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Tag: Aged Care

SIRS, the new aged care incident scheme

Posted on by Laurence Inkpen

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)

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

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Elder financial abuse: early signs and what to do

Posted on by Beatrice Hobson

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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Clinical governance in aged care – putting the principles into practice

Posted on by Beatrice Hobson

Clinical governance is essential for delivering safe, quality clinical care and good clinical outcomes for each consumer. It provides the organisation with a framework for continuously improving services. At its core, it is about all members of the organisation, at all levels, asking: ‘What went well? What can I be doing better?’. Implementing a clinical governance framework will assist providers to consistently deliver good clinical outcomes for all patients and meet their requirements under various sets of standards.

The requirement for a clinical governance framework is consistent across the major national standards that apply to providers who may deliver clinical services to consumers, including the RACGP Standards for general practices, the National Safety and Quality Health Services Standards and the Aged Care Quality Standards. Although the three standards have different underlying approaches to clinical governance that are specific to their relevant service providers, there is commonality across all three in their focus on key areas including risk management, continuous quality improvement and consumer-centred care.

The Aged Care Quality Standards require aged care services that provide clinical care to demonstrate the use of a clinical governance framework (Standard 8, 3(e)). Standard 8  – Organisational Governance – of the Aged Care Quality Standards requires a clinical governance framework to be in place, which “includes but is not limited to” processes to address antimicrobial stewardship, minimising the use of restraints and practising open disclosure.

To supplement these high level requirements in the Aged Care Quality Standards, and to provide more practical assistance to providers, the Aged Care Quality and Safety Commission has released a number of resources that address clinical governance at a more granular level, and detail the processes that should be in place for a clinical governance framework. The Commission has worked with a number of stakeholders to develop these resources to help providers enhance patient care and safety, allocate resources effectively and work towards continuous improvement.

Roles and responsibilities

Clinical governance encompasses all of the relationships within the service, and the way they work together to deliver safe and high-quality care. A key element of implementing clinical governance in practice is understanding what everyone’s responsibilities are, what they should be held to account for and how you can support them to fulfil their roles. Implementing a clinical governance framework not only assists all stakeholders to understand their roles and responsibilities, but creates an environment where clinical care can thrive because all team members accept responsibility for ensuring effective care.

All stakeholders must be involved in the implementation of the clinical governance framework, from the governing body, which plays a key role in implementing and reviewing clinical governance processes, right down to the consumers who play a role in working in partnership with the organisation.

     ·      Governing Body

The governing body is accountable for clinical quality and safety and the clinical governance arrangements within your service. Governing body members should set a clear strategic direction and organisational culture that drives safety and quality in care. 

     ·      Senior executives

Senior executives are responsible for visibly supporting and implementing the culture around clinical care set by the governing body, as well as reporting against the framework’s KPIs. They assist with ensuring that information, support and opportunities are provided to the workforce to assist them to understand their roles.

     ·      Operational managers

Operational managers must manage the implementation of clinical governance measures and support the workforce in implementing the framework.

     ·      Staff members

All members of the workforce have a role in providing care to consumers. They must prioritise the provision of safe, quality care and services to consumers in everything that they do. 

     ·      Health practitioners

Health practitioners are accountable for delivering clinical care that meets relevant professional standards. 

     ·      Consumers

Consumers themselves play a crucial role in the implementation of a clinical governance framework. Their communication of their preferences for clinical care, engagement with staff in the planning and delivery of their clinical care, and their feedback about their experiences are important elements of the clinical governance framework.

How can we help?

Our new clinical governance self-assessment is based on the resources developed by the Commission, and will assist providers to put in place and monitor the core elements of their clinical governance framework.  It will also help you to ensure that each stakeholder group understands their roles and responsibilities, and contributes to the process.

The self-assessment addresses the following areas:

  • Leadership and culture
  • Consumer partnerships
  • Organisational systems
  • Monitoring and reporting
  • Effective workforce
  • Communication and relationships

Within these areas, the self-assessment also segments the roles and responsibilities of individuals and assesses whether they are appropriately trained and have the competence to fulfil their roles.

Completing the self-assessment will help you implement best practice by identifying any gaps or opportunities for improvement within your organisation’s clinical governance systems and processes.

You can find the new self-assessment in SPP under the Standards tab > Australian National Standards.

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You have policies and procedures – but are they being implemented?

Posted on by Beatrice Hobson

A common theme across just about all standards that apply to community and health service providers is a requirement to have appropriate policies and procedures in place in order to:

  • ensure the delivery of safe and high-quality services to clients, and
  • meet the governance and quality management requirements of the standards and legislation that applies to them.

But having policies and procedures in place is only the first step.  Even more important is that the policies and procedures are specific to the services and operations of each individual provider, and that they are understood and followed by all workers.

We’ve reviewed a number of recently published audit reports, and we’ve also had some discussions with auditors, and it is clear that some providers fall short along the way to actually implementing their policies and procedures across their organisation.  The consequences of this can be very serious, ranging from unprepared or ill-informed workers, through to the delivery of services that have an increased risk profile, or that are unsafe.

For example, in one recent audit it was found that while the provider had an open disclosure policy and risk framework policy, workers were not consistently following procedures in relation to risk management and incident and feedback identification, and so these were not effective.

In another audit, a provider was found to be non-compliant in their medication management.  Despite the provider having a policy for medication management, workers demonstrated poor practices, including leaving medication out and not keeping them secured. Additionally, despite the service having an incident reporting system, many workers appeared to not use or be aware of the system.

In a number of cases, auditors have reviewed providers’ policies to find that they didn’t even refer to the correct organisation, or the specific services delivered by that provider.  A very early indicator to an auditor of a shortfall between documentation and implementation!

So, how can providers improve the consistent implementation of relevant and appropriate policies and procedures across their organisation?

We’ve set out below some key principles that should be followed.  As well as a couple of key actions.

The policies and procedures must reflect how your particular organisation operates, the services you deliver, and the types of clients to whom you provide services 

  • Auditors report that policies often fail to reflect the practices of the organisation and the skill base of the staff.  Your policies need to be relevant to your organisation and the needs of your consumers.  When tailoring policies to your organisation, consult with consumers, other relevant stakeholders and your workers, to ensure that they reflect the needs and rights of consumers as well as the capabilities and expected practices of workers.


    Policies and procedures also need to address and meet the specific requirements of the legislation and service standards that apply to your organisation, so ensure you refer to and understand the relevant legislation and service standards that apply.  Ensuring that policies and procedures reflect how your organisation operates means that they will underpin consistent practices and service delivery across the whole organisation.

Ensure that staff have read, and understand, your organisation's core policies and procedures 

  • Auditors have provided feedback that organisations often fail to adequately communicate policies and procedures to staff.  You should ensure that each worker reviews, considers and acknowledges their understanding of policies.  To ensure that staff have read and understood them, you can distribute a core pack to each worker containing the relevant policies and procedures, and then structure discussion sessions so that they understand what these mean in practice.  You could maintain a record that each worker has acknowledged receipt of, and read and understood the core pack, for example:

     “I, [insert name here], confirm that I have read and understand the organisation’s policies and procedures relating to (e.g. Client rights, medication management, complaints management, Code of Conduct, incident reporting etc).

    Policies and procedures should be easily available to staff on an ongoing basis, so that they can re-familiarise themselves with them as needed.

Boards play an important role in implementation 

  • Board members play a critical leadership role in setting expectations for behaviour and organisational culture.  They have a responsibility to ensure that policies and procedures are in place, so that all aspects of the business are functioning in line with their purpose and objectives.  Board members should create a culture of review and understanding of policies and procedures.  They need to periodically evaluate the policies that are in place, and be alert to the need for new or updated policies.

Policies and procedures must grow with the organisation 

  • The organisation’s policies and procedures should reflect its sense of identity, its approach to service delivery and the standards it expects of all workers – and these policies and procedures must also be living documents.

    They must be reviewed and updated regularly, to take into account changes to or expansion in services provided, experience from incidents and near misses, as well as feedback and complaints.  Auditors often find that as organisations grow, sometimes their policies and procedures do not adapt to reflect these changes and growth.  Organisations can then find themselves providing certain supports that their policies and procedures don’t address.  It is important for senior management and the governing body to review and update policies regularly throughout the year, so that they reflect any changes.  A good way to implement this is to incorporate a review of policies into regularly scheduled meetings.  

Reinforce policies and procedures through training 

  • Auditors have also found that staff are often not provided with regular refreshers of policies and procedures, some of which may have been amended or updated.  In addition to new staff receiving training on policies and procedures, six monthly refreshers could be scheduled (and records of attendance kept), to ensure that all staff remain familiar with current policies and procedures and are trained on any new requirements, for example for any new or specialised service delivery.

The delivery of consistent, safe and high-quality services does not just depend on having policies and procedures in place for your organisation.  You must ensure that they reflect the services that you currently provide, how you provide those services, and that they are understood and followed by all workers.

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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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The importance of spiritual health when delivering quality care

Posted on by Beatrice Hobson

Over the past few decades there has been a move towards a more holistic concept of care that includes emotional, physical, social and spiritual aspects.  Consideration of a patient’s spiritual health has been identified as a key component when providing high quality health care.  Research has demonstrated that patients want their spiritual needs considered as part of their overall health care, and that an increase in discussion around spiritual beliefs strengthens the trust between the provider of services and their client or patient.

Everyone has spiritual needs – for some, this is intertwined with their religious beliefs, and for others it may involve a search for a deeper understanding of their purpose and meaning.  Spirituality plays many roles in the lives of patients and of those who are elderly.  For many patients, spirituality can help them cope with health outcomes, and contribute to their having a more positive outlook on life.  Spiritual care often holds greater importance at the end of one’s life, when it can help a person explore what has given meaning to their life, and reduce their stress as they contemplate dying.

Spirituality has also been found to assist with recovery, and spiritual practices such as meditation have been found to improve health outcomes through increasing relaxation.  Spirituality is an important aspect of health, and assists with coping with changes to health and maintaining positive wellbeing throughout the recovery process.

How can your organisation ensure that people's spiritual care needs are met?

Spiritual Health Association’s Guidelines for Quality Spiritual Care in Health, and Meaningful Ageing Australia’s National Guidelines for Spiritual Care in Aged Care were both developed with extensive stakeholder consultation and research, to help providers implement a nationally consistent and best-practice approach to spiritual care.  The two guidelines provide a wealth of information and resources, within their frameworks, to assist providers and practitioners to deliver spiritual care services in a way that ensures high-quality and safe care, and which addresses each person’s individual needs.

Guidelines for Quality Spiritual Care in Health

These Guidelines emphasise the importance of considering the whole person when providing person-centred care.  They provide a standardised and consistent approach to spiritual care, which aligns with the National Safety and Quality Health Service Standards, the National Palliative Care Standards, and evidence-based care.  They focus on responsive and respectful patient-centred care and serving all aspects of patient care.  The Guidelines assist providers with the delivery of quality, evidence-based care through offering a consistent approach to the provision of best practice spiritual care in health services. 

National Guidelines for Spiritual Care in Aged Care

The National Guidelines for Spiritual Care in Aged Care state that “spirituality is integral to quality of life and well-being and it should be accessible to all older people in a way that is meaningful to their beliefs, culture, and circumstances”.  The Guidelines reflect best practice and highlight that the offering of spiritual care is the responsibility of all caregivers.  The guidelines provide resources and suggestions, as well as ideas for implementation.  They are intended to offer spiritual care and support to older people living in residential aged care or receiving care and support through home care packages. 

Assess your organisation's approach to spiritual care

In order to provide more holistic and high-quality care, organisations should work towards embedding spirituality into their key systems and processes.

We’ve developed self-assessments in Standards & Performance Pathways (SPP) for each of the two Guidelines.  Using SPP’s new self-assessments will assist organisations to better understand the best-practice frameworks for delivery of spiritual care, and track their progress over time towards delivery of those best practices.

You can find these self-assessments in SPP under the Standards tab > Australian National Standards.

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Aged Care Diversity Action Plans

Posted on by Beatrice Hobson

The ageing population in Australia is increasingly diverse, with one in three older Australians born overseas. Aged care facilities have not always responded well to these diverse needs and often do not reflect the diversity of the wider population. Without taking specific actions to address the diversity of consumers in care, there is a risk that older people can be left feeling neglected and isolated.

A recent hearing on diversity in aged care in the Royal Commission into Aged Care Quality and Safety heard of instances where providers have failed to accommodate diverse older people. Malloy, a lesbian woman in her 80s, spoke of the discrimination that she has felt in aged care facilities, and highlighted the lack of awareness and the discrimination that she had experienced from staff.

Providing residents with choice and control is central to Standard 1 of the Aged Care Quality Standards: Consumer Dignity and Choice. To exercise this choice and control, residents need to have their diverse needs catered for.

In 2019, as part of the Aged Care Diversity Framework initiative, the government released four Diversity Framework Action Plans. These action plans outline procedures that can be taken to support all diverse groups of older people. These plans are not mandatory compliance requirements, however they guide organisations in delivering more inclusive and culturally appropriate services to all older people.

BNG has developed self-assessments in Standards & Performance Pathways (SPP) based on the action plans, to help guide your organisation in delivering a safe and inclusive service environment for individuals. There are three levels of each action plan to work through: foundational actions, next steps and leading the way. The action plans acknowledge that each provider is starting from a different place and therefore allow providers to work through three different levels according to what is most relevant to their services and client base.

The four diversity action plan self-assessments are:

This self-assessment assists providers in creating a more safe and inclusive service for all diverse older people. The action plan recognises that there is no ‘one size fits all’ approach to diversity. Taking steps to make the services more inclusive for diverse older people means better engagement with existing and potentially new consumers, improved wellbeing for consumers and new partnerships built within the community.

While the national Aboriginal and Torres Strait Islander population is projected to grow by 59% between 2011 and 2031, the Aboriginal and Torres Strait Islander population aged 65 and over is projected to grow by 200%[1]. This means that aged care facilities need to respond to the growing demand from older Aboriginal and Torres Strait Islander people. Aged care providers need to ensure that they are working to address the current barriers to service access that many older Aboriginal and Torres Strait Islander people face, and ensure they receive culturally appropriate services.

Many older CALD Australians face additional barriers to access and awareness of aged care services. In June 2015, only 18% of people in permanent residential aged care were from non-English-speaking countries, which is not reflective of the fact that around 33% of people in the wider community were born in a non-English-speaking country[2]. As a bilingual person ages, they can lose the English skills that they have acquired over their lifetime and revert back to their original language. This means that additional support needs to be provided to allow older CALD people to access aged care services, and ensure they receive culturally appropriate care.

BNG has an interpreter services policy that can be a useful resource for organisations when providing care to older CALD people.

The action plan acknowledges that many older LGBTI people have faced significant discrimination and neglect throughout their lives. This means that many older LGBTI people may be ashamed or may face significant anxiety in expressing themselves. Organisations should be considerate of this experience and build confidence among older LGBTI people by providing the support and care that they need.

The action plans have been developed to assist aged care providers to ensure continuous improvement in providing care that meets the diverse characteristics and life experiences of all clients. Completing the new self-assessments in SPP is a simple way for providers to incorporate the Aged Care Diversity Framework into their service delivery, and work towards best practice in tailoring their care to assist individuals.

[1] https://www.health.gov.au/sites/default/files/documents/2019/12/actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-aged-care-providers.pdf
[2] https://www.health.gov.au/sites/default/files/documents/2019/12/actions-to-support-older-cald-people-a-guide-for-aged-care-providers.pdf

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Intimacy and sexuality in aged care

Posted on by Beatrice Hobson

When we talk about the elderly, the topics of sex and intimacy are often taboo. There is a common misconception that older people lack sexual drive, however intimacy, sexuality and sexual expression continue to be important throughout our lives.

Understanding and supporting the sexual and intimacy needs of older individuals can be challenging for staff who have limited training in the area. The area of sexuality and intimacy remains largely misunderstood and often ideas about sexuality and intimacy are informed by cultural and social constructions. Understanding the needs of older individuals is an ongoing responsibility that requires special skills and knowledge. Having a policy is essential for addressing embarrassment, confusion and helplessness around the area and for training staff to provide this level of care. Neglecting these needs can cause mental health issues and can affect self-esteem for elderly residents.

In late 2018, a research report by the Australian Centre for Evidence Based Aged Care found that less than a quarter of Australian residential aged care facilities surveyed had a policy on sexuality or sexual health, and less than one-tenth reported having a written policy. This means that the sexuality and intimacy needs of residents are at risk of being mishandled or ignored.

Policies regarding sexuality and intimacy are important to guide staff through this sensitive topic. Helping residents to connect with others and maintain relationships, including intimate relationships, is an important component of Standard 1 of the Aged Care Quality Standards: Consumer Dignity and Choice.

To help you support clients with their needs surrounding intimacy and sexuality, BNG has developed a policy and an information sheet. These outline:

  • how to maintain an inclusive environment within the organisation;
  • the importance of recognising the diversity of residents and that they all have different needs and preferences;
  • how to start a conversation around the sexual and intimacy needs of the individual;
  • how to handle unwanted or inappropriate sexual behaviours;
  • the importance of respecting the privacy of individuals; and
  • the importance of recognising the diversity of residents and treating things on a case by case basis.

The new resource will help you to develop answers for questions such as what to do if:

  • A couple moves into a residential facility, but there are no shared rooms?
  • A resident asks to pay for the weekly visits of a sex worker?
  • A resident wishes to continue to express themselves the way they did in their own home?
  • A resident is showing inappropriate behaviour towards another resident?

These are now available in SPP:

  • Policy: Intimacy and Sexuality in Aged Care
  • Info sheet: Intimacy and Sexuality in Aged Care

You can access these resources by searching for “Intimacy” in the Reading Room. 

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Preventing and responding to abuse

Posted on by Beatrice Hobson

The Royal Commission into Aged Care Quality and Safety  hearings to date have highlighted that many older Australians experience serious instances of abuse and neglect. Similarly, people with a disability are 10 times more likely to experience violence than people without a disability, and the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability  has been established in response to the seriousness and prevalence of these incidents.

With these Royal Commissions bringing the issues of abuse and neglect to the fore, now is a landmark period for organisations to re-assess how they are protecting human rights within their operations.

It is paramount that organisations are working to prevent abuse wherever possible, and have effective policies and procedures in place to respond to instances of abuse.

Some important elements of preventing abuse include:

  • Policies and guidelines that protect an individual’s rights
  • Empowering the elderly and people with a disability
    • Informing them about the rights that they possess
    • Ensuring that clients feel respected and valued in the organisation
  • The organisational culture
    • Ensuring that the staff screening process is thorough
    • Ensuring that workers undertake training in abuse prevention and client rights
    • Ensuring that there is a positive culture of feedback and complaints, encouraging people to speak up

It is essential that in cases where incidents do occur, the organisation responds appropriately. We have developed some new resources to help organisations implement processes to prevent and respond appropriately to abuse.

Find our policy and information sheets in SPP’s Reading Room:

  • Policy: Responding to Abuse
  • Info: Responding to Abuse

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