Here at Yarno, we like to be the early bird when it comes to identifying industries in need of training. Right now, there is no industry more in need than Aged Care. There’s a lot going on: a Royal Commission, the establishment of an Industry Reference Committee dedicated to ensuring that the national Aged Care education and training system is up to scratch, as well as the Commonwealth government putting its statutory foot down with some pretty serious legislative changes.
These changes are pretty important(and at times, pretty confusing), so we made this guide to help you decode what these new changes actually mean, and what obligations they impose.
The Commonwealth government has drafted new legislation which replaces the existing Aged Care standards. These new guidelines are called Aged Care Quality Standards (Quality Standards) and are legally binding under multiple statutes.* These standards hold aged care providers to new, more rigorous codes of conduct regarding the level of care provided, as well as the way in which it's provided. Principally, the standards require staff to be trained and perform in a way that takes into account “soft” qualities such as dignity, respect and compassion.
The Royal Commission report into Aged Care Quality and Safety will be provided by no later than 30 April 2020. There’s little to report on it for now, but we’ll be keeping an eye on it as it progresses.
Who is affected?
The Aged Care Quality Standards are legally binding for all agencies providing Commonwealth subsidised aged care services. So, if you're an aged care service provider, work for an aged care service provider, or have aged care services provided to you, you are directly affected by these standards.
When do the standards come into effect?
As of 1 July 2019, compliance with the standards is mandatory.
What do the standards actually consist of?
Note before we proceed - in this article I use “consumer”, “customer” and “client” interchangeably to refer to those who are receiving services under the Aged Care Quality Standards. I do this as it is the language used by the guidelines, and to encapsulate the multitude of people who both receive Aged Care services, and will therefore be affected by them.
There is nuance within each guideline, however the purpose of the standards can be grouped into two neat categories:
- Consumer agency
Every guideline is geared towards allowing those receiving services more decision-making power. Instead of the care provider making all the decisions, the guidelines mandate that decision-making power be split between both the provider and those receiving the services.
2. Personalised care
These guidelines overall demonstrate a shift away from standardised care, towards more personalised services, catered specifically for each individual. Almost all sections place a burden on service providers to consider the individual needs of those they are serving, rather than roll out standardised care, regardless of circumstance.
Standard 1 places a legal burden on service providers to ensure that they provide services in a manner that is culturally aware and sensitive to the individual needs of their clients. It also aims to give more autonomy to the consumer in making decisions regarding their own health care, rather than have the service providers make decisions unilaterally.
Standard 1 also emphasises decision-making capacity when it comes to risky-choices. The guideline acknowledges that health-care decisions often involve risk, and empowers consumers to take risks regarding their health, as long as they have been appropriately informed of those risks by their service provider.
This standard places a burden on service providers to plan and assess the services of each individual client effectively. Basically, this standard gives a legal basis to remedy clients whose services have been poorly executed. It also places a burden on service providers to work effectively with other service providers; where two or more service providers are working with one client, under these standards, they are legally compelled to share information about that client, and plan and execute their services together effectively.
Again, this standard places a legal duty on service providers to ensure that the services they provide are effective and personalised to the client. This standard requires that the services provided not only optimise the client’s physical health, but also have regard for their mental and spiritual health. This standard is similar to Standard 1 in that it requires the individual cultural diversities of each client to be considered when planning services.
This standard also provides a duty surrounding end-of-life care - it requires not only that end-of-life care be handled with sensitivity, but that such services are provided in a timely manner. This standard also demands that end-of-life services preserve the dignity of the client they are serving.
This standard then goes on to place two duties on service providers in relation to infection control and management:
1. Infection control
Health-providers must take active steps to isolate infected clients to prevent spreading of disease. This involves the use of effective hand washing practices, not sharing infected medical implements, among other practices. Organisations must develop an effective infection control guideline and plan in accordance to national standards.
As part of effective influenza infection control, organisations that provide residential aged care need to offer its workforce influenza vaccinations and keep records of these vaccinations. They also need to promote the benefits of the vaccinations to their clients.
2. Antibiotic resistance
This standard also requires service providers to develop practices which reduce antibiotic resistance. Service providers are legally obligated to help minimise the development and spread of antimicrobial resistance in accordance with national guidelines.
This standard can effectively be broken into three sections:
- Consideration of individual needs.
The first three subsections of this standard impose a duty on service providers to consider each individual's unique needs when providing services, and to attempt to ensure that the services provided support each consumer’s individual social, emotional and spiritual needs. It also requires consideration of how provided services can assist the individual to participate in their community. Think of this as an obligation to assist individuals to be as mobile and independent as possible, so that they can best participate in the community around them.
2. Obligation to store and share customer information effectively.
This standard mandates that service providers both store and communicate an individual’s information effectively, as well as that they effectively communicate that information to other relevant service providers. It also obligates service providers to effectively refer consumers to other relevant service providers in the individual’s local community, in a similar vein to what is required by Standard 2.
3. Obligation to provide quality food and equipment services.
This standard administers a burden that any meals or equipment provided are of a particular quality. It effectively provides means to reprimand service providers for providing consumers with low quality food and/or equipment services.
This standard only applies to organisations who provide a physical service environment. This means it applies to any aged-care service provider that treats individuals at the service provider’s own physical location. It doesn’t concern organisations that only provide in-home care. Essentially, this standard imposes a “soft” quality duty on service providers to ensure their physical premises are “welcoming” and allow consumers to move freely within them.
It also obligates service providers to make accommodations for age related changes and disabilities, such as sensory or hearing loss (i.e. including braille directions, the availability of wheelchairs for consumers with restricted mobility.) Also look to this section for the legal requirements that anything within your physical premises must be safe and well maintained.
Service providers are under a duty to ensure that consumers are able to make complaints, and give feedback on the services provided to them. The process to do so must accord with the principles of natural justice and procedural fairness (these are massive concepts, but basically think of them as requiring feedback and complaints services to be available to all, cheap, and quick to process).
This standard also requires that consumer complaints are actually considered and implemented.
This standard concerns the hiring, rostering, performance and management of all staff providing aged care services. It obligates service providers to manage and roster staff effectively; to ensure there are enough staff as required, and that extenuating circumstances which may require more staff, such as influenza outbreaks, are accommodated for.
It also imposes a duty that hired staff are suitably qualified and that their actual performance is satisfactory. Determining whether performance is satisfactory, under this standard, includes not just whether they actually complete the job, but whether they have soft qualities such as compassion and consideration of each individual’s diverse backgrounds. A burden here is also placed on service providers which requires their staff to be appropriately trained and equipped. It also obligates service providers to monitor and review staff performance to ensure that high quality care is administered.
This standard essentially holds the governing body of a service provider responsible for any care provided that is sub-quality. It begins with a soft quality requirement that the organisational structure adheres to the cultural and diversity purposes of the act. It also contains a list of specific systems which must be managed effectively, however, as the section provides an overall duty to manage organisations effectively, this list is unlikely to be considered exhaustive.
This standard also places a duty on organisational governments to put in place effective risk-management practices and responses to neglected consumers. Also note the emphasis placed on implementing systems to reduce microbial resistance, which was also a concern listed in Standard 3. This standard also requires the structure of an organisation to minimise the use of restraint (though it admits that in some cases, it may be necessary to restrain consumers), and that the structure of an organisation should advocate for open disclosure of all practices.
Conclusion: What does this all actually mean?
Overall, aged care providers don’t so much need to change what services they provide, but how they provide them. These guidelines legally burden service providers, and their staff, with soft quality responsibilities such as consideration, compassion and maintaining their client’s autonomy. If nothing else, these guidelines show us that going forward, there is going to be a lot more importance placed on the training and subsequent performance of health care providers and their staff. But don’t worry, that’s exactly what Yarno can help you with.
If you’re in the Aged Care industry and don’t know where to start when it comes to training the behaviours required by these guidelines, call Mark for a chat today on 0401 872 305 or head on over to our contact us page.
*The full legislative requirements are found in:
Quality of Care Amendment (Single Quality Framework) Principles 2018 (Cth).
Aged Care Quality and Safety Commission Rules 2018 (Cth).
Aged Care Act 1997 (Cth), Schedule 1 User Rights Principles 2014. Charter of Rights and Responsibilities – Residential Care.
Aged Care Act 1997 (Cth), Schedule 2 User Rights Principles 2014. Charter of Rights and Responsibilities – Home Care.
Aged Care Act 1997 (Cth), Schedule 3 User Rights Principles 2014. Charter of Rights and Responsibilities – Short-term restorative Care.
There is an extensive list of the all the statutory authorities under which these guidelines are enforceable, which can be found here. However, listed above are the primary authorities.