Commissioner’s message
On 11 May, the Australian Government delivered its budget for 2021–22. At the heart of the Budget, the Government announced a record investment of over $17.7 billion to transform the aged care sector.
With this Budget, the Government also provided its full response to the final report of the Royal Commission into Aged Care Quality and Safety. In identifying shortcomings and deficiencies across the aged care sector, the Royal Commission also pointed to a wide range of opportunities and imperatives to remedy these problems. The Government’s response aims to ensure that older Australians have timely access to the high quality, safe care that they need and deserve.
You can read the Government’s full response to the Royal Commission’s final report on the Department of Health website.
The Budget outlines the Government’s detailed, costed and appropriately ambitious roadmap to be delivered over the next 5 years, built around 5 pillars where improvements are required and will be implemented:
- Home care – at home support and care based on assessed needs
- Residential aged care services and sustainability – improving and simplifying residential aged care services and access
- Residential aged care quality and safety – improving residential aged care quality and safety
- Workforce – supporting and growing a better skilled care workforce
- Governance – new legislation and stronger governance.
The Commission’s role as the independent aged care regulator will be strengthened, with an additional $262.5 million to be made available to the Commission over four years. This investment will support us to increase our front-line and operational support workforce to respond to growth in demand for our regulatory activities. It will also provide the resources necessary for us to lead or contribute to the implementation of many of the reforms planned for the sector. A review of the Commission in 2023 will inform Government decisions about the role, functions and operation of the national regulator going forward.
There is a lot of detail in the budget papers and providers are encouraged to make time to read about the reforms. The Department of Health has published a useful ‘budget at a glance’ resource which provides a high-level summary of key initiatives. Fact sheets and more detailed information are also available on the department’s website.
Two new quality indicators to report on from 1 July
In last month’s edition, we reminded the sector that the National Aged Care Mandatory Quality Indicator Program (QI Program) is being updated and expanded from 1 July 2021.
More information about the 2 new quality indicators – falls and major injury, and medication management – is now available for residential aged care providers.
In brief, in addition to the current 3 indicators of pressure injuries, use of physical restraint and unplanned weight loss, providers must collect and report the following data on a quarterly basis from 1 July:
Falls and major injury
- The percentage of care recipients who experienced one or more falls.
- The percentage of care recipients who experienced one or more falls resulting in major injury.
Medication management – polypharmacy and antipsychotics
- The percentage of care recipients who were prescribed 9 or more medications.
- The percentage of care recipients who received antipsychotic medications.
More detailed information on these new quality indicators and providers’ requirements is available in the National Aged Care Mandatory Quality Indicator Program Manual – 2.0 – Part A – Final draft, available on the Department of Health website. This manual can help you prepare for the upcoming changes to the program, so we recommend you review it before 1 July.
If you have any questions about the expansion of the QI Program, contact the My Aged Care service provider and assessor helpline on 1800 836 799.
Updated Serious Incident Response Scheme guidance
As highlighted in last month’s Quality Bulletin, the Commission has continued to closely review reporting data under the new Serious Incident Response Scheme (SIRS). Following our review as well as feedback from the sector, we have updated the ‘SIRS: Guidelines for residential aged care providers’ to assist providers in better understanding their reporting obligations.
The updated guidelines includes additional information about a number of issues including:
- the categorisation of reportable incidents as either Priority 1 or Priority 2
- reporting unexpected deaths
- an additional example of ‘rough handling’
- the Commission’s process for requesting further or missing information.
We've also updated the 8 fact sheets covering each type of ’reportable incident’ under the SIRS.
We have also received strong feedback on the need for a flowchart tool to assist providers when assessing, recording and potentially, reporting incidents. A new tool is now in development and will be made available on the Commission’s website soon.
An initial overview of notifications received in the first month of the scheme will also be published shortly.
Are you still COVID-ready?
When did you last review your service staff’s adherence to infection prevention and control measures? Have you offered a refresher course recently or undertaken a staff drill to test readiness to respond swiftly and effectively to an infectious disease outbreak? If not, why not?
As we’re seeing in Victoria right now, the possibility of a COVID-19 outbreak within the community is still with us. Even with the protections afforded by the progressive vaccination rollout to residential aged care facilities, approved providers must remain alert to the threat of COVID-19 and other transmissible viruses such as influenza. This is critical for the health of consumers, and for staff wellbeing and workforce retention.
Planning and preparing in close consultation with your workforce is key to enabling you to respond effectively to an outbreak. You are also responsible for ensuring the continuity of your business in the event of a crisis. Effective outbreak management planning will support you to build in redundancies that can allow you to continue to operate during and after an outbreak at your service.
Be vigilant and maintain a state of readiness by:
- staying up to date with the latest COVID-19 infection prevention and control guidance
- ensuring your staff are trained regularly in infection prevention and control, and new staff are trained prior to commencing at your service
- reminding staff regularly of their responsibilities regarding infection control, including appropriate hand washing techniques, cough etiquette, social distancing, use of personal protective equipment and waste disposal
- using available resources such as posters and fact sheets for consumers, staff and visitors, as a reminder of the infection control processes that are in place
- regularly reviewing, testing and improving each service’s outbreak management plan.
There are a range of COVID-19 resources available on our website for providers and for consumers, in addition to the COVID-19 information provided by the Department of Health. You should also routinely monitor advice from your local state or territory health department.
Free access to Alis still available
The Commission’s Aged Care Learning Information Solution, or Alis, opens up online access to our education programs for aged care services. Once you have an account within the platform, all you need is a device and an internet connection to access Alis anywhere, at any time.
To help you access the existing Aged Care Quality Standards modules in Alis, as well as the currently available and soon-to-be-released Serious Incident Response Scheme modules, all Commonwealth-funded aged care services can access 4 free registrations to our online learning platform until 31 October 2021.
If you haven’t already registered for Alis, we encourage you to do so now. You can also purchase additional Alis registrations if needed, to support your staff’s ongoing professional development.
To register for Alis, go to learning.agedcarequality.gov.au.
Free online forum on elder abuse on 17 June 2021
Approximately 16% of people aged over 60 are subjected to abuse but many cases of elder abuse are not reported, according to the World Health Organization. World Elder Abuse Awareness Day (WEAAD) is held on 15 June each year to shine a spotlight on this important issue.
Elder abuse is any act which causes harm to an older person and is carried out by someone they know and trust, such as a family member or friend. Elder abuse can occur in aged care services. The abuse may be physical, social, financial, psychological or sexual, and can include mistreatment and neglect.
The Aged Rights Advocacy Service (ARAS), the South Australian member of the Older Persons Advocacy Network (OPAN), is hosting a free online forum to observe WEAAD on Thursday 17 June 2021.
The theme for this year’s forum is ‘Elder abuse prevention – let’s talk’, and 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.
To register for the free forum, visit the ARAS website.
Examining consumer feedback on medication use in residential aged care
At the recent National Prescribing Services’ National Medicines Symposium 2021, A/Prof Juanita Breen (a consultant pharmacist to the Commission) presented findings of research undertaken into medication-related complaints received by the Commission from consumers between July 2019 and June 2020.
Medication-related matters consistently rank at the top of complaints received by the Commission and A/Prof Breen’s findings suggest most are related to basic aspects of care such as delayed medication administration, and poor policies and procedures. During the period of time reviewed, 1,224 complaint issues related to medication use, with 45% of complaints relating to administration alone. Three categories received over 60% of complaints including:
- not receiving medication at the right time (27%)
- poor medication management policies and procedures (22%)
- chemical restraint (14%).
The Australian Journal of Pharmacy covered A/Prof Breen’s presentation, highlighting that the research demonstrated the importance of training of staff in basic medication administration.
Resources
- If you’re uncertain about access to the COVID-19 vaccination for people working in residential aged care, a fact sheet translated in 19 languages, and poster are available on the Department of Health website explaining the vaccine options for residential aged care workers.
- Workers and recipients of in-home and community aged care can learn more about their COVID-19 vaccine options by viewing a Department of Health fact sheet on its website. This fact sheet is also available in 19 languages.
- The Older Persons Advocacy Network (OPAN) recently launched its new Stay Connected and Supported in Your Community initiative. This OPAN and ABC partnership aims to reduce the chances of social isolation and loneliness for older people, and to help them remain independent and living in their own home. The initiative includes a new Stay Connected website (opan.org.au/stayconnected) and new phoneline (1800 001 321) for older people about connecting with the services they need.
