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Compliance to culture: Meeting and exceeding Aged Care Quality Standards

Meeting and exceeding Aged Care Quality Standards

With choice now in the hands of customers, meeting quality standards for care in aged care services is the absolute minimum expectation. Successful providers will need to move from a compliance mind-set to a culture of quality to not only meet but exceed the new Aged Care Quality Standards.

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Partner, Health, Ageing & Human Services

KPMG Australia

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A nurse assisting an elderly person

From July 2019 the Single Quality Framework (SQF) will be introduced with a new single set of Aged Care Quality Standards implemented across all aged care types. These Standards are set to replace the various Standards currently in place across aged care.

The new Standards place consumers at the centre of their care and focus on giving people greater choice and flexibility. It is expected that the Standards will make it easier for customers to understand what they can expect from an aged care service.

Preparing for change

This means that providers will need to:

  • align systems, policies and practices with the new Standards
  • enable practices and supports amongst your workforce to meet the requirements of the new Standards
  • support care recipients and their families, carers and representatives to understand what the changes mean for them
  • enable Board and Senior Executive to lead align with the SQF.

It is expected that aged care service providers will begin to transition to the new Standards ready for assessment against these in July 2019. This may present challenges in finding time and resources to transition while maintaining focus on the core services and care that you provide to your consumers.

Where to start? Three steps to readiness

Providers will need to take a structured approach to prepare:

1. Maturity assessment

  • Undertake an assessment of current policies, procedures and how these translate in to practice
  • Identify how you are measuring performance against each standard
  • Map staff knowledge of SQF and enabling behaviours to embed practices
  • Identify the maturity of your organisation in implementing the SQF including strengths, and areas for improvement

2. Scoping and transition planning

  • Define what your desired outcomes are
  • Develop a program of work to embed the SQF in to practice including consideration of documentation development, risk process development, workforce training and development and change management
  • Develop a detailed transition plan outlining what you need to do and when

3. Implementation and embedding practice

  • Develop/amend policies and procedures including clinical governance framework
  • Design supports to embed the policies and procedures in to practice
  • Develop tools to monitor how practice is being delivered in line with SQF and reporting framework for Board, Senior Executive and workforce.

What is quality in aged care?

Quality in aged care is a complex construct. As a minimum standard, ‘quality’ means that providers should be meeting regulatory requirements, which outline the minimum requirements for good quality care in aged care. However, there are other components of quality that need to be considered, which often overlap. Much of the focus of customers and their families on quality is centred on their experience with a service or provider.

The four areas of quality in aged care are: 

Regulation: These are the quality standards that are applied to approved aged care providers, who are funded by the Commonwealth to deliver a range of aged care services. From the 1st July, the sector will transition to the Single Quality of Framework. Regulation currently has a strong focus on ensuring appropriate policies and procedures and other measures are in place, with the assumption that this will then deliver quality of care. This is one of the reasons why regulation is the minimum level of delivery care.

Care: This overlaps with regulation, as some components are mandated within the quality standards. However, quality of care relates to how care is delivered focusing on care, including health, personal care and lifestyle being safe, effective, timely, efficient, equitable and people-centred. Quality of care can be measured in a number of ways, including through quality indicators, that may be linked to particular care outcomes.

Quality of life: While quality of care is important, it does not equate to quality of life. This measure looks at indicators connected to psychological wellbeing, social relationships, independence, privacy and dignity. How involved is the care recipient around decision-making? How content are they?

Customer experience: This is the sum of customer interactions with an organisation, and is reflective of an emotional connection. It begins with the first interaction, which could be online research, through to a resident leaving a home. Customer experience is key to the perception of quality, and is a key driver of decision making by customers and their families.

Embedding a culture of quality

The key to ensuring consistent and robust approach to quality s is ensuring that everyone understands what is being measured, and their personal part in upholding quality.

Creating specific roles within organisation that are responsible for quality can help bring accountability, as can setting the new culture in stone with policies, procedures and protocols to follow. 

However, this isn’t to replace the view that quality is everyone’s business. It is important to embed regulatory requirements into business processes, performance management, reporting systems and training programs. 

Leading by example is also key – quality needs to be understood and embedded at the Board level, as well as executive level, and evident within the strategic plan.

Trust through transparency

With all this information, there is an opportunity to be more transparent with customers, to help them understand what quality means, and how your organisation is driving it.

For example, if you have statistics on the use of resident restraint, can you communicate what that means? Why is restraint sometimes required? Or, do you have statistics on fall rates? Can you share this, and be open with customers about what you are doing to prevent falls?

In summary

While no organisation can have ‘perfect’ quality, striving beyond the minimum standards of quality can place you in a better position to meet and exceed customer expectations in today’s competitive market conditions. By putting the customer needs at the core, building a culture of quality, and being transparent about continual improvement, providers can take significant steps to improving the quality of life for their customers.

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