Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697634179792.pdf (Australia)
Intellectual Disability Rights Service Submission to Senate Inquiry into Violence, abuse and neglect against people with disability in residential settings Contact Janene Cootes Executive Officer Intellectual Disability Rights Service Inc About Intellectual Disability Rights Service (IDRS) Intellectual Disability Rights Service is a community legal centre and disability advocacy service working with and for people with intellectual disability in NSW.
We deliver the following assistance to people with intellectual disability:  Legal advice and casework  Advocacy and support persons for people in contact with the criminal justice system as victims and defendants  Advocacy and legal assistance for expectant parents and parents with intellectual disability at risk of having their children removed  Rights training and self-advocacy development  Policy and law reform to protect and advance the interests of people with intellectual disability Our Submission Intellectual Disability Rights Service invited people with disability, their families and friends and disability service staff to phone in to IDRS over a two day period to discuss their experience of violence, abuse and neglect and to register their thoughts about what needs to change to prevent violence, abuse and neglect of people with disability in the future.
This submission focusses on information recorded and lessons learned from the No Abuse-No Excuse Phone In.
Page 1 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1 No Abuse- No Excuse Phone In - 20 & 21 March 2015 To inform our submission to the Senate Inquiry IDRS conducted a Phone In on violence, abuse and neglect of people with disability in residential settings.
Thirty five instances of violence, abuse or neglect were recorded as a result of the Phone In.

Thirty four instances involved people with intellectual disability as the victim of violence abuse or neglect.

Fifteen reports related to staff abuse, ten to abuse by one person with disability toward another and a further ten reports were recorded as instances of neglect.
Callers to the Phone In People with disability Family member/friend Disability staff Other disability advocates, a neighbour, a police officer 2 20 8 5 Nature of Violence Abuse Neglect reported during Phone In Nature of abuse reported Staff abuse of person with disability in service Total reports 15 *some people encountered more than one form of abuse 7 5 3 3 2 Physical abuse Sexual abuse Psychological abuse Restraint Financial abuse Aggression by person with disability against another person with disability in service Total reports 10 *in one case 2 types of abuse were reported 8 2 1 Staff abuse of people with disability in their care 15 callers reported abuse of person with intellectual disability by a staff member.
70% of that abuse occurred in residential or respite services.

Two other reports of abuse by staff who provided drop in support to a person with disability living in their own home.

One report involves a day centre.
Page 2 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1 None of the callers about staff abuse of people with disability felt that the abuse had been handled satisfactorily by the service.
Common issues were  Family were not informed of the accusation at an early stage and were not kept informed of how the abuse allegation was being managed  Some staff who reported abuse by another staff member had been reprimanded (2 cases)  Staff do not have clear instructions about what to do if they suspect another staff member is abusing a person with disability.
Three staff who suspected abuse at the hands of another staff member were fearful of reporting the abuse to management  Services are very slow to act in response to allegations of abuse and often their responses did not focus on protection of the person with disability  In one third of cases, the response to allegations of abuse by staff simply involved interviewing everyone involved and if the alleged abuser denied the abuse there was no other action  Staff accused of abuse were often left in their positions or moved to another part of the service  Staff involved in 3 allegations had quickly left the service once they were aware of the allegations  In most cases caller reported that no action was taken to respond to the effects of abuse on the people with disability who were the victims of abuse.
The exceptions were 2 cases where the person had suffered sexual abuse and counselling was arranged.

 Alleged abuse by staff was reported to the police in six of the fifteen cases reported.

Charges were pursued by the police in only one of those matters.

What needs to change to prevent abuse of people with disability by staff?
Callers views of what needs to change to protect people with disability from violence and abuse from staff in the future:  Better procedures to ensure that reports of abuse by staff are followed up by management as soon as they are reported.

 Move more quickly to resolve investigation of abuse allegations It was common experience that investigations of abuse were very slow to occur.

 Inform family of any allegation of abuse by a staff member immediately.
 Someone independent of the service, such as an advocate, should be involved to support and advocate for the victim, especially if there are no involved family.

Both of the people with disability who contacted the Phone In raised the need for advocacy.

 Training for people with disability about what behaviour is OK and what is not OK from paid carers.

This should include what to do and who to tell if they feel something is not OK.

They need easy access to someone they can trust.


Their families and friends need the same information.

Page 3 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1  Protection for whistle blowers in disability services.
 Better screening of staff is essential.

Only one of the staff alleged to have abused people with disability would have been picked up by the National Police Record Checks because only one alleged abuser was charged.

All the other alleged abusers could have attained further employment in disability services with no-one being aware of their history.

Police Record Checks alone are inadequate to screen out staff with a history of abuse of people with disability.
The experience of IDRS is that staff accused of abuse against people with intellectual disability are rarely charged and even more rarely convicted.

 Better training of disability support staff.

Callers reflected that staff are often untrained and have little or no experience.

They are often out of their depth.

 Better staff training about what to do if you suspect abuse.

 More full time and permanent staff.


Callers felt the high level of agency and casual staff in services made abuse and failure to report abuse more likely.

 Police should take action against abusive staff.

One caller reported police who were investigating a fellow staff member saying ‘we understand it’s a difficult job you’ve got’ as if that excused the assault on a resident.

 There should be repercussions for any sort of abuse by staff.
 The victim of abuse and their family should be better looked after when abuse has occurred.

It is traumatic for the person and for family.

Abuse of a person with disability by another service user There were ten reports of abuse of a person with intellectual disability by another service user.

Eight of these reports involved physical abuse and one of these was also seen as involving psychological abuse.

Two reports involved sexual abuse.

Nine reports were about abuse occurring in group homes.
One incident had occurred in an employment service.

In most cases the abuse involved aggression by a person with intellectual disability who had a pattern of challenging behaviour.

In six cases the instances of abuse had been occurring over months and in one case over two years.

Two families had taken their daughters home for some months because they felt they were unsafe in their group homes and no safe alternative was provided.
Only two of the ten callers said they were satisfied with the response of the service to the abuse.

In most cases the caller did not indicate that they felt the abuser could or should be held legally responsible for the abuse.

Police were involved in three cases.

In each of these cases the caller did see police involvement as appropriate.

Charges were laid in one of these cases.

One disability worker commented that ‘there is much suffering happening in group homes.
It has serious results on everyone’s behaviour’.

Page 4 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1 What needs to change to prevent abuse by people with disability on other service users?
 Support needs of people with disability should be carefully assessed.

Some of the people abused by other service users had limited support hours and support hours had been reduced.

Supervision must be sufficient to ensure protection from abuse.

 Require that service must notify family of incidents of aggression or injury toward their family member as soon as possible.

Services should listen to people with disability and their families.
Most family contacting the Phone In had not been notified quickly about early instances of abuse.

 People who have been victims of abuse and who have no family involvement should have access to an advocate or guardian external to the service to support them and advocate on their behalf.

 Compatibility between residents in group homes should be the major factor in deciding groups of people who are required to live together.
Some callers reported that people who had very high support needs, could not move independently and had no verbal communication were in houses with people who were known to be aggressive and unpredictable.

This seems a clear situation of likely incompatibility and risk.

 Services should act immediately to ensure the safety of a resident when abuse has occurred.
Alternatives must be found quickly when it is realised that people who have been required to live together are not compatible, are unhappy living together or are at risk from each other.

It is not acceptable to force people who are incompatible to live together.

Most callers reported that there was no alternative accommodation available to separate victim’s from other people with disability who harmed them.

 Choice of accommodation.


Most families had no options to choose between when arranging accommodation for their family member with disability.

They had to take what was offered.

 There is a need for an independent organisation with power to act quickly to ensure that adequate protection is provided when abuse is occurring in services.

Current options are not sufficient.

Focus of investigation of complaints should be to ensure safety first.
 One caller commented that there should be an enforceable legal obligation on services to provide safe accommodation.

 It should be acknowledged that many people in group homes have developed challenging behaviour and adequate expert support must be available to deal with this.
Page 5 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1  Incident reports should be required for any incidents of aggression or violence against residents in group homes.
Management of services should be required to respond to incident.

Staff who contacted the phone felt generally unsupported by management in finding solutions to abusive situations.

 More permanent full time staff.

Less reliance on casual and agency staff who do not know the clients.

This exacerbates the likelihood of abuse.


 Better training of staff to recognise and manage risk, to apply effective behaviour support strategies and to recognise and respond to indicators that a person in their care may be experiencing abuse.

 People with disability must be taught to recognise abuse and must have a clear, known and accessible avenue to report abuse.

People with disability need to be asked if everything is OK, do they have any worries.
Services shouldn’t rely only on people initiating a report of abuse.

Neglect Ten callers reported instances of neglect.

Some callers reported more than one example of neglect.

Nine of the ten reports of neglect occurred in a group home.

The one non-group home report involved a paid respite carer leaving a person with intellectual and physical disability sitting alone in her wheelchair in a shopping centre foyer for over an hour while the respite carer did her own shopping.
Seven callers contacted about instances of medical/health care neglect.

One case involved staff failing to recognise a serious health issue and refusing to follow up even when the parents expressed their serious concerns about symptoms because their records did not record the symptoms.

The woman’s parents had to take urgent action.

Five callers reported neglect that put the safety of the person with disability at risk.
Seven callers reported instances of neglect of the well-being of residents including people having no activities and boredom leading to behavioural problems; people being left alone in their house for long periods without staff and with no access to phone or any emergency backup; access to services such as physiotherapy or podiatry being cancelled; poor diet and no opportunity for exercise leading to morbid obesity and ill health.
One caller reported adults with physical disability being put to bed at 8pm every night in several houses.

Several callers reported there being no attention to individuality with everyone in a house being required to attend the same hairdresser or doctor even they had long relationships with their hairdresser or doctor.

A major recurring theme for callers about issues of neglect was the low level of training and experience amongst staff.
Many callers mentioned the high turnover of staff, the high use of agency and casual staff and the lack of consistency amongst staff in many services.

These and other workforce issues appear to be systemic problems impacting on the well being of people with disability in NSW.
Page 6 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1 What needs to change to prevent Neglect?

 Services should listen to those who know the person well, particularly families.
 ‘Employ permanent staff who have some long term investment in the long term welfare of residents’ quote from a disability worker  Standards and service accreditation are not enough to ensure good service.

It is easy for services to look good on paper and pass audits but this may bear no resemblance to what happens in practice.

Who is checking?

Community Visitor Programs focused on the well-being of individual service users are an important protection.
Families need to be informed about Community Visitor programs so that they can access the assistance of a community visitor.

 Better complaints options and more power to require action by services.

Four callers about neglect had made complaints to the Ombudsman.

While one caller was happy with action taken when a matter was raised with the community visitor program of the Ombudsman, 3 other callers raised their frustration with the long delays and process involved in investigation.
Two callers did not feel the Ombudsman had sufficient power to achieve solutions to problems of neglect.

 Strategies to ensure compliance and prevent services from cutting corners to save money.

 Better staffing levels so that activities are possible  Advocacy for people without involved family.

One former disability worker commented that people without family are very disadvantaged in residential services.
Conclusion The experience of IDRS in providing legal assistance and advocacy is that violence, abuse and neglect are serious and frequent experiences for people with intellectual disability in residential settings.
Our main purpose in this submission was to give voice to some people’s experience of the violence, abuse and neglect that people with disability, families and disability workers are experiencing and witnessing in residential services and importantly to record what they feel needs to change to make a difference.

We greatly appreciate the generosity of the people who contacted the Phone In to share their experiences.
IDRS has made a submission to Department of Social Services about the NDIS Quality and Safeguarding Framework which is relevant to this Inquiry and which is attached to this email.

It is essential that the serious problem of violence, abuse and neglect is addressed as part of the revolution in the lives of people with disability that the NDIS promises.
Page 7 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1 Page 8 of 8 Violence, abuse and neglect against people with disability in institutional and residential settings, including thegender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people withdisability, and culturally and linguistically diverse people with disabilitySubmission 128 - Attachment 1