What is the outcome that needs to be achieved?
Older people have autonomy and can take time and seek advice before entering into any agreements about their care and services. Older people are supported to understand agreements, fees and invoices to make informed decisions.
Actions
Prior to entering into any agreement or commencing care (whichever comes first), the provider gives older people information to enable them to make informed decisions about their care and services.
The provider supports older people to understand information provided to them, including any agreement they will be required to enter into, the terms relating to their rights and responsibilities, the care and services to be provided and the fees and other charges to be paid.
The provider allows older people the time they need to consider and review their options and seek external advice before making decisions.
The provider informs the older person of any changes to previously agreed fees and charges and seeks their informed consent to implement these changes before they are made.
The provider implements a system to ensure prices, fees and payments are accurate and transparent for older people.
The provider ensures invoices are timely, accurate, clear and presented in away the older person understands.
The provider promptly addresses any overcharging and provides refunds to older people.
Why is this outcome important?
Outcome 1.4 explains providers’ obligations for agreements, charges and invoices. Providers must make sure the information they give older people, their families and carers is clear and easy to understand. This helps them to make informed decisions and maintain their autonomy. Older people have the right to make decisions about their care and services. This includes understanding the fees for these services and any changes a provider makes to an older person’s agreements.
Outcome 1.4 makes it clear that providers must get informed consent* from older people before making any changes to services, fees or charges. It’s important providers give older people enough time to:
- explore their options
- get advice
- understand the consequences of their decisions.
This supports older people’s autonomy and can also help them to feel more in control of their care and financial choices.
You need to give focus to:
- making sure older people have time to think about their options and get advice before signing an agreement
- getting informed consent* from older people before you make any changes to agreed fees and charges
- supporting older people to understand agreements, fees and invoices and make informed decisions.
Key tasks
Providers
Providers
Use your communication system* to help older people understand the agreements they are entering into, including the fees and charges for care and services (Outcome 3.3).
Give information about agreements to older people before they enter into any agreements. It can also be before they start receiving care, whichever happens first. For example, give them information about:
- any agreements they will have to sign before receiving care or services
- any situations where a change needs to be made to a current agreement
- the terms and conditions about their rights and responsibilities
- the care and services you will provide
- fees and other charges they need to pay.
Include information about fees and other charges in agreements and invoices.
This information should help the older person make an informed decision about whether to enter into an agreement (Outcome 1.3).
Give older people, their family and carers* time to understand the information you have given them (Outcome 1.3) before they enter into any agreements or start receiving care. In particular:
- make sure workers give older people enough time to consider their options when entering into a new agreement. They also need to do this when the organisation makes changes to the prices, fees and payments.
- give older people time and support to ask for external advice if needed.
Help the older person, their family and carers* understand the information you have given them (Outcome 1.3). Consider each older person’s language and communication needs and preferences (Outcome 1.1). For example, use plain language, large text, images, or have a conversation with them directly. Check to see if you need to use interpreters or translators.
Make sure workers check that the older person, their family or carers* understand the information they have given them.
The guidance for Outcome 3.3 has more information on using the communication system*.
Put in place a system* to manage prices, fees, invoices and payments.
This system* needs to include processes* to make sure that:
- the prices, fees and chargeable items specified in agreements and shown on invoices are accurate and transparent. This means invoices need to show the care and services given to the older person. For example, invoices need to be itemised so the older person knows exactly what you’re charging them for. Make sure charges follow the older person’s agreement.
- you give invoices to older people, or people responsible for paying them, in a timely* way
- you give invoices to older people in a format that they can understand clearly. Consider older people’s language and communication needs and preferences (Outcome 1.1). Make sure that if they need any other support to understand this information, that you document this in their assessment and planning (Outcome 3.1).
- you tell older people and those involved in their care when issues in invoices are found. Make sure you address these in a timely* way and where needed, give refunds to older people (Outcome 3.3).
- you investigate any issues. Resolve any system* issues to stop any overcharging or undercharging from happening again.
Do regular checks to make sure invoices are accurate and any issues with agreements can be found and resolved in a timely* way.
Give older people or people responsible for paying invoices ways to give feedback* or make complaints* if they have been given incorrect charges (Outcome 2.6). Don’t rely on older people to make complaints* about incorrect charges. Instead, have strong systems* in place to make sure billing is accurate at all times. These systems* should also allow you to monitor complaints* and record how you managed them.
Make sure that your system* for getting informed consent* from older people includes situations where fees and charges have changed (Outcome 1.3).
Use the system* for getting informed consent* when there are changes to:
- an older person’s care and services
- fees and charges they have agreed to in the past.
Get informed consent* from the older person before making any changes. This is so you can encourage them to choose freely and with dignity of risk* (Outcome 2.1). This makes sure that you record changes about the older person when making decisions about their care and services. This means you will be able to find records of care or financial changes that may affect the ability of older people or their family to pay the agreed fees.
The guidance for Outcome 1.3 has more information on informed consent* and decision-making.
Make sure workers have the time, support, resources and skills to use the systems* for agreements, invoicing and payments.
Give workers guidance and training on how to prepare invoices and agreements that are clear and easy for the older person to understand (Outcome 2.9). This needs to be in line with:
- the organisation’s policies* and procedures*
- workers’ roles and responsibilities*.
Make sure workers understand how to:
- give older people prices, fees and payments:
- that are sufficient, accurate and transparent
- in a timely* way
- in a way they can view and understand.
- give older people enough time to think about their options before making decisions
- let older people know about any changes to fees and charges they have agreed to in the past
- get informed consent* from the older person before you make any changes to fees and charges.
The guidance for Outcomes 2.8 and 2.9 has more information on workforce planning and worker training.
Monitor the use of your systems* for agreements, invoicing and payments and how well they work.
Check if your workers are following your systems* for agreements, invoicing and payments (Outcome 2.9).
To check if workers are supporting older people to understand their agreements, invoicing and payments, you can review:
- older people’s care and services (Outcome 3.1). For example, care and services plan* s and progress notes.
- complaints* and feedback* (Outcome 2.6)
- information about incidents* (Outcome 2.5).
Look for situations where older people have had issues with differences in their:
- agreements
- the care and services they receive
- fees.
Also, talk with older people, their families and carers about the care and services they receive (Outcome 2.1). Ask them if workers have given them information about their agreements and fees in a timely* way and in a way they can view and understand. 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.
If you find issues or ways you can improve though your reviews and assessments, you need to address them. If things go wrong, you need to:
- practise open disclosure*. 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*.