Better health and ageing for all Australians

Quality Framework for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program

1 Executive Summary

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The purpose of this document is to provide an overview of:

  • the development of the Quality Framework
  • the Quality Framework Design
  • the Review Process
  • the Quality Improvement Cycle.

1.1 Introduction

The Quality Framework for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (the Program) was developed to provide a set of quality stan-dards for services funded under the Program and a process for monitoring achieve-ments against these standards.

The Program aims to provide quality, flexible and culturally appropriate aged care to older Aboriginal and Torres Strait Islander people close to their home and community.

Services funded under the Program can deliver a flexible mix of residential and community based aged care services that can change as the care needs of the communities vary. Funding is based on an allocation of places and not on the occupancy of places. This provides a constant income stream to allow service providers both stability of income and flexibility to manage the delivery of aged care services and respond to community need. Communities are encouraged to participate in all aspects of service provision from planning through to the operation of services.

The objectives of the Program are to:
  • provide quality, flexible, culturally appropriate aged care services to older Aboriginal and Torres Strait Islander people close to their home and community
  • enable these communities to provide a range of services which are able to respond to individual needs of older people within the community
  • develop financially viable cost effective and coordinated services, outside the existing conventional program structures
  • facilitate community involvement in the care of their older people through the management of the service.
There are currently 28 services funded under the Program with the majority located in very remote or remote areas.

1.2 The Development of the Quality Framework

The development of a culturally appropriate Quality Framework for the Program is one of a number of Australian Government measures which aim to improve the long-term quality of aged care services for Aboriginal and Torres Strait Islander people.

The Quality Framework includes a set of quality Standards and a process for monitor-ing achievements against the Standards, designed to assist service providers to continuously improve their services.

The Quality Framework was developed with the support of Australian Healthcare Associates, service providers, the communities they support and representatives from the Department of Health and Ageing (DoHA) and included:
  • initial consultation forums with 28 service providers
  • initial consultations with representatives from DoHA
  • completion of a literature scan
  • review and mapping of other Quality frameworks common to flexible aged care services
  • design and delivery of five workshops across Australia for the 28 current service providers, to introduce the draft Quality Framework and the resources developed to support service providers to implement the pilot
  • provision of support to service providers to complete a self-assessment against the draft Standards
  • completion of 21 site visits to validate the self-assessments and the development of a report and action plan to address the findings from the site visit
  • consultation with DoHA
  • evaluation of stakeholder feedback in relation to the draft Quality Framework.
The themes that emerged from the consultations held across Australia included:
  • a culture that ensures each person is cared for, as well as their families and the community
  • the Standards developed need to take into account the importance of culture to service users and service providers
  • each service provider and their communities have unique and diverse cultural needs that must be accommodated
  • there is considerable diversity in the types of services delivered across Australia
  • there is wide variation in the level of experience that service providers have in meeting quality standards
  • some providers have sound quality systems and processes in place, while others are still learning about quality systems
  • all services have struggled at various times to recruit and retain suitably qualified staff
  • there is the need to build the capacity of service providers, communities and staff to ensure quality service delivery
  • risk management – the need to minimise risk for the people cared for and for staff, while respecting the needs and wishes of all stakeholders
  • the relationships of flexible aged care services – with the people they care for and their families, the community, other providers and government.
The literature highlighted that the Standards should:
  • be simple in intent, achievable and few in number
  • be measurable
  • encourage continuous quality improvement.
Taking into account the above themes, the Quality Framework has been developed based on two overarching principles, Continuous Quality Improvement (CQI) and Cultural Safety. It is expected that these two principles will be recognised and embedded in all aspects of each organisation’s service delivery and quality systems.

1.3 The Quality Framework

An overview of the design of the Quality Framework is described in Chapter 2 of this document.

The Quality Framework comprises:

1. A set of Quality Standards, with Expected Outcomes and a Guide to requirements (described in Chapter 3).
2. The Quality Improvement Cycle which outlines the Review Process (described in Chapter 4) including:
    • the steps which measure and assess service provider performance against the Standards
    • support for service providers to meet and continually improve their quality performance against the Standards
    • how service provider complaints or feedback about the Review Process are addressed
In addition, Quality Framework Guides and Tools and Templates, have been developed to support Service Providers and Quality Reviewers, as follows:

3. Quality Framework Guides 4. Quality Framework Tools and Templates