At the end of 2018, our health and social impact teams undertook a review of the disability services ‘space’. The goal was to identify the market forces and trends influencing providers and policymakers, map the impacts to people with disabilities while considering the different types of disability (mental, intellectual, physical), and ask ourselves, ‘how can we help’?
Significant steps have been taken in pursuit of an inclusive Australia – a place where people with disabilities are able to access a quality of life equal to others.
A recent study by the National Disability Services (NDS) illustrates the state of the sector where 71% don’t believe the Australian government is responding well to the needs of people with disabilities, 80% of operators are uncertain of disability policy and 55% see the operating conditions in the disability sector as worsening. The study indicates that disability service providers believe the outlook for the National Disability Insurance Scheme (NDIS) is that it will not deliver on its promise to Australians with a disability.
There needs to be a shift to quality outcomes such as independence, employment, and participation rather than just personal care services. We’ve spoken to members of the community who agree with us – the disability sector is in need of reform and we must do better.
The harsh reality about the workforce within the disability sector is that there is a lack of employee rights and values. Predominantly the workforce in this sector are casualised, underpaid, and there is a lack of supervision for employees even though the sector has experienced a history of abuse from carers. NDIS providers are currently understaffed and under skilled, as the sector experiences a high turnover of employees and difficulty attracting staff as there is no formal transition into the field.
Employee engagement is vital for disability service providers in developing the workforce. Establishing an effective engagement process will foster lasting, mutually beneficial relationships with employees that enhance organisational morale, reputation and business outcomes.
The visualisation of employee needs will lay the foundation in the process of co-creation; this process would build staff competencies and facilitate forums to identify community needs and scope service options. Involving employees in the decision-making process leads to higher levels of trust and enables the provision of quality services that are defined by consistency, compassion, and care.
There are directions for employers in the work we completed with Beyond Blue for health workplaces.
The market for services is limiting choice and control.
Today, the NDIS is a flipped version of its former structure – it needs time to iron out the crinkles and space to allow the market to establish supply and demand. The tricky thing about this transition is that there is currently a huge gap between the level of support people were able to access in the past versus now.
There is common consensus amongst service providers that the NDIS systems and processes are not effective as price guidelines are fixed, controlling the market and limiting competition. A sector that had previously received block funding is now receiving funding for individual clients, seeing many service providers either hit a wall or shut down completely.
To survive and thrive, providers need to innovate. The best model is social innovation, where the focus is on shared value creation: social and health outcomes that return sufficient revenue and competitive advantage to enable sustainable growth. Among not-for-profits, this is about lifting business competency to meet a well established social mission. For private providers, it is about ensuring social impact is always fundamental to revenue and profit, thereby underpinning sustainable business growth.
In work we completed with Neami Australia, the social innovation model was adapted to facilitate the identification and assessment of new services and partnerships that leveraged the core competencies and assets of the business – and attracted revenue outside of that regulated by the NDIS.
Lack of community integration.
Throughout history, people with disabilities have been segregated from mainstream society and they continue to remain socially isolated from basic institutions such as employment. A recent study has shown that only 4% of Australian employers practice positive attitudes towards hiring people with different abilities.
Many employers have revealed significant barriers to hiring people with a disability which include perceptions, prejudices, and capability issues – resulting in a low and static employment rate of Australians with a disability. There is a complete lack of social inclusion in community settings and a need to include disability into the breadth of diversity.
As the NDIS rolls out across the nation, there are several opportunities to leverage the scheme’s activities to address social needs of the community while delivering economic returns. A range of social impact initiatives for NDIS and employment service providers, local area coordinators, and businesses can be executed alongside the NDIS Information, Linkages and Capacity building (ILC); a program that supports organisations addressing the social needs of people with a disability.
Fundamentally we need to tell a different story about people with disabilities, mostly by focusing on the people not the disability. If you’ve ever watched The Last Leg with Adam Hills, you’ll know how the disabilities of the presenters are revealed to have no more emphasis than a common character trait. We find video helps, such as the one below produced for Just Better Care (it achieved 13,000 views in the first two weeks online with minimal boosting).
Employers need to ask, how am I telling this story? How can I challenge tired stereotypes long proven to be untrue?
Catering for complex needs
Fundamentally, the objective of the NDIS is to provide people with disabilities choice and control over daily lives, however, the shift from a social model to a medical model has neglected people with disabilities who have complex needs.
They are unable to access required services for their mental health, degenerative disease, intersectionality, and fast-changing needs. A system which previously focused on allowing people with disabilities to engage with society as fully participating social and economic citizens, has taken a step back to focus simply on individual health and care.
Co-creation in the disability sector would involve connecting local councils, community leaders and disability support experts in setting a vision tailored to the needs of the community. In our experience, it is an inspiring and unifying experience – disability providers are able to apply their experience alongside people with disabilities and their family members, at a peer-to-peer level, to come forward with ideas for improving aspects of services.
Working closely with the community, our team addresses complex needs and elevates unique perspectives as a starting point for innovation.
An example is the work we completed with national disability service provider, Scope. In a series of workshops we worked with people living in assisted living, and their carers, to reveal how the company and its staff could change the setting and delivery approach to empower the client, and adapt corporate services to real-life needs.
What can be done to make this work?
The NDS disability sector report has put forward 12 recommendations – it calls for the National Disability Insurance Agency (NDIA) to intervene and reform the scheme at play, including funding, complexity and market stewardship. There are major opportunities for service providers, not for profits and all levels of government to do better.
At Ellis Jones, we are equipped with a decade’s worth of deep sector knowledge and an understanding that heavy-handed government deregulation is not the only solution to improve outcomes. Community engagement is essential – we need to ask people with disabilities and their family members what they want in a service provider to ensure that the services offered are relevant and desired. Disability providers need to undergo organisational change in order to meet increased demand. Social impact measurement frameworks need to be put in play, the impact of these services communicated to attract more consumers.
We have the expertise that will allow disability service providers to co-create, develop shared value strategies and deliver impactful outcomes at a standard the community truly deserves.