The aged care policy priorities of the newly elected Labor Government were published in the lead up to the recent election, and more detail on these will undoubtedly become available in coming weeks and months. In the meantime, it is useful to remind ourselves of some key current and ongoing provider responsibilities.
As is now well understood across the sector, all aged care providers are required by law to meet the Aged Care Quality Standards (Quality Standards). You must also have an effective incident management system in place at every service. Fulfilling these 2 critical responsibilities (among others) is key to delivering safe and quality care to older Australians.
The Commission has a range of resources available on our website to help aged care providers better understand their responsibilities in relation to the Quality Standards, including the comprehensive ‘Guidance and resources for providers to support the Aged Care Quality Standards’ and online learning program and modules available through our Aged Care Learning Information Solution (Alis). With respect to having an effective incident management system, you can read more about what is involved with this in the fourth article of our series on essential elements of these systems in this edition of the Quality Bulletin.
Through our assessment and auditing activities, we continue to identify some providers who are not fully compliant with the Quality Standards. A proportion of these providers indicate that they were unaware of shortcomings in their performance. This underscores the importance of providers proactively seeking to pinpoint areas where you need to improve before they are pointed out by the regulator. One way of doing this is to regularly self-assess your performance against the Quality Standards using the Commission’s self-assessment tool.
Incident management system essential element #4 – Analyse the incident
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 fourth element that residential aged care and home care providers must demonstrate.
IMS essential element #4 – Analyse the incident
It is crucial that providers have in place a process that helps you to understand the underlying causes of an incident, and how systems and practices could be improved to reduce the risk of similar incidents occurring in the future.
You may need to take immediate action to reduce the risk of harm and potential for recurrence after an incident. It is important you inform your consumers, their families/representatives and your staff of any actions you take. You’ll then need to take additional steps after you’ve completed a more thorough analysis.
The nature of the incident will inform the extent and type of analysis (or investigation, where necessary) you need to undertake. For example, your approach may depend on:
- the severity of the incident
- the impact of the incident on your consumers’ confidence and safety
- the probability of a recurrence
- whether the same or a similar incident has occurred in the past
- whether the incident involves a similar underlying cause to another past incident
- whether it involves people who have been involved in other past incidents
- the complexity of the incident (for example, if the facts are in question or the underlying cause is unclear)
- if it is a reportable incident under the Serious Incident Response Scheme (which currently applies to residential aged care providers)
- the views of the affected people (including consumers or their families/representatives).
There may be circumstances where an independent investigation is the most appropriate response following an incident. This may be relevant where the facts of the incident are in dispute, where it involves an allegation that a staff member has acted in an inappropriate manner or if an independent investigation has been requested by a consumer or their family/representative (where appropriate).
Read our ‘Effective incident management systems: Best practice guidance’ for detailed information about how you can develop and embed an IMS in your service.
Home services quality reviews
The Commission’s enhanced quality review program of home service providers’ performance against the Aged Care Quality Standards continues to gather momentum. Home services include care and services delivered through a Home Care Package, Commonwealth Home Support Programme and some flexible services delivered in a home service setting.
Notwithstanding the sector-wide challenges arising from the COVID-19 pandemic, the Commission is obliged to continue undertaking quality reviews as a core component of its activities in monitoring and assessing the quality and safety of care and services delivered to aged care recipients.
As the number of quality reviews of home services continues to increase, providers should ensure that they are ready to demonstrate compliant performance against the Quality Standards as part of their provider responsibilities. A visit by Commission staff may be carried out on an announced or unannounced basis, and requests to reschedule are only considered in exceptional circumstances.
Providers who undertake regular self-assessment against the Quality Standards are far better placed not only to achieve ongoing compliance, but more importantly, to drive continuous improvement in their performance.
Leadership and governance during a COVID-19 outbreak
Effective leadership and governance within a provider organisation will greatly increase its chances of successfully managing a COVID-19 outbreak, according to the Aged Care Quality and Safety Commissioner Janet Anderson.
The Commissioner spoke at a recent webinar hosted jointly by the Commission and the Department of Health which discussed Aged Care Quality Standard 8, Organisational governance, and the systems and processes which need to be in place before the start of an outbreak.
The webinar highlighted that good governance also requires leaders to provide a clear sense of direction by:
- being ready to activate their organisation’s outbreak management plan
- ensuring staff are well-drilled in the plan
- knowing the risks and how to mitigate those risks, for example, how to fill rosters when key staff are unable to work
- remaining present, available, well informed, confident and able to take charge of decision-making and problem-solving
- ensuring staff, residents and families are kept informed
- maintaining morale even when concerned about the outbreak.
The Commission’s Executive Director, Approvals, Compliance and Investigations, Ann Wunsch, spoke about a residential aged care service that activated its outbreak management plan in March 2022 and, through good governance and effective leadership, effectively steered the service, the staff and the residents through the contained outbreak.
Management ensured there was a steady supply of personal protective equipment (PPE) which staff were supervised in using, PPE waste was handled appropriately and quickly, COVID-positive residents were separated from non-positive residents, essential visitors were able to continue visiting residents by following strict protocols, staff had COVID tests on a 72-hour schedule, and there was regular communication with staff, residents and their families throughout.
These actions resulted in a positive outcome, with only 2 residents and 3 staff testing positive during the outbreak and the service being able to re-open 11 days after the first case was identified.
You can watch the full webinar on demand.
World Elder Abuse Awareness Day forum
According to the National Elder Abuse Prevalence Study 2021, one in 6 people over the age of 65 experienced abuse during a 12-month period, whether that was psychological, neglect, financial or physical abuse. Only a third of those who experienced abuse sought help from a third party.
As we all continue to live through COVID-19 and the transition into a ‘COVID normal’ environment, we need to continue to build community awareness of elder abuse to create the momentum for change and strengthen safeguards for vulnerable older people.
The Aged Rights Advocacy Service (ARAS) has held an annual World Elder Abuse Awareness Day (WEAAD) conference for the past 16 years, and this year’s free forum on 17 June will be hosted online with ‘Building resilience’ as the theme.
The focus will be on building a community that supports older people to retain control of their lives, enhance their wellbeing, and maintain their independence living at home.
For more details or to register for this free forum on 17 June, visit the ARAS website.
Free online course in aged care advocacy
The Older Persons Advocacy Network (OPAN) is offering free online training about aged care advocacy.
The course, ‘Talk To Us First’, aims to help aged care professionals, health professionals, carers, volunteers and visitors better understand the rights of older people and the significant role that advocacy services play.
The course outlines advocacy principles alongside a series of videos portraying scenarios encountered by advocates.
Those who complete the training will learn more about the role they can play in ensuring older people feel safe, encouraged, and supported to give feedback or make a complaint.
Aged care workers will gain a certificate of completion which will demonstrate they are working towards the Aged Care Quality Standard 6, Feedback and complaints. The course is self-paced and usually takes less than one hour to complete.
For more information on this course, visit the OPAN website.
New and updated Commission resources
- New: Our new Clinical alerts share important and timely information and advice to aged care providers on clinical matters from the Commission’s Chief Clinical Advisor. Our first alert issued in May focused on reducing heater burn risks in residential aged care services. We will email these alerts to relevant providers as they are released. We will also publish them on our Clinical alerts webpage.
- The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that provides a platform to amplify the voices and lived experience of Stolen Generations survivors and their families. The Foundation promotes trauma-aware, healing-informed practice to help government, policymakers, and workforces understand their role in intergenerational healing. The Healing Foundation has released a fact sheet, Working with the Stolen Generations: understanding trauma, about providing effective aged care services to Stolen Generations survivors. The fact sheet will help providers to comply with the Aged Care Quality Standards and meet their obligations to care for Stolen Generations survivors.
- Forgotten Australians, the children that were placed into institutional care and out-of-home care in Australia in the last century, may experience many challenges as they face the possibility of aged care. Helping Hand Aged Care’s Real Care the Second Time Around Project has been funded by the Australian Government to provide free online workshops for the aged care sector on the About Me One-page Story. The About Me One-Page Story resources and workshop help providers to support Forgotten Australians. The one-page story provides information on a single sheet of paper that supports staff to know what really matters to people and how to support them in an individual way. The workshop will help service providers to comply with Aged Care Quality Standard 1, Consumer dignity and choice. To find out more about the workshops, email Meg Schwarz at firstname.lastname@example.org.