In 2023, we asked Jennifer to review the way we handled Irabina.

When you review something, you check to see what: 

• works well 
• needs to be better. 

We explain what we found out from Jennifer on the following pages.

We started teaching Irabina about the right way to use restrictive practices in 2019.

But in October 2020, people started making complaints to us about Irabina.

When you make a complaint, you tell someone that something:

• has gone wrong 
• is not working well. 

Most of the complaints were about restrictive practices in the new day program.

In 2021, we learned that Irabina was using restrictive practices when they were not allowed to.

We also learned that Irabina used restrictive practices in the new day program that put participants at risk of:

• getting hurt
• dying.

We received information from Irabina about their use of restrictive practices.

We believed that this information was true.

We now know that this information was often:

• not true
• not all the information we asked for.

We also received information from:

• people who made complaints

• a report from the Victorian Government.

We could not visit Irabina in-person because of COVID-19.

This made it hard to confirm if the information was true.

Our computer systems also made it hard to share information about Irabina with the right people.

We now know that there were some problems with how we handled Irabina.

We believe this is because:

• lots of people stopped working for us
• we did not have enough people to do the work.

In October 2021, we had enough proof to give Irabina an infringement notice.

An infringement notice is a document that explains:

• that someone has broken the law
• what they need to do now.

We did not give Irabina an infringement notice.

In August 2022, we received 2 reports about the way Irabina was using restrictive practices.

These reports showed that we:

• should have stopped what Irabina was doing

• could have banned 2 of the people who ran Irabina from working in disability support services.

We did not take any action after we received these reports.

When people made complaints to us about Irabina, we:

• did not answer some of them

• took too long to answer some of them.

We have already fixed many of the problems that the review found.

This includes funding for more staff.

Funding is money from the government to pay for public services.

We also plan to get a better computer system.

But there is still more to do to make sure participants are safe.

We need a better way to check that programs for children with autism:

• are safe
• work well.

We need to check that providers have the right skills for the supports they deliver.

And we need to check that new programs are safe for participants.

We need to work more closely with the National Disability Insurance Agency (NDIA).

We need to work more closely with state and territory governments to make sure providers follow the law.

We need to make it easier for families and carers to contact us when they have a problem with a program.

We can look into starting a new family and carers group.

This could help us communicate with the families of participants.

We can also look at new ways of:

• visiting providers
• checking how providers treat participants.