Disability advocates have warned that support workers are struggling with woeful pay, high turnover, and casualisation, while dealing with added responsibilities and complexities in group homes.
Advocacy for Inclusion chief executive officer Christina Ryan has warned the staffing pressures currently experienced in ACT group homes, both government and non-government, will not simply be cured by the transition to the National Disability Insurance Scheme.
"Even with the best intentions, it's pretty clear that the system is still needing a hell of a lot of work," Ms Ryan said.
"It's not going to be solved by the NDIS. Everybody is just thinking the NDIS will fix all of this, but the truth is it won't."
Disability Minister Joy Burch said on Wednesday that she had been disappointed with the Commonwealth's lack of action on the disability support workforce strategy for the NDIS.
Ms Burch said an additional 70,000 workers would be needed nationally for the NDIS, something the federal government was supposed to have taken charge of.
But she said that a paper presented on the issue at a meeting of the disability reform ministerial council last week was in such a poor state that it had to be withdrawn.
"I am disappointed that the Commonwealth, which has carriage of a workforce strategy, is yet to deliver," she said.
"Here in the ACT we can't wait, we are stepping up to deliver a workforce strategy, to make sure we've got an attractive work environment in the community sector, in terms of their pay and conditions."
"Again we can't wait for the Commonwealth and states and territories to agree because they won't get there til 2019."
The 2011 death of Stephanie Fry highlighted problems of staffing continuity and preparation, and a concerning tendency to place casuals in unfamiliar environments. Similar criticisms were made a decade earlier in Justice John Gallop's far-reaching inquiry into the ACT's disability sector.
Ms Fry choked and died after being fed sandwiches without proper supervision, in clear contradiction of written warnings on her file about her potentially-fatal choking risk, which was supposed to be required reading for staff.
"If Stephanie gets the chance she will gorge until she chokes and dies. Stephanie is not to be given bread," the warning stated.
Two of the three casuals on shift that day had never worked in the group home before. The third, who had worked 10 shifts there, left the home while the sandwiches were being prepared.
Two senior managers were also in an office attached to the group home, but were not there in a support worker or house supervisor capacity. One of those managers walked in as casual staff were preparing the sandwiches.
Nothing was done to stop the bread being given to Ms Fry.
Her family had previously warned Disability ACT about the staff turnover in the home and told police investigating Ms Fry's death that the government appeared unable to retain staff.
They said the turnover was causing communications breakdowns and distressing Ms Fry.
Ms Ryan said she was concerned that the problems identified in the Gallop inquiry 14 years ago appear to have been unresolved.
She said the casualisation of the workforce must be avoided, and the constant turnover of staff addressed.
A significant part of the problem, she said, was the "embarrassing amount of money" being paid to support workers.
"The casualisation, coupled with the very poor rates of pay, and at the same time you've got an increased expectation of responsibility and commitment from workers... there's an equation here that's not stacking up," Ms Ryan said.
"It doesn't stack up and of course you're not going to get the workforce you expect.
"It's about the community and governments, both state and territory, respecting people with disabilities, respecting [support work] is actually highly-skilled and important work, and allocate funds accordingly."
The government is expected to transition out of group home environments by 2017.