The residential community | Aged Care Quality and Safety Commission

Intent of Standard 7

When people move into a residential care home, the residential community becomes a central feature of their lives. It is critical that older people feel safe and at home in the residential community, have opportunities to do things that are meaningful to them and are supported to maintain connections with people important to them. Meaningful activities can include participating in hobbies or community groups, seeing friends and family or activities that contribute to the residential community such as gardening, cooking and setting tables.

A residential community can involve diverse members from different cultures and backgrounds. It is important that each older person's culture is respected, and their diversity valued so they feel included, safe and at home in the service.
Given the scope of responsibility in residential care, providers also have increased requirements to ensure that older people have access to other services and to coordinate a planned transition to or from the service to maximise continuity of care for older people.

Standard 7 is intended to apply only to residential care homes.

Updates to guidance

The Commission is currently updating our guidance content to reflect these changes. Please ensure you check back regularly.

Governing body

Information for governing bodies*

This guidance should be read in conjunction with Quality Standard 2 which relates directly to the governing body*.

The governing body* plays an important role in aged care and services. They’re responsible for an organisation delivering quality care* and services (Outcomes 2.2 and 2.3).

The governing body* needs to:

supervise provider activities
lead a culture of safety, inclusion and quality
help identify and address issues.

It is important the governing body* puts in place processes* to check the organisation’s strategies for delivering tailored care and services meet each older person’s needs and preferences. This includes monitoring the organisation’s performance, such as by reviewing reports on:

how they’re delivering care and services
how they’re managing complaints*, feedback* and incidents* (Outcomes 2.5 and 2.6)
the quality of care and services workers are delivering. For example, through quality assurance or system reviews (Outcome 2.8).

Make sure the organisation has a culture of safety, inclusion and quality by monitoring and investigating areas you find in the organisation’s reports you can improve. Identify opportunities and make recommendations to your organisation to improve its culture of safety, including quality care*. Provide feedback* and support to the provider*.

You also need to monitor the performance of any subcontracted providers.

If you find any issues or ways you can improve, 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 this information with older people, their family and carers*
have strategies to reduce the risk of things going wrong again.

The provider* guidance for Outcome 2.3 has more information on open disclosure*.

Standard 2 provides detailed information for governing bodies*.

Key tasks:

Track the organisation’s performance. You need to make sure older people receive services and support that are important for their health and wellbeing*.

The governing body* needs to make sure the provider* delivers services and supports for older people in their activities of daily living* by:

optimising older people’s quality of life*
improving their wellbeing*.

You need to review how providers* support older people. Support for older people should include:

engaging in meaningful activities
maintaining their independence
managing their physical and psychological health.

The governing body* should review the provider’s* systems* and processes* regarding:

older people’s care and services plans*
progress notes and feedback*
incident* reports
data on social engagement, reablement* and preventing boredom and loneliness (Outcomes 2.5, 2.6, and 7.1).

The governing body* should also consider feedback* on how effective these services and supports are. This could come from older people, their families, and workers*, including resident experience surveys. You should address any issues or ways to improve straight away. You must support the organisation* to improve their services. They should provide care that improves older people’s wellbeing* at home.

Track how well the organisation supports older people to get the care and services they need during transitions of care*.

You need to make sure the organisation has processes* to manage transitions of care* for older people (Outcomes 3.4 and 7.2). This includes processes* that outline the:

coordination of care between workers* or settings
communication of care and services plans between workers*, health professionals*, and other parties
people involved in each older person's care during planned or unplanned transitions (Outcomes 3.4 and 7.2).

As the governing body*, you need to review reports on these processes*. This includes documentation of:

transitions of care*
feedback* from older people and their families
any incidents* or complaints* from transitions (Outcomes 2.5 and 2.6).

You should also examine how the provider*:

facilitates continuity of care
supports access to specialist services
makes sure to consider older people’s needs and preferences* during transitions.

You should promptly address any issues or areas for continuous improvement*. This will make sure of safe and smooth transitions. It will also support the ongoing wellbeing* of older people.

You can find more resources on the role of the governing body* and governance* at the Commission Resource Centre

The Commission developed the Governing for Reform in Aged Care Program to support the key recommendations of the Royal Commission into Aged Care Quality and Safety. The Program supports governing body members, leaders and emerging leaders to strengthen corporate and clinical governance capabilities and enact critical reform.

Workers

What does this Standard mean for workers*?

Standard 7 describes requirements for supporting older people to feel safe and optimise their quality of life* in the residential care home.

Tips for workers

Workers* involved in assessment and planning

You should try to find out what’s important to the older person and the things they like to do. This could include:

important relationships, including intimate relationships, or family, carers* and friends
communities and connections outside the service
hobbies and activities
skills, strengths, their past work life and positive experiences.

Also see Standard 3.

Workers* involved in designing lifestyle activities

It’s important to work in partnership* with older people to identify and design lifestyle activities that are meaningful and enjoyable for them. Draw on older peoples’ skills, strengths and past positive experiences to find activities which have purpose and are not just a diversion. Support older people to take part in activities outside of the residential service and maintain connections to communities, places and people outside of the residential service.

Activities may include, for example:

Domestic activities: baking, preparing morning tea, setting tables, clearing and wiping tables, washing dishes, folding washing, dusting.
Outdoor activities: walking, raking the leaves, sweeping up, gardening, feeding chickens or pets, small repair jobs, doing woodwork in an outdoor shed.
Social activities: shopping, outings like visiting a park, going to the beach, seeing a film, attending a concert, games, exercise.
Cultural activities: attending places of worship and community gatherings.
Artistic activities: painting and drawing, knitting and crocheting, decorating placemats, papier mâché work, making cards, flower arranging.
Personal activities: facials, hand massages and manicures, life review, looking at photos, pet visits.
Individual activities: activity board projects, sorting objects, reading, writing letters or cards.
Work activities: working at a desk, using a computer, other tasks related to past jobs.
Physical activities: Tai Chi, strength training, standing and seated exercises.

Make sure there are opportunities and spaces for older people to invite family and loved ones to visit them. Spaces should include both communal and private spaces and in older peoples’ rooms.

Workers* should respect older people’s dignity of risk* by supporting them to take part in meaningful activities of their choice, even if these involve some level of risk. This approach supports the emphasis on autonomy and person-centred care* in Standard 1.

Workers* supporting older people in the residential environment

You can create a safe and inclusive residential environment by treating everyone (older people and workers* alike) with respect and kindness (see Standard 1).

You should engage older people in conversations and activities that relate to their interests, skills and strengths.

You should support older people to build and maintain relationships of their choosing, including intimate and sexual relationships. You should also respect the privacy and independence of older people and the right of older people to meet with visitors in private (free from bias, discrimination* or judgement).

In line with Standard 1, workers* should recognise dignity of risk* when supporting older people in their choices. This means respecting their right to make decisions about their lives, even when these decisions involve some risk. Workers* should balance this by providing appropriate support and safeguards to minimise harm while maintaining the person’s autonomy and independence.

Workers* involved in transitions of care*

As outlined in Standard 3, workers* should manage risks during planned and unplanned transitions of care*. This includes identifying potential risks, such as interruptions to care, medication errors, or communication gaps, and taking proactive steps to mitigate these risks while coordinating a smooth and safe transition for the older person.

Well-coordinated transitions are key to ensuring continuity of care for older people. Planned and unplanned transitions of care* may occur between the residential care home and hospitals, community care settings, and the home of a carer*, family member or loved one. It’s important everyone involved in caring for the older person has the information they need to deliver care in line with the older person’s needs, goals and preferences* and that transition risks are effectively managed. To support this, you should:

identify those involved in the transition (from both the discharging and receiving organisation or home)
make sure roles and responsibilities* for the older person’s transition and ongoing care are clear
make sure the older person has access to enough of their medication for the transition
give accurate, complete and up-to-date information about the older person’s care needs to the receiving organisation, health professional*, family, carers* or substitute decision makers*
facilitate and maintain access to specialist health services, health professionals* and existing community engagements.

Key concepts:

The residential community

The residential community can be complex, involving diverse people with different cultures, backgrounds and experiences. It’s important each older person's culture and differences are respected and valued so they feel included, safe and at home in the residential care home.

You may identify or see incidents* involving violence, abuse, racism, neglect, exploitation and discrimination*. When this happens, you should provide immediate support to those who may have been harmed or upset by the incident*. You should let the appropriate person in your organisation know about what happened, so steps can be taken to prevent this from happening again (see incident management* under Standard 2).

Risk management, as emphasised in Standard 2, is a critical part of delivering safe and high-quality care*. Workers* should assess and address risks in all aspects of care and service delivery, from designing activities to managing transitions, while making sure these measures support the older person’s independence and quality of life*.

Its critical older people feel safe and at home in the residential community. Similarly, workers* should feel safe and supported in their workplace. A culture of mutual respect, safety, and inclusivity is essential for fostering a positive environment for everyone within the residential community.