There are challenges ahead for the aged care sector, with new Aged Care Quality Standards coming into law later this year, and the Royal Commission into Aged Care Quality and Safety being announced. What do Boards and managers of Approved Providers need to do now to be prepared for the changes?
What are the new Aged Care Quality Standards?
Subject to parliamentary processes, the new single set of Aged Care Quality Standards will come into law later in 2018 (it was passed on 21 September 2018), with assessment and monitoring against these new standards commencing from 1 July 2019.
This new single set of standards will replace the Accreditation Standards, the Home Care Standards, the National Aboriginal and Torres Strait Islander Flexible Aged Care Program Quality Framework Standards, and the Transition Care Standards, and will apply to all aged care services, including residential care, home care, flexible care and services under the Commonwealth Home Support Program.
What is different?
The new Aged Care Quality Standards focus upon consumer outcomes.
New Aged Care Quality Standard 8 – organisational governance
The new Aged Care Quality Standard 8 deals with organisational governance and covers the following consumer outcome:
- I am confident the organisation is well run. I can partner in improving the delivery of care and services.
The requisite organisational statement is:
- The organisation’s governing body is accountable for the delivery of safe and quality care and services.
It significantly elevates the role of the ’Governing Body’, who must now be fully aware of the organisation’s compliance with all aspects of its operations, including financial performance and care and services.
What are the challenges ahead?
There are challenges in moving to a more consumer-focused and outcomes model. How are outcomes measured? What is involved in meeting consumer ‘needs, goals and preferences’?
It is currently unclear how the new Aged Care Quality and Safety Commission will measure outcomes. However, we could use Home Care CDC as an indicator. Approved Providers need to spend more effort in measuring and responding to consumer and staff feedback. Consumer wants must be balanced with consumer needs.
How do you know if you have a culture of compliance?
Boards and senior leadership will need mechanisms to measure their performance and test the measures against customer outcomes and satisfaction.
A culture of compliance can be measured in terms of consumer and staff satisfaction surveys, as well as against clinical indicators and industry benchmarks.
Some Approved Providers are using consultants for independent audits and unannounced visits to identify areas of risk and exposure.
How can you foster a change in culture and a culture of compliance?
The change can be fostered by senior leadership demonstrating that they are interested and informed about performance at the front line of service delivery, and that action and prioritisation of resources is consistent with the needs of customers and the workforce.
A culture of compliance is when everyone within the organisation understands their compliance obligations and when staff and residents/clients feel enabled to raise concerns (in a blame-free environment without penalty or adverse treatment) and that those concerns are adequately listened to and responded to.
What should directors and managers be doing in the lead-up to the Royal Commission?
We recommend that directors and managers:
- put risk management as a standing agenda item on their Board Agenda and identify, prioritise and address risks and review risk registers and implementation plans for continuous improvement
- identify areas of potential risk and exposure
- ensure that relevant documents can
- be quickly identified
- train staff in flexible work-practices
- and to be more consumer-focused
- put together an appropriate team of advisors, including lawyers and media advisors
- review performance against clinical indicators to ascertain if there are areas of non-performance against industry benchmarks
- ensure there is an appropriate media policy (including social media)
- review policies and procedures, including in relation to client and staff feedback, complaint management, open disclosure, elder abuse, infection control and restraint
- engage consumers in appropriate decisions, including their own care; this may include the use of consumer advocates.
