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Transcript

10 January 2026

DSS Provider Quality Forum: Enhanced Audit Programme

Forum introduction 

[Angela Desmarais] 

OK, Kia ora, welcome

Ko Angela Desmarais tōku ingoa. My name is Angela Desmarais. I am Principal Advisor Quality Improvement here at DSS. Welcome to this provider quality forum with the topic on the Enhanced Audit Programme with guest speakers here today from KPMG. I'll start us with a karakia tīmatanga – opening karakia then I'll talk through some of the housekeeping and pass over to Carmela Petagna the General Manager of Quality Assurance and Improvement to introduce the topic of today's forum.

[Opening Karakia]

Kia hora te marino

Kia whakapapa pounamu te moana 

Hei huarahi mā tātou i te rangi nei 

Aroha atu 

Aroha mai 

Tātou i ā tātou katoa 

Hui ē!

Tāiki ē!

Okay, so for housekeeping for today. All of today's attendees will have had your cameras and microphones turned off on entry so you'll not be able to turn these on yourselves, but you will have opportunities for questions and answers at the end of the session. If you choose to ask a question, you will be able to enter that into the Q&A and you'll find that button next to where you would usually find the chat function button, we have disabled the chat today. So, there's only that one function available to ask written questions. So, the way that works is very similar to chat. So, if you do click on that Q&A function, you should have a panel appear down the right-hand side of your team's screen. Make sure that it's showing ask a question next to your name. If it doesn't, click on the drop-down menu to select ask a question as the format. You may see other people's written questions pop up as they enter them into the Q&A function. 

If someone has already submitted the question that you wanted to ask, you don't need to write it again. Instead, you can support that question by using the vote up arrow. There's a little arrow just next to people's questions. It's kind of like a thumbs up like and this can be helpful because the questions can be responded to in order of the ones that have the most up votes.

There are lots of people in attendance today. So, this part is really important. We want to be able to get through as many of your questions and the most common questions as possible during the session. So, these questions will be read out by one of our staff here in the DSS Quality Assurance and Improvement team, Mark, who will change between questions depending on how many up votes I've had a reminder as well that the session is being recorded.

So, we will be posting the recording of the forum on our DSS website after the event along with a transcription of the content and also any slides that have been presented to you today. So please speak clearly for the transcription purposes and when you are [talking], please also identify yourself and your organisation. So, introducing our forum topic today is Carmela Petagna, our general manager of Quality Assurance and Improvement and she'll be talking a little bit about what the Enhanced Audit Programme is. So, Carmela, over to you.

[Carmela Petagna]

Thank you, Angela. I hope everyone can hear me okay. Ayu is going to put up a holding slide to start with. Great. All right. So, as Angela said, Carmela, I'm a general manager here at DSS for Quality Assurance and Improvement. Great to see such huge interest.

So, welcome this afternoon to this provider quality forum. It's a great opportunity to meet some of our KPMG colleagues. It is a change programme for us which is really exciting, and we are keen to work with providers as closely as possible. I'm going to provide just a little bit of scene setting that talks about how we got here. So we'll go on to the next slide Ayu.

The impetus really for change and improvement was brought about by the Royal Commission of Inquiry and its budget 2025 funding. It included funding for a number of quality management processes which are really important for us. It included the introduction of additional audits to improve quality and safeguarding across DSS services. We recognise that quality of course is not static. So, we've identified a strengthening of our DSS quality assurance and improvement activity and that's going to give us improved visibility across the services we fund and how we monitor and actually more importantly what we do with the data and intelligence. Pivotal to DSS obviously are the critical functions that we have as funder, steward, and commissioner of disability support services and we are committed to working to support high-quality and safe care. The next slide Ayu.

Right, this particular programme is going to have a strengthened focus on safeguarding. So, as part of the broader approach to this, the Royal Commission of Inquiry funding did also include other funding for us to improve our systems for managing complaints and critical incidents and supporting providers to better understand their responsibilities with regards, records management. We're also working on some pretty exciting workforce development opportunities and there'll be an opportunity to circle back to you on that once we've got a few things hopefully across the line.

The government's response and the way all this was couched through the commission of inquiry was that we needed to make the care system safe, and we recognise totally that we can't do that alone. So, we are committed to working with providers to ensure that our audit programme is fit for purpose. Thank you. Next one Ayu.

So, we are taking a phased approach, and we know it's ambitious but as I said earlier, we do have a commitment to deliver and that's part of the caveats that come with the budget funding. We're up for the change and the challenge and the opportunity to make this a positive experience for providers involved in the process. The first 12 to 15 months will focus on community group homes and in time the programme will expand to other service provider categories as well.

We won't go into all the detail today, but we have grouped the audits into five types, and we can expand on that at a later time, and they range from organisational audits through to bespoke audits as required. We continue to work closely with the Ministry of Health, which is really important as part of the health certification programme they run, and we've tried very hard to make sure that this will be complementary and does not duplicate services. Next slide Ayu.

Most important in all of this is going to be a very smooth transition and we're working closely with our existing audit and developmental evaluation providers to ensure minimal disruption to the change over to the new programme. And I do want to take time to acknowledge the ongoing support of our existing audit and developmental providers including SAMS, Mana Ātea, Whakanui, and Kawakawa Group. I know some of them are probably in the audience today. So, thank you for your commitment to working closely with us as we work through a smooth transition phase. The next slide Ayu.

So, closing off, it's a nice segue for handing to our KPMG colleagues acknowledging that the essential principles of this Enhanced Programme focus very heavily on partnership and that will take place at many different levels. there will be an opportunity to engage further with providers whether that's at a category level or future forums as the programme continues to evolve. I hope that today is valuable for you all and I will hand back to Angela to introduce our KPMG colleagues. Thanks Angela.

[Angela Desmarais]

Thank you, Carmela. Thank you very much. So yes, we've now got three colleagues here from KPMG. So, you'll be hearing today from Peter Chew: the lead partner at KPMG, Emma Williams: delivery lead and clinical subject matter expert as well as James Poskitt: the design lead. So, I'm going to hand over now to Peter who will introduce the KPMG team. Welcome Peter.

[Peter Chew]

Thanks very much.

[Speaker delivers opening remarks in te reo Māori]

So, thank you. I just wanted if you can jump on to the next slide please to take a few moments to introduce the audit team. To speak a little bit about our approach to hand over to Emma who is going to speak about our plan of action and then to hand over to my colleague James who's going to speak about some key messages in relation to the audit plan and approach. If you jump onto the next slide, please.

It's a huge privilege to be leading this work, I'm hugely passionate about improving the quality and safety of care for disabled people and their whānau. By way of introduction, I'm Peter Chew I've got over 25 years of experience of leading large-scale public sector programmes of work to improve outcomes for individuals and communities across health, disability, and social well-being. My role is overall accountability for the quality and delivery of KPMG services. Particularly important to me during this work is being relentlessly outcome focused through the work.

So, we recognise the importance of safety and well-being for disabled people under the care of DSS providers and that that's of the highest quality and that will be our core focal point throughout this work. Also particularly focused around independence and objectivity in undertaking this work and also around ensuring disability voice, whānau voice, and lived experience is included throughout all phases of this work.

The team that you can see on the page here is our leadership team for the piece of work. When I hand over to Emma and James, they'll introduce themselves too. But I wanted just to take a few moments to say a little bit more about the other members of the team, too. So, Kirill Voronchev who you can see in the top right there, Kirill leads our internal audit team in Wellington and will be a key member of the team here. Kirsten Pulbrook is in our Australia office. She has led a large number of similar audits across Australia in disability and will be an international subject matter expert for this piece of work providing international insights and good practice experience in the work. Aptin Maghsoodi will be implementing our data framework and we'll be building the audit tools which we will use um for the audits and Timoti Brown down the bottom there will be our Pou Whakatere who will be providing cultural guidance throughout this work on the programme and to our people to make sure that we reflect Te Tiriti and Te Ao Māori where appropriate. We haven't included on this team the 20 plus audit professionals who will be undertaking a lot of the audits with us. But we will be supported by a diverse team of around 20 audit professionals based across seven of our offices across Aotearoa who will be conducting the audits with us.Just on the next page please.

I'd love to talk a little bit more about the overall goals and objectives for the work. So, as I say absolute forefront in our focus is the goal that you can see top left. We are here to ensure that the safety and well-being of disabled people under the care of DSS's contracted providers is of the highest quality. We're here to ensure and support the delivery of high-quality safe and person-centred disability support services across Aotearoa and we will provide independent robust timely assessments of provider performance against both the national standards and contractual requirements and focusing primarily across safeguarding, service quality, and continuous improvement. There are a few outcomes which are key to us in undertaking this work.

And there's the short-term outcomes, the immediate things that we'll be focused on, more medium-term outcomes, and then longer-term areas of focus which we'll ultimately be seeking to achieve. I thought I'd just take a moment to talk through each of these in turn. From a short-term perspective, we're really looking to strengthen and have consistent tools for how we undertake audits. We're seeking to enhance the visibility of provider service delivery and performance. Where we identify issues, we're keen to ensure that immediate actions can be taken to address those issues. We will be open, transparent and provide timely and clear feedback to providers. Key to having Abtin involved in the team will be that all of our decision-making will be evidence-based and informed by data and providing awareness of rights, risks and quality gaps throughout. From a medium-term perspective, a focus around improving the consistency of service, identifying emerging sector trends, improving feedback loops and provider engagement, and improving workforce and provider capability and ultimately all of this leads to our long-term goals which are around improving a culture of continuous improvement, ensuring high-quality, safe and equitable service delivery, increase public trust and confidence in disability support services, building on what Carmela said at the beginning around making sure that we take a risk proportionate approach to the audit programme and ultimately better outcomes for disabled people. I'm going to hand over to my colleague Emma who is going to speak a little bit well, she'll introduce herself and then she'll speak a little bit more about our plan of action for how we intend to conduct this.

[Emma Williams]

Kia ora. Thank you, Pete. Can you hear me now? Thank you.

Kia ora all. Ko Emma Williams tōku ingoa. I just want to say firstly thank you so much for having us at your forum today to talk about this really vital work so I feel really honoured to be part of this mahi and it's been really great to get moving over the last little while we've already done you know a fair bit so it's really great to be able to give you some insights today so thank you so much for having us. In terms of me, I am an associate director at KPMG and I've been with the firm for just about a little bit over four years.

I'm a health professional by background and have been in health for over 26 years. So not giving away my age but a long time and the last seven years of my career have pretty much been in operational and programme management leading a large workforce programme and operational programmes of work across health and disability services.

So, bit of a change for me in terms of coming into KPMG and the reason I came here is to really be involved in mahi like this. This is really vital work and to be able to make a positive impact on those living in our communities, particularly vulnerable people in our communities, and to drive quality improvement across health and disability at a sector wide level is really as I said an honour and a really exciting piece of work to be involved in.

I'm very passionate, so anybody that knows me from a health perspective, I'm very passionate about person-centric approaches and ensuring that people are at the core of all that we do whether that be from a professional level whether that be from a health level health and disability level you know client level it doesn't matter I'm very person-centric and this work really matters to me even more so due to my personal experience of a precious whānau member who had lived with disability for the majority of their life. Their life really changed when they moved from a large institution to a group home as part of change in legislation in the UK and Wales. Obviously, I'm from the UK originally in the 1980s. So, I've really been able to witness firsthand the impact that that change, you know, for that person living in safety, living in a positive and nurturing environment and with choices about them and what they wanted really literally enabled them to start their life. So, this work is crucial.

So, in terms of my role and why I'm here in this piece of work. So, I'm part of the leadership team as Pete has introduced already and I'm really blessed to work with James, Pete, and Kirill. So these three guys are incredibly passionate, incredibly driven, and incredibly motivated in the work that we can do and so we really bring, we all bring a real passion and drive to this work and so my role is as the delivery lead and clinical SME and as Pete has mentioned already supported by a wide team of great people so from a programme management perspective through to our auditors who are going to be doing this work. Yeah, we have a really great supportive team.

So in terms of my piece today, I'm just going to take you through our plan on a page. So I just want to be really clear that this is a very high level plan on a page. It's just given you some insight into what the next 11 months looks like. Please note that whilst this just has the latter part of 2025 and 2026, the programme does run across three years to 2028. So this just represents a really small part of the programme thus far.

So, in terms of where we're at the moment, you can see there's a lot of a lot of work being done, really at the front end here and that's really to get our programme set up. We really need to get ready. So, it's essentially what we're doing is getting ready for the work. Confirming our objectives, which Pete has just gone through, and our guiding principles, and really building up our relationship and partnership with DSS and the awesome team in the quality space at DSS really fantastic group of people that we are going to be working with. Really important obviously that we set up our governance and reporting structures correctly. So that's what we are in the midst of doing and have done and really working through what the plan and the timelines look like.

So really kicking off the mahi as part of a large programme of work across that three years span. I just want to acknowledge that we are not in any way blinkered by the amount of work that we have ahead of us and also, we are very clear on the criticality of this work. As we said we have a large team. We're all fully on board and we're all very passionate but we really do want to convey to you that we understand there is a lot of work ahead. And I will say that you'll see at the very bottom of that page that the timeline is subject to change and so for us and for DSS the people that we're working with this has to be right. So, we want to make sure this is right. So there might be some tweaks to this timeline. We are very early on in the process at the moment. We are also at this point in time, you can see across January and February there, we've all come back to work with a hiss and a roar. So we really are building the audit framework.

So, James, I'm not going to steal his thunder. He's going to talk a little bit more to that later as the lead of this work stream and our approach here I mean with the audit framework is really to draft to listen to take feedback and really ensure that the framework supports the audit. So Ngā Paerewa standards service specifications and enabling good lives really are underpinning the framework at its foundation. So, it's really vital that we really ensure that we're doing that. Once the framework is built, we need to test it. So, you can see there around February-March time going into April we're going to be testing that framework.

So, we need to make sure that the framework does what it needs to do and that it captures the information that we need. We will be testing this with various groups which is already underway as we gain valuable insights. So, we really want to ensure that we gain those insights along the along the path of this and James will talk to a bit more of that later. In conjunction with all of that, we are building the digital tools and the reporting that we need to, to get the audit framework kind of live, if you like and so we the audit framework underpins all of that digital tooling.

So, I think what's really cool about that is – Pete's already mentioned data driven. You're getting a lot of evidence there. It's data-driven approach, but also the audits will be consistent. The same information is collected one central repository will collect it and the reporting will align with that consistency.

So, in terms of the reporting that you get and DSS get, it will all be consistent in terms of how it's provided in terms of the scheduling approach you'll see that is across February to May and agreeing that audit schedule. So that's already underway. So, we're currently working on that audit schedule and seeing where you all are around the country. So, want to make it clear that our people that are working on this piece of work are all around the country.

So, we have a wealth of expertise and offices from Auckland all the way down to Dunedin and all the places in between. So, we have people across the country that will be undertaking this work. So, we really want to see where you are, where we're going to, and build out that schedule across the year. So, what that means for you as providers is that you'll know when we're coming. So yeah, really great that you will be able to know when we're coming. Real good transparency, well in advance. In terms of our plans around introducing the team, we've talked a little bit about the team and this wider group of people.

So, it's really important to us that, you know, we recognise that we're coming into people's homes. We recognise that this is this is their environment, their home, their place of safety. So, we really want to ensure that you know they get to know us ahead of time. So, at the moment we're working through that and we're you know talking to various different people around that and groups within the disability sector. So, it could be you know a phone call, it could be video, it could be an introduction document up front obviously taking into account accessibility.

So, we really want people to feel as comfortable as they can with us coming into their environment, whether that be a staff, whether that be leadership, whether that be the person in the whanau. So, we really want to to build that. I just want to be clear that this is not being designed to catch anyone out, but it's really about building an environment of continuous improvement and safety and ultimately choice for the people living in those homes. So, I just want to be really clear about that and we like you want people living with disability and those living within a group home to feel like they can and are living their best lives.

So, this is why we're here is really to ensure that you will see that we've got a training element here across February and April. So obviously as we build the framework, we build the digital tools, we then need to build a comprehensive training plan for our people which goes beyond the framework and beyond audit to make sure our people are well prepared. So that will be an ongoing process. It's not a case of you know one and done. People will be constantly trained and supported throughout this work. You will then see that audits will take place from April onwards. I just want to be clear that the first audits are kind of initial audits.

So that's again testing and validating that framework, making refinements, refinements as we need to make sure it is fit for purpose and does what it needs to do. And in conjunction with that, we will also start the reporting. So obviously as we start the auditing, reporting will come in behind that. So, as I've already mentioned, that will be consistent reporting for you as providers and for DSS as the contract holders.

So, that really just gives you a high-level plan on a page. There are lots of intricacies there and lots of extra little elements, but I won't go into all of those, but you can see broadly that's what we have planned for the next little while. So, yeah. So, thank you. I will hand over to James.

[James Poskitt]

Thank you, Emma. Kia ora tātou, Ko James Poskitt ahau. I'm James. I'm a director at KPMG – as mentioned, I'll be heading up the design phase of this engagement and will also be involved in some of the delivery and ongoing phases. I do come with a little bit of disability sector experience, starting out at MSD as GM disability policy which very fortunately for me came with it responsibility for the Waikato Enabling Good Lives site, which gave me a really good taste and passion for EGL and all of their principles behind that, which then took me to the Ministry of Health to the DSS team there to, at the time, intentioned to lead out the disability system transformation work but very quickly ended up being COVID response for a good 18 months and really proud of the work that the whole sector came together through that period to ensure disabled people in far got the support they needed through all of that and then culminating in the work to set up Whaikaha Ministry of Disabled People which is great addition to have and great advocacy for disabled people and whānau.

But that's not why I'm here today but it's great to be back in that sector great to be an ally for disabled people and whānau again and great to be doing you work of great meaning and importance. I just wanted to spend a couple of minutes talking a little bit about the how and the what. So Pete talked a lot about the why we're here and so did Emma and so I just want to emphasise a couple of points about that. I am conscious that you'll probably have a lot of questions and don't want to dwell too much. So, I won't be reading through all of the slides and I'm sure you'll get the opportunity to engage with them yourselves.

The first point I want to make is that we have started with community residential and community group homes as the first place that we're looking at. But this is about looking across the entire DSS system. DSS identified that community residential was an area that they had the least visibility and so an important place to start but it's not the entire extent.

So we wanted to came into this thinking quite clearly about what does beyond audit mean. That when Pete talked about the outcomes when Carmela and team made it really clear to us what they were trying to achieve overall auditing alone won't achieve those outcomes. They're really important to collecting the information. They're really important to get a sense of what's happening in the sector where the challenges might be and being able to make you know improvements and identify areas that could be changed as we go, but they won't achieve those outcomes themselves.

So, we thought a lot about beyond order and what does that mean? And four themes within that or many themes I guess but just wanted to highlight those. One is the commitment to partnership and that means a few different things. One is we are partnering with DSS. We are there to be independent and objective and you know make assessments against some pretty clear parameters but we're really clear about the fact that the partnership means providing context providing information in a way that's going to be helpful and will lead to the continuous improvement and the system improvement that that DSS is really striving for.

So, working really closely in partnership over that extended period of time. It also means being clear and transparent with the sector about what those expectations are, what is needed to meet with them and giving everybody the best possible opportunity to achieve the standards and know what's coming. Firmly believe everyone I talk to firmly believes that everybody you wants and is trying to do the best possible thing and so it's about identifying what's preventing that and so working with the sector to be really clear and transparent about what those expectations are and equally being practical and reasonable about what's required, the amount of effort, the amount of administration that that's required to support these order checks.

We know that you know you've got a million things on at once that this isn't in isolation, and you have multiple funders, multiple regulators and multiple performance frameworks that you're working to and we're really conscious about you and minimising duplication and replication of effort, wherever possible. And thirdly, what it also means is ensuring that voice of disable people and whanau is guiding everything that we do and whether that means taking advice in the design phases and working together to shape and making sure that we're being inclusive in our approaches, making sure that the frameworks that we end up with, you know, are relevant and meaningful and actually work to achieve the outcomes that disabled people and whānau are seeking and it means that as we're engaging with people in their homes that that voice is respected as valued and is you know engaged in in the best possible way so that influence shapes what it is that that we're seeing.

So, we've got we'll be establishing some mechanisms to help us do that on the provider side, we we've had some conversations with the NZDSN already to think about the best ways to engage broadly across the sector for that transparency. with this help people and whānau we we're thinking really carefully about who has the money and the mandate in these spaces to provide whether that's the advice or you know instruction about how best to engage whether that's you know national enabling good lives around the EGL vision and principles whether it's the DPR coalition around the strategy and UN conventions or you whether it's people first or particular you know people in groups. But we're think really carefully and we're going to be very inclusive about that to ensure that that voice is paramount.

That's part one and there was four. So, I'll be really quick the others. But system level improvement was really key. So, what KPMG does bring to the party is expertise across a whole bunch of domains. You know we understand that the full context that it's not just about an individual level what the issues are in a particular home or a particular provider. A lot of our work is about setting a baseline. It's about understanding trends and themes. it's about using the data to see what will make the biggest difference at a system level, at a regional level, at an individual level. We'll be drawing on expertise from Australia.

So, KPMG Australia led a very similar exercise across all of Australia recently and still is and we'll be drawing on the lessons from that experience and some of the findings from that and using our smart data that Emma talked about. Similarly, we offer a depth of leadership across a whole bunch of domains, whether that's, you know, performance improvement, sector relationships, clinical experience. And so, we're not thinking about this as a pure audit exercise. It's not a tick box against a set of checklists that we have to complete. This is very much about how do we bring the best of all of the experience that we have to offer as we're engaging with what we're seeing and you know KPMG is a very well-known and large consulting firm and so you know we have very mature project management and delivery mechanisms in place so that we can be as efficient as we can be the biggest impact and we can minimise the amount of disruption as possible on the on the sector.

So that's a little bit about the how and then on the final slide that the framework itself is, and the design plan is still very much a work in progress, but I wanted to make a couple of points here. The first one is bringing it back to those outcomes. So, what is it that we're actually trying to achieve and keeping that as our true north and so the key phrases there around supporting the delivery of high quality, safe and person-centred disability support services is about delivering care to the highest quality disabled people in whānau focus on safety and well-being. It's about strengthening quality and safeguarding. It's about being independent, robust, and timely and lots again recurring things around safeguarding.

So, we know that that's where the emphasis is, and we'll build it a framework designed to achieve that and really you know shine a spotlight on those areas. Also wanted to make the point that we are working within a set of parameters. These aren't we're not going to be blue sky thinking. There's already existing frameworks. There's Ngā Paerewa standards for example, there's all the great work that's being done under the developmental evaluation frameworks. All the all providers have service specifications that they are you know adhering to and meeting and perform and reporting requirements around that and there'll be other standards and reporting mechanisms that we can draw on so that we're not replicating but and working through all of those different things at the moment. What we've found is there's some really recurring themes. There's eight kind of headline recurring themes around staff capability, person directed, cultural safety, health and well-being, safeguarding, environment safety, service leadership, business viability. Those eight areas came up the most and we've recognised that there's three core domains that we're going to be looking at.

So, first the primary emphasis is on people. What's the experience that the people involved are having in their homes and what's the capability and the experience of the people supporting them in those homes. That's really clearly paramount. But equally we don't want to ignore the fact that you know the physical environment or the environment that people are living in is equally important and that organisational health and structures and the ability to support people is important.

So, we'll be bringing all of those factors into play and we're working through a design process at the moment. There will be some ongoing work to test and validate that make sure that it is practical, make sure that it is feasible that make sure the expectations are clear and there will be opportunity to engage with those you know well before um we come out and start talking to you.

So just a couple of quick points there conscious of time. We've got about 20 minutes left for Q&A and continue to those. So perhaps Pete if you'd like to wrap up our section and we can move on to people's questions.

[Peter Chew]

I think you've wrapped our session up beautifully. Thank you, James. I'll hand back to DSS.

[Angela Desmarais]

Excellent. Thank you so much, Peter, Emma, and James. it was great hearing about the programme of work. We're going to move to the Q&A session now. I just want just for those who have joined after the housekeeping just to let you know that we did disable the chat function so that the channel for asking questions is the Q&A function which you'll find at the top of your window. Just make sure that you select ask a question before entering your question in and if you see a question that you support that you would like to have answered, instead of repeating it, you can click on the up arrow button, which is to the left of your name or photo to vote that question up. We will try to get to as many questions as possible and, but you can submit that them at any time throughout the Q&A session and there's also an option to get in touch with us afterwards: quality@msd.govt.nz with any questions that might come to mind later. So, on that note for the Q&A session I'm going to hand over to Mark Singson who is our senior adviser service provider audits in the Quality Assurance team. Thank you, Mark.

[Mark Singson]

Kia Ora Angela. I'm the senior advisor for service provider audits here at DSS and I'm moderating the Q&A session for today. So, I'll be reading out the most up-voted questions and then putting them out to our presenters. So we've actually got some questions now.

So, I'll read the first one. This is in regards to the time frame for advising providers of an upcoming audit. Have [we] got anything planned at this stage? What I understand is we do have provision in the contracts about time frames but does anyone from KPMG team want to talk to this?

[Emma Williams]

I can go to that. Awesome. Thanks. So yes, so contracted time frames are within are there already as I understand, as I said earlier, we will be scheduling all the audits well ahead of time. So, our vision is that you will probably hear about your audit ahead of time. We want to really make sure that we've got ahead of that contracted time. We really want to make sure that we have got the information we need you know before we come to the home. So yes, at this stage I can't give you an actual time frame but transparency and you knowing well ahead of time is really important to us and as I said we're scheduling those at the moment, so my vision is that you know you'll get a good a good scope of notice there

[Mark Singson]

Thank you, Emma. Kia ora.

Next question. Will the national toolkits be available to support our own internal CI (continuous improvement) programme. National toolkits?

[Carmela Petagna]

Do you want me to answer that, Emma? We'll have a bash.

[Emma Williams]

Yeah. Or James. Would James be good? James might well be a person for that.

[James Poskitt]

Yeah, we haven't we haven't got to designing toolkits. That's a really good point at this point, we're very much clear on the design framework, which is, you know, what are the things that we – what are the standards that we expect to be adhering against or measuring against. What is the information that we need to collect from providers. What are the things that we'd need to see when we validate on site and what are the things that we need to talk to residents, disabled people, and whānau about, and build up you a real body of information – reports will be provided to DSS and there'll still be conversations between DSS and providers depending on what the outcome of that is – where there's you know system level trends you will be providing reporting as much as possible that show what we're finding.

That'll be a decision for DSS about how; on how and when those things get released and we're still designing those now anyway. But good point around toolkits. I guess the principle there is around transparency which is that we want to give everyone the best opportunity for success as possible. We're not trying to run gotcha campaigns. And so that any material that we can share that that gives you the best opportunity to either prepare for audits or to put continuous improvement in place absolutely will be sharing. Yes.

[Mark Singson]

Kia ora James. Our next question is about opportunity for consultation with disabled people and their whānau. So, acknowledging that it is essential to recognise that some people in the whānau are not directly engaged with a large national representative group. So, are there any opportunities for consultation? What does it look like? Yep. James. Awesome. Thank you. Yeah.

[James Poskitt]

Good question. Working with those recognised bodies obviously has a lot of merit – again that they're established because they have a mandate. We really want to recognise those and not you know undermine that. But it's been pointed out to us too that the people with direct lived experience of your residential group homes are best placed to share their experience and we'll be looking at opportunities where we can do that. We know that organisations like People for Us, for example, will be a good source of information. We don't want to overwhelm those groups with our information requests but there are other mechanisms to do that and of course talking to people in their homes and how we work with, how to engage with disabled people and their whānau in their homes will be you know the best source and so making sure that we're creating environments where people can and feel comfortable sharing in whatever way works for them.

[Emma Williams]

And I think just to pick up on James’s point there, as we said in the presentation, like really important to us that we introduce our people in a way that people do feel a level of comfort when we're going into their homes. Appreciate that this might be, you know, uncomfortable for some. And so, we really are not here to want to do that. We really want people to know who's coming into their home and be able to recognise you know something around them. And I think you know, to James' point, you know as I said in in my intro, people-centric. So, we really want to ensure that disabled people and their whānau have a voice as part of the actual audits. So yeah, that will be front and centre.

[Mark Singson]

And I think this is slightly related question: in the audit teams that will be delivering the programme or going on site, is there any disabled person with lived experience part of the audit team or was there any consideration?

[James Poskitt]

Yeah, this is an important question we've thought a lot about. So, two parts to that. One is primarily we'll be drawing from the KPMG workforce. We're a very diverse and inclusive workforce and people lived experience will be will be part of that. Absolutely. And we'll be using, we'll be building our teams, based on, you know, all of their experience and where lived experience contributes to that. Absolutely. We'll be relying on that. But I think equally important is that understanding the context of the home that we're visiting; understanding the context of the people that live there. Their particular situations and then taking advice around what's most important in that situation. I think it would be a bit simplistic to say we've got a team of disabled people who will go to these homes. I think it's about really understanding what the requirements and needs are of the people who are living there and what's the best way to engage with them. What's the best way to hear from them about what they want to tell us and what that requires. If that's improved by having someone with lived experience or particular experience in an area then we will draw on that as required.

[Mark Singson]

Kia ora James, our next question is about the concurrent or perhaps similar auditing programme that our providers actually go through. So how does MSD accreditation level one to three fit into this programme? (This is the social services accreditations by Te Kāhui Kāhu) and there's also the Ministry of Health certification. Also, all assessing similar things at times…

[James Poskitt]

OK, I can have first go at this, and then maybe DSS friends can supplement with more detail. Both of those have come up, so the HealthCERT has come up a lot, and I'm sure Jacinda and Carmela can talk to the conversations that are ongoing with HealthCERT now. And I guess from a KPMG broad perspective, we understand that there are existing reporting requirements and standards that you're working to. And so, as I said before, we'll be looking across all of those and making sure that we're avoiding duplication and replication wherever necessary and adhering. We do have some parameters that we're working within. And so we're not saying because you've done this one that automatically means you're not required to undertake ours but we will make sure that it's as efficient and streamlined as possible but I think others are best placed to talk about HealthCERT specifically.

[Carmela Petagna]

I might make a comment, you go Jacinda – you go.

[Jacinda Allwood]

Excellent. Kia ora koutou. Ko Jacinda Allwood tōku ingoa. Just letting Ayu catch up with the spotlighting from Carmela to me. It's really nice to have so many people present at this forum. Obviously, I was involved with previous forums and presenting them. So, Angela Desmarais is doing a fabulous job to do so for these last couple of forums. So, I've taken on the role as the manager of the quality assurance team here at DSS. Just taken that position from the 1st of October. You've now met Mark Singson and we have another couple of people new to the team who are focusing on this Enhanced Audit Programme and also the transitioning of the current system into what KPMG will be providing.

A very good question about the other accreditation and Audit Programme that providers are subject to. We are working very closely with HealthCERT who do the HealthCERT accreditation under Ngā Paerewa and we also are contacting the Te Kāhui Kāhu team here within MSD. We, as I think James alluded to as well, we don't want to have duplication so we're going to work across agencies behind the scenes to make sure it's as streamlined as possible for providers and do what we can with respect to investigating information sharing pathways for that.

So, that's work that is underway over the next few months and we will let providers know where we get to with that. We will be communicating regularly through the provider newsletters that go out monthly so you can be aware of where we're at. If you do have questions for the quality team around this, which they will cover off at the end of this and that we might not get to during the session, please let us know. We'll cover off any questions that haven't been answered here, but you can always email us at quality@msd.govt.nz and we can summarise those key questions that are coming through and make sure that we're communicating really openly with providers to answer all your questions.

Back to you, Mark.

[Mark Singson]

Kia ora James and Kia ora Jacinda. I am meant to be neutral as the moderator for the Q&A, but I must say that this must be my favourite question that I'm going to read out now. Will the audit framework be built on a person-centred or person-directed approach? Because they're kind of like distinct difference to that. But I would say that's probably a combined approach. But I'll let the KPMG team perhaps talk more.

[James Poskitt]

You could spend probably the rest of the day discussing the merits of both or either even the meaning of both or either person-centred, or person-directed. But I think the point we want to make here is – just reiterating two things. One is that because this might cover some other questions as well, that the audit is against the providers and providers meeting certain standards. And so that's about policies and procedures. It's about staff capability. It involves a whole bunch of things about making sure that the environment is safe, and that the environment meets the level of quality for disabled people and their whānau to thrive in that.

So, that’s really important recognition. You know what's critical to understanding is the experience of the people that are living there. And so, the disabled people that we engage with will be directing the conversation, directing how they tell us about their experiences and how they want their voice to be represented in this. So that part will absolutely be person-directed. But I think we could get into a very long conversation about the differences between centred and directed.

[Mark Singson]

Kia ora James

Keep these questions coming. Very nice. What issues currently exist within the auditing system? Are we simply adding more standards or are we fundamentally altering the audit schedule such as with initiatives like Ngā Paerewa and Enabling Good Lives. Can we get a comment from the team?

[James Poskitt]

Well, I can talk about the fact that we are thinking about as we're designing the audit framework overall, we're really conscious about making sure that the Ngā Paerewa standards are underpinning across all those organisational standards that the principles of Enabling Good Lives are inherent in both what we're measuring and how we go about the audits. So, this isn't an exercise in replacing or throwing away all those things that already exist. It's about bringing it together into one place so that you can get a really good understanding and perspective of the overall level of quality. But I think the DSS team is best place to talk about the kind of the current audit environment.

[Jacinda Allwood]

I'm happy to speak to that. Following James. So just wanted to put it out there that we will not be introducing additional requirements that are not part of the provider contracts that you have with DSS. So, our basis will be those contracts and the specifications within that that we are providing funding for providers to deliver.

Back to you, Mark.

[Mark Singson]

Kia ora Jacinda. Yes. So, the Ngā Paerewa and the current frameworks that we are actually relying on or adhering on, they're actually not new. 

[Angela Desmarais]

Angela here just to let us all know that there's probably time for one maybe two quick questions to be asked.

[Mark Singson]

Awesome. Right.

[Angela Desmarais]

And while Mark's looking at those questions there, I'll just add that it's great to see so many questions coming in. Sorry, I'll just put my camera back on. Just to add that it's great to see so many questions coming in. We can put together an info sheet of the frequently asked questions or ones that we haven't been able to get to and put that together with the slides just so that everyone does have an opportunity for their answers for their questions to be answered. So, no pressure for Mark.

[Mark Singson]

Yeah, these are really good questions actually. And we will endeavour to answer them all via channels, but I'll yeah, you put me a little bit hard position. I think this is really good. Will there be Māori representation as part of the team when auditing a kaupapa Māori service? How's that for?

[Peter Chew]

I can say that one if you like. the short answer is yes. We have the Pou Whakatere that I spoke about in our audit leadership team. But we also in terms of the audit professionals across our team have a very diverse team and a good number of the team are Māori. We have conducted similar pieces of work entirely in Te Reo where appropriate and will certainly take a te ao Māori lens to our approach.

[Angela Desmarais]

Kia ora Pete. Awesome. Thank you. And yeah, thank you all. Yeah, mainly thanks Mark for running that Q&A session. So, you've been hearing from Mark Singson, our senior advisor service provider audits in the quality assurance team here. Now I think we can probably wrap up the session for today. Just repeating that we will respond to all the questions that have been asked. It was wonderful as well having all these presenters here from KPMG today. 

Thank you so much to our colleague Ayu for organising everything in the leadup to this forum and spotlighting. Mark for managing questions, Lara for supporting us, the whole team really for support and a big thank you to Carmela for all the work that you and the rest of the team do to support these forums in the background and an especially large thank you to Peter, Emma, and James for coming along to talk about the Enhanced Audit Programme today.

So, we're about to put the closing slide up for this forum which does have contact emails that you can reach out to if you have any further questions or feedback. Obviously, it's on a slide so you can't click on the hyperlink, but you can look for Enhanced Audit Programme on the Disability Support Services website to find out more information about the programme. if you want to come back and review this forum or have a look at the transcript or if you know of other people who might have missed today's session, please direct them through to the DSS website. This normally goes up on either Friday or early next week which we'll post along with the slides and the FAQs.

All right, so it's been a pleasure having you all here this afternoon. I think we got up to about 200 participants which is a record for these relatively new forums which is excellent. Wonderful to have you all along. Again, any questions get in touch with us here at quality@msd.govt.nz.

So I'll close us now with karakia whakamotunga – closing karakia – and hope you all have a wonderful rest of your day.

[Closing Karakia]

Kia whakairia te tapu 

Kia wātea ai te ara 

Kia turuki whakataha ai

Kia turuki whakataha ai

Haume e 

Hui ē! 

Tāiki ē!

Forum introduction

[Angela Desmarais]

Kia ora koutou. Welcome to our fifth provider quality forum. The topic today is an introduction to some of the People for Us peer workers.

I will start us with an opening karakia, and then I'll talk through some housekeeping and then pass over to the speakers for the day.

[Opening Karakia]

Kia hora te marino

Kia whakapapa pounamu te moana 

Hei huarahi mā tātou i te rangi nei 

Aroha atu 

Aroha mai 

Tātou i ā tātou katoa 

Hui ē!

Tāiki ē!

[Angela Desmarais]

Kia ora Koutou. Hotu hotu ana taku manawa ki te whanganui-a-hei, nō Tamaki Makaurau ahau, kei Ōtautahi e noho ana, ko Angela Desmarais tōku ingoa [Māori greeting]. Good afternoon, everybody. My name is Angela Desmarais. I'm a Principal Advisor in the Quality Improvement team here at DSS.

Previously, these forums were facilitated by Jacinda, the manager of our Quality Assurance team. I’ll be facilitating them going forward, and I want to say a big thank you to Jacinda for your work on the past forums.

Some housekeeping for today – all attendees will have cameras and microphones turned off on entry, you cannot turn these on yourselves, but there will be opportunities for questions and answers at the end of the session.

If you choose to ask a verbal question, use the raise hand function in Teams. We will unmute you and turn your camera sharing on. You’ll also need to turn on your microphone and camera on your end as well. But we call deal with that closer to the Q&A section. We will also have written questions available throughout the presentation that we will group together and then answer at the end in the question-and-answer time.

The way to do that is through the Q&A function. You'll find that button on your Teams screen next to where you would usually find the chat button. We have disabled the chat today so there's only the one Q&A function available.

The way that works is very similar to chat. If you click on the Q&A function, you should have a panel down the right-hand side of your team's screen. Make sure that it's got ‘ask a question’ next to your name though, that it says that in the window.

If it doesn't, just click on the drop-down menu next to your name and select Ask a question as the format. You may see other people's written questions pop up as they enter them into the Q&A function.

If someone has already asked the question that you wanted to ask, you don't need to write it again. Instead, you can support that question by using the vote up arrow. So that's a little arrow just next to people's questions.

It's kind of a bit like a thumbs up ‘like’ and this is quite helpful because the questions can be responded to an order of how many have the most up votes.

We'll try and get through as many questions as possible during the session. These will be read out by one of our staff here in the DSS Quality Improvement team and we will change between written questions and questions from the Q&A function. But anyone else that wants to raise their hand to ask a verbal question can do that by clicking the raise hand button.

A reminder that the session is being recorded, so we will be posting the recording of the forum on our DSS website after the event, along with a transcription of the content.

I just want to also acknowledge that we have two New Zealand sign language interpreters here today. They will take turns to interpret the speakers in this forum. So please, please try to speak clearly and especially when saying names so that the interpreters can follow. If people are speaking too quickly, the interpreter may just ask us to slow down.

Before I pass over to the first speaker, I'd just like to acknowledge that tomorrow is the 3rd of December, which is International Day of Persons with Disabilities and this year's theme is ‘fostering disability inclusive societies for advancing social progress’, and that links in quite closely to equitable employment for disabled people, which is something that certainly fosters inclusive societies. So, it's wonderful timing to hear from disabled people today about the important work they're doing. Now introducing our forum topic today is I think Kelly or Richard from People First.

They will give you an introduction to the topic, explaining what People for Us is, how it came about, a little bit about peer workers, so who we will hear from directly afterwards.

People for Us introduction

[Richard Buchanan]

Kia ora koutou, ko Richard Buchanan toku ingoa. Thank you, Kelly Woolston and I are just going to give you a brief overview of People for Us.

People for Us is a peer visiting service who visits disabled adults and tāngata whaikaha Māori who live in homes funded by Disability Support Services to find out three key things.

First is whether they are living their good life. Secondly whether they are getting good support. Thirdly whether they are safe and feel safe.

[Kelly Woolston]

Kia ora koutou. Ko Kelly Woolston toku ingoa. Why has People for Us been created?

The Royal Commission of Inquiry into Abuse in State Care found that people with disabilities were abused while living in residential care. People for Us was created to make sure that disabled people are safe and get good support. The Royal Commission said that more needs to be done to stop the abuse of disabled people in care, and People for Us will focus on the human rights of disabled people and tāngata whaikaha Māori.

Our role, Richard and I are part of the regional management team at People First, People for Us, but we are lucky to have two partners alongside us in our work in the Auckland and Waikato regions. That’s Te Ahi Kaa, who visit tangata whaikaha Māori in Waikato and South Auckland, and Vaka Tautua which visits Auckland’s Pacific communities.

[Richard Buchanan]

There are three key outcomes of the People for Us service. The first one is that Disability Support Services will gain an understanding of the voices and experiences of disabled people tāngata whaikaha Māori within the services they procure as well as the voices and experiences of families and whānau). Secondly, issues of safety and wellbeing for this group of disabled people and tāngata whaikaha Māori visited by Kaiārahi, or peer worker, are identified and responded to at an early stage, rather than too late. Thirdly, Disability Support Providers deliver safer services that are aligned with the Enabling Good Lives vision and principles.

Just to finish, this is a photo of a recent gathering of all three partners, where we came together for training and meeting the tutors.

Presenters

[Angela Desmarais]

Wonderful, thank you both, Richard and Kelly. That's a great photo seeing everyone come together. We'll be introducing now our first speaker who is David King from People First. Welcome David.

David will be talking a little bit about their work.

[David King]

Kia Ora, my name is David King. I'm in a Peer Worker for People for Us in Otago. About me, I grew up here in Dunedin. I have a disability, I love animals and do rugby. I was a full-time career for my dad and then later for my mom.

I have been involved in People First for 15 years as a Dunedin member, regional president, and national chairperson. I have been involved in DPA, I am on the Committee of DPA. I’m with Your Way Kia Roha and now I’m on the leadership team.

I also have many years of experience working for CCT (Community Care Trust) quality checkers. We work with DAA (Designated Auditing Agency) every couple of years to audit and support houses, how they are going, for Ministry of Health.

My role was to visit people in their homes and see if they were happy with their lives. A highlight of my career has been working with Sir Robert Martin. In 2008, I travelled overseas with Sir Robert visiting People First groups in Scotland and Wales, and it was brilliant. I went to New York, where we both presented at the United Nations building. Working along with Sir Robert has inspired me to carry on and work hard to make sure everyone’s voice is heard.

Why I wanted to do this role? I want to help other disabled people in the community. I have lots of local contacts in my community that I want to share with others. I want to help people have better lives with less barriers.

The Training. I was lucky enough to be asked to be on the advisory group to guide the Donald Beasley Institute, where they were setting up their training. In the training, we learned about the UN, about the Treaty of Waitangi, different ways that people can use their communication, and how we can work together with both parties – People getting their support and people giving their support.

What it is like being a peer support worker? You learn that every house is different. You learn that everyone has different needs, it’s good to be open minded to get to know people and reassure meeting other disabled people and hearing about their lives. It is good to be able to go with the flow. An experience, an example of this, was one of our first visits in a group house. We were presenting ice breakers, and a short presentation.

When we arrived, we could see that people living there had a very high needs and don’t communicate verbally. This was not what we were expecting, and our plans went out of the window, and we needed just go with the flow and take time to get to know everybody in the building.

This work is so important, and everyone deserves to have a bigger voice in their own lives. Thank you very much.

[Angela Desmarais]

Wonderful. Thank you, David. You certainly have some valuable insights from your governance experience that you bring to your job, so thank you. Next speaker is James Carr from People First. James will now talk to us about their work.

[James Carr]

Kia ora, my name is James. I’m one of six peer workers and I first started back in July this year. What I learnt from the training on the training we did down in Dunedin with Donald Beasley Institute is I learned how to communicate with people that are in residential homes [technical difficulties].

[Angela Desmarais]

Would you like us to move to another speaker so you can take a moment [to resolve the technical issue]. That’s no problem at all. Natasha, how do you feel about starting your talk now, are you OK with that?

[Natasha Brown]

So ready.

[Angela Desmarais]

We will go to Natasha Brown, also from People First, to hear about their work and then we will come back and see if James would like to join us.

[Natasha Brown]

Kia ora everyone. I’m Natasha Brown, based in Hamilton on the Waikato. I am one of the peer workers that are employed by People First People for Us team. I'm also one of the peer workers that was first employed to be part of the initial pilot team with People First People for Us. Kelly, my regional manager, believing in me and my skills when other people have not in the past has been everything to me.

One other person that we all know and that believed in me also, that was Sir Robert Martin. He told me once to keep up with my People First work and he believed me like Kelly believes in me now. All my life I have wanted to help and advocate for other people with disabilities and now I finally can. People First and providers has given me that opportunity and I'm glad to be able to share with you today.

We were trained by Donald Beasley Institute, and it was a great experience. Having people feel the same way as I do and then be able to make a difference is important to me. When we finished the training, we were sent our certificates, which I'm very proud of. The training leader also wrote in the card, and she said “I hear you're doing a great job of it, which is no surprise of all, Natasha. What can we say? You're a natural social justice warrior. Your energy for and commitment to this role are second to none. This training has just given you the tools to do what you have been working toward for a long time. Your passion for advocacy is so obvious and we know people's rights will always be upheld when you're around”.

This role has made a huge difference to my life and now I have a job, and I have wanted since I was 18 years old. I know what I do helps change lives.

Because I have a disability, I'm able to connect to the people we visit. I have similar experiences with self-confidence and not having friends in the past and being lonely has also been a key in situations. I have now got to visit quite a few people and we're working together to grow their voice.

The people we have visited so far have chosen where we visit them at a time and place that suits them. I can now see that as soon as I visit them, and I say I have a disability; they relax and open up and are so comfortable. I noticed people talk about how they feel, and they ask me how I grew my confidence, and they want to grow it too. When I revisit people, they really like that they know us and open way more. Lots of people have not wanted us to leave.

I'm looking forward to us to do more and more and grow people's voices. I know we are going to make so much of a difference. I really like making sure people feel safe, and are getting good support, that is important to all of us.

People also notice that I have a job and where I have come from in the past and people really want to do that also. People really want friendships and to grow confidence and to be able to speak to staff and whanau about how they feel. I look forward in assisting people to do this and connecting people to Speaking Up courses through People First, and others, to assist this.

Lots of people we visit want more friends and I'm working hard to link people with places they can meet more people other than the residential service they live in. I have linked people to friendship groups, People First groups and other local groups and Speaking Up courses.

These things have also helped me in the past and to be who I am today. Having faith in myself has been hard but getting the offer and seeing the word ‘permanent’ in black and white, in the e-mail saying I got the job, it was the best feeling, and I don't even know how I express it.

Knowing how much of a difference I can make by being able to give people a voice and seeing they feel safe and happy is everything to me. Knowing also I have been through similar things and I can relate, that makes it worthwhile. Being able to let disabled people know about courses that helps build confidence, or even the friendship programmes that they can join, means the world to me also.

The connection between Kaiāwhina and Kaiarahi makes a big difference to our work. Once my Kaiāwhina commented that it's like two sides of the same coin and that we do the same job from different perspective, but both are important and that's how I feel too. We work together and learn together and share the things we learn with the people.

I hope you all here assist the people you support to visit with us as I really think it will make a difference. Thank you everyone and thank you for listening to me.

[Angela Desmarais]

Ka rawe, awesome. Thanks for that, Natasha. James, are you okay to go next?

[James Carr]

Yep

[Angela Desmarais]

Awesome, welcome back [technical fix].

[James Carr]

Kia ora. My name is James Carr. I’m one of six Kaiarahi peer workers working for People for Us. I am one of the six original pilot team of Kaiarahi and I work alongside Hayden, my Kaiāwhina peer assistant.

I have been with People First since 2013. My previous experience is Central Region President on the People First National Committee, Vice President for People First Central Region, as well as being a person who has lived experience with a learning disability, has prepared me greatly for the role and gives me the drive for the work ahead.

In July, I went down to Dunedin for training with the Donald Beasley Institute. What I learned from the training with DBI was how to work with disabled people in residential care homes and how to communicate some of the topics that would come up during our conversations.

The training covered multiple topics, including the Treaty of Waitangi, the History on Disability, the UNCRPD, supported decision making, communication, privacy and confidentiality, and self-care. Since then, we’ve had our induction into the role and have covered the visiting process, referral pathways, reporting and debriefing, and tips for guided conversations.

I have completed 6 residential visits so far and gained a lot of experience from these. I learned how to adapt the pathways that we learned during the training. Mainly with our first referral pathway, teaching self-advocacy and options for them to have a better life.

So far, we have had a positive response from the visits that we have made, as the people we have invested in are safe and living their best lives. I have really enjoyed the work since I started.

Currently we are networking to spread the word about people for us. We are meeting with different community groups and providers to see if people in residential services are living a safe life. Thank you.

[Angela Desmarais]

Great, thanks for that James. Awesome work. And now our next speaker is Ray Faleafa from Vaka Tautua. We'll just pause a moment and switch interpreters and then invite Ray.

[Ray Falaefa]

Mālō e lelei family (Tongan greeting). My name is Ray Faleafa and I’m a peer support worker in our new People for Us service here at Vaka Tautua. We are a for-Pasifika by-Pasifika community health, disability and social services provider, serving families across Auckland, Wellington, Canterbury and Otago.

As peer support with my own lived experiences of not only caring for different family members with various disabilities but also living with a learning disability of my own brought on by a stroke as a child. So, I am blessed to be able to serve our Pasifika communities. Through my own personal experiences of disability, it has been hard. No, it’s been really difficult. In fact, no, it's been nigh on impossible to access the help and support needed to take care of my loved ones and family.

Part of it was the perceived stigmas around disabilities. You know, family must have done something in the past to deserve it, or karma coming back to hit the family, and the shame and embarrassment that comes with it, and another part of it is pride, not wanting to reach out for help as it shows weakness – where people with disabilities are still viewed with shame and embarrassment.

Part of it also is, as Pasifika, we are used to living surrounded by friends and family, where the village would look after the village., but that dynamic doesn't really exist nowadays, especially here in New Zealand. And adding on to this, I guess the main reason why we found it hard to care for our loved ones was our lack of knowledge and the inability of the professionals whom we put our trust in to point us in the right direction.

You know, even what to do next was hard to get. My recent experiences with Dad, who passed away earlier this year in April, highlighted my frustrations, where I honestly felt ripped off by the system. We stumbled along with supporting dad from home that we were really struggling. You know, we got the run around from dad's GP, we were told he was the one that we're meant to go through, but he wasn't much help, and that happened for a good couple of years, and it wasn't until dad had a stroke at home in January this year, where dad was rushed to the hospital, I had to plead with the nurses, with the doctors, the staff at the hospital to get any type of support for Dad. Somehow, we stumbled along and got Dad into a hospital level care facility in February.

Dad passed away in April this year, April 24th this year, which really makes me feel, you know, some sort of negative way, which is putting it mildly. Even though I was dad's welfare garden, dad's home dictated how dad's cares went, and in some cases we didn't agree. But you know, we didn't know nothing about the system. So we were just thankful Dad was in a facility to give him the cares that he needed and deserved.

We as a family felt we were not properly informed of what was happening with Dad. With today, we still haven't received an official diagnosis for Dad, even though we were told by numerous doctors and experts, you know, that Dad had dementia, which made it hard for us to access support.

I am blessed in this space to be peer support for People for Us, because I don't want anybody to experience that kind of system helplessness like we did. From the start, when I started with People for Us in May, just finding out that we do have rights. The Health and Disability Code of Rights, our EGL, I didn't even know that. It's not common knowledge. Even our rights in the United Nations Convention for the Rights of Persons with Disabilities – didn’t even know that – so we end up getting these people who we put our trust in to help us, but they're not.

Since my journey here as a peer support, we've learnt a lot. We've learnt how to engage with different tagata sa'ilimalo (Pacific disabled people, their whānau and carers). So, tagata sa'ilimalo is a Samoan term. It means people pursuing success and ultimately that's what we're trying to do with our disabilities. We want them to live their best lives the way they want and how they want.

Based off my experiences of Dad, I'm blessed to be able to help our people. So yeah, thank you family, and have a good day.

[Angela Desmarais]

Awesome. Thanks, Ray and good to hear on how you can draw on those experiences to bring your knowledge and awareness to the community. Thanks, Ray. And next we have Saini Schwenke from also from Vaka Tautua.

[Saini Schwenke]

Hi everyone, talofa everyone and warm Pacific greetings. My name is Saini and I'm a proud Samoan woman and also I work as a peer worker for People for Us.

I also bring that experience. I also live with Asperger's, which is a big part of my story and how I see the world. When I think about this theme, I think about my journey as a Samoan, as a mother, and someone who is learning to embrace her difference and turn it into strength. Having Asperger's means I see and experience things a bit differently. Sometimes that can be hard but I also see it as a strength.

Then there's leadership. In my role as a peer worker, I work alongside others who have lived experience. Leadership for me isn't about being in front, but it's about walking together and being able to listen to them and also helping them or uplift them and encourage them.

Within People for Us we believe that our voices, our experiences, and our leadership matter. An example of that is when we go and see tagata sa'ilimalo, they will need us to help them, empower them, to live the good quality of life and also enabling them to live the quality of life and giving them the rights to make their own decisions. To me, that's what inclusion and true leadership are about. So we all have a role, some lead from the front, some lead from behind, and every person matters.

As a mom, I think about my son. I wanted to grow up where inclusion isn't just talked about, but it's lived. So, when I said I want to elaborate more on that, I want people out there to know that their voices matter – where people with disabilities are seen, heard and respected, where our Pacifica values and our differences can walk hand in hand. So people with disabilities should never be discriminated. They all have a voice, they should be included, and they have the rights to live a good quality of life like anyone else does.

Within my role as a peer worker, I'm learning a lot in my role. I do struggle in areas, but I'm learning to be – my main skill is to be more confident – and this is helping with public speaking with others as well.

I'm blessed as well to be in this role. Blessed to help others wherever is needed, so I'd like to thank you all for listening and God bless everyone here. Thank you.

[Angela Desmarais]

Thank you, Saini. That was great. Loved hearing that framing of leadership. Thank you. And our last speaker for this session is Jessica Nelson from Te Ahi Kaa. We'll hear Jessica talking about their work. Welcome, Jess.

[Jessica Nelson]

Kia ora everyone, my name's Jessica Nelson. So I work for Te Ahi Kaa. I've only just started at Te Ahi Kaa since August this year. I have just, obviously I'm starting as a Kaiarahi in peer support, so this is my first time being in this sector. I actually come from hospitality, so I have a hospitality background and I'm used to speaking and talking to people but this is very new in regard to speaking on Zoom and everything. However personally, I have actually enjoyed working alongside my team so far in this industry. It’s taught me confidence.

There has been a bit of struggle within myself actually, but I’m slowly getting there. It’s family as well as work, but as Peer Support worker I’m actually enjoying it.

I'm probably not gonna speak as long as everyone else, just cause this is very new, but a bit about me is I live in Pukekohe in in Auckland, I am whangai (raised by whānau) right from when I was two weeks old, and I have Fetal Alcohol syndrome as well, but I've slowly come out of that due to a lot of work that was put into me when I was younger.

I have really had ups and downs in my life, being the youngest of six too. I’ve really struggled at school due to my Fetal Alcohol Disorder (FASD). That’s pretty much me, I hope everyone has a good day.

Questions and Answers

[Angela Desmarais]

Awesome. Thank you, Jessica. That that was great, you did really well. Great to hear about your journey and that you're now a peer worker along with our other speakers. It's wonderful having you all together for this forum.

So now we'll sort out some spotlighting of our speakers today, of David, James, Natasha, Ray, Saini and Jessica, and we'll start the Q&A session. Just a reminder that you can either select the raise hand function to verbally ask a question or you can select Q&A to enter. a written question.

It looks like we'll get going there, and I'd like to also invite my colleague Solmaz, who will be reading out the questions for our panel today, so welcome Solmaz.

[Solmaz Nazari]

Thank you. Kia ora koutou. I am Solmaz Nazari. I am Senior Advisor in the Quality Improvement team in DSS. Very nice to see you all. And thank you for the kōrero, I really enjoyed listening to your kōrero and learning from your mahi.

So, for the first question we have in the Q&A function chats, Aimee asked, of the homes that have already been visited by People For Us, how were they selected? Did people directly ask for the visit, or an organisation, or were they randomly visited? Who wants to answer the question, one of the managers or one of the peer workers?

[Kelly Woolston]

It's come in a multiple of ways. Obviously, we've received referrals from people just on our website or that have contacted us wanting a visit. Natasha, you may want to talk too about all the places that you've gone to visit people, at groups, or disability leadership groups within providers, different organizations. Providers have been fantastic about getting us along to self-advocacy groups or leadership groups in different places where people have said that they really would like a visit as well, so sometimes we approach through that way.

We also have approached organizations to see if people would like an opportunity to visit and many people have come forward for that. So it is really in each region we focus on that, but we even got some referrals from attending the IDEA Services kapa haka group and people came up to us there, to Te Ahi Kaa, and other places wanting that as well. And yeah, so we go around different places, but also people approach us, and family members have come to us, or sometimes we've even received referrals from one provider about another provider, about people there in a multiple of ways.

[Solmaz Nazari]

Thank you so much, thank you. And the second question is from John Taylor. Thank you everyone for introducing yourselves and what you do. What do you think are the most important things for you to look out for when you are visiting houses?

[Saji Varghese]

Thank you, I'm Saji from People First People for Us service. What are we looking for? We are looking to hear from the person who is living in the residential service how their life is. We're not assuming that life is not good. So we are inquiring how good their life is, how safe they feel in the place where they are living, are their voices being heard, are they getting a quality service. Those are the themes which came out of the Royal Commission's inquiry that disabled people spoke about.

So we have got very wonderful, you know, guided questions which is led by the peer workers who speak to them and intention is to find out by those questions and by that kōrero that their voices are heard.

John, if that answers your question, what are the most important thing we are looking for? Yes, they're looking for safety, quality, and are they living a good life? That's the three themes which we're looking for.

[Natasha Brown]

Kia ora koutou everyone. I've done a few visits myself and I have noticed a few things. I kind of noticed, say, if any person may have injuries on themselves, that's one thing we do look out for. Are they happy where they're living. There could be maybe locks on cupboards, so we definitely have a look, see if they feel safe.

We do have the guided questions which Saji just speak about and it's about if you have a good life. Any relationships that are important to you. Safety – do you feel safe where you're living. Do you feel safe in, like, out in your community. How about the support you get – are you happy with the support that you get from the service that you're provided. Are you happy with the choices or having control over your life.

So I have them on little cue cards and I ask some questions and yeah, that's what we kind of look out for.

[David King]

I was the one of the people on the pilot program for six months and I got the confirmed I got full term role. Body language – look around the house, make sure their personal stuff is around. How much choice they have got in their lives in the house. Communication – that they are happy where they live. They are happy with the people they live with, because sometimes they don't have a voice on who wants to live with things. So sometimes their voice is not heard on who is flatting with them. And abuse – you pick up that, sometimes, you can feel if things are not right or if things are right, because with us having lived experience of being abused, or being knocked around, with no rights, we can pick up more easily the good points and the bad points.

[Ray Falaefa]

I was just gonna add on to that answer. You know, we've been talking here what to look out for when we go to our visits. As well as the things that have been brought up, we've been told to keep an eye out of like the physical surroundings in the actual residence. You know, how does it look, is it clean, I mean, is it dishevelled, things like that. Also what we've been talking about here is, the interactions of the tagata sa'ilimalo and their support worker, you know sometimes you can see with that interaction how things are with them, does tagata sa'ilimalo look scared when they're interacting with their support worker and things like that, You know, are they constantly flinching or are they looking down, do they visually look scared when they're around their support worker, so that’s some of the things that we've talked about. Thank you.

[Solmaz Nazari]

So the next question is thanking all of you for your awesome presentation and amazing mahi. They ask, following the kōrero about not being aware of rights and EGL principles, if there are any thoughts from any of the peer workers of ways we can make sure our community and whānau know their rights?

[Natasha Brown]

Hi, as I was saying in my speech, there is People First that you can join. People First is arranged of the whole of like New Zealand. They can help with Speaking Up courses, they help you with self-confidence, so there's lots of different ways to be, and People First groups around can also help you out with, like, teach about your rights as well. So yeah, it's quite big there.

[David King]

One way is DPA. Another group that will help anyone with a learning disability with issues and we talk to the Government about issues. Enabling Good Lives support them to think outside from houses to streamline in community services like, to be part of a community outside., so we like, instead of saying stay in your house and do nothing, which is a bit scary for some people, what is our community we can support you with, to be streamlined, so that you would be a part of community outside of the house.

This is where the things is not that flash with the system, so we try to talk to them, ask what you want from your life, if you want something outside of your support house, then we support you, to find, organise, a community to support you to do things in the community.

So, Enabling Good Lives is part of our thinking always of getting people out of the thinking and going a different thinking, some way thinking differently outside of the box in community. So very important to give them little hints and a little push that there is more to life, way of living.

[Saini Schwenke]

I think for me would be the rights for people is Enabling Good Lives, so that's what I've learned in our People for Us team, enabling good lives, enabling them, making sure that they live the best quality of life because we give them supported decision making on their rights, based on their rights, to make their own choices. So it's based on choice and control and that they are understood and that their needs are met as well, so that's what we're here for – here as peer workers – we ‘re here to make sure that their needs are met and for their choice and control over their life.

[Solmaz Nazari]

Mindful of time, I see you wanted to say something, you’ve had your hand up.

[Hayley Te Ao]

Kia ora mai tatou. Actually, Saini put it perfectly, she took the words out of my mouth, so kia ora for that Saini.

[Solmaz Nazari]

Thank you so much and Angela, do we have time for me to read another question?

[Angela Desmarais]

Not quite, we are on four o’clock but was the question about how to become a peer worker? Because I’m seeing in the Q&A there's a couple of questions there around what opportunities there could be in the future for becoming a peer worker. We'll be giving you, in the closing slide, some contact details for People for Us and other organisations, so maybe if that is something that you're interested in finding out more about, you could reach out to either the organisations that have been represented here today, or us in the quality team, and we'll share those contact details with you because just mindful of time.

I just want to say thank you so much to Solmaz for facilitating those questions. It's been great hearing from you, our Senior Advisor in the in the Quality Improvement team here at DSS. We'll wrap up the session now.

Wonderful, truly wonderful having all our presenters here today, and also thank you to our DSS colleagues in the background helping make this forum happen.

A huge thank you to Kelly and Richard from People First for the introduction, to our speakers David, James and Natasha from People First, Ray and Saini from Vaka Tautua and Jessica from Te Ahi Kaa for sharing their experiences of being peer workers at People for Us – thank you.

We're about to put up the closing slide for the forum, which has those contact details I mentioned, that you can reach out to, including quality@msd.govt.nz.

Now, if you want to come back and review this forum or have a look at the transcript, or if you know of any other people who missed today's session, please direct them through to the DSS website because we do post the link to this recording once we've written up the transcription. This is helpful for people who prefer to read the forum content rather than watch it.

So, it's been a pleasure having you all here this afternoon for this fifth forum. I think we got up to, I didn't quite get the number there. I think it was about – a lot – I think over 100, which is excellent. If you do have any questions, the details are on the contact slide and will be included with the transcript or contact us here at Quality.

I'll close now with a karakia whakamutunga, closing karakia, and hope you all have a wonderful rest of your day and also a reflective day tomorrow as we observe International Day of Persons with Disabilities.

[Closing Karakia]

Kia whakairia te tapu

Kia wātea ai te ara

Kia turuki whakataka ai

Kia turuki whakataka ai

Haume e

Hui ē!

Tāiki ē!

Closing slide

Contact details

• People for Us: peopleforus.org.nz external
• People First: peoplefirst.org.nz external
• Vaka Tautua: vakatautua.co.nz external
• Te Ahi Kaa: teahikaa.co.nz external
• DSS Quality Assurance and Improvement Team: quality@msd.govt.nz

[Jacinda Allwood] 

Kia ora koutou, everybody. Welcome to, this is, our fourth provider quality forum with the topic today being the DAPAR service, the Disability Abuse Prevention and Response Service that DSS funds.  

I will start us with an opening karakia, and then I'll work through some housekeeping before passing on to the speakers for the day. 

Whakataka te hau ki te uru  
Whakataka te hau ki te tonga  
Kia mākinakina ki uta  
Kia mātaratara ki tai  
E hī ake ana te atakura  
He tio, he huka, he hauhū  
Tihei mauri ora! 

Kia ora koutou, ko Jacinda Allwood tōku ingoa. Good morning, everybody, I'm Jacinda. I am, actually as of the 1st of October, the new manager of the Quality Assurance team here at DSS. Yes, we have two Quality teams now. The Quality Assurance team and the Quality Improvement team. We're really excited to jointly bring you this fourth forum.  

A little bit of housekeeping as I mentioned. All of those of you entering as attendees will have your cameras and your microphones turned off on entry. You will not be able to turn these on yourselves, but we will have opportunities for questions and answers.  

If you choose to ask a verbal question, you can use the ‘raise hand’ function on your Teams, and we will unmute you and turn your camera on and then you will need to do that yourself as well. But I can deal with that closer to the Q&A section of the forum.  

We will also have written questions available throughout the presentation that we will group together and then answer them in the question-and-answer time at the end. The way to do that is through the Q&A function. So, you'll find that button next to where you would have the chat function.  

We have disabled the chat so that there's only one function available for today. And the way that works is very similar to chat, so if you click on that Q&A function, you should have the panel down the right-hand side of your Teams call. Make sure that it's got ‘ask a question’ next to your name. If it doesn't, just click on the drop-down menu to have ‘ask a question’ as the format. 

You should see other people's questions pop up as people write questions into the Q&A. If someone's already asked the question that you're interested in, please don't type it in again, but instead you can support that question by using the vote up arrow. There's a little up arrow just next to the people's questions. It's kind of like a ‘like’. And then the questions will be responded to in order of the ones that have the most up votes. We will try and get to as many questions as possible throughout the session and they will be read out by one of our staff here in the DSS Quality teams. And we will interchange between written questions that have been put into the Q&A function and anyone who wants to raise their hand and ask a verbal question.  

This session is being recorded, so we will be posting the recording of the forum on our DSS website after the event along with a transcription of the content and any presentations that have been presented to you today.  

I will now pass over to my colleague, Lara Penman, who is the new manager of the Quality Improvement team here at DSS, who will give you an introduction. Over to you, Lara.  

[Lara Penman] 

Kia ora koutou. Thank you again for joining us on another DSS Quality Forum. We’re really excited to be able to share a bit more of where we’ve got to with the DAPAR service. We’ve had a couple of years of operation getting this service going. We’ve just recently been through a procurement process and have now some new providers that we’d like to give the opportunity to talk to you about that today.  

So hopefully, it’ll turn up. So, what is DAPAR? Just so we’re all on the same page of what DAPAR is. DAPAR is, I guess a service that DSS funds and it stands for ‘Disability Abuse Prevention and Response.’  

Now this, DAPAR is for disabled adults who are experiencing abuse or neglect or are at risk of experiencing abuse or neglect. Our DAPAR service, we’ve done some development work on it. We have kind of two main focus areas that we’re going to be focussing on going forward.  

The first is about response for individual disabled adults. Second is support for DSS-funded organisations. I’ll go through a bit more about what those are in summary. That link there gives you more information on our DSS website.  

So, DAPAR for individuals. Anyone can refer any disabled adult to DAPAR. The disabled person can, their whānau can, providers can, NASCs can, EGL sites can, anyone can. You can make a referral to DAPAR for support for someone who is an adult (18 years or older), a disabled person / tangata whaikaha Māori, who is experiencing or at risk of experiencing abuse or neglect.  

We have three suppliers of the DAPAR service now: PASAT, a joint venture of Vaka Tautua, Te Ahi Kaa and Taikura. Those two organisations do the service for individuals and VisAble is the one that does the service for providers of organisations.  

So, we have two different kinds of responses for individuals. We have what’s called an intensive response. That’s when PASAT or the joint venture will work directly with the disabled person to help them to access the supports they need to live free from abuse and neglect, but more kind of direct relationship. And, or – they can do both – or either a multi-agency response which some of you may be familiar with. Whereas bringing together the disabled person, the family and whānau and other organisations in the family violence sector and the disability sector to help come up with a plan of collective action to support that disabled person.  

Just for clarity, I said ‘all disabled people,’ but here are the caveats. People who are not eligible for DAPAR are children. So, this is for adults only because Oranga Tamariki has the responsibility for children. Older people – if the person is over 65 and doesn’t receive DSS supports, we think it’s more appropriate to go to the existing elder abuse services and people receiving services under the IDCC&R Act – so, people in the RIDSS or RIDSAS services. They have existing statutory functions that support them for safeguarding things. So, we ask those providers to go to those roles as well.  

The second focus area for DAPAR is for DSS organisations. So, this is what we really wanted – is to support you all to build your safeguarding capability and what you do and help your teams be more responsive to situations of abuse and neglect of disabled people.  

So there’s kind of four parts to this, and this is delivered by VisAble. There’s a safeguarding capability building work that VisAble will be doing with all NASC and EGL sites between 2025 and 2027. So, each NASC and each EGL site should expect someone from VisAble to connect with them and talk to them about how they can be working together on building their safeguarding capability.  

VisAble will develop a website with freely available information about safeguarding and some resources that will kind of develop over time so that people can find wee gems to support your capability. They’ll also be providing a safeguarding DIAS (disability information and advice service), which is pretty exciting. They will respond to questions and requests for information. Then also VisAble will be able to provide some sort of targeted safeguarding capability for a small number of DSS providers, if that’s useful to you.  

That is an overview introduction to what the DAPAR service is going forward. You can find out all this and more information on our website or give us an email if you’ve got some specific questions.  

[Jacinda Allwood]  

Hi, kia ora. Lara, thanks so much for that. Now I will introduce the first of our three groups of speakers. We have Claire Ryan from VisAble and Claire is, I believe, the Business Support Manager and Training Lead for VisAble. 

Speaker One 

[Claire Ryan] 

Kia ora. Thanks Jacinda and kia ora to everyone. Ko Claire Ryan tōku ingoa. As Jacinda said, I work at VisAble as the Business Support Manager and Training and Development Leader. We’re getting used to our new titles. So, VisAble as some of you will know has been around for a few years. About two years, just over two years. And VisAble was founded by Sue Hobbs and Debbie Hagar, two people that you may be aware of in the sector. And so, we’ve been really lucky to be offered the opportunity to focus on the area of growing capability for DSS providers. As Lara said, for NASCs and EGL sites and other providers.  

So, we are a whānau of around eleven kaimahi. VisAble doesn’t have an office, so everyone works remotely. We work from home. Our CEO is Jonathan Totati, who some of you may know and our workforce are made up of three Voice and Choice Educators is the name that we’ve given to the kaimahi who’ll be providing training, education, support and resources to the community. The key thing about VisAble is that we are a disability-led organisation. I don't identify as having a disability, but there are whānau members, there are people who identify as tangata whaikaha and disabled people working for our service.  

So again, as Lara said – it’s good, Lara, you've given me all the points to talk about – is that we are developing and have developed a website that will be going live soon, which will be a place where you'll be able to come and download resources or look at information. Also make contact with us through an advisory-type option. I don't know how these things work, but we're going to have a chat bot so you'd be typing in a message to us and there will be someone on the other end to respond to your query, but we'll also be making sure that the website is accessible so that people can ask questions or seek advice in a variety of ways and is that we are going to be working towards becoming a family and sexual violence DIAS that is specific to the disability, tangata whaikaha Māori and whānau communities. So very exciting. 

What else would I like to tell you? So, because we are in and it's great to be a part of a bigger whānau in the DAPAR world, so we are all working together. But just acknowledging that we are still working out some of our systems, so please do let us know if things are feeling confusing or if you can, if you need support in how to make referrals, you'll be able to contact any three of us. That's certainly that we're working together as one whānau and we can't do this work alone, so we also need to hear back from you within the community. 

So, VisAble still does have a small number of tangata that we are supporting who are experiencing violence or abuse or neglect and we’re working with those whānau to transition or to transfer over to either PASAT or to the joint venture. So, that should all be wrapped up by the beginning of December, but it may take longer for some people, so we’ll let you know if you’re currently supporting any of those tangata and you’re not sure about the process, again, just make contact with us. Other than that, very exciting times.  

Training and education information has been lacking as a cohesive piece of work in this space for a long time, so it’s really wonderful we can all work together and share our knowledge and reduce and eliminate violence and abuse for disabled people and tangata whaikaha Māori.  

So if you do need to make contact with us, then the email address is inquiries@visable.co.nz. That will be the best way to make contact with us in the meantime.  

[Jacinda Allwood] 

You are absolutely perfect, Claire, and I'm loving the horses in the water of your background. Thank you so much. And for those of you watching, we will have the contact details for all of the different providers in a closing slide. So you can note them down later. And they will be put on the website afterwards, so that's great. Thank you. Thank you so much, Claire. Next speaker we have up is Oliver Halford, who is the general manager at PASAT, one of the other, the second of the three DAPAR providers. So over to you, Oliver. Kia ora.  

Speaker Two 

[Oliver Halford] 

Kia ora koutou. Yes, my name is Ollie Halford. I'm the General Manager with the Personal Advocacy and Safeguarding Adults Trust or PASAT, otherwise known as PASAT.  

So, we, just a very quick introduction to who we are as an organisation. We've been around since the late 60s. In 1967, we were established to provide lifelong advocacy services for adults, disabled adults for after their natural advocates in their life, their parents or guardians were no longer able to fulfil those roles. 

We continue to provide that service, and we've still got over 300 members enrolled in that service. But we closed our doors to taking on new enrolments in that work a couple of years ago. Since then, and that's by and much what all PASAT did for many, many years. 

Then back in 2017, we started doing a few other bits and pieces, started obtaining philanthropic funding to do short term advocacy where that was needed. So that's something that we still continue to do. And in 2019, we merged with the Safeguarding Collective and became, well, we were the Personal Advocacy Trust and we became the Personal Advocacy and Safeguarding Adults Trust at that time. And so that was in 2019, and since then we have been working with adults at risk, providing safeguarding services since then. So, we're very, very pleased to have the opportunity to be awarded the DAPAR contract and now have public funding to be able to carry on this work.  

We have advocates based in Auckland, Bay of Plenty, Waikato, Mid-Central, Taranaki, Wellington, Nelson / Marlborough, Christchurch, and Dunedin. And for the areas that we don't currently have advocates, we have advocates who are prepared to travel, so we've advocates who will travel up to Northland, we've got somebody who covers Hawkes Bay and they travel up to Gisborne, advocates in the South Island who will go out to the West Coast or to Southland. So, we are, we're in a stage where we've been able to use our existing capacity around the country, but we're also recruiting and we'll be continuing to look to see where the hotspots or areas of high demand are in the months that follow. 

So, we have both service components as part of our contract, the intensive safeguarding, and the multi-agency response. So, I thought it might be helpful just to sort of briefly touch on how on our model, how it's how it's looked to date and how we anticipate it will continue to look, unless we need to respond to different scenarios in a changing world. But we, as we receive referrals, the first thing that we're looking at is can they be resolved through intensive safeguarding through the use, through allocating to a local advocate or an advocate that can travel to meet with the person, the disabled person face to face, and go from there?  

If there are a lot of different people involved or a lot of different organisations, or maybe some complexities with some strong opposing views, those are some of the things that may indicate to us early on that we need to commence with a multi-agency response from the start.  

When we have a multi-agency response, that involves bringing everybody together that are currently involved, and determining who maybe else needs to be involved that aren't in the room yet and we will support the disabled person to participate in those meetings if they want to, or otherwise we would get an advocate to find out what their views are and bring those views into the meeting to ensure that the whole process is informed by the person who's at risk right from the start. 

Now we, the first part of that process is really defining and finding out from the disabled person who's at risk and everybody else in the group, like, what does safe mean for that person? Because the whole purpose of that multi- agency response is a collaborative and coordinated approach to ensuring that safe picture, that definition of safety for that person is met.  

And that can take some time. It depends on what we're navigating. Issues where we've got coercive control being carried out by people who may hold guardianship. Sometimes we wish and we hope that we can get people into safe situations as soon as possible, but it can, unfortunately, be a process. So we make sure that we've got an advocate with somebody along the way at every interval when that multi agency response convenes. One of the questions we frequently get is can I refer somebody if they have a guardian? Or a welfare guardian? And maybe there's concerns that the welfare guardian is the one who's perpetrating the abuse. Maybe there's financial abuse or coercive control elements.  

And so, like, the answer is always yes. And how we work out, you know, communicating that with the guardian is it gets decided within that multi agency team because the main thing is, if we can, we want to influence people to stop the abuse. That's the easiest pathway, for people to realise what they're doing and immediately stop and be part of that positive change. 

But I mean, we're talking about people being at risk. And so safety trumps privacy every time. So, I think if you want to, you'll be able to find our referral form on the website, PASAT.org.nz. On our safeguarding page, there's access to our referral document and then that gets sent through to referrals@PASAT.org.nz, or any of the other contact details up on the website, it'll all come through to the same place essentially. Otherwise, if you can’t locate our referral form on the website you can just flick an e-mail inquiry through and we'll be able to sort you out and get you get you referred. 

[Jacinda Allwood]  

Kia ora, Ollie. Thanks so much for that and for joining us on your phone today from your busy schedule.  

Third for the day, we have a couple of members from our joint venture. So, I would like to welcome Sonia Hawea, who is the Chief Executive of Taikura Trust, the overarching umbrella association, and Anna Redican-Kolose, who is the Chief Executive of Vaka Tautua. These also work in conjunction with Te Ahi Kaa to form the joint venture as the third supplier of the DAPAR services. So, I will hand over to both Sonia and Anna who I believe also have a – oh, there you go, I don’t even have to say it – a presentation that they'll be providing.  

As I said before, the slides will be available on the website after this forum and if you do have any questions while you're listening to things to the presentations, you can pop them in the Q&A as a written question, but we will address those at the end in the Q&A session, along with any verbal questions. 

Speaker Three 

[Moananu Anna Redican-Kolose] 

Malo le soifua maua ma le lagi e mamā. Fakaalofa lahi atu. [Samoan greeting] 

Fakaalofa lahi atu. [Niuean greeting] 

Kia ora koutou, ko Anna Redican-Kolose tōku ingoa.  

As Jacinda said, I’m the Chief Executive of Vaka Tautua.  

I’m here today with Sonia Hawea, Chief Executive of Taikura Trust to let you know a little bit about our new, small but innovative Disability Abuse Prevention and Response Service, which is a result of a partnership between Te Ahi Kaa, Indigenous Solutions, Taikura Trust and Vaka Tautua.  

I want to acknowledge also Danielle Oates, the Pou Ārahi at Te Ahi Kaa, who unfortunately couldn’t make it here today. But fortunately, she’s on lead for the first time in eight years so Sonia and I said we’ll come along today to represent our partnership. So, the partnership between our three organisations is based on knowing each other and trusting each other. We are like minded and we recognise the value of our unique relationship, which brings together our strengths as kaupapa Māori and by Pacific, for Pacific service providers.  

Collectively, we have deep experience working alongside people with disabilities, tangata whaikaha Māori, tangata sa’ilimalo and whānau. And collectively, we have the skills, the workforce, the systems, and practices to provide a service that is both culturally strong and culturally – I mean clinically strong and culturally responsive. Our organisations are all proficient in delivering culturally responsive services for the communities we serve and for all those who come into our services.  

Now onto service scope. Our service covers the intensive individual safeguarding response component and also the multi-agency response. Our service will be for tangata whaikaha Māori, tangata sa’ilimalo, and their whānau in the Waikato and Tāmaki Makaurau regions. Our level of response, our level of resourcing has necessitated that we take a phased approach to rolling out our DAPAR service to enable us to gain insights about the need and demand for our service. We will of course be working very closely alongside PASAT as their DAPAR has the nationwide coverage and working very closely alongside VisAble.  

The first phase for our service will be to connect our DAPAR service to those referred through the People For Us services delivered by Te Ahi Kaa and Vaka Tautua, and I think it was at the last forum there were representatives from both Te Ahi Kaa and Vaka Tautua talking about our People For Us services, which are also new, and so Te Ahi Kaa service People For Us service is actually starting in Kirikiriroa, so this is where our DAPAR service will focus during phase one for tangata whaikaha Māori. Vaka Tautau’s People For Us Service is starting in Tāmaki Makaurau, so this is where our DAPAR service will focus during phase one for tangata sa’ilimalo.  

So, as we gather data and insights about demand and our service capacity to respond to that demand, we expect to be able to expand beyond the People For Us services, which are currently focused in residential settings. So, we do expect that we will be able to move to other settings in the community, but we want to be able to roll this our in a phased way so that our small service can learn and adapt and set up a really good service and not be sunk by demand. That’s why it’s so important we’ll be working alongside you, Oliver, and your PASAT service. 

Speaker Four 

[Sonia Hawea] 

Malo. Tena koe Moananu. Tēnā koutou katoa, he mihi nui ki a koutou e tenei ahi ahi. Ko Sonia Hawea toku ingoa, he urihunga te Kahungunu ahau. No reira, tēnei te mihi atu ki a koutou. [Māori greeting] 

Kia ora, everyone. So, I pick up from Moananu and just share a little bit about where we’ve got to and the things we’ve been working on. Important, as everyone has said, are the partnerships and these services. So, that’s where we’ve started and we have made some early connections with Ollie and we plan to with the VisAble team as well, as Claire has said.  

There’s a lot of work to connect our services and have those discussions to ensure ‘no wrong door’ seamless process and that people have some genuine choice, engagement, with service providers, so many of you who are online today, kia ora. And that has already made some early starts through the People for Us services. I know Moananu has spoken to us about their team, Pania, and getting out there and meeting with organisations already. The NASCs and the two rohe: DSL, and obviously Kaikaranga, in Tāmaki Makaurau. We’ve had a good meeting with Barb and Esther in DSL.  

Next are going to be our wider system partners in this space, our growing voice and safety partners, as well, and the People for Us in assisting change space. And some of those important advisors in this space have also been mentioned before, who have mana and a huge amount to offer in the space. So, Sue and Dr Debbie Hagar referenced before. Those and others who have got some real value to offer are important to us on our journey, so those initial connections are being made. We continue to develop our approach and service model very much based on principles of our community ecosystems, whakawhanaungatanga, and we'll continue to work on those things together that we want to see tested and evaluated.  

Gathering information and insights is really important. So, through service organisations and also the backgrounds to people and families, what do we already know? What can we start to gather information about going forward? And Ollie has touched on how important it is to deal with that in the right way.  

Establishing our services infrastructure has also been a focus for us. So how we will connect as three partners in this initiative, and recruitment is well underway. I think Moananu touched on the intensive response service being led by Vaka and Te Ahi Kaa as providers of People for Us service, but they’re recruiting specifically for our DAPAR service as well. So, they’re well down the track with their recruitment and we’ll determine how we’ll want to engage around the multi-agency response, and we want to do that very much in collaboration with partners, particularly those working in the DAPAR space.  

Also, about how we present our service. So, how we're going to establish our profile out in the community so it's easy for service partners and whānau to find us. So, contact information and referral pathways and we've got some information that can be used from today so that you can still make contact with us from straight away from now.  

And finally, our name – because I don't think we want to be called the ‘joint venture’ forever. And so, today is where we're going to unveil our ingoa, our name of our collective today. And as Moananu has acknowledged, she mentioned that our third partner, Danielle, unfortunately, is away, so couldn't join us, but want to credit Danielle with giving us our name and for her service. So, this has all come from her beautiful whakaaro. So, this is my last slide before the contact slide, mindful of time. So, the name of our joint venture collective is AroVā, and AroVā is a statement of intent. It's made up of two words, Aro and Vā. Aro means to turn towards an action, a readiness, a way of being present. It's the spark of recognition, the first turning of the heart towards someone in need. It's the courage to notice, to pay attention and to act.  

And Vā speaks of the sacred space of relationships. It is balance and harmony between people, holding both connection and respect. 

So AroVā embodies aroha, manaakitanga, and the sheer duty to protect. It is both a call and a response to notice, to care, and to move, to take action. So, we're thrilled and feel very blessed and honoured to have this ingoa with us. And you're the first all to hear it, other than ourselves.  

And our final bit of information is how you might contact AroVā until we establish our own space. We're going to, we can offer that through this e-mail address which I know Angela will put in the information that comes out at the end. And if you could pop in that e-mail address that it relates to the DAPAR, then they'll like enable us to make sure that our team can pick that information up and we can respond. And when we do have new contact information, we'll make sure that's shared through MSD and other channels. Kia ora. 

[Jacinda Allwood] 

Kia ora, Sonia and Anna and the AroVā team, who have put a lot of work into getting this established. Thank you also to Ollie from PASAT and Claire from VisAble. So, you've now heard from the three suppliers of the DAPAR service. Very comprehensive, great information about how to contact, which I said again will be provided at the end of the session, but we do have the bit of time now and space to answer any questions that anyone in the audience has. 

We don't appear to have any at the moment, but you can pop into the Q&A function which again if you missed the start, there is a little tab up the top called Q&A. If you press on that it comes up with a list down the right-hand side of your Teams forum call where you can have ‘ask a question’ in a written format.  

So, beside your name, you should have one of the options is to ask a question if there's not showing, please use the downtick arrow and type in any questions that you have. You can also ask a question by raising your hand and we can ensure that your microphone and your camera are enabled so that you can turn those on and ask any questions of either us here at DSS, Lara or myself, Ollie, Claire or Sonia and Anna around the DAPAR services.  

I guess one of the things from our Quality Assurance team perspective is that we have started the new process of when we assess critical incidents that you as providers report to us from your services. If we identify any of the situations as being suitable for a DAPAR response, we have a process in place where we contact providers directly from DSS to suggest that you as providers who are close to the situations, closest to the disabled people involved, that you make the DAPAR referrals yourself and provide you with the necessary contacts for either the joint venture, which I'm not allowed to call it anymore, AroVā, thank you, and / or whether it's more suitable as a PASAT referral, depending on the region of the disabled person where they are being supported or their cultural identity. You can also obviously refer people yourselves or others, advocates, supporters, family and whānau can refer to the DAPAR service.  

So just looking at my colleagues here at DSS, Angela will turn on her microphone and her camera and ask the first question.  

Q&A session 

[Angela Desmarais] 

Kia ora. We have a question from Katie asking what people in supported living, regarding people in supported living, which agency do you recommend or expect an individual to be referred to? I guess, would it be VisAble, or another DAPAR service?  

[Lara Penman] 

Ollie, that’s probably PASAT, isn’t it? Do you want to talk to that?  

[Oliver Halford] 

Yeah, so I suppose just so VisAble are working with providers and assisting providers with their own, the way they conduct business in a way that takes into account safeguarding principles. When you're looking at referring, if you've got an adult where there is a situation you're concerned about for that adult and you're wanting to refer them to a DAPAR provider for either intensive safeguarding or a multi-agency response, then whether they live in supported living or in residential services or in a contract board situation or in the family home, none of that matters, really.  

What it is - we're, I suppose geography first, because we're operating nationwide. So, if the person isn't residing in Auckland or Waikato then PASAT are really your only option. Unfortunately, there's no choice, it's just it's just us in those circumstances, if the person lives in one of the areas that AroVā are working in then I suppose it's, does that person, do they want a kaupapa Māori or a ‘for Pasifika, by Pasifika’ response? Is that appropriate? Is that what the person would like?  

And then I suppose it also depends on where AroVā are in their referral intake process because as they were just sharing, they're currently looking at just through working with people that are coming through their People for Us service currently. I mean, I anticipate, like we've already had conversations that we will be talking with one another. So, if PASAT receives a referral for someone that we really feel that they do need that kaupapa response then we would be having that conversation and checking in with AroVā at the time a bit about it. So, I think either one of us would suit but yeah, defer to my AroVā colleagues there just to verify that that's the way that you guys are seeing it. 

[Sonia Hawea] 

We’ll have to work this part out too. But yes, I think you’ve captured it, Ollie. That’s what we want to ensure the best response. People’s choice and working through what those options are.  

[Moananu Anna Redican-Kolose] 

Yeah, I agree. I mean, I think the point made in the scope of ours and I think it relates to the next question, is that the capacity for AroVā is starting out pretty small. So that's why we're being, we don't want to get overwhelmed for us, for our small service. So, but obviously we have, we always as a kaupapa Māori and by Pacific, for Pacific organisations, we always tend to go the extra mile for our family, people and families that need us, but I think we just want to make sure that we're working like one big service. So, we need to work with our other partners, like PASAT and make sure that we have some a system that's doable and yeah, and responsive. 

[Oliver Halford] 

That may be that we get advice. You know, if you’re not in a position to take on a referral and it’s what a person’s wanting, it may be that you support us to work with that person until I met and transition over.  

[Moananu Anna Redican-Kolose] 

Yes. And obviously, if the demand through the People for Us service isn’t want we think it might be, if it’s low, well then we’ve actually got, we’re going to have capacity. So, it’s just more for us about being able to manage that capacity.  

[Jacinda Allwood] 

That’s great. 

[Angela Desmarais] 

And I have a question for Sonia. When you were – two questions in one. When you were talking to your slides, there was a mention of provider profiles and resident profiles. Is that in relation to the People for Us programme? And regarding the resident profiles, is that all clients of residential care or only those for whom potential abuse has been identified?  

[Sonia Hawea] 

Good question. I was typing my answer, but you got to it quicker, Angela, thank you. Thanks, Lisa, for the question. The idea was to have a sense across Waikato and Auckland of the potential for, you know, the size of the population that may be necessary. And both, I guess residential, but potentially community as well, Lisa.  

So the first look at where our tangata sa’ilimalo and tangata whaikaha are, just to make that that visible for us as a collective and just in terms of high-level estimates, we haven't yet got through these other than the formal referral process for identifying particular issues that will come through the process that was, is being established.  

So, I know the People for Us is a peer support and there may be referrals to a DAPAR service if there is an issue that needs to be worked through using the response and /or the multi-agency part of the service. So those are the types of things that we'll try and work through, but it was more a broader view about the potential so we can sort of help with the things we want to help influence is greater awareness of the need for services like these for tangata whaikaha and tangata sa’ilimalo. So, it's part of that visibility that answers that, Lisa. 

[Angela Desmarais] 

Kia ora, Sonia. We’ve got another question here asking which agency is most appropriate for disabled adults to contact if they have concerns about abuse by a paid family carer under self-managed funding arrangements, such as individualised funding or choices in community living.  

[Lara Penman] 

Ollie? 

[Oliver Halford] 

I’d look to first answer, as I think any of us, right, like, I just wouldn’t want anyone to stop and think, who should I contact? I think first answer is contact any of the three organisations here and they’ll get the information, and they’ll help the person get to the right place from there. 

[Claire Ryan] 

Yeah, I’d agree that if you’re wanting some initial advice that you know any of us would be able to answer that, and we will be working together so we can refer on or it might, it may be an education opportunity for the provider or all sorts of things, so don’t hesitate.  

[Angela Desmarais] 

Kia ora, we do have a question here. It’s been touched on already, but just in case there’s any of our speakers who would like to expand on that, someone was asking about capacity for the providers because they understand there have been waitlists in the past for individual support. If there’s anything else one of our speakers would like to expand on.  

[Oliver Halford] 

Yeah, I mean I can. It’s a hard one to speak about because it’s always in a state of flux, right, because capacity is always dependent upon how many of referral have come in in the last sort of few days. We meet twice a week to discuss all referrals and then allocate them from there. So, we're looking at the template doesn't require you, our referral template doesn't require the person referring to give some thought around, am I referring for an intensive safeguarding or a multi-agency? We want to know what the issues are.  

So, we're getting that information about issues and what the alleged abuse or neglect, or abuse and neglect that you're concerned might be happening. We want to find out what that is and then we work out what our response is from there. So, we may have, I mean, right now we don't have, we don't have a waiting list right now, but there might be areas that, if it's requiring an advocate to visit and it's in a geographic region that requires some travel that we're not going to be able to respond immediately.  

We may have, look, we probably, we've got some training happening at the moment. So, we might be a couple of, or two-week turnaround by the time that the referral comes in and us getting underway, but it does depend on the area.  

The other thing I’d say is we are at a point where we’ve built capacity and we’ve got capacity around the country, but we need to see where the hot pockets are. We need to see where we don’t want, we need to be responsive as well. If we’re noticing that there’s areas in the country where there’s a lot more need. So yeah, sorry that’s the best I can probably answer that question for now. 

[Claire Ryan] 

Yeah, I was just going to add that. Part of VisAble’s mahi in the space, and I think, again, it’s probably for all of us, but at VisAble we are also working with non-disabled family and sexual violence services.  

Disabled people and tangata whaikaha Māori have told us that they are wanting to use mainstream support services as much as what is on offer through DAPAR. So, VisAble has a contract for the next year through the Centre for the Elimination of Family and Sexual Violence, what was Te Puna Aonui to do training with mainstream services. So again, we’d be working with our partners in the DAPAR space to find out what providers are in the area and upskill those providers around disability access, etc.  

[Angela Desmarais]  

Thank you, Claire. There don’t seem to be any other questions in the Q&A chat. If anyone does have anything else they would like to ask, feel free to enter a question or raise your hand. Otherwise, we’re at the end of this webinar. There will be contact details for the services or the organisations that are speaking today, and also quality@msd.govt.nz. 

Closing 

[Jacinda Allwood] 

Great. Thanks so much, Angela. And so, you've just been hearing from Angela Desmarais, who's one of our new principal advisors who's in the Quality Improvement team here at DSS. So, it's great to have you on board, Angela, and we will encourage our staff to be involved in these forums so you can get to meet a few of us as we roll them out every couple of months or so was the original plan for forums.  

So yes, we do have no raised hands, so no one has been game to speak up verbally today, which is absolutely fine. And I think we have answered all the questions. So just giving another couple of seconds to see if there's anyone who would like to answer and ask another question. 

And there are none so, I think we can wrap up the session for today and give everybody a little bit of time back in their calendars. It was fabulous to have our presenters here today. Thank you so much to my colleague Lara Penman, Angela, for the questions. A big thank you to Ollie from PASAT, Claire from VisAble, and Sonia and Anna from AroVā, the three providers of the DAPAR service.  

If you have any questions, as we have said, we will be about to now put up the closing slide for this forum, which has the contact details that have been mentioned throughout. And if you also want to come back and review this forum, or have a look at the transcript, or if you know of other people who missed today's session, please direct them through to the DSS website because we do post them once we have written up the transcription. For those who prefer to read rather than listen to verbal forums.  

So, it’s been a pleasure having you here this afternoon for our fourth forum. I think we got up to about 125 participants, which is excellent. If you have any questions, as I said, contact any of the contact details on the slide, or you could always contact us at DSS, quality@msd.govt.nz. 

So, I will close us out with a closing karakia and wish you all a very pleasant 14th of October evening.  

Kia whakairia te tapu   
Kia wātea ai te ara 
Kia turuki whakataha ai   
Kia turuki whakataha ai   
Haumi e. Hui e. Tāiki e! 

Closing slide: contact details  

VisAble: www.visable.co.nz  

AroVā: enquiries@vakatautua.co.nz (subject line: DAPAR) 

Joint Venture: Vaka Tautua www.vakatautua.co.nz/people-for-us  

Joint Venture: Te Ahi Kaa www.teahikaa.co.nz  

PASAT: www.pasat.org.nz  

DSS Quality Assurance and Improvement Team: quality@msd.govt.nz  

[Jacinda Allwood]
OK, Kia ora, everybody. Ko Jacinda Allwood tōku ingoa. Hello and welcome. I'm one of the principal advisors here in the Quality and Performance team here at DSS and would like to welcome you through to the second of our forums that we're running for 2025

I'll be opening up with opening karakia. I'll be following on with some general housekeeping and instructions for you, and then I'll introduce Sue Sherrard, who is the first speaker of the session from DSS. She will introduce the topic and she will introduce the speakers thereafter.

(Karakia)

So welcome everybody. You will have been entered into this DSS Quality Forum. The topic is the Growing Voice and Safety Initiatives. You will all have your cameras turned off and your microphones turned off.

And fortunately, or unfortunately, you are unable to adjust that at this time, so they will remain off. We will be taking questions in this forum and we will be using the Q&A function -  so in the top of your screen, please click on the Q&A function button. We have actually disabled the chat for this forum, so there's only one function that we will be running the questions and answers through for convenience and so we don't get all confused.

When you go into your Q&A function, you should have a little icon with “Ask a question” which sits beside your name or your initials or your photo if you're there.

If it doesn't say “ask question”, and if it says something about start a discussion, please tick on the down arrow and click on “Ask a question” because otherwise we won't be able to manage the questions properly.

Are there any other instructions that we have? If you want to ask a question, please do so throughout the course of the discussions while people are speaking. If someone has already asked a question that you would like to ask as well, please don't add it in, because it might get quite tricky to manage that with so many people on the call. We have about 100 and.10 people at the moment, which is fantastic.

If you are interested in hearing the answer to a question that someone else has asked, there is an upvote button to the left of the question when it pops up in that Q&A function. There will be a little up arrow, and if you hover over that it will give you a vote, so you just click on that to vote for that question. So please use the upvote button and I will reiterate this later when we get to the Q&A section.

After we have the speakers, we will then move into the Q&A session for the first topic that we're talking about, and then we will introduce the second topic with the speaker and we'll do questions on that second topic afterwards.

But Sue will be explaining all that, and again, I'll reiterate how the Q&A function will work when we get to the time. We will also allow people to ask a question verbally if that's what you would like. So please use the “raise your hand icon”, click on that, and we will try to get to questions that have come up in order. So click on your raised hands and make a note of the question that you are going to ask, so you don't forget by the time we get to you. If we don't manage to get to all the questions, we'll cover some off at the end of the session if there's time, or we will definitely put them on the DSS website when we post the video of this forum.

So that was the other thing. We are recording this forum and you will have all had to to select that you're OK with the forum being recorded before you ask a verbal question if you choose to. I'm happy to manage that so your voice just appears and not your camera, but we can manage that at the time.

You've heard enough from me. I'm sure you want to hear more about the topic at hand, so I it is my great pleasure to introduce Sue Sherrard to you. Sue is one of the principal advisors in our Quality and Performance team at DSS and she will introduce the topic. Over to you, Sue.

[Sue Sherrad]
Kia ora, Jacinda. Thank you so much and thank you to everyone for being here this afternoon. It's a huge pleasure to have this opportunity to talk with you about the Growing Voice and Safety initiatives that the Disability Support Services are developing.

I'm Sue Sherrard. I am, as Jacinda said, a principal advisor with our DSS team. I identify as a disabled woman and I've worked for many, many years in the disability sector.

This is exciting times. Let me tell you a little bit about one of the services and this service is called People for Us. And after we've had our presentations around People for Us, then we'll move into the assisting change topic.

So People for Us is a peer visiting service and it's a really exciting opportunity. We think it's coming out of the quality space because we really want to have the voice of disabled people included in our quality services.

So way back in ‘23, we really did a large engagement around this People for Us idea and we talked with over 420 people and really got a positive go ahead that People for Us sounded like a great idea. We took that information, and we worked alongside the Insights Alliance and developed this new service.

From there we had a procurement process, and let me tell you that takes a long time, and came out with three wonderful suppliers who are working in partnership. and collaborating together, and they're going to talk to us this afternoon about their approach to this People for Us visiting service. I really want to acknowledge the members of the Insights Alliance, and for Lara Penman, who really was significant in the development of this work. And of course my co lead who has sadly left at this point in time, but Kate Cosgriff, we couldn't have done this work without you, Kate, so thank you.

What is People for Us? Well, it's a peer service who will visit disabled adults, tangata whaikaha Māori and Tagata Sa'ilimalo, who were also disabled Pacific people and whānau. It's about visiting people who live in a DSS contracted residential service to find out - and this is our priority - to find out if they are safe, living their good life and experiencing high quality support and services, they will assist those with safety or well-being concerns to follow the relevant pathways to resolve them.

This really grew out of wanting to increase the voice of disabled people and their safety. We know that disabled people experience higher rates of abuse and harm when compared with non-disabled people. And the Royal Commission of Inquiry into Abuse in Care also recognised that inadequate monitoring and support for well-being contributed to the abuse of disabled people in care. This is a really important service, and we believe it will have quite an impact once we start working alongside those people in residential services, so this is an opportunity.

Safeguarding is about protecting a person's right to make their own decisions about their life, including decisions about their safety and well-being. It means taking action to prevent, identify and respond to situations. Where a person is at risk, or experiencing at risk of or experiencing violence, abuse or neglect, People for Us as a DSS safeguarding an initiative that is about identifying and responding.

What will People for Us do? Well, disabled peer workers will visit disabled adults who live in residential services to find out if they are safe, living their good life and experiencing high quality support and services.

They will assist those to who need some kind of follow up into the relevant pathway to resolve issues. Peer workers is a new role in the disability support system. The peer worker is a disabled person or tangata whaikaha Māori, employed to check in with other disabled people regarding their well-being and safety. The peer role is different to other roles in disability support system, including the support worker, a mentor, a connector or a navigator. And People for Us is a free service.

We've got some speakers who are coming to talk about how they and their service is going to really deliver the People for Us work, so I'm not going to say too much more about it. I am going to take this opportunity to again, thank you for coming and being here.

And I'm going to pass over to Gary from People First to talk about their delivery of the people for our service. Kia ora, Gary.

[Gary Bashman]
I'm the manager of People for Us at People First New Zealand. People First is a disabled people's organisation that's run by and for adults with learning disabilities or intellectual disabilities. We've got members across six regions and 41 local groups around the country and all of our members have a learning disability. One of our Kaupapa is about learning about rights and self advocacy.

And because of this, and because the majority of people in DSS funded care have learning disability, we were really interested in being part of People for Us and submitted a tender. And clearly with my presence here, we were successful in that and since that time we've been working to establish the service. I just thought I'd talk you through some of the steps that we imagine - how the visit will happen, and then talk very briefly about what this means for you as providers and members of NASCs.

So the first step is that we will either be contacting a provider about a visit which we are calling a proactive visit, or we'll have received a referral from either an individual, a self referral or a third party. We'll then contact you about setting up the visit because obviously we need to be able to talk to you before we come into one of the houses that you're responsible for.

As Sue's mentioned, the visit team will be a person with a disability, and it’s been announced since we're having a two person visiting team, a peer with a disability and an assistant for that person. At the moment we're thinking the visit consists of three kind of separate parts, some whanaungatanga.

We need to get to know people, understand who they are, and they need to understand who we are. We need to talk to them about getting consent for the information or the conversation that we then have with them. And then we want to have what's we're referring to as a guided conversation, focusing on the points that Sue mentioned -  safety, living a good life and receiving quality services and support.

After we've had that visit, we'll determine if any action is required. We're doing a bit of categorisation work around that at the moment, so we're sort of assuming that we will make some kind of determination based on whether actions needed for the individual in relation to their relationship with the provider, whether there's a safety concern, or whether there are systemic issues that might have arisen for safety.

Once again, Sue's mentioned that will probably be a result in an escalation to a third party, and almost certainly that will be the case. We're just trying to work out some of the detail of that might be that we're organising a meeting with, you know, the people in this audience or staff in the House to discuss issues raised by the person we visited.

That would only be with the permission of the person that we have visited as well. Or we might be working with the individual and or their whānau to help them develop some knowledge about their rights and self-advocacy, you know, building up their skills as well. We think the point of this, the key I guess, is doing something that keeps a person safe and or makes a difference in their life.

In terms of the relationship with providers, I guess some key points we wanted to put out there. First, we're not an audit. We're more interested in safeguarding, looking after the people that whose voices don't often get heard and saying that, we're very much centred on the people we're visiting.

This needs to be about them from our perspective, but we also realise we need to be working with you and providers and NASCs to make this happen. Our ideal is that you end up seeing us as a service that adds value for your residents and you'll be welcoming us in.

It's one of those situations that, you know, especially the people in this audience, you can't always be there to talk to the people in your houses. So we're hoping that we can be the people that can have those conversations and find out what's happening for those people in their lives.

A really quick overview of what we're doing. We're one of three providers as noted working really closely, but I think the idea is that we bring our individual flavour to how we work. So I'll pass you back to Sue to introduce the next presenter.

[Sue]

Kia ora, Gary. Thank you so much for that introduction from People First. Appreciate it. And with great pleasure, I believe we are going next to, uh, Warren from Te Ahi Kaa. So welcome, welcome, Warren. Lovely to have you with us. Kia ora.

[Warren Katipa]

Kia ora Sue. Ngā mihi atu kia koe, o mihi kia ā rātou. Tēnā te mihi, tēnā te mihi atu kia koutou. 

Thank you for having me on. My name is Warren Katipa, from the Waikato and I work for currently the operations manager for Te Ahi Kaa. And I'll be taking you through just a little bit about People for Us. I just want to say that's carrying on from Gary. I think Gary said most of it of what what we do.

Just who is Te Ahi Kaa? We're a Kaupapa Māori provider located in Te Puaha, Waikato down in the toward the Port Waikato region. We're established back in 2016 with the vision from our kaumatua and whānau and we deliver a range of different health and social services, including having a rongoā clinic in our in our premise, but we have services grounded in mātauranga.

Just to expand on also with Te Ahi Kawi, I suppose you could view it as being coming around a fire to be able to solve solutions for the community. So just with our our framework that we're taking in regards to people, People for Us is using the Te Paerata framework. Obviously we're taking control of the taiao or the environment.

And then being able to be the kaitiaki for the region, the area that we're working in, looking then seriously into whakapapa, where people were from and our whanaungatanga, being able to you know bringing all our whānau together, but the ultimate goal of being able to unite in the pursuit of mana motuhake – or to be self-determining. So that's a framework that we're going to push in terms of how he would roll out People for Us. As Gary mentioned, he's mentioned a lot of different processes and we'll be following similar ones, however, we'll be following this particular framework.

Just in regards to some of the processes that we would also consider is similar to actually being on a marae, we would walk through in terms of right from the front gates in terms of the waharoa from the car park, establishing intentions and trust our karanga with respect and inclusion through the recognition of others and their roles and contribution, that when we also then get welcomed down through the whakaeke, being respectful and mindful in these spaces and being ready to engage coming into this this space. Then we have our mihi and we have our speeches, sharing our stories and our intentions.

And obviously with the way out to supporting and strengthening that that bond and connection and that's where we bring in the Hongi, pressing of the noses and building the close relationships and trust is probably the main things that we want to build with our clients. So and then finally finishing off with most of those things that we always have as the hākari is the feast. To me that was where we do the whakanoa. We really bring everything together, celebrating partnership and collaboration. And then we have the poroaki, which is a farewell, ending with respect with future intentions and just so a couple last things, the final wrap up of these things.

So Ti Ahi Kaa will be starting the Our People for House programme in Kirikiriroa, in the Hamilton region and over time we'll expand it to the greater Waikato region. We're going to start small and then build from there because we want to ensure that we get the right processes, and look after the clients because they deserve to be looked after the right way. So we want to make sure that we have our systems in place to be able to continually look after our kaitiaki.

We also have our website up and running for more information about People for Us providing pathways to other things that we can look at for looking after our kaitiaki and making sure they're well established.

And then being able to, you know, having that lovely space in Kirikiriroa for you to be able to come down, visit us, have a cup of tea. And as my CEO Danielle said, and you hopefully you should be lucky to actually come out and actually have a fried bread.
'Cause you know when we have that kai, that kai brings us all together with lovely, great intentions and to be able to actually have the right intentions and that is looking after our people. Kia ora tatou.

[Sue Sherrard]
Kia ora Warren, thank you so much. Really appreciate your korero this afternoon and obviously that you have stepped in at short notice, so we acknowledge that and thank you and our hearts are with Danielle at this time.

It's my great pleasure to now welcome Tevita, and Tevita is going to introduce himself and he is from Vaka Tautua. So warm Pacific greetings, Tevita. Lovely to have you with us this afternoon.

[Tevita Tuita]

Kia ora koutou katoa, warm Pacific greetings ‘Oku ou fie tuku ‘ae faingamalie ko eni ke fai ha fakamalo ki he DSS koe ‘uhi koe faingamlie ‘oku ou pukepuke he efiafi ko eni keu fai ha talanoa mei he Vaka Tautua fekau’aki moe polokalama ngaue People for Us.

(English version: "Greetings to you all, warm Pacific greetings. I would like to take this opportunity to express my thanks to the DSS for the opportunity I have this afternoon to give a talanoa from Vaka Tautua about the People for Us programme.")

Thank you Sue, kia ora koutou katoa, warm Pacific greetings.

As I mentioned, my name is Tevita Tuita. I am the team lead for People for Us here at Vaka Tautua and I'm going to take you guys through a few slides on my presentation.

I also wanted to talk to you guys about Vaka Tautua, who Volataua is.

Volataua is a Pacific for Pacific National Pacific services for mental health, disability and social services. We operate in Auckland, Canterbury, Otago and Wellington.

Here is our workforce, our Pacific workforce. We we are madeout of community social workers, community navigators, peer workers, community support workers. And we work along across services, as I mentioned, mental health, disability, social services.

We are honored to be part of People for Us, as it has been mentioned that the People for Us was created in response to finding from the Royal Commission of inquiries into abuse and care. But what we as Vaka Tautua are best interested in is to
look at utilising or delivering this service into our Pacific community to have an impact, to show the light and help our disabled community to uphold their rights, to enhance their mana and their dignity and to look at what good lives look like for our disabled community. We deliver this work by listening to people are not often not heard, in their own views. We built trust and relationships with them, not only the tangata, but with their family, their support networks, the provider that support them.

As our safeguarding Pacific holistic approach, we look at safeguarding everyone and make sure that we're there. As mentioned before, we're not an audit service, but we're there to support the tagata sa’ilimalo and the aiga and also the provider that we work with, we're committed, we're cultural and communication responsiveness. So we ensure that our Pacific values is incorporated within our service delivery.

How do we do this work? As mentioned, delivery is led by peer workers with lived experience to have a conversation with tagata sa’ilimalo in Malo and DSS funded homes. We use the Easy Read materials, the resources to enable us to communicate with them and to have a better understanding through talanoa using these these materials to unfold the unmet needs in those homes, and for us to be able to work with them, identify the needs and then work with them towards looking at the brighter future, as I mentioned.

We focus and give them hope, give them life, give them, give them light and uphold their rights. We engage with tagata sa’ilimalo and their families, and as I mentioned in residential disability providers. We also work alongside the whānau. The whānau and the ‘aiga are really important in their life. We're the secondary support system. We need to work with them with their support networks. We also support pathways when concerns are raised - response pathways. So we have that in place that we identify concern in regards to neglect, harm and abuse. We follow our response pathways.

Our Pacific strengths in action.

 We draw into our Pacific shared values. As we believe as a Pacific organisation, we hold on to our Pacific shared values. For example, the alofa, respect the vā, the talanoa. We engage better with Pacific people through our talanoa, and the talanoa approach is we tell the story or we talanoa until it's finished.

When it's finished, that's when we look at the bigger picture of our disabled person and how can we better support them through our integrated model of care. Then we can navigate through the system to make it work for them. We collaborate with families and providers, tagata sa’ilimalo stories shared and treated with care and confidentiality. Privacy is one of the things that’s a barrier for Pacific people, but knowing who works for Vata, knowing who's there in our Pacific workforce and it's all about the the the privacy of the the information, sharing the information. So we have a better system that we protect the privacy and the stories of (our community).
I want to ensure that they are in a safe, safe space in our hand and in our practice, empowering people to recognize their rights and well-being. Yeah, so that's how we we deliver this very important mahi and our Pacific Space.

And the last one slide is how we think about this very important work together. We make the difference to People for Us. It's not just a service, it's a movement of safeguarding. We honour the Pacific disabled voices and let's continue to uplift, protect and stand alongside our communities. Thank you so much.

One more thing, People for Us deliver across regions. Thank you so much.

[Jacinda] 
Kia ora, Tevita, thank you so much for your presentation.

So now that that comes to the end of the three providers of the People for Us service, and while I'm introducing the Q&A part of the session, we've got a few minutes set aside at this point to ask specific questions around the People for Us service and those questions can be directed to any one of the providers.

Our spotlighting expert will be looking after spotlighting - Sue who will manage any questions that come in, as well as the three providers that you've heard from so far. We don't have any questions in the Q&A function as yet, so whether or not nobody has any questions or you're not able to use the Q&A function, which is not ideal, so hopefully that's not the case, but we do have the option for people to raise their hands as well if you would like to ask a question verbally.

So we'll just give everybody a minute or two. And we'll start with the written questions that have come through through the Q&A function. So um, we will commence with the first question and our colleague Solmaz Nazari will be reading out those questions. Thank you.

[Solmaz Nazari Orakani]
Yes, I am Solmaz, I am Senior Advisor in Quality team and the first question is can you please reiterate the areas that the providers are operating in.

[Sue Sherrard]
Kia ora Sue here. Um, I think, uh, Tevita, you said that the area you were working in was Auckland and Warren said, I think that, um, Te Ahi Kara is starting out in Kirikiriroa Hamilton. And Gary, would you like to talk about People First?

[Gary Basham]
Kia ora. So we're a national provider, so everywhere, but we're starting our build in also in Kirikiriroa, here in Wellington, in Christchurch and Ōtepoti Dunedin. So be the four places that we're starting very soon, but growing to be national.

[Sue Sherrard]
Kia ora. Thanks, Gary.

Solmaz Nazari Orakani
Kia ora, thank you so much. And the next question is, how is this similar or different to the DAPAR contract?

[Sue Sherrard]
OK, so People for Us is again similar to DAPAR in some ways, in terms of it's not a crisis service. This service is about visiting people in residential service and working with them so that we can understand, and they can understand, what their current experience is in terms of their safety and their well-being and then working towards response pathways should that be needed.

One of the response pathways will be into a DAPAR service, and so we are currently in contract negotiations around who will be providing the DAPA service and so that's just one of the response pathways. Others will include family a whānau. Possibly NASC and EGL sites, maybe things like health service or social service. So there's there's a variety of different ways that People for Us will refer into different response pathways.

[Solmaz Nazari Orakani]
Thank you, Sue. Kia ora. And uh, the next question from, uh, one of our attendees. So Jay's asked about what is the referral pathway please.

[Sue Sherrard]
The referral pathway that's at this point in time is still being really finalised, but each of our providers will be available through their websites.

And I know, uh, Vakatoto, I think you said, um, Tevita, that your website was up and running or was that you Warren? Would one of you like to comment?

[Tevita Tuita]
We're working on, sorry, we're working on a website and the electronic referral process. Thank you.

[Sue Sherrard]
Warren, would you like to add a comment there from Te Ahi Kaa?

[Warren Katipa]
Yes, it's the same with us. We're just currently in the process on how to make it a lot more easier, especially with the referral process.

[Sue Sherrard]
Nice. So people can refer themselves, family can refer, anyone concerned can refer into the people for our service and then we will also, as Gary talked about, be reaching in and visiting through the provider networks, Gary, would you like to make a comment around that?

[Gary Basham]
I think like everybody else, we're building a website. We're also exploring an 0800 or a free phone number for people as well. We think we might learn a lot of different ways about how people want to refer, and we want to just be responsive and as Warren said, make it as easy as possible for that to happen.

[Sue Sherrard]
Kia ora. Thanks, Gary.

[Solmaz Nazari Orakani]
Thank you so much.

[Sue Sherrard]
I think Tevita just wanted to add something.

Solmaz Nazari Orakani
Yes, sure.

[Tevita Tuita]
Yeah, I just wanted to add on, while we were working on our website and all that anyone can just ring up 0800 825 282 and be put through to myself during work hours and then we will create a pathway to engage with those inquiries into People for Us. Thank you.

[Sue Sherrard]
Kia ora. Thanks, Tevita.

[Solmaz Nazari Orakani]
And we have one more question. Can you please detail your plans to connect with people living in services who experience significant communication barriers?

[Sue Sherrard]
Nice. This is really important because it is the population that we are most concerned about and really want to get alongside. And so how people communicate is really critical to the service and the success of really bringing their voice and their experience into this space. So we've doing some training and working alongside people. I'm gonna throw to you, Gary, to see if there's some other things that you've been considering.

[Gary Basham]
Yeah, I mean, as you say, it's super important doing a lot of thinking about this. We've got a meeting next week with an organisation called More Talk who specialise in speech and language therapists who specialise in working with people with different communication styles. Where part of People First is Easy Read as well. So we're making sure that a lot of our information is in the Easy Read (format) so it's easier for people in particular with learning disability to be able to absorb that, but we sort of recognize that we're going to have to involve wider people around the person that we're visiting potentially to make sure that we are able to, you know, understand and hear the stories that they've got to tell us.

[Sue Sherrard]
Oh, nice one. Thanks, Gary. Appreciate that. And I see Jacinda is waiting in the wings. Kia ora, Jacinda.

[Jacinda Allwood]
Kia ora, Sue. Thanks so much for that, and thank you for the questions that you've posted in the in the Q&A function. Everybody, we will move on to the Assisting Change service now just so we can cover off the information that we've got for you. But we will come back to some of those other questions if we have time at the end.

So I'll hand back over to Sue to introduce the Growing Voice and Safety Assisting Change initiative and our speaker. Thanks, Sue.

[Sue Sherrard]
Kia ora, Jacinda, thanks so much. I'm feeling very, um, just so excited to be able to also introduce the assisting change work that has been going on now for maybe five months or so. I'm looking at John who's nodding at me. So yes, Assisting Change is again, a quality initiative and it's about how can we support providers with quality questions, concerns, issues possibly in ways that are useful to providers.

We know as the quality team that there are various ways quality issues come into us and we become aware sometimes of more and it's this. This service is not so much about individuals, but it's about providers and recognizing that sometimes there are patterns that we can recognize within the quality team. And so we can often pick up issues. Also our portfolio managers within DSS come to us with questions about “0is this an issue that perhaps assisting change could support if it is?”.

Then we contact to Te Pou Wairoa, who is the provider of the Assisting Change work and they will work together and I'm going to get John to talk about how they do this.

But really, it's about setting up systems to support providers to manage issues that they might come up with. So that's enough for me and kia ora, John, I know you are here from Te Pou Wairoa.

[John Taylor]
Yes, I am talking about Te Pou Wairoa, which has the Assisting Change contract. So I'll talk a little bit about Te Pou Wairoa, and then how we hope to work and some of the projects we've been working on. We established specifically do this work, and we are a disabled person and family led organisation that is about to support the voice and leadership of disabled people, tangata whaikaha Māori families and whānau.

And we have as our foundation principles Te Treati O Waitangi, Enabling Good Lives and the United Nations Convention on the Rights of Persons with Disability. Our name comes from was gifted to us by Ngāti Awa ki re Awa o Te Atua, Iramoko Marae and they are closely associated with the work that we're doing.

Our goal is to support providers to insure, to assist disabled people to have the best life that they can have, and the way it works is that if a provider is finding that there's some systemic issues going on for them, either within their control or without of their control, they can talk to their contract relationships manager or - what's the new name for that? Sorry, I can't remember - and a referral can come through to Te Pou Wairoa.

The way we operate is that we have a range of associates who work for the organisation, and other associates are people like Grant Clayland, Lorna Sullivan, Jonathan Tautari, Poroto Naropu, Jane Bawden. There's a bunch of us who have a fairly long history in the sector, and we all have different expertise that we can bring to support providers to do what they need to do. Our way of operating is to figure out with the provider what the issue is, look at a range of options for how things might change so it's more successful in supporting disabled people and then help them bring about whatever change is required.

Some of the things that we're working on at the moment, just to give you some examples how this looks, is that we are working with one organisation that has had a number of people in senior management leave the organisation through, well, frankly through death and through other unfortunate situations. So we're supporting that organisation to develop the expertise of the current senior managers, we're working with another organisation to look at Enabling Good Lives training and how to imbue the organisation with Enabling Good Lives and the processes that would put that into effect. We are working with another organisation to think about alternative alternatives to their current respite model. The current respite model is an in-house in residence one and they want to do things differently. So working with them.

One of the larger projects we're working on is to think about one organisation's having quite a bit of or has had quite a bit of trouble in working out a pathway for people with learning disability or intellectual disability who also experience mental health distress. Now, for most of you will know this is an issue right across the country, so in one area we're working with this provider to try and develop a pathway and we're working with mental health services and a whole bunch of other organisations to think about how we can successfully work with people who have a learning disability, and who might also experience mental distress because you know the current situation of how that works and it's not very successful.

We are working with another organisation on some individualized service design for some people are they're supporting who have very high and complex needs, and we've also established a very small provider group who want to think about things such as how they can make sure their housing is the best housing they can find for disabled people and suits future demand, how they can think about outcome measurements to see if what they're doing works well for people.

We're hoping in time that we'll be seen as a partner to to assist them to do better, rather than somebody who gets called in when things aren't going well.

Yeah, that’s it in brief. Depo by order. Hope that is obvious helps.

[Sue Sherrard]
That was that was great, John. Thank you. And some of this information, once you've done the thinking and figured out some of the pathways that you talked about, will go up on the website and be freely available to anyone.

[John Taylor]
Absolutely. It's a very good point. Yes, thank you. So, a lot of the learnings we take out of this, we'll anonymise it and we'll make it available to providers on our website which is tepouwaiora.org.nz, and over time there'll hopefully be a section which you can go on to and if you've got a similar issue, you can read what's happened before, make contact and we'll better put you in touch with other providers who have gone through that journey.

[Sue Sherrard]
Awesome. Hey, thanks, John. Thanks for sharing the work for Te Pou Waiora under the assisting change banner of Growing Voice and Safety. Jacinda, have we got some questions?

Jacinda Allwood
Kia ora Sue and thank you to both yourself and John, Gary, Tavita and Warren for sharing some of the updates on this, these really important initiatives and services that are going to be rolled out shortly.

So we don't have any raised hands, so this is your opportunity to star and shine and ask your question verbally if you'd like to, and I’m more than happy to just have your microphone turned off so we don't have to have your camera. If you would like to ask a question, you should be able to access the raise hands function on this Teams forum, but we don't have any as such.

I'll just keep an eye on that for the next couple of minutes and hand over to Solmaz because I think we have a few more written questions. So thank you.

[Solmaz Nazari Orakani]
So the question for Gary, do you have services available in Whangarei?

[Gary Basham]
Not as yet. As I said, we're just in the very early starting place and so the four places we're starting would be in the Waikato region, Lower Hutt, Christchurch and Dunedin.

[Solmaz Nazari Orakani]
Thank you so much. And the next question is from Adrian. How far out are plans to provide services in Northland?

[Gary Basham]
I wonder if Adrian is working with Helen to ask both those questions. It's probably for me again as well. I think what we need to do is we need to develop a plan for growth and have a good chat with Sue about the timeline for growing. So no, no details on that as yet.

[Sue Sherrard]
Nice.

[Gary Basham]
But you know, we we're keen to get up and get running as quickly as we can.

[Sue Sherrard]
It's certainly, certainly beginning to work alongside people as soon as we can. And it's, yeah, exciting times and we will be putting more information up on the website, the DSS website and so people can refer there as well to really get a sense of how things are going, we want this to succeed. It's really important for disabled people. So we're encouraging the start small and build slowly and and try and learn and adjust as we go. So kia ora, thanks for the question.

[Solmaz Nazari Orakani]
Thank you, Sue. And another question about “is there any plan or process being put in place to deal with the barrier individuals are currently experiencing with accessing support through NASC specifically for supported living services?”

[Sue Sherrard]
I think that question is sort of outside of the People for Us service. We are aware certainly that very sadly the abuse of disabled people is very widespread, but we had to make a call to start somewhere. We decided that working with the people in residential service who may communicate in a variety of different ways, and those who have limited contact with family or whānau and community - that that's our beginning audience, that's our beginning participants for People For Us, and we will grow from there. That's certainly the aim.

[Solmaz Nazari Orakani]
Many thanks. And we have a question for John. “Is there any intention to share with the sector any solution that might be common across providers?”

Which means mental health pathway for people with intellectual disabilities.

[John Taylor]
Yes, there is. I've just actually posted there about this, but this is quite a long project. So we're not anticipating anything will happen particularly quickly, but we are working with the NASC mental health providers in the area, a number of disability support providers. We're working with Te Whatu Ora's disability team. So the whole range of people involved in this project now looking for a solution to get a pathway where we can work with disabled people who might experience mental distress and put some processes in place where it's less likely to be an issue in the first instance, and then look at some ways that we can have some immediate support for providers and families when things might get a little bit difficult, and also have some longer term processes for assisting those individuals. So it's a multifaceted sort of thing, and we're only really at the front end of getting that sorted. I'm hoping by the end of the year we'll have some stuff out there because it is, from my own practices, something that is critically required across the country. Yep.

[Solmaz Nazari Orakani]
Many thanks, and we don't have any question in the Q&A function now.

[Sue Sherrard]
Right. Thanks so much.

[Jacinda Allwood]

Yes, thanks, Omaz. I was just having difficulty turning on my microphone then to jump in here as well. There's always got to be one in these things, doesn't there? So, that's excellent managing to cover off the questions within time. Hopefully there's no other burning questions, but you absolutely can contact one of the four providers of these services. Um, I think we have a little slide that we might just put up shortly. I think I've got the 0800 number that you talked about – Tevita? Was it Tevita that had an 0800 number? So I'll see if I got the numbers correct with that slide shortly and you can contact Te Pou Waiora through their website, which will pop up shortly.

And if you have any questions about this, you can absolutely contact DSS. So as Sue said, we will update our website with information about the contact details and referral pathways once they are finalised and sorted, and once the suppliers have their websites set up and there are 0800 numbers if they choose to have an 0800 number established, but you can either go to the DSS website and find the information, or you can e-mail us at our Quality team shared mailbox and we will distribute your questions if you have any to the appropriate person.

The (email) address which you all probably have is quality at msd.govt.nz., But you may already have that on speed dial on your computers!

I would just like to say another warm thank you to all of the attendees who came and gave up an hour of their time on this Tuesday afternoon. I don't know what the total numbers were, but I did spot 137 at one point. So that's amazing to have so many people attend and listen to what we're trying to share at these forums. Please give us any feedback if this style of forum worked for you, including the Q&A functions and the option to ask questions verbally if people choose to. If you don't like that, please tell us as well, and we can adapt that for future forums to make it work to your needs.

I'd also like to thank all of the speakers once again for coming and sharing a bit about the work that they're developing and we are really excited in DSS to get these initiatives and services off the ground. Supporting providers and supporting disabled people to have a voice, and giving people other opportunities and avenues to speak to someone if they have any issues, and to support them through the pathways to help both the disabled people, their families and whānau and providers enable our disabled people to have a better life and live a better life.

I think we'll wind up the session for today and give you all a couple of minutes back in your afternoon. So, um I will close us off with a closing karakia here.

(karakia)

So thank you everybody. Have a lovely evening, everybody.

[Jacinda] Kia ora koutou and welcome to the first  DSS provider quality forum. Ko Jacinda Allwood toku ingoa. Good morning everybody, my name is Jacinda Allwood. I'm a Principal Advisor in the Quality and Performance team here at DSS. I'll open us up 
with opening karakia, then follow on with some general housekeeping and then I will introduce you to the three speakers we'll be having today.

Whakataka te hau ki te uru
Whakataka te hau ki te tonga
Kia mākinakina ki uta
Kia mātaratara ki tai
E hī ake ana te atākura
He tio, he huka, he hauhū
Tihei mauri ora!

Thank you, it looks like we have numbers ramping up - we've got over 100 people that have joined the call now which is fabulous.

So people will just be joining us as they come in and there will be no announcements so we won't be interrupted. But the housekeeping - you will all see that your cameras have been switched off and your microphones have been muted when you have entered the forum. They will stay that way and presenters 
will be spotlighted and so you'll be able to see the presentations as well.

They will be sharing their screens with PowerPoint presentations as they speak. This session is being recorded so that we can post it on the DSS website following the forum for people who have missed out, or if you want to go back and watch this all over again. 

Question time - there will be some time at the end of the session for questions. Preferably we'd like people to use the chat function so you can put in questions through the chat function at any time throughout the presentations, but we won't be addressing any of the questions till the end.  

Please indicate who your question is for if it's not really obvious, and we will be monitoring those in the background. If your question's already been asked and you've noticed that, please don't ask it again. Instead maybe um give it a thumbs up or a a like emoji and we will be ordering it in the background, so if you're  liking a question um a lot of times then that's more guaranteed to be asked. We'll get to as many of the questions as we can but we may run out of time so we'll just manage that towards the end of the session.

So I would first like to hand over to Carmela Petagna. Carmela is the General Manager of the Quality and Insights team here at DSS and she will do a short introduction. Over to you Carmela.

[Carmela] All righty can you hear me okay Jacinda? 

[Jacinda] yes

[Carmela] yeah okay perfect all right. Ko Carmela Petagna toku ingoa. I am the group manager at the moment of the Quality team here at DSS and I'm delighted actually to welcome you all. We've  
got 123 people now registered and it's fabulous to have you all here at what is our inaugural Provider Quality Forum.

Now we aim to host these every two months and perhaps even more frequently dependent on the need, what feedback we get and the number of topics that we've got that are of interest to all providers and maybe some subgroups of providers.

So we are here to add value and to work with you all as providers. Today hopefully you will have a chance to meet some of our Quality team members which is great as we take you through some of the changes that we propose to our critical incident management processes.

We're supported today uh by Te Tāhū Hauora which we're 
delighted to be working with them. 

Just a little bit of context  - the provider quality forum initiative has really been set up and the recent establishment actually of the DSS national Quality Leaders Group have been set up so that DSS is improving its direct engagement with its contracted providers. We've heard a lot from people to say you know we "it's one-way traffic, we give you a lot but we don't get anything back in return", so this is our way of improving that and we hope it's a sign of things to come.  

We've plans underway to establish a series of topics for the provider quality forums and if you have any ideas that you'd like to submit then please email those to us directly. Jacinda will cover some of that off at the end of the presentation today I'm sure.

And just a reminder - Jacinda's already spoken about the questions. This is our first forum and we may not get it all right so bear with us. And for the questions - it's important that we stay focused on the quality topics that we're covering today. We 
won't stray into other topics because there are many going on across the DSS programs of work so we will try and stay focused today. Our aim is to respond to as many as we can, and if we can't, we'll theme them as Jacinda said and we aim to put a lot of this material on the website.

So again, I'm delighted to welcome you all - great to see you all and I'll hand back to Jacinda to take us through the proceedings thank you. 

[Jacinda] that's great thanks Carmela, so I will hand over pretty 
much straight away to the first speaker that we have today. This forum is being co-hosted by the DSS quality team as well as Te Tāhū Hauora the Health Quality and Safety Commission. So first  up we have Rebecca Mitchell from Te Tāhū Hauora who will be talking about the healing, learning and improving from harm policy. Over to you Rebecca!  

[Rebecca] Thank you Jacinda. So I'm Rebecca, I am the system safety advisor here at Te Tāhū Hauora and it's a great pleasure to be with you today. My colleagues Caroline Tyler - our senior manager for the system safety team, and Leona Dan, the specialist in system safety are also here with me and you may hear from them again in the question time. So I'm going to just start by sharing my presentation.

Sound okay? So thank you for the opportunity to be with you all today and giving up the valuable time in your day to join us. This is an exciting time for us as we near the launch of the onboarding of the disability support providers to our policy and orientate you all to our reporting requirements. So what I'm going to cover briefly in the short time that we have today is how the policy and the associated reporting to Te Tāhū Hauora is about being open to learn, and our emphasis is really on sharing these learnings and improving as a result.  

I'm going to give you a brief overlook of the draft severity assessment code guide for disability service providers, and then perhaps most importantly, give some more information about the ongoing support that we can provide to you all.

So who are we? It's a great question. We are Te Tāhū Hauora, otherwise known as the Health Quality and Safety Commission. You probably know a little bit about us, but just for a bit more 
background, we came into being in 2010 and are a crown entity so this means that we're separate to the minister and other government agencies such as the Ministry of Health or Ministry of Social Development. Our objectives under the legislation is to lead and coordinate work across the health sector for the purposes of monitoring and improving the quality and safety of services, and helping providers to improve the quality and safety of those services. That is to involve inform, influence and improve.

So in February 2022 the revised NAPRA health and disability standard was launched, and it marked the national adverse events reporting policy a criterion within this.

Service providers shall follow the national adverse event reporting policy for internal and external reporting to reduce preventable harm by supporting systems, learnings service. Providers encompasses disability services, meaning that services must now meet the standard. This is following the adverse event policy and reporting harm - so the revised policy which is now called "healing, learning and improving from harm".

It was developed during 2022 and involved a commission-led co-design process with a national working group that included health and disability sector represent representatives from across the country. The aim of the policy is to improve consumer and health care worker safety by supporting organisations to heal, learn and improve following harm.

In keeping with our increasing awareness of how language influences our approach and understanding of these types of events, you may hear us refer to harm events - this is what 
we previously referred to as adverse events.  

We are still evolving too so you may hear us use these interchangeably to help introduce the policy. 

I'm going to share a short video which helps to really ground the policy, and show its application.

Okay so following an extensive evaluation of other definitions and using the feedback from the ROU, we have defined both harm and its individual components. We recognised in the revised policy that harm comes in different forms especially from a Te Ao Māori worldview, and therefore the policy needed to be clearer.

So there are now four different definitions of harm that includes the physical, the psychological, cultural and spiritual. The policy has eight principles as listed here. So consumer and whānau participation - this is an active engagement with the person 
who has been harmed and/or with their whānau to understand their experience of the harm and to include them throughout the review process.  

Culturally responsive practice - this is about asking how best can we meet your needs during the process, what does this look like for you, and then doing your best to do so. This is about consumers, whānau and care workers' cultural values and beliefs.

Equity - we often focus on reducing in inequities when delivering care but it can be equally important to reduce inequities during the review process itself to reduce the chance of compounding 
the original harm.

 Open communication - again this is with all involved. We have moved beyond open disclosure but rather keeping communication lines open throughout the entire review period.

Restorative practice or responses and the Te Ao Māori concept of hohou te rongo is about speaking openly about what has happened to understand the human impact and to consider how to make that situation right again. This is a type of restoration practice carried out by skilled facilitators. Safe reporting, system accountability and system learning is all about creating a culture of openness, learning and responsiveness.

For an example an organisation that is regularly reporting harm events is not one to be critical of, but rather shows that they 
have a culture where its care workers feel safe to report the harm, acknowledge it and then learn from it. It's the quiet ones that are more concerning.

We promote the learning review as the preferred methodology as there needs to be a new way to review harm in light of modern understanding of safety. We provide support for this methodology by running workshops that simulate learning review. We prefer it because the learning review methodology seeks to limit any further harm to on all those involved in these often distressing events. It limits the role of biases in reviews by focusing on understanding why rather than apportioning blame.  

It is well suited for the health and disability sector because it can account for the complex system in which we work, and the way in which we work, and is largely carried out by humans and all the complexity that we bring to a situation. It gives everyone involved a voice and understands that as care workers we all turn up to work to deliver the best care we can, but the system itself can trip us up.

So what is this method? The learning reviews use a three-phased approach. It's used to understand the event and then to develop learning opportunities. The first phase is collecting information by understanding there is not a single source of truth but a range of perspectives to consider.

The second phase is taking these sources of information to understand the influences and context to the actions, or inactions, that led to the unintended harm, presenting these to a group who are familiar with the work and environment, and seek to understand how the harm emerged and then consider what system level changes can be made to limit the opportunity for the same harm to occur.

The third phase is about having a developed network to be able to share the learning and action the changes required, thereby promoting a learning and improving culture.

So we are aware that there is already some engagement within the disability support sector with our policy and who are using the learning review methodology already.

We've recently had some of the learnings from this process shared with us. The feedback from using this methodology is that they found value in the sense making aspect, and it helped connect the reviewers to the work being carried out. And the perspectives of those doing it is it took no longer than other traditional review methods. Especially for ones that require - if there's been a death in care - and require that complex level review, there was also an emphasis and understanding of the need to care for those involved in a harm event, and again, both care worker and the person who was harmed thereby reducing the compounded harm that reviews can often cause.

So this is the end goal and what we should all be striving for by utilising the principles of the policy and reviewing harm: it is to understand the harm, restore the relationship, learn from what the event told us about the system, and identify an opportunity to intervene or disrupt the system.

So we also need you to tell us about the harm, and this is the reporting requirement so harm events that happen within your organisation that meet the definition of a severity assessment code one or two must be reported through to us at Te Tāhū Hauora within 30 working days.   

This is done by completing a submission, undertaking a review and then submitting a Part B along with a copy of your anonymised report within 120 working days. From 1 July 2025 we will have a new submission portal for you which means that you don't have to deal with our old portal which was less than ideal.

Our new portal is very user-friendly and has been streamlined with a focus on relieving the reporting burden. It has also got some new features meaning you can keep better track of what events have 
been submitted, and where, to review these.  

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However to focus on what needs to be 
reported first, I'll just touch on what  

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is a severity assessment code one or two. 
These are our established descriptors  

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 of the categories of harm that we give 
to the health and disability sector on what  

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to report. Our requirement is in these red 
and orange boxes.  the SAC severe and SAC 2 major  

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events - so those are the types of events 
that you'll need to report through to us. The  

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SAC 3 and SAC four in the yellow and green boxes 
should still be reported within your organisation  

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and reviewed for learning opportunities, 
but they do not need to come through to Te Tāhū Hauora

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For each provider type we developed 
these severity assessment code guides that  

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relate to specific areas across the health and 
disability system. So for example, there's one for  

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mental health, for hospitals, age residential 
care, and this is the guide that will be  

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in draft form that's available for 
disability services. It's been developed and  

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tested with some disability providers, and this is 
best reflected the examples of harm that they've  

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seen in their experience. However, we are aware  
that as the disability support providers start  

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reporting through to us, there may be situations 
that we haven't anticipated or covered here yet,  

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but we will have the flexibility to review and 
amend these guides as we go forward. So I've  

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got here a few examples of what's been included. 
It's not an exhaustive list but there's the  

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um the in this grade out box, here is the 
definition, so it is severe - death or harm,  

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causing severe loss of function and/or requiring 
life saving intervention. So this means that  

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without that intervention, the person would have 
died. So suspected suicide, departures from care  

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plans, delays in care delivery that result in 
death or severe harm are the type of events  

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that we would have reported through to us 
as a SAC one. Note here on the second line  - 

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uh sorry the first bullet point - that the cause 
of death is not related to the natural cause of  

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illness or treatment. So for example not a 
premature death from underlying heart failure.

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SAC 2 is a slightly more lengthy 
list, and it is what I have here is for it is   

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the events related to major harm resulting in 
loss of function and/or requiring significant  

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intervention, meaning a hospital admission for 
urgent care. So include it. Again what you  

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would expect to see at this level - so self 
harm, delayed recognition of deterioration,   

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falls resulting in a fracture of a major bone, a 
stage three or four pressure injury. Perhaps  

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the most important slide - how can we support you! 
So um there's a variety of ways in which we do  

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this. We run the learning from harm workshops, there's the in-person workshops that are  

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currently scheduled for Christchurch, 
Hamilton, Palmerston North and Auckland. See our website!  

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We do run bespoke workshops as well - whether 
in person or virtual. We do need a minimum of  

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15 people so smaller providers may need to 
band together. We've also got a range of  

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e- modules and templates on our website that 
are really uh helpful for undertaking this. We'll  

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also with the launch of our new submission 
portal, we will need to hopefully come back  

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to you in this forum and walk you through that as 
well. I've included our email there at the bottom.

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harm.event@hqsc.govt.nz if you have any um further 
questions or want to talk about more. To  

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finish, here's a QR code which will helpfully 
link you through to our supporting resources.  

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Thank you again for the opportunity to 
presentation. We do understand that this does signal a  

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change in the way that things are done, but we are 
in this together and I'm here to support you.  

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Tena koutou ka toa. I'll hand you back to Jacinda, thank you.

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[Jacinda] Rebecca thank you so much for that presentation, 
and it's great to know that there's support out  

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there for providers. What we will do is we'll post that email in the chat as well so that  

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people could have access to it through the chat. And answering one of the questions, we will make  

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the presentations available following this forum. So I will move straight on. We we can see that  

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there's some questions coming through in the chat 
which is great. We are looking at those in the  

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background, and we'll deal with those at the end. 
The next presenter who is Lara Penman who  

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is Principal Adviser in the Quality team here at 
DSS, and she'll be talking about how we're working  

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to align our DSS critical reporting with the 
Te Tāhū Hauora policies so over to you Lara.

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[Lara] Thank you Jacinda. Ko Lara Penman toku ingoa. Nice to have you along to hear a bit of the story of the work that  

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we're doing.  I'll share my 
presentation if I can click the right buttons (!). 

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I also just want to acknowledge there's been 
a bit of work with a few uh providers already,  

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and help building and testing this already, so 
just want to acknowledge and thank those who have  

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contributed to this so far. So what we're 
doing in DSS is a project to align the critical  

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incident process that we have for providers to 
the Te Tāhū Hauora healing learning and improving  

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 policy that you've just heard about. So today 
I'm going to talk about our current approach.  

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I'm going to talk about our future proposal and 
what changes we're proposing, and the next steps.  

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So currently in your contracts - all DSS contracted 
providers - there is a clause there that requires  

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you to report critical incidents within 24 hours. This is across all different service types. 

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So what is a critical incident? Our definition 
of that is an event where there is severe or  

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major harm to the person. DSS has this 
rule of requiring critical incident reporting  

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 as part of our stewardship and commissioning 
role, so that when a critical incident report  

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comes in, we check it to see that providers are 
doing a great job at delivering safe and quality  

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supports and that you're managing that incident 
well. About 75% of the reports that come in  

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come from community residential services. I think that's great that community residential services  

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are reporting so well - but we suspect there's 
probably other service types out there that  

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aren't reporting where they should be so we really 
want to encourage a strong reporting culture to  

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inform ongoing service improvement. As Rebecca said -  
"it's the quiet ones we get worried about"  

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There's a link to the DSS website where you 
can find out more if this is news to you! So  

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here's a bit of data to see about how the critical 
incidents we've had reported to us over the  

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first quarter of this year. So you can see we get 
on average about 282 critical incident reports  

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each month, and me and others on the team read 
every single one of them. These are our  

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current categories that we have - you can see most 
of them are around hospitalisation of the disabled  

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person, followed by abuse or assault by a 
disabled person to a non-disabled person. That's  

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usually assault of a staff member. Police or 
emergency services involved comes up next, and that  

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is mostly being about ambulance callouts. Abuse 
or assault of a disabled person is next, and that's  

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often between flatmates in a house. Restraint 
or seclusion is next and remember just  

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remember that uh seclusion is only permissible in 
hospital level services like our um RIDs services  

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so there are strict rules around when and where 
and how seclusion and restraint is managed. Then  

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we've got serious injury and um a few stragglers 
down the end. So what we are doing is updating  

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our critical incident categories and severity 
threshold to align with Te Tāhū Hauora as  

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you've heard about. So there are DSS providers 
who are contractually or legally required, so those  

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that are legally required are required because 
they are certified providers under the Health and  

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Disability Safety Act um and must comply with 
Ngā Paerewa. However also we have uh clauses in our  

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contract requiring compliance with npa also so 
most providers will be covered under this so you  

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uh because you are required to comply with Ngā Paerewa
you are required to report harm events to Te Tāhū Haora.

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As Rebecca has talked about, that's going to be um a new thing for you. For

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many of you to be thinking about how you do it. 
So we want to try and align our process as  

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much as possible to reduce the burden for you, 
so we want to improve our targeting of the most  

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high-risk incidents, align the process and support 
learning and improvement. So in a nutshell there's  

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four main changes that we want to go live from 
the 1st of July. What we're doing is raising the  

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threshold of what we class classify as critical, so 
it aligns with the severity assessment codes that  

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Rebecca talked about, so it aligns with those 
SAC one and SAC 2 ratings. We're updating  

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the DSS critical incident categories based on 
some feedback we've had from providers. We're  

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updating the critical incident form to match 
these other changes, and we want to support you  

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 to meet your obligations to report SEC 
1 and SEC 2 harm events to Te Tāhū Haora. So  

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in this diagram you can see a triangle with an 
orange triangle at the top, and the bottom half is  

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green. So the top part of the triangle is what we 
classify as DSS critical incidents, and those are  

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those incidents that are severe life-threatening 
or major harms. And you can see the little circle  

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in there to that says SAC one or two, and that's 
to reflect that DSS wants to know about all  

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of the major or severe harms that might occur in 
your services. But some of them won't meet the  

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criteria for SAC and some of them will. The harms include but are not exclusive to  

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SAC one or two, and the non-critical incidents are 
moderate or minor harm and they relate to SAC three  

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or four. At the moment if you see that line that 
goes between the between the orange and the green  

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that's currently lower down, we're more into the 
moderate. We're asking for moderate - moderate harms  

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we're lifting that up so it's we'll be collecting 
more of ...focusing more on the severe or major  

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harms. If you think I haven't explained that 
very well, which is fine, the next two slides  

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say what I just said more eloquently. And so 
this is what we define as critical, and these are  

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sort of always report events, and that's where 
there is either a severe harm or a major harm. And  

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the difference between what we at DSS requires for a 
severe harm versus the ST criteria -  it's the same  

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wording the same level of severity um but we... 
Oh oh sorry um but um in the purple text you  

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can see the difference. So for DSS it includes 
but is not limited to incidents that meet  

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the S1 criteria versus in Te Tāhū Hauora - the 
condition of that harm is that the harm must  

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00:33:38,160 --> 00:33:43,520
 be an event where that was the result of a 
departure from the planned provision of support 

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00:33:43,520 --> 00:33:49,440
differs from the immediate expected outcome of 
care, or was not related to the natural course of  

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00:33:49,440 --> 00:33:57,040
illness and treatment. Now you don't always know 
that straight away, so that's why we know the  

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cause or the reason behind the harm - you just know 
that a harm happened but you don't know why, if it  

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00:34:02,400 --> 00:34:07,360
had anything to do with the departure from the 
provision of support immediately.  So that's why  

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00:34:07,360 --> 00:34:20,240
we say that DSS severe harms include but are 
not limited to those that meet the SAC one criteria.   

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00:34:20,240 --> 00:34:25,680
This slide gives the same information 
but for three and four. This might be easier  

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00:34:25,680 --> 00:34:32,880
for future to look and read and digest later, 
once we send the slides out. But the point  

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00:34:32,880 --> 00:34:40,320
is that we're matching moderate harm and minor 
harm to that, and whilst we don't require  

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00:34:40,320 --> 00:34:47,040
you to report these harms to us, we still expect 
providers to be doing a great job at managing  

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00:34:47,040 --> 00:34:53,040
those harms and learning and reviewing and you 
know, preventing an escalation into more serious

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00:34:53,040 --> 00:35:02,400
harms. Okay so what do providers need to do 
so for the orange ones uh which are critical  

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00:35:02,400 --> 00:35:08,960
incidents? You are required to 
always report those to DSS within 24 hours.  

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That's the current process, that's what you do at 
the moment. We just got a few tweaks to it. We  

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00:35:14,800 --> 00:35:22,560
expect you to manage review and learn from the 
incident. The additional requirement is that  

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00:35:22,560 --> 00:35:27,840
for those critical 
incidents you need to review it to determine  

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00:35:27,840 --> 00:35:36,000
if that incident meets the SAC one or two criteria, 
and if so Te Tāhū Haora within 30 working days  

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00:35:36,000 --> 00:35:44,000
using their part A form with a provisional 
SAC 1 or SAC 2 rating. And then after 120  

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00:35:44,000 --> 00:35:52,640
working days you need to provide the full 
learning report, so that's the additional step  

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00:35:52,640 --> 00:36:04,080
 that you'll need to take. We 
anticipate that the volume of SAC one or  

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00:36:04,080 --> 00:36:09,600
two reports that you sent to Te Tāhū Haora would have been 
much smaller than the volume that you send to us.   

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00:36:10,800 --> 00:36:16,080
And non-critical incidents you don't need to 
report to us, you don't need to report to to Te Tāhū Haora, 

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00:36:16,080 --> 00:36:22,960
 however we both expect you to be doing awesome 
jobs at managing reviewing and learning from the

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00:36:22,960 --> 00:36:33,440
incident. Okay so here is our updated critical 
incident categories. We've reviewed them  

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00:36:33,440 --> 00:36:40,080
based on some feedback from yourselves. There's 
currently about 11 categories and not all of them  

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00:36:40,080 --> 00:36:45,040
are terribly useful, so we've done an 
exercise and reviewed them. Probably the  

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00:36:45,040 --> 00:36:50,560
biggest change is that we have removed the 
category called 'hospitalisations' because that  

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00:36:50,560 --> 00:36:57,760
is more of an outcome of an incident. Rather 
than the incident saying, we've beefed up the  

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00:36:57,760 --> 00:37:04,000
incident category called 'serious medical 
event' or 'serious injury of a disabled person'  

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00:37:04,000 --> 00:37:07,840
so we expect that's where most of the ones 
that you would have previously reported  

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00:37:07,840 --> 00:37:13,920
under 'hospitalisation' will go. Under 
that one we've added 'self harm', we've  

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00:37:13,920 --> 00:37:21,120
split 'abuse' or 'assault' from two 
categories to three categories, depending on who is  

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00:37:21,120 --> 00:37:30,560
involved in that abuse. And yeah, that's 
our proposal of 10 different category types.

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00:37:32,240 --> 00:37:38,560
So here's a bit of an example. Let's say that 
there's a serious medical event or serious injury  

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00:37:38,560 --> 00:37:45,520
of a disabled person that happens in your service, 
so you'll need to work out, okay was this a severe  

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00:37:45,520 --> 00:37:52,960
harm, a major harm, moderate harm or a minor harm? 
So we will produce guidance that will help you  

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00:37:52,960 --> 00:38:02,320
work that out - you and your teams. So let's 
say use the example of a choking - somebody choked  

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00:38:02,320 --> 00:38:09,680
and they needed to be admitted into 
hospital perhaps, resulting in aspiration pneumonia...

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00:38:09,680 --> 00:38:17,920
that would meet the definition of major 
harm. So the difference, as Rebecca said, is about  

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00:38:17,920 --> 00:38:26,720
was there - did it require life-saving intervention 
or severe loss of function? Major is essentially  

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00:38:26,720 --> 00:38:33,280
did they needed to be admitted to hospital. 
Moderate harm is did they need kind of moderate  

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00:38:33,280 --> 00:38:40,080
medical intervention, like they had to go to their 
GP or ED? Things like that, and a minor harm would  

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00:38:40,080 --> 00:38:46,800
be they needed a bit of first aid or just a a 
small intervention in the home. So we're  

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00:38:46,800 --> 00:38:52,720
developing guidance to help you work through  
that for all of the different incident types.

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00:38:55,840 --> 00:39:00,880
We are also doing updates to 
our critical incident form.

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00:39:00,880 --> 00:39:06,160
I hope we are being quite intentional about 
not making too many changes for you, because  

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00:39:06,160 --> 00:39:11,600
we know that has flowing effects for you and 
your own processes within your organisation.

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00:39:11,600 --> 00:39:17,200
So we're trying to limit it to the ones we 
have to do, so they're pretty minor changes.  

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00:39:17,200 --> 00:39:23,040
The key changes are we're updating the incident 
categories to reflect on new categories. There's  

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00:39:23,040 --> 00:39:28,880
a new field where you have to choose a severity 
level. You have to choose whether it is a severe  

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00:39:28,880 --> 00:39:35,680
harm or a major harm based on the guidance we'll 
provide you, and that might give you a bit of  

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00:39:35,680 --> 00:39:42,240
a flag - oh might this end up being a SAC one or 
might this end up being a SAC two in the future. 

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00:39:42,240 --> 00:39:48,160
There's a new box - new boxes to indicate 
that you've notified next of kin, a care worker  

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00:39:48,160 --> 00:39:54,240
or a safeguarding organisation. Given the Royal 
Commission Inquiry into Abuse in Care, we're just  

318
00:39:54,240 --> 00:40:00,480
really aware that we need to be really 
proactive about how we are engaging with  

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00:40:00,480 --> 00:40:05,360
safeguarding support for disabled people .
We've done a bit of rearranging so it fits  

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00:40:05,360 --> 00:40:11,760
and flows better, and the instructions page 
is much clearer. So we'll publish that  

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00:40:11,760 --> 00:40:20,800
on our website once we've updated it and 
tested it with some of you. And here is our  

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00:40:20,800 --> 00:40:31,200
next steps. So if you've got your thoughts, 
suggestions, concerns then send us an email  

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00:40:31,200 --> 00:40:38,560
in the quality inbox. What we are going to 
be doing is working with the quality leaders group,  

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00:40:38,560 --> 00:40:46,080
which is a few provider quality leads, to kind 
of finalise and endorse these, and then we'll be  

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00:40:46,080 --> 00:40:53,280
able to publish them on our DSS website, hopefully 
by the 20th of June. Now don't freak out - although  

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00:40:53,280 --> 00:40:58,880
I say go live on the 1st of July, we don't expect 
you to have magically changed all your systems and  

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00:40:58,880 --> 00:41:05,840
processes by then. That's just the date that we'll 
start expecting you to... that we can accept the  

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00:41:05,840 --> 00:41:12,480
new form and new process. But we'll give you 
three months transition period to implement your  

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00:41:12,480 --> 00:41:21,920
new system so by the 30th of September we will... 
by the 1 of October we will only accept  

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00:41:21,920 --> 00:41:28,920
reports using our new form. So that is the story 
um and I will hand it back over to Jacinda.

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00:41:28,920 --> 00:41:45,440
[Jacinda] thank you that's great, thank you Lara. Yeah 
obviously a lot to digest, you've had two  

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00:41:45,440 --> 00:41:51,600
quite substantial presentations there. We do 
have some time for question time now. And they were  

333
00:41:51,600 --> 00:41:55,600
a little bit more speedy - Rebecca and Lara - than 
they could have been, so we might be able to get  

334
00:41:55,600 --> 00:42:01,680
through most of the questions. I see there's about 
six or seven in the chat, and these have been 

335
00:42:01,680 --> 00:42:06,960
summarised a little bit, some of them um slightly 
paraphrased, so if we're getting it a little bit  

336
00:42:06,960 --> 00:42:13,040
wrong then please feel free to to correct us.  
So we'll go through, then what we'll do is we will...  

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00:42:13,040 --> 00:42:19,360
I will pass over to um a colleague from the DSS 
Quality team um introduce you to... well she can  

338
00:42:19,360 --> 00:42:25,440
introduce herself - Solmaz Nazari Orakani, and she'll 
read out the questions and then direct them to  

339
00:42:25,440 --> 00:42:29,680
the most relevant person to respond to those 
questions, so you might get to meet a couple  

340
00:42:29,680 --> 00:42:36,480
of other people particularly from Te Tāhū Haora, who 
are in the background ready to respond. So I will  

341
00:42:36,480 --> 00:42:46,880
hand over to you now Solmaz, to read out the first 
question.
[Solmaz] Thank you so much. My name is Solmaz Nazaro, kia ora e te whānau.   

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00:42:46,880 --> 00:42:58,000
I'm a senior advisor in the Quality team at DSS. So 
we have several questions. I am going to read  

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00:42:58,000 --> 00:43:12,560
the questions for you, yeah. So the 
first question um I'm assuming that it's for Te Tāhū Haora. 

344
00:43:12,560 --> 00:43:22,000
So it asks why does the definition of harm not 
include workers? It refers to negative consequences  

345
00:43:22,000 --> 00:43:33,600
for consumers and whānau - why are worker excluded? 
Rebecca?
[Rebecca] Thank you for the question. 

346
00:43:33,600 --> 00:43:40,960
The definition of harm is because consumers 
are at the centre of what we do, and it is  

347
00:43:40,960 --> 00:43:47,760
about the care provision to them as well, so it is 
about the the healing and the restoration of the  

348
00:43:47,760 --> 00:43:53,680
relationship with the consumer. The beauty of the 
learning review methodology is that it does take  

349
00:43:53,680 --> 00:44:03,200
into consideration the harm that could be 
experienced by care workers as well, and can  

350
00:44:03,200 --> 00:44:12,400
be addressed through that process. I hope that 
answers your question. 
[Other speaker] I'll just add to that, Rebecca,  

351
00:44:12,400 --> 00:44:18,400
so in terms of harm to workers you will still 
follow the Worksafe health and safety legislation,  

352
00:44:18,400 --> 00:44:24,160
and the reporting requirements for Worksafe so 
as Rebecca's highlighted, this is around harm to  

353
00:44:24,160 --> 00:44:36,240
consumers who are in care, as opposed to harm 
to workers. That's outside the scope of our policy.

354
00:44:36,240 --> 00:44:44,960
[Solmaz] thank you so much, thank you and the 
next question is for you again, I think.   

355
00:44:44,960 --> 00:44:54,800
I think. So why concentrate on post-event 
responses rather than prevent preventative

356
00:44:54,800 --> 00:45:04,000
measures? 
[Rebecca] I'm liking that! Look, preventative measures is still  

357
00:45:04,000 --> 00:45:12,560
absolutely a fundamental thing to do 
in these care provision services, however  

358
00:45:12,560 --> 00:45:17,920
 it is part of what we do. This is 
acknowledging that harm does occur  

359
00:45:17,920 --> 00:45:25,040
 within um service provision, and uh we 
need to address it.  So it's not to diminish  

360
00:45:25,040 --> 00:45:30,800
the role of preventative measures - we absolutely 
support learning opportunities or improvement  

361
00:45:30,800 --> 00:45:36,480
opportunities - but it's also about addressing 
harm that we know occurs regardless of best

362
00:45:36,480 --> 00:45:48,480
intentions. anything further to add? okay thank 
you 
[Solmaz] Thank you so much, I'm going to ask the DSS  

363
00:45:48,480 --> 00:45:56,400
colleague to give you a quick break and 
short break. So, my DSS colleagues,  

364
00:45:56,400 --> 00:46:04,240
 this question is for us. What sort of critical 
incidents reporting would you expect to see  

365
00:46:04,240 --> 00:46:16,240
from IF host who are not responsible for direct 
provision of support services?
[Lara] I can answer that.  

366
00:46:16,240 --> 00:46:22,720
Our only lever for requiring 
reporting of critical incidents is through  

367
00:46:22,720 --> 00:46:28,880
the contracts that DSS has with providers, 
so if we don't have a a contract with  

368
00:46:28,880 --> 00:46:33,920
a provider - say for example if someone's 
using their IF budget or personal budget -   

369
00:46:33,920 --> 00:46:39,920
then we've got no way to compel them to 
report a critical incident to us. And  

370
00:46:39,920 --> 00:46:45,280
we don't actually require if hosts 
to do that either at the moment.

371
00:46:49,600 --> 00:46:59,520
[Solmaz] Thank you Lara, and again a question for 
DSS - how will critical incident reporting be  

372
00:46:59,520 --> 00:47:07,200
shared with relevant NASCs to support 
resource reviews for people provider

373
00:47:07,200 --> 00:47:10,089
support?

374
00:47:10,089 --> 00:47:18,400
[Lara] Yeah good question! I think that's an opportunity for us to think about isn't it? um yep 
great let's let's think about how  

375
00:47:18,400 --> 00:47:30,640
we might do that well.
[Solmaz] Thank you so much, and I'm going back to the colleagues.

376
00:47:30,640 --> 00:47:40,960
Do providers still need to report to Worksafe when harm occurs to people they support?  

377
00:47:42,800 --> 00:47:49,280
uh and have Te Tāhū Haora and Yeses 
done work with Worksafe to

378
00:47:49,280 --> 00:47:56,480
align?
[Lara] Sure, sorry I'll hand over to Caroline who you may hear in the background  

379
00:47:56,480 --> 00:48:03,600
who can answer that for you. 
[Caroline] yeah thank you. So the legislative legislation health and  

380
00:48:03,600 --> 00:48:08,480
safety reguirement legislation's quite clear in terms 
of what needs to reported to Worksafe, and  

381
00:48:08,480 --> 00:48:13,520
you know disability support services is one of 
the last provider groups that we've worked with  

382
00:48:13,520 --> 00:48:20,000
um under the um NAPA era standard, and we do 
understand that people struggle a little bit  

383
00:48:20,000 --> 00:48:25,440
with this, so the SAC guide is designed to help 
support you with separating what we mean by  

384
00:48:25,440 --> 00:48:31,280
staff harm and consumer harm. But we will 
work with you with this. You know, this is all  

385
00:48:31,280 --> 00:48:37,440
new to all of you, and this is expected as of the 
1st of July. The learning from harm workshops  

386
00:48:37,440 --> 00:48:42,480
that we can do with you, we can do these 
virtually for you, we can do these in person  

387
00:48:42,480 --> 00:48:48,640
at no charge. They will help you unpick 
this, and we can use scenarios so that helps you  

388
00:48:48,640 --> 00:48:53,680
understand. And as Rebecca highlighted in 
our presentation, please just pick up the  

389
00:48:53,680 --> 00:48:58,080
phone and give us a call or email us directly 
and we can help work through with you, whether  

390
00:48:58,080 --> 00:49:02,960
it's something that has to go to Worksafe, or 
whether it's something that would come to us. 

391
00:49:04,240 --> 00:49:15,200
[Solmaz] Thank you so much and SAC one should include 
the hospitalisation in the description?
[Rebecca] yeah so   

392
00:49:15,200 --> 00:49:22,000
just got to be careful around the hospitalisation, 
because going to hospital itself does not  

393
00:49:22,000 --> 00:49:31,120
mean it equates directly to a Sac one event.  
So that's why uh we've used the phrases "death  

394
00:49:31,120 --> 00:49:36,880
or harm causing severe loss of function and/or 
requiring life-saving intervention". So I think  

395
00:49:36,880 --> 00:49:43,040
with the requiring life-saving intervention, it's 
implied somewhat that it would be a hospital as  

396
00:49:43,040 --> 00:49:51,200
well, but I think we don't specifically 
mention hospitalisation because there's...

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00:49:58,480 --> 00:50:15,720
[Solmaz] I think something happened we lost Rebecca. um so 
next question for the colleagues in DSS.

398
00:50:15,720 --> 00:50:28,240
Do providers still need to report under 
section 31 of the Health and Disability Services  

399
00:50:28,240 --> 00:50:37,120
Safety Act 2001 that requires all certified 
providers to notify the director general of  

400
00:50:37,120 --> 00:50:45,520
subsections?
[Lara] Yes it's still a requirement, but 
what we're doing is working with HealthCert on its  

401
00:50:45,520 --> 00:50:49,680
a next phase, about how we can streamline that for 
you because it might feel like "oh we're having  

402
00:50:49,680 --> 00:50:56,640
to report to so many places!" and we want 
to try and streamline that for you. So we'll  

403
00:50:56,640 --> 00:51:05,120
 talk to Health Cert and come back to you with 
where that's landed.
[Solmaz] Thank you so much, and the next  

404
00:51:05,120 --> 00:51:14,800
question is for my colleague in DSS. In terms 
of prevention, of early intervention, how are SAC  

405
00:51:14,800 --> 00:51:24,880
three and four incidents handled, particularly 
when they indicate patterns that could  

406
00:51:24,880 --> 00:51:34,000
suggest abuse? Perhaps there should be a process 
for reporting such incidents at a local level  

407
00:51:34,000 --> 00:51:39,760
perhaps through NASCs to ensure 
timely intervention and safeguarding

408
00:51:39,760 --> 00:51:48,160
measures. 
[Lara] This is something we've grappled with too, 
as we've lifted the threshold. There's a certain  

409
00:51:48,160 --> 00:51:53,920
amount of discomfort about us not knowing about 
those lower level incidents and harms that happen,  

410
00:51:53,920 --> 00:52:00,800
and we all know that sometimes 
those lower level ones can be sort of  

411
00:52:00,800 --> 00:52:08,480
 precursors or kind of red flags that something 
is escalating and building up to a higher severity.  

412
00:52:08,480 --> 00:52:16,400
So we are we are all interested in learning as 
early as possible, and making changes as early  

413
00:52:16,400 --> 00:52:23,120
as possible from those lower severity harms. 
However we can't collect data on everything - that  

414
00:52:23,120 --> 00:52:28,640
would be too much burden for you, and it would 
be really difficult for us to really focus in and  

415
00:52:28,640 --> 00:52:36,800
hone in to target those most severe incidents. 
What we do - what we are thinking about is  

416
00:52:36,800 --> 00:52:42,000
whether if you noticing in your systems there's 
a cluster of incidents that are happening that  

417
00:52:42,000 --> 00:52:46,080
you think "oh they're lower level but there's a 
whole lot of them with this person and they're  

418
00:52:46,080 --> 00:52:53,280
really escalating, I might just report that to to 
DSS as a as a cluster. I might have an internal  

419
00:52:53,280 --> 00:52:58,240
process within my organiaation to think about 
how I might treat a cluster or an escalation  

420
00:52:58,240 --> 00:53:07,040
a little bit differently" and and DSS 
really wants to be able to get assurance that  

421
00:53:07,040 --> 00:53:11,600
providers are doing a great job at that, 
and that'll be part of our regular  

422
00:53:11,600 --> 00:53:17,520
audit process - checking how well providers 
are managing that for those lower severity

423
00:53:17,520 --> 00:53:29,920
harms.
[Solmaz] Thank you so much, and another question 
for my colleague in DSS. When we send a harm  

424
00:53:29,920 --> 00:53:39,280
or critical incident report to our funder 
MSD DSS, should we send a copy  

425
00:53:39,280 --> 00:53:44,800
to HealthCert as well? 
[Lara] oh yeah that's the same as the previous question about the section  

426
00:53:44,800 --> 00:53:51,440
31s. Yes we'll get back to you on that. 
[Solmaz] Thank you so much and is the reporting  

427
00:53:51,440 --> 00:54:02,880
form completed electronically online?
[Lara] We would love to have that but  for DSS we still have our  

428
00:54:02,880 --> 00:54:08,720
 a Word document that you fill in and email 
to us, and we enter into a spreadsheet. However we  

429
00:54:08,720 --> 00:54:14,640
have got in the works to get an IT solution 
that will help us make that more automated. One  

430
00:54:14,640 --> 00:54:22,560
day we'll have a sexy new um uh portal like 
Te Tāhū Haora do for their reporting. As  

431
00:54:22,560 --> 00:54:31,280
Rebecca said the Te Tāhū Haora portal goes live on 
the 1 of July.
[Solmaz] thank you so much and...
[Rebecca] I'm so sorry  

432
00:54:31,280 --> 00:54:36,400
to interrupt, we've just answered in the 
chat that yeah ours is online thank you Lara 

433
00:54:36,400 --> 00:54:41,920
for highlighting that as well. We've waited a 
long time so we're happy to have that going now!  

434
00:54:41,920 --> 00:54:52,880
[Solmaz] Thanks, thank you so much and this question is for 
um the DSS colleagues or their colleagues, either  

435
00:54:52,880 --> 00:55:01,040
can answer. Will the HCSS severity criteria 
also be reviewed to be consistent with DSS

436
00:55:01,040 --> 00:55:10,080
criteria?
[silence]
[Lara] Is that you Rebecca?

437
00:55:11,440 --> 00:55:17,760
[Rebecca] Um sorry, I'd need further expansion on 
what the HCSS severity criteria?  I'm  

438
00:55:17,760 --> 00:55:23,760
not sure if that's a typo?
[Lara]  the home and community 
support services - you've got SAC guidance  

439
00:55:23,760 --> 00:55:30,960
for home and community support 
[Rebecca] Oh yeah, in 
process, that's on the to-do list so  

440
00:55:30,960 --> 00:55:38,880
um yeah there will be some consistency across 
the board of the SAC guides. Sorry, apologies  

441
00:55:39,600 --> 00:55:47,680
[Solmaz] thank you so much, and I'm just mindful of time 
I think the last question for my colleague at DSS.  

442
00:55:47,680 --> 00:55:57,760
When reporting to DSS of this cluster of 
events, what we put this under in the new  

443
00:55:57,760 --> 00:56:07,920
report form? 
[Lara] uh yeah I'll let you know once 
we've once we've once we've figured that out [laughs]

444
00:56:08,800 --> 00:56:16,000
[Solmaz] thank you so much and..
[Rebecca] Sorry Solmaz, just to... from our 
perspective, you would need to put for  

445
00:56:16,000 --> 00:56:23,200
a cluster of events, we would be um wanting Part 
A's submitted for those.  It could then be a later  

446
00:56:23,200 --> 00:56:28,960
part B for the cluster of events but yes we would 
require that you can review them as a cluster and  

447
00:56:28,960 --> 00:56:38,960
report them as a part B but individual part A's 
for each event yeah.
[Solmaz] Thank you so much, I  

448
00:56:38,960 --> 00:56:52,240
think it's all questions we received so far, thank 
you so much, and I'm going to hand over to Jacinda.

449
00:56:52,240 --> 00:57:00,800
[Jacinda] From both Te Tāhū Haora,  and and DSS colleagues 
it's been great to have a bunch of really good  

450
00:57:00,800 --> 00:57:06,240
questions from from the audience. I think 
we've had about 140 people on this call,  

451
00:57:06,240 --> 00:57:13,680
so it's been a large group and it's been very 
clean, so from our perspective so we appreciate it.  

452
00:57:13,680 --> 00:57:19,360
As it has been referred to, DSS is sort of running 
on the smell of an oily rag a little bit - we don't  

453
00:57:19,360 --> 00:57:28,320
have the mod cons tech as yet but we'll try 
and improve the technical knowhow prior to the next  

454
00:57:28,320 --> 00:57:36,560
forum that we run. So as as we've said, this is 
not the end of things. You do have the email  

455
00:57:36,560 --> 00:57:43,440
addresses for both DSS and Te Tāhū Haora, of which 
I've just put again in the chat so you've got them  

456
00:57:43,440 --> 00:57:48,560
down the bottom of the chat if you have further 
questions or comments or suggestions. You can go  

457
00:57:48,560 --> 00:57:54,240
to either organisation, we'd be really really 
happy to help from hear from you about those.  

458
00:57:54,240 --> 00:57:59,440
This is a this the first of many forums. 
We'd love to run these every couple of months.  

459
00:57:59,440 --> 00:58:05,840
As Carmela alluded to, we have a bunch of topics 
that we're really keen to proceed with and discuss  

460
00:58:05,840 --> 00:58:11,280
with providers, but if you do have suggestions 
about what you'd like to be covered, we'd be really  

461
00:58:11,280 --> 00:58:20,400
happy to hear about those as well. Any other 
final questions? I think we've we've got one minute  

462
00:58:20,400 --> 00:58:27,360
 to go, so maybe it's time to to close this up. We 
will, as I've said post the recording of this forum  

463
00:58:27,360 --> 00:58:31,520
onto the DSS website. We're just getting a page 
established for that, and we will let providers  

464
00:58:31,520 --> 00:58:37,680
know where that is, and how you can find them. We'll be posting dates for future forums and 

465
00:58:37,680 --> 00:58:42,880
topics once they've been decided so you can, with a 
little bit more advanced notice choose which ones  

466
00:58:42,880 --> 00:58:50,800
um are of most interest to you, and we will try and 
work out a less administrative burdensome  

467
00:58:50,800 --> 00:58:56,560
registration system in future. It's been great 
to have you all here today, appreciate that time is  

468
00:58:56,560 --> 00:59:05,760
precious and we really support working with you 
together on this really important mahi. So I will  

469
00:59:05,760 --> 00:59:15,520
close us off now with a closing karakia and we can 
come back to any of those of you who have asked  

470
00:59:15,520 --> 00:59:22,480
questions. I had just noticed that there's 
a ETA on the slides -  I'll find out  

471
00:59:22,480 --> 00:59:28,800
what the ETA is on the web page. If we are 
going to have a bit of a delay with that we  

472
00:59:28,800 --> 00:59:33,920
can probably just send them out so I'll check 
with our Te Tāhū colleagues and DSS and  

473
00:59:33,920 --> 00:59:42,000
maybe we can send them out um to attendees more 
quickly. So we'll come back to you on that okay?  

474
00:59:42,000 --> 00:59:46,320
Any other questions we'll deal with after the 
presentation, so thank you again for your time,  

475
00:59:46,320 --> 00:59:56,360
it's been great having you all here this afternoon 
and I'll close us out now with a closing karakia:

476
00:59:56,360 --> 01:00:02,672
Kia whakairia te tapu
Kia wātea ai te ara 

477
01:00:02,672 --> 01:00:02,791
Kia turuki whakataha ai 

478
01:00:02,791 --> 01:00:03,040
Kia turuki whakataha ai
Haumi e. Hui e. Tāiki e!

479
01:00:03,040 --> 01:00:11,680
Thank you so much everybody and 
have a really pleasant Tuesday evening!