Aged Care Quality Bulletin #67 - July 2024
In this issue
Commissioner’s message
Earlier this month I hosted a webinar to introduce the Commission’s new Regulatory Strategy for 2024–25. We have refined our strategy to ensure that we, as the national regulator, are ready for the anticipated introduction of the new Aged Care Act. If you missed the webinar, I encourage you to watch the recording.
The updated Regulatory Strategy describes how we will deliver on our commitment to protect older people, and how we hold providers and workers to account. It sets out for providers and workers what we expect from them and how we will engage with them. Importantly, it also explains what older people and their families, as well as providers and workers, can expect from us.
Founded on best practice principles, the strategy describes how we aim to be fair, balanced and effective in all that we do. The strategy will be available on our website in coming weeks.
COVID-19 vaccination rates among aged care residents continue to be a matter of keen interest in the context of ongoing outbreaks in aged care facilities. The Commission expects providers to ensure that all older people in their care have timely access to vaccinations and anti-viral medications as part of routine care planning and clinical care. For this reason, we are seeking explanations from providers that have low vaccination rates. If we find that providers are putting residents at risk by not meeting their vaccination responsibilities, we will take compliance action.
Vaccination is the best defence to reduce the risk of serious illness and death of older people from COVID-19. Residential providers must make sure they support their residents to make informed decisions about vaccination and help them to access COVID-19 vaccinations. They also need to have strong infection prevention and control measures in place to reduce the risk of an outbreak.
To remind providers of their vaccination responsibilities, I draw your attention to our Regulatory Bulletin and letter to board chairs of residential aged care providers. I also encourage you to watch the recording of the Department of Health and Aged Care’s webinar to help providers and workers prepare for and manage outbreaks and organise vaccination clinics.
All residential aged care providers should also be making sure they’re prepared by using the IPC operational readiness and IPC governance self-assessment checklists. If you want to set up a vaccination clinic in your facility, you can find the help you need through your local Primary Health Network or your department state or territory office.
Our reports
Sector performance – latest insights
Our latest aged care quarterly Sector Performance Report is now available. The report includes data from 1 January to 31 March 2024 (Quarter 3 2023–24).
The Commission applies the findings from the report to inform how we focus our regulatory activities. Working together with providers, our goal is to continuously improve the delivery of quality care that safeguards the wellbeing and rights of older Australians receiving aged care services.
Compliance with the Aged Care Quality Standards
Just under 1 in 7 residential aged care services and 1 in 3 home care providers didn’t meet all the requirements of the Aged Care Quality Standards.
Quality Standard 2 (Ongoing assessment and planning with consumers) and Quality Standard 8 (Organisational governance) have the lowest rates of compliance in both residential care and home services.
In home services, we found that over a quarter (26%) of all providers we audited were not complying with Quality Standard 2. Key issues included providers:
not reviewing their services
not managing risk when there has been a change in circumstances
not communicating well with people receiving care.
Complaints
In this quarter, the most common complaints were about:
clinical issues in residential care
communication and financial issues in home services.
Serious incidents
The number and rates of incidents under the Serious Incident Response Scheme (SIRS) for residential care have increased slightly since Quarter 1. The number of SIRS notifications from home services has increased steadily as providers become more familiar with their reporting obligations.
In residential care, notifications of neglect increased again this quarter by around 5%. It’s the second most common notification type after unreasonable use of force.
Analysis of patterns and trends in reporting will become an increasingly useful additional way for the Commission to identify individual providers requiring follow-up.
In focus: Food, nutrition and dining experience
We still receive many complaints about food, nutrition and dining. We highlight this in the report’s In focus article. This quarter, the quality and variety of food is the fourth most complained about issue in residential care, appearing in 26% of complaints.
Read the full report.
Pre-conference workshops report
In April this year, we hosted a day of 9 workshops prior to the National Aged Care Provider Conference 2024. The workshops focused on best practice for delivering aged care.
The 9 workshops gave providers the opportunity to come together for an informal conversation with Commission executives and other providers on a range of topics. Participants took part in frank and open discussions on what safe, compassionate care looks like, and how we can work together to achieve it.
We have now produced a pre-conference workshops report that summarises the discussions that took place in each workshop. The report lists the key themes that came out of the workshops and gives an overview of the observations panellists and participants made. These include recommendations for how the Commission can better support the sector.
Thank you to everyone who attended the workshops and shared their insights. The popularity of the workshops shows there is a lot of interest in these sorts of opportunities. Next year’s program will likely be even bigger and better.
You can also watch recordings and view presentations from the main conference sessions on our conference page.
Aged care reform update
Regulatory Bulletin on Infringement Notices
Aged care providers, workers and governing persons must comply with their aged care obligations. This includes complying with the offence and civil penalty provisions under the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018.
Infringement notices are one of the enforcement actions that the Commission can use if a person or provider hasn’t fulfilled their aged care responsibilities.
We recently published a Regulatory Bulletin on infringement notices. The bulletin explains how we issue and manage infringement notices. We encourage you to read this bulletin and the Commission’s Compliance and Enforcement policy. These documents help you understand:
what offence and civil penalty provisions are
our decision-making processes for infringement notices
what we must do when we issue an infringement notice.
If we issue you with an infringement notice, we will send you information about your non-compliance, why we have issued the notice and how you can respond. We will also send you a copy of the infringement notice regulatory bulletin.
Hear from Interim First Nations Aged Care Commissioner Andrea Kelly
Transcript for 'Catching Up With the Interim First Nations Aged Care Commissioner'
One of the recommendations of the Royal Commission into Aged Care Quality and Safety was for the Government to make a statutory appointment to a new position of First Nations Aged Care Commissioner. A principal responsibility of this new role is to make sure that Aboriginal and Torres Strait Islander peoples have access to culturally safe, tailored and flexible aged care services.
As a transitional step to this statutory role, the Department of Health and Aged Care appointed Andrea Kelly as Interim First Nations Aged Care Commissioner in January 2024. Andrea is a proud Warumungu and Larrakia woman with strong family connections throughout the Northern Territory. She has 32 years of experience engaging with Aboriginal and Torres Strait Islander communities and developing public policy for Aboriginal and Torres Strait Islander populations.
In this video, Andrea Kelly talks about her role and key functions, including:
leading extensive public consultations with Aboriginal and Torres Strait Islander stakeholders and communities about the design and functions of the permanent Commissioner
contributing to the changes necessary to bring improvements for Aboriginal and Torres Strait Islander people across all tiers of the aged care system
advocating for and promoting culturally safe, aged care for Aboriginal and Torres Strait Islander people across Australia.
Andrea says it’s important that when we consult with Aboriginal and Torres Strait Islander peoples, we really listen and try to understand their story. This is the first step in building relationships with Aboriginal and Torres Strait Islander peoples to deliver quality, safe and culturally appropriate aged care.
This is the approach the Commission has taken in our Aboriginal and Torres Strait Islander reforms communications project. This project has included widespread consultation with key stakeholders, sector peaks, providers, workers and older people and their communities. New co-designed resources are now being tested by Aboriginal and Torres Strait Islander stakeholders.
To find out more about our First Nations reforms communications project, please visit our First Nations resource hub.
Join our culturally and linguistically diverse communications project
The Commission is seeking expressions of interest from providers, workers and older people and their communities to take part in our culturally and linguistically diverse (CALD) communications project.
This is part of our national communications, engagement and education program to support providers, workers and older Australians receiving care to understand the upcoming legislative and regulatory changes. These changes include a new Aged Care Act, strengthened Aged Care Quality Standards and a new regulatory model.
These reforms respond to recommendations from the Royal Commission into Aged Care Quality and Safety’s final report. For CALD communities, the report found that people who come from diverse backgrounds and have had varied life experiences have unique challenges in accessing aged care services that meet their particular needs.
In the months ahead, we will consult with key stakeholders, sector peaks, providers, workers and CALD older people and their communities to make sure that the resources we co-design are meaningful and relevant.
To get involved and find out more information about our CALD communications project, please email agedcarecommunications@agedcarequality.gov.au
Aged care volunteering booklet
The Department of Health and Aged Care has developed a booklet about volunteering in aged care and the Aged Care Volunteer Visitors Scheme (ACVVS).
This new resource is to help volunteer managers and aged care providers improve their volunteer programs and find volunteers.
The booklet has information and practical advice to help you plan, resource and manage your volunteer program. It covers everything from recruitment to training and support for volunteers.
There is also information for people who are interested in volunteering. It offers clear, detailed information about what volunteering involves.
The booklet includes real stories about people receiving care and volunteers. By sharing these stories, the department hopes to help current and potential volunteers see the benefits of volunteering and encourage more people to get involved.
The booklet also has information about the ACVVS. It explains how the program works and how providers can refer older people into the program. It also has specific information for residential and Home Care Package providers.
Read, download or order the aged care volunteering booklet.
Monthly Care Statements
The Department of Health and Aged Care encourages all residential aged care providers to offer Monthly Care Statements to residents from 1 October 2024.
These statements will help you improve communication and develop processes and care planning with your residents. Starting the statements early will also help your planning before they become mandatory.
Monthly Care Statements give an overview of a resident’s:
wellbeing activities
nutrition and weight
medication changes
appointments.
They can also include information about a resident’s:
wound management
mobility
falls
summary information, such as diagnoses.
You’re probably already recording the information you need to start giving each resident or their representative a Monthly Care Statement.
The department is introducing Monthly Care Statements because of issues raised during the Royal Commission into Aged Care Quality and Safety about a lack of communication in residential aged care.
To develop the Monthly Care Statements, the department consulted with:
older people
their representatives
residential aged care providers
advocates.
The department also completed a pilot in 2023. Residents who took part in the pilot:
liked that the Monthly Care Statements helped them keep track of the care they received
felt Monthly Care Statements were a useful reference point for their future care planning
saw benefit in sharing the Monthly Care Statements with their family to foster transparent communication about their care journey.
The department will host a webinar in late August 2024 to help you prepare. The details will be available soon on the department’s webinars for the aged care sector webpage.
Food, nutrition and dining
Addressing malnutrition in older people: a vital focus for quality care
The risk of malnutrition in older people is probably not well-recognised and is often overlooked. As people age, a range of things can increase the risk of malnutrition like:
reduced appetite, that can be associated with a less active lifestyle and a diminished sense of taste
difficulty chewing or swallowing
chronic illness
social isolation.
A frail older person who is also experiencing problems with memory or comprehension is at greater risk of malnutrition.
Malnutrition can have a significant impact on their health, wellbeing and quality of life. It can:
increase the risk of falls and infections
impair immunity and wound healing
lead to extended hospital stays.
Regularly screening older people for malnutrition is important in preventing and treating it as early as possible. There are malnutrition screening tools that are validated for use in Australian aged care settings. You need to work out which screening tool will be best for your service, considering your processes and consulting with health professionals. These tools can help you:
detect the early signs of malnutrition
make timely interventions
understand when there needs to be an allied health referral.
Successful malnutrition screening
Some aged care services are using best practice in malnutrition screening. They’re using structured processes and collaborative strategies to achieve good outcomes for older people. Examples include providers who are:
working with their dietitian to develop their malnutrition screening policies and processes
providing extra training for staff to help them understand malnutrition and malnutrition screening tools
developing a weight monitoring process with their allied health professionals.
You can read more about these successful screening processes in our full article.
Clinical update
National Pain Week 2024: Research shows high use of pain medication in Australian aged care
National Pain Week – 22 to 28 July – highlighted the work and research being done to support people who live with chronic pain and reduce their dependence on pain medications.
One recent study, led by Monash University’s Centre for Medicine Use and Safety, shows that Australian aged care residents are 7 times more likely to be taking painkiller medications than aged care residents in Japan.
Both Australia and Japan have rapidly ageing populations but appear to use and prescribe painkiller medication, including opioids, very differently.
The study found that while the goal of Australian prescribers was to relieve a person’s pain, pain medications including opioids were often prescribed on a regular and ongoing basis. The Japanese prescribers’ goal, however, was to reduce the effects of pain on daily activities. They reported that they only prescribed opioid painkillers for short-term use, when a person was in pain.
The Monash research team’s study confirms other Centre for Medicine Use and Safety research showing that up to one-third of Australian aged care residents are prescribed opioid painkillers. The study highlights areas where onsite aged care pharmacists could support services to use opioids appropriately.
Other data suggests that a significant proportion of aged care recipients with chronic pain also have cognitive impairment or trouble communicating and aren’t able to tell people when they’re in pain.
Applying the research
Ensuring effective pain management for residents is a responsibility shared by the residents’ medical practitioner and the provider.
We encourage clinical and pharmacy staff and providers to look at the options available to help someone manage their pain. This includes non-pharmacological, or non-medication based, options where these will make a positive difference.
Webinars
Co-designing aged care through Consumer Advisory Bodies
Tuesday 20 August 2024, 2.00pm – 3.00pm AEST
This is a webinar for approved aged care providers and people receiving aged care, their family, friends, and supporters.
The webinar will focus on the specific responsibilities for approved providers about their governance arrangements, particularly Consumer Advisory Bodies. Sound provider governance arrangements are critical to providing high-quality care for people using aged care services. Governing bodies and leaders play a key role in ensuring that organisation policies and procedures are designed in consultation with people receiving care. The most effective way to achieve this is through co-design using Consumer Advisory Bodies.
We hope at the end of this webinar we will have:
helped older people to understand their right to participate in Consumer Advisory Bodies
reinforced approved provider responsibilities in relation to good governance
demonstrated the benefit of establishing and becoming involved in Consumer Advisory Bodies to co-design high-quality care.
Registrations are now open.
Recording available - A new regulatory strategy for aged care
The recording and slides are now available from our 16 July webinar, A new regulatory strategy for aged care. This webinar introduced the Commission’s new Regulatory Strategy for 2024–25 that describes how we will deliver on our commitment to safeguard and protect older people, and how we hold providers and workers to account. The strategy explains to providers and workers what we expect from them, and how we will work with them.
Recording available - Department webinar - Vaccinations and outbreak preparedness
In June, the Commissioner joined a panel discussion at a Department of Health and Aged Care webinar on vaccinations and preparing for outbreaks in residential care. The recording and slides are now available for the 20 June webinar. Residential aged care providers must minimise infection-related risks. This webinar information will help providers and workers prepare for and manage outbreaks and organise vaccination clinics.
Department webinar - New General Practice in Aged Care Incentive
Tuesday 6 August 2024, 2.00pm – 3.00pm AEST
The Department of Health and Aged Care is holding a webinar for residential aged care providers and workers, and aged care residents, their families and carers about the new General Practice in Aged Care Incentive.
As of 1 July 2024, eligible general practitioners (GP) and their practices can receive incentive payments to support permanent aged care residents to have:
better access to a regular GP
continuity of care with regular visits and better care planning.
Residents, their GPs and the GP’s practice must be registered with MyMedicare to take part in the program.
In the webinar you will:
learn about the new incentive
understand the roles and benefits for aged care residents, providers and workers
ask questions in a Q&A session.
Governing for reform
New Governing for Reform webinar
Registrations are now open for the Governing for Reform in Aged Care webinar: Harnessing risk management to achieve better outcomes in aged care. Managing risk is key to decision-making in aged care. Using real case studies, this webinar provides practical ideas on how you can use risk management to drive innovation. Our expert panel will also explain how you can use ‘risk appetite’ to support your decisions and build a positive risk culture.
Before for the webinar, you can read our risk focused resources:
Module – Re-thinking risk (via our education platform Alis)
You can find more resources and activities on governance on our Governing for Reform webpage. You can also subscribe to keep up to date with events and new content.
Training and resources
Online workshops for approved providers
Have you looked at the Commission’s workshop program for people working in the aged care sector? These workshops give practical tips to help learners understand how to meet obligations within their service setting.
Our current workshop topics are:
The strengthened standards in practice – learn about the strengthened quality standards and how you can start preparing for their implementation
Effective incident management systems – understand how to use an incident management system to drive continuous improvement
The Serious Incident Response Scheme – understand your obligations under the SIRS and know how to identify a reportable incident and notify the Commission.
These workshops are delivered by experienced Commission facilitators, with subject matter experts from our regulatory teams on hand to answer your questions.
Places are limited, so head to Workshops | Aged Care Quality and Safety Commission to learn more or register.