The COVID-19 pandemic is not over, and this winter presents ongoing challenges to safeguard your aged care consumers and workers. Precautionary measures are available and should be prioritised, including ensuring up-to-date vaccination for both consumers and staff against COVID-19 and influenza. Reducing the risk of severe illness, hospitalisation or even death is in everyone’s interests, and providers are reminded of your obligations under the Aged Care Quality Standards to ensure timely access to vaccine and effective infection prevention and control to protect older people in your care. The Department of Health and Aged Care is continuing its series of free webinars to help providers be ready for and respond to an influenza outbreak alongside the continuing threat of COVID-19. The second winter preparedness webinar, which focused on response, is now available to watch on demand. Well-rehearsed decisions and actions taken without delay during the response phase of an outbreak, based on preparations made during your readiness phase, will ensure that your service can address any outbreaks early and lessen the potential impacts. Also, to make it easier for providers to contact the Commission and obtain relevant information, we have recently updated our ‘Contact us’ webpage. You can read more about this in this edition. An incident management system (IMS) is an important element of effective clinical governance for all aged care providers. There are 6 essential elements to an effective IMS and in this next article in our series, we look at the fifth element that residential aged care and home care providers must demonstrate. When an incident occurs, you will need to consider and take all reasonable actions to prevent or minimise the risk of the same or similar incidents recurring. Whenever an incident occurs, you should consider whether it could have been prevented, or the impact lessened, if you or your staff had taken some action. You should also consider if the incident presents ongoing risks to consumers, visitors, staff or others. When considering what actions you should take to respond to an incident, ask yourself: Keep in mind that consumers’ views on these questions may contribute unique insights. Possible actions you may take could include: Depending on the circumstances of the incident, it may also be appropriate to take staff disciplinary action. This may include ongoing performance management, implementing a probationary period, standing down a staff member pending an investigation or terminating employment. As an aged care provider, you are responsible for ensuring that all necessary actions are taken, and updates on progress and outcomes are given to impacted residents, families, staff and service providers. Read our ‘Effective incident management systems: Best practice guidance’ for detailed information about how you can develop and embed an IMS in your service. To read the previous articles in this series, go to the February 2022, March 2022, April 2022 and May 2022 editions of this newsletter. The Commission receives more than 80,000 pieces of communication each year via phone, email, post and the contact forms on our website. Communication with aged care consumers, families and aged care services is a very important part of our business and we want to make it easy and simple for anyone to contact the Commission. We’ve recently improved the contact forms on our website. The new forms are available on our ‘Contact us’ webpage and start with the simple question: ‘How can we help you?’ There are a range of options to guide users to the help they need. You can make a complaint, an enquiry, order a publication or request more information using these forms. We have streamlined the process for lodging a complaint about a service provider or about the Commission by creating a single ‘I want to make a complaint’ form. This form captures all the essential information we need to progress a complaint. These changes have been introduced following consultation with older Australians, their carers and service providers. The new forms are available on our website. We expect that these changes will make it easier for people to connect with us and help us to respond more quickly. On 27 June, improvements were made to the Serious Incident Response Scheme (SIRS) online reporting form found in the My Aged Care Service Provider Portal, which is being renamed as the My Aged Care Service and Support Portal. These improvements will give residential aged care providers the ability to: A number of other changes have also been made to the My Aged Care system. A full summary of the updates is available on the Department of Health and Aged Care website. The information collected through the SIRS reports benefits aged care residents by driving improvement at a sector and service level to reduce the number of preventable serious incidents. Residential aged care providers must include descriptive and accurate details in their SIRS reports. This enables the Commission to assess the risk and impact of the reportable incident on the resident, identify whether the provider has appropriately responded to the incident, and whether the provider has an effective incident management system in place. It is important to appreciate that the information collected about serious incidents in local IMSs and through the SIRS reports to the Commission benefits all aged care residents. Individual residential services are expected to use their own information to drive down the risk of preventable serious incidents to their residents. The Commission’s use of the information is aimed at reducing avoidable risks at both service and sector-wide levels. For incidents involving unlawful sexual contact or inappropriate sexual conduct, the Commission considers these incidents to be Priority 1 reportable incidents that must be notified to the Commission within 24 hours. Where an incident involves actual, suspected or alleged unlawful sexual contact, this must also be immediately reported to the police. If in doubt, contact the police. You must also take action to ensure that appropriate support is provided to the affected consumer and their family. Updates are being made in July to our SIRS decision support tool and other guidance to reflect this. Visit our website for more information on the SIRS, to access SIRS guidance, and to register to attend one of our virtual SIRS workshops.Commissioner’s message
Incident management system essential element #5 – Implement actions
IMS essential element #5 – Implement actions
More information
It’s now easier to contact the Commission
Recent updates to the Serious Incident Reporting Scheme reporting form
Home services – assessment and monitoring
The Commission recognises that there are many types of home services providers working in a wide range of care and service settings, ranging from relatively small or specialised to very complex.
A quality review of a home service provider undertaken by the Commission involves an onsite quality audit. During the quality audit the Assessment Team will assess the quality of care and services provided through the home service against the Aged Care Quality Standards. The quality audit includes a visit to the provider’s premises.
The Assessment Team will request relevant documents during the quality audit to inform the performance assessment. The key documents that will be requested include, but are not limited to:
- a consumer’s care planning documentation, such as:
- the most recent assessments of the consumer’s care needs, goals and preferences
- the consumer’s current care plan and the date it was last reviewed
- progress/consumer file notes for the previous 30 days
- the consumer’s home care agreement
- the consumer’s home care budget and monthly statements for the past 2 months
- a list of key staff (employed or contracted) currently involved in service delivery to the consumer and their contact details.
The outcomes of the performance assessment are written up as a quality audit report. Providers are given an opportunity to respond, reflect on their current practices and explore continuous improvement strategies.
Further information can be found on our ‘Home services’ webpage.
Are you focusing on managing the key risks in providing home services?
The Commission’s enhanced quality audit program of home services continues to gather momentum with 142 quality reviews completed between 1 July 2021 and 31 May 2022, and a total of more than 190 expected to be undertaken in the 2021–22 financial year.
To help home services providers to ensure and improve the standard of their care and services, we have recently released guidance on the key risks to safe, quality care for consumers of home services, which includes a new risk checklist tool for governing bodies.
The guidance identifies the 5 key risks in the provision of home services as:
- organisational governance
- care planning and assessment
- clinical care
- vulnerable consumers
- management of package funds.
This guidance will help you to review your performance and identify any areas for improvement including your organisation’s governance, systems and processes. This will support you to deliver quality, best-practice care and services to consumers in a way that suits them and assists them to remain safely in their homes for as long as possible.
In addition to assessing and monitoring provider performance against the Quality Standards and legislation, our team of home service quality assessors is focusing on provider compliance with the identified key risk areas. As part of these activities, we will be looking at evidence that you are proactively assessing your organisation’s performance to identify issues and make improvements.
The risk checklist tool will help you to identify and manage these key risks to deliver quality consumer experiences and ensure that you are well positioned to meet your ongoing regulatory obligations. We will be doing a deep dive of each of the 5 key areas in upcoming editions of the Quality Bulletin, starting with organisational governance in the July edition.
Review your prudential compliance systems and controls now
Approved providers who receive refundable accommodation deposits (RADs) from consumers are accountable for safeguarding those deposits, managing them appropriately and ensuring that they are refunded as they fall due.
The Prudential Standards encourage residential aged care providers to develop strategies to manage associated risks, supported by good financial governance and record-keeping controls.
The end of the financial year is an appropriate time for you to review and update the systems and controls you have in place to manage your prudential obligations under the Aged Care Act 1997 and the Fees and Payments Principles 2014 (No.2). This includes reviewing and updating your written governance system, liquidity management strategy (LMS) and, if applicable, your investment management strategy, to ensure that they reflect your current processes and meet the legislative requirements.
Undertaking effective business planning now will help you to strengthen your corporate governance, better manage risks, and achieve desired outcomes for both care recipients and your organisation.
Your governance system
You should review your documented governance system as required by the Governance Standard. This should set out your arrangements and processes for the management of RAD balances and identify roles and responsibilities. It may also include position descriptions, delegations, training and qualifications registers, policies, processes, board and committee meeting minutes.
Your LMS
Your LMS, as required by the Liquidity Standard, should:
- set out your minimum liquidity level in a whole dollar value – this is the minimum level you will hold at any time to ensure you can refund RADs as they fall due
- outline the factors you considered in setting the minimum liquidity, such as previous RAD trends, current RAD and cash holdings, as well as environmental risks, expenditure and operational pressures
- state the form in which you will maintain liquidity (such as cash, term deposits, and line of credit) which should allow for funds to be readily accessible.
Investment management strategy
If you invest RADs in financial products other than an authorised deposit-taking institution, you must implement and maintain an investment management strategy. Review your strategy and current investing practices in line with your governance system and LMS to ensure the investment approach and level of acceptable risk is in line with your strategic objectives and note if you are outsourcing investing responsibilities.
Document control
Document control, including review dates and approvals from key personnel, is strongly recommended from both a compliance and record-keeping perspective. Visit our website for more information about residential aged care providers’ prudential responsibilities.
Our latest ‘Sector performance report’ is now available
If you are not yet a regular reader of the Commission’s quarterly reports on sector performance, now is a good time to start. Our ‘Sector performance report’ for the January–March 2022 quarter is available on our website.
These quarterly reports present whole-of-sector performance data about residential aged care and home services, including complaints, applications for approved provider status, accreditation outcomes, and assessed performance against the Aged Care Quality Standards.
The Commission continues to monitor the performance of approved providers through quality assessment and monitoring activities. Some noteworthy quality assessment and monitoring statistics from the third quarter (Q3) report include:
- There was an increase in off-site assessment contacts as we used provider surveys and telephone calls to better understand the impact on residential aged care consumers’ health and safety from COVID-19 and flooding events in New South Wales and Queensland. (Of the 486 residential services we contacted in flood-affected areas, 35 services were escalated to relevant authorities in relation to issues such as pending evacuations, medication/catering supplies, staffing shortages and emergency service/medical officer access.)
- The Commission undertook 758 site visits and found 120 residential and home care services to be non-compliant with one or more requirements of the Quality Standards. The most common requirements not complied with were:
- Residential care: Standard 3 – Safe and effective personal and clinical care, Standard 7 – Human resources and Standard 8 – Organisational governance.
- Home services: Standard 2 – Ongoing assessment and planning with consumers, Standard 3 – Safe and effective personal and clinical care and Standard 8 – Organisational governance.
We continued our focus on the regulatory risks associated with the COVID-19 pandemic, including undertaking targeted activities to monitor infection control outbreak preparedness. During the January–March 2022 quarter, the Commission participated in 2,795 outbreak management online team meetings with services across the country.
Read our latest report for more sector performance information.
Early insights from the Enriching Life Through Aged Care roundtables
As mentioned in our April newsletter, our Enriching Life through Aged Care roundtables form part of our broader program of sector engagement. The roundtable forums provide a valuable opportunity for the Commission to connect with senior sector leaders and hear directly from providers about how they are responding to consumer expectations for a different and better experience of aged care.
In-person and virtual roundtables have been held so far in Queensland, Tasmania and Victoria with around 140 attendees from across 100 services.
The discussions are exploring 3 key issues: understanding and enabling a great aged care experience, measuring performance in aged care, and engaging with continuous improvement. We have heard a fascinating range of views and experiences from sector leaders across a diverse range of providers in residential aged care, home services and community care.
Some of the key themes emerging include:
- Consumers and families really value their relationships with care staff. Kindness, respect, listening and responding to consumers as individuals are essential ingredients to a great care experience.
- Workplace culture is considered to be the most important enabler in delivering great person-centred care.
- Many providers described significant change programs to drive performance uplift and transform workplace culture. Providers say these changes are complex, need significant leadership investment and take time.
- Some providers say the demands of managing through COVID-19 and workforce pressures mean that they’re concentrating on delivering care and it’s difficult to find scope to focus on organisational change.
- Providers are looking for more opportunities to identify and share good practice across the sector.
One example of wonderful and innovative care has come from Melbourne's Elderly Chinese Home Victoria. Their mocked-up Hong Kong bus stop and streetscapes video wall is helping their residents to recall, enjoy and share their history.
We are gathering the rich insights offered by participants and will be reflecting those back to the sector in a program report. The report will include case study examples of some of the great initiatives that providers have shared with us.
Roundtable registrations are still open for the ACT, NSW, SA and WA. If you’re a board chair or chief executive officer in any of these locations, you can still register your interest to attend a forum via our online registration form.
Preventing elder abuse is everyone’s business
All of us, as members of the community, expect older Australians to be cared for respectfully, safely and with dignity. World Elder Abuse Awareness Day (WEAAD), held on 15 June each year, served as a reminder of aged care providers’ responsibility to do everything possible to protect those in their care.
The Older Persons Advocacy Network (OPAN) recently launched its ‘Ready to Listen’ campaign to help build the skills and capacity of residential aged care providers to better respond to and prevent the sexual assault of older people living in aged care. The Commission engaged with OPAN on the development of resources and information to support this initiative.
Providers have an obligation to ensure their staff have the necessary knowledge, skills and expertise to prevent and minimise the risk of sexual abuse of those for whom they have caring responsibilities. Training is required for staff in how to respond to suspicions, allegations and witnessed accounts of sexual abuse of aged care consumers. Read our media release for more information.
We participated in the Elder Abuse Forum, organised by the City of Parramatta Council last month, for aged care and home support workers across Western Sydney and NSW. The event’s focus was on addressing and preventing elder abuse, relevant legislative requirements and reporting mechanisms.
Representing the Commission, Ann Wunsch, Executive Director Approvals, Compliance and Investigations, spoke about our role and functions. She also gave an overview of the Serious Incident Response Scheme and how it relates to responding to elder abuse in aged care settings, as well as information on providers’ reporting requirements. A recording of the event is available on the City of Parramatta’s website.
Do you provide care for older Australians with diverse needs?
Aged care providers who specialise in delivering care that is sensitive to the needs of individuals with diverse backgrounds and experiences can now apply to the Department of Health and Aged Care for verification.
To claim specialisation, providers need to show evidence that they meet the criteria for individual groups. This goes beyond the minimum standard of inclusive, person-centred care required under the Aged Care Quality Standards and Charter of Aged Care Rights.
An independent assessor will verify applications and the outcome will be published on your My Aged Care Find a Provider profile from October. Verified specialisations will remain valid for 3 years.
Following a transition period, providers whose specialisations have not been verified will have those claims removed from their My Aged Care profile.
New and updated Commission resources
New: Reducing the use of sedatives in aged care video
Other resources
- The Department of Health and Aged Care recently led a webinar about its Consumer Experience Interviews Program, which is currently underway. The program’s objective is to compile a consumer experience report for all government-funded aged care facilities based on interviews with their residents. These reports will be combined with data on the 5 quality indicators, service compliance ratings and staff care minutes to produce an overall star rating for each facility. This rating will appear on the My Aged Care website from December 2022. Facilities are invited to participate and provide industry input to these consumer interviews. If a facility is unable to participate, this will be noted in their My Aged Care listing. The webinar recording is available to watch on-demand.
- The National Ageing Research Institute has developed a range of animated videos in 10 languages, to make information about dementia more accessible for people from non-English speaking backgrounds. The short videos provide practical tips about lifestyle changes that can help reduce the risk of dementia, and information about support services for families caring for someone living with dementia. The videos are available in Arabic, Cantonese, Mandarin, Tamil, Spanish, Vietnamese, Greek, Italian, Hindi and English.
- The Victorian Department of Health has developed a free, online learning package to help people understand infection prevention and control (IPC) and the simple steps to slow or stop the spread of COVID-19 and other infectious diseases. There are 6 modules, with each taking about 10–15 minutes to complete. A certificate of completion is available at the end of each module. IPC eLearning is especially helpful for people working in non-clinical roles in aged care, public and community health, disability, education and industry. IPC eLearning was developed in partnership with VICNISS. VICNISS registration is not required to access the modules, which are available on the VICNISS website.