Aged Care Quality Bulletin #53 - May 2023 | Aged Care Quality and Safety Commission

Group of ethnically diverse elders smiling

Commissioner’s message

The preparation of this Bulletin has coincided with widespread media coverage of a shocking incident in a NSW aged care home that involved emergency services and resulted in the hospitalisation of an elderly resident who subsequently tragically died. The details of the incident are now being examined by various government agencies including the Commission and are not for exploration here – except to acknowledge how distressing this experience must have been for everyone involved, including the aged care staff.

As a matter of general principle, it is unarguable that aged care consumers are entitled to receive safe, quality care, irrespective of the care setting or time of day. For their part, aged care providers have clear legal responsibilities to prevent, minimise the risk of, and respond effectively to incidents that may adversely impact consumers.

Since 1 July 2021, approved providers have had updated and specific responsibilities under the Aged Care Act 1997 and the Quality of Care Principles 2014 relating to the use of any restrictive practice in residential aged care or short-term restorative care in a residential care setting. The importance of developing and skilfully implementing a behaviour support plan for any consumer who requires one is clearly articulated in the legislation.

Ensuring that older Australians are treated with the dignity and respect they deserve is a continued commitment of the Government. This is reflected in the 2023–24 Federal Budget, which included key initiatives to fund a 15% pay increase for aged care workers, introduce a new regulatory model along with the proposed new Aged Care Act, and improve access to high quality aged care for First Nations Elders. Further information on the aged care Budget initiatives is provided in this issue.

The Government also increased its commitment to improving food, nutrition and the dining experience for older Australians in residential aged care through a range of new measures. This includes the Commission’s establishment, from July this year, of a new food hotline with access to specialists to help manage food complaints and provide advice on food, dining and nutrition. The Commission’s new support unit will also help providers build capability by linking them with support and education programs, including those delivered by accredited practising dietitians. More information about this will be published in coming weeks.

Earlier this month, I hosted a Complaints handling webinar which provided an excellent opportunity to introduce Ms Louise Macleod, our new Complaints Commissioner to the sector. The discussions focused on explaining the Commission’s approach to complaints handling and resolution together with real life examples illustrating how providers can effectively manage complaints. We were joined by Craig Gear OAM, CEO, Older Persons Advocacy Network (OPAN) who talked about the work that OPAN does to support consumers and providers. If you missed the webinar, I encourage you to watch the recording.

After months of preparation, my executive team and I are keenly anticipating spending 1.5 days with around 1000 aged care providers at our National Aged Care Provider Conference at the Melbourne Convention and Exhibition Centre. The conference offers an important opportunity to come together and reflect on ‘Working together – our journey through aged care reform and regulation’.

I look forward to sharing key insights from the conference with you in the June issue.

Aged care reforms update

2023–24 Budget overview

The 2023–24 Budget reflects the Government’s commitment to ensure that older Australians are treated with the respect they deserve. Key aged care initiatives include to:

fund the Fair Work Commission decision for a 15% pay increase for aged care workers to recognise the complex work they do
improve provider regulation through a new regulatory model and enhancing the measurement of quality standards. The new regulatory framework will be reflected in a new Aged Care Act
establish a new Aged Care Taskforce to review aged care funding arrangements and develop options to make the system fair and equitable for all Australians
develop the final design of the Support at Home program, postponed to now start on 1 July 2025, allowing for further refinement of the program’s design
put older people at the centre of residential aged care, assigning care places to people
introduce new initiatives for GPs to provide care to residents through My Medicare
ensure long term sustainability for the aged care system by monitoring providers for financial risk and supporting their viability through targeted programs
improve access to high-quality aged care for First Nations elders and boost provider support and worker training to build care capacity.

Read more about the above aged care Budget initiatives on the Department of Health and Aged Care’s website.

24/7 registered nurse cover and care minutes

The Commission has published responses to questions asked at our recent webinar on 24/7 registered nurse cover and care minutes that could not be answered due to time constraints. If you missed this webinar, the recording and presentation slides are available on our website.

Further information is available in the Commission’s regulatory bulletin on workforce-related responsibilities. This document provides detailed information on the new responsibilities being introduced from1 July and 1 October 2023 respectively for approved providers of residential aged care, and how the Commission will regulate these responsibilities.

You can stay up to date on 24/7 registered nurse cover and care minutes by visiting the Commission’s website.

On Thursday 1 June 2023 at 2pm–3pm AEST, the Department of Health and Aged Care will host a webinar on the upcoming 24/7 registered nurse responsibility to provide information on reporting obligations and the data quality expected, and the 24/7 registered nurse responsibility supplement.

You can register to attend this webinar on the department’s website, and a recording and presentation slides will be published there afterwards.

Further information is available to support providers to understand their new responsibilities:

A new model for regulating aged care

A new model for regulating aged care is being developed for implementation as part of the proposed new Aged Care Act.

The Department of Health and Aged Care is looking for feedback on the A new model for regulating Aged Care, Consultation Paper No.2: Details of the proposed new model until 5pm, 23 June 2023. You can read Consultation Paper No.2, submit your thoughts on the proposed model and register for workshops on the Aged Care Engagement Hub regulatory model page.

The recording of the webinar, A new model for regulating aged care held on 9 May, is now available on the department’s website. The webinar is part of the department’s consultation activities.

Biennial aged care provider workforce survey

The Australian Government’s Aged Care Provider Workforce Survey will be open from 31 May until 30 June.

This national online survey collects information about the size and composition of the workforce in residential aged care and in-home care settings. The information enables a better understanding of the aged care workforce and supports the development and evaluation of workforce policy decisions.

The research is being conducted for the Department of Health and Aged Care by the Social Research Centre (SRC). All data collected will be confidential and published in a summarised, de-identified format. This means that no names or contacts will be connected to the published data, and it won’t be used for compliance purposes. As an additional benefit, participating providers can also receive an individual report on the profile of their workforce.

A representative sample of services from over 50% of all aged care providers has been selected to complete the online survey. This includes providers from:

residential care
home care
Commonwealth Home Support Programme
National Aboriginal and Torres Strait Islander Flexible Aged Care and Multi-Purpose Services Program.

These providers will have already received an invitation to complete the survey from the SRC, on behalf of the Department of Health and Aged Care. If you have received this invitation, we encourage you to complete the survey and help inform policy that addresses workforce challenges in the sector.

If you haven’t received a direct invitation from the SRC, you can still complete the survey. To register your interest in the survey, or if you have any questions about it:

visit the SRC survey website
call the survey helpline on 1800 800 996
email acpws@srcentre.com.au.

Food, nutrition and dining

Analysis of food and dining experiences in residential aged care

There are many factors that can influence a person’s dining experience in residential aged care. To make effective improvements, it’s important to have a deeper understanding of needs and interests from the residents’ perspectives.

The Commission has published a report outlining the key findings of an analysis of food and dining experience surveys that Older Persons Advocacy Network (OPAN) conducted. OPAN interviewed 365 residents of residential aged care services across Australia between 2021 and 2022.

Most residents (87.4%) interviewed in this study viewed food to be important to them and more than half (58.1%) said that they enjoyed cooking. Some commented on their enjoyment of participating in cooking activities at their service while others said that they missed the opportunity to prepare meals for themselves or others.

Residents were also asked about the foods and snacks they missed. Many said that they preferred food that was familiar and ‘homelike’, consisting of fresh, high-quality ingredients like seasonal fruit and vegetables. Some said that they enjoyed being able to access takeaway meals on occasion because it brought them a sense of pleasure, familiarity and a link to their past.

Many spoke of the pleasure they continued to derive from eating meals with their family and friends in a social setting. They described meals or occasions that continued to make them happy where they lived now, such as:

a Sunday roast
happy hour (the opportunity to share a drink with others)
celebratory lunches
an onsite BBQ.

In summary, we know that factors supporting a more positive dining experience include:

familiar or favourite foods with a focus on fresh ingredients
food delivery and serving arrangements that optimise timeliness and temperature
regular events and occasions
homelike and social dining environment
the availability and knowledge of staff
resident participation (such as residents being involved in food planning, preparation, cooking and serving)
resident co-design (such as residents being involved in menu planning, design of dining environments and events).

For more details you can access the report on our website.

Supporting informed choice

Supporting older Australians to make informed choices about their food, drink and dining experiences is a key part of maintaining their quality of life in residential aged care.

Getting the dining experience right is important:

Choice upholds residents’ rights and enhances their quality of life.
Residents who can make choices about their food and drink are more likely to be healthier, happier and live longer.
The Aged Care Quality Standards underscore the need for residents to have the dignity of choice.

To assist providers, workers and older Australians, we have released a suite of resources on consumer choice as part of our collection of food, dining and nutrition resources.

Through the resources you can learn more about:

why choice matters
the benefits of providing choice
the risks of limiting choice
how to enable choice.

To access these and all of the food, dining and nutrition resources, visit the Food, dining and nutrition page (providers) on our website.

Food, glorious food

The Older Persons Advocacy Network (OPAN) recently hosted a webinar, Food, glorious food: what to do if it’s not. It explores what older people can expect from service providers during mealtimes and how to provide effective feedback.

Dr Melanie Wroth, Chief Clinical Advisor to the Commission, was on the panel together with industry experts Maggie Beer AM (leading Australian chef) and Dr Sandra Iuliano (Dietitian and Senior Research Fellow at the University of Melbourne). They provided information and advice on improving food, dining and nutrition in aged care.

You can access a recording of the webinar on OPAN’s website.

The Food and dining – your choices matter fact sheet explains how the Commission can help residents raise concerns about their food and dining experience in residential aged care. Consumers can also seek support or advice from free, independent advocacy services such as OPAN.

For more information on the Commission’s Food, Dining and Nutrition campaign, visit Food, Dining and Nutrition (consumers) page or Food, Dining and Nutrition (providers) page.

Clinical update

New online IPC tool

A new online tool is now available for residential and home services providers to quickly access key information and reference materials on infection and prevention control (IPC).

The Commission launched the IPC online tool to provide direct access to the main aged care specific guidance at both federal and state levels. You can filter at the state or territory level, based on the information and location most relevant to your service.

This tool will be progressively expanded to become a more extensive toolkit to support the sector.

IPC is a critical component of delivering safe and quality care to older Australians. Approved providers have a responsibility to ensure that their IPC policies, processes and practices are up to date. They also need to make sure that staff have the required level of training and competence to manage IPC.

The new tool can be accessed on our website.

Clinical alert on hot water scalding

Earlier this month, the Commission’s Chief Clinical Advisor, Dr Melanie Wroth issued a clinical alert on hot water scalding. The alert followed an incident in NSW where a person receiving personal care from a disability services provider suffered severe burns (scalds) while being bathed. They subsequently died from their injuries.

Providers were reminded that they must ensure there is clear oversight of staff, and that staff receive appropriate education and training to safely provide personal care such as bathing and showering. Those providing direct care need to:

always check the water temperature
know the immediate response required to treat a scald or burn
apply immediate and appropriate first aid treatment
understand when to seek medical attention and when to seek emergency treatment.

The clinical alert provides advice on:

how to reduce the risk of scalding
the steps to take if a scald burn occurs during bathing or showering
links to key resources.

All providers are encouraged to share this information within your services.

National Palliative Care Week 2023 (21–27 May)

End of life care and the people who provide it may not feature prominently in our day-to-day conversations, but that doesn’t mean they are unimportant. In fact, quite the opposite!

That is why this year’s National Palliative Care Week’s theme, ‘Matters of Life and Death’, aimed to bring this special work to the forefront of all Australians’ minds. It also provided the opportunity to thank those who provide care and support to people with life limiting or terminal illnesses.

Those who support people coming to the end of their life to live the remainder as fully and as comfortably as possible, include:

nurses and nurse practitioners
general practitioners
allied health professionals
care workers
lifestyle staff
hotel services staff
community workers and volunteers.

Palliative care considers the individual's physical, emotional, social, and spiritual needs, as well as the needs of their loved ones and everyday carers.

As demonstrated by the breadth of the above list, many who work in the aged care sector are touched by the deaths of people you care for, and care about. Your service is acknowledged and appreciated.

We also support Palliative Care Australia (PCA) in the ongoing work they do. We encourage you to check out the many amazing things they have created for this year’s National Palliative Care Week, including this video, to shine a light on this important work.

Further information and resources

As the majority of older Australians don’t have an advance care directive, also called a living will, we encourage providers to discuss end of life planning with those in your care and their families.

Advance Care Planning Australia provides specific resources to assist clinical staff and other care givers to engage with those in their care to support them in planning for their future health needs and preferences.

ELDAC (End of Life Directions for Aged Care) also provides information, guidance, and resources to health professionals and aged care workers to support palliative care and advance care planning.

Webinars

Stronger Standards, Better Aged Care

Register now for our next monthly webinar on 20 June 2023 from 1:00pm – 2.00pm AEST.

This webinar will provide an overview of our Stronger Standards, Better Aged Care program and discuss what we’re doing to prepare the sector in the lead up to the introduction of the strengthened Quality Standards next year.

Registrations are open on our webinars page.

Complaints handling in aged care

The recording of our webinar on Complaints handling in aged care, held on 16 May, is now available. Commissioner Janet Anderson PSM facilitated the webinar and panellists included Louise Macleod, Complaints Commissioner and Michelle Bampton, Executive Director, Intake and Complaints Resolution Group from the Commission and Craig Gear OAM, Chief Executive Officer, Older Persons Advocacy Network.

The webinar focused on:

assisting approved providers to understand the complaints management process
what the Commission is looking for from providers in response to complaints
how complaints can improve outcomes for both providers and care recipients.

Residential aged care funding

The Department of Health and Aged Care recently held a webinar on the residential aged care funding initiatives announced in the 2023–24 Budget, which provides for $11.1 billion (over 4 years from 2023–24) in funding for residential aged care. You can view the presentation slides and webinar recording on the department’s website.

In addition to the 15% award wage increase for aged care workers, the webinar covered the:

Australian National Aged Care Classification (AN-ACC) price increase
increase to the 24/7 registered nurse supplement
new hotelling supplement
new grant opportunity under the AN-ACC Transition Fund
increased funding for upcoming changes to care minutes targets
changes to care minutes allocation for individual AN-ACC classes.

Reforming in-home aged care

On 18 May, the Department of Health and Aged Care hosted a webinar to provide an update on several in-home aged care reforms in the 2023–24 Budget to support older Australians. The webinar covered:

reforms to in-home aged care
Commonwealth Home Support Programme
Home Care Packages Program
the new regulatory model
the new Aged Care Act.

The recording of this webinar is now available on the department’s website.

Elder Abuse – Perception versus Reality

Registrations are open to take part in the Aged Rights Advocacy Service 2023 World Elder Abuse Awareness Day Online Forum: Elder Abuse - Perception versus Reality.

This free event is on 16 June 2023 from 10.30am – 12.45pm AEST.

Governing for reform

Expressions of interest are invited for the Governing for Reform in Aged Care Program’s free coaching program. The program is designed to provide support and collectively uplift the governance capability of your board. Coaching is provided specifically to governing bodies and executive teams (as groups) of small, medium or regional and remote aged care providers.

Coaching sessions are highly tailored, enabling your governing body members and executives to collectively focus on issues relevant to your organisation.

Below are what some of the participating governing body members and executive leaders have enjoyed most about the coaching sessions:

explanations regarding legislative requirements
collaborative learning and ability for robust discussion
opportunity to discuss and consider impacts of reform on our organisation.

If your governing body and executive team would like the opportunity to access curated coaching that is relevant to your organisation’s needs, you can find out more and register your interest by visiting the Governing for reform in aged care program webpage.

Be quick because places are limited!

Training and resources

‘Welcome to Aged Care’ online learning modules

A reminder that last month we released a series of online learning modules for staff who are new to the aged care sector.

The ‘Welcome to Aged Care’ series provides aged care staff with:

an overview of the Commission
the obligations that aged care staff and providers have in providing safe and quality care to older Australians
the resources available to support their work.

The modules are:

Introduction to the Aged Care Quality and Safety Commission
Introduction to the Charter of Aged Care Rights
Introduction to complaints.

Access to the Commission’s online learning platform is free for all staff of Australian Government funded aged care providers. For further information and to register for the Commission’s online Aged Care Learning Information Solution (Alis), visit the Commission's website.

Financial and Prudential Regulatory Insights

In the May edition of Financial and Prudential Regulatory Insights, the Commission’s Paul Heinemann discussed the new educational resources available to support providers in financial and prudential matters.

A new poster and a series of factsheets are available to help you understand, and assess your compliance with, the prudential standards. You can view these resources at the links below:

Subscribe to Financial and Regulatory Insights to receive monthly updates.