Government urged to maintain regulatory focus on poor-performing providers

Industry peak body Catholic Health Australia has raised concerns about how the Federal Government might respond to the Carnell and Paterson review of regulatory issues triggered by the failures at Oakden in South Australia.

On 25 October, Minister for Aged Care Ken Wyatt said the government would “move as soon as possible to implement Recommendation 8,” whereby the current practice of notifying providers ahead of re-accreditation visits would be removed, “replaced by comprehensive unannounced visits conducted over at least two days.”

Writing in a special Aged Care Update for Catholic Health Australia, the peak body’s director of aged care, Nick Mersiades, said the government’s initial step was “a significant departure from what was envisaged by the reviewers.”

The reviewers envisaged ongoing accreditation and unannounced visits whose frequency and rigour would be determined by a risk-based process.

Carnell and Paterson said the current prescriptive system of annual unannounced visits for all providers would be changed so that high-performing facilities would receive fewer unannounced visits.

“All that would change as a result of the Minister’s announcement is that the advance notice required for site audits would no longer apply. The current regime of unannounced visits to monitor performance, whereby each service is visited at least once a year, will continue,” Mr Mersiades told AAA.

“It may be that the government settled on one element of recommendation 8 as its initial response because it could be implemented without legislative change, while at the same time being seen to be responding to community concerns pending further consideration of the review’s recommendations.”

He warned that the full implementation of the recommendation has “significant potential resourcing implications for government and providers, both in terms of initial systems development and ongoing administration.”

He also pointed out that the level of industry reporting under the review’s series of recommendations would increase significantly due to:

• mandatory reporting of an expanded suite of quality indicators
• reporting on all allegations or suspicions of a ‘serious incident’, along with the outcome of an investigation, including findings and action taken
• reporting all uses of restrictive practices and seeking the proposed new aged care commission’s approval for the use of antipsychotic drugs
• adoption of a modified version of the Australian Open Disclosure Framework.

“The review identified that best practice included greater responsiveness to encourage good performance, including tailoring regulatory enforcement and inspections on risk rated evidence.

“The risk is that the sector will end up with both increased reporting and no diminution, or indeed an increase, in Commission visits,” he said.

Mr Mersiades also questioned how the recommendations would assist moving towards a private market for the provision of accreditation services, announced in the 2015-16 Budget.

He said that the Quality Agency’s failure to detect and adequately respond to the serious and longstanding care failures at Oakden may be used to ramp up considerably the level of regulation across all aged care services at significant cost to the Commonwealth, providers and the provision of aged care services.

The aim should be to focus regulatory activity on higher risk services and services that are not delivering, he said.

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