Standard 3 - Requirement (3) (d)
Deterioration or change of a consumer’s mental health, cognitive or physical function, capacity or condition is recognised and responded to in a timely manner.
Intent of this requirement
This requirement explains how organisations are expected to respond to deterioration or change in a consumer’s mental health, cognitive or physical function, capacity or condition.
A consumer may experience health conditions or impairments that restrict their capacity or abilities. How these restrictions affect the consumer’s day to day activities or function also depends on the consumer’s personal circumstances and environment. The right care and services can support the consumer’s day to day function, their activity and participation in the community. However, the balance can change quickly due to changes in the consumer’s circumstances, environment or health status. It is important that organisations pick up these changes because:
- if the consumer’s loss of function is temporary, it can be improved or reversed with the right care and services
- a higher level of ongoing care and services may be needed to meet the consumer’s needs
- further health complications for the consumer can be avoided by intervening early.
However there is evidence that warning signs of a consumer’s deteriorating function, capacity or condition is not always recognised or acted upon on promptly or in the right way. Changes may be mental, cognitive or physical in nature. Identifying deterioration early can improve outcomes and mean that consumers need less intervention in the future.
Organisations are expected to have systems and processes, relative to the services they deliver, that support the workforce to recognise, and respond to a consumer whose function, capacity or health condition deteriorates. This includes ways for the workforce, consumers, and others to identify and escalate concerns so that the organisation can assess the situation and take action.
- What systems and policies are in place in the organisation to recognise and respond to deterioration in the health or function of a consumer?
- How is the workforce supported to recognise and respond to a sudden or unexpected deterioration of a consumer’s mental health, cognitive or physical condition, function or capacity? For example, how do members of the workforce recognise signs and symptoms of deterioration and what to do?
- Are there any gaps or delays in identifying, communicating and responding to deterioration between providers, organisations or individuals providing care and services? How can consumers, the workforce and others who review systems and processes, improve early recognition and response to deterioration or loss in a consumer’s health or function?
- How does the organisation provide information to consumers and representatives on recognising deterioration in health or function? This includes how important recognising it can be. And how does the organisation support consumers and representatives to understand how they can raise concerns about possible deterioration?
Examples of actions and evidence
- Consumers say they are confident that members of the workforce providing their care and services know them and would pick up a change in their condition, health or abilities. They also say the members of the workforce providing their care and services would know what to do about a change in their condition, health or any loss of abilities.
- Consumers and representatives say that they understand how to raise concerns about any deterioration in condition, health or ability which occurs.
- Consumers and their representatives say that the organisation responded well to a change or deterioration in condition, health or ability when they needed to.
Workforce and others
- The workforce can describe the different situations where a change in a consumer’s condition, health or abilities should be identified and what response they should take.
- The workforce can describe how they should communicate information about a consumer’s condition, health or abilities deteriorating, who should be involved and what actions they should take.
- The workforce can describe how they identify signs of deterioration. They can also describe their understanding of their role and the organisation’s processes for communicating and escalating any concerns.
- Workforce orientation, training or other records that show how the organisation supported the workforce to meet this requirement.
- Evidence that the workforce who deliver care and services, document routine observations in line with the care and services plan and relevant policy and procedures. They also respond to triggers to escalate care when a consumer deteriorates.
- Consumer records show critical information about a change in a consumer’s condition, health or abilities provided by members of the workforce, the consumer or their representative is acted on by the organisation.
- Roles, responsibilities and accountabilities for members of the workforce for recognising and responding to a consumer’s deterioration are documented.
- Policy and procedures document the organisation’s processes for responding to deterioration or change in a consumer’s condition, health or abilities, relevant to the services they provide. This includes how to communicate appropriately and involve consumers, their representatives and others including carers and families.
- Examples of documents about recognising and responding to deterioration. This can include advance care plans, documented needs, goals and preferences and documented discussions with consumers their representatives and others.
- Evidence of improvements adopted after incident reports, investigations or feedback. This can include records from an incident management system about incidents or ‘near misses’ where the service didn’t recognise a consumer’s deterioration.
- Evidence of how the organisation monitors and reports its performance against this requirement.