plan for meeting and interviewing 
Most people prefer to interview their potential support workers before agreeing to work with them.
You can organise to meet someone by phone, online (through face time, Skype or Zoom), email or in person.

This will give you the opportunity to ask them about:

  • their experience with people with a disability
  • their qualifications and other skills,
  • maybe their find out about their hobbies and interests.  
  • It also give you the chance to see if think you will get along.
Think about questions you would like to ask them beforehand and maybe write them down.
 

Also be mindful of things that are not ok to ask in an interview, because they might be considered private or could be seen as being discriminatory.
If you have decided to ask a disability support organisation to provide your support workers, ask the organisation about how you can meet and interview potential support workers before they commence working with you.
Some more tips for meeting, interviewing and deciding on potential support workers 
  • Be careful when advertising and meeting people for the first time to keep yourself safe
  • If you are meeting face to face - meet  in a public place the first time – for example, at a library, in a café or at the pub
  • Think about questions you would like to ask them and what would you like to know about them.
  • Ask for contacts for their referees – so you can find out a little bit more about them and what they are like to work with
  • Check out if they have a current NDIS Worker Check , First Aid Certificate, drivers licence and car insurance (if you will be needing them to help with transport)
  • Check if there have been any concerns with their work in the past or if they are not allowed to work as a support worker: 
  • You might like to take a friend or someone you trust with you so that you can hear their thoughts on the person as well ​

4 tumbs up made by for different coloured hands in top of a desk
7. Know how to make an agreement
Once you’ve decided on your new support worker/s, it’s a good idea to have a written agreement in place between you and your support worker or their organisation that you both agree to and sign.
The agreement should set out things like:
  • What the support worker will assist you with and when
  • Any expectations about how you will treat each other
  • How much you will pay them and how you will pay them
  • What to do if things go wrong
  • How to end or change the agreement
  • Any contact details for you, the person and emergency contact
  • Space for signatures and dates 
If you are directly engaging your support worker, it should also include things like:
  • Who is responsible for paying income tax, GST, superannuation etc
  • Any insurance arrangements and who is responsible for those

Finally, do you know that all people who work with people with disability need to complete the NDIS Safeguard Commission’s Worker Orientation Module ‘Quality, Safety and You’?

The course is free and a Certificate of Completion is provided on completion. can ask your worker to show you their certificate. If they don’t have one, they can do the training for free.
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