Government Review Prompts 10 Recommendations to Ensure the Safety and Quality of Care for the Elderly

After months of research, and consumer and staff submissions, the independent review of the Commonwealth’s aged care quality regulatory processes is completed.

This review was proposed by the Aged Care Minister, Ken Wyatt, after failures of regulatory bodies to recognise issues that were occurring at South Australia’s Oakden facility, where there were reports of poor care and abuse.

At the beginning of May it was announced that there would be a review of the agencies involved in regulating the quality of care in residential aged care.

There will be a particular focus on roles of the Australian Aged Care Quality Agency, the Aged Care Complaints Commissioner and the Department of Health.

The review will primarily examine the Commonwealth Government’s accreditation, monitoring, review, investigation, complaints and compliance processes.

The Aged Care Minister appointed a two person panel to lead the independent review.

This panel includes Kate Carnell, a veteran public administrator and regulator, and Professor Ron Paterson, who is an international expert on patients’ rights, complaints, health care quality and the regulation of healthcare professions.

What were the recommendations of the review?

The report includes ten recommendations to increase the effectiveness of aged care quality regulation.

1. Establish an independent Aged Care Quality and Safety Commission to centralise accreditation, compliance and complaints handling.

It has been suggested that the Aged Care Commissioner could chair an umbrella regulatory body, overseen by an Aged Care Commission Board, with a Care Quality Commissioner a Complaints Commissioner, a Consumer Commissioner and a Chief Clinical Advisor.

2. The Aged Care Commission will develop and manage a centralised database for real-time information sharing.

So that there is better care, The Australian Health Ministers’ Advisory Council (AHMAC) have asked to consider ways to improve sharing patient /resident information between state operated acute and mental health services and the Commission.

With information being better transferred, it allows carers and agency to know the person better and make better informed choices in care.

3. All residential aged care services in receipt of Commonwealth funding must participate in the National Quality Indicators Program.

While the regulatory system prescribes minimum standards, the National Aged Care Quality Indicator Program aims to promote continuous quality improvement using evidence-based performance measures. This is a voluntary program, under which providers of residential care can compare their performance on a number of quality indicators against national data.

4. The Aged Care Commission will implement a star-rated system for public reporting of provider performance.

It has been recommended that residential aged care services are rated against key domains, where they adopt mandatory reporting of provider performance against quality indicators.

This information would be published in residential service performance reports on the My Aged Care website and allow consumers to compare the performance of residential services in a particular area.

5. The Aged Care Commission will support consumers and their representatives to exercise their rights.

The Consumer Commissioner, in partnership with the Complaints Commissioner, will promote and protect consumer rights.

All approved providers must inform and educate consumers and their representatives about consumer rights and must ensure all staff undertake regular Older Persons Advocacy Network education on consumer rights.

6. Enact a serious incident response scheme (SIRS) for aged care.

The SIRS will require approved providers to inform the Aged Care Commission of any allegations or suspicions on reasonable grounds of a serious incident, which would be investigated and then have findings and action taken.

The Aged Care Commission will monitor and oversee the approved provider’s investigation of, and response to, serious incidents and will be empowered to conduct investigations of such incidents.

7. Aged care standards will limit the use of restrictive practices in residential aged care.

This is in reference to the use of physical and medical restraints.

Any restrictive practice should be the least restrictive and used only as a last resort, after alternative strategies have been considered, to prevent serious physical harm.

Approved providers must record and report the use of restrictive practices in residential aged care to the Aged Care Commission.

Chief Clinical Advisor must approve the use of antipsychotic medications for aged care residents.

8. Ongoing accreditation, with unannounced visits, to assure safety and quality of residential aged care.

Announced accreditation visits will be replaced with unannounced audits across Australia’s residential aged care facilities, to help ensure safe, quality care standards are maintained at all centres at all times.

This new process would eliminate re-accreditation visits and replace with unannounced visits, which are conducted over at least two days, where they would assess residential service performance against all standards.

9. Ensure that assessment against Standards is consistent, objective and reflective of current expectations of care.

This would require work with the Australian Commission on Safety and Quality in Health Care to develop a clinical governance framework and clearer guidance on the assessment of clinical care measures to ensure they are fit for purpose for residential services.

10. Enhance complaints handling.

Submissions to the review reported widespread dissatisfaction with complaints handling by facilities and by the Aged Care Complaints Commissioner.

It has been advised that all residential aged care providers must have well-publicised, clear, prompt and fair complaint handling processes. The new Complaints Commissioner within the new Aged Care Commission must be an exemplar of prompt and fair complaint handling.

The Minister has announced that the Government supports the broad direction of the  Carnell and Paterson Review and have also agreed to implement, as soon as possible, the recommendation to eliminate announced reaccreditation audits and replace them with unannounced audits.

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