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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
March 2016
2
Housing and support in Australia
NDIS Specialist Disability Accommodation Pricing Framework
Research background
Methods
Key findings and translation
Next steps in research
Presentation overview
3
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
5
6
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
7
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
8
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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
10
Key evaluation criteria
11
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
12
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
13
Furnishing decisions
14
Furnishing decisions
15
‘High frequency use’ spaces
16
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 …
20
Report of the Federal Senate Inquiry into Affordable Housing,
8 May 2015
21
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
22
Health condition present % (N=173)
0
10
20
30
40
50
60
70
80
23
Private vs public spaces
24
25
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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
27
AT data logging
28
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
20
30
40
50
60
70
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
29
User
Satisfactio
n
30
User
Satisfactio
n
31
Psychosocial
impact
32
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
33
34
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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
36
Mobility tracking
37
Mobility tracking
SANAV Nano
GPS Tracker
38
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’
39
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
40
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
