Lutheran Services – St Pauls 5256

Assessment contact Performance Report

An assessment contact was conducted with this service on 26 July 2023.

The attached Performance Report details the assessment of performance against the Aged Care Quality Standards following the assessment contact.

Accreditation decision

Following a site audit conducted on 04 May 2022 to 06 May 2022, the Commission made a decision on 30 June 2022 to re-accredit this service.

The period of accreditation of the service will expire on 30 June 2025.

Site audit Performance Report

A site audit was conducted with this service on 04 May 2022 to 06 May 2022.

The attached Performance Report details the assessment of performance against the Aged Care Quality Standards following the site audit.

Exceptional Circumstances

During the COVID-19 pandemic, the Aged Care Quality and Safety Commission has temporarily modified our Regulatory Program, including the suspension of site audits to determine whether to accredit, not to re-accredit or vary the periods of accreditation for a service. 

In order to give effect to continuity of accreditation the Department of Health has, under Section 42.5 of the Aged Care Act 1997, made a decision to grant ‘exceptional circumstances’ to this service until 20 October 2022.

The service remains subject to compliance monitoring by the Aged Care Quality and Safety Commission.

Exceptional Circumstances

During the COVID-19 pandemic, the Aged Care Quality and Safety Commission has temporarily modified our Regulatory Program, including the suspension of site audits to determine whether to accredit, not to re-accredit or vary the periods of accreditation for a service. 

In order to give effect to continuity of accreditation the Department of Health has, under Section 42.5 of the Aged Care Act 1997, made a decision to grant ‘exceptional circumstances’ to this service until 20 April 2022.

The service remains subject to compliance monitoring by the Aged Care Quality and Safety Commission.

Exceptional Circumstances

During the COVID-19 pandemic, the Aged Care Quality and Safety Commission has temporarily modified our Regulatory Program, including the suspension of site audits to determine whether to accredit, not to re-accredit or vary the periods of accreditation for a service. 

In order to give effect to continuity of accreditation the Department of Health has, under Section 42.5 of the Aged Care Act 1997, made a decision to grant ‘exceptional circumstances’ to this service until 20 October 2021.

The service remains subject to compliance monitoring by the Aged Care Quality and Safety Commission.

Compliance monitoring update

An assessment contact was conducted by the Aged Care Quality and Safety Commission (Commission) on 31 January 2019 at St Pauls to monitor the service’s progress in meeting the Accreditation Standards. The Commission found the service complies with all Accreditation Standards.

Serious risk decision

On 28 August 2018 a delegate of the CEO of the Quality Agency made a decision that failure by Lutheran Church of Australia - Queensland District to meet one expected outcome in the Accreditation Standards in relation to St Pauls has placed the safety, health or wellbeing of a care recipient of the service at serious risk.

An assessment contact was conducted by the Aged Care Quality and Safety Commission on 31 January 2019 at St Pauls to monitor the service’s progress. The Commission found the service complies with all Accreditation Standards.

Serious risk is not an ongoing state; it is a statutory decision based on evidence at a point in time.

Following an audit we decided that this home met 44 of the 44 expected outcomes of the Accreditation Standards and would be accredited for three years until 20 April 2021.

Following an audit we decided that this home met 44 of the 44 expected outcomes of the Accreditation Standards and would be accredited for three years until 20 April 2018.