Aged Care: Accreditation key processes explored
AN INSIGHT into the complexity of the accreditation system for Aged Care facilities and service providers may help allay some of the fears around finding the best support for an ageing family member.
Australian Aged Care Quality Agency (AACQA) chief executive officer Nick Ryan talked to Seniors News about how the system of Aged Care facilities and services providers are assessed, accredited, reaccredited or sanctioned, and what changes to the current system are happening from July 1 this year.
How often is there an inspection?
- Reaccreditation audits across 2697 facilities are conducted almost every three years. This can be reduced to two years, one year or six months if there are specific concerns about a facility. About 95 per cent facilities are found to be compliant.
- Every facility receives at least one unannounced visit every year. When there are concerns about a facility, those visits can be more frequent.
- Newly accredited facilities are initially accredited for 12 months.
- There are 2248 approved Commonwealth-subsided home care providers and 35 Aboriginal and Torres Strait Islander services which also come under the supervision of AACQA.
Who does the audits?
- The audits for residential or home care are conducted by surveyors.
- Just over 50 per cent of them hold a nursing qualification. Others have Public Service experience, are allied health professionals or have other professional experience. All of them have specific training and go through a supervisory period of six months, and participate in annual tests for re-registration.
How long does each audit take?
- Normal unannounced visits can take a day to complete.
- A reaccreditation audit can take two to three days depending on the size of the facility.
- For review audits, it can be four or more days depending on the nature of the department's concerns.
How many people conduct an audit?
Normally two surveyors attend a facility visit. If the facility is in a rural or remote location, there may be only one surveyor and if it's a large facility there may be up to three surveyors.
What is surveyed?
- Four different areas are targeted for audit in residential aged care - administration (such as human resource management, information management, staff training), clinical care and personal support (medication and pain management, behavioural issues), resident lifestyles (dignity, wellbeing, cultural and religious beliefs are properly recognised and supported), and built environment (kitchen, laundry, maintenance, safety, compliance of the building).
- With home care surveys which cover everything from Level 4 packages through to Commonwealth Home Support, similar areas are inspected except for the built environment.
What happens expected outcomes failure is found?
When non-compliance in any of the 44 Accreditation Standards outcomes is identified, its impact is tested to identify if residents are placed at serious risk. If so, then the secretary of the Department of Health is notified which is where sanction decisions are made.
When there is no risk found, the provider is -
- Notified of the specific non-compliance and what improvements must be implemented.
- A timetable for improvement is also established, which normally is within three months.
- A series of compliance monitoring visits are conducted.
- The facility is offered education.
"We have a very strong industry engagement and education function where we run specific courses for providers or provider groups," Mr Ryan said about his department's work in helping facilities to achieve compliance.
Where a facility has multiple failures or serious risks, a full review audit can be conducted taking into consideration the situations around those risks. "We have conducted 47 review audits since July 1 up until the end of March," Mr Ryan said.
This financial year there have already been 626 referrals from the Aged Care Complaints Commissioner received by Mr Ryan's department.
"If we think there are significant issues and that the home simply isn't complying, we will revoke accreditation," Mr Ryan said. "We have done so six times this financial year." The Department of Health will also notify residents and their family members of an accreditation revocation.
Online help for choosing a facility
The department website - www.aacqa.gov.au - publishes the two most recent facility reaccreditation decisions including information on non-compliance and sanctions.
Also published on this website are consumer experience reports which reflect statistical responses to 10 standard questions which are posed to a 10 per cent random selection of residents at the start of a surveyor's facility visit. "We also want to test against the lived experience of the residents and their family members," Mr Ryan said.
Lodging a complaint
- The place to start is with the facility. "Every home under the Standards needs to have an effective complaints and feedback mechanism," Mr Ryan said.
- If you are not satisfied with the response of the facility to your complaint, the next step is to contact the Aged Care Complaints Commissioner on 1800 550 552. They look at individual concerns and seek an agreed outcome to resolve the complaint.
- If a complaint is perceived to reflect a wide-scale problem within a facility, it is referred to Mr Ryan's department for action where it will be classified into tiers - Tier 1 (next time you are there), Tier 2 (visit within the next fortnight) and Tier 3 (visit quickly). With Tier 3 complaints, Mr Ryan says the "vast majority" are normally dealt by the next working day.
- In rare instances an individual may lodge their complaint with the Commonwealth Ombudsman.
- A single set of common Standards for all Commonwealth-subsided aged care services are due to be introduced on July 1 this year and fully implemented on July 1, 2019.
- From July 1, 2019, reports from quality reviews of Home Care providers will be published online.
- AACQA is looking to collect and publish more consumer information on how they rate the quality of care they receive.
- The surveyors training is being improved and they are being equipped with better software tools for consistent real-time data collection.
- There will be a strengthening of information sharing between the Aged Care Complaints Commissioner, AACQA and the health department.
"These (changes) combined give better focus on risk and performance, better escalation of risk and concern when they are uncovered, and gives better consumer information around performance of homes and the way consumers experience homes," Mr Ryan added.