We all have a vested interest in aged care. Whether the recommendations of the Royal Commission are sound and implemented will answer the vital Four Corners question Who Cares?
From 1 July 2018, residential aged care homes are no longer given notice of the date of their AACQA re-accreditation audit. Under a crackdown by the national auditor following the Oakden scandal, unannounced audits are catching some homes out, who are failing to meet all 44 expected outcomes.
When a home fails to meet the Accreditation Standards, the Quality Agency may put the home on a Timetable for Improvement (TFI). A TFI sets out the improvements and the maximum time allowed to address the expected outcomes not being met by the home. The Quality Agency then monitors the home’s progress in meeting the Accreditation Standards.
Because residential aged care homes are required to meet the Accreditation Standards at all times and ensure that care of residents is not compromised, it is vital that the home resolves the non-compliant issues promptly, and in any event, by the end of the timetable.
If not, the Quality Agency may conduct a review audit and may vary or revoke the home’s accreditation. In addition, the Department of Health may decide to impose sanctions on the home.
In the 2017-18 year, 194 residential aged care homes did not meet outcomes. This financial year may see the numbers soaring with government cracking down on Auditors and homes. Three months in, previously compliant homes are not meeting outcomes and receiving TIFs. Since 1 July, 46 homes have received non-compliance notices and 11 sanctions have been put in place.
Audits currently include reviewing documents, onsite observation and interviews with residents, family, management, care staff, hospitality staff and allied health. A mass of documentation is considered in addition to care records including food & equipment temperature records, cleaning schedules, duty lists, emergency contact list, external agreements, fire service documents, staff appraisals, professional registrations, staff and volunteer orientation pack, hazard reports and meeting minutes. It seems no stone is left unturned. This will continue.
While the expected outcome of current Standard 2.10 requires that “care recipients receive adequate nourishment and hydration”, the new standards coming into effect from 1 July 2019 will focus on Standard 1 Consumer Dignity, Autonomy and Choice. Nick Ryan, CEO of AACQA, recently advised the focus for Auditors will be to interview residents, looking for evidence that Standard 1 is being met. In other words, person-centred care will be central to the new standards.
Aged care is in transition and under attack. Providers are an increasingly diverse mix from those listed on the ASX to long term standalone “not for profit” organisations without the strategic, financial or technological smarts corporates take for granted.
Inevitably there will be more consolidation and more media savvy corporates with shrewder lobbying skills. Time will tell whether that delivers improved quality of care or a lowering of quality benchmarks.
Strategic providers are already implementing continuous quality improvement strategies now to ensure they hit the ground running from 1 July 2019. A major part of this is the meal service and dining experience, frequently top of mind for residents.
Dining Experience Specialists have been undertaking meal service and dining experience projects at residential care homes for 6 years aged care projects across Australia for 30 years through Blue Chip Consulting Group. We are constantly reminded how tough it is to deliver quality care services to increasingly frail and complex residents through multi-disciplinary staff 24 hours a day, 365 days a year.