Weekly Wrap: 1 December 2019

Aged care news highlights from the week ending 1 December 2019.

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Four Practical Things Aged Care Providers Can Do Right Now in Response to the Royal Commission’s Interim Report

Unless you’ve been living under a rock for the past few weeks, you would have heard something about the Interim Report of the Royal Commission into Aged Care Quality and Safety. And it probably wasn’t good news.

If you’ve attempted to read the Interim Report, you’re probably feeling overwhelmed. After all, it doesn’t just describe “a shocking tale of neglect”, it describes it in expansive detail across two volumes that together run to over 600 pages.

Residential aged care providers, of course, are keen to engage with the Royal Commission’s findings, but in the face of such grim immensity it’s hard to know where to start. That’s why we’ve set out these four things that you can do right now to help you understand and respond to the Interim Report.

 

1. Read a Short Summary of the Interim Report

If you don’t have time to get through all 600 pages (and who does?), the Royal Commission’s media release provides an excellent summary that is only three pages long.

But if even that is too much, here is a summary of the summary:

  • Entitled “Neglect” the Interim Report described the Australian aged care system as a “shocking tale of neglect” and found that “a fundamental overhaul of the design, objectives, regulation and funding of aged care in Australia is required.”
  • The Interim Report identified three areas where immediate action can be taken: home care packages, chemical restraint, and young people with disability going into aged care.
  • The Interim Report identified five systemic problems in aged care with a system that:
    • is designed around transactions, not relationships or care
    • minimises the voices of people receiving care and their loved ones
    • is hard to navigate and does not provide information people need to make informed choices about their care
    • relies on a regulatory model that does not provide transparency or an incentive to improve
    • has a workforce that is under pressure and under-appreciated and that lacks key skills.
  • The Interim Report does not make specific recommendations – those will be released with the Final Report when it is published on 12 November 2020.

 

Share the Chemical Restraint Bulletin and Scenarios with Staff

As noted in our summary of the summary, chemical restraint and workforce skills were major issues of concern in the Interim Report.

The bad news is that the regulation of restraint is a complex and developing area, so it’s not easy to keep staff up to date with the latest requirements. The good news is that the Aged Care Quality and Safety Commission (ACQSC) provides some resources to help you cope with this challenge.

At 10 pages, the Regulatory Bulletin on Regulation of Physical and Chemical Restraint is a reasonably easy read that lays out some useful information about what constitutes restraint and what the ACQSC will be looking for when they assess a provider’s use of restraint. Consider reviewing your Restraint and Restrictive Practices Policy against the Bulletin to see where you need to make updates. The Interim Report was particularly concerned about the use of restraints on the many residential aged care consumers who have dementia, so it is worth paying close attention to that area during your review.

A great supplement to the Bulletin is the nine-page Restraint Scenarios, which provides some practical, illustrative examples of what is and isn’t restraint.

Sharing and discussing these documents with staff is one way to get a head start on an issue that will almost certainly be subject to major reforms over the next few years. It’s also a good prompt for your leadership team to start developing a learning program that teaches staff about restraint and assesses their understanding.

 

Watch the ACQSC Video on Open Disclosure

If you jump back up to our summary above and take a closer look at the five systemic problems identified in the Interim Report, you will see that almost all of them involve failures to engage with consumers.

Consumer engagement is already a major theme – if not the major theme – of the Aged Care Quality Standards, so it’s not surprising that it’s also a major theme of the Interim Report, and you can bet that it will be a major theme of the Royal Commission’s Final Report too.

One crucial aspect of consumer engagement is transparent and inclusive decision-making, or what the ACQSC calls “Open Disclosure”. Open Disclosure is particularly helpful for improving your understanding of consumer-engagement because it puts that somewhat abstract concept into a practical context. 

If you’ve got 11 and a half minutes to spare, you can learn all about Open Disclosure via the ACQSC’s Open Disclosure video.

 

Discuss the Clinical Governance Toolkit with Your Leadership Team

The Royal Commission’s Interim Report is one more manifestation of the rapid and dramatic regulatory change that is affecting the aged care industry. To keep pace, you’ll need to have systems in place that can efficiently inform your leadership team and respond to their decisions. In other words, you’ll need good governance.

Our final tip is to check out the ACQSC’s Clinical Governance Toolkit and use it to start a conversation with your leadership team. Also consider using the Toolkit to review your policies and identify areas for improvement in your current clinical governance system. In conducting your review, bear in mind that the Interim Report highlighted the disconnect between policies as written and policies in practice, noting that in many cases providers had adequate policies but lacked adequate systems to put those policies into practice and monitor and record their effects.

 

Conclusion

The Royal Commission’s Interim Report has presented an overwhelmingly grim picture of the aged care industry and the challenges that providers must face. But there are resources available to help you face these challenges one manageable step at a time.

Mark Bryan
ABOUT THE AUTHOR | Mark Bryan
Mark is a Legal Research Consultant at CompliSpace. Mark has worked as a Legal Policy Officer for the Commonwealth Attorney-General’s Department and the NSW Department of Justice. He also spent three years as lead editor for the private sessions narratives team at the Royal Commission into Institutional Responses to Child Sexual Abuse. Mark holds a bachelor’s degree in Arts/Law from the Australian National University with First Class Honours in Law, a Graduate Diploma in Writing from UTS and a Graduate Certificate in Film Directing from the Australian Film Television and Radio School.

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