Office of Aged Care Quality and Compliance (OACQC)

Protecting the safety and wellbeing of aged care recipients: The aged care quality and compliance framework

Presentation of 15 June 2011.

You may download this document in PDF format:

PDF printable version of the WEAAD presentation - 15 June 2011 (PDF 103 KB)


Today’s presentation

• The Australian Government’s aged care quality and compliance framework
• Compulsory reporting of assaults, data and case studies
• The Aged Care Complaints Scheme and the reforms to strengthen complaints handling
• Important role of advocacy

Some important principles

If a concern is not reported, it cannot be examined or resolved.

Compulsory reporting requirements are part of an approved provider's responsibilities under law to provide a safe and secure environment.

People must be able to raise concerns and make reports without fear of retribution.


Quality and compliance framework

The Department uses a range of approaches to ensure older people receive safe and quality aged care services.

Key elements of the framework are regulation, standards, quality, support and monitoring. Complaints serve as an important ‘safety net’ to further protect individual care recipients.

Under the framework, our goals are to:
• promote quality of care and quality of life for care recipients
• improve and protect the safety and wellbeing of care recipients
• promote open and transparent systems in aged care
• promote continuous improvement in aged care.
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Quality in aged care

Standards:
• Residential care standards
• Community care standards
• Indigenous flexible services
Regulation:
• Market entry
• Supply of place
• Funding
• Quality of care
• Protecting resident's funds
Monitoring
• Approved provider's responsibilities:
  • Quality of care
  • Key personnel
  • Financial management
  • Police checks
  • Fire safety
  • Emergency management
• Compulsory reporting
• Accreditation
• Quality reporting
• Prudential compliance
• ACFI
Complaints (saftey net)
Quality
• Skilled workforce
• Promoting quality practice
• Informed consumers
• National Aged Care Advocacy Program
• Community Visitors Scheme
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Aged Care Complaints Scheme

We examine concerns:
• relating to individual care recipients
• who receive Australian Government subsidised residential or community aged care relating to an approved provider’s responsibilities under the Aged Care Act 1997.
Complaints are ‘pre-compliance’ – but we can (and will) refer complaints for compliance action, where required.

We can refer a matter to the Agency, who may then assess the service against the Accreditation Standards.

We can refer complaints to other organisations such as professional registration boards, police or health care complaints bodies.


The facts

In 2009-10:
• 13,166 contacts
• 61.2 per cent (8,055 cases) were in-scope
  (compared to 7,496 in 2007-08; 7,962 in 2008-09)
• 96.5 per cent related to residential care
• Average of 2.8 in-scope cases per residential care service
• 38.8 per cent were out-of-scope – resolution included referrals or more information.

Compulsory reporting of assaults

Compulsory reporting aims to ensure homes provide a safe and secure environment for care recipients.

All aged care homes are required to report assaults to:
• ensure swift action is taken to support the alleged victim
• ensure that appropriate actions are taken to protect all residents
• meet their obligations and responsibilities under the Act
• ensure that all affected parties are offered support eg counselling.
We monitor compulsory reporting requirements in relation to reportable assaults, including allegations of unlawful sexual contact.

We may investigate if a facility has failed to make a compulsory report. We can also refer a matter to the Police.


What is a reportable assault?

Defined in the Aged Care Act 1997 (section 63–1AA) as allegations of:
• unlawful sexual contact with a resident of an aged care home (any sexual contact, without consent, that is unlawful under any Commonwealth, State or Territory law) or
• unreasonable use of force on a resident of an aged care home (from deliberate and violent physical attacks on residents to the use of unwarranted physical force on a resident.
These definitions aim to avoid the difficulties of applying legalistic definitions that vary widely throughout Australia.


Approved provider’s responsibilities

Must report to the Scheme and the Police all allegations or suspicions of unreasonable use of force or unlawful sexual contact on a resident.

Make the report within 24 hours of the allegation being made or becoming suspicious that an assault may have occurred.

Must have systems and protocols in place to enable compulsory reporting.

Must provide protections for staff who report.

Have the discretion not to report if alleged assault perpetrated by resident with an assessed cognitive or mental impairment.

To report or for more information, call 1800 550 552
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Compulsory reports in 2009-10

1,488 reports
(1,411 reports in 2008-10 and 925 reports in 2007-08)

1,232 reports of alleged serious physical assault; 239 reports of alleged sexual assault; 17 reports of alleged physical and sexual assault.

We are currently analysing the data to gain an understanding of the trends, and inform the sector as part of a broader awareness program.


Case study 1

• Couple living together in residential care
• Husband discharged to hospital; the service didn’t want to take him back due to aggressive behaviour (not dementia-related)
• Scheme investigated an alleged breach of security of tenure
• Found that wife was being subjected to verbal and physical abuse by husband (and had been for many years)
• Staff were aware but thought they weren’t able to intervene in private affairs
• Scheme initiated compliance action, requiring the service to implement an education program – that abuse was abuse in any form, and they were responsible for the welfare of the care recipients, regardless of the relationship they had with the alleged offender
• The service implemented the changes successfully
• Upon follow-ups, the husband had been transferred and the wife had ‘blossomed’ and was reportedly very happy

Case study 2

• AP reported that a resident (with significant cognitive impairment) had alleged that a man had come into his room at night and kicked him for no reason, on several occasions.
• The description matched a part-time staff member. No evidence was found to implicate the staff member, however he was moved to day shift and a different part of the service.
• Several weeks later another reportable assault was received relating to a female resident who had a history of fabricating events. She alleged she had been slapped by a male staff member, however changed the story later when interviewed by police.
• Nothing came of this event however it led an AIN to come forward to the DON to advise she had seen the employee from the first incident slap the female resident when she was non-compliant with her care. The AIN was not aware of the allegation from the male resident.
• As a result of this second identification, the staff member’s employment was terminated.

Strengthening the Complaints Scheme

Strengthened complaints management framework:
• expands the range of resolution techniques
• encourages local resolution, where possible
• care recipient at the centre of initial decision making
• risk assessment
• focuses on achieving a sustainable and quality outcome
• broadens review rights
• maintains right to complain confidentially or anonymously
• a greater focus on education and support
Strengthened processes: natural justice, evidence-based decision making, clear and ongoing communication, access to advocacy at any time.

Improved information for consumers and industry.


Advocacy

Advocacy services in each state and territory are funded under the National Aged Care Advocacy Program.

In 2009-10, services under NACAP undertook over 4,100 advocacy cases, handled over 5,300 general enquiries, and provided over 1,600 face-to-face education sessions.

We consulted with many advocacy services about the reforms to the Complaints Scheme and the proposed complaints framework.

We are strengthening the information we provide to consumers about their right to access advocacy at any stage of the complaint.

To ensure consumers are aware of how advocacy can assist, we will capture this information through an updated satisfaction survey (issued once a complaint has been finalised).


Thank you

Any questions?


Visit our website agedcarecomplaints.govspace.gov.au
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