Put in place strategies to maintain a safe, clean and comfortable service environment*.

Use your risk management system* (Outcome 2.4) when you put in place these strategies. This will help you to find, assess, document, manage and review any environmental risks that may affect the safety of the older person and workers. This includes risks related to the equipment or aids you use in the delivery of care and services.

Make sure strategies include:

• a cleaning process*:
  • that makes sure the service environment* is clean, safe and comfortable. This can include buildings, access points, parking areas, gardens and the service environment*’s general appearance and homeliness. Have a cleaning schedule that includes how often you recommend cleaning, as well as procedures* and the responsibilities of all workers. Providers must store cleaning products safely.
  • that is in line with infection prevention and control* practices (Outcome 4.2). Make sure you clean the service environment* and equipment straight away if it’s visibly dirty or soiled. You may also need to increase how often you clean high touch surfaces and during infectious disease outbreaks. These processes* will help reduce the risk of surface contamination and transmission of infectious diseases.
• a cleaning and maintenance process* for equipment in the service environment*. This makes sure that equipment is cleaned and checked regularly*. Make sure equipment is cleaned and maintained using the right products, cleaning method, tools and following the manufacturer’s instructions and safety advice.

Make sure the design and maintenance of the service environment* is fit-for-purpose and supports older people to do the things they want to do (Outcome 7.1). Do this in partnership with older people (Outcome 2.1) to make sure the environment meets their needs, goals and preferences* (Outcome 1.1). Also, consider feedback* from older people, their families and carers (Outcome 2.6). When designing and maintaining the service environment*, consider spaces that:

• are welcoming, comfortable and provide older people with a sense of belonging
• have areas and equipment that keep older people safe while also:
  • promoting movement, engagement and inclusion among older people
  • enabling older people to move about indoors and outdoors.
• are culturally safe*. For example, this includes the design of a culturally inclusive environment that:
  • meets the needs of the community you mostly deliver services in. For example, you may work with Aboriginal and Torres Strait Islander older people, their families and the wider community to design a service environment* that encourages cultural safety, respect and being inclusive of local cultures.
  • enables the increased presence of an older person’s loved ones such as family, friends and carers to be with them more often during end-of-life care* and allows them to stay overnight if needed to follow cultural practices.
  • supports an older person to pray or practise other spiritual rituals
  • allows older people to host visitors.
• enable dementia-friendly design principles
• allow older people privacy when they want it.

For regional and remote providers, limited resources and higher costs may affect access to best practice design principles and design options. These providers should consider strategies to make sure their service environment*:

• is safe
• is well maintained
• is fit-for-purpose
• meets older peoples' needs and preferences
• allows older people to do the things they want to do.

Make sure strategies consider if the service environment* is suitable for each older person. Consider the service environment* during the assessment and planning process (Outcome 3.1), and in partnership with the older person, to make sure it meets their needs, goals and preferences* (Outcome 2.1). For example, look for ways to:

• make the service environment* accessible, by considering the needs of each older person (Outcome 1.1). This includes older people living with disability. For example, installing entrance ramps or elevators in areas older people with mobility challenges may have difficulty accessing.
• identify and minimise risk. When you identify risks in the service environment*, make sure you follow the risk management system* (Outcome 2.4) to address them. Do this in partnership with older people (Outcome 2.1) to understand how you can support their needs and preferences (Outcome 2.1) while also removing and reducing risk where possible. Consider the older person’s right to exercise dignity of risk* if they choose to (Outcome 1.3). Make sure the controls you have to minimise risks:
  • are unobtrusive. This means you should minimise safety risks in a way that is least restrictive on an older person’s freedom. For example, placing a fence around a secure area that is designed to blend into the landscape, or hidden using plants. Where it’s in the interests of an older person’s safety, it’s appropriate to risk assess the controls (Outcome 2.4).
  • optimise useful stimulation. For example, by using visual cues such as appropriate contrast to highlight key features, direct visual access to spaces, and text and image in signs. This also includes reducing unnecessary clutter and background noise.
  • make the service environment* easy to navigate. For example, by placing objects older people commonly use in clear sight, clear signage on the bathroom door and motion sensor activated lights in hallways.
• maintain and design the service environment* to improve older people’s quality of life*, reablement* and maintenance of function (Outcome 3.2).

Older people should also have the choice to bring personal items to the residential care home (Outcome 1.3). For example, valuables, furniture or pictures. This can support the older person’s daily living, including their quality of life*, and help them to take part in meaningful and engaging activities (Outcome 7.1). Make sure you put in place processes* to identify, manage and minimise risks related to personal items using the risk management system* (Outcome 2.4). This can include providing older people with enough secure storage for their belongings.

Put in place strategies that make sure the equipment used in the care and services you deliver are suitable, safe and clean and meet the needs of older people.

These strategies can include:

• an inventory management system*. This system* is to record a list of your equipment. It includes details such as where they are and what condition they’re in. It can also include their technical specifications. This may help improve information sharing, communication and use of your equipment.
• a maintenance plan. This plan is to track the schedules for maintenance and repairs of your equipment used inside and outside the service environment*. This will help you to make sure equipment is maintained and safe for the older person and workers to use.
• a cleaning plan. This plan makes sure that your equipment is cleaned and checked regularly. Regular cleaning is important because dust, dirt or other materials can build up when equipment is used or has been stored. It needs to be clear whose responsibility it is to clean and maintain equipment and aids.

Make sure equipment that older people share is checked and cleaned between each use. This will help reduce the risk of infection and outbreaks of infectious disease as a result of contaminated equipment and surfaces (Outcome 4.2).

Make sure any equipment you use in the service environment* meets each older person’s needs and preferences (Outcome 1.1). Make sure this is based on the older person’s care and services plan* as part of the assessment and planning process* (Outcome 3.1). Some older people need a clinical assessment to identify what assistive equipment, aids and devices they need (Outcome 5.4). For example, an appropriately qualified health professional can complete an assessment to identify suitable mobility aids or transfer equipment if the older person has difficulty moving around.

Also, make sure there is enough equipment available to meet each older person’s needs.

For regional and remote providers, limited resources may affect timely* access to equipment, allied health* and health professionals*. These providers should have strategies to make sure equipment is safe, clean, well-maintained and meets the needs and preferences of each older person.

Make sure your workers have the time, support and resources to keep a safe, clean, comfortable and welcoming service environment*.

Provide workers with guidance and training on how to maintain a safe, clean, comfortable and welcoming service environment*. This needs to be in line with:

• the organisation’s policies* and procedures*
• contemporary, evidence-based practice*
• workers’ roles and responsibilities*.

Make sure workers understand how to:

• maintain a safe, clean, comfortable and welcoming service environment* that is fit-for purpose and meets the needs and preferences of the older person
• use equipment safely and support older people to use equipment and aids safely
• use the risk management system* to identify and manage environmental risks in the service environment*.

Assess if workers are following your quality system* (Outcome 2.9). Do this through quality assurance and system* checks.

The guidance for Outcomes 2.8 and 2.9 has more information on workforce planning and worker training.

Make sure the workers who use or manage equipment have the time, support and resources to maintain and clean equipment.

Provide workers with instructions, guidance and training on how to maintain and clean equipment used in the service environment* (Outcome 2.9). This needs to be in line with:

• the organisation’s policies* and procedures*
• contemporary, evidence-based practice*
• workers’ roles and responsibilities*.

Make sure workers understand how to:

• maintain and clean equipment following the manufacturer’s instructions and safety advice and in line with your organisation’s plans
• use the right cleaning products and method in line with your organisation’s cleaning plan
• do a risk assessment when equipment is faulty, damaged or causing risk of harm to people using it
• check that equipment and aids meet the older person’s needs and preferences. This includes knowing processes* for how to escalate and refer to appropriately qualified health professionals (Outcomes 3.2 and 5.4) who can recommend suitable equipment and aids.

The guidance for Outcomes 2.8 and 2.9 has more information on workforce planning and worker training.

Monitor how well workers are maintaining a safe, clean and comfortable service environment*.

To check if you’re maintaining a safe, clean and comfortable service environment*, you can review:

• the older person’s care and service documents (Outcome 3.1). For example, care and service plans and progress notes.
• complaints* and feedback* (Outcome 2.6)
• incident* information (Outcome 2.5).

Look for situations where:

• you haven’t involved older people in deciding how you’ll manage risks in their service environment*
• you haven’t managed environmental risks or incidents well
• people have reported not feeling safe, welcome or comfortable at the service.

Also, talk with older people, their families and carers about the safety, condition and comfort of the service environment* (Outcome 2.1). For example, ask them if their environment is safe, fit for-purpose and meets their needs. Ask them if they feel that their provider involves them when they manage any environmental risks in the service environment*. These conversations can then inform continuous improvement* actions and planning (Outcome 2.1).

Assess if workers are following your quality system* (Outcome 2.9). You can do this through quality assurance and system* checks. For workers caring for older people in a residential care home, you can do this as part of the monitoring process* in Outcome 7.1.

If you find any issues or ways you can improve through your reviews and assessments, you need to address them. If things go wrong, you need to:

• practise open disclosure* (Outcome 2.3). This means being open about what has gone wrong. Share what went wrong with older people, their family and carers.
• put in place strategies to mitigate the risk of things going wrong again.

The guidance for Outcome 2.3 has more information on monitoring the quality system*.

Monitor how well workers are using and managing equipment.

To check if workers are using and managing equipment well, you can review:

• older people’s care and service documents. For example, care and services plans and progress notes (Outcome 3.1).
• complaints* and feedback* (Outcome 2.6)
• incident* information (Outcome 2.5)
• reports from your inventory management system* and maintenance request records.

Look for situations where equipment or aids have been reported as:

• unsafe
• unclean
• not functional
• not suitable for the older person’s needs.

Also, talk with older people, their families and carers about the safety, condition and comfort of the equipment and aids they use (Outcome 2.1). For example, ask them if their equipment and aids are clean, safe, fit-for-purpose and meet their needs. These conversations can then inform continuous improvement* actions and planning (Outcome 2.1).

Assess if workers are following your quality system* (Outcome 2.9). You can do this through quality assurance and system* reviews. For workers caring for older people in a residential care home, you can do this as part of the monitoring process* in Outcome 7.1.

If you find any issues or ways you can improve through your reviews and assessments, you need to address them. If things go wrong, you need to:

• practise open disclosure* (Outcome 2.3). This means being open about what has gone wrong. Share what went wrong with older people, their family and carers.
• put in place strategies to mitigate the risk of things going wrong again.

The guidance for Outcome 2.3 has more information on monitoring the quality system*.