Aged Care Quality Bulletin #14 – February 2020 | Aged Care Quality and Safety Commission

Commissioner message

Across the world, a lot of attention is now being given to COVID-19 (novel coronavirus) as new cases of this infectious respiratory virus are diagnosed in a growing number of countries. While Australia’s containment strategy has to date proven to be very effective, it is generally expected that over time the number of people with the viral infection in Australia will increase. Given that the virus seems to have more serious consequences for older people with chronic illness, all aged care providers should be on high alert and taking steps now to reduce the risks to their consumers and staff.

Professor Brendan Murphy, Australia’s Chief Medical Officer, has recently issued advice to all aged care providers about these matters. In his letter, as well as stressing the importance of infection control and preparedness for health emergencies, Professor Murphy outlined the factors aged care services should consider in relation to emergency planning:

first steps if infection is suspected or identified (e.g. seeking medical assessment, diagnosis and contact with local public health officials, if needed);
arrangements to ensure adequate care of the infected individual (e.g. staffing, isolation/quarantine within the facility, medical care, further liaison with public health officials);
protection measures for other residents, visitors and staff
notification advice to families, carers and relevant authorities.

At the top of the list of precautionary measures is, of course, robust infection control protocols and processes. The importance of infection control to ensuring consumers’ safety, health and wellbeing is underscored in Standard 3 (Personal care and clinical care) of the Aged Care Quality Standards. Requirement 3(g) in this standard requires aged care services to demonstrate “minimisation of infection-related risks through implementing standard and transmission-based precautions to prevent and control infection”.

Additionally, Standard 8 of the Quality Standards requires providers to have clinical governance arrangements in place that ensure safe and quality care for people receiving aged care – which can include effective organisation wide systems for preventing, managing and controlling infections.

The Commission is working closely with the Department of Health to monitor the impact of COVID-19 in Australia and is providing up to date information to aged care services as it becomes available.

As noted above, while the numbers of COVID-19 cases in Australia are currently low, services need to plan and be prepared for the situation to change rapidly.

Further information and links to useful resources can be found on the Department of Health website.

Getting to know the Standards – Standard 6 Feedback and complaints

Standard 6 is featured this month, in our regular look at each of the Quality Standards, the overarching principles and requirements, along with links to supporting information including guides, resources and case studies.

The consumer outcome for Standard 6 is:

I feel safe and am encouraged and supported to give feedback and make complaints. I am engaged in processes to address my feedback and complaints, and appropriate action is taken.

Standard 6 requires an organisation to have a system in place to resolve complaints that is accessible, confidential, prompt and fair. It should also support all consumers to make a complaint or give feedback.

Standard 6 covers key elements of an effective complaints management system, including that it should encourage consumers to give positive and negative feedback about the care and services they receive, and that it responds to feedback whether written or verbal, formal or informal. An effective system should also help organisations to keep improving and should resolve issues for consumers and others.

One of the most important elements of Standard 6 is the demonstration of open disclosure, in line with up-to-date practices of open communication and transparent processes. It includes acknowledging and apologising when the organisation has made a mistake, acting promptly to address any impact, and taking deliberate steps to prevent any recurrence.

It is important that consumers (and their representatives) feel safe and comfortable giving feedback to the organisation. Some consumers may experience difficulties or reluctance in raising complaints, such as cognitive or communication difficulties, language or cultural differences, or even a concern about possible repercussions for themselves. Organisations are expected to look for ways to tackle these potential barriers and create a culture that welcomes feedback and supports consumers and their representatives to raise concerns and make complaints.

As with all the Standards, it is recommended that organisations review the reflective questions for each of the Standard’s requirements, along with the examples of actions and evidence.

Alis – our new online learning solution – is live

The Commission’s new Aged Care Learning Information Solution, or Alis, is now live and ready for people across the country to use. Alis extends the reach and opens up access to the Commission’s education programs for aged care services. Anyone with a registration, internet connection and suitable device can access Alis anywhere at any time.

The first learning program focuses on the Aged Care Quality Standards, in particular:

understanding the intent and application of the Quality Standards
understanding some of the key concepts within each of the Quality Standards
understanding the importance of working with consumers in achieving quality outcomes
demonstrating compliance with the Quality Standards.

All Commonwealth-funded aged care service providers are being offered four free registrations until the end of March 2021 so they can evaluate the benefits of Alis.

You can also purchase more registrations to support your organisation’s ongoing professional development.
To find out more, please check out the Alis FAQs on the Commission’s website.

To register for Alis, visit learning.agedcarequality.gov.au/

Consumer engagement resources

Effective and ongoing consumer engagement is essential for successful aged care services; involving consumers in joint planning to meet their care needs and preferences is fundamental to achieving quality care outcomes. But what does good consumer engagement look like?

To help providers embed the kind of strategies and processes that lead to successful consumer engagement, the Commission has produced three separate documents under the umbrella title of ‘Consumer engagement resources.’ Each is described briefly below – follow the links to access the resources on the Commission’s website.

Working with aged care consumers – a resource

This practical resource has been designed to support providers of aged care to partner and engage with consumers to drive the delivery of consumer-centred care. It draws on a literature review, surveys of consumers and providers, the experience of the Commission, and case studies to offer suggestions and examples of the ways consumer engagement has been done well.

Consumer engagement in aged care – Literature review

This literature review examines published peer-reviewed articles and a broader set of literature, including strategies, reports, guidelines and toolkits to gain an understanding of existing models of co-design that have been successfully applied in a range of sectors both in Australia and internationally, which could be applied in the Australian aged care sector.

Consumer engagement in aged care – survey report

The purpose of this report is to describe the key themes and findings from online surveys of aged care consumers and aged care providers, regarding best practice models for engagement between consumers and providers.

Watch out for our new Consumer Engagement Workshops in 2020 which are coming soon.

Additional risk assessment of compulsory reports

The Government has provided funding through its mid-year budget process for the Commission to expand its processes in relation to responding to compulsory reports.

From 1 March 2020, Commission staff will be looking more closely at incident reports in relation to risk assessment and may follow up with individual approved providers to determine the outcome of internal investigations undertaken in response to incidents. In some cases, providers may be requested to provide additional evidence of actions taken such as staff training and amendments to resident care plans or behaviour charts. Alternatively, or in addition to this, a site visit may be conducted in particular cases to collect additional information, including through staff and resident interviews. Depending on the findings, further regulatory action may be considered.

These changes respond to issues identified through Royal Commission hearings and increase engagement with residents and their representatives following serious incidents.

The project will be monitored and reviewed in July 2020. In line with our commitment to education and performance reporting, the Commission will analyse trend data in compulsory reports and inform the sector and approved providers as relevant.

From the Chief Clinical Advisor

The ‘Better use of medication in aged care’ project continues to go from strength to strength. Recently, contracted pharmacists accompanied by Commission staff members have travelled to remote aged care services in Queensland, Tasmania, South Australia and Western Australia, working with nursing staff and personal care workers to implement the Reducing the Use of Sedatives (RedUSe) program in aged care services.

This project is being delivered under the education function of the Aged Care Quality and Safety Commission Act 2018.

The first visit under the project took place on 21 January 2020, with the delivery of training for twelve nursing and care staff at the Matthew Flinders Home in Port Lincoln in South Australia.

Further sessions have taken place in Queenstown and Swansea in Tasmania and Thursday Island in far North Queensland, and the project team has been impressed by the commitment to the well-being of consumers demonstrated in all the sites visited so far.

More details of these visits will be published on our website over the coming weeks.

The project is currently targeting services in remote and very remote locations. If you would like your service to be included in the next round of visits, please contact pharmacyunit@agedcarequality.gov.au.

Assessing the Standards workshops – still time to book

The ‘Assessing the Standards’ workshops, running throughout the year, will focus on helping providers to understand the accreditation or quality review process, how to be prepared for these processes and how to use the self-assessment tools to gather and analyse evidence.

Find details of a workshop in your state.