Infection Control Spot Checks in Residential Aged Care: What Providers Need to Know

The Aged Care Quality and Safety Commission (ACQSC) is stepping up its program of infection control spot checks of residential aged care homes.

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New Aged Care Commission Rules for 2020: Key Changes Providers Need to Know

We’re barely halfway through January and already the Aged Care Quality and Safety Commission (ACQSC) has made extensive changes to its rules and procedures. 

What’s new? What’s changed? How can we possibly absorb more information when we’re still wading through the inundation from 2019?

Don’t panic. Here is a summary of the key ACQSC updates for 2020 and why they’re happening.

 

Overview of the Changes

According to the ACQSC website, the Aged Care Quality and Safety Commission Rules (Rules) have changed. These changes affect the way the ACQS deals with:

  • Quality Assessment and Monitoring
  • Non-Compliance
  • Accreditation and Re-Accreditation

We’ll discuss each of these areas in detail below. But first let’s look at why the changes are happening.

 

Why Are These Changes Happening?

Last year, responsibility for regulating the aged care industry was shared between the Department of Health and the ACQSC. The government decided that it would be better to have one regulator rather than two, so it transferred the Department of Health’s powers and responsibilities to the ACQSC.

This involved changing the two sets of laws that govern the ASCSC: the Aged Care Quality and Safety Commission Act 2018 (Cth) and the Aged Care Quality and Safety Commission Rules 2018 (Cth).

Importantly, the government didn’t just transfer the exact same powers from one regulator to the next – they also changed, clarified and expanded some of those powers.

 

Changes to the way the ACQSC Deals with Quality Assessment and Monitoring

In an upcoming article we will look in more detail at the changes to the way the ACQSC conducts assessments. But for now, here are some of the key changes.

 

The ACQSC is No Longer Required to Give Written Notice of An Assessment Contact

According to the ACQSC Assessment Contact Fact Sheet, the ACQSC may give the provider of a service written notice of the arrangements for assessment contacts, but this notification will no longer be a required.

 

New Power to Assess Previously-Accredited Services

The ACQSC has expanded the kinds of services that it can assess. It is no longer restricted to assessing currently accredited services; it can now make an assessment contact at a service that was previously accredited.

 

New Power to Assess All of a Provider’s Services in One Assessment Contact

The ACQSC can now make a single assessment contact that covers all of a provider’s services. So, if a provider runs multiple residential care services, or a residential care service and home care service, the ACQSC can now assess all their services at once.

It seems unlikely that the ACQSC will use this power when assessing compliance with Standards, such as clinical care, that require assessors to see what happens on the ground in each service. But the ACQSC may use this new power to assess things that are more relevant at the ‘head office’ level, such as compliance with Standard 8: Organisational Governance.

 

New Terminology for Assessment Contacts

The ACQSC has said that its assessment contacts will now fall into one or both of these categories:

  • Assessment Contacts (Performance Assessment)
  • Assessment Contacts (Monitoring).

Here’s a quick breakdown of what these terms mean:

Assessment Contacts (Performance Assessment)

Purpose is to assess a provider’s performance against one, or more, of the Aged Care Quality Standards.

Will result in an assessment contact report.

Assessment Contacts (Monitoring)

Purpose is to monitor the quality of a provider’s care and services.

Includes such things such as an ACQSC delegate attending a provider’s board meeting or calling them on the phone to discuss a performance assessment, plan for continuous improvement or a change in compliance expectations.

It might also include includes a visit by an ACQSC delegate to a service to conduct consumer experience interviews.

Will not result in an assessment contact report but could result in a decision to conduct a performance assessment.

 

New Terminology Regarding Reports

 The ACQSC has introduced this new terminology to differentiate reports written by the Assessment Team from reports written by a Delegate of the Commissioner:

Reports Written by the Assessment Team

Reports Written by a Delegate of the Commissioner

  • Site audit report
  • Review audit report
  • Quality audit report
  • Assessment contact report

These reports are written by the Assessment Team following an Assessment Contact (Performance Assessment).

It assess a provider’s performance against the relevant Quality Standards and includes whether they have Met/Not Met the requirements.

This report is given to the provider, for an opportunity to respond, and the Commissioner, to consider for the Performance Report.

  • Performance report.

A Performance Report is written by the Commission’s delegate in response to a report from the Assessment Team and any accompanying information.

A Performance Report sets out the ACQSC’s decisions about a provider’s performance, including whether they are Compliant/Non-Compliant with the requirements under the Standards.

The purpose of a Performance Report is to set out the reasons and evidence for a delegate’s decision. It gives the Provider an informed opportunity to respond.

 

New Publishing Procedures

The ACQSC has adopted some new procedures when it comes to publishing reports on its website:

  • From 1 January 2020, the performance report will be published on the ACQSC website following a site audit or a review audit.
  • From 1 July 2020, all performance reports developed following an Assessment Contact (Performance Assessment) or quality review will also be published on the ACQSC website.

 

Changes to the way the ASCQS Deals with Non-Compliance

The ACQSC is No Longer Required to Notify Providers of Timetables for Improvement

According to the ACQSC Timetables for Improvement Fact Sheet, it used to be the case that if a provider failed to comply with the Aged Care Quality Standards, the ACQSC had to notify them of a timetable for making the necessary improvements.

That requirement has been removed from the Rules and no longer applies. Instead, providers must submit their revised Plan for Continuous Improvement (PCI), which details their intended actions to correct an area of non-compliance within a specified timeframe. 

 

The ACQSC Will No Longer Make Decisions about “Serious Risk”

According to the ACQSC Serious Risk Fact Sheet, it used to be the case that if a service failed to comply with the Aged Care Quality Standards, the ACQSC had to decide if the failure placed consumers at serious risk.

That requirement has been removed from the Rules and no longer applies. This change reflects the ACQSC’s new general ‘risk-based’ approach whereby the ACQSC will now be more focused on the details of a particular case and its responses to non-compliance will be proportionate to the particular level of assessed risk.

The ACQSC says that its Assessment Teams will still be on the lookout for serious risks and ACQSC officers will take any serious risks into account when determining further actions. Where the ACQSC makes a finding of non-compliance that poses high or severe risk, they may issue a Notice to Remedy that requires the provider to remedy the non-compliance within a certain period.

Note that this new situation applies even to pending decisions. In other words, if a report of serious risk reached the ACQSC in December 2019 but hadn’t been considered yet, the ACQSC still won’t make a decision about serious risk (though they might take other action).

 

Changes to the way the ACQSC Deals with Accreditation and Re-Accreditation

Reaccreditation of certain previously accredited services (recommencing services)

According to the ACQSC Accreditation and Re-accreditation Fact Sheet, it is now easier for some previously accredited services to get re-accredited. The kind of services the ACQSC has in mind are those whose accreditation has lapsed and now have no consumers but are trying to start up again. In the past, those services would have to have a site audit done to get reaccredited. Now they don’t. Instead, they can just follow the same process as a commencing service seeking accreditation.

 

Flexible Care Services Can Now Be “Deemed” Accredited Services

Sometimes a Flexible Care Service will provide short term restorative care within a residential care home. In those circumstances there used to be some confusion about the accreditation of the Flexible Care Service. The ACQSC has now clarified the situation by allowing the Flexible Care Service to be “deemed” an accredited service. This means the Flexible Care Service’s accreditation is included in the accreditation of the larger service they operate within, so they don’t have to go through a separate accreditation process.

 

Conclusion

Sweeping changes were made to the aged care industry in 2019 and providers were flooded with rules, procedures, guidelines and fact sheets. If the ASQSC’s recent announcements are anything to go by, 2020 will be just as complex and overwhelming. To help you cope, ACE will continue to sift through the detail and highlight the key points you need to know as the new year rolls out.

Mark Bryan
ABOUT THE AUTHOR | Mark Bryan
Mark is a Legal Research Consultant at CompliSpace and the editor for ACE. 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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