Selasa, 16 Agustus 2011

Ombudsman reports on Licensed Residential Centres

The media has recently shone a light on Licensed Residential Centres (LRCs, sometimes called licensed boarding houses) for people with disability. Now it's the turn of the NSW Ombudsman – again, with yet another report on LRCs and their regulator, NSW Ageing, Disability and Home Care.

Read it and you will be appalled, both at what it shows of life – and death – in LRCs, and at a decade of government inaction in the face of desperate need for reform.

We reproduce the Ombudsman's introductory message, with our own emphasis added:

This report is about marginalised and vulnerable people living in accommodation that does not afford them adequate protection, support, or rights; and the need for significant reform to address this longstanding and unacceptable situation.

For nine years, my office has highlighted the vulnerability and poor circumstances of people living in licensed boarding houses. The majority of residents have a mental illness or a cognitive impairment, or both; have considerable health problems; and require daily supervision and support. They are typically reliant on income support, and hand over most, or all, of that money to the boarding house operator to pay for their board and lodging.

While there are standards and conditions that licensed boarding house operators are required to meet, our work has identified that these requirements are often not met, and the health, safety and wellbeing of the people living in these facilities suffers as a result. We have repeatedly found critical failings on the part of Ageing, Disability and Home Care (ADHC) to fulfil its responsibilities to monitor licensed boarding houses and ensure their compliance with requirements.

However, the problems are much larger than poor monitoring and enforcement. The current legislation governing licensed boarding houses and the standards expected in such facilities are inadequate to protect already vulnerable residents from harm and violations of their fundamental human rights. People living in unlicensed boarding houses have even fewer safeguards and protections.

Significant reform is required to provide adequate protections and appropriate support, and to uphold the rights of people living in the boarding house sector. At a minimum, our work demonstrates that there is a critical need for legislative change to improve the circumstances of, and outcomes for, people living in licensed boarding houses. In part, this is about improving standards to enable people with disabilities to obtain appropriate support to meet their needs; and delivering greater protections, that are rights-based. This must be accompanied by a rigorous system for ensuring compliance and removing providers that are exploitative or do not meet minimum standards.

My office has made many recommendations over the past nine years aimed at improving the circumstances of people living in licensed boarding houses and progressing the broader reforms. We have received repeated advice from ADHC about its intentions to progress a review of the legislation governing licensed boarding houses, and interagency work to explore options for reform of the boarding house sector. However, almost a decade in, the legislative review has not been completed, and no decisions have been made about the proposed reforms.

The slow pace of work and the lack of practical action to commence necessary reforms are unreasonable given the implications for the individuals living in boarding houses. The need for concerted and sustained cross-government action to achieve real and improved outcomes for people living in licensed and unlicensed boarding houses is overdue.

The Ombudsman has, in journalistic parlance, 'slammed' ADHC and the previous State Government. And if the Ombudma's message is not blunt enough, consider the first of the several case examples from the Ombudsman's investigative work that's cited in the report:

The death of a licensed boarding house resident in 2008 raised questions about living conditions in the facility and the adequacy of monitoring by ADHC. Our review of the man’s death found that hospital staff had raised concerns about his hygiene and nutrition during an admission to hospital for pneumonia three months before his death. At that time, hospital staff noted that the man was at high risk of malnutrition and staff had to use a peroxide solution to remove dirt from his skin and nails.

The man was found in his room by a staff member at the boarding house. He had been dead for at least 12 hours and had blood stains on his fingers, head and clothes. There was also evidence of blood stains on the walls and body tissue was found on two exposed nails on the back of the door to the room.

The police officers who attended the scene reported that the man’s bedclothes were covered with cobwebs and dust, and faeces and used toilet paper were strewn around the room. There was also several unopened sandwich packages in the room.

At the same time as our review of the man’s death, Official Community Visitors complained to us about the failure of the licensed boarding house manager to address concerns they had identified. These included domestic duties not being attended to, smoking by residents indoors, the selling of cigarettes on the premises, broken windows, limited access to bathrooms and the dining room, and unsecured medication left on a shelf in the kitchen.

We met with ADHC to discuss these concerns. They told us about initiatives in place to improve the support provided to residents at the boarding house and to monitor compliance with the licence conditions. They also advised us that they were seeking legal advice in relation to the boarding house operator’s ongoing failure to comply with many of the conditions of their licence.

ADHC subsequently told us they received legal advice that they did not have the power to enforce the licence conditions that apply to the health, wellbeing and cleanliness of residents and the facility. They said they were considering their options – including prosecution and/or revocation of the licence – in relation to the licensee’s failure to comply with a fire safety order issued by the local council.

As a result of unrelated factors, the boarding house subsequently closed and the residents moved to alternative accommodation.
In the midst of this awful scene, note the reference to ADHC's legal advice regarding the unenforceability of licence conditions. This legislative defect was repaired in the Youth and Community Services Regulation 2010... 11 years after the problem was first identified. And as the Ombudsman says, the review of the Youth and Community Services Act is still not complete, and the government has yet to commit to a broader reform of the boarding house sector.

In response, the new Disability Services Minister, Andrew Constance, has stated that he shares the Ombudsman's concerns. And prior to the tabling of the report, his colleague, Fair Trading Minister Anthony Roberts, also indicated to the Parliament that boarding house sector reform is a 'key issue' for the new State Government. Amongst these positive, encouraging signs from the O'Farrel Government, the Ombudsman's report is a powerful reminder of past promises unfulfilled, and a warning that the new government must do better – and urgently.