Now that the initial Provider Surveys have been submitted or will be shortly, providers should now be focusing their attention on the next stages of preparation for the Royal Commission.
Next steps following submission
We suggest that providers move to the next phase of data collection which should involve the following.
Identifying your high risk occasions and complaints
We recommend that you go back through your responses for each service/outlet and identify the high risk incidents and those that might catch the interest of the Royal Commission. These include matters that reflect systemic failure and any trends in substandard care occasions that appear in your documents.
You should also identify those occasions which involve issues specifically mentioned at the Commissioners’ initial directions hearing: those being elder abuse, medication management, over use of psychotropic medications, food safety (including issues around dysphagia), call bell and staff response times, wound management followed by death and poor record management.
High risk entries will include those that relate to complaints from care recipients and their representatives which touch on staff ratios, end of life care and dementia management in addition to incidents involving serious outcomes for care recipients.
We also recommend that you identify the number of self-assessed “systemic failures” you have reported in your response to the Provider Survey and isolate these occasions for review. You will be expected to have an understanding of why these systemic failures occurred and what was done in response not only on the particular occasion but as part of your organisation’s continuous improvement plan.
Having submitted de-identified information in the Provider Survey may mean it will be hard for you to locate the incident in a short time frame if requested to provide further information to the Royal Commission. If your organisation does not yet have a system of cross referencing the occasions and complaints submitted in the Provider Survey to the care recipients and individuals involved, we suggest one be developed immediately. Your organisation’s system for identifying the particular care recipients and documents involved with these high risk occasions and complaints will then form the basis for collating documents.
Collating documents relating to high risk occasions and complaints
Having this information ready will ensure your organisation is able to comply with any timeframes the Royal Commission may impose for further information to be provided. It will also ensure your advisers have sufficient time to identify any risks they may present.
Documents should comply with the Royal Commission’s document management protocol, meaning, in addition to formatting electronic records, any paper records of interest should begin to be scanned and settled in the required format. Once prepared, we recommend this data be kept centrally.
Seeking advice on these documents
Once the documents have been compiled, they can be reviewed in detail for any legal or reputational risks. Attempting to complete this review later when a Notice to Produce has been issued under a short timeframe will be difficult.
Continuing your searches for information
Where information about occasions or complaints have been limited by the availability of documents or reports, we recommend that you seek to retrieve those documents. Documents that could not be accessed before the deadline should be recalled and reviewed. Comments in responses like “unable to locate documents; not accessible at this time” will no doubt be of interest to the Royal Commission as poor record management has already been highlighted as a point of contention.
We also recommend that you review your answers to questions 3, 5 to 8 and begin compiling supporting documents for any statements made. This would include any data held by your clinical committees or management/Board referred to in your response.
Ensuring your representatives know the data that was submitted
The Royal Commission will be hearing evidence from witnesses from 11 February 2019. Witness statements for the February hearings are being prepared and we can expect that witness statements will be sought from providers soon enough.
Ensuring that your organisation’s representatives are familiar with the information submitted in the Provider Survey and the data behind it is crucial to ensuring witness statements and information provided in these hearings are both comprehensive and accurate.
Knowing how your organisation tracks against the recommendations of past inquiries
A key theme from the preliminary hearing of the Royal Commission on 18 January 2019 was the reform recommendations raised in previous reports and inquiries. The Commissioners stated that they will seek to understand what (if any) of the recommendations made in key inquiries like the Tune Review etc have been implemented including by providers where relevant to their operations.
Providers will be expected to be familiar with the recommendations made about their industry and seek to understand if they have adopted any recommendations targeted at how they deliver quality and safety in aged care.