Attention: 

Dear registered NDIS provider

Information regarding new NDIS Practice Standards and Quality Indicators

This letter is to inform you of important changes to the National Disability Insurance Scheme (Provider Registration and Practice Standards) Rules 2018 (the Rules) and the National Disability Insurance Scheme (Quality Indicators) Guidelines 2018 (Quality Indicators Guidelines).

The Acting Commissioner, Samantha Taylor has recently made amendments which will come into effect from Monday 15 November 2021, with transition periods that will apply for registered NDIS providers. The amendments create three new NDIS Practice Standards:

• Mealtime management: this standard applies to a provider that is responsible for providing supports to participants who require assistance to manage mealtimes (such as those with mild dysphagia) and is intended to help ensure quality and safety in the provision of mealtime management. It deals with the nutritional value and texture of meals, and with their planning, preparation and delivery. It will appear in Schedule 1 – Core Module, Part 5 – Support provision environment, of the NDIS Practice Standards;
• Severe dysphagia management: this standard applies to a provider that is registered to provide high intensity daily personal activities and has severe dysphagia management set out in the provider’s certificate of registration. It requires those providers to ensure that each participant requiring severe dysphagia management receives appropriate support that is relevant and proportionate to their individual needs and preferences. It will appear in Schedule 2 – Module 1: High intensity daily personal activities, of the NDIS Practice Standards; and
• Emergency and disaster management: this standard is intended to address the planning required by providers to prepare, prevent, manage and respond to emergency and disaster situations whilst mitigating risks to and ensuring continuity of supports that are critical to the health, safety and wellbeing of NDIS participants. It will appear in Schedule 1 – Core Module, Part 3 – Provider governance and operational management, of the NDIS Practice Standards.

The NDIS Commission provided an update on these changes in the August Provider Newsletter.

The three new NDIS Practice Standards and their respective outcomes and quality indicators are detailed in the Attachment to this letter below, and can also be found in the amending Rules and Guidelines on the Federal Register of Legislation. A number of other standards have had their quality indicators updated to take into account the new emergency and disaster management standard.

I note a new high intensity skills descriptor has been developed to accompany the new NDIS Practice Standard for severe dysphagia management. The new descriptor will be detailed in the NDIS Practice Standards: Skills descriptors document before the amendments are due to come into effect.

The development of the new NDIS Practice Standards and Quality Indicators has occurred in consultation with stakeholders representing people with disability and NDIS providers, and academic and other industry experts. They are the result of commitments made by the NDIS Commission to explicitly address quality and safety in mealtime supports following our Scoping review of causes and contributors to deaths of people with disability in Australia. They also address evidence to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (DRC) and have been developed in response to the experiences of people with disability during the COVID-19 pandemic. The need for adjustments to the NDIS Practice Standards to better reflect provider practice in the context of the pandemic and other emergencies was a recommendation of the DRC.

Date of effect for the new NDIS Practice Standards and Quality Indicators

The new amendments come into effect from Monday 15 November 2021, and will be visible in the NDIS Commission Portal and Applications Portal from this date.

The following transition periods apply for existing registered NDIS providers:

• The mealtime management practice standard applies to existing registered NDIS providers from Monday 13 December 2021.
• The emergency and disaster management practice standard applies to existing registered NDIS providers from Monday 24 January 2022.

There is no transition period for the severe dysphagia management practice standard, which will be in effect from 15 November 2021.

Note that for registered NDIS providers who are transitioned providers (to whom the transitional arrangements under any of sections 26-29 of the Rules apply), the new practice standards do not apply until you make an application to renew registration.

Providers who have commenced an application for registration

If you have commenced an application to renew your registration, but have not yet been audited by an approved quality auditor as meeting the applicable NDIS Practice Standards and other requirements before 15 November 2021, the new NDIS Practice Standards and Quality Indicators relevant to your application, will apply.

Your auditor will work with you to identify if the new NDIS Practice Standards and Quality Indicators apply.

Mid-term audits

If you are currently undergoing a mid-term audit, and that audit is not completed prior to 15 November 2021, you will be assessed against the new NDIS Practice Standards in the mid-term audit, subject to the transition periods noted above.

Further information

Further information on the amendments to the NDIS Practice Standards and Quality Indicators will be published shortly on the NDIS Commission website, including a fact sheet and resources to assist providers in complying with the new requirements.

If you have questions about this letter, contact the NDIS Commission by phone on 1800 035 544 or by email via contactcentre@ndiscommission.gov.au.

Yours sincerely

Melissa Clements
Acting Registrar
NDIS Quality and Safeguards Commission

2 November 2021

Ref: EC21-001749

ATTACHMENT A: NEW NDIS PRACTICE STANDARDS AND QUALITY INDICATORS

Emergency and disaster management – Core module

Outcome: Emergency and disaster management includes planning that ensures that the risks to the health, safety and wellbeing of participants that may arise in an emergency or disaster are considered and mitigated, and ensures the continuity of supports critical to the health, safety and wellbeing of participants in an emergency or disaster.

To achieve this outcome, the following indicators should be demonstrated:

• Measures are in place to enable continuity of supports that are critical to the safety, health and wellbeing of each participant before, during and after an emergency or disaster.
• The measures include planning for each of the following:
  • preparing for, and responding to, the emergency or disaster;
  • making changes to participant supports;
  • adapting, and rapidly responding, to changes to participant supports and to other interruptions;
  • communicating changes to participant supports to workers and to participants and their support networks.
• The governing body develops emergency and disaster management plans (the plans), consults with participants and their support networks about the plans and puts the plans in place.
• The plans explain and guide how the governing body will respond to, and oversee the response to, an emergency or disaster.
• Mechanisms are in place for the governing body to actively test the plans, and adjust them, in the context of a particular kind of emergency or disaster.
• The plans have periodic review points to enable the governing body to respond to the changing nature of an emergency or disaster.
• The governing body regularly reviews the plans, and consults with participants and their support networks about the reviews of the plans.
• The governing body communicates the plans to workers, participants and their support networks.
• Each worker is trained in the implementation of the plans.  

Note: A number of other NDIS Practice Standards have had their quality indicators updated to take into account the new emergency and disaster management standard. The full list can be found in the Guidelines on the Federal Register of Legislation.

Mealtime management – Core module

Outcome: Each participant requiring mealtime management receives meals that are nutritious, and of a texture that is appropriate to their individual needs, and appropriately planned, and prepared in an environment and manner that meets their individual needs and preferences, and delivered in a way that is appropriate to their individual needs and ensures that the meals are enjoyable.

To achieve this outcome, the following indicators should be demonstrated:

• Providers identify each participant requiring mealtime management.
• Each participant requiring mealtime management has their individual mealtime management needs assessed by appropriately qualified health practitioners, including by practitioners:
  • undertaking comprehensive assessments of their nutrition and swallowing; and
  • assessing their seating and positioning requirements for eating and drinking; and
  • providing mealtime management plans which outline their mealtime management needs, including for swallowing, eating and drinking; and
  • reviewing assessments and plans annually or in accordance with the professional advice of the participant’s practitioner, or more frequently if needs change or difficulty is observed.
• With their consent, each participant requiring mealtime management is involved in the assessment and development of their mealtime management plans.
• Each worker responsible for providing mealtime management to participants understands the mealtime management needs of those participants and the steps to take if safety incidents occur during meals, such as coughing or choking on food or fluids.
• Each worker responsible for providing mealtime management to participants is trained in preparing and providing safe meals with participants that would reasonably be expected to be enjoyable and proactively managing emerging and chronic health risks related to mealtime difficulties, including how to seek help to manage such risks.
• Mealtime management plans for participants are available where mealtime management is provided to them and are easily accessible to workers providing mealtime management to them.    
• Effective planning is in place to develop menus with each participant requiring mealtime management to support them to:
  • be provided with nutritious meals that would reasonably be expected to be enjoyable, reflecting their preferences, their informed choice and any recommendations by an appropriately qualified health practitioner that are reflected in their mealtime management plan; and
  • if they have chronic health risks (such as swallowing difficulties, diabetes, anaphylaxis, food allergies, obesity or being underweight)—proactively manage those risks.
• Procedures are in place for workers to prepare and provide texture-modified foods and fluids in accordance with mealtime management plans for participants and to check that meals for participants are of the correct texture, as identified in the plans.
• Meals that may be provided to participants requiring mealtime management are stored safely and in accordance with health standards, can be easily identified as meals to be provided to particular participants and can be differentiated from meals not to be provided to particular participants.

Severe dysphagia management – Module 1

Outcome: Each participant requiring severe dysphagia management receives appropriate support that is relevant and proportionate to their individual needs and preferences.

To achieve this outcome, the following indicators should be demonstrated:

• Providers identify each participant requiring severe dysphagia management.
• With their consent, their individual severe dysphagia management needs are assessed by appropriately qualified health practitioners, including by practitioners conducting regular and timely reviews if needs change or difficulty is observed.
• Each participant requiring severe dysphagia management is involved in the assessment and development of their severe dysphagia management plan. The plan identifies:
  • their individual needs and preferences (such as for food, fluids, preparation techniques and feeding equipment); and
  • how risks, incidents and emergencies will be managed to ensure their wellbeing and safety, including by setting out any required actions and plans for escalation.
• Appropriate policies and procedures are in place in relation to the support provided to each participant requiring severe dysphagia management, including training plans for workers supporting them.
• Each worker responsible for providing severe dysphagia management to participants has received training, relating specifically to each participant’s needs, managing any severe dysphagia related incident and the high intensity support skills descriptor for severe dysphagia management, delivered by an appropriately qualified health practitioner with expertise in severe dysphagia management.