We recently published our last confusion-clearing piece called ‘Is it true that self management means hiring all my workers?’
Well we got some great responses and comments and asked one commentator if she would like to write a Guest Blog to keep the conversation going. Thank you Ellen Fraser-Barbour*! We think you have raised some excellent points to consider around the recruitment of support workers.
We have reached out, and are hoping that our next piece is a response from some organisations discussed in our original piece. That way we can get a really good conversation going.
Over to you, Ellen.
The NDIS market has seen a rise in the range of services offered, from large traditional provider models to smaller in-community neighbourhood team and online connector models. In my experience the NDIS is opening doors to new exciting opportunities and this should be encouraged. In my experience online models offer simplicity, flexibility, ease of booking, convenience and affordability. In-community support workers working within an agency or team, can offer a degree of support and “back-up” when planning and managing all the ins and outs of what this important work entails.
I have been wondering, however, about how these new types of self management models safeguard. Yes they, alongside all service providers, have policies in place to ensure safety, security and support for individuals, families and workers and these policies are vitally important but I can think of many examples where traditional large agencies are up to the hilt in policy but do necessarily invest in developing an active organisational culture or practice that truly embraces a human rights approach at base level. Policies are there, but putting this into practice seems to be easier said, than done. This has been highlighted in recent inquiries into abuse in disability services.
If questions of accountability and complaints processes were difficult to ask within large traditional service systems prior to the NDIS, it is now an urgent consideration with the NDIS. Bureaucracy is still there and it is still exhausting and ‘messy’ and complex for people with disabilities and their families to navigate. The only difference is that ideally, people with a disability now decide who is worth the stress and who isn’t.
In my experience, the issues of safeguarding are not black and white, like they might seem in policies. I can think of many examples of risky scenarios and ethical dilemmas people find themselves in every day. Life is complicated and there may be times when individuals or families are under immense stress. These stresses vary over time and place. Some situations of crisis are very apparent but others seem more hidden and are not identified until things have already escalated and workers might need to be able to respond in a moment to these situations. Adversity and crisis can take over and informal support networks may disintegrate. In these circumstances, support workers and professionals may be the primary point of contact for support and a vital link. In reality, however, workers may only be employed for short times, may not be not highly skilled and are working for a basic wage with a high turn over rate. There may be times when there’s a crisis beyond the scope of what that worker can deal with. I think there are times when the worker may well decide it’s “too hard” and leave, or alternatively, individuals may question the actions of workers and may well decide to sack. One hears about families who have been through a whole range of workers lasting a very short time. I think this usually suggests that the support networks fail both workers and individuals.
I think this is where Support-Coordinators or case-managers can be useful. If they’re good at their job, they would be “checking in” to see how things are going with individuals and with their support ‘team’. There may also be times when conflicts happen (because we’re human) and NDIS goals slip to the bottom of our priority list. Issues need to be addressed rapidly, calmly and sensitively and this is aided when there is an identified person available and accessible within that person’s network. Support Coordinators can debrief with families and assist with transitioning to new supports or linking to other disability or mainstream services.
At base level, questions need to be asked about safeguards when self-managing support workers. I admit to feeling out of my depth in even trying to pinpoint some specific questions and I worry I’m opening a can of worms, but I will put myself out on a limb here in the hope that some conversation is generated.
Here are a handful of questions I think organisations or self-managing employers could consider.
How do we show commitment to building trust between people with a disability, families, workers and organisations?
Without trust, it is very difficult for anyone to feel safe disclosing concerns. We are human and what is conflicting for one person, may not be for others. I think this is particularly relevant if connecting workers & individuals online without face to face meetings or a “middle man”. Expectations of stakeholders aren’t always made clear.
What avenues are there for disclosing issues safely and confidentially if things go wrong between individuals and their workers?
If support workers are not part of an organisation who do individuals and/or workers negotiate and receive support from, in times of conflict and stress? Being the direct employer is appealing when things are going well. With participants “driving the bus” so to speak, it means issues should be discussed with them first (as it should be). But what happens when there is a crisis and the person with the disability and/or their workers need more support and resources?
In my experience and from what I have heard of others, even in large organisations with strict hierarchical structures, support for individuals and workers is often lacking in times of crisis. With more workers without any back up or organisation, how are stakeholders protected when approaching sensitive concerns and possible conflicts?
Who is responsible for offering professional development to individuals, their families or their workers as we navigate this new NDIS world?
How is training is offered and how frequent is this training? In particular how do self-managed employers and independent employees access professional development to keep abreast development in the field and up to date best practice? How do we standardise training across sectors in light of the NDIS? In circumstances where agencies are involved, how much time do service providers really have and how often do they touch base with both individuals and workers and offer professional development, training, debriefing or support?
Of course, these are just a handful of questions one could ask – the issues are complex and I don’t think there are silver bullet solutions or quick answers in terms of how we navigate safeguards and dignity of risk. I am, however, an optimist and a believer in generating conversations about where the gaps are. These conversations need to represent diversity in order to be truly productive. I hope that there are opportunities for the voices of many to be heard.
I also hope that in writing this piece, I might encourage people to share personal experiences and ideas about how we engage, build bridges and offer the best quality supports and continue to work towards progress.
*Disclaimer: The author wishes to make it clear that this writing does NOT represent the views of organisations she works for – past or present and is merely her own perspective.
NOTE; The majority of concerns are not necessarily about abuse, or violence and are not severe in nature- but there are times when they are and in these circumstances professionals at all levels of services are mandated to formally report any incidences or suspicions of abuse, violence or neglect to their respective statutory bodies such as the Child Abuse Report line (in SA).