Lessons from Regulatory Case Studies Ann Wunsch Executive - PowerPoint PPT Presentation

Lessons from Regulatory Case Studies Ann Wunsch Executive Director, Operations The Australian Aged Care Quality Agency

Risk Based Regulation • Focuses on outcomes; • Constantly monitors performance; • Detects and assesses risks and • Changes priorities or instrumental choices as needs arise

2017- 2018 Unannounced Assessment Contacts • Has there been any adverse findings by another regulatory agency or oversight body in the last 12 months? (e.g. Healthcare complaints commission or similar, Food safety authority, Workcover etc). • What trends do your complaints data show you? • How many care recipients are receiving pressure area care? • Have there been any medication incidents in the past 6 months where a care recipient required hospitalisation or attention by a medical officer? • How many care recipients have had falls and required medical attention in the past 3 months? • How many care recipients are subject to physical restraint and/or chemical restraint? • Can you tell me about incidents in the past 6 months where a care recipient or staff member has required medical attention as a result of a challenging behaviour from a care recipient?

High Risk Characteristics • Mental illness and substance abuse • Managing challenging behaviors • Being a new service • Undertaking a building program • Sharp increase in intake of people with complex needs • Infrequent or no family visiting • Change of approved provider • Change of key personnel • Isolated service • Staff/industrial disputation

Summary of non-compliance in residential aged care services 2016/17 YTD 30 Jan-18 472 529 No. of re-accreditation site audits 15 18 No. of times new expected outcomes not met 33 37 No. of review audits 20 20 No. of times new expected outcomes not met 583 233 No. of announced assessment contacts 7 4 No. of times new expected outcomes not met 2,876 1,740 No. of unannounced assessment contacts 39 45 No. of times new expected outcomes not met

Primary Intelligence Sources that Resulted in Findings of Failure and Serious Risk Decisions Nov 2015 – Jan 2018 Media Public 4% 6% Unannounced ACCC 10% 38% Reaccreditation AACQA 4% 26% Risk Profiling 12% Dept 26%

Serious Risk Decisions - June 2016 to January 2018 • Issues identified in the following areas – Behaviour Management - 42% of decisions – Wound Management - 32% of decisions – Medication management - 30% of decisions – Pain management - 27% of decisions – Privacy and dignity - 27% of decisions – Use of restraints - 24% of decisions – Nutrition and hydration - 24% of reports of decisions – Management of complex care needs, specifically, management of catheters - 20% of decisions – Significant falls and mobility management - 20% of decisions – Staff behaviour towards care recipients - 20% of decisions

Serious Risk Decisions June 2016 to January 2018 Other identified issues contributing to the serious risk picture – poor continence management including evidence of urine soaked pads; – no assessment or reassessment when changes to care recipient occur; – lack of response to requests for assistance (including call bells), – poor management of blood sugar levels; – lack of choice in services; – unsecured environment or inadequate supervision; – poor delivery of palliative care; – poorly maintained living environment and lack of security of tenure

Consumer Experience Reports

Consumer Experience Report Open ended questions What would you say was the best What is one thing you would thing about this home? suggest as an improvement at this home? • Well run, it’s like a babbling brook • Management and staff should • Has lots of company if I need it. take notice of what is happening Have met friends. • Food- sometimes very bad • Likes that has a say in what is • More freedom to go out. happening at the home • More sex • They have improved my health. • Bit bored on weekends- could be • They will always offer you improved with more activities. something else if you don’t like what is being served. • To have more staff, especially • To be able to live as a couple but carers still have individual rooms

Questions Ann Wunsch Executive Director Operations The Australian Aged Care Quality Agency Tel: (02) 8831 1010 Email: ann.wunsch@aacqa.gov.au Website: www.aacqa.gov.au