May 29, 2019

New aged care regulations expected to cause spike in non-compliance

The new aged care regulations are due to come into effect on 1 July, and while providers have been busy preparing for the change, there remain some gaps that could make it difficult for them to comply and the Quality Commission has said it expects a spike in non-compliance.

At the Criterion Governance in Aged Care conference held in Sydney today, Pat Sparrow, CEO, Aged and Community Services Australia, said that while ACSA support the new quality standards, some gaps in the guidance materials remain that could make it difficult for providers to comply.

“I am most definitely not contesting the new regulations,” she said. “Most people agree with the new standards.”

The new standards require new attitudes, new policies, new procedures, new systems, and new training, she noted.

“But there are some real issues we need to talk about,” she said.

Guidance materials only released four months ago

Ms Sparrow said the guidance materials for providers have only available for four months.

“We’ve known they’ve been coming for 12 months, but the guidance materials only been made available in the last four months,” she said.

Pat Sparrow, CEO, ACSA speaking at Criterion’s Governance in Aged Care conference.

Ms Sparrow also noted that there are some gaps in the new regulations, meaning it’s almost impossible for providers to know how to fully prepare, even at this late stage.

Open disclosure framework needs to be “nailed down”

“We’re still waiting for open disclosure framework,” she said.

The current definition is “much broader” than the health department’s. She said ACSA’s view is some issues are better dealt with through feedback and complaints, rather than the open disclosure framework.

“It’s very important it’s nailed down,” she said. “There’s going to be incredible confusion when assessors come in if we haven’t got the framework locked in for open disclosure,” Ms Sparrow said.

Ms Sparrow also said she was concerned about the time and resources it will take to have all aged care residents and recipients of home care services sign a charter of rights.

Questions remain about consent in cases of chemical constraint

Clinical guidance materials, which lay down the requirements for the use of physical and chemical restraints, are not out yes, Ms Sparrow noted.

“Consent in relation to chemical restraint needs to be clarified,” she said, as the draft legislation is “silent on this point”.

Ms Sparrow said there is confusion about who is responsible for consent when prescribing chemical restraint. Some believe it is the provider’s responsibility, while others say it’s the doctor.

Ms Sparrow said ACSA is working with the AMA on this point.

Ms Sparrow said there was also concern about the level of training of the assessors, especially around being able to communicate with those living with dementia.

“With 5.5, six weeks to go, we have a number of things that are not clear. We can’t be 100 per cent ready for 1 July until we are clear, and we’ve only had the guidance materials for four months,” Ms Sparrow said.

“We expect a spike in non-compliance”

A member of the audience asked if providers will be given a transition period to comply fully when the new standards come in on 1 July.

“It’s unlikely there’ll be grace period,” Ms Sparrow said, noting the intense scrutiny the sector is under.

Pam Christie, executive director, industry engagement and communications with the Aged Care Quality and Safety Commission, said it’s likely some providers won’t meet the new quality standards when they come in on 1 July.

“We do expect a spike in non-compliance, and that’s what everybody does expect,” she said.

While the Quality Commission will have an obligation to notify the provider, set a timetable for improvement, and to notify the Department of Health, “we do have the ability to be proportionate in how we respond,” she said.

“If it is an isolated incident of non compliance and the provider had a good history of compliance, then the response is going to be different than if we’re very concerned about safety,” she said.

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