Answering the royal commission’s questions about substandard care and complaints needs fresh critical analysis rather than a defensive response, writes Greg Adey.

While being fully prepared with a comprehensive risk management approach is essential, managing the Royal Commission into Aged Care Quality and Safety with a ‘war room’ mindset results from asking how can we defend ourselves from attack.

Greg Adey

But the right question to ask is: “How can people trust our governance systems to provide high quality safe services?”

This shifts our response to a focus on customer relationships and to genuine, transparent, emotional engagement with the people using our services. Only 18 per cent of people trust the aged care sector and only 30 per cent believe that we provide high quality care according to data presented at LASA National Congress this year.

This shows we have a serious problem and it is not a problem a war room mindset is going to fix.

New culture, new thinking

We need to use the positive opportunities coming from the royal commission’s scrutiny to acknowledge the gaps and then strengthen and improve our practices and governance systems. Providers need to know:

  • How is the board and executive team fully informed about people’s experience?
  • What evidence do you have that processes and outcomes are effective?
  • Do you really know why things went wrong?
  • How do you use the customer’s voice and experience to validate those results?
  • How do you engage with people through deep honest conversations, especially about difficult topics, for example, why didn’t every person interviewed by the agency for the consumer experience report say that they feel safe “Always”?

Answering the commission’s questions about substandard care and complaints needs fresh critical analysis, not the default-mode thinking or defensiveness that typifies many organisational processes.

It’s important that you understand the big picture your five years of data is telling you by using root cause investigation and trend analysis. Your board and management then need to take action to use that knowledge to improve the customer experience of quality and safety.

As we’ve learnt from the financial services royal commission, practices and outcomes are determined by organisational culture. Providers should be developing metrics that provide ongoing evidence of how your culture actually translates into everyday experiences for people. Unfortunately, unwritten ground rules are much stronger than glossy values statements.

Responding to the commission survey

There are two stages in shaping your formal written response:

  1. the defensive position, which examines each individual episode and ensures that you have risk managed those specific issues;
  2. the learning position, which provides a deep critical analysis of the root causes and significant trends to identify the system-based improvements that you made or still need to make, and how you are communicating this to the people you serve.

It’s highly likely that this self-assessment will identify organisational gaps that need to be recognised and addressed with a prioritised action plan. If you don’t find those gaps yourself, you can be sure the royal commission analysis will.

You can’t change what you haven’t done over the last five years, but you will certainly be expected to demonstrate to the commissioners that you now understand and have acted on current community and regulatory expectations of the sector.

Building trust, not barricades

Relying on a defensive ‘war room’ strategy won’t build trust with people, and it doesn’t align with the legislated open disclosure requirement of the new aged care quality standards.

Australia’s aged care and wellbeing services are undoubtedly world class – and the royal commission provides us with a unique opportunity to do things even better.

Greg Adey is a director at g88consulting, a national advisory to the aged care and ageing services sector.

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