How is the home care sector is managing with the increased compliance requirements of the aged care quality standards?  Lorraine Poulos shares some insights.

Lorraine Poulos

Our team recently held a webinar titled ‘Lessons learned from Quality Reviews’.

We initially surveyed our large database to gain some feedback around recent experiences with assessments and preparedness of providers.

Less than 50 per cent of respondents felt fully prepared for the risk-based questions that are asked at the beginning of a quality review.

Clinical governance

Respondents who had undergone a quality review reported heightened interest from the commission around how clinical governance and oversight of vulnerable consumers are being managed by providers.

This isn’t unexpected. We know that the management of deteriorating conditions in clients is a key feature of the standards and reflects the change from a psycho-social model of care to one that is more psycho-social-health focuses.

Respondents who had undergone a quality review provided us with feedback that it had identified the need for them to have systems in place to support the collection and analysis of data and for management monitoring and reporting.

Feedback was given that there was additional increase in the level of documentation required by assessors, particularly for level 3-4 packages regarding clinical assessments and care plans.

Documentation

Another important area of compliance is the evidence that consumer preferences and needs are clearly documented and shared with all those involved in care provision.

Gone are the days where we can have a simple task list for care workers – there now needs to be a comprehensive assessment and care planning process in place.

Another area of interest during a quality review or assessment is the self-directed model, where providers may be unwittingly allowing consumers to manage all aspects of their package without realising the legislation around the responsibilities of approved providers.

Or advice for providers is quite simple: ensure your documentation is accurate and up-to-date and that you have a systematic approach to internal auditing.

Clinical care governance /care provision needs to be sufficient to manage the increased acuity of level 3-4 home care package consumers.

Contractors

Another area of interest that our clients have told us about is increased scrutiny around contractor management.

It’s well known that it’s almost impossible for a provider to cater for all the needs and preferences of consumers, and therefore there is a need to use subcontractors and have extensive referral networks.

For approved providers the legislation is very clear around the management of subcontractors.

Recent high-profile cases like as the death of South Australian woman Ann Marie Smith while under the care of the NDIS, and the COVID 19 pandemic, have heightened the requirement of oversight of vulnerable consumers, including when care is subcontracted.

That’s why we encourage providers to rigorously review their contractor management, particularly the reporting mechanism in place between providers.

Life after lockdown

 Of particular importance are the challenges that home care providers are likely to experience once lockdown is finished.

Given the likelihood that COVID-19 will start to affect some of our more vulnerable consumers, it’s expected that providers employ staff who are fully vaccinated, well trained and able to provide quality care, including recognising and responding to deteriorating conditions.

Providers are telling us about challenges they are having with recruitment of staff particularly, registered and enrolled nurses and other allied health practitioners.

This is a particular issue in regional and rural areas. With some staff choosing not to be vaccinated this is placing additonal pressure on the sector.

The increased use of technology during COVID 19 has provided some comfort to providers that they are able to stay in contact with their consumers. However we have yet to see hard evidence around the number of consumers who are capable of using technology in a meaningful way.

In summary, it’s a challenging time for home care providers, but compliance with legislation is not negotiable. That’s why it’s  important for there to be clear processes, systems and practices in place to support staff to provide the highest model of care.

Quality reviews are only one part of the cycle of providing quality care to our valued older members of the community.

Lorraine Poulos is managing director of care sector training consultancy Lorraine Poulos Associates

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