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Content Warning: These stories are about violence, abuse, neglect and exploitation and may include references to suicide or self-harming behaviours. They may contain graphic descriptions and strong language and may be distressing. Some narratives may be about First Nations people who have passed away. If you need support, please see Contact & support.

‘[We need] mandatory minimum educational requirements [and] a registration of all carers, NDIS and aged care. And there needs to be a reporting structure.’

Kelsie is a registered nurse working with people with disability and advising service providers.

‘I’m totally shocked that disability workers are not required to have any experience at all to work in the community, in people’s homes on their own with them, with no supervision,’ Kelsie told the Royal Commission. ‘That is an accident waiting to happen. I’m really, really concerned about it.’

Kelsie, who’s investigated fatal incidents in aged care, described the lack of mandatory training for NDIS support workers as ‘scary’.

‘There is no accreditation process for these [support workers] to make sure that they are following guidelines and the standards … Basically every NDIS worker should know these standards. They should be able to say, “Okay. If you were going to assist with medication, what standard is that within?”’

Kelsie said she is particularly concerned about small organisations and sole traders advertising their services online.

‘You’re relying on somebody to do the right thing, but there is no accreditation process for these people to make sure that they are following guidelines and the standards … It could very easily be somebody who thinks, “There’s a lot of money in NDIS. I’m going to become a carer.”’

She said all support workers need some training and clinical management to prevent disasters.

‘Say Joe is on a modified diet and say he might have a little bit swallowing difficulty and he starts getting a lot of chest infections. That is a sign that this person has inhaled something into his lungs and got a chest infection.’

Kelsie said that without training a support worker might think he ate too quickly and will give him a drink of water.

‘And then it keeps happening and happening and happening until he gets aspiratory pneumonia and dies … Probably that’s happening and they’re not even identified as incidents.’

Kelsie said all NDIS organisations need a senior nurse on staff.

‘There needs to be somebody in those organisations that can do the clinical governance and they can educate … Do carers understand what is abuse? … If you have somebody’s bed up against the wall and then they’ve got a cot side at the side, that’s restrictive practice. And if that person wants to get out to go to the toilet they crawl at the end of the bed and they fall out of the bed.’

‘All NDIS … workers need to be registered. Just as nurses do. Just as everybody else has to be. There should be minimum educational requirements and that would include medication assistance.’

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Disclaimer: This is the story of a person who shared their personal experience with the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability through a submission or private session. The names in this story are pseudonyms. The person who shared this experience was not a witness and their account is not evidence. They did not take an oath or affirmation before providing the story. Nothing in this story constitutes a finding of the Royal Commission. Any views expressed are those of the person who shared their experience, not of the Royal Commission.