Aged Care Quality Bulletin #70 - October 2024

4 Nov

In this issue

Commissioner’s message

Last month, we received the Australian Government’s Statement of Expectations for the Aged Care Quality and Safety Commission. This document sets out what the Government expects from us as the national regulator as we fulfil our statutory responsibilities to safeguard and protect older people receiving aged care. It also sets out expectations about transparency and accountability. I welcomed and supported this Statement.

In response, this month we published our Statement of Intent for the Commission. It outlines how we will meet the Government’s expectations and describes how the Government’s priorities are being addressed. It is further supported by the Commission’s corporate and operational plans.

We are committed to continuing to support sector readiness for the reform program, including the introduction of the new Aged Care Act. As outlined in our Statement of Intent, the Commission will deliver on our goals and commitments principally through our Regulatory Strategy, which we will update annually, including ahead of the introduction of the new Act.

In November, we are focusing on residential aged care providers’ workforce-related responsibilities, including mandatory care minutes. I encourage you to join our webinar on 19 November which will discuss workforce responsibilities as the key to delivering a great aged care experience for older people.

On 1 October, the care minutes responsibility increased to a sector-wide average of 215 care minutes for each resident each day. This includes 44 minutes of direct registered nurse (RN) care. Providers can meet up to 10% of this RN target with care provided by an enrolled nurse (EN).

This change recognises the important role of ENs in aged care and aims to improve recruiting and retention of these skilled workers. It follows feedback from providers, workers (particularly ENs), worker representatives, older people and the TAFE sector. It will also help providers to deliver their care requirements if they face workforce shortages.

Residential providers have to report on care minutes delivered as part of their Quarterly Financial Report (QFR) submitted to the Department of Health and Aged Care. This data, along with data on 24/7 RN coverage, is shared with the Commission and used to monitor whether providers are complying with these workforce responsibilities. It helps us to identify where there are risks to the delivery of quality and safe care that require our intervention. More information will be provided about the Commission’s regulatory response to persistent non-compliance with workforce-related responsibilities in our webinar on 19 November.

In other news, Complaints Commissioner Louise Macleod and I gave evidence to the Senate Community Affairs Legislation Committee’s Inquiry into the Aged Care Bill 2024 in October. You can read the Commission’s submission and others, and access transcripts from the Committee’s hearings, on its website. The Committee is planning to report on its inquiry in early November. Subject to parliamentary processes, the new Act is expected to commence from 1 July 2025.

For more information about the Aged Care Bill, you can read the Minister for Aged Care’s media release, the Bill or a plain language fact sheet on the department’s website.

And a reminder for 2025 diaries – please save the dates of Monday 28 to Wednesday 30 July for our National Aged Care Providers Conference 2025! The conference will be held at the Melbourne Convention and Exhibition Centre. We’ll have more to share in the coming months on the exciting Conference program.

Our reports

Complaints Report – Year in review 2023–24

The Commission has published our latest complaints report –  Complaints about aged care services – Year in review (July 2023 to June 2024)

This is our second full year report exploring complaints that the Commission receives about aged care services.

In this report, we draw attention to clear patterns and trends in the complaints made about residential care and home services for 2023–24.

These patterns and trends tell us where we need to target our monitoring and assessment of providers – holding them to account for addressing older people's needs and preferences.

Everyone receiving aged care services has the right to safe, compassionate care. They deserve to be treated with dignity and respect. Providers and their governing bodies are responsible for protecting the rights of people in their care and delivering high-quality services.

If you’re a provider of aged care services, we encourage you to read the report for the latest data, insights and lessons from the sector. Providers should use the report to examine their own performance and identify areas where they need to improve.

The report also covers:  

information for people receiving care and the importance of sharing your concerns
information for providers and how to make sure that your complaints management process is meaningful and effective
the Commission’s complaint handling performance.

We want to empower people receiving care to speak up, offer feedback and raise concerns if something doesn’t seem right. We also want to help providers to understand their obligations to support and manage feedback and complaints.

Complaints about aged care services can be made to the Commission by telephone on 1800 951 822 or by visiting our website. You can also find more information about making a complaint on our website.

Read the full report - Complaints about aged care services – Year in review (July 2023 to June 2024).

Aged care reform update

Changing aged care for the better – new website section

As part of our support to get the sector ready to get the for the anticipated new Aged Care Act, we have published a new section on our website, Changing aged care for the better.

This section, which can be easily accessed from the homepage, provides information on the regulatory changes proposed under the new Aged Care Act for older people, for providers and for aged care workers.

As more information and resources become available, we will continue to update this section to support the sector to understand the upcoming changes and what you need to do to be ready for the new Act.

Support at Home program updates

Details of the Support at Home program were announced on 12 September 2024 by the Minister for Aged Care, the Hon Anika Wells MP.

The Support at Home program will replace the Home Care Packages (HCP) Program and Short-Term Restorative Care (STRC) Program from 1 July 2025. The Commonwealth Home Support Programme (CHSP) will transition to the new program sometime after 1 July 2027.

Under the new Support at Home program, older people with more complex needs will have access to higher levels of care in their home. This will help them to stay in their home for longer.

Older people will only pay for services that have been delivered and they will never pay for clinical support. Based on their financial situation, older people will be asked to make a fair contribution to help pay for high-quality care and services – services that will help keep them independent and support everyday living.

How much people who are already receiving or are assessed as eligible for a package will contribute, will be based on a ‘no worse off’ principle. This will be for anyone already receiving a package, on the National Priority System, or assessed as eligible for a package on 12 September 2024. These people will be no worse off because of the reforms. They will make the same contributions, or lower, than they would have made under the HCP Program.

The Department of Health and Aged Care will keep working with HCP and STRC providers to make sure they’re prepared to move to Support at Home on 1 July 2025.

More information

The department has a range of information and resources about the Support at Home program on their website. This includes recordings of their recent webinars and fact sheets.

New resources on how to raise a complaint

We have new resources about complaints which we have developed for older people and aged care workers. The 3 fact sheets cover how to raise concerns and complaints and how we can support you through the process.

Resource for older people

Our fact sheet for older people is How we regulate aged care workers’ behaviour for your wellbeing and safety. It explains how we support older people if they have concerns or complaints about the behaviour of the people caring for them.

All people receiving aged care have the right to a positive, safe aged care experience. We expect providers to make sure that the people working in aged care have the right skills, experience and attitude to deliver care that is safe and supports each older person’s quality of life.

Worker resources

There are 2 new resources for workers.

The first, Your voice in improving aged care fact sheet for aged care workers, explains how we can assist aged care workers to make sure that people receiving care are treated well and feel safe. It has advice on how workers can raise a concern or complaint about the safety or quality of care that older people are receiving.

The second resource for workers is the How we handle complaints and concerns about conduct of aged care workers fact sheet. This fact sheet explains how we respond to concerns or complaints about the behaviour of an aged care worker.

New Quality Indicators for staffing coming in 2025

From 1 April 2025, residential aged care providers will collect data on 3 new staffing quality indicators under the National Aged Care Mandatory Quality Indicator Program (QI Program).

The Department of Health and Aged Care is expanding the QI Program. The 3 new staffing quality indicators are:

enrolled nursing
allied health
lifestyle officers.

This will increase the number of quality indicators from 11 to 14.

Staff have a crucial role in providing high-quality care to aged care residents. The new indicators measure this and make sure that providers are delivering high-quality services.

Residential aged care providers will:

collect the new data from 1 April 2025 (quarter 4, 2024–25)
report the new data for quarter 4, 2024–25, though GPMS by 21 July 2025.

Data for these quality indicators build on existing reporting where possible. For this reason, 4 of the 5 new data points will come from the Quarterly Financial Report. This means that providers won’t have any extra reporting for those 4 data points.

The department consulted with the aged care sector to design the new staffing quality indicators. Read more about what the department heard in the consultation.

Reporting on quality of care helps providers to measure, monitor, compare and improve the quality of their services. The new staffing quality indicators will help providers to address any gaps in operations and care.

In the next few months, the department will publish more information and guidance. Find out more about the QI Program and subscribe to the department’s newsletters for updates.

Food, nutrition and dining

Food, nutrition, dining and dementia resources

Supporting people living with dementia to eat and drink well is important. People living with dementia are more likely to have changes in memory, physical abilities and appetite. They can have difficulties eating, drinking and swallowing, and poor oral health. This can mean they don’t eat enough, which can increase their risk of:

unplanned weight loss
malnutrition
dehydration.

To support people living with dementia to eat and drink well, we have developed resources for providers, workers, and family members and friends. These resources explain the importance of nutrition and hydration in dementia care, and how dementia can affect a person’s eating, drinking and swallowing.

The resources can help you understand these challenges. They offer guidance on delivering supportive, person-centred care based on a person’s needs and preferences. You can create enjoyable dining experiences that improve the health and wellbeing for people living with dementia.

More information

Improving mealtimes for people in aged care: The role of occupational therapy

A sense of independence can greatly improve a person’s quality of life, particularly for people in residential aged care. But for some, such as people living with dementia, it can be challenging to do simple daily tasks, like taking part in mealtimes. Occupational therapists (OTs) help people to maintain function and be more independent at mealtimes. They also help remove barriers that may affect a person’s ability to connect, make choices and enjoy their dining experience.

The theme for Occupational Therapy Week this year (21–27 October) was Celebrating 80 Years of Connection! To highlight the important role that OTs play for people in residential aged care, we spoke to some OTs. They told us about the ways they support people in residential aged care to enjoy their mealtimes. These include:

prescribing mealtime equipment such as non-slip placemats, modified cutlery and crockery
making sure that people are seated in a stable and comfortable way
coming up with strategies to involve residents in preparing for meals – such as setting the table or peeling vegetables. This can help to maintain or improve skills and give a sense of purpose
supporting people living with dementia to use memory supports like labels or signs
providing rehabilitation to help older people keep feeding themselves
catering for a person’s cultural and religious beliefs and practices about mealtimes.

You can read more suggestions and tips from OT’s about improving mealtime experiences and independent eating in our full article.

Menu and Mealtime Review Program EOI – round 2

We’re working with the Department of Health and Aged Care to deliver a free national Menu and Mealtime Review Program for residential aged care services.

The program:

is completely free and confidential
is run onsite by an accredited practising dietitian
provides tailored feedback and recommendations.

Only residential aged care services are eligible for this program. We will prioritise providers that:

are in small rural towns, remote communities and very remote communities
are under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program
are small (with 1–2 services) and medium (with 3–10 services)
operate smaller services (with 60 or fewer residents)
have services with a score lower than 3 on the Residents’ Experience Survey question - ‘Do you like the food here?’

We invite residential aged care services wanting to take part in this tailored educational program to submit an expression of interest (EOI). EOIs close on 4 December 2024.

For more information and to express your interest, please visit our website.

Clinical update

Protecting older people from COVID-19 and other infectious diseases

We continue to monitor how providers meet their requirements to protect older people in their care from the risk of infectious diseases, including COVID-19.

Providers are required to make sure that all older people in their care have timely access to vaccinations and anti-viral medications as part of routine care planning and clinical care.

Being up to date with COVID-19 vaccinations gives significant protection against the virus and reduces the risk of developing serious illness. Up-to-date vaccination for older people includes having had a booster shot in the last 6 months.

Monitoring vaccination rates

We actively monitor services’ COVID-19 vaccination rates and outbreak data to identify providers who may not be meeting their responsibilities.

During winter this year, we worked with the Department of Health and Aged Care to address low COVID-19 vaccination rates in residential aged care. Almost all providers that were part of our targeted activities have now taken steps to improve vaccination rates including:

care planning that includes older people’s vaccine needs and preferences and revisits choice options for those who have refused in the past
promoting the importance of vaccination, holding vaccine clinics and planning to make sure that ongoing vaccinations are encouraged
making sure that staff, residents and families know current medical advice on boosters
reporting regularly to their governing body on vaccination rates by service.

Where non-compliance was identified, we used a case management approach to make sure that providers reduced risk to older people.

Focus on vaccination

We want to see vaccination rates continue to rise. We will continue working with the department and keep a focus on infection prevention and control (IPC) and COVID-19 vaccinations.

We expect provider responses to COVID-19 to be part of the day-to-day operations of all residential aged care services, as well as the governance of their organisations. You can find more information in our Regulatory Bulletin 2024-24.

Opioids in aged care

In the latest Compliance Management Insights, Loren de Vries, Senior Practitioner, Behaviour Support and Restrictive Practices Unit and our Chief Clinical Advisor, Dr Mandy Callary examine the use of opioids in aged care.

You can read about their concerns where opioids are inadvertently used to manage a person’s behaviour. Opioids are strong painkillers but they can also have a sedating effect. Examples of the most commonly prescribed opioids in aged care are Targin (oxycodone and Naloxone) and Buprenorphine.

Freedom of choice and movement is a fundamental human right. As we age and access formal aged care services, there are some additional protections under the Aged Care Act to make sure that aged care providers don't unnecessarily restrict that right. The obligations around use of restrictive practices make sure that providers consider all the alternatives to manage a person’s behaviours before restricting a person’s free choice and movement.

Opioids have their place in managing a person’s persistent or chronic pain where the medication is used under specialist supervision and is subject to regular review. However, there is a problem when opioids are used for their sedating effects rather than for pain relief. Undue sedation in older people often carries with it additional risk of harm and clinical deterioration.

You can read the full article here.

Webinars

Workforce responsibilities – the key to delivering a great aged care experience

Tuesday 19 November 2024, 2.00pm – 3.00pm AEDT

All older people receiving aged care should have confidence that they will receive safe, high-quality care and services that meet their changing needs. Our focus at the Commission is always on making sure that providers deliver quality and safe care to older people. It's vital that providers understand their workforce responsibilities to make sure that their workforce is equipped and supported to do the same.

Hosted by Commissioner Janet Anderson PSM, this webinar will discuss providers’ workforce responsibilities with a particular focus on care minutes responsibilities. It will offer guidance for providers to embed effective workforce governance and management processes.

Registrations are now open for this webinar.

New aged care regulatory model: how it will work

Thursday 14 November, 2:00 pm – 3:00 pm (AEDT)

The Department of Health and Aged Care is hosting a webinar on the new aged care regulatory model. Panellists will include a representative from the Commission.

You will learn about:

benefits of the new regulatory model and how it will work
the new registration process and how we’re preparing providers
changes to reporting and what to expect
how providers will be regulated under the new model
engagement and communications on the new model.

You can submit questions before the webinar.

Recording available – Trust is built in drops and lost in buckets – Why open disclosure matters

The recording is now available from our 15 October 2024 webinar about what open disclosure is, why it’s important and what we are doing to support service providers to meet their open disclosure obligations.

Our panel included:

Janet Anderson PSM, Aged Care Quality and Safety Commissioner
Louise Macleod, Complaints Commissioner, Aged Care Quality and Safety Commission
Bill Lyon, Chief Executive Officer, Churches of Christ
Donna Hart, Executive Director - Seniors Living, Churches of Christ

Open disclosure is an important way for providers and workers to work with older people to resolve issues when things go wrong. More than that, it can help to restore trust and confidence in the service and can help stop issues from happening again.

Visit our website for more information and resources related to open disclosure.

Training and resources

Help us shape the future of the Alis platform

Alis is the home of the Commission’s online learning program. We are committed to making sure the system is easy to access and supports effective learning. We have recently launched a short online survey to help understand what it is like to use the Alis platform. We will use information from this survey to improve the platform user experience, including any future platform updates.

The anonymous survey takes 3–5 minutes to complete. You can access it by logging in to the Alis platform at https://www.learning.agedcarequality.gov.au.

New Learning Programs on Alis

Aged care providers and workers can now access 2 new training programs on the Commission’s online learning system, Alis.

The Hand Hygiene and Infection Prevention and Control program was developed by the Australian Commission on Safety and Quality in Health Care. The modules in this program are consistent with the recommendations of the Australian Guidelines for the Prevention and Control of Infection in Healthcare and provide hand hygiene and infection prevention and control education for clinical and non-clinical workers and students.

Forced Adoption: Practical Skills and Awareness was developed by the Department of Social Services. The effects of forced adoption are deep and far-reaching, causing long-lasting pain to mothers, adopted people and fathers who were separated. Completing the course will help learners to recognise and respond to the needs of people affected by forced adoption and family separation. By the end of the course, learners will be better prepared to provide care and support with kindness and respect.

Alis access is available free of charge for approved providers and their workers. Visit Online learning - Alis | Aged Care Quality and Safety Commission to find out more about Alis or to register your organisation.

Online workshops for approved providers

Places are available for our upcoming workshops in November. Each month, we deliver workshops for people working in the aged care sector. These workshops offer practical tips to support learners to understand how to meet their obligations within their service.

Our workshop topics for November are:

Effective incident management systems – understand how to use an incident management system to drive continuous improvement
Strengthened Quality Standards in practice – learn about the strengthened quality standards and how you can start preparing for their implementation.
The Serious Incident Response Scheme, for residential services and for home services – understand your obligations under the SIRS and know how to identify a reportable incident and notify the Commission.

These workshops are delivered by experienced Commission facilitators, with Subject Matter Experts from our regulatory teams on hand to answer your questions.

Places are limited, so head to Workshops | Aged Care Quality and Safety Commission to learn more or register today.

New resources

Sarah Burrell-Davis