Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697643324180.pdf (Australia)
Submission to the Senate Inquiry into violence, abuse and neglect against people with disability in institutional and residential settings, including the gender and age related dimensions, and the particular situation of Aboriginal and Torres Strait Islander people with disability, and culturally and linguistically diverse people with disability.

Introduction Advocacy Tasmania Inc. (ATI) is an independent, non-government organisation that has been providing advocacy services across Tasmania since 1990.
Our client groups consist of people with disability, older persons, people who have experienced mental illness and people who use or have used alcohol, tobacco and other drugs.

We are also responsible for the operation of Tasmania’s Elder Abuse Helpline as well as providing volunteer representatives for people who appear before Tasmania’s Mental Health Tribunal.

We provide advocacy services for people with disability where their fundamental rights are at stake.
We recognise that all people have a right to be safe from harm and protected from abuse and neglect, and over the past three years, we have supported people with disability with over one hundred issues involving abuse or neglect.

We recognise that significant improvement has occurred in the culture of residential and institutional settings over the twenty-five years we have been providing advocacy services in Tasmania.
We do not intend to describe the well-documented abuse that occurred in previous Tasmanian institutions such as Willow Court in this submission.

Rather, this submission is drawn from our experiences, and the experiences of people with disability we have worked with, over the previous three years.

Where case studies are used, names and some details have been changed, in order to protect the anonymity of people we have worked with.
Page 1 of 10 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 97 Contents Introduction ........................................................................................................................................ 1 A.
The experiences of people directly or indirectly affected by violence, abuse and neglect perpetrated against people with disability in institutional and residential contexts ......................... 3 B.
The impact of violence, abuse and neglect on people with disability, their families, advocates, support persons, current and former staff and Australian society as a whole .................................. 3 Case Study 1 .................................................................................................................................... 3 C. The incidence and prevalence of all forms of violence, abuse and neglect perpetrated against people with disability in institutional and residential settings ........................................................... 4 D. The responses to violence, abuse and neglect against people with disability, as well as to whistle-blowers, by every organisational level of institutions and residential settings, including governance, risk management and reporting practices ..................................................................... 4 Case Study 2 .................................................................................................................................... 6 Case Study 3 .................................................................................................................................... 6 E. The different legal, regulatory, policy, governance and data collection frameworks and practices across the Commonwealth, states and territories to address and prevent violence, abuse and neglect against people with disability ................................................................................................. 7 F. Australia’s compliance with its international obligations as they apply to the rights of people with disability ...................................................................................................................................... 7 G. The role and challenges of formal and informal disability advocacy in preventing and responding to violence, abuse and neglect against people with disability ........................................ 7 H. What should be done to eliminate barriers for responding to violence, abuse and neglect perpetrated against people with disability in institutional and residential settings, including addressing failures in, and barriers to, reporting, investigating and responding to allegations and incidents of violence and abuse .......................................................................................................... 8 I.
What needs to be done to protect people with disability from violence, abuse and neglect in institutional and residential settings in the future, including best practice in regards to prevention, effective reporting and responses ...................................................................................................... 8 J. Identifying the systemic workforce issues contributing to the violence, abuse and neglect of people with disability and how these can be addressed .................................................................... 9 K. The role of the Commonwealth, states and territories in preventing violence and abuse against people with disability .......................................................................................................................... 9 L. The challenges that arise from moving towards an individualised funding arrangement, like the National Disability Insurance Scheme, including the capacity of service providers to identify, respond to and prevent instances of violence, abuse and neglect against people with disability .... 9 M. What elements are required in a national quality framework that can safeguard people with disability from violence, abuse and neglect in institutional and residential settings ......................... 9 Page 2 of 10 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 97 A.
The experiences of people directly or indirectly affected by violence, abuse and neglect perpetrated against people with disability in institutional and residential contexts Our experience is that people with disability continue to face situations of abuse and neglect in residential and institutional contexts in Tasmania, despite the significant improvements that have occurred.
We continue to see situations where some service providers, and the families of people with disability, fail to give due weight to allegations of abuse.

These responses, which we discuss under Term of Reference D, compound the experiences of abuse by those affected.

We have worked with people with disability where their staff and family have treated responding to allegations of abuse as merely creating a problem that, they believe, is not in the best interest of the person with disability to pursue.

B.
B.

The impact of violence, abuse and neglect on people with disability, their families, advocates, support persons, current and former staff and Australian society as a whole Through our advocacy work, we have observed the major impact that abuse and neglect can have on the lives of people with disability and their families.
We have also witnessed the way that institutional responses to allegations of abuse and neglect can exacerbate the impact of the abuse on people with disability.1 Where people with disability are living in residential and institutional settings, they can often be highly dependent on staff; staff who have a great deal of power and influence over their lives.
When people in these positions of power perpetrate abuse and neglect, they can place people affected in a position where they feel powerless, without the means to escape.

Case Study 1 Aled is a person with mild intellectual and psychosocial disability, who lives independently in his own unit.

He has support from paid staff several hours each day.

Aled keeps cash in a “hidden tin”, at his unit.

When Aled had a new staff person commence, he alleged that $200 had gone missing from his tin.
Aled was sure that the money was taken by the new staff person.

Aled was able to call the Police and the coordinator of his support staff, to report and compla in about this incident.

Police took Aled seriously and interviewed him and the alleged perpetrator.

1 See Case Study 1.
1 See Case Study 1.

Page 3 of 10 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 97 The staff person was removed from Aled’s support team.

However Aled was distressed by how long this took to happen, and he wanted his money back.
The support service said they would reimburse him, but they took an unreasonable amount of time to do so.

The delays and poor communication caused Aled to become increasingly distressed and upset about the incident, which further affected his mental health and wellbeing, and the trust he has for his support workers.
C. The incidence and prevalence of all forms of violence, abuse and neglect perpetrated against people with disability in institutional and residential settings It is well recognised historically that people with disability in large institutional facilities are especially vulnerable to abuse and neglect.

Tasmania closed its last state run institution for people with disability in 2000; however, three large non-government institutions continue to operate within the state.
We believe that addressing the vulnerability of people in these facilities ought to be a priority when the full rollout of the National Disability Insurance Scheme (‘NDIS’) commences on 1 July 2016.

Over the last three years, we have supported people with disability with over one hundred issues involving abuse.

This represents around 10% of our total cases.

Approximately 35% of these cases related to alleged abuse by a paid staff member.
In the vast majority of instances where a staff member was presumed to be involved, they were either moved to another part of their existing organisation or they resigned.

The National Disability Abuse and Neglect Hotline (‘Hotline’) does not currently make statistics publically available around the reports they receive and their responses.
We suggest that this information could form part of a transparent system, so that the prevalence of, and responses to, allegations of abuse and neglect can be better known and addressed.

Unfortunately, we have seen little promotion or education around the Hotline in recent years, and our experience is that awareness of the Hotline is currently low in Tasmania.
D. The responses to violence, abuse and neglect against people with disability, as well as to whistle-blowers, by every organisational level of institutions and residential settings, including governance, risk management and reporting practices It has been our experience that while improvements have occurred, some service providers continue to ignore, discourage or treat allegations of abuse and neglect without due weight.
Page 4 of 10 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 97 This inadequate response continues to occur at multiple levels, including people affected by abuse and neglect:  not being able to readily voice their concerns about abuse and neglect;  not having concerns that are raised taken seriously by staff;  fearing reprisal within residential and institutional settings for speaking up or contacting advocacy services;  not receiving effective outcomes from internal complaint mechanisms;  not having allegations of abuse and neglect promptly dealt with;  not having allegations of abuse and neglect pursued externally by Tasmanian Police because of perceptions related to the person’s disability; and  having abuse by other people with disability treated as a ‘behavioural problem’ to be managed, and not as abuse or assault in residential settings.2 People who are not verbal or have intellectual disabilities continue to be especially vulnerable to these response failures.
Our observation is that this is especially so when there is a perception that individuals are unable to provide accurate or reliable information.

In our experience, the response of Tasmanian Police to allegations of abuse and neglect has improved in recent years.

Police generally take allegations of abuse seriously and investigate allegations raised, although this response does vary somewhat across Tasmania.
However, we have rarely seen staff working in residential and institutional settings formally charged when allegations of abuse have been raised against them.

We are aware of only a small number of cases where charges were brought, and generally this was only where a third party, usually a co-worker who has witnessed an abusive incident, or other evidence supported the complaint.
Where there are witnesses or independent corroboration of staff-client abuse, our experience has been that most organisations react swiftly and appropriately to allegations of abuse.

There is also current disability abuse policy3 and procedure4 in place in Tasmania.

However, these documents do not appear to be widely known about, and are often not acted on.

Our experience has been that this knowledge gap occurs amongst service providers and at the departmental level.
We have observed a difference in response from disability service providers towards staff-client abuse and client-client abuse.

Allegations of staff-client abuse are generally taken seriously, however some service providers treat client-client abuse as simply challenging behaviour to be managed, even in circumstances of high levels of physical abuse.5 2 See Case Study 2 and Case Study 3 on Page 6 for examples of these inadequate responses.
3 Tasmanian Department of Health and Human Services Policy: Preventing and Responding to Abuse in Services Policy (P2010/1102-001).

4 Tasmanian Department of Health and Human Services Procedure: Preventing and Responding to Abuse in Services Procedure (P2012/0177-014).

5 See Case Study 3.
5 See Case Study 3.

Page 5 of 10 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 97 Case Study 2 Jackie lives in a group home and is supported one to one, due to the level of her disabilities and high support needs.
Over a period of one to two years, Jackie complained about a particular staff person, regarding his verbal and psychological abuse towards her.

Jackie requested issue on independent advocacy support with this numerous occasions, and was supported to raise a complaint with the management of her support service, and with Disability Services.

6 Due to staff shortages, the support service continued to roster this staff person at Jackie’s group home.
This occurred despite Jackie’s continued complaints, which were particularly demonstrated by her behaviour.

Jackie simply wanted the staff person not to work with her.

After numerous complaints, the staff person was moved fro m Jackie’s group home to work elsewhere, but still within the disability sector.

There was no police involvement.

Case Study 3 Phil and Tom lived together in a group home for several years, and for that time, they verbally and physically abused each other.
Two other people lived in the home with Phil and Tom, who were also affected by the ongoing abuse.

All four people who lived in the group home had significant intellectual disabilities.

The Disability Assessment and Advisory Team7 were involved in trying to address the behaviour and abuse, by giving staff strategies for better and more intense support of Phil and Tom.
Many representations were made to their residential support service and Disability Services by families and advocates to address the issue.

However, the abuse continued until a neighbour with young children became involved in the abuse and contacted the Tasmanian Police.

This occurring triggered a series of discussions and Phil was relocated to a more suitable residential option with housemates and staff that better met his needs.
6 When we refer to Disability Services in this submission, we are referring to the Tasmanian Government Disability and Community Services, which has responsibility for the oversight of disability service providers funded under the Disability Services Act 2011 (Tas).

7 The Disability Assessment and Advisory Team is a group of Allied Health professionals with specialist skills and knowledge in disability, which is operated by the Tasmanian Department of Health and Human Services.
Page 6 of 10 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 97 E. The different legal, regulatory, policy, governance and data collection frameworks and practices across the Commonwealth, states and territories to address and prevent violence, abuse and neglect against people with disability Tasmania does not have a current disability abuse and neglect prevention framework in place.
We do have Tasmanian Department of Health and Human Services policy and procedure in place, which we discussed earlier under Term of Reference D, but there has only been limited education about these documents.

We understand that a training session occurred in each of the three major Tasmanian regions about these documents in 2014, with approximately thirty people attending each session.
F. Australia’s compliance with its international obligations as they apply to the rights of people with disability G. The role and challenges of formal and informal disability advocacy in preventing and responding to violence, abuse and neglect against people with disability We provide an issue-based disability advocacy service, which is responsive to issues of neglect and abuse.
Our service is confidential, and can assist people with disability to make a complaint and have their voice heard if they are experiencing abuse or neglect.

We also provide rights education and empower people with disability to speak up and self-advocate when their rights are at stake.

Knowing that advocacy services are available, and that people will respect you, listen to you, and stand beside you to have your voice heard, is a significant protection against abuse and neglect occurring.
This is a part of why it is important that advocacy services have a high profile in the sector and a visible presence within residential and institutional facilities.

The education provided by, and the presence of, advocacy services provides a regular reminder that people have rights irrespective of the circumstances of their lives.

The benefits of advocacy within residential and institutional settings require advocates to have access to, and a presence within, these settings.
This depends upon receiving sufficient funding to employ visible and effective advocates, who are able to act and respond promptly to abuse and neglect.

This protection is particularly vital in Tasmania, which currently lacks a Community Visitor Scheme, which we discuss under Term of Reference H. A major challenge faced by disability advocates is that responding to more subtle abuse and neglect depends upon the response of service providers and staff.
People with disability often do not know what protections are available to enforce their right to be free from abuse and neglect, and may depend upon staff to bring available protections, such as advocacy services, to their attention.
Page 7 of 10 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 97 H. What should be done to eliminate barriers for responding to violence, abuse and neglect perpetrated against people with disability in institutional and residential settings, including addressing failures in, and barriers to, reporting, investigating and responding to allegations and incidents of violence and abuse We believe that improving knowledge and education around the nature of abuse addresses a vital barrier in combating the abuse of people with disability.
A lack of understanding by everyone involved with Disability Services, including staff, family, and people with disability can often contribute to situations where abuse is not identified or steps taken to address its occurrence.

Safeguards such as a Community Visitor Scheme provide a mechanism for an external body to look at what is occurring in residential and institutional settings and speak up for people with disability.
We believe that similar safeguards should be established nationwide to provide independent oversight and input for people in this vulnerable group.

We would also recommend the adoption of a zero tolerance approach towards abuse against people with disability, similar to current campaigns about domestic violence that are underway in various states and territories.
We would advocate for the Commonwealth Government to develop and implement a national campaign to expose abuse of people with disability and highlight the Hotline, which we discussed earlier under Term of Reference C. It is well recognised that receiving whole of life care from a single service provider places people with disability in an especially vulnerable position.
While it may be difficult to ensure that multiple providers work with people with significant needs under the NDIS, mechanisms for external scrutiny and oversight are required to address this vulnerability.

It is further vital that the NDIS planning process informs and protects people who may only have experienced the situation described above.
People have a fundamental choice about who will provide their services, but informed choice depends on people being made aware of the potential benefits and protections available to them in having multiple services in place.

We recommend that addressing this vulnerability be given priority when the full NDIS rollout commences on 1 July 2016.

I.
I.

What needs to be done to protect people with disability from violence, abuse and neglect in institutional and residential settings in the future, including best practice in regards to prevention, effective reporting and responses There is no single body in Tasmania that currently has authority to accept and investigate reports of disability abuse or neglect.
Tasmania does have mandatory reporting of abuse in Disability Services policy and procedure; however, our experience has been that there are major shortcomings in knowledge and understanding of these documents in practice.

We recommend that an independent and national complaints body be established and that mandatory reporting of abuse of people with disability be implemented on a national basis.
To be effective, these mechanisms would need to be well publicised both within service providers and the wider community.
They would also need to provide effective remedies and deterrence against Page 8 of 10 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 97 people who perpetrate violence and abuse, which prevent them from being able to continuing perpetrating abuse elsewhere within the sector.
In this regard, we favour the rigorous, independent and interventionist options discussed in the NDIS Quality and Safeguarding Framework8 as they relate to complaints, vulnerable person checks, and restrictive practices.9 We would further advocate for the Commonwealth Government to investigate legislative responses to abuse against vulnerable adults in overseas jurisdictions, such as the United Kingdom, with a view towards law reform in this area.10 J. Identifying the systemic workforce issues contributing to the violence, abuse and neglect of people with disability and how these can be addressed We believe that education about abuse and neglect, as discussed under term of reference H, needs to be a core element of the training and professional development of all people working with people with disability.
K. The role of the Commonwealth, states and territories in preventing violence and abuse against people with disability As the NDIS is further established, the Commonwealth has an opportunity to take the lead and develop a rigorous and consistent approach to preventing violence and abuse against people with disability.

We believe that having a national framework is preferable to the mixed approach currently undertaken by states of territories.
L. The challenges that arise from moving towards an individualised funding arrangement, like the National Disability Insurance Scheme, including the capacity of service providers to identify, respond to and prevent instances of violence, abuse and neglect against people with disability M. What elements are required in a national quality framework that can safeguard people with disability from violence, abuse and neglect in institutional and residential settings 8 NDIS Senior Officials Working Group for the Disability Reform Council, ‘Consultation Paper: Proposal for a National Disability Insurance Scheme Quality and Safeguarding Framework’.
9 We refer specifically to “Option 3: Independent statutory complaints function” on Page 54, “Option 3: Working with vulnerable people clearances” on Page 62 and “Option 2b: Creation of an excluded persons or barred persons scheme” on Page 71.

10 Dr John Chesterman of the Office of the Public Advocate, Victoria has undertaken comparative research in this area.

See: John Chesterman, ‘Responding to Violence, Abuse, Exploitation and Neglect: Improving Our Protection of at-Risk Adults’ (30 July 2013).
Page 9 of 10 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 97 We are supportive of the more robust, independent and centralised options in the related NDIS Quality and Safeguarding Framework, as discussed under Term of Reference I. Ken Hardaker Chief Executive Officer Advocacy Tasmania Inc.
Please contact us on the details below if you require further information regarding this submission.
Contact Details PO Box 426 Sandy Bay TAS 7006 (03) 6224 2240 advocacy@advocacytasmania.org.au Page 10 of 10 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 97