New legislation passed in Aged Care

Last week the government introduced two new aged care bills to the House of Representatives, which together respond to a number of recommendations from the Aged Care Royal Commission’s final report.  

Royal Commission Response Bill

Just a week later, the first bill, the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill 2022, has now passed through both houses. Some of the key changes that this bill introduces include:

  • Introducing the new AN-ACC funding model which will replace the existing ACFI model.
  • A Code of Conduct that will apply to approved providers, their aged care workers and governing bodies. It will be based on the NDIS Code of Conduct and will be implemented from 1 December 2022.
  • Extending the Serious Incident Reporting Scheme (SIRS) to include home care by 1 December 2022.
  • From 1 December 2022 there will be new governance responsibilities around suitability requirements for key personnel and other requirements including:
    • The requirement to notify the Commission of changes to key personnel or changes to the suitability of key personnel;
    • At least every 12 months the provider must consider the suitability of all key personnel and be reasonably satisfied that they are suitable to be involved in the provision of aged care;
    • The provider must ensure that a majority of the members of the governing body are independent non-executive members, and at least one member of the governing body has experience in the provision of clinical care. (This does not apply if the governing body has fewer than 5 members or provides aged care service to less than 40 recipients, or is an Aboriginal Community Controlled Organisation).
    • Providers must establish a quality care advisory body that:
      • Complies with the requirements specified in the Accountability Principles; and
      • Gives the governing body a written report about the quality of care being delivered at least once every 6 months.
    • The governing body must respond in writing to those reports and other feedback from the advisory body.
  • Changes to restrictive practices arrangements to address unintended outcomes due to the interaction with state and territory guardianship and consent laws.
  • A requirement for the Department of Health and Aged Care to publish information about the quality of aged care provided through an aged care service, and the performance of the approved provider in relation to responsibilities and standards under the Aged Care Act by the end of 2022.

Implementing Care Reform Bill

The second bill, the Aged Care Amendment (Implementing Care Reform) Bill 2022, has been referred to the Senate Community Affairs Legislation Committee, with an expected report date of 31 August 2022, and includes:

  • mandatory requirements for there to be a registered nurse on site 24 hours a day at all residential aged care facilities starting from 1 July 2023;
  • caps on home care charges from 1 January 2023; and
  • improvements to transparency of information from 1 December 2022.

Stay in the loop

Providers are encouraged to stay across these changes as a number of the reforms are expected to come into place soon, with many being implemented before the end of the year. We will keep you updated!

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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.

Is your aged care board equipped to govern successfully?

Quality services arise from good leadership. As an aged care provider, your governing body plays an integral role in promoting a culture of safe, inclusive and quality care and services, and overseeing your organisation’s operations.

Responsibilities

Under the Aged Care Quality Standards, the governing body is accountable for the delivery of safe and high quality care and services to all consumers in the organisation’s care. 

Each member of the governing body must be satisfied that the organisation has in place the culture, strategies, policies, practices and behaviours to ensure delivery of care and services to that standard.

Challenges for non-executives

But boards are usually (and should be!) composed of non-executive directors, who very often will be fulfilling their role on a voluntary basis.  On any one board there may be directors with varying levels of knowledge about the specific requirements of the Aged Care Quality Standards.  Directors may be located remotely from the provider and, especially over the last 18 months with COVID, opportunities for face to face on site meetings has been extremely limited.

And yet, individually, each director shares the responsibility to oversee that their provider delivers safe, quality and compliant care.

Problems highlighted by the Royal Commission

The importance of strong governance in aged care was a central finding of the recent Royal Commission into Aged Care Quality and Safety. In their Final Report, Commissioners Pagone and Briggs were blunt in their assessment of the failures of some aged care providers’ governing bodies:

“Provider governance and management directly impact on all aspects of aged care. Deficiencies in the governance and leadership of some approved providers have resulted in shortfalls in the quality and safety of care. Some boards and governing bodies lack professional knowledge about the delivery of aged care, including clinical expertise. There is a risk that they may focus on financial risks and performance, without a commensurate focus on the quality and safety of care.”

The Commissioners spoke unambiguously of the duty held by governing body members:

“Accountability begins and ends with the leaders of an organisation, the board and senior management. If boards and governing bodies do not have the knowledge or skills to understand the care that is being delivered, they are unable to ensure that this care is high quality and safe. The values and behaviour of people in these senior positions have a significant impact on workplace culture and the quality of care that is delivered.”

It is clear that scrutiny of aged care provider governing bodies will be a focus of the Aged Care Quality and Safety Commission – now and into the future. Already, government has begun legislating for greater accountability and responsibilities for governing bodies, with the recent Aged Care and Other Legislation Amendment (Royal Commission Response No. 2) Bill 2021 signalling strengthened governance arrangements from March 2022.

Now, more than ever, providers must ensure that their governing bodies are highly informed, involved, and are advocates for quality and safety in the aged care sector.

Our solution: the Board Governance Toolkit

In response to the findings of the Royal Commission, and requests from our customers, we have developed the Board Governance Toolkit.

Our new Board Governance Toolkit addresses all of the requirements in the Aged Care Quality Standards for oversight of the organisation’s provision of quality and safe care and services, and oversight of management and staff.

For each requirement, we ask a series of questions that walk directors through the necessary avenues of enquiry, so that they understand their obligations and are guided to ask the right questions and receive the correct and relevant information from management. Directors also have the opportunity to comment on how their organisation is meeting that requirement, or how it could improve.

Our Toolkit helps each individual board member to:

  • Understand their ACQS responsibilities
  • Record their assessment of organisational performance
  • Engage effectively with senior management
  • Identify gaps and areas for improvement
  • Regularly review progress and update priorities

Our Toolkit facilitates regular review and continuous quality improvement.  As part of regular quality improvement processes, governing body members should revisit the Toolkit and update their comments, for review and discussion at board level on a regular basis.

Click here to view our Board Governance Toolkit flyer.

Seeking guidance for your board?

Access the Board Governance Toolkit on SPP.

Royal Commission Series: the Government’s response

On the 11th of May, the Australian Government published its response to the final report of the Royal Commission into Aged Care Quality and Safety. The government accepted 126 of the 148 recommendations and rejected six of the recommendations, including the independent aged care commission model.

We’ve looked at a number of the key recommendations throughout this series and we will now provide an overview of the government’s response to those recommendations.

Dementia and palliative care - Recommendation 80: Accepted

The government has flagged dementia and palliative care as something that it will begin to address immediately. Starting this year, the government will target improvements to the quality of dementia care, including increased support when a person is first diagnosed, improved connection between services and an increase in the number of care minutes provided to people in residential aged care. Some of the government’s targeted funding includes:

  • $7.3 million to build dementia care capacity in residential aged care;
  • $67.5 million for the Dementia Behaviour Management Advisory Service and the Severe Behaviour Response Teams to reduce use of restraints; and
  • dementia training for an additional 1000 GPs and GP registrars per year.

The government’s review of the Aged Care Quality Standards will consider regulations that require:

  • providers to ensure that staff are appropriately trained in dementia and palliative care; and
  • that the Certificate III in Individual Support include units of study on dementia and palliative care.

For more information, see aged care – reforms to support people living with dementia and their carers.

Our previous blog post on dementia and palliative care outlines Recommendation 80.

Culturally safe service delivery – Recommendations 30 and 21: Accepted

The government has highlighted a number of initiatives targeting improved outcomes for the culturally safe delivery of services, including:

  • by 2023, the establishment of a network of 500 local Community Care Finders to engage with vulnerable Australians and provide face-to-face assistance to help them access aged care and other health and social supports;
  • increased funding for translating and interpreting services for diverse older Australians; and
  • the introduction of a specialisations verification framework and audit process by June 2022, to ensure that providers have demonstrated their capability to provide specialised services for people with diverse backgrounds.

We expect the government will consider the priority issues contained in recommendation 21, including potentially making mandatory the Aged Care Diversity Framework and underlying Action Plans, as part of their review of the Aged Care Quality Standards, to be completed by December 2022. 

For more information see: aged care – reforms to support people from diverse backgrounds

Our previous blog post on culturally safe delivery outlines Recommendation 30 and 21.

Aboriginal and Torres Strait Islander aged care – Recommendations 47, 48, 49, 50, 51: Accepted

The government will immediately begin addressing these recommendations, with the 2021-22 budget investing in targeted measures to improve the experience of Aboriginal and Torres Strait Islander people in aged care. In 2022, the government aims to establish a new workforce of 250 Indigenous people to provide face-to-face support for Aboriginal and Torres Strait Islander people to navigate and access care. Other reforms include upgrading existing buildings and constructing purpose-built residential facilities to connect people with communities on Country, improved access to translation and interpreting services and assistance to Indigenous organisations with governance, business training and leadership.

For more information see: aged care – reforms to support Aboriginal and Torres Strait Islander people and governance – more equitable access to aged care for First Nations people and special needs groups

Our previous blog post on Aboriginal and Torres Strait Islander care outlines Recommendations 47, 48, 49, 50 and 51.

Protection for whistleblowers – Recommendation 99: Accepted

The government has accepted this recommendation and referenced the new Aged Care Legislation Amendment (Serious Incident Response Scheme and Other Measures) Act 2021  which creates protections for providers, staff members, volunteers, family members, carers or representatives who make disclosures of information relating to reportable incidents. These changes came into effect on 1 April 2021.

Our previous blog post on whistleblowers outlines Recommendation 99.

New governance standard – Recommendation 90: Accepted

The government has outlined that it will introduce measures to strengthen the accountability of aged care providers including:

  • new governance obligations from 2022 requiring improvements to the composition and accountability of aged care boards;
  • a review of the Aged Care Quality Standards, focusing on areas of governance, dementia and food and nutrition (scheduled to be introduced in 2023); and
  • the appointment of an assistant commissioner for Sector Capability and Education to the Aged Care Quality and Safety Commission.

For more info see: governance – strengthening provider governance and governance – a new Aged Care Act

Our previous blog post on a new governance standard outlines Recommendation 90.

Restraints – Recommendations 17 and 65: Accepted

The government has indicated that strengthened legislative provisions to regulate restraints will commence from 1 July 2021. This will include clearer regulations on the use of restraint, clearer definitions of restraint and ensuring that restraint is only used as a last resort following deployment of alternative behaviour management strategies. The government has also indicated that it will appoint a Senior Practitioner to the Aged Care Quality and Safety Commission to lead education of aged care providers and General Practitioners in the use of restraints.

Additionally the government highlighted that the ACQSC, the Australian Commission on Safety and Quality in Health Care and the NDIS Quality and Safeguarding Commission are collaborating to align regulatory approaches to the use of restraints.

Our previous blog post on restraints outlines Recommendations 17 and 65.

Other areas of significance

Serious Incident Response Scheme (SIRS)

The government has outlined that $14 million will be spent on expanding the SIRS from residential aged care into home and community care from 1 July 2022. The government has also highlighted that dementia specialists will provide further training to representatives from all aged care providers on preventing the use of restraint.

Mandatory care time standards and reporting

From July 2021, providers will be required to report on care staffing minutes at the facility level as part of their annual reporting. From July 2022, providers will also be required to provide a monthly care statement to residents, outlining the care they have received and any significant changes. From December 2022, this information will inform a staffing star rating allowing clients to compare staffing levels between homes. The government is forecasting that by October 2023, providers will be required to meet a mandatory care time standard of 200 minutes per day for each resident.

Expanding the National Mandatory Quality Indicator Program

By July 2021, two new quality indicators relating to falls and fractures and medication management will be introduced alongside the existing domains of pressure injuries, physical restraint and unplanned weight loss. Additional quality indicators including indicators around quality of life in residential aged care and home care will be introduced by the end of 2022.

Subject to further consideration…

The news of the $18 billion to be invested in the aged care system has been welcomed by the sector, however there remain some significant areas that have been flagged by the government as subject to further consideration, or that have not been addressed in the government’s response:

  • the recommendation to increase supports to older people with disability to the equivalent level as a participant under the NDIS would receive;
  • a mandatory minimum qualification for personal care workers; and
  • the recommendation that by July 2024 the minimum staff standard should require at least one registered nurse on site at a residential aged care facility at all times.

It seems that the government will take a more moderate pathway to addressing these issues, or that it will consider the issues further before deciding to act.

We will be monitoring the changes closely and will be developing resources and tools to assist providers to meet any additional obligations under the changes.

Make sure to get in touch if you have any requests around resources, templates or self-assessments to assist you to meet your requirements. 

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You can access all of our aged care resources in the SPP platform. 

Royal Commission Series: new governance standard

Over the past few weeks, we have been highlighting a number of the Royal Commission’s recommendations, as well as updating you on resources that can help you implement best practices.

Our focus today is on Recommendation 90: New governance standard.

The Royal Commission’s executive summary of its final report emphasised the need to ensure high standards of governance within aged care providers:

“Provider governance and management directly impact on all aspects of aged care. Deficiencies in the governance and leadership of some approved providers have resulted in shortfalls in the quality and safety of care.

“Governance arrangements provide for the systems by which an organisation is controlled and operates, and the mechanisms by which the organisation and its people are held to account. They are set by the leaders of an organisation, in particular the board or governing body. They are implemented by executive leaders and workers who report to those executive leaders. They involve everyone in an organisation.”

In the Royal Commission’s view, the existing governance requirements under the Aged Care Quality Standards “do not provide a sufficiently strong basis for the governance and leadership of aged care providers.”

The Commission's recommendations

Recommendation 90 sets out a proposal for more robust governance requirements to be introduced, to drive improvements to the aged care system.  Key components of the recommendation include requirements that providers:

  • Have governing body members who possess the appropriate mix of skills, experience and knowledge of governance responsibilities, to ensure the delivery of safe and high-quality care by the provider;
  • Have a care governance committee, to monitor and ensure accountability for the quality of all care provided;
  • Seek and receive regular feedback from consumers, their representatives and staff, on the quality and safety of the services they deliver, and ways in which the services could be improved;
  • Have an integrated complaints management system, including regular reporting to the governing body about complaints, any patterns, and underlying reasons for the complaints;
  • Have effective risk management practices in place covering care risks and also financial and other organisation risks;
  • Give particular consideration to ensuring continuity of care in the event of default by contractors or subcontractors; and
  • Have a governing body representative provide an annual attestation that the governing body has satisfied itself that the provider has structures, systems and processes in place to deliver safe and high-quality care.

How can BNG help?

SPP’s existing self-assessment for the Aged Care Quality Standards is an excellent way for providers to better understand the core components of a comprehensive approach to governance.

The self-assessment goes well beyond just listing the requirements of the standards.  It guides providers through the core approaches and processes they should implement in order to achieve best practice across their organisation, and in the area of governance it includes detailed, educative, best practice modules covering topics such as:

  • Organisational structure and accountabilities; governing body recruitment, induction and training; and reporting;
  • Clinical governance;
  • Risk management systems;
  • Financial controls and management; and
  • Performance monitoring and evaluation, and quality improvement.

It also includes modules on client and community feedback and complaints.

All of the modules include downloadable resources such as policy templates, to help providers develop their own policies and procedures.

Towards Best Practice: Clinical Governance self-assessment

We also have a separate self-assessment for Clinical Governance, which is based on guidance from the Aged Care Quality and Safety Commission. It addresses clinical governance at a more granular level and details the processes that should be in place for a clinical governance framework. The self-assessment outlines the roles and responsibilities of all individuals involved in care including the governing body, senior executive team, operational manager, the workforce, health practitioners and consumers.

Resources

We have many resources which will assist providers to implement a comprehensive approach to governance across their organisation, including a whole resource topic on “Governance and Management”.  You can find this section in the Reading Room under the heading “SPP Resources by Topic”.

You can also search for other resources using the search bar in the Reading Room. A number of our resources address Recommendation 90, including information sheets and policies covering:

  • Client Feedback;
  • Quality Management and Continuous Quality Improvement;
  • Complaints Management; and
  • Risk Management.

While the governance requirements are yet to be formally implemented, your organisation can get ahead by working through our self-assessments and implementing best practice policies and procedures across the organisation.  

To access these resources, and hundreds more, log in to SPP.

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

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

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.

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

Royal Commission Series: dementia and palliative care

In its Final Report, titled Care, Dignity and Respect, the Royal Commission into Aged Care Quality and Safety made 148 recommendations for action and improvements in response to the problems it identified in the aged care system. 

We’ve gone through the recommendations in detail, and over the next couple of weeks we will be providing a number of updates on how SPP can help you to get ahead with many of the recommendations. 

Our focus today is around dementia and palliative care. Dementia care is one of the four concerns that were singled out by the Royal Commission as requiring immediate attention:

“It is estimated that more than half of the people living in permanent residential aged care in 2019 had a diagnosis of one of the forms of dementia. The real percentage is likely higher, given the prevalence of undetected dementia.

“Despite this, our inquiry has revealed that the quality of aged care that people living with dementia receive is, at times, abysmal. We heard time and time again that staff members do not have the time or the skills to deliver the care that is needed. The quality of dementia care in the aged care system needs significant and immediate improvement.” 

To address the above identified issue, the Royal Commission has made Recommendation 80: Dementia and palliative care training for workers.

“By 1 July 2022, the Australian Government should implement as a condition of approval of aged care providers, that all workers engaged by providers who are involved in direct contact with people seeking or receiving services in the aged care system undertake regular training about dementia care and palliative care.”

We have several resources that can assist your organisation to get ahead in training workers in dementia and palliative care. 

Towards Best Practice Self-assessment: Dementia Australia’s Quality Care Recommendations (2019)

This self-assessment is available in SPP’s “Aged Care – towards best practice” group, and is based on Dementia Australia’s Quality Care Recommendations, which were developed in consultation with people living with dementia, their families, carers and advocates. 

Working through the self-assessment will assist your organisation to appreciate how it can work to support greater inclusion, respect and ultimately improved quality of life for people living with dementia. In particular, Recommendation 7 of the Quality Care Recommendations “Dementia trained staff” takes you through worker training regarding dementia. 

Dementia Australia’s Centre for Dementia Learning provides a range of resources, foundation learning modules and consultancy services that can assist providers who wish to access more detailed material or training for their workers. 

Resources

In SPP’s Reading Room, you can find Policy: End of Life Care and Palliative Care, which can help your organisation to embed advance care and end of life planning into your delivery of care. The resource addresses recognising end of life, assessing palliative care needs, responding to deterioration, and managing dying and bereavement. 

In addition to this resource, SPP also has these advance care resources:

  • Info: Advance care planning; and
  • Policy: Advance care planning.

We also have some other resources that address supporting clients with dementia, including:

  • Policy: Safety and security in residential aged care facilities
  • Policy: Intimacy and sexuality in aged care
  • Info: Intimacy and sexuality in aged care

You can find these resources by searching for key words in the SPP Reading Room. 

To access these resources, and hundreds more, log in to SPP.

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

SIRS, the new aged care incident scheme

The Aged Care Quality and Safety Commission’s (the Commission) Serious Incident Response Scheme (SIRS) for government-funded Residential Aged Care Providers is set to commence in April 2021.  The new SIRS aims to further safeguard aged care consumers from abuse and neglect by empowering consumers, and by ensuring that providers follow the incident response procedures specified in the scheme.

The SIRS brings the requirements of incident reporting in aged care into alignment with those of the NDIS. For providers of both aged care and NDIS services, and providers familiar with the NDIS requirements, the new scheme will not present new compliance concepts.

The SIRS will fit in alongside several other residential aged care compliance requirements. Under the Charter of Aged Care Rights, consumers have a right to live without abuse and neglect. Likewise, under the Aged Care Quality Standards, providers are required to uphold this consumer right by identifying and responding to abuse and neglect. Additionally, the scheme will uphold the principles and requirements of open disclosure.

The SIRS is made up of two key components, being incident management obligations and compulsory reporting obligations.

The incident management component consists of identifying, responding to, managing, and recording incidents, as well as improving to prevent similar future occurrences.

The compulsory reporting obligations require providers to submit reports to the Commission within specific timeframes, depending on the severity of the incident.

Defining incidents under the SIRS

It will be essential for workers to understand which occurrences constitute an incident, as well as the category of the incident (ie “Priority 1” or “Priority 2”) and the appropriate procedures that must be followed when an incident occurs.

The Commission’s documentation includes detailed explanations of the various categories of incidents, which are certain “alleged, suspected or actual occurrences … where the person affected by the incident is a consumer in residential aged care”.

The types of incidents as defined by the SIRS are:

  • unreasonable use of force;
  • unlawful or inappropriate sexual contact;
  • psychological or emotional abuse;
  • unexpected death;
  • stealing or financial coercion by a staff member;
  • neglect;
  • inappropriate physical or chemical restraint; and
  • unexplained absence from care.

It is important to note that providers must assess the degree of impact on, or harm to, the consumer for each incident.  If there is a higher level of impact on or harm to the consumer, then the incident must be categorised as a Priority 1 incident.

Unexpected deaths and unexplained absences will always be categorised as Priority 1 incidents.

Supporting affected individuals

One of the requirements under the new scheme will be to support aged care consumers affected by an incident. The central component of this requirement is clear, ongoing communication between the provider and affected consumers, in line with the principles of open disclosure. Affected consumers may also require trauma or counselling services, and the provider is expected to help consumers access these services.

Incident reporting to the Commission

The SIRS outlines timeframes within which providers must report alleged, suspected or actual Priority 1 and Priority 2 incidents to the Commission.

Timeframe for reporting Priority 1 incidents

Priority 1 incidents have the highest priority, with the Commission requiring an initial report within 24 hours. Additionally, a follow-up incident status report is required within 5 business days of a Priority incident occurring.

Timeframe for reporting Priority 2 incidents

On the other hand, Priority 2 incidents must be reported to the Commission within 30 days.

In some cases, the Commission will require providers to submit a final report detailing the findings from incident investigations and, where relevant, how an incident was resolved. If required by the Commission, the final report will be due within 60 days of the incident occurring.

SIRS record keeping requirements

The SIRS will bring only minor changes to the current record-keeping requirements related to incidents. Providers will need to continue recording the details of each incident which occurs, regardless of whether the incident was determined to be trivial or have negligible impact. The SIRS adds another record keeping requirement: the category of incident will need to be recorded and, in the case of Priority 1 or 2 incidents, whether the incident has been reported to the Commission.

Quality and Safety

One of the central goals of the scheme is to “drive learning and improvement at a system and service level to reduce the number of preventable serious incidents in the future”.  The SIRS will encourage organisations to use the quantitative and qualitative data collected from their incident management recording processes to refine their procedures, minimise the likelihood of incidents re-occurring, and to improve the overall quality and safety of the care they deliver.

Further reading

We have several resources to help providers identify, assess, investigate, manage, record and resolve incidents in line with the new scheme. Our resources are intended to complement one another, and have been updated to take into account the requirements of the SIRS.

Our aged care incident management resource templates include:

  • Policy: Incident Management Procedures (Aged Care SIRS)
  • Template: Incident Investigation Template (Aged Care SIRS)
  • Template: Incident Register (Aged Care SIRS)
  • Template: Incident Report Template (Aged Care SIRS)

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Help with aged care incidents

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Elder financial abuse: early signs and what to do

As Australians age, they may require increased support not only in their daily activities and living requirements, but also in managing their financial affairs.  This could include assistance in paying regular bills, help in entering into financial arrangements as they transition into residential care, and ensuring that their finances are in order and their testamentary intentions are clear.

Stress and confusion

The Royal Commission into Aged Care Quality and Safety’s interim report noted that stress and confusion about financial options and consequences is common in elderly people. For people entering residential aged care in particular, the financial decisions that must be made are significant, and are often being made at times of great stress.

Potential for abuse

As they age, people become increasingly reliant on those around them to assist them with making these important financial decisions. This reliance on others leaves them increasingly vulnerable to financial abuse. The situation is even harder for people living with dementia, for people for whom English is a second language, and for people with difficulty hearing or visual impairments.

A 2016 report by the Australian Government on elder abuse showed that psychological and financial abuse were the most common types of abuse reported. The report found that around 70% of victims were women and around 70% of the perpetrators were family members. Early intervention or preventative strategies are key in assisting to identify instances of financial abuse.

Preventative strategies

One of the main barriers to older people addressing financial abuse is a lack of knowledge about the powers and safeguarding options available to them. Here are some important preventative strategies that can be implemented to minimise the instances of financial abuse in elderly people:

  • Providing clients with accessible information regarding their financial situation and their options for seeking financial assistance
  • Supporting clients to make their own decisions or, if this is not possible, organising a lasting power of attorney and naming a person that is trusted to look after their financial decisions
  • Improving knowledge and awareness about financial management and signs of elderly financial abuse among carers and professionals
  • Ensuring clients are aware of community support services that can assist them

How to spot elder financial abuse

Red flags to be aware of in elderly clients include:

  • Behavioural changes
  • Signs of distress, confusion or lack of care
  • Anxiety, nervousness or tension in discussions around a particular third party (including a family member)
  • Significant withdrawals from bank accounts
  • Any of the above behaviours accompanied by a request to make a change to the individual’s long-standing financial arrangements without being able to provide a reason as to why

How can we help?

We have two resources to help providers ensure that they are equipped to assist individuals with their money management and deal with any instances of financial abuse.  

  • Policy – Money Management for Clients Requiring Assistance
  • Policy – Elder Financial Abuse

These resources can be found in the Reading Room by searching for “money” and “financial”.

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