TRANSCRIPT
FAMILY AND COMMUNITY DEVELOPMENT COMMITTEE
Inquiry into social inclusion and Victorians with a disability
Melbourne — 5 May 2014
Members
Mrs A. Coote
Ms B. Halfpenny
Mr J. Madden
Mrs J. Powell
Ms D. Ryall
Chair: Ms D. Ryall
Deputy Chair: Ms B. Halfpenny
Staff
Executive Officer: Dr J. Bush
Research Officer: Ms V. Finn
Administrative Officer: Ms N. Tyler
Witness
Mr I. McLean, chief executive officer, Golden City Support Services.
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The CHAIR — Welcome and thank you for your time in appearing today before the committee for our
inquiry into social inclusion and Victorians with a disability. As is noted in the guide you were provided with by
the secretariat, all evidence in this hearing is taken by the committee under relevant legislation, including the
Parliamentary Committees Act 2003, and attracts parliamentary privilege. Anything said outside this hearing is
not afforded such privilege. We are recording the proceedings through Hansard, and you will be provided with a
copy of that proof to make any factual or grammatical corrections as necessary. I ask you to introduce yourself,
giving your position, and perhaps provide the committee with a 15-minute presentation and then we will have
the opportunity to ask some questions.
Mr McLEAN — My name is Ian McLean. I am the CEO of Golden City Support Services, which has its
offices based up in Bendigo and provides services within the Loddon and Mallee areas of Victoria to Victorians
who require support. Traditionally the organisation started back 36 years ago now, and it was one of the
organisations that took the opportunity with a group of families to provide accommodation support to their
family members with an intellectual disability. The families had kept their kids out of institutions, and so they
had taken the opportunity to have an adult life in the community back then in 1978, about when the organisation
started. Is that enough about the organisation? We provide support to anyone who requires support. They can be
in the area of ageing and dementia or mental health, can have a cognitive disability or can have a physical
and/or sensory disability.
I am not, obviously, going to speak to the detail that I have handed to you, but the information that I start with is
in ‘Organisational capacity and people who at times exhibit challenging behaviour’, the paper that I submitted
to the panel. I wrote this for a national disability services February newsletter as we were preparing for the
NDIA and looking at what organisational attributes are required to support this group of people to have a good
life in the community.
I have slides that I can talk to in detail if you have questions already from that paper, so I have more resources,
but I would like to take a slightly different tack for my 15 minutes, if I may. First of all I would like to present
the first slide. A guy called Eric Emerson, who is one of the three researchers in intellectual disability, over time
in the UK looked at the experience of people as they came out of institutions and what was the experience of
hundreds of people in institutions — in large institutions, smaller institutions and smaller homes within
residential settings. He looked at the amount of engagement in the activities of daily living or in just day-to-day
life that people had.
What the chart and his research show quite clearly is that living in a community provides an opportunity that
institutional support, in even smaller institutions, does not give. But, challengingly, his research also shows that
you could have an institutional life in a small home in the community in that it is not just the physical
environment that creates and limits opportunity but it is what staff and the community, but largely staff, do that
also limits opportunity. So the line that you see, the square box and the end of it, was the average in each of
those settings, from large institutions and medium institutions to small homes in the community with about five
or six people. The line shows the variation that was found in each one of those settings. You could have on the
bottom right a poorer life than someone living in a large institution in regard to engagement in your own life. So
what occurs is that living in the community provides a golden opportunity, gives much more opportunity, than
an institutional setting gives. But when someone requires staff support to be functional, it is the practice of staff
that determines whether someone maximises the potential that community living brings.
I suppose I focus on that because I am going to put the main focus of my discussion today on a quite
marginalised group within our community, as the paper talks about — that is, people who exhibit severe
challenging behaviour at times in their life. When they do not understand, cannot communicate well, are
frustrated or have pain, others around them might not be explaining what is coming next in their lives. There is a
whole range of reasons. It is that group that I really want to focus on.
To finish in regard to people with cognitive disabilities, if staff provide institutional care, then the amount of
privacy, personal possessions, self-determination, personal relationships, physical activity and engagement in
your own life can be diminished. The same goes for the number of people who are supported in the setting in
which you live. The work that I have given you here was written by the advocacy group in New South Wales
back in 2006. It presents evidence in regard to community living. One of the conclusions they came to was that
it is clear from the research that as the number of people who are supported in an accommodation setting rises,
the amount of privacy, personal possessions, self-determination, personal relationships, physical activity and
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engagement in your own life diminishes. One thing does go up, and that is the amount of medication that you
take. While you live in a place, the more beds there are, the more medication you take and the less of those
other things you have access to.
Setting the scene, the interesting thing is that Professor Jim Mansell, who passed away a couple of years ago
now, was the second researcher within the UK who made a significant contribution to the field of intellectual
disability support. He says through his research that it is people with severe challenging behaviour who show
the greatest steps forward of anyone with a cognitive disability who moves out of an institution into the
community because they get the opportunity to show and exhibit skills that they do not have the opportunity to
within institution care, because the setting of institutional care maximises their challenging behaviour. That is,
the degree of restrictions and seclusion that they have within an institutional setting actually maximises their
challenging behaviour; it does not address the fundamental issues of their challenging behaviour. They live in a
world where they do not have the opportunity to even exhibit their skills, which living in the community brings.
The document that you have, Transforming Care — A national Response to Winterbourne View Hospital, was
produced by the English Department of Health. Back in 2011–12, there was a major scandal. Privately run
treatment centres which housed up to 24 people with severe challenging behaviour were subject to a BBC
expose where an undercover person had gone in and uncovered enormous abuse of people. These people were
being restrained just for asking for ordinary things in life. One of the supervisors was recorded putting their foot
on the head of a person who was restrained to the ground with a two-person restraint. It was quite a large
amount of abuse. This report identifies the number of people who were charged and went through to jail. But
the UK Department of Health did something else: they reviewed their whole service system to people with
challenging behaviour. For that reason, I submit it for your interest, because the conclusions that were drawn in
2011–12, which are the basis for what they are still implementing to this day, were that this group of people had
not got the best services. I will turn to a number of pages of the report to highlight this. The first is page 5. I
have highlighted some things for you in yellow.
The report states that the Winterbourne event and the subsequent investigation has catalogued:
… failings at all levels, both from the operating company and across the wider system.
The report goes on to say that this event has exposed a wider issue in the UK of a care system that is not
supporting this group of people and that too many people are staying too long within hospitals or within
residential homes when they should be living in the community. The report says this practice must end.
It then makes a really telling statement, which is a pivot for looking at what I am presenting today:
We should no more tolerate people being placed in inappropriate care settings than we would people receiving the wrong cancer
treatment.
That is why the minister dealing with this issue is asking councils and clinical commissioning groups, or the
funders, to put these issues right as a matter of urgency.
I will move on to page 9. At the top of the page it says that the UK government believes that people with severe
challenging behaviours have the right to have support and to live in their community just like everyone else —
alongside their family, their neighbours and their friends.
Down in item 12 on that same page it says that:
… vulnerable people, particularly those with learning disabilities and autism —
need to —
receive safe, appropriate, high-quality care. The presumption should always be that services are local and that people remain in
their communities …
Their expectation is — and mine is also — that there will be a subsequent reduction in the reliance on inpatient
or other specialist care by these groups of people.
The finding of the UK government was that largely the service system was not using the best practice that had
been outlined within the Mansell report that was first delivered by Jim Mansell in 2007. He updated it, but the
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first one was in 1997, I think. I provided you with that particular document, which is Services for People with
Learning Disabilities and Challenging Behaviour or Mental Health Needs. Professor Jim Mansell wrote this
not as an article to publish but as a document to be picked up by the UK government in regard to how to support
this group of people.
Let us jump to page 49 of the green document. The conclusion of this document, which I will let you read at
your own leisure, states that ‘people with challenging behaviour have … been too much out of sight’ and that
‘in too many places the needs of this highly vulnerable group of people’ have not been addressed.
I suppose this rings a chord for me within our work and within the state of Victoria. The results that I see show a
service system that has not grappled with the best practice framework that is outlined here — we will get to that
next — and is largely using the same interventions of physical restraint, of chemical restraint, of punishment, of
seclusion and of putting on more and more staff. These folk get the tag of being both violent and also
dangerous.
The answer to that is not better practice within our service system at the moment; it is more and more staff. So
you have about 1800 people on restricted interventions, according to the Office of Professional Practice — the
old senior practitioner title — and you have, within Jim Mansell’s calculation, in the UK about 24 people per
100 000 of general population that will exhibit serious challenging behaviour. That is about 1500 people in
Victoria that we would expect to exhibit frequent, episodic, serious challenging behaviour if the world is not
going well for them. Of course the world does not go well for those around them when that happens either.
That is to say, and it does not take away, that services to people with intellectual disability can expect to see
challenging behaviour very frequently within their services. It is running at about 15 per cent to 35 per cent of
people with intellectual disability exhibiting severe challenging behaviour four or five times in a year. I am not
putting that category as the group we are talking about — that is, about 15 000–25 000 Victorians who will
exhibit serious challenging behaviour within a year within a service setting, four or five times a year — but I am
talking about people who without the right support will exhibit serious challenging behaviour on a daily, if not
weekly basis, if not supported well. The question for this group in looking at inclusion within the community is
what are the right supports to get it right for this group of people to not be marginalised and have a good and
contributing life to the community — not just be contained because their behaviour is escalating through wrong
support.
I will go to page 54 before I finish with this particular document. It relates here that providers should ‘provide
effective and appropriate leadership, management, mentoring’ within their organisations; that there should be ‘a
whole organisation approach to positive behaviour support training’; and that organisations should recruit for
values and ensure that staff have training for skills — mandatory training — which would include positive
behaviour support, types of communication, including non-verbal, active support and engaging people in
meaningful activities, having regard to mental health capacity.
It is those areas that need attention, and people who are funded to provide services within Victoria — in fact it is
an Australian issue, not just Victorian — are largely funded without a request or a check of what skills they
bring to support this group of people in a positive way with that training and those skills. We therefore have a
service system that is — I suppose I did hear Arthur use this word once — stuffed at the moment in regard to
this group of people. It is lucky I am under parliamentary privilege, is it not?
This is a group that I would put to you has never had a service system developed for them, at least within recent
times. Behaviour intervention support teams were developed 25 to 28 years ago and were headed up by Gary
Radler, who is now a clinical psychologist in Victoria. We have not had a revisit to a service system with
current knowledge since then in regard to practice and service, and it is time that we did.
Let me go on to the services for people with learning disabilities. I will only refer to three pages, if I may, but I
would submit this whole document as being really interesting to look at inclusion for this group of people in the
Victorian — —
The CHAIR — Ian, if I could interrupt, could I ask you to just summarise to finalise your presentation so
that we can move on to the asking of questions?
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Mr McLEAN — Okay. I would just like to go to the dot point on page 25. Jim outlined the exact skills that
were required. When you look at staff training, you can see he has identified that what is required is
person-centred active support, positive behaviour support, total communication approaches, recognising and
responding to mental health problems and person-centred planning. This seemed to be absent in the review of
services, even though this was published prior to the review. Part of the UK government’s response was to
develop an accord that was signed by organisations to get back on track and to put this way of working into
place within people’s local community.
I suppose to summarise I will give two examples of people who we support who are de-identified. One is a
person who I have referred to in a submission in your kit. A piece of research was done by La Trobe University
into that person’s history before they came to what is called Welcome Support Services here, which is Golden
City Support Services. I apologise for some of the pages being upside down. When you read it you can see that
this is a person who would be regarded as having serious challenging behaviour. This is what is able to occur
with that list of supports over time and over years. This is the incidence of challenging behaviour of that
particular person within months. You can see from his support history — coming with us through to where he is
now — that this fellow, who was largely within other organisations down in Melbourne, had what we call
agency staff brought in by the organisation concerned because they could not get their own staff to support him.
Agency staff would stay for between 15 minutes and the whole shift, and they would leave and the person
would seriously self-injure or seriously damage property. He now goes on vacations at holiday resorts with
everybody else, jumps into the spa with other members of the public and is learning about work. He has his first
milk run delivering milk to organisations on a Monday. It is the start of something different for this lad.
The other thing that occurs, which is exemplified in what I said, is that it is cheaper in this person’s case to do
this work right than to do it wrong. Over this time we have saved $300 000 a year. Over this guy’s lifetime that
will be a saving of over $25 million to $30 million if you add 3 per cent for the cost-of-living adjustment.
It is similar for another woman who came from child protection services at the age of 18. She was being
supported by two staff all the time, day and night, continually. She is now supported by one staff member and is
going to continuing education where she does not need a staff member’s support anymore — she just goes
along as a student and is starting to take taxis on her own. For the staff who used to support this person the
strategies were a two-person drop to the ground in restraint or putting the person outside until they had so-called
‘calmed down’, which meant that they were stripped naked and left to wear themselves out. Something different
has occurred for this woman now. I put it to you that something different can be done and we need to have a
service system that is developed for this group of people, a renewed service system, because 25 to 28 years is a
long time since they have been revisited.
The CHAIR — Thank you very much, Mr McLean, for your presentation. Can I clarify, or perhaps
summarise correctly in case I may be wrong, that the basis of the support system centres on education —
specialisation of service providers in a deinstitutionalised setting for people with challenging behaviours?
Mr McLEAN — That is true. It needs more than that. It needs skills for staff; it needs organisational
capacity to be able to resource support, crisis manage and develop with their staff support teams the responses
to the challenging behaviours as they occur. But it needs the staff to have proactive, reactive and developmental
learning skills that are not often developed, or applied, within staff teams in Victoria. It needs the organisation to
know more than its staff and have expert skill to resource those staff teams in their day-to-day work and to be
present enough so that when there is something untoward that might be going on where staff feel like it is over
their head, you have skilled practitioners to support those teams as they develop their proficiency and their
expertise as well.
The CHAIR — Given that and given the two case studies you have provided, is there somewhere in this
state or within Australia that does this exceedingly well?
Mr McLEAN — There are very few examples of it being done.
The CHAIR — But is there somewhere that does this very well?
Mr McLEAN — We have at Golden City enough moments of excellence to get things right with people we
support. We still have moments of ordinary and we still have moments of failure. We support about 600 people
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but have about 15 people who have had reputations of having serious challenging behaviour for many years in
their past.
The CHAIR — So you would see the model that you have as one that could be replicated?
Mr McLEAN — Yes. What needs to be replicated is that we need specialist clinical services that are skilled
in doing assessments in regard to clinical psychology, speech pathology and OT in regard to sensory
assessments et cetera; and in the mental health field the psychiatry needs to be involved at the assessment level.
You then need organisations with those skills that I pointed out within Jim Mansell’s list and then you need staff
to be trained on a recurrent basis and coached, not just left out there. It is the practised competency that counts
here, not the verbal competency of training.
The CHAIR — To go back to that, you would consider in your instance, and you have examples, that the
model you use which incorporates these things could be something that could be rolled out?
Mr McLEAN — Yes. There are also the clinicians within Anglicare in Launceston in Tasmania who
presented at the ASID conference in Sydney last year. They presented a really interesting paper — it is here
somewhere — that I would submit to you in regard to looking at and reviewing using non-aversive reactive
strategies instead of punishment and diversion.
In answer to that, just let me give you a quick example of what they found. The benefit is that it is Australian,
but you see it within Lavigna’s work from the States and you also see it in the work of Professor David Allen
from Wales. They looked at aversive therapies within their own services. They looked at what was used by staff
and what happened when staff used aversive therapies, which was, ‘If you keep on doing this, you won’t go to
McDonald’s’, ‘If you keep doing this, if you don’t stop now, we’ll call the police’. That is the aversive therapy.
The challenging behaviour in that event escalated about 50 per cent of the time when they said that, it did not
change behaviour 40 per cent of the time and it resolved 10 per cent of the time.
When they saw restrictive practices being used, which were seclusion, people dropping to the ground or locked
doors, there was a 50 per cent increase in challenging behaviour when those were applied, no change for 40 per
cent and a de-escalation in 12 per cent of cases.
Then when they used non-aversive reactive strategies, which was trying to divert people to a preferred activity,
to come and help you to try to get them through the event, it resolved for about 50 per cent of the time, it
de-escalated 20 per cent of the time, continued for 25 per cent of the time and escalated for 7 per cent of the
time. When you know the function of someone’s behaviour you can actually resolve it for them. If you are
going to the supermarket and you are doing something and someone passes a cream bun shop and wants a
cream bun and you say, ‘No, you’re on a diet. You can’t have a cream bun’, if someone has a kitbag of
challenging behaviour at that moment, you may have bit of an issue for everyone in that local community. So
you have got a choice. Many staff, of course, if they are not trained and coached well, will say, ‘No, you’re on a
diet. We’re doing shopping. We’ve got to go do that’, instead of actually strategically capitulating at that
moment, giving the cream bun, because that will resolve the challenging behaviour completely, and then
coming back to the staff team and saying, ‘Okay, what do we do next time if they can’t have the cream bun?’.
Because what they showed, which is in the literature too, that if you actually understand the function of
someone’s challenging behaviour and they get what their need is and it is resolved, it resolves it 100 per cent of
the time. This has not just got ramifications for quality of life, it has got major ramifications for the safety and
wellbeing — that is, the occupational health and safety — of staff.
The CHAIR — Thank you. We might now move to further questions.
Ms HALFPENNY — Going back to the government’s role in this issue and in this inquiry, as I understand
it, the government pays money to mostly non-government organisations; it contracts out the care of people with
disability. At the moment there is not really any say in how much money is spent per person. It might be that
$200 000 is provided per person in this situation but maybe only $100 is spent on actually caring for the person.
As I understand it, there is not really any accountability in terms of once money goes from government to an
organisation you do not really know where the money is spent and the Auditor-General does not have any role
to investigate these things. In a lot of these places, as you were saying, there are agency staff, with a lot of casual
workers on the lowest of pay, so I do not understand how you can really do the training in that situation. Do you
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think that government needs to do a bit more? You say the government should mandate training. How do you
see that working based on how things are working today or how it operates today?
Mr McLEAN — About 50 per cent of services are provided by the non-government sector and 50 per cent
by the government sector in regard to community accommodation.
Ms HALFPENNY — I have been to one place which had this issue with challenging behaviour and it was
terrible, and it was a government-run unit.
Mr McLEAN — Sure. If I can deviate before I answer, one of the things that is in the documentation is that
the commissioning, the funding, the purchasing of services — whichever you want to call it — needs to come
with expectations. For this group of people it needs to be expectations of skill support; otherwise why would
you leave people to be supported in such negative and downhill spiralling lives?
Back to the training. Every organisation is responsible for training. The funding, or the unit price within
disability services that gets struck every now and then — maybe not in the future under the NDIA — has a
component for training. It is only a small component, but all organisations would train their staff on top of that
in regard to lifting, in regard to orientation and in regard to occupational health and safety within general
training. For us at Golden City we have made a strategic decision to put strategic direction and emphasis on this
sort of training, because I cannot see how you can keep staff safe when working with people with an intellectual
disability when about 15 000 a year will exhibit challenging behaviour. At that moment you have got to have
skilled staff to be able to deal with it.
Ms HALFPENNY — So for this group of people, which is not large from what you are saying, how does
government deal with that? You are saying that they have already determined what people will be employed, or
do they get a certificate IV or something like that? Is that what you mean? How much money should be spent
on training the person?
Mr McLEAN — It would be great for certificate IV to be upgraded — if that changed, yes — and to be
relevant. There would be a lot of industry partners that would say that. The malaise within the skills to support
people with high needs with challenging behaviour at times in their life has been occurring for about 20 to
22 years, so it has been over successive governments. I am saying that, yes, it does need government focus, it
needs policy direction. The dilemma is, as the UK found, we are crisis-driven. Someone with challenging
behaviour gets so severe that it has to be solved, and it gets solved in that crisis time and often in the wrong
way, and it becomes more and more costly. You talk about sums of $200 000. We are talking about sums of
$800 000 to $1.2 million. We are talking about very large sums. I am saying that you can come down to
$380 000 and then even less as people develop their activities of daily living skills and do not need staff support
during the day and they can do things for themselves. You do not need to support them during that time, so
there is even more savings to staff. This involves groups that often are called two-to-one people, and some in
Victoria are three to one.
Ms HALFPENNY — How does the government make sure this happens? Does it monitor it at all to get
that, rather than what the cost is?
Mr McLEAN — All governments become aware of individuals with this group of people when their
challenging behaviour gets so severe that it becomes a problem. I am suggesting that we start to do something
different and that we develop a service system that is proactive for this group of people, and that ends up being
able to be afforded within the current amount of what it is costing. To do services badly for this group of people
costs the same, if not more, than doing supports well. Just for those two people I talked about, we are saving
$600 000 a year. Now surely that could in the future move over into a service system development that had
skilled practitioners for other organisations and skilled clinical groups of people to support and get more of this
outcome for other people as well, not just within Golden City
Mrs POWELL — You gave two really good examples of people with challenging behaviours who over
time were supported and their behaviour was modified. When we talk about serious challenging behaviour,
things like violence, a person who has a sexual deviation, or self-harm in rural areas — and you are from a rural
area — what sort of accommodation do you think we could provide to support those people while they are
having those services, given that in regional Victoria you might have community accommodation with five or
six people accommodated with some staff, and you cannot find a place in that accommodation because the
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behaviour is not something that you can put in with a home group of people? How do we accommodate those
people while they are getting that support over the time, because we are talking about people with serious
challenging behaviour?
Mr McLEAN — I have got a list there of the types of behaviours that I am talking about, and I think they
are the types of behaviours that you are in fact alluding to as well. Let me first of all say that the research in this
area shows clearly that the model of five people with serious challenging behaviour in the one home is a failed
model. It does not link to good outcomes. It needs to be highly individualised. For people who are often on the
autism spectrum, it is not that they all have to live on their own, although for many that is in fact a better option,
but they need to live to what their needs can cope with. They find the activity of other people often quite
confusing, and so to put them into five-bed or six-bed places with other people with challenging behaviour —
—
There has been 15 to 20 years of research now that shows that that is one of the failed models that should not be
funded; and, what is more, it ends up being expensive. We had a service that did not have five people in it with
challenging behaviour, but we were going to have two. We had one staff member for each of those two people
individually in this five-bed home funded — we were going to concentrate on those two people all the time in
the five-bed home — and then one staff member for the three others that did not have severe challenging
behaviour. We negotiated back then — this was back in the early 1990s during the Kennett era — for one of
those staff to not be in the group home but to support someone in their own home. It was just as expensive, but
the outcomes for that fellow who is living in Echuca on his own were good. I do not think we have had an
episode of challenging behaviour for maybe six months or a year from him. Let me say quickly that we have
been supporting him since 1992, so there has been a lot of support and water gone under the bridge since then.
However, at the same time, with this group of people, the higher their challenging behaviour and the more
specific their support needs, the more time it takes. They do not have to live with other people, and it is not
more expensive. Very often this group of people has one-to-one or two-to-one in a group setting anyway to
contain or to control them. I am asking to swap to developing and supporting, instead of putting all the energies
into containment and control.
Mr MADDEN — Thanks for the presentation; it has been fantastic. You have highlighted the fact that for
the individual with a serious challenging behaviour, or severe challenging behaviour, and for the state there is
enormous merit in the cost benefit of an improved service. I suppose it is not unusual for general members of
the public who do not necessarily have a great deal of interaction with individuals like this to have a memory of
a serious incident somewhere in public — as you said, somebody walking past a shop — and that actually
forms a perception in the general public’s mind, because obviously a situation like that has a fairly significant
impact on the local area. The sense I have is that that becomes in itself a barrier to inclusion —
Mr McLEAN — Yes, it does.
Mr MADDEN — because people have a bad experience just by being out in public when something like
this happens, or that is what they recount or recall. In a sense it puts other sections of the community in a
defensive position about inclusion. I would be interested to hear your comments about that.
Mr McLEAN — There are three elements that are important to understand for an organisation in regard to
capacity and working with this group. One is the opportunity for environmental control. If you know that
someone struggles with groups, then you do not take them to a group setting, because you know that the setting
will probably be overwhelming and will cause challenging behaviour. You might work towards it in a year’s
time, or something like that, being able to go to that setting and to develop a person’s resilience and skills, but it
is the skill of the organisation to actually environmentally control aspects that the person cannot control for
themselves. So if you are going shopping, and the person has difficulty with crowds, with groups or with
uncertainty, it would be good not to do it at 5 or 6 o’clock at night.
Organisations that are unskilled will say, ‘Well, they have to learn’. Just saying ‘No’ and ‘Wait’ to someone
who has severe challenging behaviour can be a major issue four times out of five when you can have serious
challenging behaviour. Yet unskilled staff will often say, ‘But they need to learn to wait’. It may be that they
can learn to wait, but it is not understanding the support that this person needs. There are other ways to
communicate with someone than using the words ‘No’ and ‘Wait’ if there is something that they cannot have or
cannot do, but those two words are serious confrontation times. They are also dangerous times for staff if they
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do not learn the skill of how else to communicate. That is very simple communication; there are a lot deeper
skills that are required there.
Mrs COOTE — I would like to put on the record recognition of the terrific work that Golden City Support
Services do. You answered a question earlier from the Chair about who does it well in this state, and I would
like to put on the record that Golden City Support Services certainly do.
Mr McLEAN — Thank you.
Mrs COOTE — I know about the very difficult clients that you deal with. In answer to one of the other
committee members, you spoke about the NDIA, and I think that we have to look at these very complex clients
that we are dealing with in this certain cohort of people. Do you think Victoria is geared for the NDIA with the
service provision that is going to be needed for this particular client group?
Mr McLEAN — At the moment, no.
Mrs COOTE — What do you believe should be being done to make quite certain that this particular group
of people can be well catered for once they get their individual packages under an NDIA system, which should
be rolled out by 2019?
Mr McLEAN — It is only hearsay that I have at the moment, but my understanding is in the start-up or pilot
site in Geelong that the suggested assessment for whether someone has challenging behaviour is the episodes of
challenging behaviour and the severity of those per day. That means that many of the people whom we support
who no longer have episodes per day but rely on skilled support every 5 minutes of the day are not going to be
funded well and are going to re-exhibit challenging behaviour. The assessment is wrong. My concern with the
NDIA is going on the record now, isn’t it? We are a supporter at Golden City. We were right there from the
start; we were up on the Gold Coast with Bruce Bonyhady and others when this was a twinkle in the starting for
the lobby eye. We have a commitment to it as a first-order change for people with a disability.
The dilemma I have is that the products on the NDIA shelf that they wish to purchase look a lot like attendant
care and attendant care and attendant care. There is not a lot of product development within the NDIA for this
group of people yet either. I am working hard with NDS and others to try to get a product on the shelf of the
NDIA that is seen as legitimate and that is costed for the different components that are required.
You do need to have skilled assessment. An organisation does need to have organisational capacity; that costs to
build. You do need skilled support. Of course those support staff turn over and you need to be reskilling and
re-motivating. All those three components need to be in place for a better system. We have pieced them together
where we are, and it is great to see it work. What we need is a service system that sees it as being required, and
we need an NDIA that sees it as required.
Mrs COOTE — So your thrust will be for social inclusion for this group of people?
Mr McLEAN — Absolutely.
Mrs COOTE — And that is the prime motivator under a person-centred approach?
Mr McLEAN — These people benefit most from a community life with skilled support. If we do not give
the skilled support, then no-one benefits.
Mrs COOTE — Thank you very much indeed.
The CHAIR — Mr McLean, thank you very much for presenting. On behalf of the committee, we really
appreciate the time that you have taken today. Thank you.
Witness withdrew.
5 May 2014
Family and Community Development Committee
9