THE NSW government insists its plan to close the Stockton, Tomaree and Kanangra disability centres is proceeding well, despite a litany of complaints and fears expressed by family members, staff and their unions.
More than 300 people are being moved out of the three centres, into some 69 group homes across the Hunter and elsewhere in the state.
The program was to have been finished by July last year but a series of delays mean the government still has to buy one block of land and only 35 of the new houses are classed as being under way.
A schedule drawn up in March showed 25 homes to be finished between June and November, with people to move into them within three months of their finish dates.
One home the Newcastle Herald has seen is due to be finished in August but was at the frame stage last week, and there are widely held doubts that the latest timetable will be met.
Family and Community Services (FACS) intends transferring staff to the non-government organisations running the group homes over the coming 18 months, with about 540 employees eligible to move.
The two main unions at the centres - the NSW Nurses and Midwives Association and the Public Service Association - hold major fears for the futures of patients who have either complex health needs or who can be violent or difficult to handle.
They are also concerned that privacy laws mean that the public - including people living next to the group homes - are not allowed to know anything about their new neighbours, including a small number who are formally classified as paedophiles, or regarded as such by staff.
The Herald has been told that concerns about such patients at Kanangra interacting with members of the public was one of the reasons the authorities recently closed the Morisset Hospital grounds to people wanting to feed its increasingly well-known kangaroo population.
Front line staff from Stockton, Kanangra and Tomaree say they have not been consulted on the habits and needs of the people they care for, and fear that new staff hired by the private agencies running the group homes will struggle to cope with the more challenging behaviours of some patients.
The group home buildings will be the responsibility of a consortium called Home4Life, which includes Newcastle's Compass Housing.
Three "supported independent living providers" have signed agreements with Family and Community Services (FACS) - New Horizons, Cerebral Palsy Alliance and The Disability Trust - to support the residents. A separate four-home tender for Kanangra clients with "particularly complex needs" was confirmed last month.
"Most of the clients aren't too bad, but there are some who are extremely violent, who will smash furniture to pieces, who attack you, who you simply can't turn your back on," one long-term staffer said.
"Then there's the coprophiles - and there's no easy way to say this - the ones who eat faeces. It's not all the happy picture of disability that the government would like everyone to imagine."
Asked what safeguards were in place when it came to patients with such troubling behaviours, the department said: "Both community and client safety is taken fully into account in the design and location of all new group homes.
"All residents have appropriate supports under their NDIS plans to enable them to engage safely with the community."
Staff are also worried that group homes will be "small prisons" for those Stockton, Kanangra and Tomaree residents used to wandering the large grounds of each centre.
"Those clients who are mobile are used to being able to walk around the grounds, to have their freedom, to get away from people if they get annoyed, just like you and I might," one staffer said.
"But what I've seen from the photos of some of the group homes once you get out the back door it's a metal fence.
"You can't swing a cat.
"The homes are designed so that there are two living areas, so people can supposedly get away from each other, but that then raises questions about how adequately a house of four or five residents can be adequately supervised with only two staff."
Staff are also concerned about their futures, with no redundancy payments available for those who do not transfer to the group homes.
Hunter Workers secretary Daniel Wallace said the disability sector was the only part of the NSW public service that did not offer voluntary redundancies during privatisation.
FACS told staff: "To ensure the success of the NDIS, it is vital that our skilled workforce is retained in the sector. If your role is identified as transferring, you will be expected to transfer to the new provider.
"You will not have the option to take a redundancy or transfer to a role in another public sector agency instead."
Staff going across will receive a transfer payment of up to eight weeks pay, and a two-year promise to maintain pay and conditions.
Paul James of the Public Service Association says the group-home care providers would almost certainly want to cut employee costs with a new enterprise agreement once the two years was up.
Pointing to an announcement this week by the Benevolent Society that it was cutting jobs and making other changes to ensure it was "financially sustainable under the NDIS", Mr James said the cost pressures emerging from the NDIS were becoming increasingly obvious.
Staff say they have been warned against speaking publicly about the situation but the Herald has been told of wide-ranging concerns about the care that would be given to patients once they moved into their group homes.
Two Stockton residents died, and another was hospitalised, soon after they moved out of Stockton in 2017, and the Ombudsman found last year that there were "significant problems" with their care in the group homes.
"With some of these people, their nervous systems are severely compromised," one senior staffer said.
"For example, the muscles in their throat lack coordination and food can easily go down the wrong way. There's a technique of feeding that the disability nurses all know, and it's different for each client, and they know what size of pieces the food has to be, it's consistency, whether it's thin or thick, and how much time they need to swallow and how long to wait before the next mouthful."
While the residents of Tomaree have had their medical needs catered for by local GPs, a team of on-site GPs look after the residents of Stockton and Kanangra, who generally have more complex and difficult medical needs.
The Herald has been told that medical staff will not be transferring to the private providers, and that their employment futures remained up in the air.
Staff said FACS tried to have suburban GPs visit the Stockton Centre recently to meet and familiarise themselves with their likely new patients, but no doctors answered the call.
A roster of specialists also visit Stockton once a month, either bulk-billing or providing their services without charge.
"They include a neurologist, a psychiatrist, a geriatrician, a gastroenterologist and an ophthalmologist," one staffer said.
"There's an endocrinologist, a rehab physician and respiratory physician visiting when necessary. They're all very experienced and each has a special interest in dealing with the complexities of developmental disability."
This service would end once the residents moved to group homes.
"Once the residents are in the group homes, they will be expected to use the public hospital system, joining public waiting lists and in all probability see a registrar without experience in dealing with such patients," the staffer said.
At present, day-to-day care of the 300 or so residents is provided by nursing-led teams, using registered nurses (RNs), enrolled nurses (ENs) and assistants-in-nursing (AINs). Some residents have nurses with extra qualifications in "behaviour support and intervention" when working with people with disability.
Group homes usually operate with disability support workers (DSWs), at pay rates under nursing levels.
Employment provider Seek says no formal qualifications are needed to be a DSW although some employers require a vocational qualification such as a Certificate III in Individual Support or Certificate IV in Disability.
The nurse's union is concerned that if members moving to group homes are employed as support workers - even if they are paid at nursing rates - then their registrations would likely lapse, rendering them unable to work as nurses.
Nurse's union organiser Margaret Burgess said the union and its members had been raising concerns about the level of care in group homes for years, but the government was "pushing ahead with the closures regardless".
The union was also concerned about workloads, with FACS relying heavily on agency nurses being brought in to cover shortages at Stockton and Kanangra.