Despite significant efforts to end it, violence, abuse and neglect continue to contribute to preventable harms and deaths among people using disability services. To explore why these harms persist and what is needed to prevent them, we examine the safety-related attitudes and practices among frontline staff delivering services in the context of an individualized funding scheme, Australia’s National Disability Insurance Scheme (NDIS). Analysis of survey data (n=2341) showed almost half of frontline disability workers were aware of harms affecting clients in the past year, and three in five felt their employers’ safety and incident reporting protocols were inadequate. Workers’ accounts of barriers to performing their safeguarding roles underline how government’s meta-regulatory approach is enabling provider organizations to prioritise financial concerns and tolerate high safety risks. We argue that advancing the rights of people with disability to be safe from harm whilst engaged in social services requires changes in their external regulatory environments and in structures of power between workers and managers, so that policy, funding and regulatory settings enable appropriate local safety practices to flourish.

尽管为结束这种情况做出了巨大努力，但暴力、虐待和忽视继续导致使用残疾服务的人可预防的伤害和死亡。为了探讨这些危害为何持续存在以及需要采取哪些措施来预防这些危害，我们研究了在澳大利亚国家残疾保险计划 (NDIS) 的个性化资助计划背景下提供服务的一线员工的安全相关态度和做法。对调查数据 (n=2341) 的分析表明，在过去一年中，近一半的一线残疾工人意识到影响客户的伤害，五分之三的人认为他们的雇主的安全和事故报告协议不充分。工人对履行保护职责的障碍的描述强调了政府的元监管方法如何使供应商组织能够优先考虑财务问题并容忍高安全风险。我们认为，促进残疾人在参与社会服务时免受伤害的权利需要改变他们的外部监管环境以及工人与经理之间的权力结构，以便政策、资金和监管环境能够实现适当的当地安全实践蓬勃发展。