In our blog post ‘DRC: Supported Decision-Making,’ last November, we explored the evolving landscape of Supported Decision-Making (SDM) within Australia’s disability sector.
SDM was a central theme in the Disability Royal Commission (DRC) findings, particularly in Volume 6, which underscored the vital need to empower people with disabilities to make their own decisions. Public Hearing 32 further emphasised the crucial role of service providers in safeguarding the autonomy and rights of people with disabilities, positioning SDM as a fundamental practice for protecting individual freedoms and ensuring people have the agency to make choices about their lives.
A year on, we are revisiting the topic to reflect on the considerable progress that has been made and the growing attention it has received in a number of jurisdictions, including:
- the National Disability Insurance Scheme (NDIS),
- the Aged Care sector,
- the Australian Commission on Quality and Safety in Health Care, and
- the Victorian social services sector.
NDIS
The National Disability Insurance Agency has incorporated SDM principles into its guidelines and information sheets, providing essential support to assist providers in empowering participants to make their own decisions.
This includes ensuring that providers are aware of how to offer people with disability a range of options to express their preferences, provide assistance in understanding and weighing choices, and ensure that their decisions are respected.
Aged Care
It is also important to consider the increased emphasis on SDM within the Australian Aged Care sector, particularly following the recommendations from the Royal Commission into Aged Care Quality and Safety. One of the significant changes in this area is in the Strengthened Aged Care Quality Standards, which will come into effect in July 2025, and which place a stronger focus on empowering older Australians to make decisions about their care, in line with the principles of SDM.
Standard 1, The Person, is especially relevant, as it focuses on concepts such as dignity and respect, older person individuality and diversity, independence, choice and control, culturally safe care, and dignity of risk. In doing so it requires providers to support older people to make informed decisions about their care and daily lives.
This includes actively involving individuals in decisions regarding their care preferences, ensuring that they have access to the information and resources needed to make those decisions.
Healthcare
The Australian Commission on Quality and Safety in Health Care has embedded SDM into its quality standards, with a strong emphasis on safeguarding the rights of people with disability.
A key document that reinforces this commitment is the NSQHS Standards User Guide for the Health Care of People with Intellectual Disability. This guide highlights the importance of respecting the autonomy of individuals by facilitating supported decision-making in healthcare settings. It aligns with Standard 2: Partnering with Consumers of the National Safety and Quality Health Service (NSQHS) Standards, which stresses the need for healthcare providers to involve patients in decisions about their care. Service providers should ensure that they adopt SDM principles as part of person-centred care, ensuring individuals with intellectual disabilities have a voice in their treatment options, and that their choices are respected throughout their healthcare journey.
Victorian Social Services
An example of the broader adoption of the principle of SDM across other sectors is its inclusion within the new Victorian Social Services Standards, which came into effect in July 2024.
These standards apply to a wide range of Victorian social services providers, including child protection, family violence, homelessness, out-of-home care, and sexual assault services. Within the standards, significant emphasis is placed on promoting the autonomy and independence of service users, particularly in Standard 2, ‘Service User Agency and Dignity’. The standards encourage service providers to develop practices that cultivate a culture of respect, ensuring individuals have a meaningful voice in the decisions that affect their lives.
Looking Ahead: Continuing Progress
At BNG, we are committed to supporting service providers to further embrace SDM practices and dignity of risk. We’ve recently reviewed our resources related to supported decision-making including:
- Info: Supported Decision-Making (Easy English)
- Policy: Supported Decision-Making and Dignity of Risk
- Policy: Supported Decision-Making and Dignity of Risk (NDIS)
We hope that by continuing to share resources, insights, and examples of best practice, we can contribute to the ongoing effort to ensure that all Australians can make their own decisions and lead lives that reflect their values and aspirations. review
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