Understanding voluntary assisted dying legislation and what it means for your service

Voluntary assisted dying (VAD) is a sensitive and complex topic, and one that is gaining increasing attention in Australia. VAD laws have been passed in all Australian states, and are currently operating in Victoria, Western Australia, Tasmania, Queensland (as of 1 January 2023), and South Australia (as of 31 January 2023). VAD laws will commence in New South Wales on 28 November 2023. The recent repeal of legislation which previously barred the territories from making laws on assisted dying, means that the Northern Territory and the Australian Capital Territory will also be able to legislate on VAD in the future.

When is VAD available?

VAD is available in limited circumstances, and allows eligible individuals with a terminal illness, disease or medical condition to end their lives with the assistance of a health practitioner. This assistance can take the form of self-administration, where the individual takes the medication themselves, or practitioner administration, where the medication is administered by a health practitioner. Importantly, VAD is only available to individuals who have decision-making capacity and who are acting voluntarily without coercion.

Eligibility

The eligibility criteria for VAD vary between states, but generally require that individuals be over 18 years of age, be an Australian citizen or permanent resident, and have been resident in the state for at least 12 months. They must have a terminal illness or medical condition that is expected to cause death within a certain time frame (usually six months), and be experiencing suffering that cannot be relieved in a manner that the individual finds tolerable.

Process

The process for accessing VAD also varies between states, but generally requires the individual to make multiple requests for VAD and undergo assessments by at least two independent medical practitioners. The individual can withdraw their request at any time.

What does VAD mean for providers?

As aged care and health providers, it is important to understand the laws surrounding VAD and to be able to support individuals and their families who may be considering this option. Providing appropriate pain and symptom relief is a crucial part of end-of-life care, and is not considered VAD. It is important to differentiate between providing pain relief and VAD, and to be aware of the legal implications of each.

Voluntary assisted dying is legislated at the state level, so specific rules vary between jurisdictions. With respect to the rights and responsibilities of residential aged facilities, there are some common themes across Australian states.

In all states, health care facilities such as residential aged care facilities can decide whether to provide VAD, and what support they will provide to residents seeking VAD. However, in a number of states such as South Australia, Queensland and New South Wales, even if a facility chooses not to provide VAD, it will still have to meet certain minimum requirements in relation to residents seeking VAD.

These obligations include not hindering access to information about VAD for residents at the facility, and allowing reasonable access to the facility by a medical practitioner who can assist a resident with VAD requests and assessments.

The act of discussing VAD with individuals is also regulated in all states, and providers should be aware of laws which prohibit health workers from volunteering information about VAD before a resident raises the topic unprompted. 

SPP Resources

For more information on VAD and the laws surrounding it we have released an Info sheet and Policy Template on VAD, available in SPP’s Reading Room. Aged care facilities may also wish to seek legal advice about how the VAD legislation will affect them.

It is important to stay up-to-date with the latest developments in this area and to provide appropriate support and care to individuals and their families who may be affected by VAD.

Additional resources

Need help with standards and compliance?

Looking back on 2022

The past year has been a time of significant change and challenge for the Australian community and health service sector. In addition to dealing with the ongoing impact of the COVID-19 pandemic, many areas were also affected by severe flooding. Meanwhile, the sector has also had to navigate a number of major regulatory changes. We acknowledge the resilience and dedication of our community and health service providers, to whom we are committed to providing services and resources to support them in their efforts. In this blog post, we will highlight some of the key areas we have focused on and look ahead to what’s to come in 2023.

Aged care

2022 has been a major year for aged care reform in Australia with key legislation introduced in July.  The Code of Conduct for Aged Care came into effect on December 1, 2022, and we have developed a self-assessment to help providers ensure they are meeting the requirements of this new code.

A series of governance requirements also commenced on December 1, and we have developed a suite of resources including policy templates and checklists to help providers get on top of these.

In addition, the Serious Incident Response Scheme (SIRS) was extended to home care and flexible care delivered in a home or community setting on December 1. In response, we published a new SIRS policy for home care providers. Looking to 2023, we will be developing new resources and assessment modules to help providers prepare for the revised Aged Care Quality Standards, which are currently in consultation draft form.

Disability services

In the disability sector, we developed guidance and a number of resources for the new NDIS emergency and disaster management standard. The emergency and disaster management standard has ongoing relevance, and our collection of resources, including an organisational emergency and disaster plan, and participant-specific risk assessment template, will help providers to implement the standard.

We’ve also developed resources to help providers publish policies in Easy English, which is an important tool for helping participants make informed choices and understand their rights. And we have provided information on the use of surveillance technology in this sector.

Child safe

In the area of child safety, we have developed self-assessments and provided updates on the implementation of child safe standards in each jurisdiction.

We have also looked at the National Quality Framework and discussed some upcoming changes to this framework, and we released a detailed self-assessment for the National Quality Standard.

ISO

We have released new self-assessments for the ISO standards, including ISO 45001: 2018 Occupational Health and Safety Management Systems, which can help providers to implement a best practice approach to occupational health and safety.

In 2023, we plan to extend our ISO offering, by releasing assessment modules for ISO 14001: 2015 – Environmental Management Systems and ISO 31000: 2018 – Risk Management.

Additionally, we have developed several new Towards Best Practice modules on topics such as Information Management and Privacy, to provide foundational guidance on good governance.

Until next year!

As the holiday season approaches, we would like to extend our best wishes to the NGO community. We are grateful to have had the opportunity to provide services and resources to support the important work you do. We are committed to delivering the best possible support to help you meet the various standards and regulations in your field, and we have a number of new self-assessments and resources in the works for the new year.

We hope you have a wonderful Christmas and holiday period, and we look forward to continuing to work with you in the new year. Happy holidays!

Need help with standards and compliance?

Code of Conduct for Aged Care comes into effect today!

We have previously written about the introduction of a Code of Conduct for Aged Care. The Code has now been finalised and applies to approved providers, aged care workers, and governing persons from today, the 1st December 2022.

The Aged Care Quality and Safety Commission has published a Code of Conduct for Aged – Guidance for approved providers document, and we encourage providers to review this guidance, where they can find useful examples of what the Code looks like in practice.  Our self-assessment modules for the Code, available on SPP are a great resource for organisations looking to ensure their readiness for the Code.

Also coming into force today are a number of responsibilities relating to provider governance, including:

  • Notifying the Quality and Safety Commission of material changes to provider suitability
  • Consideration of suitability of all key personnel
  • Notifying the Quality and Safety Commission of changes regarding key personnel
  • Ensuring appropriate staff qualifications, skills and experience
  • Reporting on providers’ operations and statement of compliance

We have developed a package of resources to assist aged care providers with these new governance requirements, including the following:

  • Self-assessment module for Provider Governance responsibilities
  • Policy: Provider Governance (Aged Care)
  • Policy: Key Personnel
  • Template: Key Personnel Suitability Checklist
  • Template: Key Personnel Declaration and Undertaking
  • Template: Governing Body Requirements Checklist

You can find these new resources in the Reading Room of your SPP or ACCPA Quality Portal account, by searching for “aged care governance”.

Looking for assistance managing your aged care obligations?

Extension of SIRS to home care

From 1 December 2022, the Serious Incident Response Scheme (SIRS) will be extended to home care and flexible care delivered in a home or community setting.

Are you a home care provider preparing to implement the SIRS in your service? Read on to understand how these new obligations will apply to you.

What is the SIRS?

We have previously discussed the SIRS in an earlier blog post. The SIRS was introduced in the residential aged care setting on 1 April 2021, and was developed to ensure incidents of abuse and neglect of older people in residential care are appropriately dealt with and prevented. To learn more about the SIRS, click here to read our blog post from 2021.

New legislation has been introduced to extend the operation of the SIRS to home care and flexible care delivered in a home or community setting. This includes providers of Home Care Packages, CHSP services and flexible care services through which short-term restorative care is provided in a home care setting. 

The concept of the SIRS remains largely similar, however there are some key differences in how the scheme will operate in the home care context.

The legislation is currently in draft form, so please note that the following advice is subject to change.

What is required of providers?

From 1 December 2022, providers of home and flexible care must have an incident management system in place, and inform the Aged Care Quality and Safety Commission (the Commission) if a reportable incident occurs.

What is a reportable incident?

A reportable incident is:

  • an incident that has occurred, or is alleged or suspected of having occurred, in connection with the provision of care to a consumer;
  • the incident has caused harm, or could reasonably have been expected to have caused harm, to a consumer; and
  • the incident is one of the following types of incidents:
    • unreasonable use of force
    • unlawful sexual contact or inappropriate sexual conduct
    • psychological or emotional abuse
    • unexpected death
    • stealing or financial coercion
    • neglect
    • inappropriate use of restrictive practices, or
    • missing consumers.

For home services, this may include any incidents:

  • resulting from the action (or inaction) of a staff member of the provider (including subcontracted individuals or organisations, those managing care coordination, administration, etc. and volunteers),
  • that occur while care and services are being delivered to a consumer.

Classifying incidents (Priority 1 vs Priority 2)

All actual, suspected or alleged reportable incidents must be reported to the Commission. Incidents will fall into categories: Priority 1, or Priority 2.

Priority 1

A Priority 1 reportable incident is a reportable incident:

  • that caused, or could reasonably have been expected to have caused, a consumer physical or psychological injury or discomfort that requires medical or psychological treatment to resolve
  • where there are reasonable grounds to report the incident to police
  • involving unlawful sexual contact or inappropriate sexual conduct inflicted on a consumer
  • that is an unexpected death of a consumer, or
  • where a consumer goes missing in the course of provision of home services.

If you become aware of a reportable incident and have reasonable grounds to believe it is Priority 1 reportable incident, you must notify the Commission within 24 hours of becoming aware of the incident.

Priority 2

A Priority 2 reportable incident is any reportable incident that does not meet the Priority 1 criteria as described above.

All Priority 2 reportable incidents must be notified to the Commission within 30 calendar days of becoming aware of the reportable incident.

So, how does SIRS in the home care/flexible care setting differ from the residential setting?

As mentioned, many of the SIRS requirements for home/flexible care are consistent with the existing SIRS regime that applies to residential care. However, there a couple of key differences in the new application of SIRS for home care that you should note.

Additional reportable incident: missing consumer

The new legislation includes an additional type of reportable incident, to cover occurrences where:

  • a care recipient goes missing in the course of a provider providing home care, or flexible care provided in a community setting, to the care recipient; and
  • there are reasonable grounds to report that fact to the police.

The phrase ‘in the course of providing … care’ is significant; this definition is intended to capture situations where a provider has the consumer in their physical care immediately prior to the consumer going missing.

This definition is not intended to require providers to report to the Commission where a staff member arrives for a scheduled visit and the consumer is not present, or where a consumer leaves their home while home maintenance services are being provided, as an example.

Different definition of unexpected death for home care

The circumstances in which home care providers are required to report unexpected deaths are more limited than in residential care.

Home care providers will be required to notify any death where the provider (including staff and health professionals engaged by the provider):

  • made a mistake resulting in death; or
  • did not deliver care and services in line with a consumer’s assessed care needs, resulting in death; or
  • provided care and services that were poorly managed or not in line with best practice, resulting in death.

This definition differs from the definition used in residential care. This difference acknowledges that home care providers have limited control and visibility over a consumer’s day-to-day living circumstances when compared to residential care settings. Home care providers may not become aware of a consumer dying until some time after the death occurs and may never be aware of the circumstances of their death.

Providers are not required to notify the Commission of the death if the cause of death was unrelated to the care or services provided by the provider or a failure by the provider to provide care and services.

Different definition of inappropriate use of restrictive practice for home care

The new legislation states that the use of a restrictive practice in the course of providing home care or flexible care in a community setting is not a reportable incident if:

  • the restrictive practice is used in the course of providing home care or flexible care in a community setting; and
  • before the restrictive practice is used, the following matters were set out in the care and services plan for the care recipient:
    • the circumstances in which the restrictive practice may be used in relation to the recipient, including the recipient’s behaviours of concern that are relevant to the need for the use;
    • the manner in which the restrictive practice is to be used, including its duration, frequency and intended outcome; and
  • the restrictive practice is used:
    • in the circumstances set out in the plan; and
    • in the manner set out in the plan; and
    • in accordance with any other provisions of the plan that relate to the use; and
  • details about the use of the restrictive practice are documented as soon as practicable after the restrictive practice is used.

This differs from the rules for residential care, where use of restrictive practices must be documented in a behaviour support plan.

The residential care environment is different to the operating environment of home care or flexible care provided in home or community settings, where care recipients generally have greater autonomy and less complex requirements. In the home care setting, a behaviour support plan may not be required.

However, providers of home care and flexible care delivered in a home or community setting must still implement a care and services plan for each care recipient that satisfies the requirements set out in the Aged Care Quality Standards.

Exception: incidents of neglect in the home care setting which are not a reportable incident

Despite neglect being a reportable incident under the Aged Care Act, the new legislation provides for circumstances in which certain incidents in the home/flexible care setting are not reportable incidents under the SIRS. An incident is not a reportable incident if:

  • the incident occurred, is alleged to have occurred, or is suspected of having occurred, in connection with the provision of home care, or flexible care provided in a community setting, to a care recipient; and
  • the incident results from a choice made by the care recipient about the care or services the provider is to provide to the care recipient, or how the care or services are to be provided by the provider; and
  • before the incident occurred, is alleged to have occurred, or is suspected of having occurred, the choice had been communicated by the care recipient to the provider, and the provider had recorded the choice in writing.

This amendment reflects feedback received by the Commission that home care/flexible care recipients should be able to maintain choice and autonomy over their living situation. The home care or flexible care provider must have recorded the choice that the care recipient communicated to them in writing before the incident occurred, and must also be satisfied that the care recipient has the capacity to make this decision.

Summing up

We hope our overview has helped you get up to speed on these new home care requirements.

We recommend providers take a look at the full draft Serious Incident Response Scheme Guidelines for providers of home services for more thorough guidance on the Scheme.

 

Do you need help with incident management?

Get ready for the revised Aged Care Quality Standards

Reforms to the aged care sector continue, with the recent release of a consultation draft of the revised Aged Care Quality Standards (‘Quality Standards’). The new Quality Standards have some key differences compared to the existing standards – they are significantly more detailed, and represent a move away from the higher-level approach of the existing standards. There is definitely a lot for providers to take in, so let us help you get up to speed with our overview of the key changes.

Why are the Quality Standards changing?

The Royal Commission into Aged Care Quality and Safety found that the existing Quality Standards are not sufficiently ‘comprehensive, rigorous and detailed’.

The Royal Commission identified specific areas of improvement for the Quality Standards, including the need to:

  • reflect the needs of people with dementia;
  • better recognise diversity and improve cultural safety for Aboriginal and Torres Strait Islander people;
  • strengthen requirements in relation to governance and human resources;
  • describe more detailed requirements relating to food and nutrition; and
  • improve clinical care.

The revisions to the Quality Standards were also informed by engagement with the sector, an independent review, and comparison with existing standards for health care and disability support – the National Safety and Quality Health Service (NSQHS) Standards, and the NDIS Practice Standards.

What will the new Quality Standards look like?

Standard 1: The Person

Standard 1 focuses on important concepts including dignity and respect, older person individuality and diversity, independence, and culturally safe care.

The new Standard 1 remains fairly similar to existing Standard 1: Consumer dignity and choice in the current Quality Standards, with a focus on the older person.

Outcomes

  • Person-centred care
  • Dignity, respect and privacy
  • Choice, independence and quality of life
  • Transparency and agreements

Standard 2: The Organisation

Standard 2 is intended to hold the governing body responsible for fulfilling the requirements of the Quality Standards and delivering safe and quality care. Standard 2 goes into more detail than the current standards by itemising more requirements for systems that providers should have in place (including requirements regarding partnering with older people, accountability and quality systems, workforce planning, and emergency and disaster management).

Outcomes

  • Partnering with older people
  • Quality and safety culture
  • Accountability and quality systems
  • Risk management
  • Incident management
  • Feedback and complaints management
  • Information management
  • Workforce planning
  • Human resource management
  • Emergency and disaster management

Standard 3: The Care and Services

Standard 3 describes the way providers must deliver care and services. It sets out more detailed requirements regarding how providers assess each older person’s needs, goals and preferences, document this in a care plan and use this to inform the way care is delivered. Standard 3 includes a new requirement that providers implement a system for caring for people living with dementia.

Outcomes

  • Assessment and planning
  • Delivery of care and services
  • Communicating for safety and quality
  • Coordination of care and services

Standard 4: The Environment

Standard 4 focuses on the physical environment, which must be clean, safe and comfortable and enable freedom of movement for older people. Standard 4 also sets out requirements regarding infection prevention and control systems.

Outcomes

  • Environment and equipment at home
  • Environment and equipment in a service environment
  • Infection prevention and control

Standard 5: Clinical Care

Standard 5 describes the responsibilities of providers, with respect to the delivery of clinical care. Standard 5 articulates more detailed and technical requirements for clinical care compared with the existing standards, including in areas such as technical nursing, advance care planning, continence, falls and mental health. This standard was developed by the Australian Commission on Safety and Quality in Health Care, and aligns with the NSQHS Standards.

This standard will apply to providers delivering clinical care, whether it is in an older person’s home or a residential environment.

Outcomes

  • Clinical governance
  • Preventing and managing infections in clinical care
  • Medication safety
  • Comprehensive care
  • Care at the end life

Standard 6: Food and Nutrition

Standard 6 sets out requirements regarding what older people can expect of the food and drink they are provided in residential care services. It includes the requirement that food and drink is appetising, nutritious and safe, and that the dining experience is enjoyable. Having a dedicated standard for food and drink is a new development, and represents a greater focus on this area.

Standard 6 will apply only to residential care services.

Outcomes

  • Partnering with older people on food and nutrition
  • Assessment of nutritional needs and preferences
  • Provision of food and drink
  • Dining experience

Standard 7: The Residential Community

Standard 7 is about the residential community, and focuses on continuity of care, security of accommodation, and strategies to help older people maintain relationships.

Standard 7 will apply only to residential care services.

Outcomes

  • Daily living
  • Planned transitions

Other noteworthy changes

  • Use of the phrase ‘older person’/’older people’ – The term currently used to refer to a person receiving services under the existing Quality Standards is ‘consumer’, however the Aged Care Quality and Safety Commission acknowledges that this term is not generally well-received by older people. The new term used throughout the revised Quality Standards is ‘older person’.
  • More requirements, that are more detailed – The current Quality Standards are outcomes-focused and consist of eight standards, which include a consumer outcome, an organisation statement and a number of requirements. The new Quality Standards describe more detailed expectations for providers, with an increase from 42 requirements to 31 outcomes with 142 supporting actions. This may look like an increase in the regulatory burden for providers, but the intention is to provide greater clarity to providers, by being more specific about how to achieve the outcomes laid out in the Quality Standards.

Similarities with NDIS Practice Standards

The updated Quality Standards will align structurally with the NDIS Practice Standards, by following a ‘modular’ format and using outcomes and actions (called ‘quality indicators’ in the Quality Standards). The two sets of standards don’t have identical content, but there are plenty of similar themes, and the same pieces of evidence may be used by a provider to satisfy outcomes across both sets of standards. For example, an organisation’s incident management policy may be used to demonstrate compliance with the incident management outcome across both sets of standards.

Government is also considering regulating providers through a registration model, similar to the NDIS Practice Standards. Employing a registration model means that, “requirements for market entry and ongoing provider responsibilities would be applied proportionately, based on the provider’s registration category. A provider’s registration category would be determined based on the types of care and services the provider is seeking to deliver and the risks associated with them”. This is similar to how the NDIS Practice Standards currently operate.

What does the rollout look like?

There will be some time before the new Quality Standards are up and running.

Currently, the Department of Health Aged Care is holding a public consultation process for the Quality Standards, and providers are invited to take part.

Following the public consultation, Aged Care Quality and Safety Commission will conduct a pilot of the new Quality Standards, to test an updated audit methodology for the Standards.

Providers can expect guidance materials and further updates on the revised Quality Standards in early 2023.

Looking for more information?

The Commission has released a number of helpful resources for the new Quality Standards, including both a summary as well as a detailed Consultation Paper, and a summary and detailed document setting out the new Quality Standards themselves.

To understand the intention behind the new Quality Standards, as well as what all of the requirements are, you might like to take a look at the Commission’s Summary Consultation Paper, as well as the Summary draft of the Quality Standards.

Do you need assistance meeting the Aged Care Quality Standards?

Why your organisation should publish resources in Easy English

Many organisations can benefit from making key policies and procedures available in Easy English format. What is Easy English and why is it relevant for your organisation? Read on to find out.

What is Easy English?

Easy English is an accessible format, that uses images and simplified language to convey information. Easy English allows information to be understood by a broad range of audiences.

Easy English documents are particularly helpful for individuals with intellectual disability, but all kinds of organisations can benefit from introducing Easy English resources. The Easy English format is ideal for anyone who has difficulty reading and understanding written English, which can include people for whom English is a second language and people with lower literacy levels.

Why should your organisation develop Easy English resources?

Many service standards require key policies and documents to be made available to clients in a number of formats, and also require that clients understand their rights and responsibilities under these policies.

Making policies available online and in person is a great first step, however policies are often wordy and complex, meaning they are not truly accessible to clients with lower literacy levels. According to a 2011-12 study, around 44% of Australians have low levels of reading literacy. Creating Easy English versions of key policies and documents can help ensure that important information is available to everyone.

Tips for implementing Easy English materials

The Easy English writing style follows some important principles. Here are some key pointers to get you started:

  1. Keep sentences short.
  2. Try to explain one idea per sentence.
  3. Use everyday language and basic grammar.
  4. Use subheadings, bullet points and white space to break up the text.
  5. Use a simple font and layout.
  6. Use a large text size.
  7. Choose images that are easily understood and add meaning to each point.
  8. Include a definitions section for any complex words used in the document.

Some clients will be able to read and understand Easy English resources independently. Other clients may need some assistance from staff to read and understand the information.

How we can help

A number of Easy English policies and templates are available in the SPP Reading Room. These include:

  • Policy: Client Rights (Easy English)
  • Policy: Incidents (Easy English)
  • Policy: Incidents (Easy English) (NDIS)
  • Policy: Complaints (Easy English)
  • Policy: Privacy (Easy English)
  • Template: Emergency and Disaster Management Plan (Easy English)
  • Template: Child Rights (Child English)

Please contact us at team@bngonline.com.au, if you have suggestions or requests for Easy English resources you would like to see in the Reading Room.

Looking for Easy English templates?

The draft Aged Care Code of Conduct is here

As part of a recent suite of reforms set out in the Royal Commission Response Act, the Department of Health and Aged Care is introducing a Code of Conduct for Aged Care. An exposure draft of the Code has been released, and the Code will come into effect from 1 December 2022.

So, what does this new Code mean for providers and their workers? And how can you prepare for this new requirement?

An overview of the Code

We’ve been keeping close to developments relating to the Code, and aim to keep our customers up to speed as the Aged Care Quality and Safety Commission publishes new information. Here are some key pointers:

  • The Code of Conduct has been introduced to “improve the safety, health, wellbeing and quality of life for people receiving aged care and to boost trust in services”.
  • It sets out standards of behaviours for approved providers, governing persons, workers, volunteers and contractors to ensure services are delivered in a safe, competent and consistent manner.
  • The policy intent for the Code is not to create new obligations for providers; but rather to focus on the protection of older Australians by setting out the suitable standards of care, and ensuring that there are consequences for poor conduct.
  • The Code will take effect from 1 December, and will apply to residential aged care, home care, and flexible care providers. The Code will not apply to Community Home Support Programme (CHSP) and National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) providers.
  • The Commission will be able to issue banning orders to aged care workers and governing persons who breach the Code – however, this measure will only be taken in the most serious cases of poor conduct.
  • The Code is in draft form but should be finalised in the near future.

Your responsibilities and how you can prepare

The responsibilities outlined in the Code are consistent with existing legislation, the Aged Care Quality Standards and the Charter of Aged Care Rights, as well as community expectations and consumer expectations. As an example, the Aged Care Quality Standards include concepts such as affording consumers dignity and respect, which feature in the Code.

The Code is also consistent with the NDIS Code of Conduct, which will be familiar to some providers who work across both the aged care and disability sectors. Both Codes have a strong focus on the individual’s right to receive quality care and share many of the same obligations.

Compared with the NDIS Code, the Aged Care Code does have additional requirements for treating people with dignity and respect, valuing diversity, and providing care, supports and services free from violence, discrimination, exploitation, neglect, abuse and sexual misconduct. These additional requirements address key concerns raised by the Royal Commission into Aged Care Quality and Safety. Whilst the Codes are very similar, they will be regulated separately.

The Aged Care Quality and Safety Commission has emphasised that the Code of Conduct does not create new obligations, in the sense that providers and workers delivering care in accordance with existing regulations should already be meeting the Code. However, there is one new responsibility providers should be mindful of in relation to the Code, and that is: providers must take reasonable steps to make sure workers and governing persons comply with the Code.

The Commission has made clear that providers need to ensure their aged care workforce (including employees, volunteers and contractors) understands and acts consistently with the Code. Some steps you can take to ensure your workforce is ready include:

  • ensuring that workers have read and understand the Code and relevant guidance;
  • ensuring workers undergo regular training and professional development that helps them comply with and uphold the Code;
  • ensuring workers understand the consequences of not complying with the Code; and
  • supporting workers to resolve concerns identified in relation to their compliance with the Code.

Next steps

Make sure you have familiarised yourself with the draft Code and have a plan to prepare your workforce.

For more detail on the Code, please access the draft Code of Conduct for Aged Care: Guidance for providers.

Looking for assistance managing your aged care obligations?

Surveillance technology and restrictive practices – what you need to know

The NDIS Quality and Safeguards Commission recently published a Practice Guide on the use of surveillance technology with respect to people with disability.

The Commission has observed that surveillance is commonly used, or proposed for use, for people with disability and in disability settings, primarily with the intention of ensuring safety, monitoring health, facilitating increased independence and preventing abuse and neglect.

However, there are a number of ethical and regulatory concerns associated with the use of surveillance technologies, thus prompting the Commission’s publication of the Practice Guide.

We’ve provided below an overview of the Commission’s guidance, as well as some important considerations for your organisation if you are thinking of using surveillance technology in your support settings.

What is ‘surveillance technology’?

Surveillance technology simply refers to any device which can record information about a person through electronic means. This can include:

  • CCTV cameras which capture audio and visual footage
  • Audio monitors
  • GPS devices which track a person’s location
  • Motion sensor alarms

When does use of surveillance technology facilitate the use of a restrictive practice?

While surveillance technology may be used by providers with the aim of preventing abuse and neglect, the Commission cites a number of studies which show limited evidence to support the effectiveness of the use of surveillance technology for this purpose.

Surveillance technology is not in and of itself a restrictive practice, however it may constitute a restrictive practice if its use has the effect of restricting the rights to freedom of movement of a person with a disability.

Under the NDIS Rules, the five regulated restrictive practices are seclusion, chemical restraint, environmental restraint, mechanical restraint, and physical restraint. The use of surveillance technology may be a regulated restrictive practice where it influences a person’s behaviour, stops them from accessing particular items or environments, or restricts their freedom of movement.

However, the use of surveillance technology is unlikely to constitute a regulated restrictive practice where it enables support or increases a person’s independence and freedom of movement.

The Commission provides as an example the use of a sound sensor that alerts staff when a person with disability who is at risk of falling and hurting themselves is getting out of bed. This would not be a regulated restrictive practice, as the device is being used to help staff to attend to the person and support them, and is therefore ‘enabling support’.

By contrast, if a sound sensor is installed on a fridge to alert staff to stop a person with disability from accessing food, this would constitute a regulated restrictive practice, as it is facilitating environmental restraint. Similarly, if an alarm is on a person’s door to alert a staff member to stop a person with disability from leaving their room, this would be a regulated restrictive practice, as it facilitates seclusion.

Providers should note that any use of surveillance technology that facilitates the use of a regulated restrictive practice must be clearly identified in a participant’s behaviour support plan, and authorised in accordance with relevant State or Territory requirements. See the Commission’s Regulated Restrictive Practices Guide for more information.

Right to privacy and meeting legal obligations

There are a number of ethical issues associated with the use of surveillance technology, not least the individual’s right to privacy.

Surveillance technology (CCTV in particular) can be very invasive and can compromise the personal privacy of a person with disability. The use of CCTV monitoring in a person’s bedroom is especially problematic and may give rise to criminal liability.

Legislation that must be considered in relation to surveillance technology includes State and Territory privacy laws, the UN Convention on the Rights of Persons with Disabilities and the NDIS Act 2013.

The NDIS Practice Standards also require that participants access supports that respect and protect their dignity and right to privacy. To meet the Privacy and Dignity Practice Standard, providers must:

  • Implement processes and practices that respect and protect the personal privacy and dignity of each participant.
  • Advise participants of confidentiality policies and ensure participants understand and agree to what personal information will be collected and why, including recorded material in audio and/or visual format.

Best practice considerations when using surveillance technology with people with disability

Human rights considerations should inform any usage of surveillance technology in the disability services context. Best practice usage of surveillance technology includes taking the following steps:

  • Adhering to any relevant privacy laws
  • Acting in the best interests of the individual, taking into account their preferences
  • Balancing safety and autonomy, including genuine involvement of the individual in discussions
  • Considering options for the individual to deactivate and reactivate the device, to allow them additional privacy, where possible
  • Considering who can access the recordings, where recordings are stored, and for how long
  • Considering the security of the surveillance technology in use
  • Regularly reviewing the use of surveillance technology to ensure it is the least intrusive option available
  • Where surveillance technology is facilitating the use of a regulated restrictive practice – ensuring it is thoroughly outlined in the participant’s behaviour support plan, and reviewed at least every 12 months, or as the participant’s circumstances change
  • Ensuring staff training goes beyond simple usage of the device, and includes legal and ethical considerations

Providers should be mindful that surveillance technology should never be used as a substitute for limited staffing or to save on costs; nor should it replace human contact, personal care or social interaction, leading to increased social isolation. Providers should also consider the limitations of surveillance technology, which can include faulty and unreliable devices, ineffective technology leading to delays in staff responses, and the potential for devices to be removed, damaged, forgotten or hacked.

For further detail on the matters discussed in the blog post, including a checklist for considering the use of surveillance technology, we suggest providers access the NDIS Quality and Safeguards Commission’s full Surveillance Technology Practice Guide.

For guidance on the NDIS Practice Standards, please access SPP/the NDS Quality Portal for self-assessments and helpful resources.

Access key resources on SPP.

Moving towards best practice service delivery in aged care

The Aged Care Quality Standards are an important part of an organisation’s quality and compliance benchmarking. However, for providers looking to go beyond their baseline obligations, SPP hosts a number of best practice self-assessments for aged care. These guidelines and standards are designed to complement your ACQS compliance, and provide further guidance across targeted areas of service delivery and governance.

Aged Care – Clinical Governance

The Aged Care Quality and Safety Commission has developed guidance on clinical governance in aged care to assist aged care providers to develop and review their clinical governance framework.

We’ve made digesting that guidance easier for providers.  By working through our Aged Care – Clinical Governance self-assessment module, you can identify key issues that need to be addressed in a clinical governance framework, as well as identify gaps and opportunities for improvement.

Aged Care Diversity Framework

The Aged Care Diversity Framework was developed by the Australian Department of Health and Aged Care. The Aged Care Diversity Framework includes four Diversity Action Plans which are designed to help providers address barriers faced by different groups, being all diverse older people, older Aboriginal and Torres Strait Islander peoples, older CALD people, and LGBTI elders.

We have a self-assessment module for each of the Action Plans, which allows providers to work through three different levels, according to what is most relevant to their organisation: foundational actions, next steps and leading the way.

Inclusive Service Standards

The Inclusive Service Standards were developed by the Centre for Cultural Diversity in Ageing to assist aged care providers in the development and the delivery of inclusive services to all consumers. 

They provide a framework for services to adapt and improve their services and organisational practices so they are welcoming, safe and accessible.

Meeting the performance measures listed in this assessment provides evidence that an organisation has embedded an inclusive, non-discriminatory approach to its delivery of care and services.  

Dementia Australia Quality Care Recommendations

Dementia Australia’s Quality Care Recommendations have been developed by people living with dementia, their families and carers in the context of the new Aged Care Quality Standards. Each of the eight Standards has a dementia-specific recommendation on how that Standard needs to be met when providing any aged care service to a person living with dementia, their families, carers and advocates. 

This module provides organisations with further insight and direction on each of the Aged Care Quality Standards, through the lens of dementia-friendly care.

National Guidelines for Spiritual Care in Aged Care

The National Guidelines for Spiritual Care in Aged Care were developed by Meaningful Ageing Australia, who state:

Spirituality is integral to quality of life and well-being, and should be accessible to all older people in a way that is meaningful to their beliefs, culture and circumstances.

The Guidelines are designed specifically for offering spiritual care and support to older people living in residential aged care, or receiving care and support through home care packages. They are intended to support organisations to embed spirituality into key systems and processes with the goal that all older people (and their loved ones) are offered best-practice in spiritual care.

ACSA Wellness and Reablement Roadmap

The Wellness and Reablement Roadmap was developed by ACSA to help CHSP providers to self-assess their progress in integrating wellness and reablement principles into core service delivery. 

Taking a wellness and reablement approach to service design and delivery enables service providers to focus on outcomes for individuals rather than service outputs.

The Wellness and Reablement Roadmap provides a framework for discussions at all levels within an organisation to help providers identify “what they are doing well” and “what actions need to be taken to improve performance” in progressing, managing and measuring wellness and reablement.

Want to learn more?

Our modules for the standards and guidelines detailed above are available in SPP under the Aged Care – towards best practice drop-down header. They can be accessed and progressed at any time, at your own pace, as relevant to the needs of your organisation. You can automatically generate a quality improvement plan for each specific module you follow.

Access best practice
self-assessments in SPP.