Home > For Health Professionals > Aged care > Publications

Publications

Aged Care Essentials - Edition 4, 2011

The 4th edition for 2011 of the Aged Care Essentials is designed for approved providers and the staff of Australian Government-subsidised residential aged care services.

You may download this document in PDF format:

PDF printable version of Aged Care Essentials - Edition 4, 2011 (PDF 917 KB)

Aged Care Education and Training Incentive Program
New Arrangements to Protect Aged Care Residents' Savings
Calculation of Medication Administration Time
Naming Practices of Resident Fees and Charges
Indigenous Remote Service Delivery Traineeships
ACATs Approval of Respite Care
Aged Care ICT Directory
Information for Approved Providers About the Validation Program
Focusing on Resolution
Department of Human Services - Medicare is Extending Online Access to the Electronic ACCR
National Aged Care Workforce Census and Survey

Aged Care Education and Training Incentive Program

The Australian Government provides incentive payments to aged care workers who undertake further studies to enhance their career as a personal care worker, an enrolled nurse or a registered nurse. Incentive payments are provided through the Aged Care Education and Training Incentive Program (ACETI).

Eligible applicants from all over Australia are encouraged to apply now, and those who complete the required training will receive two incentive payments: a commencement payment and a completion payment. Payments range from $500 to $3000 and depend on the level of study.

Helen Stauffer has worked at the Sir Thomas Mitchell Nursing Home in Illawong, New South Wales, for more than two years and has recently received a commencement payment of $500 through ACETI. Helen is studying for a Certificate IV in Aged Care and at present is completing her course through Bannister Technical in Surry Hills, New South Wales.

Helen enjoys working with the elderly and, after hearing about the program, welcomed the opportunity to enhance her skills as a personal care worker. During her studies Helen has learnt new skills to assist her in the workplace and would encourage others to find out if they are eligible for the program.

Helen looks forward to receiving the $500 completion payment when she has finished her course and intends to undertake further studies.

To qualify for the incentive payments, aged care workers must be employed in an eligible aged care service and commence training between 1 July 2010 and 30 June 2014.

For further information on the ACETI Program please see www.health.gov.au/aceti or telephone the Medicare Australia Aged Care Information Line on 1800 195 206.

New Arrangements to Protect Aged Care Residents' Savings

Clearer and stronger arrangements to protect aged care residents’ savings held in the form of accommodation bonds came into effect on 1 October 2011.

Since the introduction of the Aged Care Act 1997 there has been strong growth in the value of bonds. At 30 June 2010 aged care providers (approved providers) held more than $10.6 billion in bonds on behalf of more than 63 000 aged care residents.

The Australian Government announced in April 2010 that it would move to strengthen the prudential arrangements for bonds. The announcement was made as part of the More Support for Older Australians in the National Health and Hospitals Network. Extensive consultations on the legislative changes were conducted with the aged care sector, consumer groups and financial services sector.Top of page

The new arrangements:

• clarify the intended purpose for bonds—to provide a capital source of funding for investment in aged care infrastructure, for prudent financial investments and for refunding bonds
• remove restrictions on the use of retention amounts, accommodation charges and income from bonds. This provides more flexibility to manage cash flow and helps offset the limits on permitted uses of the lump sum element of the bonds
• ensure that approved providers holding bonds have governance systems in place to effectively manage bonds through the introduction of the Governance Standard. Effective governance reduces the risks of bonds being used for other than permitted uses and the incorrect repayment of bond balances
• increase transparency and accountability by improving the information available on how approved providers use bonds
• introduce new information gathering powers where the Secretary of the Department of Health and Ageing reasonably believes that an approved provider is experiencing financial difficulties, has misused bonds or has not or is unlikely to refund a bond balance
• apply criminal offences to approved providers and key personnel where misuse of bonds has been identified and the approved provider has become insolvent and failed to refund bonds. These offences apply only in the most extreme circumstances.

Further information

Protecting Residents’ Savings— a guide to the arrangements for accommodation bonds from 1 October 2011, three information sheets for approved providers and the information sheet Accommodation Bonds for Residential Aged Care (for consumers) are available on the department’s website at www.health.gov.au.

For more information call 1800 200 422 or email prudential@health.gov.au.

Naming practices of Resident Fees and Charges

Recent enquiries to the department indicate that some residents are experiencing difficulty in understanding their fees and charges where the invoice from their service provider describes them in terms that do not match the descriptions used in departmental advice letters or the Schedule of Resident Fees and Charges.

To avoid this confusion, facilities may wish to consider referring to aged care fees and charges in line with the charges listed on the Schedule of Resident Fees and Charges, rather than under the generic term accommodation costs.Top of page

For example:

Basic Daily Fee - $41.34
Income Tested Fee - $66.43
Accommodation Charge - $32.38

Aged Care Funding Instrument:

Calculation of Medication Administration Time

ACFI 11 Medication

This question relates to the needs of the care recipient for assistance in taking medication. It relates to medication administered on a regular basis. Infrequent or irregular administration of medication is not covered in this question.

To calculate the timing for this question the below table on page 9 of the ACFI Answer Appraisal Pack needs to be completed when funding claims are submitted to Medicare.

Medication round: circle applicable rounds	Administration time (minutes)
Early morning
Middle of day
Afternoon/evening
Other
	Total time

The following advice aims to assist with understanding how to calculate medication administration time for ACFI appraisals.

The heading Administration time (minutes) refers to the information in the ACFI User Guide, December 2009, p. 34 which states:

For daily medication ordered by an authorised health professional, record the medication administration time in the Answer Appraisal Pack and calculate how many minutes are required for medication assistance over a 24 hour period.

The expectation is that for each timing period, exact times in minutes and seconds should be recorded and then at the end of the 24 hour period, the total time taken should be recorded in minutes.

When identifying total minutes in the 24 hour period the appraiser will need to add the individual figures recorded across the day to a total figure. Any figure including 30 seconds or more would be rounded up to the nearest minute, whereas figures less than 30 seconds should be rounded down to the nearest minute

Example 1:
Early morning = 3 min 30 sec
Evening = 1 min 45 sec
Total = 5 min 15 sec

Therefore, rounded down, this calculation should be recorded as 5 minutes.

However, to ensure all times required for administering medication is recorded there is an exception to this rule when the recording time is less than 1 minute. In these cases it is expected all figures below would be rounded up to 1 minute.Top of page

Example 2:
Early morning = nil
Evening = 25 sec
Total = 25 sec

Therefore, rounded up, this calculation should be recorded as 1 minute.

This information takes into account the outcome from the initial National ACFI Trial in 2006 where feedback indicated that the time taken to assist a person with their medication was more indicative of their resource need rather than just the type of medication taken. After analysis of the National Trial data, the question on medication included the time needed to assist a resident (based on the resident’s impairments etc.) with their medications over a 24 hour period.

As per page 6 of the ACFI User Guide, it is the responsibility of the ACFI appraiser to assess how long it takes over a 24 hour period to assist the resident with their prescribed medication:

The ACFI appraiser will ensure that the ACFI Appraisal Pack has been completed in accordance with these guidelines. The person authorised by the approved provider to complete and submit the ACFI Application for Classification must certify as part of the application that it is true and correct.

When medication is administered, care staff on each shift should calculate the time taken, using the method outlined above. The ACFI appraiser can then accurately complete the evidence requirements, as per the source materials specified on page 9 of the ACFI Answer Appraisal Pack.

For further information on ACFI appraisal or claiming issues please refer to the ‘Frequently Asked Questions’ at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-acfi-faq.htm or, alternatively, enquiries can be sent to the ACFI inbox at acfi@health.gov.au

Indigenous Remote Service Delivery Traineeships

Under the Aged Care Workforce Fund the government provides $300m to train the aged care workforce. As part of this the government provides Indigenous Remote Service Delivery Traineeships to support Aboriginal and Torres Strait Islander aged care and primary health care workers to undertake qualifications in business and management.

Krista Carbine works for the Umoona Aged Care Aboriginal Corporation in Coober Pedy as a finance officer.

She is one of the first trainees to start with the Indigenous Remote Service Delivery Traineeship initiative and completed her Certificate IV in Business in June 2011.

As part of her traineeship Krista worked with a team to come up with a Cultural Model of Care for Elders in her community. Krista was asked to present her ideas at a national conference.

The first time she presented to a group Krista was very shy and nervous, saying, ’You could see me shake’.

We recently spoke to Krista about how she found the training and what it has meant for her. This is what she had to say.

The experience of travelling and meeting new people was awesome! I had not been to Sydney before and not been in a training group that included people out of our community and from other Aboriginal and Torres Strait Islander communities.Top of page

The trainers made it easy by the way they spoke to us. If we didn’t understand things they would explain it in a different way and spend time with us one on one until we got it.

Acknowledgement and confidence were the two big things I got out of my Certificate IV. At the conclusion of my training I had an opportunity to present at a National Conference for the Aboriginal and Torres Strait Islander Aged Care Service Providers with our Executive Officer.

I felt a lot more confident and comfortable presenting at the conference as I had gained skills during my training and was presenting on an area that I was not only passionate about, but proud to be a part of.

One special part was having two of my aunties at the conference who work for another service in Ceduna where some of my family live. They were so pleased to see my presentation that in the morning tea break they phoned my nan and mum to tell them how good I did.

My boss says that she has a 10-year plan for me. When I know what it is I will tell you! P.S. I am at the 3rd year of the plan and I have my Cert IV in Business!

We work with very special Elders and people need to know that as well as that we work really hard to support them. It was an awesome experience. I can’t wait for the next opportunity to share the story of my workplace.

ACATs Approval of Respite Care

Aged Care Assessment Teams (ACATs) assess care requirements on the basis of agreed guidelines for the needs of the care recipients and their carers.

It is important that ACATs conduct assessments of older people in accordance with relevant legislation and guidelines, and that the care services recommended and approved produce the optimum outcome for the person assessed.

It is not necessary for care recipients to be approved for both permanent residential care and residential respite care. There are instances where the care recipient is approved for permanent residential care only.

Residential respite care is provided as an alternative care arrangement with the primary objective of giving a carer or care recipient a short term break from their usual care arrangement. Residential respite care places should be made available to support the carer and care recipient at times of stress, including illness, holidays or the unavailability of the carer for any reason.

While some aged care service providers prefer to initially admit the person for residential respite care before admitting the person permanently without prior knowledge of assets, this should not be a consideration for ACATs in terms of assessment of the care recipient.

The role of the assets assessment is primarily to identify residents for whom the government will help support their aged care accommodation payment. For other residents an assessment may help them negotiate an appropriate accommodation bond or charge amount.

It is acknowledged that the aged care service provider will make the final decision to determine whether the person can be appropriately cared for in their facility.

Aged Care ICT Directory

The department has been working with CHIK Services Pty Ltd to develop an Aged Care ICT (Information and Communications Technology) Directory, which is a ready source of information about technology options supporting residential aged and community care.

An extension of the Health-e-Directory, the Aged Care ICT Directory assists in identifying and comparing the latest e-Health products and services. It has been developed with the support of the Aged Care Association Australia, Aged and Community Services Australia and the Aged Care Industry IT Council.

The directory, along with its companion website eHealthspace. org, offers details of vendors of IT services, IT news and opinions, white papers, and research and case studies relevant to the health and aged care settings.

A fortnightly newsletter will also be sent out to residential and community aged care services by CHIK Services. Newsletter content will include collated news, resources, event feeds, editorial and feature articles.

The Aged Care ICT Directory is available at www.Health-e-Directory.com.au and as a resource on www.eHealthspace.org. Select the Aged Care Directory tab to find the latest IT products and services.

Aged Care Funding Instrument:

Information for Approved Providers About the Validation Program

Reviews of funding claims under the Aged Care Funding Instrument (ACFI) commenced in February 2009. As the ACFI has been in place for more than three years, the department is refining the ACFI Review Validation Program to better target specific ACFI claiming patterns.

Approved providers have been seeking clarification from review officers about the review program. This article gives answers to three of the most common questions regarding the validation of ACFI appraisals.Top of page

Common questions about validation activities

1. Can a review visit to an aged care facility occur within six months of the last visit?

Yes. The department can choose to visit a facility to undertake a review at any time it deems necessary. In most circumstances a review visit will not follow within six months if no concerns have been identified in the previous review.

2. Can a validation visit review more than 25 per cent of the residents at the aged care service?

Yes. There is no limit on how many ACFI appraisals the department can consider when they undertake a review visit. However, to limit the administrative burden on approved providers, and where no other concerns have been identified, the department may choose to limit validations to no more than 25 per cent of residents.

The department uses a riskbased approach to prioritise its ACFI review activities. It continues to refine this approach, based on analysis of the ACFI’s operation over the past three years (the life of the ACFI to date). Current review activities may include review of complete appraisal documentation for a number of residents, and/or review of specific questions. This refined risk-based approach also aims to reduce the burden on approved providers who make accurate claims under the ACFI.

3. Can review officers ask to see more documentation than the ACFI Answer Appraisal Pack?

Yes. Review officers are authorised under section 90-3 of the Aged Care Act 1997. If a review officer is unable to support a claim using the available documentation, the review officer can request additional documentation from the approved provider as set out in section 90-4 of the Act. Making this information available at the time of the review allows claims to be validated immediately, thus reducing the need for follow-up actions by providers and review officers.

ACFI statistics update —March 2011 and June 2011

The statistics for the March quarter 2011 and June quarter 2011 on the Review Outcomes by State and Review Outcomes by Question have been uploaded to the internet at the following address:

http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-resident-appraisal.htm

If you have any queries please email acfi@health.gov.au.

We recommend you continue to review the Frequently Asked Questions (FAQs) and the department’s manuals as a resource for clarification. All of these can be found at http://www.health.gov.au/acfi

The new Aged Care Complaints Scheme:

Focusing on Resolution

From 1 September 2011 major reforms to the Aged Care Complaints Scheme (previously called the Complaints Investigation Scheme) took effect.

The priorities of the new Scheme are to resolve the concern for the complainant in the interests of the care recipient, to work with the provider wherever possible in reaching the most positive result and, most importantly, to ensure the safety and wellbeing of the care recipient.

The Scheme has also strengthened its communication approach. The Scheme processes are transparent and regular feedback is provided to all parties of the complaint throughout the complaints resolution process.Top of page

The reforms occurred in response to the 2009 review conducted by Associate Professor Merrilyn Walton. The government accepted the majority of the review’s recommendations including:

• having a more robust risk assessment for complaints so they are managed in the most appropriate way
• broadening the options for resolving complaints including approved provider resolution, investigation, conciliation and mediation
• reviewing recruitment and training practices
• further developing relationships with key agencies.

The revised Aged Care Complaints Scheme is underpinned by new legislation (Complaints Principles 2011) and a new framework for handling complaints.

What does this mean for aged care providers, services and staff?

• We’re encouraging and supporting complainants to talk to the provider first, where appropriate.
• We’re referring some complaints to the provider for resolution.
• We’re supporting providers through greater communication of complaints data, trends and lessons; case studies; on-the-ground education; and online information.

Providers also have a role to play:

• to have a good complaints system in place
• to encourage local and early resolution of concerns at the service level
• to ensure consumers know how they can provide feedback and get their concerns resolved
• to resolve concerns we refer to them
• to be willing to work with us and the complainant to achieve a positive result for the care recipient.

Information materials that describe the new Scheme (brochure, booklet, poster, service charter, fact sheets) have been mailed out to providers and services for display and distribution to care recipients and their families, friends and representatives

Visit our website agedcarecomplaints.govspace.gov.au for the latest information and updates about the Complaints Scheme.

You can also email us at agedcarecomplaints@health.gov.au

Department of Human Services—Medicare is extending online access to the electronic ACCR

Access to the electronic Aged Care Client Record (eACCR) through the Department of Human Services—Medicare’s Aged Care Online Claiming System is currently available to aged care service providers of residential and community care

Medicare, in a project funded by the Department of Health and Ageing, will be extending this access to providers of:

• Extended Aged Care at Home (EACH)
• Extended Aged Care at Home Dementia (EACHD)
• Transition Care Serviices (MPS)
• Commonwealth Respite and Carelink Centres (CRCC).

For an eligible provider to gain online access to the eACCR, they must be registered in Medicare’s Online Claiming System.

Further information on how to register will be released in the coming months.

National Aged Care Workforce Census and Survey

The National Aged Care Workforce Census and Survey is coming to aged care homes and community aged care services.

Your support for the Census and Survey is vital.

The Census and Survey will assist the Department of Health and Ageing to provide reliable, evidence-based advice to government on aged care workforce issues. Assisting us to obtain a high response rate will provide the data we need to plan for the future of the aged care workforce. It will also be a valuable resource on aged care workforce characteristics and trends for providers of community and residential aged care services, health professionals, professional associations, unions and a wider audience.

The Census and Survey is coming to your service in early February 2012.

It is a requirement of the Residential Care Subsidy Principles 1997 that for Conditional Adjustment Paymernt (CAP) to continue to be paid a residential aged care facility must complete the Census and return it to the address provided, or submit it online by the due date.

Where a completed Census has not been received within four days of the due date the CAP payment for that facility will be stopped. CAP will not be reinstated until the first day of the month following the date on which the department receives a Census that has been completed to its satisfaction.

For further information regarding the Census and Survey please visit www.ipsos.com.au/NACWCAS or email censusandsurvey@health.gov.au

The Survey has been commissioned by the Australian Government and is supported by our Expert Reference Group members who include representatives from Aged and Community Services Australia, the Australian Nursing Federation, the Australian Physiotherapy Association, Health Services Union East and the Lincoln Centre for Research on Ageing, La Trobe University.Top of page