Jun 28, 2019

Provider fears introduction of new standards will be “trial and error”

On Monday, one of the most significant changes to the Australian aged care sector in decades will take place, as the industry shifts to a new quality framework.

Aged care operators will be assessed for the first time on a new set of quality standards that are based on ‘person-centred’ care.

Anton Hutchinson, whose family has owned and operated the Canberra Aged Care Facility for 35 years, spoke to HelloCare about the home’s readiness for the change. 

Mr Hutchinson said he and his staff are “quietly confident” they will be able to meet the new standards when they are first audited under the new regime. 

“I think we’re ticking all the boxes,” he said.

But he said even though management and senior staff have done all they can to prepare, some uncertainties remain.

“We have moments of thinking we’re really on it, and then something else comes through and we think, ‘oh god, maybe we’re not’,” he said.

“The registered nurses and other staff, they don’t really know (about the changes), they’re a little bit naive about it. 

“I think that’s good,” Mr Hutchinson said. 

“They don’t have to take that responsibility,” he said.

Goalposts are moving

Mr Hutchinson said there are 300 fewer operators in the sector than there were two years ago because it harder for operators to comply with standards.

“We’re confused about where the goal posts are,” he said.

Canberra Aged Care has not been immune, he said.

The facility has always complied with all 44 of the quality standards “until last year”, Mr Hutchinson said, when they were “given a flogging” by assessors. However, Mr Hutchinson said the facility was able to address all concerns.

“We’ve had three accreditation visits in the last six or seven months, and on each occasion the goal posts aren’t where they were last time.”

“The industry’s feeling a little bit tentative about the new standards,” he said, “mainly because it depends on which assessor comes on the day.” 

Compliance has become an exercise in “box ticking”

Mr Hutchinson said he is concerned “box ticking” to achieve compliance is taking away from hands-on care.

“Unfortunately, box ticking almost now takes the place of hands-on care,” he said.

Mr Hutchinson said his organisation has installed new software to make compliance as efficient as possible.

“We’ve just changed over to person-centred software,” he said.

“All the girls and guys are getting around with little phone-type laptops. Every time they go into a room, they press a button for showering, toileting, feeding, and (to show) Harry’s health. But that takes time away from hands on care,” he said.

Compliance is adding to costs when operations already feeling the pinch

The new compliance regime has added to his facility’s workload and increased costs, Mr Hutchinson said.

“We’ve maintained our staff levels, while lots of other places haven’t, and that’s been at our peril. We’re certainly one of the 45 per cent,” he said, alluding to the recent StewartBrown report which stated nearly half of operators are operating at a loss. 

Mr Hutchinson said he and his wife, who remain involved in the business, have not drawn a wage for 15 months. 

“To remain compliant, we’ve put on a second clinical manager, because the compliance burden is growing. It’s astronomical. 

“Unfortunately that clinical manager is just for compliance – it doesn’t create one ounce of face-to-face care time for a $90,000 cost,” he said.

Information from the department is “scarce”, “not clear”

Mr Hutchinson said the information their facility has received about the new standards has been “scarce” and “not clear”.

Training and education ahead of the new standards has “definitely not” been sufficient, he said.

Mr Hutchinson said, in his view, compliance with the new standards will be a matter of “trial and error”.

“There’s no amnesty period to get used to it,” he said.

“It’s going to be “trial and error”, he said. 

“Trial and error’s all very good if you’re buying a jumper, but trying to deliver care on a trial and error basis, when you don’t know where the goalposts are, there’s so much (left to) interpretation,” he said.

New psychotropics form “best thing in 30 years”

On a brighter note, Mr Hutchinson said a new assessment form to help aged care facilities manage the use of psychotropic medication and show compliance is “the best thing they’ve done for us in 30 years.” 

“They said, ‘here’s the form we want you to use. And when they (the assessors) come in to check, this is what we want to see’.” 

Mr Hutchinson said when they received the forms, his team “just smiled” and said ‘that’s so helpful’.”

“If every facility across the nation had identical documentation (as with these forms), we’d all be measured on the same yardstick,” he said.

“It’s a great sign, I’d love to think they were going to continue with other areas.”

Greater opportunity for non-compliance under the new standards

Mr Hutchinson said he’s concerned there is more opportunity for non-compliance under the new standards.

“I think taking them (the standards) from four to eight… gives them (the assessors) a bigger opportunity to cross reference and fail (facilities). If you fail 1.1 continuous improvement, you’ll probably fail 2.1, 3.1, and 4.1,” he said.

“More people will be non compliant for basically the same issue,” he said.

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