Top 8 questions on residential aged care and NDIS answered

On 1 December 2020, Residential Aged Care (RAC) providers supporting NDIS participants were automatically registered with the NDIS Commission under the class of support (also known as registration group) 0115 – assistance with daily life tasks in a group or shared living arrangements.

This new regulatory approach gives NDIS participants coverage across all NDIS Commission functions including reportable incidents and behaviour support.

1. How do these changes impact on NDIS participants?

NDIS participants living in RAC are dual participants of the NDIS and aged care systems. The new regulatory approach is proportionate, recognising the existing regulation that RAC providers continue to be subject to under the Aged Care Act 1997.

2. What do RAC providers need to do?

All RAC providers supporting NDIS participants must commence registration renewal before their certificate of registration expires. Registration simply requires logging into the NDIS Commission portal and providers then have nine months to complete the full renewal process, including a third-party audit.

3. What standards do you need to meet?

RAC providers have the same responsibilities towards NDIS participants as they do to other residents who receive services and support under the Aged Care Act 1997. RAC providers have obligations for service provision under the Aged Care Act 1997 and are accredited by the Aged Care Quality and Safety Commission, which independently accredits, assesses, and monitors aged care services subsidised by the Australian Government. Residential aged care providers who are registered NDIS providers have additional requirements to support NDIS participants in residential aged care.

Registered NDIS providers in states and territories where the NDIS Commission operates must:

• Comply with the conditions of registration stated in their certification of registration;
• Demonstrate compliance with the NDIS Practice Standards for their relevant registration groups, including through a quality audit;
• Comply with the NDIS Code of Conduct;
• Have an in-house complaints management and resolution system to record and manage any complaints received and support NDIS participants or other relevant concerned parties to make a complaint;
• Have an in-house incident management system, and notify the NDIS Commission should a reportable incident occur fulfil worker screening requirements; and
• If applicable, meet behaviour support requirements, including reporting the use of restrictive practices to the NDIS Commission.

4. Already registered? What does this mean for those RAC providers?

RAC providers have been sent a certificate of registration from the NDISCommission. The certificate of registration includes details of the registration, including the period of registration and any conditions that apply. RAC providers that have been automatically registered aren’t required to immediately undertake the audit process against relevant NDIS Practice Standards – new applicants do have to complete this process before receiving their certificate of registration.

A phased approach is being taken to the date when each transitioned RAC provider is required to commence the NDIS registration renewal cycle, including undergoing a third-party audit against the relevant NDIS Practice Standards. Transitioned RAC providers have been advised of their registration renewal date on the certificate of registration that they received from the NDIS Commission. Registration renewal allows an assessment of the suitability and capability of the RAC provider to maintain NDIS provider registration.

An audit against the NDIS Practice Standards will take a look at the provider’s
alignment with the Aged Care Quality Standards and minimise the regulatory burden on providers, without reducing safeguards for NDIS participants. It’s important to note that some Standards will cross over between the Aged Care Quality Standards and the NDIS Practice Standards.

Aged Care Quality Standards

Standard 1. Consumer dignity and choice
Standard 2. Ongoing assessment and planning with consumers
Standard 3. Personal care and clinical care
Standard 4. Services and supports for daily living
Standard 5. Organisation’s service environment
Standard 6. Feedback and complaints
Standard 7. Human resources
Standard 8. Organisational governance

NDIS Practice Standards

• 1.1 Person-centred Supports
• 1.2 Individual Values and Beliefs
• 1.3 Privacy and Dignity
• 1.4 Independence and Informed Choice
• 1.5 Violence, Abuse, Neglect, Exploitation and Discrimination
• 2.1 Governance and Operational Management
• 2.2 Risk Management
• 2.3 Quality Management
• 2.4 Information Management
• 2.5 Feedback and Complaints Management
• 2.6 Incident Management
• 2.7 Human Resource Management
• 2.8 Continuity of Supports
• 2.9 Emergency and Disaster Management
• 3.1 Access to Supports
• 3.2 Support Planning
• 3.3 Service Agreements with Participants
• 3.4 Responsive Support Provision
• 3.5 Transitions to or from the provider
• 4.1 Safe Environment
• 4.2 Participant Money and Property
• 4.3 Medication Management
• 4.4 Mealtime Supports
• 4.5 Waste Management

5. What are the rules for residents who require restrictive practices?

There are significant differences between the behaviour support requirements in aged care and those in the NDIS. The transitional arrangements will help facilitate orderly processes for the NDIA to add funding for behaviour support to NDIS participant plans where required, for the development of positive behaviour support plans for participants, and to obtain state and territory authorisation for the use of regulated restrictive practices.

Transitioned providers will:

• by 1 January 2021, have to notify the NDIS Commission regarding the use of a regulated restrictive practice for an NDIS participant (this doesn’t replace the requirement of providers to report the use of an unauthorised restrictive practice as a reportable incident). Where no positive behaviour support plan exists for the NDIS participant:
• by 1 March 2021, take all reasonable steps to obtain an interim behaviour support plan and obtain authorisation for the use of the regulated restrictive practice from state and territory bodies.
• by 1 June 2021, take all reasonable steps to obtain a comprehensive behaviour support plan and obtain authorisation for the use of the regulated restrictive practice from state and territory bodies.

Comprehensive positive behaviour support plans for NDIS participants who need one will need to be in place by 1 December 2021.

Any use of a regulated restrictive practice not authorised (however described, by the state or territory) and not in accordance with a behaviour support plan is an unauthorised restrictive practice and needs to be reported to the NDIS Commission as a reportable incident within five business days.

6. What are the frequent registration groups a RAC Provider registers against?

RAC providers were automatically registered for 0115 – assistance with daily life tasks in a group or shared living arrangements. As a Registered NDIS Provider, RACs can complete a Variation Application with the NDIS Commission to have additional Registration Groups added to their scope.

RAC’s would need to consider the types of support and services they wish to provide to NDIS participants. Other registration groups for consideration may include:

• 0104 – assist personal activities high
• 0110 – behaviour support
• Module 2a – Implementing behaviour support plans

7. What screening requirements do you need to meet?

From 16 June 2021, NDIS worker screening clearances allowed aged care providers to satisfy the requirements under the Aged Care Act 1997 for aged care staff and volunteers who support NDIS participants.

For aged care providers that are also registered NDIS providers, these changes remove the dual screening obligations for workers in the aged care and disability sectors. Creating an alternative pathway for you to meet the requirements for staff and volunteers under the aged care legislation.

From 1 February 2021, registered RAC providers are required to ensure workers in a risk-assessed role have:

• An acceptable aged care provider check under the requirements of the Accountability Principles 2014;
• An acceptable check under state and territory transitional arrangements; or
• An NDIS Worker Screening Check clearance. An acceptable aged care provider check will no longer be valid three years after its issue date if it was issued before 1 February 2021.

8. What should you do to prepare for an audit?

• PDCA – Plan, Do, Check, Act;
• Be prepared;
• Conduct a Gap Analysis;
• Develop an Action Plan;
• Training is critical; and
• Get direct feedback from your participants, carers, family, or guardians.

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