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Risk profiling, star ratings among new quality reforms


A new single independent quality and safety commission will oversee aged care regulation, compliance and complaints from January next year, the government has announced.

The new cost-neutral reforms also include enhanced risk profiling of providers, developing options for a Serious Incident Response Scheme and a performance rating system for providers accompanied by a comparison tool for consumers on My Aged Care.

The measures were recommended by the Carnell-Paterson Review, which was ordered after the serious failures at the Oakden facility in Adelaide, and follows the recent introduction of unannounced re-accreditation audits in residential aged care, also recommended by Carnell and Paterson.

AAA has confirmed the announced measures are cost neutral to government, however no further details of the funding arrangements were provided.

The Aged Care Quality and Safety Commission will bring together the functions of the Australian Aged Care Quality Agency, Aged Care Complaints Commissioner and aged care regulatory functions of the Department of Health. A proposal for an independent aged care regulator was also a recommendation of the 2011 Productivity Commission inquiry.

The new body will be led by an independent Aged Care Quality and Safety Commissioner who will report to the Minister for Aged Care and be supported by an advisory group and a new Chief Clinical Advisor.

The commission aims to drive better coordination between all involved in aged care, increase transparency and sharing of information, provide a single point of contact to aged care recipients and their families and provide greater protections to seniors in care, said the government.

Minister for Aged Care Ken Wyatt said the new commission would be a responsive “one-stop shop” to prevent failures, highlight quality concerns and work with aged care providers to have them quickly rectified.

“We recognise that the vast majority of providers give consistent, quality care to their residents. But, as we have seen, there can be failures. We must ensure that disasters like Oakden are never repeated,” Mr Wyatt said.

A new taskforce within the Department of Health will oversee the reforms to ensure the new commission is in place by 1 January 2019.

Minister Wyatt also announced that options for a Serious Incident Response Scheme would be developed in consultation with providers for the reporting and investigation of alleged incidents of abuse and neglect in aged care.

The Serious Incident Response Scheme was recommended by both the Carnell-Paterson review and the 2016 Australian Law Reform Commission report on elder abuse (read more here).

Enhanced risk profiling of aged care providers to determine the frequency and rigour of visits and ensure a more timely response to quality failures will also be implemented.

Consumers will be able to see how a provider’s performance rates against the quality standards and access “a user-friendly provider comparison tool” on My Aged Care Website, according to the announcement.

Stakeholder reaction

From left: Pat Sparrow, Sean Rooney and Ian Yates

Provider peaks have welcomed the establishment of a new independent commission to centralise accreditation, compliance and complaints handling, but have reiterated concerns over the proposed Serious Incident Response Scheme and a provider rating system.

Aged & Community Services Australia CEO Pat Sparrow said there was little evidence the proposed SIRS outlined in both the Carnell-Paterson and ALRC reports would improve residents’ quality of care.

“Refinements to the existing scheme [for reporting abuse in residential care] may achieve that aim more effectively than introducing an entirely new one,” Ms Sparrow said.

Similarly, Leading Age Services Australia CEO Sean Rooney said implementing a SIRS could place new and extended reporting responsibilities on providers without adequately considering the arrangements already in place.

“Several mechanisms already exist to report issues if they arise so the proposed SIRS program needs to be further investigated to determine what additional value it brings to the system.”

Ms Sparrow said the performance rating system and comparison tool needed to add value to the quality system by being fair and accurate for providers with meaningful information for consumers.

A greater understanding of what consumers valued and how they could best get accurate information to assist decision-making was needed to inform a rating system, Mr Rooney said.

Consumer advocacy body COTA Australia chief executive Ian Yates welcomed the government’s announcement as “another significant step towards the better monitoring and enforcement of quality in Australia’s aged care system.”

He said a consumer commissioner within the new commission – as recommended by the Carnell and Paterson Review – was also needed to make it easier and normal practice for consumers and families to be involved.

“The atrocities at Oakden were only brought to light thanks to the tenacity and persistence of Oakden family members, demonstrating the importance of having strong consumer voices heard in aged care quality processes,” Mr Yates said.

AAA has sought clarification on whether the government is adopting the Carnell-Paterson’s proposed model for an Aged Care Safety and Quality Commissioner in full, which includes the consumer commissioner role.

On the new provider ratings system, Mr Yates said it was appropriate the new commission explained how individual providers complied with the quality standards expected of them in a way that consumers could easily understand.

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8 Responses to Risk profiling, star ratings among new quality reforms

  1. Rhonda Nay April 18, 2018 at 12:49 pm #

    Years ago we provided a report on star ratings which concluded it should not happen until there were QIs and then should rate separate items such as food, Care, environment and so on because consumers value different aspects of care.

  2. Daniella April 18, 2018 at 2:06 pm #

    Thanks Rhonda

  3. Greg Mundy April 18, 2018 at 3:33 pm #

    I remember that project and the conclusion (as I remember it) that quality is multi-dimensional rather than measurable on a single linear scale. True, but consumers want something that’s comprehensible and the Government wants something that stops them looking bad.

    Providers want nothing that interferes with what they are doing anyway and the Department wants a bureaucracy that they can control but is separate enough for them to be able to say ‘not us’ when something goes wrong.

    A tall order but do-able, with the right structure and the right people.

    Building a culture of quality in aged care is a worthwhile and do-able project.

  4. val fell April 18, 2018 at 3:46 pm #

    There are 44 categories in the accreditation system so it should be possible to develop a star rating system for each system.
    If that is not possible, survey the ten most important criteria listed by consumers.
    a star rating for those can then be established.

  5. Huntress53 April 18, 2018 at 5:18 pm #

    The writer sought responses from ‘stakeholders’ but not from any aged care recipients. We are stakeholders too. There are plenty of us around – far more than CEOs of organizations administering care and heads of bodies like COTA. We have to be the principal stakeholders here, along with our families . I wonder whether you think we’re not competent to form or express views on this, and I really hope not.

  6. Louise April 19, 2018 at 8:21 pm #

    Sorry all,I just see another administrative level. Maybe I don’t quite understand?
    So many times people write in about the issues that have not been tackled.
    There are alot of people providing good care and those that don’t should not be in the industry.
    Hence, as stated previously there are 44 Outcomes from 4 Standards. If a home does not meet x amount then they should be closed down immediately, Government steps in and assists those residents with moving to another facility, any bonds to be transferred. No second, third, fourth chances. You had your chance the first time. We are talking about people and the care they deserve.
    Really there is absolutely no excuse for not having all your checks and balances in place with strong reporting, assessment and plans in place & ongoing improvements. Ongoing system and policy checks for those groups. You cannot accept monies and not deliver.
    Another issue that we keep on going around in circles – PCA Training groups.
    My bug bear.
    6 – 8 weeks and people are Qualified? Give me a break – I have caught so many people crying after their first week – as they tell me it is nothing like what they were taught.
    Others are pushed by Centrelink to do the course and then are pushed into working in the Aged Care sector when clearly they are totally unsuitable for the role.
    Training as a Carer should be 12 months minimum – ability to work part time in the understanding that they are students.
    Each Carer should be registered similar to nursing staff.
    Not all groups have quality On Going training of staff – it is watch an in house video – here are your answers and tick they have met a criteria as highlighted in the Standards.
    This needs to be looked into more closely.
    As a Diversional Therapist I commenced with a Leisure & Lifestyle Certificate which is 12 months in duration including volunteer hours. Then onto a Degree – another 2-3 years. Then other courses to increase my knowledge in Dementia.
    It has been proven so many times that a vibrant Activity program assist those living in a Facility – we provide a holistic approach and support those in emotional needs etc.
    Then why is this area not being funded. I know of 1 Lifestyle person to 130 people. Another to 80 and then another person to over 200.
    Then some groups are amazing clearly seeing the value and having several rostered on.
    There is no way on earth that 1 person can plan activities, implement activities to suit different likes/dislikes physically take the activity/plan activities for various stages of Dementia, write Daily Progress Notes, write Lifestyle Plans & Assessments, review all Lifestyle Plans & Assessments every 3 months etc etc and provide Person Centred Care.
    This is not looked into closely enough when Accreditation people walk through the door. How can they pass this area when clearly not enough Lifestyle people working?
    Then lets look into the Nurses – they are paid 10-15 dollars per hour less than in a hospital, why?
    It means that their role is somewhat devalued in the eyes of the Government, Facility Operators and the various Departments.
    I see hard working individuals, who spend more time on paperwork than managing Care Staff & interacting with Residents, people who are there up to 1 to 2 hours after their shift has ended.
    Groups need to have an extra person on board to do more of the nursing administrative paperwork.
    Then there is Care Staff ratio’s and Nursing Ratio’s – somewhere along the line the two have been blended when they should not – these are separate functioning groups providing care.
    We need to stop Facility Management & Directors timing Carers in how much time they spend with a person. 15 minutes to undress, shower, dry, groom an elderly person!!! Bloody Ridiculous – who cares if it takes an hour, however this is the reality of it all – why so many skin tears, people living with dementia labelled as aggressive or difficult. These people need to be given time.
    Who stated that a person should be given 2 hours per day of time? I will leave this one alone for another time. This makes my blood boil.
    If by this extra level of administrative government we can get the above sorted then I support it.
    In the mean time I cannot feel a bit cynical that nothing will really change too much.
    In the meantime the real people who must receive top care are languishing – those people who work in aged care who really provide care above and beyond the call of duty are tarred by the same brush. All really quite unfair!!!

  7. Mark BRANDON April 20, 2018 at 9:30 am #

    I agree with Rhonda. Along with many others representing all stakeholders ACEBAC considered and reported on Warren Hogans recommendation for star ratings. A number of Hogans recommendations from 2007 have resurfaced in recent reports. Maybe a re-look at the working party report could save some time.

  8. Melissa Jenkinson May 5, 2018 at 5:36 pm #

    Well stated Louise. You have seen it as it really is! Top staff working in understaffed conditions places pressure on not only themselves but on the resident’s who can feel it. When I was working in a facility, my heart went out to our elderly residents who just wanted some chat time or a little extra attention. Everything was so time orientated that quickie chats were only during shower or dress times. It would be amazing if more staff were allocated to aged care facilities, not only in the caring position but to take up the admin side so carers had more care time. I have not stopped studying for nearly 6 years and want to complete my dementia degree this year as well while I continue to work in the industry as a caring support worker in the field.

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