The NDIS is failing profoundly disabled people stuck in group homes. Here’s how to fix it

The National Disability Insurance Scheme (NDIS) is transforming the lives of hundreds of thousands of Australians with a disability. For the first time, many can get the support they need to live more independently and be part of society.

Yet the NDIS is failing people with the most severe disabilities: those in housing and intensive care needs.

The huge majority of people in this part of the program live in group homes, with little choice about where they live, who they live with, and who provides support. Worse, they face high levels of violence, abuse, neglect, and exploitation.

Intensive housing and housing supports are one of the most costly parts of the NDIS, costing approximately AUD 15 billion in 2023-2024. Although this is a tiny group – around 7% of all NDIS participants – the total number of support packages for these participants is approximately 37% of the total program expenditure.

At this price, disabled Australians deserve and taxpayers expect high quality services.

Fresh analysis in latest Grattan Institute study report shows how the government can create creative alternatives to group homes that cost the same or less.

Create alternatives to housing and life support

There are better alternatives to group homes: these are known as individual life arrangements. United Kingdom, Canadaand closer to home, Western Australia reformed housing for people with disabilities and introduced recent housing solutions that offer people greater choice and a more individualised approach.

Individual housing solutions are integrated into the community as much as possible. They rely on a mix of supports, from formal (hourly paid support workers), to semi-formal (landlords or roommates who receive a subsidy for their expenses), to informal (family and friends).

A host arrangement is where an adult with a disability in the NDIS lives with a ‘host family’ or ‘host roommate’, who is not related to them, in the host’s home, becoming part of the household. The host can be a couple or an individual, and they provide semi-formal support to support with day-to-day activities.

A similar arrangement is home-share: an adult with a disability in the NDIS lives in their own home (either owned or rented) with a housemate who provides support. Hosts and housemates can support with emotional support, companionship, cooking, cleaning, night-time support and other household duties, and receive funding for their own expenses.

Based on our estimates, individual housing solutions could be cheaper than group homes, which operate on a one-to-three basis (one support worker for three disabled residents), as recommended in last year’s Independent NDIS Assessment.

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Individual housing solutions cost the same or less than group homes, compared to the 1:3 benchmark proposed in the review

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Individually adapted housing is not only cost-effective, but also gives people with disabilities the opportunity to choose where they live, who they live with and who supports them.

Share homes, not group homes

Instead of group homes that are run more like service facilities than people’s homes, we recommend reforms that create shared homes. So when people with disabilities choose to live with other people with disabilities and share support, they can choose the rhythm of their daily lives and who cares for them.

Moving to a system where paid support staff time can be shared can dramatically reduce support costs, as this chart shows. This is critical in a system that is facing enormous cost pressures.

We also recommend making systemic changes, including:

• separation of housing and living support in shared accommodation, as Independent NDIS Assessment recommended
• enforceable service agreements (similar to contracts) between disabled people and suppliers
• support from housing and accommodation “navigators” to determine individual living conditions.
• mandatory registration for providers of housing and life support services and unannounced inspections.

To give disabled people the opportunity to choose where to live, the government should introduce a rental levy to support disabled people move out of group homes and into the private rental market.

An increasingly common feature of shared homes may be the sharing of both formal and semi-formal support. Combining the economies of scale of co-worker support with semi-formal roommate support would be a cost-effective way of running shared homes in the future.

Time for NDIS to come on board

Currently, disabled people have to provide extensive evidence about the support they need and are then told what support they can get and how much – often without ever meeting the decision maker.

People are therefore forced to choose between different options before they have the opportunity to try alternatives that may be better, safer and cheaper.

Our proposal is that people with disabilities get a adaptable budget up front. Then you can start planning.

People should have access to independent advice to plan their best life within their budget. The National Disability Insurance Agency should commission housing and living navigators to provide disabled people with this vital support.

We all try different arrangements in life and gradually work out what works best for us. We need information and options to choose from to get the best outcome – the same goes for people with disabilities.

Providing the right services for people with the most severe disabilities who need 24/7 support should be a litmus test for any government that wants to get the NDIS back on track. Our research shows that real choice and better quality services are within reach for Australians with disability – and governments don’t need to spend a lot more to do it.