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Ann-Marie Smith's death exposes systemic disability care failures

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Human Services Minister Michelle Lensink says Ann-Marie Smith’s paid care worker had likely worked “many years” with vulnerable people without correct screening approval, with “systems failures” to blame for the State Government giving the care worker an official clearance weeks after Smith’s death in hospital following prolonged neglect.

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As the State Opposition called for an independent judicial inquiry into Smith’s death, Lensink today revealed a disturbing insight into the confusion and blurred reporting lines between state and federal oversight of disability care.

Lensink said that Smith’s paid carer Rosa Maione had apparently worked for years for employer Integrity Care SA without the proper State Government screening checks and approval – despite unproven allegations of theft from clients and being stopped from working with Domiciliary Care in 2013, while it was still a state-run agency.

“Probably for many years, on my estimation,” Lensink told ABC Radio Adelaide.

“And that is a responsibility of the provider – all providers are required to have valid screening checks in place.”

Lensink also said that any other Maione clients were now being checked by federal authorities.

“That is the role of the NDIS and, in terms of any of the people who were cared for by Rosa Maione, the federal minister has let me know that all those people are being checked,” she said.

This afternoon, the NDIS appointed a former Federal Court judge to conduct an independent investigation into circumstances surrounding Smith’s death.

NDIS Commissioner Graeme Head has appointed Alan Robertson to lead an inquiry into the adequacy of the supports and services provided to Smith.

Federal NDIS Minister Stuart Robert said on Tuesday he fully supports the review which will be conducted in a manner that avoids prejudice to any other proceedings, including an SA police manslaughter investigation.

Maione was a paid carer employed by Integrity Care SA, a non-government organisation administered under the federal National Disability and Insurance Scheme (NDIS) since 2018.

She had for some years been the sole paid carer for Smith, a 54-year-old Kensington Gardens woman with cerebral palsy who died in hospital on April 6 from septic shock, multiple organ failure, severe pressure sores and malnourishment.

Police have opened a manslaughter investigation and the death has also sparked Coronial, state and federal inquiries.

Smith was previously under the care of state-run Disability SA, but was transferred to the NDIS in 2018.

While the State Government is no longer responsible for oversight of Commonwealth clients such as Ann-Marie Smith, it is still responsible for screening paid care workers in SA.

Despite Smith’s death on April 6, Integrity Care on April 16 applied to the State Government for a working with vulnerable people screening for Maione – which was granted.

Integrity Care also failed to tell the NDIS about the death of the client it was paid to care for, despite a requirement to do so within 24 hours.

And despite the SA Public Advocate and Principal Community Visitor being told of Smith’s death three days later on April 9, Lensink said she and the Human Services Department only found out after police declared it a major crime a month later.

Lensink said it was only then that Maione’s carer history was checked – and her just-granted screening approval revoked on April 24 – because the State Government did not know paid carer’s names, and the screening unit was only alerted or red-flagged if a serious charge was laid.

“In order to revoke screening of the carer, we would have had to know the carer’s name,” Lensink said.

“At the time that this worker applied for her screening, she hadn’t been charged and she didn’t have a criminal history.

“And the history of her alleged stealing in 2013 didn’t show up, that information didn’t go anywhere, it was in a file which we discovered very recently and had been there for seven years.

“So if she had had a screening which is required by law, then as soon as she was charged that would have flagged the system.”

Lensink said there were “a lot of unanswered questions”.

“I am disturbed as anybody about these systems failures,”she said.

“We have a continuous monitoring system in South Australia for screening and we were left without knowledge of this situation.”

Premier Steven Marshall said he would “absolutely” back the Federal Government if it opted to shut down Integrity Care, after the State Opposition demanded it be closed.

“We need to be working much more closely with the Federal Government,” he said.

“I don’t particularly want to comment on a particular case that’s the subject of a major crime investigation in SA as well as a coroner’s inquiry, but I do want to talk about the need for us to identify the gaps that exist [and] it’s quite clear there are some gaps and they need to be addressed.”

Human Services Department acting chief Lois Boswell yesterday gave evidence to a Parliamentary committee that Maione had been “banned” by Domiciliary Care in 2013 after a client’s family alleged that money had gone missing from a home while she was present.”

“There was no specific investigation and (it) was not reported to the police because the family asked for it not to be, so it was an internal ban within the department,” Boswell said.

Maione’s legal counsel Stephen Ey today told InDaily that allegations of theft were unsubstantiated.

“They were never proceeded with and we deny any wrongdoing,” he said.

Ey also said it was wrong to claim that Maione had been “banned” from working within Domiciliary Care.

“We dispute that as well,” he said.

He said Maione would contest any police charges that might arise from their investigation into Smith’s death.

Boswell also told the Parliamentary committee that it was “horrendous and unthinkable” that Integrity Care SA rostered a single paid carer for Smith’s full-time needs.

“The circumstances of this are the first we’ve ever heard; where one person was the only one providing care to someone who needed it seven days a week,” she said.

“Any responsible provider would know that doesn’t appear to be possible.

“There has clearly been safeguarding failures for Ann Marie, and these may have occurred over a number of years.”

Opposition Leader Peter Malinauskas today called for the State Government to abandon a taskforce it announced on May 18 to examine any gaps in oversight and safeguarding for people living with a disability, which will recommendations to both the State Government and NDIS.

The taskforce will be chaired by Disability Advocate David Caudrey, who was appointed to the new role in 2019 by the State Government as a response to the NDIS.

“What we want is an independent judicial inquiry into this astonishing and appalling situation that we are continuing to learn information about by drip-feed over the last couple of weeks,” Malinauskas told told ABC radio.

He said part of the government’s ignorance of Smith’s death for weeks was that the state’s Principal Community Visitor is also the Public Advocate, and did not report the death to Human Services despite being told about it within three days.

“The reason why the Minister didn’t know what was going on, the reason why her department didn’t know what was going on, was because the Minister set up a system which would ensure she didn’t have a line of sight over these instances,” he said.

“And more than that, she was specifically advised repeatedly by a range of different authorities to not go down that path and she decided to and we now have the situation we’re in.

“We need an independent judicial inquiry, not a bunch of reviewers reviewing themselves which is exactly what the Premier and Minister have set up now.”

Lensink set the former Labor Government knew before the last state election that under the NDIS, the state’s Community Visitor Scheme would not be able to operate as it previously did.

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