Standard 5. Organisation's service environment

Meaning of 'service environment'

An organisation’s service environment means the physical environment through which care and services are delivered, but does not include an individual’s privately owned or occupied home at which in-home services are provided.

Standard 5 applies to the physical service environment that the organisation provides for residential care, respite care and day therapy centres. It doesn’t apply to home care services where the environment is the consumer’s home. And it doesn’t apply to other environments that consumers visit, such as bowling clubs or libraries.

This Standard is for organisations providing a physical service environment. It makes sure that the service environment, furniture and equipment support a consumer’s quality of life, as well as their independence, ability and enjoyment. This means that the service environment suits the consumer’s needs and is clean, comfortable, welcoming and well maintained. It includes how the safety and security, design, accessibility and layout of the service environment encourage a sense of belonging for consumers.

This Standard covers how an organisation’s service environment:

• supports the consumer’s ability to take part in the community and engage with others

• minimises confusion so consumers can recognise where they are and see where they want to go

• encourages consumers to make their living areas more personal

• welcomes consumers and their family or visitors and provides spaces for culturally safe interactions with others

• is safe, well maintained and clean

• helps consumers to move freely in the environment (including access to outdoor areas)

• subtly reduces risk where needed so safety features don’t dominate the environment

• provides security arrangements in line with best practice to protect consumers when lawful and necessary.

The furniture, fittings and equipment provided at the service are also covered by this Standard. It is expected that these are safe, clean, well maintained and suitable for the consumer.

This Standard doesn’t replace work, health and safety laws, or requirements under building legislation.

Standard 5 links to:

Standard 1 – A well considered service environment promotes consumers’ independence, privacy and cultural safety.

Standard 7 – The workforce focus on maintaining a physical environment which is safe, comfortable and welcoming promotes consumers enjoyment of their surroundings.

Standard 8 – The organisation’s governing body is accountable for the delivery of safe and quality care, services and supports, including the physical environment in which these are delivered.

Intent of this requirement

This requirement is about creating a service environment that is well designed and welcoming for all consumers and encourages a sense of belonging.

Consumers will experience service environments differently, depending on their backgrounds, situations and what they expect from an organisation. A service environment that’s designed to be inclusive helps all consumers feel welcome. A service environment that looks familiar to a consumer helps them feel that the organisation is welcoming them. It lets them know they can be themselves in the service environment.

The physical, emotional and social features of a space are all important parts of creating a welcoming service environment for consumers. This includes design, the feeling of being supported, and the quality of the relationships consumers develop with the workforce and other consumers and visitors to the service environment.

A service environment that’s easy to understand is particularly important. Age-related changes and disabilities can make it more difficult for consumers to understand and get around in buildings and spaces. Such impairments can include hearing or sensory loss, and declining mobility and cognitive impairment. For example, the service environment can help maximise a consumer’s function by reducing the level of unnecessary or competing noise or clutter.

Reflective questions

• How does the organisation ask for advice to create a welcoming and easy-to-understand service environment for all consumers? How have they used this advice?
   
• What signals does the service environment give about who the organisation accepts and provides care and services for? Do the posters, photographs, artwork, magazines or reading materials in public areas show that this is an inclusive service environment?
   
• How does the organisation make sure the service environment maximises support for consumers’ independence and ability? What environmental strategies are in place to improve function and independence for consumers with sensory loss, such as hearing or vision loss or a cognitive impairment? For example, noise management, lighting, colour contrast, signage, textures and design.
   
• How does the organisation deal with any challenges that consumers are having getting around the service environment?

Examples of actions and evidence

Consumers

• Consumers say the service environment is welcoming to them, their friends, family visitors (and pets where agreed). They say the service environment encourages a sense of belonging.
   
• Consumers say they have spaces to interact with others and spaces for quiet reflection. They also have spaces for religious or cultural practices and private spaces if they need them.
   
• Consumers say they can find their way around easily and can easily get to key locations, such as dining areas or a suitable bathroom.
   
• Consumers say they decide on the decoration, furnishings and layout of their bedroom. This includes bringing their own furniture and fittings (where agreed).

Workforce and others

• The workforce can describe how the organisation removes barriers that might exclude some consumers. This makes sure the service environment is welcoming to all consumers.
   
• The workforce can describe strategies to support consumers to get around the service environment at their own pace and with dignity.
   
• The workforce can show how different consumers can use the service environment in different ways. This means the service environment supports all consumers’ independence and ability.
   
• Workforce orientation, training or other records that show how the organisation supports the workforce in this requirement.

Organisation

• Observations of the service environment show that consumers’ rooms have a personal character and feel.
   
• Evidence that the organisation takes steps to understand how consumers experience the service environment.
   
• Evidence that the organisation monitors and can adapt the service environment to support a consumer’s changing needs such as a decline in mental or physical ability. This means the consumer can continue to do the things that are important to them.

The service environment:

i) is safe, clean, well maintained and comfortable; and
ii) enables consumers to move freely, both indoors and outdoors.

Intent of this requirement

This requirement is about the expectation that the service environment is safe, clean, well maintained and comfortable. It also covers the need for consumers to be able to move freely around the service environment, indoors and outdoors.

The service environment is expected to be fit for purpose in line with statutory requirements and national best practice. Each service environment is different. This means that organisations should consider the layout, the potential number of consumers using the service, and their needs to make sure the service environment is safe, clean, well maintained and comfortable. It can include buildings, access points, parking areas, gardens and the service environment’s general appearance and homeliness.

The service environment is expected to promote the free movement of consumers (including to access outdoor areas). It may be important that the service environment is secure or access to certain areas are restricted to help create a safe service environment for consumers. Arrangements to protect consumers require assessment, documentation in care and services plans, informed consent from the consumer and regular monitoring and review, in line with best practice and legislation.    

If third parties provide maintenance or other services, the organisation should clearly define their responsibilities in regard to the service environment. Organisations are responsible for monitoring and dealing with any issues that come up with contracted services.

Reflective questions

• How does the organisation avoid environmental risks to keep consumers safe? 
   
• How does the organisation monitor and fix any safety issues, obstacles, barriers, poor lighting, glare or hazards? 
   
• How does the organisation look after the safety of each consumer? For example, how would a consumer who is hearing impaired know an emergency alarm is going?
   
• Can the atmosphere, size and shape of spaces in the service environment be changed? Can the service environment be controlled so that the level of stimulation in spaces meets consumers’ diverse sensory and comfort needs?
   
• How do workforce attitudes and their understanding of risk and safety, affect a consumer being able to move freely in the service environment, indoors and outdoors?
   
• How do workforce attitudes and their understanding of dignity of risk, affect a consumer being able to move freely indoors and outdoors?
   
• Is the level of security in place in balance with the care and services being delivered?

Examples of actions and evidence

Consumers

• Consumers say the service environment makes them feel welcome.
   
• Consumers say they feel safe in the service environment and know how to let the workforce know if they don’t feel safe.
   
• Consumers say the service environment is clean, well maintained and comfortable.
   
• Consumers say the service environment has plenty of natural light and fresh air and they can change the lighting, air flow and heating to make the service environment more comfortable.
   
• Consumers say they can move freely within the service environment and access the parts of the service they use independently, including the outdoor environment.

Workforce and others

• The workforce can describe their responsibilities to protect consumers from avoidable harm.
   
• The workforce demonstrates their knowledge of how to respond to a safety incident, hazard or emergency.
   
• The workforce can describe strategies to make sure consumers who can’t move about on their own can access the outdoors if they wish.
   
• The workforce can explain how landmarks in the service environment help consumers find their way around and support consumers’ independence. For example how discrete safeguards mean consumers living with dementia can safely access areas, such as kitchenettes.
   
• Workforce orientation, training or other records that show how the organisation has supported the workforce in this requirement.

Organisation

• Evidence the organisation has a range of strategies to create a relaxed, welcoming, peaceful, safe and comfortable service environment in line with consumers’ needs and preferences.
   
• Observations that risks to consumers are unobtrusively managed and any security measures in place in the service environment reflect the consumer’s assessed needs.
   
• Observations that the service environment enables consumers to move safely about the service indoors and out.
   
• Evidence that the organisation asks for consumers’ opinions when making decisions about the layout of the service environment.
   
• Evidence that the organisation asks for consumers’ opinions about how space in the service environment is used so that consumers can keep active and move around as much as possible.
   
• Evidence that any restriction in place at the service environment which impacts a consumer is based on the least restrictive option. The basis for any restriction is also up-to-date, evidence-based, transparent and able to be reviewed.
   
• Evidence the organisation has arrangements to maintain the internal and external service environment. This makes sure the environment is comfortable, safe and secure.
   
• Records that the organisation has arrangements for cleaning the internal and external service environment. This includes removing general and hazardous waste.

Intent of this requirement

This requirement covers the need for furniture, fittings and equipment in the service environment to be safe, clean, well maintained and suitable for consumers to use.

The furniture, fittings and equipment in each service environment are different. This means that organisations should consider how they will make sure equipment is safe, clean, well maintained and suitable.

If a consumer owns the equipment they need, the organisation needs to make every effort to make sure that it’s clean, safe and suitable for the consumer to use. This would include raising any concerns with the consumer, or their representative, so that the equipment can be maintained, cleaned or reassessed.

Reflective questions

• How does the organisation assess and plan what furniture, fittings and equipment they provide to make sure consumers have suitable and safe items?
   
• How do furniture design and the layout of furniture and fittings help consumers who are frail, less flexible and less mobile to be comfortable and independent?
   
• How does the organisation ask for and consider consumers’ opinions about furniture, fittings and equipment?
   
• What are the systems for ensuring that any equipment used in the course of the provision of care and services, including equipment owned by the consumer, is clean safe and well maintained?

Examples of actions and evidence

Consumers

• Consumers say they have access to a range of good-quality equipment and furnishings that meet their needs and preferences.
   
• Consumers say they feel safe when using the furniture, fittings and equipment.
   
• Consumers are confident the workforce knows how to safely operate the equipment they use to support their health and well-being.
   
• Consumers say the design of furniture and fittings helps them to be independent and adds to the comfort of the service environment.

Workforce and others

• The workforce can describe the organisation’s options for adapting or replacing furniture, fittings or equipment that doesn’t suit the consumer’s needs. They can also describe how they assess this.
   
• The workforce understands that when multiple consumers use equipment and devices, they must be cleaned and disinfected between each use. They also understand that single-use and single-consumer devices mustn’t be reused or shared.
   
• The workforce says that equipment is suitable and there’s enough equipment to support them to deliver quality service.
   
• Evidence that suitably qualified members of the workforce are involved in the assessment of suitability of furniture, equipment  and fittings to meet consumers’ needs.
   
• Workforce orientation, education other records show that the organisation supports the workforce in this requirement.

Organisation

• Observations that the furniture, fittings and equipment are safe, clean, well maintained and suitable for the consumer.
   
• Evidence that the organisation can purchase, service, maintain, renew and replace indoor and outdoor, furniture, fittings and equipment.
   
• Evidence that the organisation acts promptly when furniture, fittings and equipment need to be maintained or replaced.
   
• Records of arrangements with third-party contractors and the systems in place to make sure any safety, cleaning or maintenance of the service environment undertaken by third-party contractors is delivered as arranged.
   
• Records of arrangements with third-party contractors and the systems in place to make sure any furniture, fittings or equipment provided by third-party contractors meet the organisation’s specifications.

• Aged Care Act 1997 (Cth), User Rights Amendment (Charter of Aged Care Rights) Principles 2019