project plan integrated audit

7/27/2019 Project Plan Integrated Audit

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Project Brief: Integrated audit, evaluation andmonitoring of residential disability services

project

PurposeThis project aims to integrate certification audits, developmental evaluations andassociated monitoring into one framework within residential disability services.

Background

Currently providers within the disability sector are concerned about the number of audits they have and the relevance of some of these to improving quality of lifeoutcomes for service users.

Over recent years there have been a number of developments that have shaped thedelivery of disability services.

• The New Zealand Disability Strategy was published in 2001 aimed ateliminating barriers experienced by disabled people promoting a moreinclusive society. The Strategy presents a vision for changing New Zealandfrom a disabling to an inclusive society.

• The United Nations Convention on the Rights of Persons with Disabilities and

its Optional Protocol was adopted on 13 December 2006 marking a paradigmshift in attitudes and approaches to disabled people reaffirming the humanrights and fundamental freedoms for people with all types of disabilities.

• The Social Services Committee’s inquiry into the quality of care and serviceprovision for people with disabilities was presented to the New ZealandHouse of Representatives in September 2006. This inquiry made a number of recommendations including that:

o Evaluations and audits of disability services focus on the quality of lifeand opportunities for people with disabilities rather than on compliancewith minimum standards for audit purposes.

o Disability standards are developed for community services withappropriate outcomes focused evaluation processes.

o People with disabilities and their families are given a key role in themonitoring process to ensure quality of life is measured and valued

o Evaluation reports of services are readily available to the public takingcare to preserve the privacy of individual residents or service usersand their families.

• A Government response to the recommendations made by the SocialServices Committee’s Inquiry was presented to the New Zealand House of Representatives in February 2009 and included:

o An agreement that quality of life outcomes for disabled people be

monitored rather than a tick box approach to monitoring.

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o Noting that the developmental evaluations undertaken by the Ministryof Health are consistent with the United Nations Convention on theRights of Persons with Disabilities.

o A review of the desirability and feasibility of and requirements for implementing quality of life monitoring of residential disability care

under the Health and Disability Services (Safety) Act 2001 would beundertaken to consider the role of disabled people and their families inthe monitoring process.

o Noting the Ministry of Health is moving towards making audit reportsof community disability services under the Health and DisabilityServices (Safety) Act 2001 publicly available and has directed officialsto consider whether it is possible to make contract baseddevelopmental evaluations public whilst protecting the privacy of service users and their families.

Further to these developments the Ministry of Health has commenced a project

within the disability sector to deliver more flexible options that are client drivenmoving to more use of Individualised funding and the possibility of direct funding inthe future.

It has also become apparent that in some cases audits against Health and DisabilityServices Standards (HDSS) do not demonstrate outcomes specific to the disabilitysector. This occurs when auditors fail to interpret the intent of HDSS outcomes andcriteria requirements for disability services. This may then impact on periods of certification awarded that disadvantages these providers.

Disability providers are concerned about the costs of compliance and may onoccasion receive conflicting or inconsistent information arising from both thedevelopmental evaluation and HDSS audit processes.

At a recent workshop held by the Ministry of Health with a representative group of residential disability providers and the Disability Support Network severalopportunities were identified to make improvements to current audit and evaluationprocesses.

In keeping with the recommendations and Government response to the SocialServices Committee’s Inquiry and calls from the sector, the Ministry intends toundertake a project to explore the possibility of folding certification auditing into thecurrent developmental evaluation process used by the National Quality team for theDisability Services Group. There is strong support from the sector for this project tobe undertaken.

Project DefinitionResidential disability providers have been subject to a range of audits andevaluations to meet regulatory and contractual requirements. This has createdunnecessary duplication in some cases with multiple processes where requirementshave not always been consistent or aligned with the New Zealand Disability Strategy

where Designated Auditing Agencies and evaluators have worked within a medicalmodel construct.

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This project aims to integrate certification audits, developmental evaluations andassociated monitoring into one framework within residential disability services thataligns with the New Zealand Disability Strategy. As a result, the integratedframework will:

• Contribute to improving quality of life outcomes for service users• Contribute to improving the quality of service delivery that is disability

focussed• Provide a transparent process for meeting regulatory and contractual

requirements for audit, evaluation and monitoring• Be managed by the National Quality team for the Disability Services Group.

Project ObjectivesThe project will:

• Develop an integrated framework that meets regulatory and contractualrequirements for audit, evaluation and monitoring of residential disabilityproviders consistent with the Government response to the recommendationsmade by the Social Services Committee’s Inquiry. This will ensure a focus onquality of life and quality improvement.

• Ensure the framework is disability focused and meets the intent of the NewZealand Disability Strategy

• Develop a process for the publication of factual summary reports of

evaluations/audits if this can be achieved without breaching privacy of serviceusers or their families

• Develop associated processes to support the implementation of the integratedframework across Disability Services and HealthCERT

• Identify and implement opportunities for improvement taking a stagedapproach for the immediate, short term and long term aligning changes withthe development and introduction of the integrated framework

• Develop competencies for evaluator/auditors that are consistent with themonitoring of quality of life outcomes sought through audit/evaluation.

Project OutcomesThe following outcomes will be measured as part of the evaluation of theeffectiveness of this project:

• An integrated framework is developed for audit, evaluation and monitoring of the residential disability sector

• The integrated framework is disability focussed and aligns to the principles of the New Zealand Disability Strategy

• The integrated framework meets both regulatory and contractualrequirements of residential disability providers

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• The integrated framework includes a mechanism for providing publiclyavailable factual summary information of audits/evaluations

• Evaluator/auditor competence supports achievement of monitoring of qualityof life outcomes.

Scope

Inclusions

• Residential disability providers subject to the requirements of the Health andDisability Services (Safety) Act 2001 and those who also hold a contract todeliver residential disability services with the Ministry of Health

• Ministry of Health policy and process development• Forums/workshops with stakeholders as needed•

Implementation planning including piloting where appropriate• First stage implementation where at all possible• Interim evaluation against project outcome measures.

Exclusions

• Residential disability providers delivering mental health services as aseparate project would be needed to work with District Health Boards ascontract holders.

• Full implementation of the integrated framework should a pilot approach beadopted

• Full evaluation of the effectiveness of the outcomes of the project as therequirement for a full evaluation will be identified at a later stage.

Linkages• Residential disability providers• Disability Support Network• Designated Auditing Agencies• Ministry of Health contracted evaluators• HealthCERT, Ministry of Health• National Quality team for the Disability Services Group• NASCs via NASCA• Child Youth and Family (Ministry of Social Development)• ACC• HDC• NGO Working Group

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AssumptionsThe Health and Disability Services Standards (HDSS) are outcome focusedstandards that apply to the residential disability sector and will continue to be utilisedin determining compliance to the provisions of the Health and Disability Services(Safety) Act 2001. The way in which the HDSS are interpreted by evaluator/auditorswill change to ensure a disability and quality of life focus.

Approach

Existing Ministry of Health staff will undertake many activities. Where activities donot have any direct involvement of the Project Manager, the Project Manager will bekept abreast of activities in order to ensure a coordinated approach that iscomplementary to the project objectives.

Deliverables•

Project Plan• Communication Plan (in conjunction with MOH Communications Team)• Monthly reporting to project sponsors• Interim evaluation of project outcomes• Health Reports• Policy (if required)• Internal processes including linkages between Disability Services and

HealthCERT• Implementation plans•

Ministry of Health Guidelines for DAA’s• Reporting template for DAA’s• Monitoring and evaluation plans• Pilot project plans and associated documents (if required)• Process for publishing summary information• Process for monitoring effectiveness of DAA reporting• Web based resources and information to support quality improvement

Project Structure OverviewDescription Who

Project sponsors Originator of the project.Ultimate decision maker.

Rose WallRhondda King

Project manager Accountable for the project work.Works with key informants to meetproject objectives and deliverables.Communicates with sponsor onprogress and issues

Christine Howard-Brown

Steering Group Resolves major issues

Decides prioritiesEnsures project plan is aligned to

Rose Wall

Marion McLauchlanRhondda King

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Description WhoMinistry strategy and objectives Gillian Grew

Janice Wilson or nomineeChai Chuah or nominee

Project workinggroup Undertake delegated project tasksto produce products required withinthe project.Works under direction of the ProjectManager.

Donna GordonRowanne JanesChristine Howard-BrownRhondda King

ExpertReference Group

Contributes to the project providingadvice and review of variousprocesses/information.

Six providers asnominated by DisabilitySupport NetworkDisability Support NetworkrepresentativeEvaluator Representative

Auditor RepresentativeMinistry of Health officialsConsumer representativeCultural representative

Consumer advisory group

Contributes to the project providingadvice and review of variousprocesses/information.

Consumer Consortium A group of consumerscurrently receivingresidential disabilityservices

Proposed TimeframeEstimated milestones and completion dates

Milestones/Key Tasks Estimated CompletionDate 1

Consumer consortium meetings x2 TBCConsumer workshop (residential consumers) x1 TBCProject start up October 2010Integrated framework structure developed December 2010Pilot or national implementation decision December 2010

Immediate priorities addressed March 2011Integrated framework content developed March 2011Evaluator/auditor competencies developed March 2011Processes to support integrated framework completed May 2011DAA Handbook updated May 2011Gazette notices issued May 2011Publishing summaries process June 2011DAA selection process June 2011DAA training July 2011IT process changes completed August 2011Pilot project planning (or national) August 2011

Pilot project implementation (or national) October 20111 Indicative

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Evaluation plan November 2011Pilot evaluation (if piloted & assumes a 7 month pilot &

2 month evaluation period) June 2012

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project plan integrated audit

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