The Impact of Service Structures on Abuse Recognition & Response

1. The Impact of Service Structures on Abuse Recognition & Response Lesley Chenoweth Professor of Social Work Griffith University

2. Overview • The current service situation • Key challenges and Implications • Compliance cultures • Procedural practice and/or cultural change?

3. Key service trends • More service outlets • Expansion of the non-government sector to deliver services to people with disabilities • Ongoing bifurcation of systems • Federal – State responsibilities • Supported living, employment • Siloed service systems (health, education, criminal justice etc)

4. Key service trends • Increased demand for services • Vastly increased compliance & audit requirements • Quality, service standards • Include abuse and neglect • Gradual shift to individualised funding approaches (patchy) • Continuance of & return to institutional models of care

5. Key service trends • Increased casualisation of the workforce • More focus on people with challenging behaviour and restrictive practices • Increased focus and awareness of the rights of people with a disability at a policy level (UN Convention)

6. Standards and policies • Australian Disability Standards • Standard 12: Protection of human rights and freedom from abuse • State service standards & policies • Protection of legal and human rights and freedom from abuse and neglect • Some agency policies and procedures

7. Productivity Commission Report The current disability support system is underfunded, unfair, fragmented, and inefficient, and gives people with a disability little choice and no certainty of access to appropriate supports. Disability Care & Support, Feb 2011

8. What are the likely implications for the prevention of and response to the abuse and neglect of people with a disability?

9. Implications • Stretched services – less capacity to address abuse effectively? • Cross agency slippage – responsibility transfer and falling through gaps • System becomes reactive rather than proactive • Increasing focus on the management of systems rather than support of people with disability

10. Implications • Models which may encourage institutional service provision • Lack of understanding of disability and disability services history • Gaps between policy and practice • Competing agendas

11. Implications • service framework which has significantly improved in acknowledgement of the categories of abuse and neglect • increased criminal checks of staff • some staff training • BUT has this changed incidence, prevention and responses? Evidence is needed.

12. The impact of compliance cultures • Increasing focus on the management of services – global response to neo-liberalism and managerialism • Management of systems given higher priority than the support of individuals (eg, OH&S restrictions) • Measurement of service activity, not outcomes for individuals • Pragmatic responses to resource allocation issues

13. Procedural or cultural responses? • Procedural responses • Legislation policy practice • Neat linear assumption • Respond to individual cases or incidence • Vulnerable people outside the system? • Do we miss the big picture?

14. Procedural or cultural responses? • Cultures that protect • The importance of organisational cultures • Service environments - physical & social • Look at deeper causation – e.g. social isolation, cumulative effects of abuse, maltreatment • Prioritise the moral aspects of service work

15. Procedural or cultural responses? Both approaches are needed.

16. Towards better service responses • Active, engaged supporters in people’s lives (family, advocate, friends) • Sharing, and funding, examples of innovation and good practice • Realistic alternatives available if not happy with service provider • True collaboration between people with disability, families, NGOs and Govt

17. Towards better service responses • Operate to maximise choice on a range of levels • Demonstrate respect to and for the person they are set up to support • Have control vested in the person or close to them • Invite and support family involvement in meaningful ways and levels • Allow and facilitate ordinary relationships

18. Towards better service responses • Education and training – workers, managers, people with disability, families, advocates • Responsiveness to findings from research & evaluation • Investment in informal supports • Vesting control of funding and support in or near the person • Invest in people with a disability – tap into and build resilience, capacity

19. References • French, P., Dardel, J., & Price-Kelly, S. (2009). Rights denied: Towards a national policy agenda about abuse, neglect and exploitation of persons with cognitive impairment, Sydney: People with Disability Australia • NSW Ombudsman. (2010). Improving probity standards for funded organisations: A special report to Parliament under section 31of the Ombudsman Act 1974 . Sydney: NSW Ombudsman. • Productivity Commission (2011) Disability care and Support Draft report. • Robinson,S. & Chenoweth L (in press) Preventing abuse in accommodation services: from procedural response to protective cultures Journal of Intellectual Disabilities.