Aged Care Quality Bulletin #64 - April 2024

Group of ethnically diverse elders smiling

Commissioner’s message

Last week we hosted our second National Aged Care Providers Conference - ‘Getting in on the Act! – working together for better aged care’. We were joined by some 2,000 providers from the across the country in person (in Adelaide) and via live streaming.

Across the 2 days, and preceding day of pre-conference workshops, there was a high level of engagement and discussion which helped everyone to understand how we can best prepare for the upcoming reforms. We heard from a broad range of providers on how they are getting ready for the new Aged Care Act and strengthened Quality Standards, and on what we in the Commission can do better to support providers.

Our conference keynote speakers included the Minister for Aged Care, the Hon Anika Wells MP; Maree McCabe AM, Chair, Aged Care Quality and Safety Advisory Council and Michael Lye, Deputy Secretary, Ageing and Aged Care, Department of Health and Aged Care. Our panellists included Council of Elders Chair, Anne Burgess AM, many representatives from big and small residential, home services and CHSP providers, and consumer peak CEOs Craig Gear OAM from Older Persons Advocacy Network and Pat Sparrow from COTA.

My thanks to all presenters and participants who travelled from across the country to share their insights and learnings with us. 

A key takeaway from the conference is that there is a high level of awareness among providers of the upcoming reforms, and work is already well underway on getting ready for the changes ahead. Providers showed throughout the conference your commitment to supporting your leadership teams, workforce and the people in your care to understand what is changing, what we need to do to prepare and how these reforms will deliver a new era in aged care.

I also want to thank the many organisations who staffed exhibitor tables throughout the conference, providing a wonderful opportunity for attendees to interact with you and find out more about the work you do.

In our May issue, we will provide a summary of the conference and in the coming weeks we will make available all session recordings from the conference itself via our website. For those who attended in person, we will also be publishing photos from the event.

In the March edition of the Quality Bulletin, information was provided about our public consultation on the draft guidance resources we produced for providers and workers on the strengthened Quality Standards. We have received a lot of useful feedback on the resources and have extended the consultation period to 19 May. A pre-conference survey we conducted showed that the majority of providers have been reviewing and using the draft resources to get ready for the introduction of the strengthened Standards. In the coming months, once we have carefully reviewed and considered all input, we will update you on the feedback received and the changes we will make to ensure the final products meet your needs and expectations.

I also want to draw your attention to our latest Sector Performance Report. This report provides data and insights on how the sector performed from 1 October to 31 December last year. To get a further understanding of this report, the data it draws from and how we hope the sector applies this information, I also recommend viewing the recording of our March webinar discussing the report.

Our reports

Sector performance – latest insights

Our latest quarterly Sector Performance Report is now available on our website. The report includes data from 1 October to 31 December 2023 (Quarter 2).

Key information in this quarter’s report includes:

  • compliance with the Aged Care Quality Standards
  • complaints and serious incidents
  • an In focus article on restrictive practices.

Compliance with the Aged Care Quality Standards

We have seen overall improvements across residential care complying with the Aged Care Quality Standards, however there are still some gaps. Compliance rates show us that just under one in 7 residential care services and one in 3 home services didn’t meet all the requirements of the Quality Standards.

Organisational governance (Standard 8) now has the lowest rate of compliance in both residential care and home services. Poor governance affects all aspects of the quality and safety of a person’s care. We are helping providers to lift their performance in this area through education and programs such as Governing for Reform.

Complaints and serious incidents

For complaints in this quarter, we found that the most common concerns that people raised with us were still about clinical issues in residential care, and communication and financial issues in home services.

This quarter, the number of incidents reported to us under the Serious Incident Response Scheme (SIRS) went up. This has been largely driven by an increase in Priority 2 incident notifications – lower impact incidents that need to be reported to the Commission within 30 days.

In home services we have seen increasing reports of stealing or financial coercion by a staff member. The Commission expects providers to have processes in place to identify and prevent this type of conduct.

In focus: Restrictive practices

The subject of our In focus article for this quarter is restrictive practices.

A restrictive practice must only be used as a last resort. Our monitoring suggests that providers still don’t understand these rules as well as they should.

You can read the full report and our past quarterly reports on our website.

Aged care reform update

The public consultation period on our draft guidance for the strengthened Aged Care Quality Standards has been extended until 19 May.

We have extended the public consultation period for our strengthened Aged Care Quality Standards draft guidance until 19 May 2024.

We are consulting on our draft guidance resources to help providers, aged care workers and other stakeholders understand the strengthened Quality Standards and their roles and responsibilities in meeting them. We have listened to your feedback that you need more time to review and comment on these resources, and we are extending the consultation period in response.

The strengthened Quality Standards will come into effect on commencement of the new Aged Care Act. The timing of introduction of the Aged Care Bill to Parliament is a matter for Government decision, and the Government has indicated that it is keen to achieve this as soon as possible.

Your insights will help us ensure that our guidance resources will support the delivery of quality, person-centred aged care.

Provide feedback

Watch Up to Standard episode 3 

We have released our third episode of the Up to Standard video series.

In this episode, Lisa Peterson PSM, Deputy Commissioner, Sector Capability and Regulatory Strategy, discusses the main changes between the current Aged Care Quality Standards and the new strengthened Quality Standards. She also gives insight into how providers will be assessed against the new Standards. 

She provides some context as to why the strengthened Quality Standards are being released before the new Aged Care Act and answers questions about any further changes that could happen. 

A new suite of fact sheets on each of the strengthened Quality Standards is now available on our website.

You can read more information and updates on our website. If you have any other questions or feedback about the strengthened Standards, please email us at agedcarereform@agedcarequality.gov.au and help us to make sure that the sector is prepared. 

New Memorandum of Understanding with the Office of the Inspector-General of Aged Care

The Commission works closely with other government agencies and departments to protect and improve the safety, health, wellbeing and quality of life for people receiving aged care services. Where there is benefit in sharing information between the Commission and another agency, we typically enable this by negotiating a Memorandum of Understanding between the parties.

Most recently, an MoU has been developed between the Commission and the Office of the Inspector-General of Aged Care (OIGAC). The MoU documents how we share information with each other. It also outlines what we need to consider if there are data breaches, third party complaints, subpoenas and court orders, and dispute resolutions and notices.

The Inspector-General has powers to do independent reviews to identify and investigate system-wide issues as well as to make recommendations to the Government for improvement. The MoU between the Commission and the OIGAC will help the OIGAC to decide if the Commission is meeting our legislative requirements and to review the progress of recommendations from the Royal Commission. The OIGAC will also check our ability to effectively handle complaints from people receiving care.

Acting Inspector-General of Aged Care, Ian Yates AM and Commissioner Janet Anderson PSM signed the MoU on 23 April 2024. You can find the MoU on our website.

New targeted review insights reports

The Commission does regular financial and prudential targeted reviews to deep dive into specific issues or particular groups of providers. These reviews help to check the aged care sector’s understanding of financial and prudential obligations as a whole. They also help us to identify where there are gaps in information and education. This supports providers to improve their compliance and makes sure they’re prepared to meet their obligations.

After each review, we publish an insights report. The 2 most recent reports – on complex corporate structures and governance issues in the aged care sector – are now available.

The review on complex corporate structures looked at the impacts of these structures and related third-party arrangements on a provider’s compliance with their prudential responsibilities and their financial viability.

The review on governance at the relationship between governance compliance under Quality Standard 8(c) and prudential governance for managing refundable deposits.

Food, nutrition and dining

Menu and meals review program

We’re collaborating with the Department of Health and Aged Care to deliver a free national Menu and Mealtime Review Program for residential aged care services. The program will give each participating provider independent feedback and recommendations from an accredited practising dietitian.

The program:

  • is free and confidential
  • is done onsite by an accredited practising dietitian
  • has an educative focus, providing customised feedback and recommendations to each participating provider.

The program is only available to residential aged care services. The program will prioritise:

  • aged care services in small rural towns, remote communities and very remote communities
  • residential services under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program
  • smaller services (with 60 or fewer residents)
  • services with a score lower than 3 on the Residents’ Experience Survey question, ‘Do you like the food here?’

Expressions of interest are invited from residential aged care services wishing to participate in this tailored educationally oriented program. EOIs close on Friday 10 May 2024.

For more information and to express your interest, please visit our website.

Celebrating success in improved food, nutrition and dining

Actively involving older people in discussions about their care can help providers make sure their services are of the highest possible standard. 

Celebrating success

We wanted to share some successful examples we’ve seen of providers engaging with older people and embracing feedback.

  1. Food focus groups and taste testing
    We’ve seen providers organise regular food focus group meetings, with some inviting older people to taste test new menu items and have a say in what is included in the menu.
  2. Resident-led engagement
    Some facilities have established food and dining committees led by elected residents. These committees have started innovative programs such as community gardens, cooking events and personalised dining experiences.
  3. Family involvement in recipe changes
    Some services host ‘family nights’ where residents and their family members share favourite recipes.
  4. Improved pureed meals
    Responding to feedback from residents, one provider started pureeing each part of a meal separately instead of altogether. This improved both the taste and the presentation.

Providers using this process get a better understanding of each person’s preferences. They also help create dining experiences that are enjoyable and promote dignity, socialisation and inclusion.

You can read more about these innovative options in our full article.

Clinical update

Planning for winter: cold and flu season

Cold and flu season is fast approaching. The Commission is reminding residential aged care providers of their obligations around:

  • influenza vaccination programs
  • supporting residents to make sure they’re up-to-date with their vaccinations against flu and COVID-19.

The Department of Health and Aged Care recommends that people 65 years and over receive a flu shot every year. Extra strength flu shots (the adjuvanted influenza vaccine, or the high dose influenza vaccine) are available for older Australians.

COVID-19 is still widespread in Australia with cases across the community. Yet many older people, particularly those in residential aged care, aren’t keeping their COVID-19 vaccination up-to-date. See recent letter from the Commissioner and the Chief Clinical Advisor.

The COVID-19 booster and the flu shot can be given at the same time if needed.

Another virus that is worth knowing about is respiratory syncytial virus (RSV). It’s highly infectious and affects a person’s airways and lungs. This bug can be a serious illness for older people. It can cause problems such as bronchiolitis and pneumonia.

RSV became a notifiable disease in Australia in 2021. The RSV vaccine Arexvy has been approved by the TGA in Australia and is registered for use for adults 60 and over. It’s available on private prescription.

Testing for viruses is particularly important in aged care homes so that outbreaks can be contained and well managed. While COVID-19 and other respiratory viruses can have similar symptoms, they may need to be managed differently.

There is now a rapid antigen test (RAT) available in Australia that detects 4 respiratory infections (RSV, flu A/B and COVID-19) in a single test.

All residential aged care staff should also be offered a flu shot each year. Providers should remind, encourage and support care staff to access the vaccines.

The Australian Government has also recently announced funding for pharmacists to provide free flu and other National Immunisation Program vaccines, to residents in residential aged care homes.

Further information

Consent for medical treatment: A new guide for aged care

Getting consent to medical treatment is not only a legal requirement but good clinical practice in aged and palliative care. It’s also a key requirement under the Aged Care Quality Standards.

End of Life Directions for Aged Care (ELDAC) has information, guidance and resources on palliative care and advance care planning. This helps support health professionals and aged care workers to improve the care of older Australians. ELDAC has recently produced 2 new fact sheets on getting consent for medical treatment.

These fact sheets include detailed information about the law on consent to medical treatment. The first explores the law on consent for minor or routine treatment or healthcare.

The second factsheet, for aged care providers (including residential and home care services), explains the fundamentals of the law on consent to medical treatment. 

ELDAC recommends that you read their overview of capacity and consent to medical treatment before reading these new fact sheets. This gives you essential information about the law on decision-making capacity and consent to medical treatment.

Falls awareness month

The Aged Care Quality and Safety Commission is a proud supporter of the 2024 April falls campaign – Better balance for fall prevention: Get strong, get going!

The campaign encourages older Australians to be more active and helps them find exercise programs to meet their needs and interests. This has many benefits, including reducing the frequency of falls and injury and maintaining function and independence. It’s never too late to get active.

For more information, visit the NSW Fall Prevention and Healthy Ageing Network.

Webinars

Getting complaints right

Tuesday 21 May 2024, 2.00pm – 3.00pm AEDT   

This is a webinar for aged care providers and people receiving aged care and their family, friends, and other supporters. This webinar will focus on our upcoming complaints report: Complaints about aged care home services - Insights for people receiving care. We will help people to understand rights in aged care, what is expected from home services providers, and how the Commission can help. We will also talk about what to do if things are not going the way people want, including how to make and manage complaints.

Registrations will open on 7 May via our website.

Governing for reform

The Governing for Reform in Aged Care Program has growing support across the sector from those who want to improve their corporate and clinical governance skills. The program is now open to anyone working in the aged care sector who is interested in strengthening their governance and leadership skills.

The program’s workshops are proving very popular, with 60 people attending the workshop Using strategy to drive change and embrace reform on 9 April. 

The program’s next webinar on the hot topic of Environmental, social, governance and climate sustainability is on 22 May. Presenters will include:

  • Catherine Daly CEO Integrated Living
  • Anne Curson, Manager Executive Services Aged Care and Community Services BlueCare and ARRCS
  • Dr Kaushik Sridhar, University lecturer and corporate leader in sustainability.

The webinar will explore the importance of environmental and climate sustainability initiatives in aged care. Registrations for this webinar will open on 8 May 2024.

Head to the Governing for Reform webpage to find more governance resources and learning activities.

Training and resources

Online workshops for approved providers

The Commission regularly hosts online workshops for approved providers of residential aged care and home services.

Upcoming workshops in May include:

  • The Serious Incident Response Scheme in residential and home services
  • Effective Incident Management Systems.

Visit our Workshops webpage for further information and registration details.

New resources

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Acknowledgement of Country

In the spirit of reconciliation, the Aged Care Quality and Safety Commission acknowledges the Traditional Custodians of Country throughout Australia and their connections to land, water and community. We pay our respect to their Elders, past, present and emerging and extend that respect to all Aboriginal and Torres Strait Islander peoples.