Violence, Abuse, Neglect, Exploitation and Discrimination: NDIS Provider ​​Rights and Responsibilities

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Published: 22 August 2021

Content warning: Please be aware that this Article contains graphics and information relating to abuse, which some people may find distressing.

People living with disabilities may depend on others for care and support. For this reason, they are some of the most vulnerable members of our society (Better Health Channel 2015).

Consequently, this means that those living with disabilities are at increased risk of harm (Better Health Channel 2015).

Any National Disability Insurance Scheme (NDIS) participant receiving care - regardless of age, gender or disability - should be able to access support without experiencing (or fearing) violence, abuse, neglect, exploitation or discrimination.

Abusive behaviour of any kind towards older participants (from staff, residents or others) is a violation of basic human rights and unacceptable in any setting (Better Health Channel 2016).

The following article provides an outline of different forms of abusive behaviour so that you can recognise the signs and take action.

Violence, Abuse, Neglect, Exploitation and Discrimination in the NDIS Practice Standards

Violence, abuse, neglect, exploitation and discrimination is a requirement of the NDIS Practice Standards under Core Module 1: Rights and Responsibilities.

This Practice Standard aims to ensure that NDIS participants are able to access supports without fear or experience of violence, abuse, neglect, exploitation or discrimination (NDIS 2020).

NDIS providers must meet the following quality indicators:

  • Providers have policies, procedures and practices in place to actively prevent violence, abuse, neglect, exploitation and discrimination
  • Participants are informed about the use of advocates (including independent advocates) and are enabled to access advocates if allegations of violence, abuse, neglect, exploitation or discrimination are made
  • In the case of alleged or witnessed violence, abuse, neglect, exploitation or discrimination:
    • The allegation or incident is acted upon
    • All affected participants are supported and assisted
    • Details of the incident, along with the outcomes of reviews and investigations are recorded (where possible)
    • Action is taken to prevent similar incidents from occurring again in the future.

(NDIS 2020)

Definitions of Violence, Abuse, Neglect, Exploitation and Discrimination

Violence (Physical Abuse)


Violence is defined as the use of physical force with the intention to hurt, damage or kill somebody else (Better Health Channel 2016). This might include:

  • Striking (with or without a weapon)
  • Hitting
  • Beating
  • Scratching
  • Biting
  • Choking
  • Suffocation
  • Pushing
  • Shoving
  • Shaking
  • Slapping
  • Kicking
  • Stomping
  • Pinching
  • Burning
  • Force-feeding
  • Inappropriate use of medicines or physical restraint
  • Physical punishment
  • Hair pulling
  • Pinning in place
  • Arm twisting.

(Hall, Karch & Crosby 2016)

Almost one in two (47%) of adults living with a disability have experienced violence after the age of 15, which is 11% more than people without a disability (AIHW 2020).

Women living with disabilities are especially likely to experience violence (Better Health Channel 2016).

abuse violence
Violence is defined as the use of physical force with the intention to hurt, damage or kill somebody else.

Abuse

Abuse is a violation of rights that involves the exploitation of power. There are several types of abuse that may be experienced by participants:

Sexual Abuse

Sexual abuse refers to any sexual activity that takes place without consent. It does not necessarily involve penetration or physical contact and may take the form of indecent exposure or other sexually inappropriate actions that are not consented to.

For participants who are minors, sexual abuse also includes enticing the participant into performing sexual activities, watching/viewing sexual activities or engaging in sexual behaviour, regardless of whether the participant is aware of what is happening.

(RACGP 2014; NSW Ombudsman 2017)

Emotional Abuse

Emotional abuse is behaviour that scares or terrorises someone, potentially causing them to lose confidence, self-esteem or self-determination. It includes:

  • Verbal abuse (subtle or overt)
  • Humiliation
  • Threats
  • Extreme jealousy
  • Suicide threats
  • Stalking and harassment (in-person or through technology).

(RACGP 2014; NSW Ombudsman 2017)

Social Abuse

Social abuse is the intentional isolation of a participant from their family, friends and other contacts (RACGP 2014; NSW Ombudsman 2017).

Systems Abuse

Systems abuse is mistreatment related to how the provider’s service is run (e.g. participants being made to eat meals at a certain time to fit in with staff changeover) (RACGP 2014; NSW Ombudsman 2017).

Statistics regarding the prevalence of abuse against older Australians is limited, however, it is estimated that between 2-14% of the older adult population has suffered abuse (AIFS 2016).

Neglect


Neglect is failure to fulfil the participant's basic physical or psychological needs (RACGP 2014). It includes:

  • Physical neglect;
    • Failure to provide the participant with adequate food, shelter, clothing or protection, or
    • Allowing the participant to be placed at risk through unsafe environments or practices
  • Passive neglect: Withholding or failing to provide the participant with life necessities
  • Wilful deprivation: Intentionally denying the participant assistance, putting them at risk of physical, mental or emotional harm
  • Social neglect: Limiting the participant’s social, intellectual and emotional growth or wellbeing).

(Better Health Channel 2016)

Exploitation (Financial Abuse)

Read: NDIS Participant Money and Property

Exploitation, also known as financial abuse or economic abuse, is the intentional misuse of a participant’s money or assets for personal gain (RACGP 2014). It includes:

  • Restricting the participant’s access to (or information about) their money
  • Fraudulently using the participant’s money
  • Stealing from the participant
  • Forcing the participant to surrender their money or assets through coercion or deception
  • Forgery
  • Taking, misusing or concealing the participant’s funds, property or assets.

(RACGP 2014; CDC 2016)

abuse exploitation
Exploitation is the intentional misuse of a participant’s money or assets for personal gain.

Discrimination

Discrimination is the mistreatment or bullying of a participant based on their personal characteristics (or presumed characteristics). These characteristics can include (but are not limited to) gender, age, sexual orientation, disability, employment, race or religious belief (Victorian Equal Opportunity & Human Rights Commission n.d.).

Policies, Legislation and Services for Preventing Abuse

Providers must have clear policies and procedures established to protect participants from abusive behaviour. It is also important to maintain a workplace culture that promotes positive values, experience and attitudes and is transparent about its processes (NDS 2017).

Disability Services Queensland (pp. 18-21) outlines key features of abuse prevention that should inform policies and procedures.

It is also essential for providers to have a code of practice stating expectations and values (DSQ 2008).

In addition to individual organisations’ policies and procedures, there is federal and state legislation designed to protect the rights of participants. These include, but are not limited to:

There are a number of Australian advocacy groups for people living with disabilities. The NDIS Standards state that participants should be provided with information about advocacy services and given access to advocacy in the case of an incident.

Mandatory Reporting

Mandatory reporting is a legally enforced requirement for designated service providers (‘mandatory reporters’) to report the suspected abuse or neglect of children to government authorities (NSW Government 2017).

Some healthcare professionals including registered medical practitioners, registered nurses and midwives are mandatory reporters who are obligated to report abuse (NSW Government 2017).

abuse mandatory reporting
Mandatory reporting is not only part of your duty of care as a healthcare professional, but also your legal responsibility.

Recognising the Signs of Abusive Behaviour

Participants experiencing abusive behaviour may not seek help due to fear, guilt, shame, lack of capacity or lack of knowledge about the resources available to them (Better Health Channel 2018).

Therefore, it is important to be able to recognise the signs of abuse in case it is not being disclosed by the participant. Signs may include, but are not limited to:

  • Malnutrition or dehydration
  • Poor personal hygiene or dirty clothes
  • Untreated medical issues
  • Fearful, anxious or withdrawn behaviour
  • Unexplained and frequent injuries
  • Unexplained cuts or bruises on the genitals or anus
  • Unexplained sexually transmitted infections
  • Sudden and unexpected changes in financial status.

(Better Health Channel 2018)

A more comprehensive list of indicators is available from Disability Services Queensland.

Responding to Abuse

Providers should have clear policies and procedures for responding to abuse. All staff should be familiar with these frameworks, as well as their duty of care to clients (Seniors Rights Victoria 2016).

NDIS workers may be the first people to notice or suspect abuse. If you suspect abuse:

  • Do not ignore the situation
  • Be respectful of the client’s rights and wishes
  • Contact emergency services if there is an immediate threat of harm
  • Gather information by asking the client non-judgmental, direct and open questions in a sensitive manner
  • Record details in writing, including anything you may have seen or heard. This must be confidential
  • Notify your supervisor.

(Seniors Rights Victoria 2016)

Mandatory reporting exists for a number of offences and it is not only part of your duty of care as a healthcare professional to report these, but also your legal responsibility. In other cases, you must gain the client's (or their substitute decision maker's) consent before reporting abuse to a third party (NSW DoH 2020).

Note that certain incidents are considered reportable under the NDIS, meaning that the NDIS Commission must be notified if they occur.

More information about incident management and reportable incidents under the NDIS can be found below:

Read: Incident Management: NDIS Provider Governance and Management

abuse recognise
Your organisation should have clear policies and procedures for responding to abuse.

Conclusion

All NDIS participants have the right to receive care without abuse or fear of abuse. Abuse is never acceptable in the workplace. Ensure you can recognise the signs of abuse and always take action if you suspect a participant is being harmed.

Useful Organisations

Additional Resources


References

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