Feb 20, 2019

Unannounced Spot-Checks, That Are Not So Unannounced


Well over a year ago, Aged Care Minister Ken Wyatt signaled the Government’s intention to introduce unannounced audits and spot-checks in Australian nursing homes as a means to ensure that high standards of care were being met.

For those of us with loved ones being cared for in aged care facilities, this news was a relief, and many hoped that having unannounced visits would provide the insight and transparency needed to give an accurate assessment of the quality of care being provided by facilities.

Recent findings from within the Aged Care Royal Commission have exposed potential  inadequacies and conflicts of interest in the auditing process.

The Head of Aged Care Quality and Safety Commission, Ms. Janet Anderson, announced that some of the people who have been hired to audit aged care facilities actually work simultaneously as consultants for aged care facilities.

One quick browse through the pages of Linkedin reveals that some of the assessors being used to perform these audits also hold current managerial positions at various aged care facilities.

Ms. Anderson told Commissioner Tracy that she was aware of the implication that there may be conflict of interest with having the aged care industry investigated by people who actually work within the industry.

But, Ms. Anderson expressed to Commissioner Tracy that auditors were obliged to adhere to a code of conduct. And that she was confident that they have managed these risks.

One of the obvious problems with having aged care auditors that work within the actual industry is the fact that they are privy to information of upcoming audits.

And they also have an acute awareness of what areas are being looked at closely, and what needs to be done in order to meet the standards.

And regardless of any scrutiny being placed on the auditors to do their job fairly, the risk of employing people that have the ability to forewarn aged care facilities of upcoming inspections is a risk that the Aged Care Quality and Safety Commission did not need to take.

There are countless ex-nurses and ex-aged care employee who possess the wealth of experience needed to fairly inspect and audit aged care facilities, many of which who no longer hold ties to anyone within the industry.

And having an industry being inspected by an outside source lessens the risk of collusion and increases the chances of fair reporting.


When Risks Become Realities

The Aged Care Quality and Safety Commission recently actioned an unannounced visit on a well known Australian nursing home as part of their commitment to providing transparency on the inner workings of Australian nursing homes.

But, there has been concerns raised on how anonymous these unannounced visits truly are.

According to one anonymous resident within that home, the day when auditors arrived did not truly represent the ‘normal day operations’ within that facility.

“There was roughly three times the normal amount of staff working on that day. People were constantly coming into my room and asking how I was going, I didn’t even understand why things were so different,” anonymous said.

The anonymous aged care resident has spent the last 5 years living in this particular aged care facility, and despite this person’s advanced age, their cognitive abilities and experiences within the facility made it easy to recognise the sudden changes that occurred within the home on the day of the unannounced check.

“It started from the second I woke up. There were people everywhere helping me and talking to me, and this is not normally how things go. I knew something must have been happening. But it was nice having more people around to talk to.”

Unfortunately, the idea that aged care facilities are given warning of upcoming unannounced checks are not a revelation within the aged care industry itself, and we have heard many stories from both staff and residents from within the facilities that echo the same sentiments.

The Aged Care Quality and Safety Commission have the responsibility of being the watchdog that ensures a realistic understanding of the level of care being given within aged care facilities.

But despite any good intentions, employing people with interests within an industry, to provide accurate and unbiased assessments of that industry, is not conducive with impartial reporting.

And those within the industry need to ask themselves exactly whose best interests they have at heart, and whether they want to do the right thing or just appear to be doing the right thing.

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  1. I think it’s a sad day when we see seemingly informed people jump to conclusions left, right and centre. Next we’ll be saying that shareholders in companies have a conflict of interest in decision making. Of course there are potential conflicts of interest and like all conflicts, there are processes to manage them. The health and care industry needs people who understand how the system works now and as such, it needs people with skills and experience in the industry to do that. Holding concurrent appointments is not a conflict, it’s a potential conflict that needs to be managed. The public health system also in Australia relies on a workforce of more than 70% of current health accreditors holding appointments in health services. They are specifically trained for this role and are subject to ongoing review. Let’s not poke every aspect of the aged care system. Let’s have an honest conversation instead.

    1. Why not “poke at every aspect” of the aged care system. Last time I looked, every part contributes to making a whole. And as to the comments “let’s have an honest conversation instead”, then I suggest that this might apply to you. To say that aged care managerial staff do not have a conflict of interest when they undertake the audits themselves is an absurdity. Those inspections MUST be undertaken by people who are at arms lengths from the facilities. As to “code of conduct” – very nice words – but we don’t have to look too far to see people in managerial positions and other senior position to see have “well” they adhered to it.


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