Governance compliance still lacking, says report

The quality and safety commission tells providers it expects to see an improvement in governance arrangements.

Aged care providers are continuing to fail to comply to the regulator’s governance requirements, according to new analysis.

Released last week by the Aged Care Quality and Safety Commission, the latest sector performance report shows that – during 1 October to 31 December 2023 – organisational governance (standard 8) had the lowest rate of compliance across residential and home care services.

“Deficiencies in governance and leadership cause shortfalls in the quality and safety of care. We expect to see an improvement in governance arrangements,” writes Aged Care Quality and Safety Commissioner Janet Anderson in the report’s introduction.

Source: Aged Care Quality and Safety Commission

Overall, 85 per cent of the 117 aged care homes audited met all of the commission’s 42 requirements of the eight quality standards – an improvement of four percentage points compared with the previous quarter.

“While this is an improving trend, it means that one in seven residential services audited were less than fully compliant,” say the report’s authors.

Janet Anderson

In contrast, only 66 per cent of the 118 home care services audited during the period were found to be fully compliant with the quality standards.

“This is one of our key focus areas,” says Ms Anderson. “We expect providers to look closely at their data to identify areas they can improve.”

As well as focusing on governance processes, home care providers are being asked to address personal and clinical care requirements (quality standard 3). Compliance in this area fell six percentage points across the sector between the fourth quarter of 2022-23 and first quarter of 2024-25. “We are closely watching this trend,” say the report’s authors.  

Source: Aged Care Quality and Safety Commission

The report also shows a 4 per cent increase in residential care and a 13 per cent increase in home care of serious incident notifications identified through the Serious Incident Response Scheme. This is largely because there has been an increase in Priority 2 incident reports – up 6 per cent in residential care and 24 per cent in home services in the second quarter compared to the previous quarter.

“It is important that providers address risk and take action to reduce the likelihood of serious incidents,” say the report’s authors.

Source: Aged Care Quality and Safety Commission

Bucking the trend of low-impact notifications, reports of financial infractions rose by 13 per cent across the home care sector during this reporting period. There was “a concerning increase in the number of Priority 1 incidents of stealing or financial coercion in home care services,” says Ms Anderson. “We expect providers to have systems in place to detect, respond to and prevent these incidents.”

Formal compliance actions carried out by the commission decreased in the second quarter of 2023-24 because of improved compliance and a change in how the regulatory body responds to non-compliance.

“Half of the non-compliance we find is now dealt with through early remediation,” say the report’s authors. “Early remediation is where providers show us that they can fix an issue quickly and prove it is fixed.” This, they add, “is good news for older people receiving care because issues are resolved promptly.”

Source: Aged Care Quality and Safety Commission

During the period, 50 per cent of the commission’s responses to non-compliance in residential care involved early remediation; 34 per cent involved direct action; 16 per cent compelling action.

Source: Aged Care Quality and Safety Commission

When analysing the commission’s responses to non-compliance in home care services, the report shows 56 per cent involved early remediation; 38 per cent direct actions; 6 per cent compelling actions.

When it comes to complaints, clinical issues and concerns about staff continue to be the top gripe of aged care residents.

Meanwhile, fees, charges, communication, planning and transparency continue to be among the top complaints received about home care services.

Data is only useful if providers act on it

Janet Anderson

Since the first quarter sector performance report, the regulatory body has changed the way it presents its data. “The performance reports now show a more detailed picture of compliance and areas of concern,” says Ms Anderson. “We join the dots between different data sources including the complaints, the SIRS and the Quality Indicator Program. We encourage providers to do the same.”

However, Ms Anderson says: “While data is the core of this report, it is only useful if providers consider it carefully and act on it.”

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Tags: aged care quality and safety commission, Janet Anderson, October-December 2023, sector performance report,

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