Major changes recommended by Disability Royal Commission

The final report of the Disability Royal Commission recommended sweeping changes to the sector and made several observations on the governance of disability service providers, ranging from governance reviews to board composition, director skills and training, risk management and beyond.

The governance and leadership arrangements of disability service providers are critical to identifying and managing risks, including the risk of violence against, and abuse, neglect and exploitation of the people who receive their services, the final report of the Disability Royal Commission found. Yet many disability service providers have a risk management approach where risks to the organisation were prioritised over risks to clients, the report stated.

Among the 222 recommendations in its 12-volume final report, the Royal Commission recommended that the government introduce a Disability Rights Act that should embody the principles in the UN Convention on the Rights of Persons with Disabilities.

It also recommended phasing out segregated education and so-called special schools by 2051, segregated employment by 2034 and group homes by 2038. While these recommendations may not impact the governance of many in the sector, the implications for directors of these organisations are huge.

The government said it wouldn’t immediately respond to the recommendations when the report was released in late September, saying it would take a “considered and staged approach”. The Royal Commission has asked federal, state and territory governments to publish written responses by 31 March next year.

In its four and a half years of hearings, the Royal Commission heard horrific stories of abuse of the 4.4 million Australians with disabilities.

The final report made several observations on governance of disability service providers. Download a copy of the report here.

1. Review Governance Arrangements

Providers should carry out a periodic review of their governance arrangements to ensure they remain fit for purpose and reflect human rights-based service delivery. Directors should consider the extent to which people with disability are involved in governance and decision-making; the necessity for evaluation of board members’ experience and skills; how approaches to risk are conceived and managed; and how positive cultures are developed.

2. Board Composition

The Royal Commission heard that a lack of representation of people with direct or indirect experience of disability can impede a board’s ability to discharge its responsibilities effectively.

It noted that some service providers had been involved in the AICD’s scholarship program to promote and support people with disability to acquire leadership skills.

Service providers should consider whether their boards and leadership structures have a meaningful representation of people with disability and aim to recruit people with disability as board directors, leaders, managers and advisers.

However, it said that quotas might not always be appropriate, particularly for smaller providers operating in regional and remote areas.

3. Participation in Decision-making

Negative consequences can result from failure to consult people with disability on decisions affecting their lives, including decisions about how services are provided to them.

Service providers’ reviews of their governance arrangements should consider the extent of involvement of people with disability and whether appropriate arrangements exist to incorporate consultation with people with disability as consumers of their services.

Service providers should have a formal committee that includes service users and their support networks (including family, friends, carers and other people who have a supportive relationship with participants) and these committees should report to the board and periodically meet with board members to provide feedback, raise issues and contribute to organisational policies and processes.

4. Director Skills and Training

Some disability service providers have grown rapidly and evolved from localised community-based organisations to handling hundreds of millions of dollars and there needs to be sophistication in governance across the sector, the commission heard.

Along with ensuring governance frameworks and structures are fit for purpose, organisations need to ensure that board directors have the appropriate experience, skills and training to oversee the safety and quality of services.

The commission heard that the board of the Australian Foundation for Disability (Afford), for instance, had a majority of directors with corporate or local government experience, but who were not adequately trained or informed about the human rights of people with disability or about disability service provision.

Directors need skills and experience relevant to the disability service environment, including expertise in regulatory compliance and financial matters; the ability to implement human rights principles; and processes to identify and manage risks of violence against, and abuse, neglect and exploitation of, people with disability.

The report recommended organisations provide resources for directors to attend AICD courses and other governance training. Organisations should provide regular training and development activities across the life of a board member’s appointment, including visiting services and meeting with service recipients and staff.

5 Risk Management

Disability service providers and their boards should have risk management systems to identify, analyse, prioritise and treat organisational risks; have a documented risk management system that effectively responds to identified risks; and provide services and support in a manner consistent with the risk management system.

Risk management overly focused on mitigating a service provider’s exposure to legal liability or reputational damage is often at the expense of upholding the rights of people with disability, the report found.

At the same time, providers need to consider the “dignity of risk”, which the National Disability Insurance Scheme (NDIS) defines as “supporting people to take informed risks to improve the quality of their lives”.

Rather than trying to find ways to eliminate all risk — which can be highly restrictive and out of proportion to the level of risk involved — the dignity of risk for NDIS providers means working with participants to define acceptable risk levels in delivering support to achieve their goals.

“We acknowledge that it can be difficult for providers and for support workers to navigate the challenges that come from weighing dignity of risk and safety in the multitude of different situations and scenarios that can arise, often at short notice,” the report states.

“This is especially the case in circumstances where the desire to undertake a riskier activity occurs in a more unplanned or ad hoc fashion that may not necessarily allow for extensive planning and assessment, and requires a decision to be made by a support worker.”

Finally, they should develop an approach to risk that is preventative and enabling rather than reactive.

6 Use of data

Service providers should take a proactive approach to preventing incidents of violence, abuse, neglect and exploitation — and data can be used to detect potential emerging cultures of concern and prevent abusive cultures developing.

Volume 10 of the Royal Commission focused on this need, stating, “Registered NDIS providers should be required to report regularly to their governing bodies about complaints and incidents, including patterns of, and underlying reasons for, complaints and incidents, and strategies to prevent any serious issues from occurring in future. The Royal Commission into Aged Care Quality and Safety made a similar finding in relation to aged care providers”.

However, it is recognized that providers also need the capacity to analyse and use that data and this can prove challenging for some.