Office of Aged Care Quality and Compliance (OACQC)

Six monthly report on operation of OACQC

Report on the operation of The Office of Aged Care Quality and Compliance

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Complaints Investigation Scheme

Overview

From 1 July to 31 December 2007, the Complaints Investigation Scheme (CIS) handled 3,947 ‘in scope’ cases, that is, relating to a potential breach of approved providers’ responsibilities under the Aged Care Act 1997. This included 418 reportable assaults. This compares with 1,260 complaints, received under the previous Complaints Resolution Scheme, during the 2005/06 financial year.

The CIS can accept and investigate concerns or complaints about the care and services provided to a care recipient in a Commonwealth funded aged care residential or community care service.

The scope of the CIS is broader than the previous Complaints Resolution Scheme, which was limited in its powers under the legislation and could only accept substantiated complaints. It was envisaged that the move to a more accessible complaints model would increase the number of issues raised and subsequent activity by the CIS.

Of the cases handled by the CIS 3792 related to residential care services, while 96 related to community care services and 59 to flexible care packages.

It should be noted that a ‘case’ means that this issue is investigated and does not indicate that a breach has occurred. For example, there were 433 instances where a breach was identified as a result of an investigation. Of these, 113 Notices of Required Action were issued in this period to address the breach. Of the remaining number of breaches, the matters were resolved through a negotiated outcome or through referral to another agency.

Cases by Month

The CIS had an average of 658 cases per month from 1 July until 31 December 2007.

Number of IMS* Cases	Jul	Aug	Sep	Oct	Nov	Dec	Total
In Scope	639	618	575	701	558	438	3529
*Investigation Management System

Number of Cases 1 July – 31 December by Office
STO*	NSW	VIC	QLD	SA	WA	TAS	NT	ACT	Total
Number of Cases	929	1447	778	369	242	102	17	63	3947
*State and Territory Office

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Departmental Site Visits

The CIS conducted a total of 1591 site visits, which means that 40% of ‘in scope’ cases received a visit. 458 (or 29%) of the site visits were unannounced.

1 Jul – 31 Dec	NSW	VIC	QLD	SA	WA	TAS	NT	ACT	Total
Total Site Visits	255	497	372	195	151	76	16	29	1591
% of Cases	27%	34%	48%	53%	62%	75%	94%	46%	40%

Reportable Assaults

There have been 418 contacts involving a reportable assault or 11% of all ‘in scope’ cases. Of those, 338 (81%) were recorded as unreasonable use of force and 80 (19%) as unlawful sexual contact.

It should be noted that a reportable assault case does not indicate that an allegation has been substantiated and the police are responsible for determining whether charges should be laid. The Department investigates whether providers are meeting aged care requirements.

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Top Issues

A contact may cover more than one issue. From 1 July to 31 December 2007, 5629 individual issues were identified. The top issue noted in 1405 instances (or 36% of all cases) concerns health and personal care.

1 July - 31 December 2007
ISSUE	Number	ISSUE	Number
Health and Personal Care (key issues include continence management, clinical care and personal hygiene)	1405	Food and Catering	315
Physical Environment	793	Choice and Dignity	291
Consultation and Communication	586	Unreasonable use of force	278
Personnel	467	Security of Tenure/Agreement	169
Specified Care and Services	377	Falls and Fall Prevention	160
Financial	353	Personal Property	103
Medication Management	332

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External Referrals

During the period 1 July to 31 December 2007, 710 referrals were made to external bodies of which 595 (or 84%) were to the Aged Care Standards and Accreditation Agency.

1 July - 31 December 2007
EXTERNAL REFERRALS	NSW	VIC	QLD	SA	WA	TAS	NT	ACT	Total
Advocacy	0	0	0	0	0	0	0	0	0
Aged Care Standards and Accreditation Agency	101	324	78	29	44	11	3	5	595
Coroner	7	7	0	1	0	0	0	0	15
Health Care Complaints Commission	5	4	2	1	0	2	1	0	15
Nurses' Board	2	27	0	1	1	1	0	0	32
Other	0	4	0	0	3	1	0	0	8
Police	23	6	0	2	0	0	2	0	33
State/Territory Government Bodies	4	5	0	0	3	0	0	0	12
Total	142	377	80	34	51	15	6	5	710

Notices of Required Action

There were 113 Notices of Required Action (NRA) issued from 1 July to 31 December 2007, of which 49 (or 43%) have been met while 64 (or 57%) were still being addressed at the end of December 2007.



In addition, there were 320 instances where a breach was identified as a result of an investigation, where either no NRA was issued because the matter was remedied immediately through a negotiated outcome, or it was referred to another agency.

External Examination by Aged Care Commissioner

From 1 July to 31 December 2007 the Aged Care Commissioner (ACC) made 39 recommendations to the Department. All recommendations related to examinable decisions.

Review of Examinable Decisions

ACC recommendations to confirm the original decision	ACC recommendations to set aside the original decision	ACC recommendations to vary the original decision
24	6	9

In relation to these recommendations the Department has undertaken a reconsideration of its original decision and has accepted the recommendations of the ACC in all but four cases.

Compliance Action

From 1 July to 31 December 2007, 11 approved providers had sanctions imposed and 60 Notices of Non-Compliance were issued.

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