From July 1 2019 all funded aged care services will be assessed against a Single Aged Care Quality Framework. This has been developed in consultation with the sector including a public consultation process, testing by the (then) Australian Aged Care Quality Agency, consultation with key stakeholders and piloting of the draft standards as part of the overall aged care reform agenda.
Foundation concepts
The Single Quality Framework comprises seven concepts that recognise the importance of the consumer’s self-worth and foster social inclusion, health and wellbeing. These concepts focus on the consumer being able to act independently, make choices and participate in the community. These are articulated in Standard One and reflected across all eight standards.
In preparing for July 1 looking at protocols and documentation is only a small part of the preparations a provider needs to undertake. The real work is in creating and embedding a culture that embraces the foundation concepts.
For many providers and services some or all of these concepts would align with and be embedded in their organisational values and principles. Transitioning to the Single Quality Framework is the opportunity for providers to look at how they articulate their values, align their values to the framework and how they would evidence that these concepts are embed throughout the organisation.
Consumer, workforce & organisation
The Single Quality Framework reviews organisational governance including clinical governance, corporate governance and risk. This is broader than the current Standards.
The guidance material for the Single Quality Framework looks at ‘Examples of actions and evidence’ from the consumer, workforce (and others) and organisation perspective; the relationship between these is pivotal. Understanding how as a business a provider will harness the energy, expertise and experience of both consumers and workforce to achieve a quality service must be the first action.
Consumers and workforce at the forefront
Under the Single Quality Framework Providers will need to seek consumer input and be able to evidence that consumers are actively involved in decision making about their care, are actively involved in service design and delivery both at the individual and service level, and are consulted and listened to about service improvements.
To date consumers have been encouraged to have input into their own care. Having broader input into service design and operation is a newer concept. For most providers this will require the development or acquisition of specific skills. The sector will need to learn how to establish and maintain the frameworks that support consumer engagement. This will include educating consumers and harnessing their inputs.
Providers need to change their dialogue and interaction with consumers and families and actively engage with them to identify and implement service improvements. This will include having open disclosure processes and actively discussing issues, incidents, near misses and complaints.
This transition process involves providers and their workforce developing the skill base and confidence to interact with and create relationships with consumers.
To do this a workforce needs to feel valued, heard and have a sense of belonging. In essence the workforce and organisational culture needs to be positive. Positive relationships benefit both the consumer and the workforce. Consumers want consistency of staffing, staff that are knowledgeable and have the skill base to meet their needs. Increasing diversity in our work force and overall scarcity of staff is an ongoing challenge.
Focus
In transitioning to the Single Quality Framework organisations need to look at their current quality and governance frameworks and ensure they cover elements have been introduced or now have greater emphasis. Generally, this will fit into updating existing policies to current best practice, amending policies, removing redundant policies and creating and implementing new policies to cover elements that are new or have greater emphasis under the Single Quality Framework.
How each organisation addresses this will depend on its resources and expertise. Some organisations may take the opportunity to completely review their organisational governance and quality frameworks; others may choose to focus more specifically on key elements including:
- Implementing a cultural safety program
- Addressing dignity of risk
- Implementing processes for open disclosure and ‘near misses’
- Addressing communication barriers
- Reviewing palliative care performance and end of life care including processes for decision making
- Developing and implementing a diversity action plan
- Choice
- Restraint minimisation
- Ensuring the high-impact/high-prevalence risks that are articulated in the Single Quality Framework are understood and are covered in the clinical governance framework
- Implement antimicrobial stewardship
This article was written by The Ideal Consultancy. If you would like to discuss how to strengthen your aged care business please contact Louise Greene via hello@theidealgroup.com.au or 1300 179 675.
