Libby Callaway & Sophie Moore - Monash University - Housing and Support within in a National...

Medicine, Nursing and Health Sciences

Housing and support within in a

National Disability Insurance Scheme:

Learning from the experience of tenants

Libby Callaway1, Dr Kate Tregloan2, Associate Professor Gavin

Williams3, Dr Ross Clark4, & Sophie Moore1

1 Department of Occupational Therapy, Monash University2 Monash Art Design + Architecture, Monash University3 Physiotherapy Department, Epworth Rehabilitation 4 Australian Catholic University

libby.callaway@monash.edu

March 2016

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Housing and support in Australia

NDIS Specialist Disability Accommodation Pricing Framework

Research background

Methods

Key findings and translation

Next steps in research

Presentation overview

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Acknowledgement

Kate Tregloan

Chris Migiliorini, Rosie Miller &

Rebecca Wood

Gavin Williams

& Ross Clark

4Pearson, 2008

“…Ideally there should be a range of

accommodation options available, so that

a continuum of support is provided – as a

person regains skills and abilities, a move to

more appropriate accommodation and

support can follow. The problem with most

existing services is they are institutions of

final destination, rather than a step in the

pathway to a life of choice.

Brain Injury Association of Queensland, 2010

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Estimates of housing need within an NDIS (from Productivity Commission & NDIA actuarial modelling)

460,000 NDIS participants

198,000 NDIS participants with a

need for affordable housing

28,000 NDIS participants eligible

for Specialist Disability

Accommodation

Source: NDIA SDA pricing framework sector consultation sessions

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Vision of framework:

Choice and control; innovation; options; tenancy rights; continuity of supply

and financial sustainability; portable funding – participant can move

between providers and funding will move

Framework to play a role in moving towards a market which achieves this

vision however accommodation choices will be constrained by market supply

and assessment by the NDIA of ‘reasonable and necessary’ needs

Goal of framework:‘Promote the provision of high quality and innovative SDA supports that enable

people with disability to maximise independent lifestyles and full inclusion in the

community’

Forecasts for benchmark prices due end March 2016, with prices weighted

for features such as geographical location, number of bedrooms, whether

the housing is furnished or not, accessibility features provided

NDIS Draft Specialist Disability Accommodation Framework

Current evidence in field of ABI

Systematic review on models of housing and support for people with ABI

1. Describe the characteristics of supported accommodation models

internationally

2. Assess the effects of models on outcomes of people with ABI

(Callaway, Winker, Sloan, Pattawage, Osborn & Pitt, 2013)

Download the review from:

https://www.tac.vic.gov.au/__data/assets/pdf_file/0018/125415/Models-of-

supported-accommodation-for-TBI-Evidence-Review.pdf

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Methodology – three key phases

Focus of today is on new models of housing and support, and post-

occupancy evaluation findings

Phase 1

- Review of project background, documents and relevant literature

- Identification of criteria and sub-criteria via stakeholders

Phase 2

- Investigation of the built, technology and support environment and

users’ (tenants’) experiences – interviews, published measures

- Evaluation of nominated site against identified criteria

Phase 3

- Communication of project findings and recommendations

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Key evaluation criteria

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Results

Supporting tenants build their capability for successful independent living

- transition planningmove inlive inmove on?

Staffing – approaches + challenges

Home automation and communication technology – opportunities + challenges

Built design – impact on supporting independence

Community design – access + inclusion

Systemic change – housing + support for people with disability

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TenantsTransition planning – start as early as possible

Understanding and staying true to the aspirations of new models of housing and

support – regular and repeated

Other stakeholders in the person’s life – influence of pre-move support network

Planning for living alone

Considering the cost of running a home

Taking the good of running a house with the bad (meal, laundry, cleaning)

Targeted support for furnishing decisions and storage considerations

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Furnishing decisions

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Furnishing decisions

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‘High frequency use’ spaces

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Building a home - TP1 + TP2 mapping

Building a home - TP1 + TP2 mapping

Projections

(horizontal)

Projected residents A-D in a

P2 unit (type 2)

(vertical) Projected

resident (B) in P2

units

“…Considering the vital importance of housing

to a person's overall wellbeing and the current

problems gaining access to affordable and

appropriate housing, the [Senate] committee is

convinced that access to affordable housing is

a matter of national importance. Furthermore,

affordable housing should be a national

economic issue that needs to be a central and

cross-cutting theme of government …

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Report of the Federal Senate Inquiry into Affordable Housing,

8 May 2015

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Support staffPractice leadership - understanding and staying true to the aspirations of the

housing demonstration project

Setting early expectations and grading support over time

Providing supervision, mentoring and consistency across the team – incidental

‘audit’ of staff practices

The tension of ‘home’ vs ‘workplace’

Primary care – role in the monitoring and management of secondary health

conditions and proactive health checks (weight, bowel + bladder, drugs +

alcohol)

Private vs public spaces

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Health condition present % (N=173)

0

10

20

30

40

50

60

70

80

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Private vs public spaces

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Technology

Testing, testing, testing – single technology failure may lead to abandonment;

back up systems required

Training, training, training

Build a ‘tech savvy’ workforce

Monitor frequency of repairs needed and establish response times

Considering learning needs of tenant – grade use

Evaluate use over time – use backend data

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AT data logging

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AT data logging

0

10

20

30

40

50

60

0‐3am

3‐6am

6‐9am

9‐12pm

12‐3pm

3‐6pm

6‐9pm

9‐12am

Nu

mb

er 

of 

Co

mm

an

ds 

pro

cess

ed

Overall Assistive Tech Usage ‐ Feb 6 to Feb 12 (5.4 days)

G.01

G.02

G.04

0

10

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60

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Friday

Saturday

Sunday

Monday

Tuesday

Nu

mb

er 

of 

Co

mm

and

s p

roce

sse

d

Overall Assistive Tech Usage ‐ Feb 7 to Feb 11 (5 complete days)

G.01

G.02

G.04

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User

Satisfactio

n

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User

Satisfactio

n

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Psychosocial

impact

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Built design

Architectural decisions early influence setting up of home (GPO, TV antennae)

Kitchens and laundries – hold off some joinery

Height adjustable or modular storage – ‘what I need to reach regularly’

Problem solving approach (lift, laundry, routes of community travel)

Outdoor spaces – private vs shared spaces

Siting – consideration of thermal, acoustic and visual comfort

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Community access & inclusion The ‘walk/wheel-ability’ of a neighbourhood – access audit, time use, reduction

in support need

Planning for visitors and guests

Neighbour relationships

Building natural supports – church, clubs, café and shop owners

Establishing community routines – walking the dog; going for coffee

Transport – low cost / flexible options

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Mobility tracking

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Mobility tracking

SANAV Nano

GPS Tracker

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Systemic changeEvidence of need for lifetime approach to skills development

State-based disability system bias entering model

Community attitudes – opportunities and barriers

Older families – traditional views and entrenched roles

Support staff – this housing is ‘different’ vs my approach is the ‘same’

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Summary reports

Bringing the NDIS home: Smarter housing design for people with disability

Libby Callaway & Kate Tregloan

https://theconversation.com/bringing-the-ndis-home-smarter-housing-design-for-

people-with-disability-47690

Sorry not my department: Why the NDIS and health systems need to

collaborate

Libby Callaway & Mark Brown

https://theconversation.com/sorry-not-my-department-why-the-ndis-and-health-

systems-need-to-collaborate-51818

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Next steps

Further post-occupancy evaluation of the next two Residential Independence

Pty Ltd sites in Victoria, funded by the Transport Accident Commission via the

Institute for Safety, Compensation and Recovery Research

Evaluation of national models of housing and support with sites across

Tasmania, Victoria and New South Wales (particular focus on learnings from

projects delivered through the $60M Supported Accommodation Innovation

Fund), funded by a National Disability Research and Development Grant

through the Department of Social Services

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Questions?

libby.callaway@monash.edu