What disability housing support could look like – beyond Australia’s outdated group home model

Group homes have long been the default for Australians with disability who need a lot of support. This has typically meant four or more people with disability living under one roof, with a 24-hour roster of support workers.

Policymakers assumed this model was the most cost-effective way of delivering safe and good quality services.

But in reality, group homes are expensive and often deliver poor outcomes for participants.

In 2023, the Disability Royal Commission and the National Disability Insurance Scheme (NDIS) Quality and Safeguards Commission’s Own Motion Inquiry Report provided overwhelming evidence that the estimated 17,000 people living in group homes are at increased risk of violence, abuse and neglect.

Emerging evidence suggests moving to more contemporary housing options, tailored to their needs, can significantly improve the health, wellbeing and community inclusion of people with disability.

One promising alternative to group homes in Australia, introduced in the last decade, is apartments funded by Specialist Disability Accommodation (SDA) payments. Most of these nearly 3,000 SDA apartments are integrated into mainstream residential developments. They are designed to maximise independence, community inclusion and the efficient delivery of support.

One apartment resident, Bruce Camplin, recently told the ABC:

I have met more people in the two years and two months that I’ve been living here than I did in the 34 years at the group home.

In some places – such as British Columbia in Canada – group homes are now reserved almost exclusively for people with the highest support needs.

So, aside from SDA apartments, what are the other alternatives to group homes? And what’s holding up their wider roll-out in Australia?

How did we get here?

Before the NDIS, housing and support were block-funded. This means the government paid providers directly to run housing and support services, regardless of whether residents’ needs were met or their lives improved.

When the NDIS was introduced, individualised funding and market competition were meant to change that and foster innovation. Instead, little has changed: most group homes and their residents simply moved across from state systems, and providers kept delivering the same services under a new funding model.

Providers delivering support in group homes have no reward or incentive for helping people become more independent or move to less resource-intensive options.

The support provided in group homes and other shared settings is called supported independent living (SIL). NDIS spending on SIL rose by 40% in three years, to A$12.4 billion in 2025–26.

By 2033, more than 50,000 people are expected to receive SIL, as more ageing parents can no longer care for their adult children with disability.

In the current market, NDIS participants with high support needs mostly only have access to two kinds of services from support workers – either a minimum two-hour block, scheduled days in advance, or a fixed round-the-clock roster in a group home.

So, despite the costs increasing, this type of care does not deliver anywhere near enough flexibility or control for the way many people with disability want to live.

So, what are the alternatives?

Internationally, there are other types of arrangements that have been shown to give people with high support needs more flexible, personalised options – often at lower cost.

In host and homeshare arrangements, a person with disability shares a house with a live-in supporter. They provide companionship and some light support, such as prompting to help get ready for the day or cooking a meal together.

In exchange, the host or housemate receives a stipend, reimbursement or free rent, depending on the arrangement. Our economic analysis shows host and homeshare could save the government $51,000 per person a year, compared to group home arrangements based on one support worker and three participants.

Another affordable option is the drop-in and on-call model. This means a person with disability lives independently but is able to schedule assistance for a short period of time (15–60 minutes), or contact a reliable on-call service when unexpected needs arise.

This support, delivered by a local team of mobile support workers, enables people to stay in their homes, knowing support will be there when they need it.

Where to now?

Pockets of innovation in Australia show alternative models of support are achievable here. But there is an urgent need to diversify what is available so that costly support in group homes is not the main option.

Now, with the government trying to rein in NDIS costs, it is consulting on a more hands-on approach. This means commissioning a smaller number of providers to deliver supported independent living, for some NDIS participants, walking back total reliance on the market driving who provides services. Three pressures are driving this: rising costs, poor outcomes and providers struggling to stay viable.

Many providers are making a loss due to the increasing number of vacancies in group homes. Some NDIS participants are voting with their feet and moving out of group homes. As older residents die, they are not always being replaced by younger residents.

For those who choose to stay in group homes, measuring the quality and outcomes of these services is essential – and services must remain viable for providers amid rising costs and vacancies.

The government must also commission more contemporary housing and supports to meet the very different needs and expectations of the next generation of NDIS participants.