Two new reports from LiDs researchers
Frameworks for Supported Decision-Making and Review of Good Practice in Group Homes.
- Tuesday 24 January 2023 12:35 pm (Add to calendar)
- Living With Disability Research Centre
- Presented by:
- Living with Disability Research Centre
- Type of Event:
Diversity, dignity, equity and best practice: a framework for supported decision-making
Research report for the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability
The Living with Disability Research Centre with colleagues conducted this research to understand the significance of supported decision-making to people with cognitive disabilities. It aimed to identify the essential elements of supported decision making across all groups of people with disabilities and locate key implementation issues.
The study reviewed the literature about supported decision making, surveyed new initiatives, and interviewed a cross section on 77 people.
Major findings were that:
- There is no shared understanding of supported decision making
- People with more severe and profound cognitive disabilities are often left out of initiatives about supported decision making
- Supported decisions is important to the rights of people with cognitive disabilities
- The disability sector has led the way in supported decision making.
- The pace of change has been much slower in the aged care and health sectors.
The report suggests that supported decision making occurs on a continuum and proposes a principled rather than binary approach. This recognises that not everyone can easily express their preferences and others may interpret their preferences. When this happens if a person’s preferences direct the decision it remains supported decision making. Risk is important to supported decision making and people must be supported to take risks.
The report developed nine principles and eight essential elements that should make up a Framework for developing and implementing reforms about supported decision making in Australia. These are:
Principle 1. The equal right to make decisions
Principle 2. Support
Principle 3. Will, preferences and rights
Principle 4. Safeguards
Principle 5. Principled approach to supported decision-making
Principle 6. Best interpretation of will and preferences
Principle 7. Dignity and risk
Principle 8. Distributional equity
Principle 9. Co-leadership of people with cognitive disabilities
1. Recognising diversity in supported decision-making
2. Interrelationships with other systems
3. Use of best practice and ethical supported decision-making
4. Capacity building at individual, system and institutional levels
5. Safeguarding, quality assurance and oversight
6. Enabling forward planning
7. Adequate funding
8. Strategies to build social connections
Source: Living with Disability Research Centre and Council for Intellectual Disability (CID)
Evidence about Best Practice in Supported Accommodation Services: What Needs to be in Place? A literature review for the NDIS Quality and Safeguards Commissioner
This review aimed to identify models of best practice in group homes that the NDIS Quality and Safeguards Commission might consider in its capacity building work with providers and the development of relevant practice standards and quality indicators. It builds on earlier reviews by the authors, and examines the peer-reviewed research published between 2015-2022 about the factors that make a difference to outcomes for people living in group homes. The review identified three distinct components of a best practice mode (foundational, specialist and collaboration) finding substantial evidence for some elements of best practice but also identifying significant gaps in knowledge. Unequivocally the review found substantial evidence that staff practice of Active Support, strong Frontline Practice Leadership and Positive Culture are key elements of best practice in group homes.
Inquiry Report: Own Motion Inquiry into Aspects of Supported Accommodation
This Own Motion Inquiry is the first of its type initiated by the NDIS Quality and Safeguards Commissioner and focuses on the experiences of NDIS participants living in supported accommodation. Its purpose was to identify trends in issues that are occurring in supported accommodation, what is causing those issues, models of best practice to eliminate or address these issues, and how the NDIS Commission can use its powers to support the delivery of higher standards of support in these settings.
This report drew on the literature review conducted by LiDs on models of best practice in supported accommodation. The report examines reportable incidents and complaints made to the NDIS Commission in connection with the supported accommodation services (specifically group homes) provided by 7 of the largest providers between July 2018 and September 2022. It considers the evidence from a literature review about best practice in supported accommodation (see below and chapters 5 & 6)). It makes a series of recommendations that include development of a set of Practice Standards and quality indicators specific to supported accommodation services which would include staff practice of Active Support and Frontline Practice Leadership.