Not-for-profit aged care providers are no better at meeting accreditation standards than for-profit organisations and ownership type has “no discernible” impact on passing accreditation, the Australian Aged Care Quality Agency has said.
The agency’s Queensland state manager, Tracey Rees, told the LASA Q conference last week that ownership was not a performance factor.
“There’s been some suggestion in the industry and in the community that the not-for-profit providers are better at meeting expected outcomes than the for-profit providers – that is not what our data is showing us at the moment,” she told the event.
“It shows that there is no discernible difference at an industry level in their performance at audit at all.”
However, Ms Rees said there were differences based on the size and location of facilities.
“We know remote services have difficulty meeting the accreditation standards more than, for example, providers in the cities and that has a lot to do with workforce. But certainly we are seeing no discernible difference between the for-profit and not-for-profit sector.”
The agency’s comments follow the release of study findings late last year showing that for-profits were more than twice as likely as not-for-profits to have government sanctions imposed on them.
As Australian Ageing Agenda reported, the research conducted by Richard Baldwin from the University of Technology Sydney found ownership type, jurisdiction and service location were significant predictors for sanctions.
A higher likelihood of sanctions in for-profit services was also identified by Australian gerontologist Anna Howe and Dr Julie Ellis in 2010.
The research has sparked debate about the association between ownership and quality failure, especially in the context of an expanding industry and growing for-profit sector.
While the Quality Agency monitors a facility’s progress in meeting accreditation standards, it is the role of the Department of Social Services to take regulatory action including imposing sanctions in response to immediate and severe risk to health and safety or where there is continued non-compliance.
In an analysis of non-compliance data, Ms Rees said there had been significant and sustained improvement by the industry in meeting accreditation outcomes.
In 2012, 95 per cent of homes met the 44 expected outcomes under the accreditation process, up from 64 per cent in 2000.
Ms Rees said it was expected that more than 95 per cent of services would meet all outcomes this year.
At 31 January this year, only 24 facilities out of 2,688 were on a timetable for improvement, which she said was “a historical low.”
“If you look at the size of the industry, the number of homes we have and those that are on timetables for improvement, it is a very small part of the sector.”
Discussing non-compliance, Ms Rees said failure in one area of performance usually impacted on other areas of care and service delivery, and was often coupled with a poor or weak systemic approach to continuous improvement.
“We have more than 10 years of accreditation data and it shows that failure in standard one, (two not met outcomes in standard one) is often the causal factor for failure in standards two, three and four,” she said.
Ms Rees said key risk factors for failure included changes in key staff, systems and processes, resident mix and ownership, and risk management was everyone’s responsibility – not just the responsibility of boards or senior managers.
“Risk can’t be avoided, it needs to be identified and managed, and your systems and your people create or reduce the risk in your service.”
Ms Rees detailed the top five areas where expected outcomes were not met by facilities in the three years to 31 December 2014. These were:
- Having effective information management systems in place including collecting information, updating care planning and sharing information (standard one) – 170 not met outcomes nationally.
- Care recipients receive appropriate clinical care (standard two) – 115 not met outcomes
- Care recipients’ medication is managed safely and correctly (standard two) – 115 not outcomes
- Human resource management which ensures appropriately skilled and quality staff to deliver services (standard one)– 106 not met outcomes.
- The needs of care recipients with challenging behaviours are managed effectively as part of behavioural management. (standard two) 97 not met outcomes.