The EFQC Enquirer: 14 February 2025

In this edition

• The Value of HIDPA Skills Audits in Ensuring Quality Care
• Landmark Federal Court Ruling Against Valmar: Critical Lessons for NDIS Providers
• Changes to the DES Program: What You Need to Know
• The Importance of Up-to-Date Mealtime Management Plans and Staff Training (Sharon Floyd, Director, Engels Floyd Quality Consulting)

1. The Value of HIDPA Skills Audits in Ensuring Quality Care

High Intensity Daily Personal Activities (HIDPA) are essential supports that enable NDIS participants with complex needs to manage their daily lives effectively. These supports include complex bowel care, enteral feeding, severe dysphagia support, ventilator and tracheostomy support, urinary catheter management, subcutaneous injections, and complex wound care. To ensure safe and high-quality service delivery, NDIS providers must comply with the High Intensity Support Skills Descriptors, which define the essential skills and knowledge required for workers supporting HIDPA participants.

Why Conduct HIDPA Skills Audits?

A HIDPA skills audit is a systematic review that helps providers assess whether their workforce possesses the necessary competencies to deliver high-intensity supports.

These audits offer several key benefits:

• Identifying Training Needs: By assessing workers’ current skills, audits pinpoint areas where additional training or refresher courses are necessary, ensuring staff remain competent and up to date.
• Improving Participant Safety: Ensuring workers have the right skills minimises risks associated with high-intensity supports and enhances the quality of care delivered to participants.
• Enhancing Service Quality: Regular skills audits contribute to continuous improvement in care delivery by promoting best practices and adherence to participant-specific support plans.
• Supporting Workforce Development: The audit process helps providers build a more skilled workforce, fostering professional growth and career development opportunities for support staff.
• Ensuring Compliance: NDIS providers will be audited against the NDIS Practice Standards, Supplementary Module 1: High Intensity Daily Personal Activities (HIDPA), relevant to the high intensity supports they provide. Auditors will use the Skills Descriptors to determine whether skills and capabilities used in delivery of High Intensity Supports ensure the provision of a safe environment for participants.

How to Use HIDPA Skills Audits Effectively

Each HIDPA skills descriptor outlines the specific behaviours and knowledge required for different support areas. The HIDPA Staff Audit serves as a self-assessment checklist for evaluating workers’ capabilities and identifying gaps in training.

Providers should:

1. Conduct skills audits annually to ensure workers remain competent.
2. Reassess staff if they have not delivered HIDPA supports for more than three months or if a participant’s needs have changed.
3. Use audit findings to develop tailored training programs that address identified gaps.
4. Ensure records of staff training and competency assessments are maintained for compliance and quality assurance purposes.

EFQC remains committed to supporting NDIS providers in implementing effective quality management practices, including HIDPA skills audits. We have developed a High Intensity Support Skills Descriptors Staff Audit Checklist for each HIDPA, if you would like more information on this reach out to our expert team today at info@engelsfloyd.com or call us on 1300 790 194.

2. Landmark Federal Court Ruling Against Valmar: Critical Lessons for NDIS Providers

On 22 January 2025, the Federal Court of Australia ordered Valmar Support Services Ltd to pay $1,916,250 in civil penalties to the Commonwealth—the highest penalty ever imposed on an NDIS provider. The Court found that Valmar’s systemic failures put participants at significant risk, leading to the tragic death of a participant. Additionally, Valmar must cover the NDIS Commissioner’s legal costs.

This case is a significant milestone for the NDIS and provides essential lessons for all providers. You can read the full judgement on the Federal Court website.

What Was the Case About?

Valmar, a not-for-profit registered NDIS provider, was found to have systemically failed in its duty of care for three participants by:

• Failing to train staff or ensure they had proper qualifications.
• Ignoring dieticians’ meal plan requirements, such as cutting food into bite-sized pieces and ensuring soft textures.
• Creating meal plans without consulting allied health professionals, including a speech pathologist.

Valmar initially engaged a dietician who requested updates to participant eating and drinking plans and recommended a speech pathologist be involved. However, Valmar failed to engage a speech pathologist and later terminated the dietician’s services.

In early 2019, unqualified staff created new meal plans without consulting a nutritionist, dietician, or speech pathologist. These contradicted the 2017 dietician-approved plans, which required food to be “soft” and “moist.” By February 2020, unqualified staff falsely recorded outdated plans as “current.”

Because of these failures—particularly concerning participants at risk of choking—Valmar directly contributed to the death of a participant.

What Can We Learn from the Valmar Case?

The Federal Court judgment (paragraphs 18-41) provides key insights into what safe and competent services looks like:

• Mealtime management: Ensuring meal plans meet dietary and safety requirements.
• Engagement with allied health professionals: Following expert recommendations and not overriding them.
• Recordkeeping: Proper documentation and compliance monitoring.
• Staff training and qualifications: Ensuring staff receive adequate training for participant needs.
• Long-term knowledge of participant risks: Addressing known risks proactively.
• Compliance audits: Regular internal reviews to ensure staff follow protocols.

This case reinforces the need for all NDIS providers—registered and unregistered—to prioritise safety, compliance, and quality assurance. Now is the time to review your practices, strengthen internal processes, and ensure participant safety remains the highest priority.

We have provided further guidance in the Ask the Experts article below on how you can do this.

3. Changes to the DES Program: What You Need to Know

The Australian Government has announced a significant change to the Disability Employment Services (DES) program. The existing DES program will cease operations on 30 June 2025 and will be replaced by the new Specialist Disability Employment Program (NSDEP), which will commence on 1 July 2025.

This transition marks a major shift in how employment services for people with disability are delivered. The NSDEP aims to improve employment outcomes by providing more tailored and effective support for job seekers with disabilities.

Key Points About the Transition

• New Program Implementation: The NSDEP will roll out from 1 July 2025, replacing the current DES program.
• Standards Remain the Same: The National Standards for Disability Services (NSDS) will continue to apply.
• Eligibility and Service Focus: The new program will continue to support individuals who currently access employment services under the Disability Management Services (DMS) and Employment Support Services (ESS) streams. However, this may include individuals who do not necessarily identify as having a disability but require support in gaining and maintaining employment.
• The fee structure and performance framework will incentivise quality service delivery.
• In addition, a single wage subsidy program of up to $10,000 per person will be available, with simplified administration, to help place participants into sustained employment.
• Providers will be working with new voluntary participants, including those with a future work capacity of less than 8 hours per week and those not in receipt of an income support payment.
• The 2-year service limit will be removed so participants can remain connected to the program for as long as they need support.
• Establishment of the Disability Employment Centre of Excellence to help providers to understand employer needs and give providers the skills and knowledge to help employers to hire and support people with disability.

Impact on Providers and Participants

Providers will be expected to place participants and employers at the centre of their service design and build meaningful relationships with both participants and employers. There will be a greater focus on providers who can demonstrate that they have staff and leadership that reflects the diversity of the communities with which they are working. Staff should also have training in supporting people with disability and disability awareness.

EFQC will continue to monitor these changes and support providers in understanding and meeting compliance requirements. Stay tuned for further updates as more details emerge.

4. The Importance of Up-to-Date Mealtime Management Plans and Staff Training (Sharon Floyd, Director, Engels Floyd Quality Consulting)

Ensuring safe and effective mealtime management is a fundamental responsibility for NDIS providers supporting participants with swallowing difficulties or complex dietary needs. A well-structured and regularly updated mealtime management plan, combined with staff training, can prevent serious incidents and improve participant safety, dignity, and quality of life.

The recent Federal Court ruling against Valmar Support Services Ltd underscores the importance of having up-to-date mealtime management plans, adequate staff training, and compliance monitoring.

Why Are Up-to-Date Mealtime Management Plans Critical?

A well-structured and regularly reviewed mealtime management plan—developed in consultation with appropriately qualified health professionals—is essential in ensuring participants receive safe, high-quality meals tailored to their needs.

A plan that is out-of-date, missing key information, or not followed correctly can lead to serious risks, including choking, malnutrition, and aspiration pneumonia.

Key elements of an effective mealtime management plan include:

• Identifying participants who require mealtime management and assessing their individual needs.
• Engaging qualified health practitioners to conduct comprehensive nutrition and swallowing assessments, evaluate seating and positioning, and develop detailed mealtime management plans.
• Ensuring regular reviews—at least annually or when needs change—by qualified professionals.
• Involving participants in their assessments and mealtime management plans, with their consent, to respect autonomy and personal choice.
• Training staff in safe meal preparation and how to respond to safety incidents, such as choking, coughing, or difficulty swallowing.
• Making mealtime management plans easily accessible for workers supporting participants during meals.
• Developing nutritious and enjoyable menus that align with participants’ preferences, informed choices, and health needs.
• Proactively managing chronic health risks such as swallowing difficulties, diabetes, anaphylaxis, food allergies, obesity, or being underweight.
• Following clear procedures to ensure texture-modified foods and fluids meet mealtime management plan requirements.
• Storing meals safely and ensuring they are correctly labeled to prevent errors and contamination.

Ensuring Effective Staff Training and Communication

A mealtime management plan is only as good as its implementation. Staff must be adequately trained, supervised, and supported to conduct mealtime protocols safely.

Best practice processes for training and supervision include:

• Onboarding training for new staff: Ensure every new hire receives comprehensive training on each participant’s mealtime needs before providing support.
• Specialist training for complex mealtime needs: When a participant has a mealtime plan developed by a dietician, speech pathologist, or other allied health professional, staff must receive specific training on that plan.
• Regular refresher training: Staff should undergo ongoing education to stay up to date with mealtime safety practices.
• Supervision and mentoring: Managers and senior staff should regularly observe mealtimes to ensure protocols are followed correctly.
• Clear documentation of training: Keep records of who has been trained, on what, and when to track compliance.

Documenting Communication and Plan Updates

Keeping accurate and up-to-date records is essential for tracking participant needs, identifying risks, and demonstrating compliance.

• All mealtime plans should be dated so staff know how recent the information is.
• Changes should be documented immediately following medical reviews, incidents, or staff observations.
• Any instructions from allied health professionals must be recorded and communicated to relevant staff.
• Incident reports related to mealtime difficulties should be reviewed promptly, with action taken to prevent future issues.

Internal Audits: Are Your Mealtime Management Practices Being Followed?

Regular spot audits and internal compliance reviews help providers ensure that staff are following mealtime management plans correctly are essential to checking that you are meeting compliance requirements.

When undertaking internal audits you should be checking:

• Are staff following the documented plans? Conduct random checks to observe mealtime procedures.
• Are meal plans being reviewed and updated as required? Look for outdated, undated, or missing plans.
• Are all staff trained on each participant’s specific plan? Verify training records and refresher sessions.
• Are allied health recommendations being followed? Ensure there is a clear process for implementing expert advice.
• Are incident reports being reviewed? Identify trends and take corrective action.

Essential Actions for NDIS Providers

To enhance participant safety and uphold NDIS Practice Standards, providers should implement the following measures:

• Perform routine internal audits to confirm that mealtime management plans are being followed correctly.
• Ensure all staff receive appropriate training and qualifications relevant to the needs of each participant.
• Maintain thorough and up-to-date records to track participant requirements and plan modifications.
• Collaborate with allied health professionals and consistently implement their expert recommendations without delay.

By prioritising these steps, NDIS providers can reduce risks, improve care quality, and ensure compliance with best practices in mealtime management.

The NDIS Commission has resources to help providers meet their mealtime management requirements including:

• Mealtime management
• Supporting safe and enjoyable meals

Mealtime management goes beyond compliance—it’s about ensuring participant safety, dignity, and overall well-being. If you need support in meeting your mealtime management quality requirements, feel free to email us at info@engelsfloyd.com or call 1300 790 194.