Royal Commission Series: culturally safe service delivery

Welcome to our second update on some of the recommendations contained in the Final Report  of the Royal Commission into Aged Care Quality and Safety.

Today we focus on the Royal Commission’s concern that there needs to be better cultural safety for every older person within the aged care system.  We’ve highlighted a couple of important themes in the following extracts from the Executive Summary of the Final Report:

“Across the aged care system, staff are often poorly trained in culturally safe practices, with little understanding of the additional needs of people from diverse backgrounds.

“To deliver high quality and safe care, those providing services must respect the diverse backgrounds and life experiences of every older person, and tailor the delivery of care to meet their needs. Diversity should be core business in aged care

“Cultural safety must be embedded throughout aged care—from initial contact with the system, during assessment, and when an older person receives aged care services at home, in their community or in a residential setting. The pressing need for trauma-informed care is also relevant to cultural safety.”

Diversity and Cultural Safety

To address the above concern, the Royal Commission made Recommendation 30: Designing for diversity, difference, complexity, individuality.  This recommendation includes a requirement that “as a condition of approval or continued approval of providers, training on cultural safety and trauma-informed service delivery be provided for all workers engaged by providers who are involved in direct contact with people seeking or receiving services in the aged care system.”

See also Recommendation 21: Priority issues for periodic review of the Aged Care Quality Standards, which includes a recommendation to consider, by 1 July 2022, making mandatory the Aged Care Diversity Framework and underlying Diversity Action Plans – as well as having them better reflected in a revision of the Standards.

Aged Care Diversity Framework

Launched in 2017, the Aged Care Diversity Framework and Diversity Action Plans are designed to guide providers through the challenges of providing aged care services to people of all backgrounds and life experiences. There are four Action Plans in total:

  • Diversity Action Plan: All Diverse Older People;
  • Diversity Action Plan: LGBTI Elders;
  • Diversity Action Plan: Older Aboriginal and Torres Strait Islander People; and
  • Diversity Action Plan: Older CALD people.

The Action Plans are based on a progression scoring model, requiring providers to reflect on the level of quality at which they deliver services to diverse older people.

To date, the Diversity Action Plans have not been broadly publicised or implemented in detail by providers.  However, about a year ago we added self-assessments in SPP for each of the four Diversity Action Plans, to help providers understand, implement and monitor the actions they can take to tailor a more inclusive service for all older persons.  These self-assessments can be found on the Standards tab in SPP, under Aged Care Diversity Framework.

Inclusive Service Standards

In addition to the Aged Care Diversity Framework, we added the Inclusive Service Standards to the platform in 2019.  Developed by the Centre for Cultural Diversity in Ageing, the Inclusive Service Standards were designed to “assist aged care providers in the development and delivery of inclusive services to all consumers”. The standards will help providers ensure that the services they deliver are culturally safe, and reflect the cultural needs of the target group. Click here to read more about the Inclusive Service Standards in SPP.

Trauma-Informed Care

The Final Report has emphasised the importance of trauma-informed service delivery across the aged care system.  The Mental Health Coordinating Council (MHCC) defines Trauma-informed Care and Practice (TICP) as “a strengths-based framework that emphasises physical and psychological safety, creating opportunities for people with lived experience to rebuild a sense of control and empowerment.

We plan to develop some additional resources to help providers align their processes with the recommendations of the Royal Commission. However in the meantime, you may wish to consider some of the excellent resources available on MHCC’s Online Learning hub, including several courses related to trauma-informed service delivery.

In addition, take a look at MHCC’s Trauma-informed Care and Practice Organisational Toolkit (TICPOT), which is a comprehensive roadmap, with resources and tools, to build and strengthen trauma-informed service delivery.

Culturally Safe Aged Care for Aboriginal and Torres Strait Islander people

The Royal Commission has also made a number of recommendations to address its particular concern that Aboriginal and Torres Strait Islander people do not currently receive services that are consistently culturally safe.

Our next post will consider these recommendations in detail, and highlight a number of resources and tools available to providers.

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

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