Choose and Control sometimes it can be a myth.
So Let’s unpack what
I am saying here it’s not that Choose and control in disability support doesn’t
exist at all, as it does but at times depending on where you are located it can
be a bit of a myth around what you can do, as for some people having absolutely
no limits placed on them can be dangerous even for people without disabilities.
Some of the restrictions can be because of a couple of
reasons and they can be as simple as behaviours of concern, a lack of impulse
control, or the lack of cognitive awareness to be able to understand that their
actions have consequences, and this leads to where restrictions as are needed
to be put in place.
But when it comes to disability accommodations it can get
complex to get into the system simply, and even in a rural, regional, and
remote area, there aren’t the disability accommodations that we know in other areas.
So, to get into the system you need to take what is out there and this can be
challenging as you might get the care you need have to move away from family
and friends, or have a support worker charge you travel time, and this isn’t
great for effective use of a support worker.
We also see support workers are thin on the ground in rural and regional
areas as it’s not a job that pays well. You do find agencies that pay above the
award but that can be rare.
But to get into a SIL house (supported accommodation) you
might have to do a bit of trial and error as you might not like your housemates,
and you don’t have any say in the stabilized care team as the housemates might
like the care team in the house and you just need to accept it. This is the
reality of disability care as you aren’t going to like everyone, but you need
to respect the care team.
We also then come into the tricky topic of insurance for the
housing so you may not be able to have other organizations in the house due to insurance
but this is a trick topic as when I was talking to the quality and safeguards commission
they were saying that depending on the circumstances this could be considered a
un approved restrictive practice and they are reportable, so I would encourage
interagency cooperation, [i]
as it makes everyone’s job easier to manage and some people choose to have
several agencies. I choose to have my housing separate from my community access
as this means that if there is a policy change around the housing and there have
been several where policies have changed overnight, and people have been left
without access to transport to get groceries or the authority of a head support
worker has been challenged we see that people need to be aware that we aren’t being
difficult in having two agencies we are just good at having a backup plan and
this is where having two agencies for people who need around the clock care can
make sense but if one agency does both a day centre and housing it might be appropriate
for them to just have one, so this is where they might say that the insurance doesn’t
cover other support workers that aren’t that agency in the house, it can be difficult
but we see that providers are running a business and that includes having policies
and procedures in place to protect both parties.
It also might be a privacy issue, but I have seen plenty of support
workers talk about clients when they shouldn’t be or actively pit one person
against another to the point of jealousy.
But when it’s the foundation of the NDIS it can be
challenging to find that some providers policies goes against choose and
control and putting the person with a disability and their families in the driver’s
seat of that persons life it seems to be that providers that existed pre NDIS
are having trouble transitioning to listening to people, who can make decisions for themselves so lets
start the conversation around what is an appropriate use of duty of care vs dignity
of risk and choose and control as these are the very bedrock of the NDIS.
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