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Author: Claire Montague

Advance care planning: the role aged care providers should play

Posted on by Claire Montague

Advance care planning is a process of planning for future health and personal care, which enables a person to set out their values, beliefs and preferences.

The Royal Commission into Aged Care Quality and Safety identified the making and updating of advance care plans as a priority issue in reforms to aged care. The Commission found that providers should be required to assist people receiving care to make and update an advance care plan, if they wished to, and to ensure that these plans are followed. The Commission also recommended that residential aged care providers should be required to provide any advance care directives to paramedics, if a resident is being transferred to hospital via ambulance.

In its response, the Government indicated that periodic reviews of the Aged Care Quality Standards would include consideration of priority issues, including advance care planning. The Government also committed to additional funding to improve transitions of aged care residents between aged care and health care systems.

With this indication that regulations around advance care planning may be strengthened in the future, providers can demonstrate best practice by developing robust policies and processes for advance care planning. 

Advance care planning and the Aged Care Quality Standards

Advance care planning does already feature in the Aged Care Quality Standards (ACQS), Standard 2 – Ongoing assessment and planning with consumers.

Standard 2(3)(b) of the ACQS requires that “Assessment and planning identifies and addresses the consumer’s current needs, goals and preferences, including advance care planning and end of life planning if the consumer wishes.”

The Guidance and Resources for Providers to support the Aged Care Quality Standards document also lists the following examples of evidence for organisations to demonstrate implementation of Standard 2:

Consumers:

  • Consumers have access to advance care planning and end-of-life planning.
  • If a consumer chooses to complete an advance care directive, it is done while they still have decision-making capacity.

Workforce

  • The workforce can describe advance care planning and advance care directives.
  • Evidence that advance care directive documentation informs end-of-life care and decisions.
  • Evidence of how the organisation makes sure the workforce has undertaken advance care planning training and has a policy to inform advance care directive documentation.
  • Advance care directive documentation should be accurate, up-to-date, complete, shared and stored with relevant care and service providers.

Providers should familiarise themselves with Standard 2 of the ACQS, as evidence of policies and procedures relating to advance care planning may be a key area of focus for assessors conducting an audit of your service. For example, within the Home Services sector, non-compliance with Standard 2(3)(b) was the second highest “top 10” non-compliance noted in the ACQSC’s October-December 2020 Sector Performance Report.

Facilitating advance care planning

Aged care providers play an important role in facilitating advance care planning. Providers can help improve the uptake of advance care planning by older Australians by informing care recipients about aged care plans and encouraging them to make one.

Community and residential aged care providers should implement the following steps:

  • Upon a care recipient’s assessment, receipt of aged care services, or admission to residential care, identify and record details of any existing documents and substitute decision-makers in their health record.
  • If the person does have documentation, make sure to determine whether it’s an Advance Care Directive or advance care plan, and whether a substitute decision-maker has been legally appointed.
  • Provide care recipients and families with straightforward information about advance care planning.
  • Discuss advance care planning and how it relates to the care recipient’s health issues, condition and treatment options.
  • Involve the person’s general practitioner in discussions where possible and appropriate.
  • Encourage the person’s participation in advance care planning if they have capacity and don’t have existing documentation. It is a voluntary process.
  • If the person has decision-making capacity, use an advance care directive. Support the person and their family to document their plan.
  • Encourage the person’s substitute decision-maker to know and understand the person preferences. If the person no longer has decision-making capacity, the substitute decision-maker could document an advance care plan to inform care.
  • Check any draft documents and help to clarify wording or intentions.

Record-keeping and implementation

Whilst it is important that an advance care plan is made, it is just as important that a provider has strong record-keeping and information handling processes in place, to ensure that a person’s wishes can be carried out. For an advance care plan to be effective, it must be known and accessible.

Providers are advised to implement the following processes:

  • Record any discussions about advance care planning and ensure others can access this information if needed.
  • Store copies of advance care planning documents in the person’s health records so they are accessible when needed.
  • Appropriately share and transfer the person’s advance care planning documents with their substitute decision-maker, hospital, specialists, in-reach services, Locum and ambulance services.
  • Ensure that documents are readily available to inform care decisions, if the person is not able to make their own decisions.
  • Encourage review of documents for those with decision-making capacity. This should occur where the person’s needs, goals or preferences change, and after any transition between services.
  • Use the person’s advance care planning documents to inform care decisions, including when the person’s condition deteriorates
  • Engage with community palliative care and residential in-reach/out-reach services to ensure care recipients have access to the care they need in their preferred place.

The steps above should be embedded in organisational policies and procedures, to ensure consistent care outcomes.

It is important to note that legislation and documentation for advance care planning varies across states and territories in Australia.

For more information on the advance care planning process, and the relevant documentation in your state or territory, you can access our advance care planning information sheet and policy template, in the SPP Reading Room.

You may also like to look at the resources provided by Advance Care Planning Australia, including the online learning modules that are available at no cost on their learning site.  And ELDAC also provides a range of helpful resources and toolkits.

Access advance care planning resources on SPP

Sign up for a free trial now to access resources and self-assessments to help you meet the Aged Care Quality Standards.

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Royal Commission Series: recommendation 99 calls for ‘protection for whistleblowers’

Posted on by Claire Montague

An issue highlighted by the recent Royal Commission into Aged Care Quality and Safety is the lack of systemic support for whistleblowers within the aged care system. In her overview of the Royal Commission’s Final Report: Care, Dignity and Respect, Commissioner Lynelle Briggs AO states:

“It is a sad fact that many older people, their families and care workers are reluctant to speak up about the quality and safety of care because of the fear of reprisal from providers or their staff members”.

Current problems in the sector

Commissioner Briggs speaks of the need to make more transparent the complaints process and to strengthen whistleblower protections, using the following witness statement from Gwenda Darling, who gave evidence at the Brisbane Hearing, as an example:

“After my first experience of having my service cut off by the provider after complaining, I’ve been a bit fearful that I could lose my package if I complain. The providers have a lot of power. I had to really fight hard to get my package reinstated. I felt hopeless and disempowered after that experience and it felt like there was no point raising issues or complaining.”

Similarly, an aged care nurse shared in a public submission to the Royal Commission that she had “learned over the years not to say anything for fear of repercussions from management”. Staff and consumers within an organisation may worry that they are in a vulnerable position, and therefore feel afraid to voice any concerns they have.

The Australian Medical Association submitted to the Royal Commission that legislated safeguards may help employees to speak up, which may “lead to earlier identification of concerns and to the improvement of services provided to older people in aged care”.

The Royal Commission, in its final report, ultimately recommends that a new Act be introduced, containing comprehensive whistleblower protections for all involved parties.

Recommendation 99 reads:

The new Act should contain comprehensive whistleblower protections for:

a)    a person receiving aged care, their family, carer, independent advocate or significant other

b)    an employee, officer, contractor, or member of the governing body of an approved provider

who makes a complaint or reports a suspected breach of the Quality Standards or another requirement of or under the Act.

What can providers do now?

Since the publication of the Royal Commission’s final report, the Aged Care Legislation Amendment (Serious Incident Response
Scheme and Other Measures) Act 2021 (Cth) has commenced. This legislation amends section 54 of the Aged Care Act 1997 (Cth), to add protections for disclosures of information related to reportable incidents.

Providers are advised to implement an internal whistleblowing policy in compliance with the Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Act , which protects consumers, staff and families from reprisal when voicing concerns.

Such a policy should:

  • articulate protections for whistleblowers from criminal prosecution, administrative action or civil litigation, such as breach of employment contract or duty of confidentiality; and
  • formalise that staff or representatives of the provider will not be permitted to cause or threaten detriment to someone who has made or wishes to make a whistleblower disclosure.

Separately, providers should ensure their complaints management policies and processes are consumer-centred, and clearly state the protections in place for consumers, staff and family who seek to report concerns. There should be clear expectations that managerial staff will act ethically and will not target consumers, staff or family who make a complaint.

In addition, whistleblowing policies and procedures should comply with the Corporations Act 2001 (Cth), which contains certain protections for ‘eligible whistleblowers’. It is important that providers familiarise themselves with the Act, and are aware of their obligations under the Act. More information is available on the ASIC website.

Resources

We have a number of whistleblowing resources on SPP that can assist you to achieve best practice in this space.

  • Info: Whistleblower protection – This info sheet provides an introduction to the concept of whistleblowing and an overview of key rules under the legislation.
  • Policy: Whistleblower protection (public companies) – This is a policy most suitable for larger organisations who are obliged to comply with corporate whistleblowing laws, or for organisations who voluntarily follow the corporate regime.
  • Policy: Whistleblower protection (small organisations) – This is a simpler policy, which still covers key steps in the whistleblowing process. It is a more approachable resource for providers who are not currently required to implement a policy, but still wish to do so.

Sign up for a free trial

You can access these resources and many more in the SPP platform. 

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Continuity of care – managing client transition to and from hospital

Posted on by Claire Montague

In 2020, the NDIS Quality & Safeguards Commission released a series of Provider Practice Alerts addressing key areas of risk for people with disability. This was in response to a scoping review into causes and contributions to deaths of people with disability, undertaken by Professor Julian Trollor, Chair of Intellectual Disability Mental Health at UNSW Sydney.

One of the key areas of risk identified was transitions of care between disability services and hospitals.

Australians with disability commonly access hospital services, with 22% being admitted to hospital and 26% having visited a hospital emergency department during 2015. Recent reports, including the review by Professor Trollor, have identified that mismanagement of transitions of care can lead to serious and life-threatening risks for people with disability. Areas of concern include management of medications, and lack of essential follow-up care after hospital discharge.

Improving transitions of care is key to improving medication safety and reducing avoidable harm. Safe transitions of care require clear communication and co-ordination between all relevant parties – the person with disability, their carers, healthcare, and disability support services. Clear communication helps ensure that critical information about a person’s health needs is passed on during transitions of care. 

How to support NDIS participants during transition to and from hospital

Prepare for planned hospital admission

Providers should undertake preparation in the lead up to a participant’s admission to hospital by ensuring the participant’s health record and medication information is up-to-date. Consider arranging a pre-admission meeting with hospital staff in order to co-ordinate the transition of care and inform hospital staff about the participant’s needs and capacities.  

Information to provide to hospital staff

If you have responsibility for a participant’s medical records and care, or have consent from participants, guardians or carers to share information, ensure you provide key medical information for the participant to hospital staff on admission.

Provide support during emergency admission

For an emergency visit to hospital, it may be necessary to arrange for a disability support worker, who is familiar to the participant, to stay with them during the admission.

Support when the participant leaves hospital

  • Plan for discharge – In consultation with health professionals, plan for the participant’s discharge from hospital as early as possible. This discharge plan should include details include date of transfer, referral services, and re-assessing support risks.
  • Understand participant’s ongoing needs and assess your capacity to meet them – work with hospital staff to understand the participant’s continuing needs post-discharge. This will include obtaining a transfer of care summary, care plan and medications summary.
  • Provide the participant with information about their follow-up care – it is important for participants to remained informed and empowered to contribute to decision-making throughout the transition process. Communication should take place in a format appropriate to the participant’s needs. 

Resources

Additional guidance, as well as more thorough detailing of these processes, is available in our resource, ‘Policy: Client Transition to and from Hospital’. You can find this resource in the SPP Reading Room, by searching for “transition”. We encourage you to make use of this template to guide your organisation in adopting best practice for client transitions of care. 

An important area for aged care

Client transition to and from hospital has also been highlighted as an important issue in aged care. Recommendation 66 of the recently released Final Report of the Royal Commission into Aged Care Quality and Safety called for improved transition between residential aged care and hospital care. Specifically, it recommended that discharge from hospital should only occur once clinical handover and discharge summary has been provided to the residential care service and the person being discharged. It also recommended that, when calling an ambulance for a resident, staff of aged care services should provide paramedics with an up-to-date summary of the resident’s health status. This should include medications and advance care directives.

We have integrated these recommendations, into our Client Transition to and from Hospital Policy, so this resource is appropriate for use by both disability support services and aged care providers.

Access key disability resources

Find a collection of helpful resources, tailored for NDIS providers, on the SPP platform. 

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Spotlight on the FIA Code

Posted on by Claire Montague

The Fundraising Institute Australia (FIA) Code is a voluntary code, aiming to raise standards of conduct across the fundraising sector in Australia. It goes beyond mandatory government regulation, to encourage best practice fundraising for charities and not-for-profits. 

The FIA Code provides guidance to fundraisers on the following key areas:

  • Compliance – The FIA Code reaffirms that members must comply with all laws and regulations applicable to fundraising. It imposes compliance requirements for board members, training requirements, and the obligation to accept the decision of the Code Authority in respect of any complaint made under the Code.
  • Ethical conduct – Members must act honestly and with respect for the causes, donors and beneficiaries they represent. They must value privacy, trust and integrity, and be open about the nature of the work they do.
  • Conduct towards Donors  – Members have a number of obligations in relation to donors. These relate to complying with donors’ reasonable requests, providing opt-out information,  transparency around the cause for the fundraising and use of funds, protecting donor information, refusing donations that are inappropriate for a number of reasons, refraining from unduly influencing or harassing donors, and ensuring the veracity and high ethical standard of promotional materials.
  • Conduct towards Beneficiaries – Members must not engage in conduct that is disparaging towards a beneficiary, or that threatens their dignity. These requirements centre around upholding respect for beneficiaries in promotional materials and in use of language.
  • Conduct in Supplier relationships – Members must have written contracts with parties in their supply chain, specifying the responsibilities of all parties. It is a member’s obligation to ensure that all relevant parties are aware of the member’s obligations under the Code, and that they do not act in a way that could breach the member’s obligations. Members must also ensure supplier costs incurred in fundraising represent fair market value. 
  • Administration and enforcement – While the Code is voluntary, members agree that compliance with the Code will be monitored by the Code Authority, and alleged breaches will be referred to the Code Authority.

FIA has published a series of Practice Notes, which should be read in conjunction with the FIA Code. The Practice Notes cover specific areas and are designed to assist organisations with their implementation of the Code. Access to the Practice Notes is available here.

Our Standards & Performance Pathways (SPP) platform hosts a self-assessment for the FIA Code, accessible to existing FIA members. Using the platform, you can work through a series of user-friendly assessments to track your organisation’s compliance with the Code. It is a convenient way to highlight what you’re doing well, and also identify areas for improvement.

What's new for the Code?

FIA has recently released a new Practice Note on Fundraising and National Disasters. This resource addresses the topical area of national disasters, which can be natural, man-made or otherwise, and for which proceeds of donations can be contentious and challenging.  Fundraising bodies should place donors at the centre of any fundraising interaction.

The Practice Note guides organisations in their responsibility to be transparent about the charitable cause and how donated funds will be used, so that donors can make informed decisions at heightened emotional times, including during national disasters. It is important that donors understand who the beneficiaries of donations will be, and the different ways funds will be used.

FIA will also be releasing a further three new Practice Notes later in 2021, so keep your eyes peeled for those.

Upcoming webinar

BNG and the Fundraising Institute of Australia will be co-hosting a webinar at 3pm AEST on Wednesday 5th May to walk you through the FIA Code as well as the corresponding self-assessment in SPP.

Click here to register for the webinar

AOD: new self-assessments across the sector

Posted on by Claire Montague

An area we’ve been focusing on recently is state and national Alcohol and Other Drug (AOD) standards. AOD treatment providers deliver important services across a broad cross-section of the Australian society. 

Over the last twelve months, we have incorporated a number of new AOD self-assessments into SPP.  Each of the three standards detailed below will support providers to implement the National Quality Framework for Drug and Alcohol Treatment Services.

WANADA Alcohol and other Drug and Human Services Standard

We mentioned the WANADA Standard in our previous AOD blog post.

Western Australian Network of Alcohol & other Drug Agencies (WANADA) supports services to improve the quality of life for individuals, families and communities affected by alcohol and other drugs, including community drug services, therapeutic communities and residential rehabilitation centres, sobering-up shelters, harm reduction services, and counselling services.

The WANADA Alcohol and other Drug and Human Services Standard was developed to ensure that safe, quality and evidence informed approaches are used for treatment and support in alcohol and other drug services, and human services.

The WANADA Standard has a strong focus on culturally responsive ways of working, and flexibility, which allows it to be followed and applied by a diverse range of human services. The WANADA Standard emphasises the primacy of First Nations people, and requires responsiveness across a service to the needs of First Nations and culturally and linguistic diverse people.

Our self-assessment on the WANADA Standard helps organisations work through each Performance Objective, with links to relevant WANADA resources and Interpretive Guides provided. 

ATCA Standard for Therapeutic Communities and Residential Rehabilitation Services

The Australasian Therapeutic Communities Association (ATCA) provides a range of services including detoxification units, family, gambling and mental health counselling, childcare facilities, family support programs, exit housing and outreach services.

The ATCA Standard for Communities and Residential Rehabilitation Services, 3rd edition, was released in June 2019. This version of the Standard has been modified to reincorporate the domains of governance and financial management, to allow member agencies to be certified/accredited under a single Standard if that was appropriate for their organisation.

We have updated the self-assessment for the ATCA Standard to meet the requirements of the revised Standard, incorporating the key areas of continuous improvement, and governance and management.

NSW Clinical Care Standards for Alcohol and Other Drug Treatment

The most recent AOD  accreditation that we’ve added to our platform, the NSW Clinical Care Standards for Alcohol and Other Drug Treatment were developed by the NSW Department of Health in 2020. The Clinical Care Standards outline the core elements of care that underpin treatment within NSW AOD treatment services. These standards apply to all drug and alcohol service treatment types and locations. They detail the foundational elements of care, support clinical decision-making and complement other sources of information that guide the delivery of high-quality and safe treatment.

We have created two self-assessments that are based on the ‘Service Review Checklists’, which are available in the Readiness Toolkit for the standards.

National Quality Framework

In an earlier blog post on this topic, we discussed the National Quality Framework for Drug and Alcohol Treatment Services, which sets a nationally consistent quality benchmark for AOD treatment providers. The National Quality Framework is applicable to all AOD providers, including those that receive government funding and providers not receiving government funding.

There are a number of accepted accreditations available to providers who wish to comply with the National Quality Framework. SPP hosts self-assessments for many of these accreditation standards, including:

  • Alcohol and Other Drug Human Service Standard (WANADA)
  • Australian Service Excellence Standards (ASES)
  • Human Services Quality Framework Queensland (HSQF)
  • ISO9001: Quality Management Systems
  • National Safety and Quality Health Service (NSQHS)
  • QIC Health and Community Services Standards (QIC)

Other standards in SPP which can be used in conjunction with one of the above accreditation standards include:

  • Victorian Human Services Standards
  • ATCA Standard
  • Tasmanian Quality and Safety Standards
  • National Standards for Mental Health Services (NSMHS)

Is your organisation ready to begin self-assessment?

For more information about the Alcohol and Other Drug self-assessments and resources on our platform, sign up for SPP!

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The Aged Care Quality Standards and the NDIS Practice Standards: common themes – and gaps

Posted on by Claire Montague

Residential aged care providers who support NDIS participants will be aware that as of December 1st 2020, they will become registered providers under the NDIS.  Importantly, providers do not need to do anything to facilitate this – registration will happen automatically.

Residential aged care providers have played an important role in supporting younger people with disabilities, and will continue to do so.  Becoming an NDIS provider brings new obligations, and providers should be aware of the specific goals and responsibilities outlined in the NDIS Quality and Safeguarding Framework, which comprises the NDIS Code of Conduct and NDIS Practice Standards. 

The NDIS Practice Standards compared with the Aged Care Quality Standards

Our SPP Platform cross-maps different sets of standards to each other.  This means that users of SPP can quickly identify thematic gaps between different standards.  And there is some good news – if a user satisfies 100% of SPP’s self-assessment for the Aged Care Quality Standards, they will automatically have completed just over 70% of our self-assessment for the NDIS Practice Standards (Core Module).  For the NDIS Code of Conduct, the crossover is even higher, with 90% completed!

So the reassuring news for RAC providers is that there is a high degree of commonality between the two sets of standards.  It is likely that if your quality management and compliance systems are keeping up with the obligations of ACQS, then you are already well on your way to accreditation against the NDIS Practice Standards.

Similarities between the standards

In our view, the main areas of similarity are in the themes of:

  • Individual Values and Beliefs
  • Privacy and Dignity
  • Violence, Abuse, Neglect, Exploitation and Discrimination
  • Information Management
  • Continuity of Supports
  • Access to Supports
  • Support Planning

For these key areas, pertaining to client rights and service access, it is likely that your organisation already has many policies and procedures in place that will align, in full or at least in part, with the requirements of the NDIS Practice Standards.

Gaps between the standards

However, there are also some clear gaps between the ACQS and NDIS Practice Standards, and these are areas that your organisation may need to focus on when preparing yourself for transition into the NDIS.  In SPP, users who satisfy all of our self-assessment for ACQS will still need to do further work regarding the following NDIS outcomes:

  • Transitions to or from the Provider
  • Safe Environment
  • Participant Money and Property
  • Management of Medication
  • Management of Waste

This is not to say that these themes do not feature in the ACQS, indeed many of you will already have policies on those matters in place within your residential aged care facilities.  However, the requirements in the NDIS Practice Standards are of sufficient specificity or detail as to delineate them from the requirements of the ACQS, and for this reason, RAC providers should pay particular attention to these areas of the NDIS Practice Standards, and the requirements outlined.

Gaps: complaints management and incident management

Another two areas which are distinct within the NDIS are complaints management and incident management.  This is because specific legislative instruments have been drafted to articulate the exact processes that must be followed for the management of both complaints and incidents by registered NDIS providers.

For incidents, the rules include the conditions under which an incident must be reported, and they also set out a comprehensive list of all of the elements that must be addressed in a provider’s incident management system procedures.  For complaints, the rules include requirements for an accessible complaints management system, and a similarly rigorous set of mandatory elements.

RAC providers should familiarise themselves with the rules.  Our SPP platform helps organisations in this, as we take users through each element of the NDIS complaints and incidents requirements, in our specific NDIS modules. 

Worker Orientation Module

Alongside compliance with the NDIS Practice Standards, there are some additional conditions of registration.  All members of your workforce who have more than incidental contact with NDIS participants are required to complete the Worker Orientation Module, ‘Quality Safety and You’.  This is a straightforward online module that can be completed in approximately 90 minutes, and is available on the NDIS Quality and Safeguards Commission website.

Worker screening

In February 2021, the NDIS Commission will launch a National Worker Screening check that will replace existing arrangements which differ across each state and territory.  It will set a single national standard for all workers supporting NDIS participants. Registered NDIS providers will need to make sure that workers have a valid and current clearance.

Until that time, workers who have more than incidental contact with NDIS participants will need to be screened according to State based legislation.  RAC providers should ensure they are familiar with State based requirements.

More information on worker screening is available here. 

Behaviour support/restrictive practices

Under the NDIS, behaviour support focuses on person-centred interventions to address the underlying causes of challenging behaviours, while safeguarding the dignity and rights of people with disability who require specialist behaviour support.  This is not dissimilar to the aim of minimising the use of restraint under the Aged Care Quality Standards.

Any behaviour support plan which contains a restrictive practice must be developed by an NDIS registered specialist behaviour support provider.  Specialist behaviour support providers must lodge behaviour support plans with the NDIS Commission and notify the Commission of the use of regulated restrictive practices.

Providers using restrictive practices as part of a behaviour support plan must report monthly.

The RAC is responsible for ensuring workers receive appropriate training and understand the risks associated with using a restrictive practice.

RAC providers should familiarise themselves with the National Disability Insurance Scheme (Restrictive Practices and Behaviour Support) Rules 2018, with which they will need to ensure they are compliant. 

Wrapping up

Ultimately, RAC providers supporting NDIS participants should not be too overwhelmed about these new compliance requirements.  The proposed regulatory approach will be proportionate, recognising the co-existing regulation that RAC providers will continue to be subject to under the Aged Care Act 1997, and as highlighted, much of your organisation’s quality and safeguarding work will carry across to the NDIS framework.  However, the NDIS Practice Standards are a distinct set of standards, and organisations should familiarise themselves with some of the new obligations imposed by the NDIS Quality & Safeguarding Framework.  Please access any of the resources listed below to help you in this process.

Additional resources

Need help understanding your obligations?

For assistance with compliance with the NDIS Practice Standards, contact our team.

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COVID-19 in residential aged care – how to respond in the first 24 hours

Posted on by Claire Montague

The prospect of dealing with a case of COVID-19 in your aged care facility is a daunting one. However, preparation is key, and an effective response in the first 24 hours of an outbreak can mitigate the extent of the outbreak dramatically. Here’s why you should get a handle on your response plan now.

The Commonwealth Government Department of Health has released a fact sheet called First 24 hours – managing COVID-19 in a residential aged care facility. This fact sheet walks providers through the steps they should follow in their immediate response to the identification of a COVID-19 positive case. These steps are based on the Communicable Diseases Network Australia (CDNA) national guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities.

The guidelines identify the following key steps providers should take, in the time periods as follows:

First 30 minutes

  • Isolate and inform the COVID-19 positive case(s)
  • Contact your local Public Health Unit (PHU)
  • Contact the Department of Health
  • Lockdown the residential aged care facility

Minutes 30-60

  • Convene your outbreak management team
  • Activate your outbreak management plan
  • Establish screening protocol
  • Release an initial communication 

Hours 2-3

  • Contact tracing
  • Identify key documents
  • PPE stocktake
  • Communication

Hours 4-6

  • First meeting of the Outbreak Management Team
  • Bolster your staff and plan your roster
  • Conduct testing
  • Clinical management of COVID-positive cases

Hours 6-12

  • Cohorting and relocation
  • Move to a command-based governance structure
  • Rapid PPE supply
  • Infection control

Hours 12-24

  • Clinical First Responder from Aspen to commence
  • Review advance care directives
  • Establish strong induction and control processes
  • Maintaining social contact
  • Follow up communications
  • Continue primary health care
  • Support your staff
  • Continue to monitor state/territory guidelines

Our First 24 hours self-assessment

We’ve built a self-assessment in SPP called Aged Care Facilities – COVID-19 Outbreak First 24 Hours, that follows each of the above steps in the Commonwealth’s guidelines. This self-assessment will serve as a useful tool to prepare your organisation for potential outbreaks. We have broken down the key steps into separate modules and quizzes, which providers can work through to help familiarise themselves with the processes they will need to follow in the event of an outbreak. By self-assessing against the guidelines, you can identify gaps in your existing systems, and download an Action Plan to address these gaps.

We strongly advise that you self-assess against these steps now, well ahead of any outbreak.  Many of the processes required in the first 24 hours following an identified case of COVID-19, will need to have already been established, ahead of time. For example in minutes 30-60 of an outbreak, providers are asked:

“As part of an effective outbreak management plan, has the provider already drafted some pre-prepared email templates for this initial communication?”

Here, it is flagged for providers that they should have email templates prepared, in anticipation of any outbreaks.

Similarly in hours 2-3, providers are asked:

“Does the provider supply the following information to the PHU and the state branch of the Commonwealth:

  • a detailed floor plan which include residents’ rooms, communal areas, food preparation areas, wings, and how staff are apportioned to each area;
  • an up-to-date list of residents, identifying residents with COVID-like symptoms, onset date, testing status, their location in the facility, and staff contacts;
  • a list of all staff employed by the facility; and
  • a list of the respiratory specimens collected and the results of tests?”

This signals to providers what information they will need to have already collected and stored on record somewhere that is easily accessible, if this has not yet been done.

The self-assessment also links to some key resources developed by the Communicable Diseases Network Australia (CDNA), that will be very useful in the event of an outbreak,  including a sample template letter to GPs, and a template report to the local Public Health Unit (PHU).

Our Respiratory Outbreak Preparedness self-assessment

We’ve also made available a self-assessment to guide providers through the components of an outbreak management plan. The self-assessment is based on recommendations from the Department of Health, the Aged Care Quality and Safety Commission, and the NDIS Quality and Safeguards Commission. See our earlier blog post on 6th May 2020 for more information. 

Items to address in an outbreak management plan include:

  • Identifying clients at greater risk and with complex support needs
  • Business continuity plan
  • Communication of the plan to staff, clients and families
  • Preparing a staff contingency plan
  • Maintenance of appropriate levels of necessary stock items
  • Implementation of regular health assessments of clients and staff
  • Preparation of a communications plan for keeping authorities, staff, clients and their families informed after an outbreak is identified
  • Cleaning plan
  • Plan to restrict visitors if relevant

Reviewing your practices against our First 24 Hours and Respiratory Outbreak self-assessments can help ensure your outbreak preparedness planning is up-to-speed, so that your facility is protected and well-prepared.

COVID-19 in aged care - outbreak management

Do you have a clear outbreak management plan? Are you  prepared for the actions you need to take during the first 24 hours of an outbreak?  Sign up to SPP to access our self-assessment, among many other resources.

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Spotlight on the National Quality Framework for AOD providers

Posted on by Claire Montague

Alcohol and other drug (AOD) treatment in Australia is provided by a variety of organisations.  Previously, there was no consistent approach to ensure minimum quality standards and continuous quality improvement in the AOD treatment system.  However, in late 2019, the National Quality Framework for Drug and Alcohol Treatment Services was endorsed by the Ministerial Drug and Alcohol Forum.

Governments and peak AOD bodies have worked together to develop the National Quality Framework, a nationally consistent quality benchmark for providers of AOD services. Importantly, the framework includes strong clinical governance requirements.

The framework is an important step in improving the consistency and quality of AOD treatment services across Australia.

What’s the framework all about?

The National Quality Framework aims to achieve positive health outcomes by improving the quality and safety of AOD treatment services for consumers and their families.

The National Quality Framework has nine Guiding Principles:

  • Organisational Governance
  • Clinical Governance
  • Planning and Engagement
  • Collaboration and Partnerships
  • Workforce, Development and Clinical Practice
  • Information systems
  • Compliance
  • Continuous Improvement
  • Health and Safety

These nine guiding principles are articulated with reference to their relevance to the sector.  For example, Planning and Engagement should be informed by what works for the needs of clients, including cultural security requirements, and as part of Collaboration and Partnerships, providers should identify co-occurring issues, such as mental health, physical health, housing and employment, and support clients through referral or collaboration to support these needs.

How do I comply?

There are a number of accepted accreditations available to providers who wish to comply with the National Quality Framework. SPP hosts self-assessments for many of these accreditation standards, including:

  • Alcohol and Other Drug Human Service Standard (WANADA) 
  • Australian Service Excellence Standards (ASES)
  • Human Services Quality Framework Queensland (HSQF)
  • ISO9001: Quality Management Systems 
  • National Safety and Quality Health Service (NSQHS)
  • QIC Health and Community Services Standards (QIC)

Governance and monitoring of the National Quality Framework will be conducted via the shared oversight of state and territory governments and the Commonwealth.

Feature standard: WANADA

In 2019, WANADA released its Alcohol and other Drug and Human Services Standard.  Like WANADA’s earlier version of this Standard (the Standard on Culturally Secure Practice), the Alcohol and other Drug and Human Services Standard has a strong focus on culturally responsive and evidence informed ways of working.  It is intended to support and encourage information sharing, mentoring and collaboration across the sector. 

The Alcohol and other Drug and Human Services Standard  is a new addition to our SPP platform and demonstrates an up-to-date and nuanced understanding of cultural competence.  The Standard is flexible enough to be applied by a diverse range of human services.  It is recommended as an excellent benchmarking tool for service providers throughout Australia.

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You can access a range of self-assessments for the National Quality Framework in the SPP platform

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Minimising the use of restraints

Posted on by Claire Montague

Amendments have been made to the Quality of Care Principles 2014 (Cth) to minimise the use of chemical and physical restraints in residential care settings, and to include specific requirements of aged care providers in relation to their use.

Requirements of  providers include:

  •  thoroughly documenting any planned use of restraint in a client’s care plan,
  • obtaining client consent,
  • notifying a client’s representative, and
  • obtaining authorisation from an appropriate health professional.

Additionally, the Aged Care Legislation Amendment (Quality Indicator Program) Principles 2019 (Cth) – which took effect from 1 July 2019 – require that use of physical restraint in aged care facilities must be submitted and documented through the MyAged Care Portal. The Aged Care Quality Standards also require that clinical care is best practice and is supported by a clinical governance framework that minimises the use of restraint.

For these reasons, it is pivotal that organisations understand the regulatory requirements around the use of restraint. To assist organisations in this regard,  BNG has developed a policy which incorporates these regulatory requirements. 

Find our policy template on SPP, in the Reading Room:

  • Policy: Eliminating the Use of Restraints (Aged Care)